bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary Practices and Associated Factors Among Adult Diabetic Patients at Academic Tertiary-Level Hospitals in Central Ethiopia: Convergent Mixed Study
Authors: Saliya Sentayehu Admasu , Ashine Taye Mezgebu , Heliso Asnakech Zekiwos , Babore Getachew Ossabo , Birhanu Bethelhem , Hailu Awoke Girma , Sebro Sisay Foga , Ezo Elias , Begizew Selamawit Wondale 
Published: September 2024

Background Diabetes mellitus (DM) is one of the most common chronic diseases globally. Despite the presence of national strategies to prevent potential sequelae DM has been associated with increased morbidities and mortality in Ethiopia, and the prevalence appears to be on the rise. Although studies have been conducted among DM patients in the country, there is a lack of information that could allow an in-depth understanding of the situation. Objective To assess dietary practices and associated factors among adult DM patients at academic tertiary-level hospitals in central Ethiopia. Methods The institution-based concurrent mixed-methods study was conducted from January 01 to 30 2024 involving 420 adult DM patients. Participants were selected using a simple random sampling technique for quantitative study. A purposive sampling technique was used to select 16 participants for qualitative analysis. For the quantitative study, a self-administered structured questionnaire was used to collect data, and an in-depth interview for the qualitative part. Multivariate binary logistic regressions were used to assess the explanatory variables associated with dietary practice. A thematic analysis was performed for qualitative data. Result Of 420 eligible participants, 406 (96.7%) participated in the study. The overall proportion of good dietary practices among participants was 172 (44.2%). The being female, urban residence a family history of DM, and good dietary were significantly associated with the dietary practice. From qualitative analysis, two themes have emerged; Living as before and not adhering to diabetic dietary recommendations and barriers to adherence to effective eating practice. Conclusions and recommendations Less than half of adult DM patients had good dietary practices. Sex, geographic location, family history of DM, and level of knowledge of diabetic diet were associated with dietary practice. Intervention programs on awareness creation and training to improve the dietary practice by stakeholders were recommended.
Endovascular treatment in patients with acute ischemic stroke presenting beyond 6 h after symptom onset: An international multicenter cohort study of the EVA-TRISP collaboration
Authors: Wali Nabila , Stolze Lotte J , Rinkel Leon A. , Heldner Mirjam R , Müller Madlaine , Arnold Marcel , Mordasini Pasquale , Gralla Jan , Baumgartner Philipp , Inauen Corinne , Westphal Laura P , Wegener Susanne , Michel Patrik , Trüssel Simon , Mannismäki Laura , Martinez-Majander Nicolas , Curtze Sami , Kägi Georg , Picchetto Livio , Dell’Acqua Maria Luisa , Bigliardi Guido , Riegler Christoph , Nolte Christian H , Serôdio Miguel , Miranda Miguel , Marto João Pedro , Zini Andrea , Forlivesi Stefano , Gentile Luana , Cereda Carlo W , Pezzini Alessandro , Leker Ronen R , Honig Asaf , Berisavac Ivana , Padjen Visnja , Zedde Marialuisa , Kuhrij Laurien S , Van den Berg-Vos Renske M , Engelter Stefan T , Gensicke Henrik , Nederkoorn Paul J 
Published: September 2024

Introduction: After positive findings in clinical trials the time window for endovascular thrombectomy (EVT) for patients with an acute ischemic stroke has been expanded up to 24 h from symptom onset or last seen well (LSW). We aimed to compare EVT patients’ characteristics and outcomes in the early versus extended time window and to compare outcomes with the DAWN and DEFUSE 3 trial results. Patients and methods: Consecutive EVT patients from 16 mostly European comprehensive stroke centers from the EVA-TRISP cohort were included. We compared rates of 90-day good functional outcomes (Modified Rankin Scale 0–2), symptomatic intracranial hemorrhage (sICH), and 90-day mortality between patients treated in the early (<6 h after onset or LSW) versus extended (6–24 h after onset or LSW) time windows. Results: We included 9313 patients, of which 6876 were treated in the early and 2437 in the extended time window. National Institutes of Health Stroke Scale (NIHSS) score at presentation was lower in patients treated in the extended time window (median 13 [IQR 7–18] vs 15 [IQR 9–19], p < 0.001). The percentage of patients with good functional outcome was slightly lower in the extended time window (37.4% vs 42.2%, p < 0.001). However, rates of successful recanalization, sICH, and mortality were similar. Good functional outcome rates after EVT were slightly lower for patients in the extended window in the EVA-TRISP cohort as compared to DAWN and DEFUSE 3. Discussion and conclusion: According to this large multicenter cohort study reflecting daily clinical practice, EVT use in the extended time window appears safe and effective.
Malpractice rates are lower for women physicians compared to men physicians
Authors: Gupta Kiran , Romero Vincent , Grenon Véronique , Sarkar Urmimala 
Published: September 2024

Background Previous literature has shown that women physicians are less likely to be involved in medical malpractice litigation than male physicians. Methods This study sought to examine the differences in malpractice experience by provider gender by using closed medical malpractice claims from 2011 through 2020. Results We found that after adjusting for the number of claims and dollar losses per full time equivalents worked, female physicians experienced fewer and less costly claims than male physicians ( p < .001). Specific specialties had a significant relationship between claim frequency and provider gender, which included general surgery ( p = .01), obstetrics ( p = .001), gynecology ( p = .04), internal medicine and family general practice ( p < .001). Conclusion The results from this analysis support the prior findings that male physicians experience a higher rate of malpractice claims. Therefore, there is an opportunity to learn how women providers achieve lower malpractice risk to inform clinical practice recommendations.
Understanding the needs for support and coping strategies in grief following the loss of a significant other: insights from a cross-sectional survey in Sweden
Authors: Benkel Inger , Skoglund Johanna , Enstedt Daniel , Hård af Segerstad Ylva , Öhlén Joakim , Nyblom Stina 
Published: September 2024

Background: Grief has previously been described in pathological terms, characterized by several stages. In the past three decades, new perspectives on grief as a reaction to the loss of a significant other have emerged. It shows that grief is an individual process based on circumstances surrounding the death and the bereaved person’s life situation, rather than being predetermined. Objective: The aim of the study was to show how grief is perceived by people who have lost a significant other, and it focuses on bereavement support, how the death affects the bereaved person’s living conditions, how the bereaved person deals with grief, and if grief is expressed differently depending on whether it was an expected death (ED) or an unexpected death (UED). Design: A cross-sectional design was used with data collected anonymously using an online survey with semi-structured answers and options for participants to add their own comments, and it was analyzed descriptively. Result: Support in grief was mainly given by family and friends, and the perceived need was primarily for emotional support or emotional support combined with practical support, and to a greater extent for UEDs and women. For some bereaved persons, health caregivers and religious institutions provided support outside their own network. Grief can affect how people socialize with others and change social relationships. People can deal with grief in social as well as religious ways in the company of friends, through everyday conversations, spending time in nature, and having a spiritual outlook on life, and with the help of pets. Conclusion: The results can contribute to an increased understanding of grief after the loss of a significant other and how grief affects the bereaved person’s life depending on whether it is an ED or a UED. There was a difference between the genders, with women perceiving a need for and receiving different forms of support and to a greater extent than men.
Preparation for implementation of evidence-based practices in urban schools: A shared process with implementing partners
Authors: Eiraldi Ricardo , Comly Rachel , Wolk Courtney Benjamin , Rabenau-McDonnell Quinn , McCurdy Barry L. , Khanna Muniya S. , Jawad Abbas F. , Banks Jayme , Clark Stacina , Popkin Kristina M. , Wilson Tara , Henson Kathryn 
Published: September 2024

Background Shifting organizational priorities can negatively affect the sustainment of innovations in community settings. Shifting priorities can present barriers to conducting clinical research in schools if a misalignment occurs between school district priorities and the aims of the study. Often this misalignment occurs due to a shift during the period between when the study is submitted for funding and when research activities begin. Participatory research approaches can be employed to restore alignment between study processes and school district priorities. The purpose of the study is to describe data from a shared process with district partners. The shared process resulted in modifications to the main study's implementation processes and strategies in order to restore alignment with evolving school priorities while remaining faithful to the aims of the study. Method Data originated from qualitative interviews conducted with 20 school district and school personnel in a large urban school district. Qualitative themes were organized into categories based on a social-ecological school implementation framework. Data from team meetings, meetings with school district administrators, and emails served to supplement and verify findings from interview analyses. Results Themes included barriers and facilitators at the macro-, school-, individual-, team-, and implementation quality levels. Adaptations were made to address barriers and facilitators and restore alignment with school district priorities. Most adaptations to study processes and implementation strategies focused on re-training and providing more information to school district coaches and school-based staff. New procedures were created, and resources were re-allocated for the larger study. Conclusions Findings were discussed in relation to the implementation literature in schools. Recommendations for sustaining strong collaboration among researchers and school partners are provided.
On the use of selective Z-pinning in stiffened composite panels to prevent skin/stringer debonding
Authors: Yan Bin , Zhu ShengWei , Zhang YunKe , Shen LiangJi , Li Yuan , Jiang WenTao , Kang WenLi , Dou Hu 
Published: September 2024

Carbon fiber reinforced plastic (CFRP) composites have been widely used in engineering. This paper investigates the effect of composite z-pin (polyimide fiber/epoxy resin) on flexural properties of skin/stringer composite structure with different z-pin densities and diameters. Compared with unpinned specimens, the peak loading and energy absorption of z-pinned specimens are increased by 98% and 9 times, respectively. Parameterized research indicates that the optimal z-pin density is 1.35%. And thin z-pins are beneficial to improve the peak loading and energy absorption, which attributes to more total contact area of z-pins. The statistical results present that z-pin pre-hole inserted (ZPI) process can significantly reduce initial damages of z-pinned specimens compared with Ultrasonically Assisted Z-fiber (UAZ) process. Specifically, the z-pin inclination angle is decreased by 60%, and the initial damages in eye-like zone are prominently reduced. The z-pin makes the specimen exhibit the quasi-brittle behavior under flexural loading by playing a bridging role, which makes the flexural properties of specimens prominently increased. In addition, the “snubbing effect” will enhance the bridging effect of z-pins, but it will lead to inter-fibers debonding, splitting, and shear failure of z-pins.
The Patient Perspective of an Inpatient Addiction Medicine Unit Implemented in an Urban Northern Acute Care Hospital in Ontario, Canada
Authors: Morin Kristen A , Bodson Adele , Ghartey Karla , Patrick Krysten A , Knowlan Shannon , Marsh David C , Aubin Natalie , Leary Tara 
Published: September 2024

Background: An Addiction Medicine Unit (AMU) represents a promising approach to enhancing hospital care for individuals who use substances, but there is limited research to understand patients’ perspectives on AMUs. Therefore, the study objectives involved exploring patients’ experiences with the AMU. Methods: Qualitative semi-structured interviews were conducted with 17 patients to gather their perspectives about the AMU. The AMU offers specialized inpatient addiction support, integrating medical and psychosocial interventions while facilitating connections to community supports to stabilize patients and manage addiction-related issues using a harm reduction philosophy. Results: Factors identified by patients that lead to positive experiences with the AMU included: efficient access to high-quality acute medical care, specialized addiction care, and additional support for non-medical needs. Patients emphasized the benefits of having peer support workers on staff, the overall positive interactions with staff, and how different these experiences were from their hospital admissions outside of the AMU. Factors identified by patients that should be considered in an AMU included: the ease of access to substances, negative interactions with other patients, and self-stigma/internalized discrimination. Also, the patient perspective reflected varied views on harm reduction. Patients’ perception of the impact of an AMU overall reflected that the AMU is an effective way to deliver comprehensive treatment, to address the needs of PWUS, both medical and substance-use-related issues. They identified that the unit’s intentional harm reduction philosophy facilitated access to care and positive patient-staff interactions, emphasizing the unit’s progress in reducing fear and judgment and rebuilding trust in the healthcare system. Conclusion: The introduction of a new AMU in a Northern urban acute care hospital in Ontario has yielded positive patient experiences. The AMU model shows potential to re-establish trust between patients and providers, but ongoing efforts are needed to address underlying stigma to be more effective.
N-formylmethionine-leucyl-phenylalanine protects against irradiation-induced damage to hematopoiesis and intestines
Authors: Li Zhihua , Wu Yatong , Du Jicong , Qian Wen , Wang Sinian , Li Fengsheng , Dong Suhe , Jiao Shunchang 
Published: September 2024

Abstract
Background
Ionizing radiation (IR), including radiotherapy, can exert lasting harm on living organisms. While liposaccharide (LPS) offers resistance to radiation damage, it also induces toxic responses. Thankfully, an LPS analogue called N-formylmethionine-leucyl-phenylalanine (fMLP) holds the potential to mitigate this toxicity, offering hope for radiation protection.

Methods
Survival of C57BL/6 mice exposed to IR after administration with fMLP/LPS/WR-2721 or saline was recorded. Cell viability and apoptosis assay of bone marrow (BMC), spleen and small intestinal epithelial (HIECs) cells were tested by Cell Counting Kit-8 (CCK-8) and flow cytometry assay. Tissue damage was evaluated by Hematoxilin and Eosin (H&E), Ki-67, and TUNEL staining. RNA sequencing was performed to reveal potential mechanisms of fMLP-mediated radiation protection. Flow cytometry and western blot were performed to verify the radiation protection mechanism of fMLP on the cell cycle.

Results
The survival rates of C57BL/6 mice exposed to ionizing radiation after administering fMLP increased. fMLP demonstrated low toxicity in vitro and in vivo, maintaining cell viability and mitigating radiation-induced apoptosis. Moreover, it protected against tissue damage in the hematopoietic and intestinal system. RNA sequencing shed light on fMLP’s potential mechanism, suggesting its role in modulating innate immunity and cell cycling. This was evidenced by its ability to reverse radiation-induced G2/M phase arrests in HIECs.

Conclusion
fMLP serves as a promising radioprotective agent, preserving cells and radiosensitive tissues from IR. Through its influence on the cell cycle, particularly reversing radiation-induced arrest in G2/M phases, fMLP offers protection against IR’s detrimental effects.
Demographic and temporal trends in mental health and substance use services provided by primary care physicians in British Columbia, Canada
Authors: Jamieson Margaret , Juda Myriam , Lavergne M. Ruth , Kurdyak Paul , Laporte Audrey , Rudoler David 
Published: September 2024

Abstract
Background
As the demand for mental health and substance use (MHSU) services increases, there will be an even greater need for health human resources to deliver this care. This study investigates how family physicians’ (FP) contact volume, and more specifically, MHSU contact volume, is shaped by demographic trends among FPs in British Columbia, Canada.

Methods
We used annual physician-level administrative billing data and demographic information on FPs in British Columbia between 1996 and 2017. This study analyzes trends in primary care service provision among graduating cohorts of FPs, FPs of different ages (as measured by years since graduation), and FPs practicing during different time periods. Additionally, analyses are stratified by FP sex to account for potential differences in labour supply patterns between male and female FPs.

Results
Our results show that while FPs’ overall contacts with patients decreased between 1996 and 2017, their annual number of MHSU contacts increased, which was largely driven by an increase in substance use visits. Demographically, the proportion of female FPs in the labour force rose over time. Observed trends were similar, though not identical in male and female FPs, as males tended to have higher overall contact volume (both total contacts and MHSU), but also steeper declines in contact volume in later careers. The number of contacts (both total and MHSU) changed across career stage - rising steadily from start to mid-career, peaking at 20–30 years in practice, and decreasing steadily thereafter. This was evident for all cohorts and consistent over the 21-year study period but flattened in amplitude over time. Our findings also point to potential cohort effects on labour supply. The inverse U-shaped career trend extended to MHSU contacts, but its peak seems to have shifted to a later career stage (peaking at 30–40 years of practice) over time.

Conclusions
Our study shows changing dynamics in MHSU service delivery among FPs over time, across the life span and between FP sexes that are likely to influence access to care beyond simply the number of FPs. Given the healthcare needs of the population, these findings point to potential future changes in provision of MHSU services.
Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis
Authors: Awad Abdelaziz A. , Itumalla Ramaiah , Gaidhane Abhay M. , Khatib Mahalaqua Nazli , Ballal Suhas , Bansal Pooja , Srivastava Manish , Arora Isha , Kumar MRavi , Sinha Aashna , Pant Kumud , Serhan Hashem Abu , Shabil Muhammed 
Published: September 2024

Abstract
Background
The proliferation of electronic cigarettes (e-cigarettes) has presented new challenges in public health, particularly among adolescents and young adults. While marketed as safer than tobacco and as cessation aids, e-cigarettes have raised concerns about their long-term health and psychosocial impacts, including potential links to increased suicidal behaviors. This study aims to evaluate the relationship between e-cigarette use and suicidal behaviors by conducting a systematic review of the current literature.

Methods
We searched PubMed, Web of Science, and EMBASE for studies up to March 10, 2024, examining the relationship between e-cigarette use and suicidal behaviors. Eligible studies included cross-sectional, longitudinal, retrospective, prospective, and case–control designs. Meta-analysis was performed to calculate pooled odds ratios (ORs). Newcastle Ottawa scale was used to assess the quality of studies. R software (V 4.3) was used to perform the meta-analysis.

Results
Our analysis included fourteen studies, predominantly from the US and Korea, with participants ranging from 1,151 to 255,887. The meta-analysis identified a significant association between e-cigarette use and an increased risk of suicidal ideation (OR = 1.489, 95% CI: 1.357 to 1.621), suicide attempts (OR = 2.497, 95% CI: 1.999 to 3.996), and suicidal planning (OR = 2.310, 95% CI: 1.810 to 2.810). Heterogeneity was noted among the studies.

Conclusion
E-cigarette use is significantly associated with the risk of suicidal behaviors, particularly among adolescents. The findings underscore the necessity for caution in endorsing e-cigarettes as a safer smoking alternative and call for more extensive research to understand the underlying mechanisms. Public health strategies should be developed to address and mitigate the risks of suicidal behaviors among e-cigarette users.
Preferences for attributes of oral antipsychotic treatments: results from a discrete-choice experiment in respondents with schizophrenia or bipolar I disorder
Authors: Doane Michael J. , Boeri Marco , Vass Caroline , Bussberg Cooper , Panchmatia Hemangi R. , Citrome Leslie , Sajatovic Martha 
Published: September 2024

Abstract
Background
Antipsychotic medications are effective treatments for schizophrenia (SZ) and bipolar I disorder (BD-I), but when presented with different treatment options, there are tradeoffs that individuals make between clinical improvement and adverse effects. As new options become available, understanding the attributes of antipsychotic medications that are valued and the tradeoffs that individuals consider when choosing among them is important.

Methods
A discrete-choice experiment (DCE) was administered online to elicit preferences across 5 attributes of oral antipsychotics: treatment efficacy (i.e., improvement in symptom severity), weight gain over 6 months, sexual dysfunction, sedation, and akathisia. Eligible respondents were aged 18–64 years with a self-reported clinician diagnosis of SZ or BD-I.

Results
In total, 144 respondents with SZ and 152 with BD-I completed the DCE. Of those with SZ, 50% identified themselves as female and 69.4% as White, with a mean (SD) age of 41.0 (10.1) years. Of those with BD-I, most identified themselves as female (69.7%) and as White (77.6%), with a mean (SD) age of 40.0 (10.7) years. In both cohorts, respondents preferred oral antipsychotics with better efficacy, less weight gain, no sexual dysfunction or akathisia, and lower risk of sedation. Treatment efficacy was the most important attribute, with a conditional relative importance (CRI) of 31.4% for respondents with SZ and 31.0% for those with BD-I. Weight gain (CRI = 21.3% and 23.1%, respectively) and sexual dysfunction (CRI = 23.4% and 19.2%, respectively) were adverse effects in this study that respondents most wanted to avoid. Respondents with SZ were willing to accept 9.8 lb of weight gain or > 25% risk of sedation for symptom improvement; those with BD-I were willing to accept 8.5 lb of weight gain or a > 25% risk of sedation.

Conclusions
In this DCE, treatment efficacy was the most important attribute of oral antipsychotic medications among respondents with SZ and BD-I. Weight gain and sexual dysfunction were the adverse effects respondents most wanted to avoid; however, both cohorts were willing to accept some weight gain or sedation to obtain better efficacy. These results highlight features that patients value in antipsychotic medications and how they balance benefits and risks when choosing among treatments.