bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of early resumption of postpartum sexual intercourse in sub-Saharan Africa: A systematic review and meta-analysis
Authors: Belay Habtamu Gebrehana , Yehuala Enyew Dagnew , Asmer Getie Simegnew , Ayele Alemu Degu , Yimer Tigist Seid , Berihun Erega Besfat , Ferede Wassie Yazie , Worke Mulugeta Dile , Mihretie Gedefaye Nibret 
Published: November 2024

Background: The World Health Organization recommends that all postpartum women be examined for resumed sexual activity. Despite this, postpartum sexual health education and health promotion are not adequately incorporated into current maternal healthcare systems in low- and middle-income nations. There were variations in the prevalence and variables associated with early postpartum sexual intercourse across several studies. Objectives: The purpose of this systematic review and meta-analysis was to evaluate the pooled prevalence and associated factors for early postpartum sexual intercourse in sub-Saharan African countries. Data Sources and Methods: Primary studies were identified using international databases such as Scopus, PubMed, Google Scholar, Embase, and CINAHL. The Newcastle‒Ottawa Scale quality assessment tool was used to evaluate the quality and strength of the included studies. STATA version 17 was used for the meta-analysis. The heterogeneity of the studies and publication bias was examined using I2 statistics and Egger’s regression test. Subgroup analysis decreased the underlying heterogeneity based on the study years and sample sizes. Results: Seventeen primary articles were included in the meta-analysis with 8507 study participants. The pooled prevalence of early postpartum sexual resumption in sub-Saharan Africa was 39.41% (95% CI: 31.55%–47.27%). Primiparous (OR = 3.32; 95% CI: 2.26–5.90), spontaneous vaginal delivery (OR = 5.98; 95% CI: 1.74–20.51), formula feeding (OR = 2.24; 95% CI: 1.46–3.44), family planning (OR = 2.91; 95% CI: 1.89–4.49), husband pressure (OR = 4.99; 95% CI: 1.38–18.05), have no formal education (OR = 2.36; 95% CI: 1.49–3.76), and monogamy (OR = 4.18; 95% CI: 2.27–7.69) were significantly associated with early postpartum sexual resumption. Conclusion: Four out of 10 women had returned to sexual activity within 6 weeks of giving birth. This suggests that a large proportion of women are more vulnerable to unwanted pregnancies and sexual health problems. Sexual health education and counseling should be incorporated into standard postpartum care to increase contraceptive use and delay unplanned pregnancies.
Obesity Stigma Among Healthcare Workers in a Teaching Hospital in Saudi Arabia
Authors: Bahamdan Ahmed S. , Shafey Marwa M. , Alabdulkader Assim M. , Aldhawyan Adam F. , Alharkan Khalid S. , Almohaimeed Omar K. , Holdar Mohammad J. 
Published: November 2024

Background: Obesity is a significant public health issue in Saudi Arabia. Rising obesity rates increase the risk of weight bias and stigma, even among healthcare workers. Objectives: This study assesses weight stigma in healthcare workers, with findings intended to inform strategies for creating a more supportive healthcare environment for patients with obesity. Methods: This cross-sectional study was conducted in a university hospital in the Eastern Province of Saudi Arabia. Healthcare workers completed self-administered questionnaires, including the Attitudes toward Obese Persons Scale (ATOP) and the Beliefs about Obese Persons Scale (BAOP), which assess levels of positive attitudes and beliefs about obesity, respectively. Data were analyzed using SPSS. Results: The study included 266 healthcare workers (HCWs), mean age 33.21 years, with 54.5% female. The ATOP mean score was 64.4, and BAOP mean score was 18.3, indicating moderate negative attitudes and beliefs toward obesity. Significant differences in ATOP scores were found based on age, patient interactions, and years of experience. Discussion Our study aligns with international findings, revealing significant weight stigma among healthcare workers in Saudi Arabia. Such stigma can negatively impact patient care, leading to biased treatment and poorer health outcomes. Societal norms and personal biases contribute to this stigma, despite misconceptions regarding its supposed motivational effects. Addressing this requires comprehensive training and education for healthcare providers. Policymakers should include weight bias education into medical curricula and establish anti-discrimination policies to promote inclusivity and respect. Conclusions: Our study highlights obesity stigma among Saudi healthcare workers and the need for targeted interventions. Creating a supportive, nonjudgmental environment can enhance patient-provider relationships and improve healthcare outcomes for individuals with obesity.
Vaccine Hesitancy Affecting Pneumococcal Vaccine Refusal in Older Adults with Morbidities
Authors: Chitaree Woothikrai , Buawangpong Nida , Yotruangsri Thanachat , Jiraporncharoen Wichuda , Pinyopornpanish Kanokporn 
Published: November 2024

Introduction: Pneumonia is a leading cause of mortality worldwide, with Streptococcus pneumoniae being the most common cause. Older adults are particularly at risk. However, vaccination rates in Thailand remain low. Objective: This study aims to examine the prevalence of vaccine refusal and its association with factors outlined in the 5C model (Confidence, Complacency, Constraints, Calculation, and Collective Responsibility) among older patients with morbidities. Setting: Study was conducted at outpatient clinic of the Department of Family Medicine, Chiang Mai University. Methods: An observational cross-sectional study. The data was collected via a self-administered questionnaire including demographic data, questionnaire in 5C model, and intention to received pneumococcal vaccine. Comparison of characteristic between vaccine refuser and non-refuser was performed by using Chi-square or a T-test. To explore the association between factors in 5C model and vaccine refusal, multiple logistic regression was performed with an adjustment for confounders. Results: From a total of 150 participants, the mean age was 69.8 ± 5.6 years old. Most of the patients were female (60.7%). The study found that 18% of the participants refused the pneumococcal vaccine. After adjusted for the confounders, the lower collective responsibility and confidence were significantly associated with vaccine refusal (Odds ratio 0.22 (95% confidence interval [CI] 0.06-0.74, P = .015) and Odds ratio 0.43 (95% CI 0.20-0.89, P = .024), respectively. Conclusion: Strategies to enhance confidence and address complacency about vaccines are essential for improving pneumococcal vaccination coverage. This insight can be used as a guideline and policies can be formulated which are aimed at reducing pneumococcal vaccine refusal in the older adults by enhancing communication about the benefits, efficacy, and risks of vaccines.
Early Full Weight-Bearing Exercises to Improve Gait Function in Older Adult Patients Following Surgery for Distal Femoral Fractures
Authors: Watanabe Shin , Watanabe Kei , Kinjo Yasuharu , Imai Koushiro , Muraoka Mikio 
Published: November 2024

Introduction Postoperative rehabilitation for distal femur fracture generally requires gait exercises with weight-bearing restrictions. We aimed to determine whether full weight-bearing gait exercises immediately postoperatively effectively maintain walking ability in older adult patients with distal femur fractures. Methods Patients diagnosed with distal femur fractures between April 2017 and March 2024 were retrospectively evaluated. Patients aged ≥75 years who had undergone surgical treatment were classified into full weight-bearing (FWB) and non-weight-bearing (NWB) groups, with FWB and NWB gait exercises starting immediately postoperatively. Patient background was evaluated in terms of age at time of surgery, sex, weight, cognitive function, and fracture type (AO classification). Postoperative outcomes were operative time, intraoperative blood loss, gait function, and postoperative complications. Two osteosynthesis conditions that allowed postoperative FWB were achievement of bony support through anatomical reduction of the medial femur and the use of adequate supplemental fixation to maintain reduction. Results The study comprised 21 patients (1 man, 20 women; mean age, 87.2 [79-99] years). Extra- and intra-articular fractures were identified in 16 and 5 patients, respectively. The surgical procedures were lateral plating, double plating, and one-stage total knee arthroplasty in 16, 3, and 2 patients, respectively. There were 9 and 12 patients in the FWB and NWB groups, respectively, with no significant differences in patient background. The mean decrease in the Parker mobility score was 0.11 points (range, -3-2 points) in the FWB group vs 1.92 points (range, 0-3 points) in the NWB group, indicating that gait function was maintained in the FWB group ( P = 0.0063). Two and 9 patients in the FWB and NWB groups, respectively, experienced complications ( P = 0.017). Conclusion Consideration should be given to treatment involving orthogeriatric care for older adults with distal femur fractures. Rehabilitation with FWB can preserve gait function and reduce postoperative complications.
Clinician Experiences With Integrative Group Medical Visits for Chronic Pain
Authors: Jackson Mary , Gardiner Paula , Leeman Jennifer , Roth Isabel 
Published: November 2024

Background The well-being of healthcare teams is an important consideration when seeking to improve patient experience and quality of care. Prior studies have found that changes to working conditions are most effective in improving clinician well-being. Integrative Group Medical Visits (IGMVs) modify working conditions in ways that have potential to improve clinician experience. Objective The objective of this study was to understand healthcare teams’ experiences with IGMVs. Methods In this qualitative study, interviews were conducted via Zoom and telephone with 21 clinicians, administrators, and staff from safety-net healthcare settings throughout the United States (U.S.) who have implemented IGMVs for patients with chronic pain. Interviews included questions about clinician experience, well-being, and satisfaction with the IGMV model. Interviews were recorded, transcribed, and coded using thematic content analysis by a team of trained qualitative researchers. Results The authors identified five themes describing how IGMV positively affected clinician well-being: organizational supports, human-centered engagement, collaboration with an interprofessional team, provision of guideline-concordant care, and enhanced meaning and purpose for the clinicians. Conclusion The current study was the first to use interviews from healthcare teams who have implemented IGMV to assess their experience. The themes identified warrant further investigation into IGMVs as a strategy to promote clinician well-being and mitigate aspects of burnout.
MIF promotes Th17 cell differentiation in rheumatoid arthritis through ATF6 signal pathway
Authors: Yan Guozhi , Song Rongrong , Zhang Jieyu , Li Zhihao , Lu Zhantao , Liu Zijian , Zeng Xiaokang , Yao Jie 
Published: November 2024

AbstractRheumatoid arthritis (RA) is a common autoimmune disease that can lead to irreversible joint damage when it occurs, but its pathogenesis has not yet been elucidated. In this study, we explored the roles of macrophage migration inhibitory factor (MIF), endoplasmic reticulum stress (ER stress), and Th17 cells in the pathogenesis of RA. We have preliminarily confirmed that MIF expression in CD4+T cells and the proportion of Th17 cells are increased in active RA patients. We also found that ER stress is activated, initiating ATF6 pathway in the UPR. Additionally, using in vitro stimulation and co-immunoprecipitation experiments, we have confirmed the interaction between MIF and ATF6, which enhances protein expression in ATF6 pathway. Subsequently, in the chromatin immunoprecipitation assay, we observed the enrichment of ATF6 subunit on the promoter sequences of the Th17 cell differentiation genes STAT3 and RORC. Additionally, the differentiation of Th17 cells was disrupted by Ceapin-A7 (ATF6 inhibitor). In summary, our results indicate that MIF enhances ATF6 pathway signaling, which promotes the differentiation of Th17 cells. This could be a potential mechanism underlying the pathogenesis of RA, offering a new direction for the clinical treatment of RA.
Mapping an avirulence gene in the sunflower parasitic weed Orobanche cumana and characterization of host selection based on virulence alleles
Authors: Calderón-González Álvaro , Fernández-Melero Belén , del Moral Lidia , Muños Stéphane , Velasco Leonardo , Pérez-Vich Begoña 
Published: November 2024

Abstract
Background
Sunflower broomrape (Orobanche cumana Wallr.) is a holoparasitic plant that jeopardizes sunflower production in most areas of Europe and Asia. Recently, populations with increased virulence, classified as race GGV, have been identified in Southern Spain’s Guadalquivir Valley gene pool. These populations overcome resistance genes in hybrids resistant to the predominant race FGV. This study aimed to (i) determine the inheritance and map the avirulence trait segregating in a cross between O. cumana individuals from populations EK23 (FGV) and IN201 (GGV), and (ii) characterize the host effect on the IN201 parental population allelic diversity.

Results
A segregating population consisting of 144 F2:3 families was evaluated for virulence using a differential sunflower genotype (Hybrid 1, resistant to race FGV and susceptible to race GGV) and genotyped with SNP markers. The ratio of avirulent to virulent F2:3 families was not significantly different to 1:3 (χ2 = 0.93; P = 0.34), indicating monogenic control of the avirulence/virulence trait. The AvrG−GV locus was mapped on the upper end of O. cumana chromosome 2, 9.2 cM distal from the SNP markers OS04791 and OS02805. Secretome analysis in the AvrG−GV region revealed a cysteine-rich CAP superfamily- and a glucan 1,3-beta-glucosidase family 3-encoding genes as possible candidates for AvrG−GV. SNP allelic analysis on the IN201 population parasitizing a highly susceptible genotype or the differential genotype Hybrid 1 showed that (i) IN201 structure was shaped towards virulent alleles at SNP loci linked to AvrG−GV (ii) there were significant allelic frequency differences associated with the host genotype at AvrG−GV–linked loci.

Conclusions
This study mapped for the first time an avirulence gene in parasitic plants using a classical genetic approach, confirmed a gene-for-gene model in the O.cumana –sunflower system, and showed the implication of this single avirulence gene in determining the structure of broomrape populations subjected to selection pressure posed by a resistant genotype. The results will contribute to a better understanding of the interaction between crops and weedy parasitic plants, and to effectively manage evolution of virulence by sustainable control strategies based on host genetic resistance.
A qualitative study of young workers’ experience of the psychosocial work environment and how this affects their mental health
Authors: van Veen Malte , Schelvis Roosmarijn MC , Bongers Paulien M , Oude Hengel Karen M , Boot Cécile RL 
Published: November 2024

Abstract
Background
The evidence base for the relationship between psychosocial work factors and mental health focuses primarily on the general working population but little is known about young workers. The aim of this qualitative study is to identify psychosocial work factors that affect the mental health of young workers, with a focus on (1) novel factors of the psychosocial work environment that are relevant for young workers but have not been described in the literature and (2) experiences of psychosocial work factors associated with mental health that are specific to and typical for young workers.

Methods
Semi-structured interviews were held with 36 workers aged up to 30. Participants were asked to describe work situations that affected their mental health. Factors were identified using a combination of inductive and deductive coding and open-coded factors were mapped onto the Copenhagen Psychosocial Questionnaire (COPSOQ), which is widely used as a framework for psychosocial work factors.

Results
Most of the psychosocial factors mentioned by the young workers could be mapped onto the COPSOQ framework and were therefore similar to the general working population. Novel factors identified by this study were “Procedural support” and “Responsibility for others”. We also identified young-worker-specific experiences of psychosocial work factors associated with mental health (i.e. Quantitative Demands, Influence at Work, Commitment to the Workplace, Job Insecurity, Quality of work, Job satisfaction, and Vertical Trust). Lastly, young workers did not report the COPSOQ factor Insecurity over working conditions and Work-life conflict was reported as an indicator of mental health status rather than being perceived as a factor of the psychosocial work environment.

Conclusions
Psychosocial work factors and their influence on mental health reported by young workers in this qualitative study are comparable to what is reported for the general working population. There are however some young-worker-specific experiences of psychosocial work factors and two novel factors. The novel factors, “Procedural support” and “Responsibility for others” are not found in common psychosocial work factor frameworks and might be studied specifically in relation to young workers. Our results provide organisations with levers that can be used to create a psychosocial work environment that benefits the mental health of young workers.
Conspiracy narratives and vaccine hesitancy: a scoping review of prevalence, impact, and interventions
Authors: Taubert Frederike , Meyer-Hoeven Georg , Schmid Philipp , Gerdes Pia , Betsch Cornelia 
Published: November 2024

AbstractBelieving conspiracy narratives is frequently assumed to be a major cause of vaccine hesitancy, i.e., the tendency to forgo vaccination despite its availability. In this scoping review, we synthesise and critically evaluate studies that assess i) the occurrence of vaccine-related conspiracy narratives on the internet, ii) the prevalence of belief in vaccine-related conspiracy narratives, iii) the relationship between belief in conspiracy narratives and vaccination intention or vaccination uptake, and iv) interventions that reduce the impact of conspiracy narratives on vaccination intention.In July 2022, we conducted a literature search using three databases: PubMed, PsychInfo, and Web of Science. Following the PRISMA approach, of the 500 initially identified articles, 205 were eligible and analysed.The majority of identified studies were conducted in Europe and North America, were published in 2021 and 2022, and investigated conspiracy narratives around the COVID-19 vaccination. The prevalence of belief in various vaccine-related conspiracy narratives varied greatly across studies, from 2 to 77%. We identified seven experimental studies investigating the effect of exposure to conspiracy narratives on vaccination intentions, of which six indicated a small negative effect. These findings are complemented by the evidence from over 100 correlative studies showing a significant negative relationship between conspiracy beliefs and vaccination intention or uptake. Additionally, the review identified interventions (e.g., social norm feedback, fact-checking labels, or prebunking) that decreased beliefs in vaccine-related conspiracy narratives and, in some cases, also increased vaccination intentions. Yet, these interventions had only small effects.In summary, the review revealed that vaccine-related conspiracy narratives have spread to varying degrees and can influence vaccination decisions. Causal relationships between conspiracy beliefs and vaccination intentions remain underexplored. Further, the review identified a need for more research on interventions that can reduce the impact of conspiracy narratives.
Evaluation of the cost and care outcomes by group related to the diagnosis of bariatric surgery
Authors: Böger Beatriz , de Souza Ribeiro Guilherme , Aguiar Bianca Fontana , Lind Jolline , Fiebrantz Anne Karine Bosetto , Ramos Moacir Pires , de Lima João Henrique Felicio , Rocha Jaime Luis Lopes 
Published: November 2024

Abstract
Background
To conduct a comprehensive assessment of real patient data undergoing the procedure within a healthcare provider, integrating both costs and care stages related to bariatric surgery, emphasizing the relevance of analysis by Diagnosis-related group (DRG).

Methods
Prospective study of patients coded by DRG within a network of providers accredited to a Brazilian healthcare provider. All patients coded with metabolic and bariatric surgery (MBS) between 01/2019 and 06/2023 and undergoing gastrectomy procedure were included for analysis. The cost base used was derived from administrative payment information of the healthcare provider. Analyses were presented as mean, median, and standard deviation. Levene, Student’s t-test, Kendall’s tau, and Pearson’s chi-square tests were used.

Results
The study included a total of 1408 patients who underwent MBS in four prominent hospitals in the area during the specified period. Among these patients, an average of 74.8% were female, with a mean age of 37.31 years and a mean body mass index (BMI) of 40.3 kg/m2. Furthermore, 88.9% of the patients underwent gastric bypass. Although there were few acquired complications during hospital admission there were vascular complications following infusion, transfusion, and therapeutic injection, 22.45% (n = 11), hemorrhage and hematoma complicating procedure not classified elsewhere, 8.16% (n = 4), leakage, 8.16% (n = 4), and one death during this study. There were 67 readmissions within 30 days (4,75%). The total costs incurred throughout the patient’s journey, covering hospitalization and one-year post-procedure, exhibited a median value of $4,078.53. Additionally, a notable positive association was observed between post-discharge expenses and age, indicating a tendency for costs to rise as patients grow older.

Conclusion
The identified results highlight the complexity and challenges associated with bariatric surgery, including patient management and substantial costs involved. Therefore, a more comprehensive and personalized approach in postoperative management and resource allocation may be necessary to optimize clinical and economic outcomes.