bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing young Kenyan women's willingness to engage in a peer-delivered HIV self-testing and referral model for PrEP initiation: A qualitative formative research study
Authors: McGowan Maureen , Casmir Edinah , Wairimu Njeri , Mogere Peter , Jahn Albrecht , Ngure Kenneth , Ortblad Katrina F. , Roche Stephanie D. 
Published: October 2022

BackgroundPre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but uptake remains low, especially among adolescent girls and young women (AGYW) in Kenya. A model in which trained AGYW using PrEP deliver HIV self-tests to their close friends and refer them to PrEP may help increase PrEP uptake in this population. To understand AGYW's potential willingness to engage in such a model, we conducted a qualitative formative study in Kenya.MethodWe conducted semi-structured in-depth interviews (IDIs) with AGYW (16 to 24 years) in Kiambu County who were determined at risk of HIV acquisition. We purposively recruited “PrEP-naïve” (no prior PrEP use) and “PrEP-experienced” AGYW who used PrEP for at least 1 month within the previous year. We solicited perspectives on initiating/engaging in conversations about HIV risk and PrEP, distributing/receiving HIV self-test kits, and referring/following through on a referral to clinic-based HIV services. We analyzed verbatim transcripts using rapid qualitative analysis and a combination of inductive and deductive approaches, with the latter informed by the Integrated Behavior Model (IBM).ResultsFrom August to December 2020, we conducted 30 IDIs: 15 with PrEP-experienced and 15 with PrEP-naïve AGYW. Participants' median age was 20 [interquartile range (IQR): 20–22]. Overall, most participants anticipated that they would be willing to engage in this model. PrEP-experienced AGYW emphasized the salience of their concerns about friends' HIV risk behaviors, with several noting that they are already in the habit of discussing PrEP with friends. Many additionally expressed positive attitudes toward the proposed target behaviors, perceived these to be normative among AGYW, and expressed confidence in their ability to carry out the behaviors with proper support. Although few participants had HIVST experience, nearly all anticipated they would be able to use an HIV self-test kit correctly if provided instruction.ConclusionThe Kenyan AGYW who participated in this study generally anticipated that they would be willing to engage in a formal peer PrEP referral model enhanced with peer-delivered HIV self-tests. Future research is needed to pilot test this model to determine its acceptability, feasibility, and effect on HIVST and PrEP uptake within this population.
Anxiety and coping strategies during the COVID-19 pandemic: A cross-sectional study of staff and students from a tertiary education center in Malaysia
Authors: Lee Kai Wei , Yap Sook Fan , Ong Hooi Tin , Pheh Kai Shuen , Lye Munn Sann 
Published: October 2022

AimWe examined the anxiety levels and coping strategies among staff and students of a tertiary educational institution during the COVID-19 pandemic and determined the association between anxiety level and coping strategies.MethodThrough an online survey, we used Coronavirus Anxiety Scale (CAS) to measure the level of anxiety associated with the COVID-19 crisis and Brief Coping Orientation to Problems Experienced (COPE) to assess the coping responses adopted to handle stressful life events. Coping strategies were classified as adaptive and maladaptive, for which the aggregate sores were calculated. Multiple linear regression was used to determine the predictors of anxiety adjusted for potentially confounding variables. Results from 434 participants were available for analysis.ResultsThe mean score (SD) of the CAS was 1.1 (1.8). The mean scores of adaptive and maladaptive coping strategies were 35.69 and 19.28, respectively. Multiple linear regression revealed that maladaptive coping [Adjusted B coefficient = 4.106, p-value &lt; 0.001] and presence of comorbidities [Adjusted B coefficient = 1.376, p-value = 0.025] significantly predicted anxiety.ConclusionMaladaptive coping and presence of comorbidities were the predictors of coronavirus anxiety. The apparent lack of anxiety in relation to COVID-19 and movement restriction is reflective of the reported high level of satisfaction with the support and services provided during the COVID-19 outbreak in Malaysia. Adaptive coping strategies were adopted more frequently than maladaptive. Nevertheless, public education on positive coping strategies and anxiety management may be still be relevant to provide mental health support to address the needs of the general population.
Independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health in medical students: A cross-sectional study
Authors: Ding Pan , Li Jinyong , Chen Huajian , Zhong Chongzhou , Ye Xiaoli , Shi Hongying 
Published: October 2022

ObjectiveStudies on the association between sleep behavior and health often ignored the confounding effects of biorhythm-related factors. This study aims to explore the independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health (SRH) in medical students.MethodsCross-sectional study. Proportional stratified cluster sampling was used to randomly recruit students from various medical specialties at a medical university in eastern China. Our questionnaire mainly included information on basic demographic characteristics, SRH, sleep behavior, and biorhythm-related factors. The independent and joint effects of sleep duration and sleep quality on suboptimal SRH were assessed by logistic regression after controlling for potential confounders.ResultsOf 1,524 medical students (mean age = 19.9 years, SD = 1.2 years; 59.1% female), 652 (42.8%) had suboptimal SRH. Most medical students (51.5%) slept for 7 h/night, followed by ≥8 (29.1%) and ≤ 6 h (19.4%). After adjusting for basic demographic characteristics and biorhythm-related factors, compared with students who slept for ≥8 h/night, the adjusted ORs (95%CI) for those who slept 7 and ≤ 6 h/night were 1.36 (1.03, 1.81) and 2.28 (1.60, 3.26), respectively (P &lt; 0.001 for trend); compared with those who had good sleep quality, the adjusted ORs (95%CI) for those who had fair and poor sleep quality were 4.12 (3.11, 5.45) and 11.60 (6.57, 20.46), respectively (P &lt; 0.001 for trend). Further, compared with those who slept for ≥8 h/night and good sleep quality, those who slept ≤ 6 h and poor sleep quality had the highest odds of suboptimal SRH (OR 24.25, 95%CI 8.73, 67.34).ConclusionsShort sleep and poor sleep quality were independently and jointly associated with higher odds of suboptimal SRH among medical students.
The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population
Authors: Ho Yi-Ching Lynn , Chew Mary Su-Lynn , Ho Clement Zhong-Hao , Latib Aisyah Binte , Lee Vivian Shu-Yi , Lin Gladis Jing , Thumboo Julian , Doshi Kinjal 
Published: October 2022

BackgroundThe Family Health Climate (FHC) is a family environment attribute postulated to influence the health behaviors of family members. It can be measured by domain scales for physical activity (FHC-PA) and nutrition (FHC-NU), which have been validated and used to identify health climate patterns in families in Western populations. To extend the use of the scales to Asian settings, this study aimed to adapt and validate the instruments for use in the multi-ethnic population of Singapore, accounting for language and cultural differences.MethodsIn Part A (n = 40) to adapt the scales for the Singapore population, we performed cognitive interviews, face validity testing and pre-testing of the instruments (n = 40). Besides English, the scales were translated into Chinese and Malay. In Part B (n = 400), we performed exploratory and confirmatory factor analyses respectively on two random samples. We also tested for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance.ResultsThe findings from the cognitive interviews in Part A led to scale adaptations to accommodate cultural and linguistic factors. In Part B, EFA on Sample I resulted in a three-factor model for the PA scale (accounting for 71.2% variance) and a four-factor model for the NU scale (accounting for 72.8% variance). CFA on Sample II indicated acceptable model fits: FHC-PA: χ2 = 192.29, df = 101, p &lt; 0.001, χ2/df = 1.90; SRMR = 0.049; RMSEA = 0.067; CFI = 0.969; TLI = 0.963; FHC-NU: χ2 = 170.46, df = 98, p &lt; 0.001, χ2/df = 1.74; SRMR = 0.036; RMSEA = 0.061; CFI = 0.967; TLI = 0.960. The scores of family members demonstrated significant agreement on the FHC-PA (Sg) [ICC(2, 2) = 0.77] and FHC-NU (Sg) [ICC(2, 2) = 0.75] scales. Findings suggest good evidence for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Short versions of the scales were also developed.ConclusionWe adapted, translated and validated the scales for assessing the health climate of families in Singapore, including the development of short versions. The results showed good psychometric properties and the constructs had significant relationships with health behaviors and routines. Improving our understanding of family influences on individual health behavior will be important in developing multi-level strategies for health promotion and chronic disease prevention.
The association between serum soluble Klotho and chronic kidney disease among us adults ages 40 to 79 years: Cross-sectional study
Authors: Zhang Zilong , Zhou Xianghong , Deng Linghui , Jin Kun , Xiong Xingyu , Su Xingyang , Qiu Shi , Yang Lu 
Published: October 2022

BackgroundChronic kidney disease (CKD) is diagnosed in more than 26 million U.S. people, which increases the risk of many adverse events. α-Klotho was reported to have potential effects on kidney function. The purpose of this study was to investigated whether CKD prevalence is associated with α-Klotho levels in the U.S. people aged 40–79 years.MethodsThirteen thousand five hundred eighty-nine participates in the National Health and Nutrition Examination Survey 2007–2016 aged 40–79 with information of Klotho and kidney function were included. The association between CKD and Klotho was calculated using multivariate linear or logistic regression models with adjustment of several possibly confounding variables. Subgroup analyses stratified by age, BMI, and diabetes mellitus were conducted. The non-linear relationship between Klotho and dependent variables with a non-normality of residues was assessed using smooth curve fitting and the segmented regression (also known as piece-wise regression) models.ResultsAmong 13,589 participants, the median of Klotho levels was 803.10 pg/mL, mean eGFR of all participants was 86.96 (SD = 19.88) mL/min/1.73 m2, and CKD was diagnosed in 20.11% of them (N = 2733). In the fully adjusted model, eGFR was positively associated with Klotho (β = 5.14, 95%CI 4.13-6.15, p &lt; 0.001), while CKD was negatively associated with Klotho (stage ≧ 1, OR = 0.62, 95% CI 0.50–0.76, p &lt; 0.001; stage ≧ 3, OR = 0.31, 95% CI 0.24–0.41, p &lt; 0.001). The non-linear relationship showed that occurrence of CKD stage&gt; 1 and albuminuria were negatively associated with Klotho when Klotho smaller than turning point (for whether CKD stage&gt; 1, turning point K = 6.85, Klotho &lt; K, OR = 0.44, p &lt; 0.001; for albuminuria, turning point K = 6.84, Klotho &lt; K, OR = 0.59, p &lt; 0.001).ConclusionSerum soluble Klotho levels were positively associated with eGFR and negatively associated with the prevalence of CKD, especially in elderly, obese, and diabetic patients.
Predicting CME arrival time through data integration and ensemble learning
Authors: Alobaid Khalid A. , Abduallah Yasser , Wang Jason T. L. , Wang Haimin , Jiang Haodi , Xu Yan , Yurchyshyn Vasyl , Zhang Hongyang , Cavus Huseyin , Jing Ju 
Published: October 2022

The Sun constantly releases radiation and plasma into the heliosphere. Sporadically, the Sun launches solar eruptions such as flares and coronal mass ejections (CMEs). CMEs carry away a huge amount of mass and magnetic flux with them. An Earth-directed CME can cause serious consequences to the human system. It can destroy power grids/pipelines, satellites, and communications. Therefore, accurately monitoring and predicting CMEs is important to minimize damages to the human system. In this study we propose an ensemble learning approach, named CMETNet, for predicting the arrival time of CMEs from the Sun to the Earth. We collect and integrate eruptive events from two solar cycles, #23 and #24, from 1996 to 2021 with a total of 363 geoeffective CMEs. The data used for making predictions include CME features, solar wind parameters and CME images obtained from the SOHO/LASCO C2 coronagraph. Our ensemble learning framework comprises regression algorithms for numerical data analysis and a convolutional neural network for image processing. Experimental results show that CMETNet performs better than existing machine learning methods reported in the literature, with a Pearson product-moment correlation coefficient of 0.83 and a mean absolute error of 9.75 h.
Oblique lateral interbody fusion stand-alone vs. combined with percutaneous pedicle screw fixation in the treatment of discogenic low back pain
Authors: Wang Weiheng , Xiao Bing , Wang Haotian , Qi Junqiang , Gu Xin , Yu Jiangming , Ye Xiaojian , Xu Guohua , Xi Yanhai 
Published: October 2022

ObjectiveOblique lateral interbody fusion (OLIF) has unique advantages in the treatment of discogenic low back pain (DBP). However, there are few studies in this area, and no established standard for additional posterior internal fixation. The purpose of this study was to investigate the efficacy of OLIF stand-alone vs. combined with percutaneous pedicle screw fixation (PPSF) in the treatment of DBP.MethodsThis retrospective case-control study included forty patients. All patients were diagnosed with DBP by discography and discoblock. Perioperative parameters (surgery duration, blood loss, and muscle damage), complications, Visual analog scale (VAS), and Oswestry Disability Index (ODI) were assessed. Imaging data including cage subsidence, cage retropulsion, fusion rate, and adjacent spondylosis degeneration (ASD) were analyzed.ResultsThere were 23 patients in the OLIF stand-alone group and 17 patients in the OLIF + PPSF group. The mean surgery duration, blood loss, and muscle damage in the OLIF stand-alone group were significantly better than those in the OLIF + PPSF group (P &lt; 0.05). However, there was no significant difference in the average hospitalization time between the two groups (P &gt; 0.05). There was no significant difference in the VAS and ODI scores between the two groups before surgery (P &gt; 0.05), and VAS and ODI scores significantly improved after surgery (P &lt; 0.05). The VAS and ODI scores in the OLIF stand-alone group were significantly better than those in the OLIF + PPSF group at 1 month (P &lt; 0.05), While there was no significant difference between the two groups at 12 months and last follow up (P &gt; 0.05). At the last follow-up, there was no significant difference in cage subsidence, fusion rate, ASD and complication rate between the two groups (P &gt; 0.05).ConclusionOLIF stand-alone and OLIF + PPSF are both safe and effective in the treatment of DBP, and there is no significant difference in the long-term clinical and radiological outcomes. OLIF stand-alone has the advantages of surgery duration, blood loss, muscle damage, and early clinical effect. More clinical data are needed to confirm the effect of OLIF stand-alone on cage subsidence and ASD. This study provides a basis for the clinical application of standard DBP treatment with OLIF.
Multimodality imaging differentiation of pancreatic neuroendocrine tumors and solid pseudopapillary tumors with a nomogram model: A large single-center study
Authors: Hu Hai-Feng , Li Zheng , Chen Ke , Liu Meng-Qi , Ye Zeng , Chen Xue-min , Zhang Yue , Yu Xian-Jun , Xu Xiao-Wu , Ji Shun-Rong 
Published: October 2022

BackgroundPancreatic neuroendocrine tumors (pNETs) and solid pseudopapillary tumors (SPTs) are two of the most common pancreatic neoplasms with different treatment procedures. However, the broad heterogeneity of pNETs and SPTs in clinical manifestations and radiological features often confuse the presurgical discrimination in clinical practice, and the clinical and molecular differentiation of the two tumors remains elusive to date. We presume that a large and comprehensive study into the multimodality features of pNETs and SPTs is necessary for precise clinical management.MethodsWe collected and analyzed the clinicopathological information and multimodality features of nonfunctional pNET and SPT patients, for a total of 631 cases from 2006 to 2021. Univariate analysis of imaging features, including contrast-enhanced computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound (EUS) and nuclear medicine imaging, and clinical characteristics was performed, and CT features and clinical information were integrated to establish a nomogram model.ResultsWe recruited 354 nonfunctional pNET and 277 SPT patients in our cohort. Regarding demographic information, pNET patients had a lower female percentage (55.4% vs. 72.9%), smaller tumor size (2.8 vs. 4.8 cm), and older age (53.4 vs. 35.3 years). In CT imaging and EUS, pNETs tended to appear as solid and homogenous lesions with strong enhancement intensity. Multifocal lesions, duct dilation, and lymph node (LN) enlargement were more likely to be observed in pNETs, while calcification was more common in SPT lesions. On positron emission tomography (PET)/CT, pNETs exhibited significant sensitivity to somatostatin receptor scintigraphy (SRS), with positive rates of 81.4% and 95% on 99mTc-HYNIC-TOC and 68Ga-DOTATATE PET/CT, respectively, while SPTs were all negative on SRS. Multivariate analysis identifies tumor size, age, enhancement intensity, calcification, and LN enlargement as statistically significant variables.ConclusionsCompared to SPT patients, pNET patients exhibit an older age and smaller tumor size. CT manifestations of strong intensity, LN enlargement, and no calcification could indicate a higher possibility of pNET. Meanwhile, the similarity in the immunohistochemical profile indicates that the two tumors could potentially develop from the same origin.
A retrospective study on the efficacy and safety of bone cement in the treatment of endplate fractures
Authors: Zhao Zhijian , Deng Lei , Hua Xi , Liu Haojun , Zhang Hao , Jia Xuejun , Wei Rushuai , Liu Mingming , Lv Nanning 
Published: October 2022

BackgroundEndplate fractures is an important factor affecting the curative effect of percutaneous kyphoplasty for spinal fracture. The purpose of this study is to investigate the effect of sealing endplate fracture with bone cement on minimally invasive treatment of spinal fracture.MethodsA total of 98 patients with osteoporotic vertebral fractures combined with endplate fractures treated with bone cement surgery in our hospital were retrospectively analyzed. They were grouped according to whether bone cement was involved in the endplate fractures. Group A: bone cement was not only distributed in the fractured vertebral body, but also dispersed into the endplate fractures. Group B: bone cement was confined to the fractured vertebra but did not diffuse into the cracks of the endplate. The basic information, imaging changes of the fractured vertebral body, VAS score, ODI score, bone cement distribution and postoperative complications of the two groups were analyzed and compared.ResultsThe height of the injured vertebra and the kyphotic Cobb angle in the two groups were significantly improved after surgery, but the anterior height of the vertebra in group B was lower than that in group A and the kyphotic Cobb angle was higher than that in group A at the last follow-up (P &lt; 0.05). VAS score and ODI score in 2 groups were significantly improved after operation (P &lt; 0.05), but the VAS score and ODI score in group A were lower than those in group B at the last follow-up (P &lt; 0.05). The incidence of bone cement leakage and adjacent vertebral fracture in group A was higher than that in group B (P &lt; 0.05).ConclusionDiffusion of bone cement into the cracks of the endplate may also restore and maintain the height of the injured vertebra, relieve pain and restore lumbar function. However, diffusion of bone cement into the cracks of the endplate can increase the incidence of cement leakage and adjacent vertebral fractures.
Real-Time Analysis of Predictors of COVID-19 Infection Spread in Countries in the European Union Through a New Tool
Authors: Balogh Aniko , Harman Anna , Kreuter Frauke 
Published: October 2022

Objectives: Real-time data analysis during a pandemic is crucial. This paper aims to introduce a novel interactive tool called Covid-Predictor-Tracker using several sources of COVID-19 data, which allows examining developments over time and across countries. Exemplified here by investigating relative effects of vaccination to non-pharmaceutical interventions on COVID-19 spread.Methods: We combine &gt;100 indicators from the Global COVID-19 Trends and Impact Survey, Johns Hopkins University, Our World in Data, European Centre for Disease Prevention and Control, National Centers for Environmental Information, and Eurostat using random forests, hierarchical clustering, and rank correlation to predict COVID-19 cases.Results: Between 2/2020 and 1/2022, we found among the non-pharmaceutical interventions “mask usage” to have strong effects after the percentage of people vaccinated at least once, followed by country-specific measures such as lock-downs. Countries with similar characteristics share ranks of infection predictors. Gender and age distribution, healthcare expenditures and cultural participation interact with restriction measures.Conclusion: Including time-aware machine learning models in COVID-19 infection dashboards allows to disentangle and rank predictors of COVID-19 cases per country to support policy evaluation. Our open-source tool can be updated daily with continuous data streams, and expanded as the pandemic evolves.