bluuebunny/crossref_metadata_2025_split huggingface dataset:
Troponin-T as predictor of mortality in patients attending the emergency department with atrial fibrillation
Authors: Celik Serkan , Eriksson Linus Bodeström , Hytting Jakob , Waldemar Annette , Mallios Panagiotis , Berggren Amanda , Oscarsson Ellen , Digerfeldt Christofer , Wijkman Magnus , Hubbert Laila 
Published: December 2024

Abstract
Background
High-sensitive Troponin-T (hsTnT) is often increased in acute illness and may be of prognostic importance in patients with atrial fibrillation (AF). The aim of this study was to analyse the characteristics and data of patients attending the emergency department (ED) with AF to determine whether age-adjusted hsTnT levels can predict mortality.

Methods
This retrospective, single centre, register-based cohort study included all patients ≥ 18 years attending the emergency department during 2018 and 2020 with a primary diagnosis at the ED of AF and sampled for hsTnT. Symptoms, comorbidities, lab results, and characteristics were registered. Patients were divided into groups based on hsTnT level (< 15, 15–50, and > 50 ng/L). Primary outcomes: 30-day and 1-year mortality.

Results
A total of 625 patients were included (median age 72, and 45% female). All-cause mortality was 2% at 30 days and 8% at 1-year. The hazard ratio (HR) for 30-day mortality was 4.17 (95% confidence interval (CI) 0.49–35.79, p = 0.192) for hsTnT 15–50 ng/L and 9.64 (95% CI 0.98–95.30, p = 0.053) for hsTnT > 50 ng/L compared to hsTnT < 15 ng/L when adjusted for age. The HR for 1-year mortality was 4.82 (95% CI 1.81–12.82, p = 0.002) for hsTnT 15–50 ng/L and 9.70 (95% CI 3.27–28.74, p < 0.001) for hsTnT > 50 ng/L compared to hsTnT < 15 ng/L when adjusted for age.

Conclusions
Elevated hsTnT levels increase the risk for 30-day and 1-year mortality independently of age. Both mild and major elevation of hsTnT levels is associated with increased risk for 1-year mortality regardless of age.
Association between number of functional teeth and physical function among community-dwelling older adults: Korean Frailty and Aging Cohort Study
Authors: Lim Nahyun , Lee Daehyun , Shin Seung-Yun , Won Chang Won , Kim Miji 
Published: December 2024

Abstract
Background
Functional teeth are important for maintaining appropriate masticatory function and nutritional intake, affecting physical function in older adults. This study aimed to evaluate the association between number of functional teeth and physical function in community-dwelling older Korean adults.

Methods
This cross-sectional study was conducted among a total of 2,527 participants (mean age, 76.5 ± 3.9; 53.4% women) who were enrolled in the Korean Frailty and Aging Cohort Study (2016–2017). Participants were categorized based on the number of functional teeth into two groups: < 20 and ≥ 20 functional teeth. Functional teeth were defined as the remaining natural teeth with visible crowns, with or without restorations, prosthetic pontics, or dental implants on panoramic radiography. Physical function was assessed using handgrip strength, gait speed, five-times sit-to-stand test (5TSTS) duration, and the Short Physical Performance Battery (SPPB) score. Multivariate linear and logistic regression models were used to evaluate the association between number of functional teeth and physical function.

Results
Of all the participants, 869 (34.3%) had < 20 functional teeth. After full adjustment for sociodemographic factors, lifestyle, health condition, and oral health, an increase in one functional tooth was associated with a corresponding increase in gait speed (men: B = 0.002, p = 0.032; women: B = 0.002, p = 0.013) and SPPB (men: B = 0.019, p < 0.001; women: B = 0.018, p < 0.001) in both men and women. The time taken for the 5TSTS was shorter for an increase in one more functional tooth (men, B=-0.033, p = 0.006; women, B=-0.036, p = 0.021) in both men and women. An increase in one functional tooth was associated with a corresponding increase in handgrip strength only in men (men, B = 0.049, p = 0.009; women, B=-0.003, p = 0.814). The associations between < 20 functional teeth and low handgrip strength [odds ratio (OR) = 1.46, 95% confidence interval (CI): 1.03–2.06], long 5TSTS duration (OR = 1.47, 95% CI: 1.07–2.02), and low SPPB scores (OR = 1.64, 95% CI: 1.07–2.53) were significant in fully adjusted model compared with ≥ 20 functional teeth only in men.

Conclusions
Fewer functional teeth were associated with low physical function in older adults. Our results emphasize the importance of maintaining adequate functional teeth to preserve physical function in community-dwelling older adults.
Sexual health after childbirth in Dutch women: prevalence, associated factors and perceived need for information: a cross-sectional study
Authors: Wassenaar EL , Lont F , Verhoeven CJ , Henrichs J , Titulaer LML , Warmelink JC , Geerts CC 
Published: December 2024

Abstract
Background
After childbirth, women often experience changes in sexual health. Little is known about the associated factors for the development of sexual health problems. Therefore, in this study we aim to investigate (1) how many women report changes in sexual health; (2) the prevalence and associated factors of women’s postpartum sexual health problems and (3) whether women want to be better informed about postpartum sexual health after childbirth.

Methods
From March to May 2021, 641 postpartum Dutch women participated in a cross-sectional study through an online survey, distributed via social media. At a mean time of 11.6 months (SD = 6.23) after birth, women reported information on maternal, pregnancy and childbirth characteristics and childbirth experience, sexual dysfunction (Female Sexual Function Index), sexual distress (Female Sexual Distress Scale), relationship satisfaction (Relationship Assessment Scale) and “perceived need for information” to discuss sexual health with their maternity care provider.

Results
Postpartum changes in sexual health were found in 88% of women. Of the women who participated, 43.7% reported sexual dysfunction and 52.3% reported sexual distress. Overall, 46% of women perceived more need for information. Multivariable logistic regression analyses showed that negative sexual experiences were associated with increased odds of sexual dysfunction (odds ratio (OR) 1.58, 95% CI 1.04–2.40) and sexual distress (OR 1.70, 1.17–2.46). Perineal damage (OR 1.54, 1.03–2.29) was associated with increased odds of sexual dysfunction, and a BMI ≥ 30 kg/m2 (OR 0.46, 0.28–0.70) was associated with decreased odds of sexual dysfunction. A higher level of relationship satisfaction was associated with decreased odds of sexual dysfunction (OR 0.36, 0.25–0.51) and sexual distress (OR 0.47, 0.35–0.63). A positive childbirth experience was associated with decreased odds of sexual distress (OR 0.88, 0.81–0.96) and decreased odds of “perceived need for information” (OR 0.86, 0.79 to 0.94).

Conclusion
Sexual health problems are experienced by half of postpartum women. Midwives should inform women and their partners about these possible problems, taking into account birth-related factors, e.g. birth experience and perineal damage. Care providers should pay special attention to women with negative sexual experiences.
Challenges and opportunities in perinatal public health: the utility of perinatal health inequality dashboards in addressing disparities in maternal and neonatal outcomes
Authors: Olakotan Olufisayo , Lim Jennifer N. W. , Pillay Thillagavathie 
Published: December 2024

Abstract
Introduction
In clinical settings, digital dashboards display medical data, with the aim of identifying trends and signals. In so doing these contribute towards improving service delivery and care within hospitals. It is not clear whether the utility of perinatal health equity dashboards could be used to identify health inequality trends that could potentially impact on health service delivery, care and public health interventions. This study aims to evaluate the implementation of health inequality dashboards that address disparities in maternal and neonatal outcomes, with a specific focus on identifying key challenges encountered during their deployment and use in healthcare settings.

Methods
Three databases, namely Embase, CINAHL, and Medline were searched to identify relevant studies in English Language published between 2010 and 2022. All findings were reported according to PRISMA guidelines for scoping reviews.

Results
Of 670 identified articles, only 13 met the inclusion criteria. The study identified three key themes: dashboard functionality, data accuracy, and challenges in collecting health inequality data. Dashboards were used to visualize disparities, with functionalities focusing on specific audiences, contents, and utility. Issues with data completeness, standardization, and challenges in collecting consistent health inequality data, especially from diverse ethnic groups, hindered the accurate tracking of maternal and neonatal disparities.

Conclusion
The use of perinatal health inequality dashboards is a critical step forward in optimizing maternal and neonatal care by providing targeted interventions. However, further research is needed to assess their long-term impact on reducing health inequalities, while addressing challenges related to data accuracy, completeness, and standardization to improve their effectiveness.
Assessment of intimate partner violence victimization and its association with the psychological state of abused women and social support in Saudi Arabia: a cross-sectional study
Authors: Innab Adnan , Shaqiqi Wejdan , Alammar Kamila , Alshammari Alkadi , Shaqiqi Rawan 
Published: December 2024

Abstract
Background
Intimate partner violence (IPV) against women is a significant global concern, profoundly affecting physical, psychological, sexual, and financial well-being. Its prevalence is notably high in conservative societies including Saudi Arabia (SA). Given the limited research on the role of social support in IPV within SA. This study aimed to assess IPV victimization and its association with the psychological state of abused women in SA, and the effects of social support on the women’s experience of IPV.

Methods
A total of 128 women participated in this cross-sectional study. Data were collected from September 2022 to March 2023 using the World Health Organization Multi-Country Violence Against Women, the General Health Questionnaire, and the Multi-Dimensional Scale of Perceived Social Support.

Results
One-quarter of women experienced at least one type of IPV, with more than half of them experienced financial (65.6%), sexual (53.9%), emotional (57.8%), controlling behavior (43.8%) and physical (39.8%) abuse. IPV victimization, be it physical, emotional, or sexual abuse, and IPV frequency were positively correlated with psychological distress (M = 15.05, SD = 6.82, p = .009), anxiety and depression (M = 6.29, SD = 2.57, p = .004), and loss of confidence (M = 2.57, SD = 1.90, p < .001). Social support was negatively associated with physical and controlling behavior abuse (p = .01) as well as IPV frequency (p = .024). The risk factors of IPV were unemployed women, employed husbands, history of child abuse for wives and husbands, financial struggle and arranged marriage.

Conclusions
The conclusion was that IPV can cause psychological distress, anxiety, depression, and loss of confidence and can be buffered by social support. Given its prevalence and impact on mental health, it is crucial to establish strict policies and regulations to prevent IPV and provide effective interventions and support for abused women.
Effects of timely case conferencing between general practitioners and specialist palliative care services on symptom burden in patients with advanced chronic disease: results of the cluster-randomised controlled KOPAL trial
Authors: Mallon Tina , Schulze Josefine , Pohontsch Nadine , Asendorf Thomas , Weber Jan , Böttcher Silke , Sekanina Uta , Schade Franziska , Schneider Nils , Dams Judith , Freitag Michael , Müller Christiane , Nauck Friedemann , Friede Tim , Scherer Martin , Marx Gabriella 
Published: December 2024

Abstract
Background
Patients with advanced chronic non-malignant conditions often experience significant symptom burden. Therefore, overcoming barriers to interprofessional collaboration between general practitioners (GPs) and specialist palliative home care (SPHC) teams is essential to facilitate the timely integration of palliative care elements. The KOPAL trial aimed to examine the impact of case conferences between GPs and SPHC teams on symptom burden and pain in patients with advanced chronic heart failure, chronic obstructive pulmonary disease, and dementia.

Methods
The cluster-randomised controlled trial compared a structured palliative care nurse visit followed by an interprofessional case conference to usual care. Data were collected from GPs at baseline and 48 weeks, while standardised patient interviews were conducted at baseline, 6, 12, 24, and 48 weeks.

Results
We analysed 172 patients from 49 German GP practices. Both groups showed marginal improvement in symptom burden; however, no statistically significant between-group difference was found ($$\:{\Delta\:}$$=-0.561, 95% CI: -3.201–2.079, p = .68). Patients with dementia experienced a significant pain reduction ($$\:{\Delta\:}$$=2.187, 95% CI: 0.563–3.812, p = .009). Conversely, the intervention did not have a significant effect on pain severity ($$\:{\Delta\:}$$=-0.711, 95% CI: -1.430 − 0.008, p=.053) or pain interference ($$\:{\Delta\:}$$=-0.036, 95% CI:-0.797 − 0.725, p=.926) in other patient groups.

Conclusions
The intervention showed promise in the timely introduction of palliative care elements to address pain management in patients with dementia. Further studies are needed to identify and effectively address symptom burden and pain in other patient groups.

Trial registration
German Clinical Trials Register: https://www.drks.de/DRKS00017795 (Registration date: 9th January 2020).
Changes in spatial bodily pain distribution one year after benign hysterectomy with emphasis on prevalence and risk factors for de novo and persistent pelvic pain- a prospective longitudinal multicenter study
Authors: Lukas Peter , Nilsson Lena , Wodlin Ninnie Borendal , Arendt-Nielsen Lars , Kjølhede Preben 
Published: December 2024

Abstract
Background
The objectives were to determine the prevalence of de novo and persistent pelvic pain after benign hysterectomy and to assess risk factors.

Methods
A Swedish prospective multicenter study of 440 women undergoing benign hysterectomy was conducted between October 2011 and March 2017. Measures of pain, the spatial extent of bodily pain, and pain sensitivity were assessed using a self-reporting questionnaire, Margolis’s patient pain drawing, and quantitative sensory testing of pain thresholds for pressure, heat, and cold, respectively. Quality of life was evaluated by EQ-5D-3L and SF-36. Psychological distress was assessed by the Hospital Anxiety and Depression Scaleand the Stress-Coping Inventory. Logistic regression models were used to assess risk factors, and the outcome was presented as an adjusted odds ratio (aOR) and 95% confidence interval (CI).

Results
Preoperatively, 18.0% of the women reported no bodily pain, 41.5% had pelvic pain, either as the only location (7.0%) or along with pain in other locations (34.5%), and 40.5% had non-pelvic pain only. Postoperatively, 6.2% developed de novo pelvic pain and 16.4% had persistent pelvic pain. De novo pelvic pain developed exclusively in women who preoperatively had non-pelvic pain only. Risk factors for de novo pelvic pain were a long hospital stay (aOR 1.50 (95%CI) 1.02–2.21)), high preoperative pain intensity (aOR 1.25 (95%CI 1.01–1.62)) and a high number of pain areas (aOR 1.15 (95%CI 1.05–1.27)), along with anxiety (aOR 10.61 (95%CI 1.84–61.03)) and low EQ-5D-3L health index (aOR 0.02 (95%CI 0.00–0.31)). Risk factors for persistent pelvic pain were lower age (aOR 0.89 (95%CI 0.81–0.97)), higher number of pain areas (aOR 1.08 (95%CI 1.02–1.14)), and a higher frequency of preoperative pain (aOR 12.75 (95%CI 2.24–72.66)).

Conclusion
Although hysterectomy appeared to be reasonably effective in curing pelvic pain, a non-negligible proportion of women developed de novo pelvic pain or had persistent pelvic pain. De novo pelvic pain seemed to affect only those who preoperatively had widespread bodily pain. Women at risk for de novo and persistent pelvic pain after hysterectomy could be identified preoperatively.

Trial registrations
The study was retrospectively registered in ClinicalTrial.gov (NCT01526668) on 01/27//2012.
Developing nurse and midwife centred rostering principles using co-design: a mixed-methods study
Authors: Holton Sara , Rasmussen Bodil , Long Karrie , Bellizia Madison , Mathieson Jac C. , Crowe Shane , Mill Douglas , Pasion Harry , Rankin Claire , Woodhouse Maree , Douglas Meaghan , Glanville Nadine , Baker Kylie , Fallon Kethly , Hoffmann Megan , Sliwa Nicole , Heinjus Denise , Fitzpatrick Lisa , Gilbert Paul 
Published: December 2024

Abstract
Background
Current nursing and midwifery rosters are based on guidelines which may no longer adequately meet the needs of health services or staff and often result in decreased job satisfaction, poor health and wellbeing, and high turnover. Little is known about the rostering needs and preferences of contemporary nurses and midwives in Australia. The aim of this study was to identify the rostering concerns, needs and preferences of nurses and midwives, and co-design acceptable, equitable and feasible rostering principles.

Methods
A mixed-methods design using a co-design approach with three components: survey, discussion groups, and co-design workshops. Nurses and midwives employed at three public health services in Victoria, Australia were invited to participate. The quantitative (survey) data were analysed using descriptive statistics and the qualitative (discussion groups and co-design workshops) data using thematic analysis.

Results
Surveys were completed by 715 nurses and midwives including unit (n = 14) and roster (n = 13) managers. Nurses and midwives (n = 688) were mostly satisfied with their roster (mean satisfaction score = 57.4). Many had responsibilities or commitments which impacted their roster availability (n = 406, 61.6%) and over half had taken personal leave due to roster-related fatigue (n = 335, 59.1%) or unmet roster requests (n = 310, 54.7%). Midwives reported significantly less satisfaction (p < 0.001) and more challenges with current roster practices than nurses. Roster and unit managers described spending considerable time preparing and reworking rosters. Thirty-nine nurses and midwives participated in a focus group and outlined concerns about the fairness and equity of current roster practices, and the adverse impact on their health, work, and personal lives. Ninety-one nurses and midwives participated in a co-design workshop and identified a need for roster practices and guidelines which ensure flexibility, fairness and equity, and fatigue management.

Conclusions
Although nurses and midwives were mostly satisfied with their rosters, they often experienced frustrations and challenges with current roster guidelines and practices as well as adverse effects on their health and work and personal lives. Nurses and midwives identified a preference for fair and equitable rosters which provide flexibility and enable them to manage their other commitments and responsibilities, reduce roster-related fatigue, and provide high quality patient care.
GP emigration from Ireland: an analysis of data from key destination countries
Authors: Hanlon Holly Rose , Shé Éidín Ní , Byrne John-Paul , Smith Susan M. , Murphy Andrew W. , Barrett Aileen , O’Callaghan Mike , Humphries Niamh 
Published: December 2024

Abstract
Background
Ireland is experiencing a general practitioner (GP) workforce crisis, facing an ageing workforce, a growing population with increased life expectancy, and increased complexity of patients. The GP crisis threatens access to primary care in Ireland, as well as Ireland’s aim to transform into a primary-care centred system of universal healthcare via the proposed “Sláintecare” healthcare reforms. The challenges faced are common to many countries as health systems seek to expand their medical workforce post-pandemic. In addition Ireland has a legacy of austerity policies which impacted the health system, and triggered/generated largescale doctor emigration. However, little is known specifically about GP emigration and the role it potentially plays in the GP workforce crisis. This paper aims to address the gap in knowledge about the level of GP emigration from Ireland and consider the implications for the Irish health system and health systems internationally.

Methods
As Ireland does not formally collect routine data on GP emigration, this paper presents routinely collected secondary data from four key destination countries; Australia, New Zealand, the United Kingdom, and Canada, in order to gain an initial picture of GP emigration from Ireland to these countries, from 2012–2021. The data were in the form of medical registration and immigration (visa) data and both stock (the total number of GPs registered in a country in a given year) and flow data (the number of GPs entering a country in a given year) were collated, where available.

Results
The stock data shows a substantial cohort of Irish-trained doctors working in general practice in key destination countries. The flow data suggests a relatively small annual emigration flow of GPs from Ireland to individual countries. However when compared with the total numbers of GPs trained in Ireland each year, the numbers are notable.

Conclusions
The available data suggests a mixed picture regarding GP emigration from Ireland. There is a significant stock of Irish-trained GPs abroad which perhaps represents a potential cohort of GPs who could be encouraged to return to practice in Ireland as part of Ireland’s strategy for addressing the GP workforce crisis. The annual flow of GPs from Ireland to key destination countries, while small, should be monitored and factored into GP workforce planning. As global demand for GPs increases, countries will inevitably compete with each other to attract and retain GPs (see for example Australia’s recent move to attract and recruit Irish trained GPs). The paper highlights the need for improved routine data on the GP workforce in Ireland, including the need for a national GP workforce dataset, in order to ensure that national workforce planning efforts are informed by the latest evidence on GP emigration.