bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Hookah and Age of Asthma Onset Among US Adults
Authors: Pérez Adriana , Valencia Sarah , Jani Pushan P. , Harrell Melissa B. 
Published: February 2025

Objective To explore the association of hookah use on the age of asthma onset among adults who were asthma/COPD free and who did not use cigarettes, cigars, electronic cigarettes or smokeless tobacco prior to asthma onset. Methods Secondary data analyses were conducted of the waves 1-6 (2013-2021) of the US nationally representative Population Assessment of Tobacco and Health Study among adults (>18 years). The four hookahs use exposures evaluated were (1) past 30-day (P30D) hookah use at the first wave of participation, (2) total number of waves before asthma onset in which adults reported P30D hookah use, (3) total number of years since first hookah use, and (4) average length of hookah sessions. Lower and upper age limits were estimated using the age reported at the first wave of participation and the number of weeks between follow-up waves until asthma was first reported or censored. Associations of the exposures on the age of asthma onset were estimated using weighted interval-censoring-Cox-regression. Results The total sample size for analysis was 5,768, representing 66.6 million adults. There was a lack of statistical power to detect differences in the age of asthma onset by (1) P30D hookah use (Adjusted Hazard Ratio (AHR) 3.77, 95CI%: .90-15.71). There was an association between (2) total number of waves of P30D hookah use (AHR 1.72, 95% CI 1.28-2.30), (3) total number of years since first hookah use (AHR 2.94, 95% CI 1.36-6.36), and (4) average length of hookah sessions (AHR 4.52, 95% CI 1.61-12.67) with the age of asthma onset. Females and Hispanics with over one year since first hookah use had higher risk of earlier age of asthma onset. Conclusion Prevention and cessation programs for adults who use hookah are needed to educate the public, protect public health, prevent adverse health outcomes, and motivate hookah users to stop.
Oral healthcare for older adults in Swedish municipal healthcare—a qualitative study of healthcare professionals’ experiences
Authors: Snogren Maria , Ek Kristina , Lindmark Ulrika , Browall Maria , Eriksson Irene 
Published: February 2025

Abstract

Introduction
Oral health is multi-faceted and influences a person’s daily life, and numerous potential barriers and factors can challenge and pose barriers to good oral health. Shortages of healthcare professionals or incorrect care practices can be barriers to performing good oral healthcare. A knowledge gap has been identified in qualitative research on description of healthcare professionals’ experiences of oral healthcare among older adults in municipal healthcare.

Aim
To describe healthcare professionals’ experiences of oral healthcare among older adults in Swedish municipal healthcare.

Design and methods
The study employed a qualitative design guided by a secondary qualitative analysis method comprising inductive qualitative content analysis. Data were collected through semi-structured individual interviews with healthcare professionals.

Results
Good relationships and mutual trust create the conditions for delivering good oral healthcare. Knowledge provides confidence and trust in performing oral healthcare, experiences and strategies influence the individual adaptation of oral healthcare, and priorities and collaboration influence oral healthcare provision.

Conclusion and implications
The performance of oral healthcare is complex and cannot be achieved without establishing a relationship with the older adult who needs care. Oral healthcare includes prerequisites such as routines, sufficient time, work-time planning, and collaboration between healthcare professionals. Registered nurses positively experience opportunities to collaborate with other healthcare professionals regarding oral healthcare and are seen as leaders in the Fundamentals of Care and are sharing good examples of oral healthcare in palliative care.
Adverse childhood and school experiences: a retrospective cross-sectional study examining their associations with health-related behaviours and mental health
Authors: Hughes Karen , Bellis Mark A , Ford Kat , A Sharp Catherine , Hopkins Joanne , Hill Rebecca , Cresswell Katie 
Published: February 2025

Abstract

Background
Adverse childhood experiences (ACEs) increase individuals’ risks of poor health across the life course. For children that suffer household-based ACEs, experiences in other settings such as schools have the potential to exacerbate or mitigate risks of poor health. However, few studies have examined such effects. This study aimed to examine relationships between household-based ACEs, school experiences and adult health outcomes.

Methods
A national cross-sectional household survey (N = 1,868 aged 18+) was undertaken in Wales using random quota sampling (November 2022 to March 2023). Measures included nine household-based ACEs; two measures of childhood school experience (having been bullied, sense of school belonging); and adult health outcomes (smoking, binge drinking, low mental wellbeing, mental illness, violence). Associations between ACEs, school experience and health outcomes were examined using chi squared tests and binary logistic regression.

Results
The proportion reporting both having been bullied and lower school belonging increased with ACE count (0 ACEs 6%, 4 + ACEs 51%). Higher ACE count was independently associated with increased risk of all adult health outcomes except binge drinking, while poorer school experience (having been bullied, lower school belonging) was associated with increased risk of low mental wellbeing, mental illness and violence victimisation. For example, adjusted odds of current mental illness rose to 3.98 in those reporting 4 + ACEs (vs. 0 ACEs) and 3.37 in those reporting both having been bullied and lower school belonging (vs. not bullied, higher school belonging). In individuals with 4 + ACEs, adjusted prevalence of current mental illness reduced from 44% in those reporting both having been bullied and lower school belonging to 19% in those reporting not having been bullied and higher school belonging.

Conclusions
For children who grow up in adverse home environments, exposure to further adversity at school may amplify risks of poorer health and life outcomes. However, schools are opportune settings for children who lack safety and support at home to recover from stress, develop resilience and access support. Trauma-informed approaches in schools that recognise the impacts of adversity and support children to overcome it have the potential to improve educational and health outcomes. Further research is needed to identify effective approaches.
Excessive screen time and problem behaviours among school-age children in Fujian, China: a cross-sectional study
Authors: Yu-ting Yang , Li-xiang Chen , Miao Yao , Yong-wei Yang , Ting Lin 
Published: February 2025

Abstract

Background
Screen time encompasses activities conducted on digital devices, including traditional devices such as televisions and computers, as well as modern devices like smartphones, tablets, and other digital screens. Excessive screen time among children has been linked to a heightened likelihood of engaging in high-risk problem behaviours. This study aimed to quantify the prevalence of excessive screen time and delve into its correlation with problem behaviours among school-aged children in Fujian, thereby gaining insight into the prevalence and trends within this region.

Methods
From October to November 2022, we used cluster sampling and invited 891 school-age children from Fujian as participants. Parents recorded children’s screen time for a week, taking the average value of seven days, and the unit is minutes. The Child Behaviour Checklist was used to assess their problem behaviours. Correlation analysis, Propensity Score Matching, Single-factor analysis, and Multi-factor analysis were used to explore the influencing factors and correlation.

Results
Screen exposure time of school-age children was 34.29 (17.14, 55.71) min/day. Then, 17.06% were exposed to excessive video. The total CBCL score of school-age children was 10.00 (3.00, 22.00), and 10.00% had problem behaviours. After matching the propensity score, the total score of problem behaviours in the daily over-exposure group was higher than that in the non-over-exposure group (Z = 5.466, p < 0.001). Generalized linear model analysis showed that after controlling confounding variables, daily video exposure time or daily excessive screening could affect problem behaviours (p < 0.05).

Conclusions
The incidence of problem behaviours among school-age children is low in Fujina. The daily screen time, weekday screen time, and weekend screen time were positively associated with problem behaviours. We suggested family members shift to more serious and cautious attitudes toward children’s screen exposure and adopt appropriate digital-related parenting practices, such as accompanying children when they inevitably need to watch electronic devices, to better understand and manage their screen time.
Age at type 1 diabetes onset does not influence attained brain volume
Authors: Claesson Tor-björn , Mutter Stefan , Putaala Jukka , Salli Eero , Gordin Daniel , Groop Per-Henrik , Martola Juha , Thorn Lena M. 
Published: February 2025

Abstract

Introduction
Type 1 diabetes is suspected to hamper brain growth, implying that people with earlier diabetes onset would, on average, achieve lower maximal brain volume. We set out to test this hypothesis.

Methods
Examining brain MRI scans of middle-aged people with type 1 diabetes, we related age at diabetes onset to intracranial volume in 180 participants, as well as to cerebral gray and white matter volumes in a subset of 113 (63%) participants, using fractional polynomial regression models. Of the participants, 118 (67%) had been diagnosed with diabetes before 18 years of age.

Results
Of our participants, 54% were women, the median age 40.0 (IQR 33.2–45.0) years and the range of age at diabetes onset was 1.2–39.0 years. We found no association between age at diabetes onset and intracranial volume (p = 0.85), cerebral white (p = 0.10), or gray matter volumes (p = 0.12). Further, correlations between age at diabetes onset and the measured brain volumes were poor in analyses stratified for sex (all correlation coefficients ρ ≤ 0.16).

Conclusions
We found no association between age at diabetes onset and attained intracranial volume or gray or white matter volumes, indicating that type 1 diabetes may not have a clinically significant influence on brain growth.
Healthcare organizations in crisis context: decision-making models and roles of CEOs
Authors: Romiti Anna , Del Vecchio Mario , Cavicchi Caterina , Vagnoni Emidia 
Published: February 2025

Abstract

Background
In times of crisis, decision-making can become a highly complex process that is shaped differently than in ordinary contexts. The literature presents different decision-making models that have not yet been thoroughly tested in practice. This paper aims to enhance our understanding of the distinctive characteristics of healthcare organizations’ decision-making models in crisis contexts, building upon and expanding the framework proposed by Arendt et al. (2005).

Methods
Based on a qualitative research design, data were collected through semi-structured interviews with 49 CEOs of Italian healthcare organizations, including both local health authorities and independent hospitals.

Results
CEOs’ decision-making processes demonstrated several commonalities: a shift from strategic issues to operational issues; a narrowed CEO focus on only a few areas of operations, and a significant concentration of the DMP in time and space. These shared elements provide insights into the nature of the centralization process adopted by CEOs in such situations. Additionally, we identified various decision-making models to manage the same crisis, with each model presenting a different level of involvement of other actors in the decision-making process, reflecting the CEO’s unique vision and background.

Conclusions
This research makes a significant contribution to the growing literature on crisis management in three key ways. First, it emphasizes the importance of analyzing the decision-making process through the combined lens of different dimensions and phases. Second, it enhances the Arendt et al. (2015) model to include multiple critical dimensions of the decision-making process beyond the initial focus on decentralization, and demonstrates how, in a crisis context, the actors involved by the CEOs diverge from the original framework. Third, it offers new insights into the variables affecting the roles of the CEOs and other key actors in crisis-related decision-making, transcending the boundaries of role theory. In terms of managerial implications, reflecting on and interpreting the core of the organization’s decision-making processes, can support top management teams in navigating change, providing them a more robust and rational base for guiding the transition to a post-crisis “new normal”.
A rapid state-of the-art review of client-reported outcomes measures used to assess dogs’ clinical signs and quality of life during chemotherapy
Authors: Harris Jenny , Fournier Quentin , Sutton Katie , Armes Jo , Ream Emma , Bacon Nick 
Published: February 2025

Abstract

Background
Quality of life is an essential component of decision-making in veterinary oncology. Poor management of adverse events during chemotherapy can impair dogs’ quality of life and be life-threatening. Consequently, client-reported outcome measures (CROMs) are being proposed to help assess both clinical signs and quality of life. The purpose of this rapid review was to: (1) identify existing CROMs that have been used to assess dogs’ clinical signs and quality of life during chemotherapy; and (2) evaluate their methodological development to inform adaptation or development of a CROM for use in routine clinical practice, including remote monitoring. Databases (Scopus, Web of Science, PUBMED/MEDLINE) were searched for CROMs (questionnaires) completed by a non-expert family member about their companion dog. CROM content (domains measured) and scale quality were appraised.

Results
Ten CROMs were identified and three were variations of the same tool. Content of the CROMs varied considerably (range 3–17 domains) with gastrointestinal being the most frequently measured clinical sign cluster (9/10 studies), followed by mobility/ambulatory activity (7/10) and global quality of life (6/10). No CROMs adhered to quality standards for the development of questionnaires and most failed to include qualitative design methods and basic psychometric assessment to ensure reliability and validity (such as internal consistency, test-retest reliability or factor analysis).

Conclusion
The validity and reliability of existing chemotherapy CROMs for dogs remains under-tested. Although CROMs combined with remote digital monitoring have the potential to enhance patient care, as has been demonstrated with physician-based oncology, there is a need to apply quality standards to ensure optimal validation. Interdisciplinary collaborations would likely improve CROM quality and clinical utility thereby allowing veterinary healthcare professionals to better support their patients.
Enhancing the uptake of intermittent preventive treatment for malaria in pregnancy: a scoping review of interventions and gender-informed approaches
Authors: Kretchy Irene A. , Atobrah Deborah , Adumbire David A. , Ankamah Samuel , Adanu Theodosia , Badasu Delali M. , Kwansa Benjamin K. 
Published: February 2025

Abstract

Background
Malaria infection in pregnancy is a critical determinant of maternal and neonatal health outcomes in endemic regions. Intermittent preventive treatment of malaria in pregnancy (IPTp) using sulfadoxine-pyrimethamine has been recommended by the World Health Organization (WHO), but its uptake remains low because of factors such as gender norms and expectations. However, interventions to optimize IPTp uptake, especially in malaria-endemic regions, have resulted in a decline in malaria during pregnancy, maternal and neonatal mortality, low birth weight, and placental parasitaemia. This scoping review aimed to synthesize evidence on IPTp uptake, particularly emphasizing gender-related strategies.

Methods
The modified version of Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) were adopted for this review. Documents were retrieved from the following electronic databases and search engines: scopus, Web of Science, CINAHL Complete (EBSCO), PubMed, WHO, Global Index Medicus, and Google Scholar. The titles and abstracts of the publications were independently screened via Rayyan review management software, and the data were organized using the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework and gender analysis matrix.

Results
A total of 32 studies met the inclusion criteria. The most reported criterion was the effectiveness of the interventions, which demonstrated an increase in IPTp uptake after the intervention. The gender analysis framework revealed that involving both men and women in decision-making processes, empowering women, and promoting shared roles could improve the success of IPTp interventions.

Conclusions
Interventions to increase IPTp uptake should be targeted at empowering women through education, increasing financial independence, and making decisions about their health.
Sway frequencies may predict postural instability in Parkinson’s disease: a novel convolutional neural network approach
Authors: Engel David , Greulich R. Stefan , Parola Alberto , Vinehout Kaleb , Student Justus , Waldthaler Josefine , Timmermann Lars , Bremmer Frank 
Published: February 2025

Abstract

Background
Postural instability greatly reduces quality of life in people with Parkinson’s disease (PD). Early and objective detection of postural impairments is crucial to facilitate interventions. Our aim was to use a convolutional neural network (CNN) to differentiate people with early to mid-stage PD from healthy age-matched individuals based on spectrogram images obtained from their body sway. We hypothesized the time–frequency content of body sway to be predictive of PD, even when impairments are not yet clinically apparent.

Methods
18 people with idiopathic PD and 15 healthy controls (HC) participated in the study. We tracked participants’ center of pressure (COP) using a Wii Balance Board and their full-body motion using a Microsoft Kinect, out of which we calculated the trajectory of their center of mass (COM). We used 30 s-snippets of motion data from which we acquired wavelet-based time–frequency spectrograms that were fed into a custom-built CNN as labeled images. We used binary classification to have the network differentiate between individuals with PD and controls (n = 15, respectively).

Results
Classification performance was best when the medio-lateral motion of the COM was considered. Here, our network reached a predictive accuracy, sensitivity, specificity, precision and F1-score of 100%, respectively, with a receiver operating characteristic area under the curve of 1.0. Moreover, an explainable AI approach revealed high frequencies in the postural sway data to be most distinct between both groups.

Conclusion
Heeding our small and heterogeneous sample, our findings suggest a CNN classifier based on cost-effective and conveniently obtainable posturographic data to be a promising approach to detect postural impairments in early to mid-stage PD and to gain novel insight into the subtle characteristics of impairments at this stage of the disease.
Stereotactic body radiotherapy with carbon ions as local ablative treatment in patients with primary liver cancer
Authors: Hoffmeister-Wittmann Paula , Hoegen-Saßmannshausen Philipp , Wicklein Livia , Weykamp Fabian , Seidensaal Katharina , Springfeld Christoph , Dill Michael T. , Longerich Thomas , Schirmacher Peter , Mehrabi Arianeb , Mathy René Michael , Köhler Bruno C. , Debus Jürgen , Herfarth Klaus , Liermann Jakob 
Published: February 2025

Abstract

Background and aims
Liver cancer is the third leading cause of cancer related death due to treatment resistance and late onset of symptoms (Rumgay in J Hepatol 77: 1598–1606, 2022). The role of external beam radiotherapy (EBRT) in treatment of unresectable liver cancer needs to be defined. The use of particle therapy such as carbon ion radiation therapy (CIRT) with high linear energy transfer (LET) could increase efficacy of EBRT while limiting the toxic effects of radiation on non-cancerous liver tissue. Promising effects of CIRT have been described in several studies during the past decades, mostly in Japan. To date, no standardized treatment protocol has been established and European data on CIRT for liver cancer is lacking. This retrospective analysis aims to investigate efficacy and safety of hypofractionated CIRT compared to photon-based stereotactic body radiation (SBRT) in primary liver cancer.

Method
Thirty-six (n = 36) and twenty (n = 20) patients with primary malignant liver tumors were treated with hypofractionated CIRT (4 fractions) and photon-based SBRT, respectively, between 2011 and 2022 and were retrospectively evaluated for survival, local control, and toxicity.

Results
Two-year local control rate after CIRT was 92.3%. Compared to photon- based SBRT, CIRT scores with a significantly longer median distant progression free survival (3.1 versus 0.9 years). In a matched pair comparison of the two treatment regimens, the CIRT cohort demonstrated both longer 2-year overall survival (100% versus 59.6%) and longer 2-year distant PFS (75.7% versus 22.9%). No significant impairment of liver function was observed in either cohort.

Conclusion
In this retrospective analysis, patients who received CIRT presented excellent local tumor control and had better oncologic outcomes than patients who received photon-based SBRT. SBRT with carbon ions is a promising local ablative treatment option that needs further investigation in large prospective trials.