bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of knowledge and attitude toward first aid among final year students at technical and vocational schools in Addis Ababa, Ethiopia
Authors: Adere Abera Lemma , Abicho Temesgen Beyene , Seid Heyria Hussien , Workneh Belayneh Shetie , Getaneh Mekonen Enyew 
Published: June 2022

Introduction: Injuries among technical and vocational school students are considered one of the most serious health problems worldwide today. Getting injuries in a technical and vocational school are high as different machines are used. Therefore, this study aimed to assess knowledge, attitude, and associated factors toward first aid among graduating students at technical and vocational schools in Addis Ababa, Ethiopia. Methods: School-based cross-sectional study was conducted from April to June 2019. A simple random sampling technique was employed. Data were entered in Epi-info version 7 and analyzed using SPSS version 24. Bivariable and multivariable analyses were employed using a binary logistic regression model. Variables with a p-value of <0.05 are considered as factors significantly associated. Results: The result of this study reveals 53.2% and 60.3% of the respondents had good knowledge and favorable attitude, respectively. Training (adjusted odds ratio: 5.14; 95% confidence interval = (2.82, 9.38)), participating in school first aid club (adjusted odds ratio: 3.66; 95% confidence interval = (2.23, 6.00)), and mother’s level of education (adjusted odds ratio: 1.90; 95% confidence interval = (1.02, 3.55)) were significantly associated with knowledge. Being female (adjusted odds ratio = 2.10; 95% confidence interval = (1.24, 3.39)), training (adjusted odds ratio: 3.18; 95% confidence interval = (1.73, 5.82)), and participating in school first aid club (adjusted odds ratio: 4.82; 95% confidence interval = (2.98, 7.81)) were significantly associated with attitude. Conclusion: Only half and nearly two-thirds of the participants have good knowledge and favorable attitude, respectively. Training, participating in school first aid club, and having an educated mother increase the odds of having good knowledge. Being female, training, and participating in school first aid clubs increase the odds of a favorable attitude. Since first aid is a frontline and lifesaving intervention during life-threatening situations, it is better to give attention to enhance students’ knowledge and attitude toward first aid by giving training, establishing first aid clubs, and considering first aid courses to be included in the curriculum.
Epidemiological and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region
Authors: Yuguero Oriol , Companys Maria , Guzmán Marianela , Maciel Rita , Llobet Cecília , López Aurora , Olles Rebeca , Pujol Violant , Ruiz Maria José , Saura Mireia , Vidal Carmel , Godoy Pere 
Published: June 2022

Objective: We aimed to assess the prevalence and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region. Methods: This is a retrospective observational study in all patients with SARS-CoV-2 infections in the Lleida health region from 1 March to 30 November 2020. Reinfections were classified as patients with positive SARS-CoV-2 PCR tests separated by at least 90 days plus a negative test result between both infection episodes. Primary and secondary outcomes: The primary outcome was the percentage of SARS-CoV-2 reinfections among all SARS-CoV-2 infections detected during our study period. Secondary outcomes were the clinical and sociodemographic characteristics of patients with SARS-CoV-2 reinfections. Results: Of the 27,758 patients diagnosed with SARS-CoV-2 infection in the study period, 14 were identified as coronavirus reinfection (0.050%). Of the reinfected sample, 12 patients (85.7%) were women. The median age was 41.5 years. Two patients died in the second coronavirus episode. Conclusion: The reinfection rate of SARS-CoV-2 in the Spanish region Lleida was relatively low during the observational period in 2020 (less than 1%). These data are in line with the notion that previous SARS-CoV-2 infections may offer a significant protection by so called natural immunity.
Preparing infection detection technology for hospital at home after lower limb external fixation
Authors: Annadatha Sowmya , Hua Qirui , Fridberg Marie , Lindstrøm Jensen Tobias , Liu Jianan , Kold Søren , Rahbek Ole , Shen Ming 
Published: June 2022

Background Patients with severe bone fractures and complex bone deformities are treated by orthopedic surgeons with external fixation for several months. During this long treatment period, there is a high risk of inflammation and infection at the superficial skin area (pin site). This can develop into a devastating, sometimes fatal, and always costly condition of deep bone infection. Objective For pin site infection surveillance, thermography technology could be the solution to build an objective and continuous home-based remote monitoring tool to avoid frequent nursing care and hospital visits. However, future studies of infection monitoring require a preliminary step to automate the process of locating and detecting the pin sites in thermal images reliably for temperature measurement, and this step is the aim of this study. Methods This study presents an automatic approach for identifying and annotating pin sites on visible images using bounding boxes and transferring them to the corresponding thermal images for temperature measurement. The pin site is detected by applying deep learning-based object detection architecture YOLOv5 with a novel loss evaluation and regression method, control distance intersection over union. Furthermore, we address detecting pin sites in a practical environment (home setting) accurately through transfer learning. Results and conclusion The proposed model offers the pin site detection in 1.8 ms with a high precision of 0.98 and enables temperature information extraction. Our work for automatic pin site annotation on thermography paves the way for future research on infection assessment on thermography.
Values in Early Childhood Education (ECE): A Cross-Cultural Comparative Study of Values for ECE Expressed in Policy Documents
Authors: Gunnestad Arve , Mørreaunet Sissel , Chahboun (صبح شهبون) Sobh , Pearson Jolene 
Published: June 2022

Purpose This comparative study identifies core values expressed in Early Childhood Education (ECE) official policy documents from a sample of thirteen countries. Design/Approach/Methods This study employs document analysis as well as content and thematic analysis. ECE values identified in the policy documents are categorized into three groups: political and society-related values, educational values, and individual and relational values. Findings Document analysis reveals the values that are common across countries and those that are more specific to just one or a few countries at most. This study discusses the characteristics of these values from the perspective of globalization. In doing so, this comparative study illustrates and discusses the tendencies for both convergence and divergence in ECE values in policymaking worldwide. Originality/Value The findings of this study expand our understanding of the values in ECE policy documents in the sampled countries, offering insights into ECE objectives and policymaking in various countries.
Deep learning-based investigation of the impact of urban form on the particulate matter concentration on a neighborhood scale
Authors: Kim Moon-Hyun , Gim Tae-Hyoung Tommy 
Published: June 2022

Despite the importance of urban forms to the dispersion of particulate matter (PM), only a few studies exist on the relationship between them due to the limitations of the data and methodology. Thus, this study used a deep learning-based investigation of the impact of urban form on PM2.5 concentration. Autoencoder, long short-term memory (LSTM), and the random forest model were used to analyze their relationship. The random forest model showed that urban form variables predict PM2.5 concentration with a 95.66% accuracy, confirming that urban form characteristics significantly impact PM2.5 concentrations. Among the urban form variables, floor area ratio turned out to be the most important, suggesting the need for more detailed efforts to reduce PM2.5 in locations with high floor areas. The effect on PM2.5 prediction accuracy was evaluated with root mean square error. It was difficult to accurately predict PM2.5 in areas with large building coverage areas and low-rise residential areas. This study improved the accuracy of results on the influence of urban form by using PM2.5 non-aggregated data measured hourly over 4 years, which expanded the applicability of deep learning-based urban analysis.
Hypoperfusion in nucleus accumbens in chronic migraine using 3D pseudo-continuous arterial spin labeling imaging MRI
Authors: Liu Mengqi , Sun Yijie , Li Xin , Chen Zhiye 
Published: June 2022

Abstract
Background
Nucleus accumbens (NAcc) played an important role in pain mediation, and presents changes of neuronal plasticity and functional connectivity. However, less is known about altered perfusion of NAcc in chronic migraine (CM). The aim of this study is to investigate the altered perfusion of the NAcc in CM using a MR three-dimensional pseudo-continuous arterial spin labeling (3D PCASL) imaging.

Methods
Thirteen CM patients and 15 normal controls (NC) were enrolled and underwent 3D PCASL and brain structural imaging. The cerebral blood flow (CBF) images were co-registered with the brain structural images, and the volume and CBF value of NAcc were extracted from the raw brain structural images and co-registered CBF images using an individual NAcc mask, which was obtained from the AAL3 template under transformation by the inverse deformation field generated from the segmentation of the brain structural images. The independent sample t test and receiver operating characteristic (ROC) curve was used to investigate the altered volume and perfusion of the NAcc in CM patients.

Results
There was no significant difference for the volume of bilateral NAccs between CM and NC (p > 0.05). CM presented a lower CBF value (49.34 ± 6.09 ml/100 mg/min) compared with that of NC (55.83 ± 6.55 ml/100 mg/min) in left NAcc (p = 0.01), while right NAcc showed no significant difference between CM and NC (p = 0.11). ROC analysis identified that the area under the curve was 0.73 (95CI% 0.53–0.88) with cut-off value 48.63 ml/100 mg/min with sensitivity 50.00% and specificity 93.33%. The correlation analysis found a negative correlation between the CBF value of the left NAcc and VAS score (r = -0.61, p = 0.04).

Conclusion
Hypoperfusion of the left NAcc was observed in CM, which could be considered as a potential diagnostic imaging biomarker in CM.
Variation in haplotypes in single cysts of assemblages C and D, but not of assemblage E of Giardia duodenalis
Authors: Veldhuis Floor L. , Nijsse Rolf , Wagenaar Jaap A. , Arkesteijn Ger , Kooyman Frans N. J. 
Published: June 2022

Abstract
Background
Giardia duodenalis, a single-celled intestinal parasite, is divided into eight assemblages (A-H), with differences in host specificity. Giardia duodenalis reproduces asexually and cycles between the binucleated trophozoite (4 N) and the infectious cyst with four nuclei (16 N). Interaction between the nuclei is limited. Therefore, genetic drift causes differences in genetic make-up between the non-daughter nuclei; the allelic sequence heterozygosity (ASH). The ASH is low (0.01%—0.0023%) for the related assemblages A and E, higher (0.43–0.53) for assemblage B and much higher (0.74% -0.89%) for the assemblage C and D at the root of the phylogenetic tree. The heterozygosity in assemblage F, in the same clade as assemblage A and E, was unknown. The heterozygosity in the sequences of the gdh and dis3 genes was used as proxy for the ASH and whole genome amplification of single cysts followed by cloning and Sanger sequencing of dis3 fragment could reveal the genetic variation within the cyst. The aim of the study was to determine the level of heterozygosity within pooled and single cysts of different assemblages.

Results
The heterozygosity in gdh and dis3 was determined in pooled cysts of the assemblages A to F. Heterozygosity in the isolates of the assemblages C (n = 2) and D (n = 1) ranged from 0.41% to 0.82% for gdh and dis3 and no heterozygosity was found in the isolates of the assemblages A (n = 4), E (n = 3) and F (n = 3). The heterozygosity in assemblage B (n = 7) was intermediate (0% to 0.62%). Next, the number of haplotypes of dis3 was determined for single cysts of assemblages C, D and E. In the assemblages C and D, two to four haplotypes were found per cyst, while in assemblage E only one haplotype was identified.

Conclusions
Having high heterozygosity is characteristic for the assemblages C and D, while having a low heterozygosity is characteristic for the clade with the assemblages A, E and F.
Presence of more than 1 haplotype per cyst in assemblage C and D suggests differences between the non-daughter nuclei, in contrast to the one haplotype in assemblage E.
Educational approaches for patients with heart surgery: a systematic review of main features and effects
Authors: Shahmoradi Leila , Rezaei Nafiseh , Rezayi Sorayya , Zolfaghari Mitra , Manafi Babak 
Published: June 2022

Abstract
Introduction
Patients who undergo heart surgery are exposed to mental and physical difficulties after discharge from hospital. They often need support and follow-up after discharge. The use of educational approaches or solutions before or after heart surgery can increase patients' knowledge on the post-operative complications and self-care. The main purpose of this systematic review is to determine the applications of educational approaches and investigate the effects of these approaches on patients with heart surgery.

Method and materiel
A thorough search was conducted in Medline (through PubMed), Scopus, ISI web of science to select related articles published between 2011 and May 2022. All of the retrieved papers were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

Results
A total of 29 articles were obtained from the search, which included in this systematic review after being assessed based on inclusion and exclusion criteria. Most of the articles (n = 10, 34.48%) had been conducted in Canada and Iran, with the most significant number published in 2016. Out of 29 studies, 23 were experimental studies, and six were observational-analytical studies. The number of participants in the studies ranged from 11 to 600 (IQR1: 57.5, median: 88, IQR3: 190). In 28 (96.55%) studies, the educational approaches had a significant effect on clinical, economic or patient-reported outcomes. The greatest effect reported by the studies was related to clinical outcomes such as patient care improvement or change in clinical practice. The most effects in the patient-reported outcomes were related to improving patient satisfaction and patient knowledge. In terms of global rating scores, 17.24% of the included studies were considered as weak, 20.68% as moderate, and 62.06% as strong.

Conclusion
The results of systematic review showed that the use of educational approaches by patients before and after heart surgery can have significant effects on reducing stress and financial burden, and increasing the quality of care and level of knowledge in patients.
Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis
Authors: Haghjoo Purya , Siri Goli , Soleimani Ensiye , Farhangi Mahdieh Abbasalizad , Alesaeidi Samira 
Published: June 2022

Abstract
Background
Adolescence is a critical period in human life, associated with reduced physical activity and increased sedentary behaviors. In this systematic review and dose-response meta-analysis, we evaluated the association between screen time and risk of overweight/obesity among adolescents.

Methods
A systematic search in electronic databases, including PubMed, Embase, and Scopus was performed up to September 2021. All published studies evaluating the association between screen time and risk of overweight/obesity among adolescents were retrieved. Finally, a total of 44 eligible studies were included in the meta-analysis.

Results
The results of the two-class meta-analysis showed that adolescents at the highest category of screen time were 1.27 times more likely to develop overweight/obesity (OR = 1.273; 95% CI = 1.166–1.390; P < 0.001; I-squared (variation in ES attributable to heterogeneity) = 82.1%). The results of subgrouping showed that continent and setting were the possible sources of heterogeneity. Moreover, no evidence of non-linear association between increased screen time and risk of overweight/obesity among adolescents was observed (P-nonlinearity = 0.311).

Conclusion
For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and overweight/obesity among adolescents without any dose-response evidence.

Trial registration
The protocol of the current work has been registered in the PROSPERO system (Registration number: CRD42021233899).
The prognostic utility of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PIGF) biomarkers for predicting preeclampsia: a secondary analysis of data from the INSPIRE trial
Authors: Kifle Meron M. , Dahal Prabin , Vatish Manu , Cerdeira Ana Sofia , Ohuma Eric O. 
Published: June 2022

Abstract
Objective
To compare the prognostic performance of biomarkers soluble fms-like tyrosine kinase-1 (sFlt-1), Placental Growth Factor (PIGF), and sFlt-1/PIGF ratio as continuous values or as a binary cut-off of 38 for predicting preeclampsia (PE) within 7 days.

Design
Secondary analysis of a randomised clinical trial.

Setting
Oxford University Hospitals, Oxford, United Kingdom (UK).

Population
Pregnant women between 24+0 to 37+0 weeks of gestation with a clinical suspicion of preeclampsia.

Main outcome
Onset of preeclampsia within 7 days of the initial biomarker test.

Methods
Logistic regression model for onset of preeclampsia using: (i) sFlt-1 (ii) PIGF, (iii) sFlt-1/PIGF ratio (continuous), and (iv) sFlt-1/PIGF ratio as a cut-off above or below 38.

Results
Of the total 370 women, 42 (11.3%) developed PE within 7 days of screening. Models with sFlt-1 and sFlt-1/PIGF ratio (continuous) had greater overall performance than models with PIGF or with sFlt-1/PIGF ratio as a cut-off at 38 (R2: sFlt-1 = 55%, PIGF = 38%, sFlt-1/PIGF ratio = 57%, sFlt-1/PIGF ratio as cut-off at 38 model = 46%). The discrimination performance was the highest in sFlt-1 and sFlt-1/PIGF ratio (continuous) (c-statistic, sFlt-1 = 0.94, sFlt-1/PIGF ratio (continuous) = 0.94) models compared to PIGF or sFlt-1/PIGF cut-off models (c-statistic, PIGF = 0.87, sFlt-1/PIGF cut-off = 0.89).

Conclusion
Models using continuous values of sFlt-1 only or sFlt-1/PIGF ratio had better predictive performance compared to a PIGF only or the model with sFlt-1/PIGF ratio as a cut-off at 38. Further studies based on a larger sample size are warranted to substantiate this finding.
Polygenic risk scores indicate extreme ages at onset of breast cancer in female BRCA1/2 pathogenic variant carriers
Authors: Borde Julika , Laitman Yael , Blümcke Britta , Niederacher Dieter , Weber-Lassalle Konstantin , Sutter Christian , Rump Andreas , Arnold Norbert , Wang-Gohrke Shan , Horváth Judit , Gehrig Andrea , Schmidt Gunnar , Dutrannoy Véronique , Ramser Juliane , Hentschel Julia , Meindl Alfons , Schroeder Christopher , Wappenschmidt Barbara , Engel Christoph , Kuchenbaecker Karoline , Schmutzler Rita K. , Friedman Eitan , Hahnen Eric , Ernst Corinna 
Published: June 2022

Abstract
Background
Clinical management of women carrying a germline pathogenic variant (PV) in the BRCA1/2 genes demands for accurate age-dependent estimators of breast cancer (BC) risks, which were found to be affected by a variety of intrinsic and extrinsic factors. Here we assess the contribution of polygenic risk scores (PRSs) to the occurrence of extreme phenotypes with respect to age at onset, namely, primary BC diagnosis before the age of 35 years (early diagnosis, ED) and cancer-free survival until the age of 60 years (late/no diagnosis, LD) in female BRCA1/2 PV carriers.

Methods
Overall, estrogen receptor (ER)-positive, and ER-negative BC PRSs as developed by Kuchenbaecker et al. for BC risk discrimination in female BRCA1/2 PV carriers were employed for PRS computation in a curated sample of 295 women of European descent carrying PVs in the BRCA1 (n=183) or the BRCA2 gene (n=112), and did either fulfill the ED criteria (n=162, mean age at diagnosis: 28.3 years, range: 20 to 34 years) or the LD criteria (n=133). Binomial logistic regression was applied to assess the association of standardized PRSs with either ED or LD under adjustment for patient recruitment criteria for germline testing and localization of BRCA1/2 PVs in the corresponding BC or ovarian cancer (OC) cluster regions.

Results
For BRCA1 PV carriers, the standardized overall BC PRS displayed the strongest association with ED (odds ratio (OR) = 1.62; 95% confidence interval (CI): 1.16–2.31, p<0.01). Additionally, statistically significant associations of selection for the patient recruitment criteria for germline testing and localization of pathogenic PVs outside the BRCA1 OC cluster region with ED were observed. For BRCA2 PV carriers, the standardized PRS for ER-negative BC displayed the strongest association (OR = 2.27, 95% CI: 1.45–3.78, p<0.001).

Conclusions
PRSs contribute to the development of extreme phenotypes of female BRCA1/2 PV carriers with respect to age at primary BC diagnosis. Construction of optimized PRS SNP sets for BC risk stratification in BRCA1/2 PV carriers should be the task of future studies with larger, well-defined study samples. Furthermore, our results provide further evidence, that localization of PVs in BC/OC cluster regions might be considered in BC risk calculations for unaffected BRCA1/2 PV carriers.
Autoamputation of the appendix and survival of the amputated part: a rare case report and literature review
Authors: Wang Mingxiang , Ning Shili , Liu Yaqing , Chen Zhao , Jiang Haodong , Faiz Shabnam , Luo Fuwen 
Published: June 2022

Abstract
Background
Autoamputation of the appendix, i.e., complete separation of a part of the appendix without any surgical intervention, has been rarely documented in the literature in recent years. Herein, we report a case where the amputated part of the appendix was viable after autoamputation and reviewed the related literature.

Case presentation
A 39-year-old female patient was admitted to our hospital complaining of abdominal pain and subsequently underwent an emergency laparoscopic appendectomy (LA). Intraoperatively, we found an abnormally short appendix protruding from the cecum and a strip-like tissue attached to the mesoappendix, considered a duplex appendix, was resected. Finally, in conjunction with the histopathology findings and the past medical history, the patient was diagnosed with “Pseudo-duplication of the Appendix”.

Conclusions
Autoamputation of the appendix resulting in preserved tissue viability and absence of necrosis at both ends, can be termed as “Pseudo-duplication of the Appendix”. This condition is very rare in clinical practice and has not been reported in China, to the best of our knowledge. It has been established that the autoamputated appendix can produce chronic inflammation, intestinal fistulae and even cancer, affecting the patient’s quality of life. Accordingly, a clear diagnosis and timely management are essential. In this report, we established a novel classification for “Pseudo-duplication of the Appendix”, hoping that our report will help surgeons better understand this anatomical anomaly of the appendix, to help during the differential diagnosis process and avoid confusion.