bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smartwatch measurement of blood oxygen saturation for predicting acute mountain sickness: Diagnostic accuracy and reliability
Authors: Zeng Zhengyang , Li Lili , Hu Li’ao , Wang Kang , Li Lun 
Published: September 2024

Objective This study aims to assess the accuracy and stability of smartwatches in predicting acute mountain sickness (AMS). Methods In locations exceeding an altitude of 2500 m, a cohort of 42 subjects had their Lake Louise AMS self-assessment score, blood oxygen saturation (SpO2), heart rate, and perfusion index measured using smartwatches, with the data seamlessly conveyed to the Huawei Cloud. Results A significant decrease in SpO2 was observed in individuals positive for AMS compared to those negative ( p < 0.05), with the mild AMS group exhibiting significantly lower SpO2 levels than the non-AMS group ( p < 0.05). Furthermore, SpO2 emerged as a significant, independent predictor of AMS [ β=−0.086, p < 0.01, OR (95% CI) = 0.92 (0.87–0.97)], indicating that each unit increase in SpO2 decreases the probability of AMS occurrence by 8.6%. Conclusion The Huawei smartwatches have demonstrated efficacy in diagnosing and foretelling AMS at elevations exceeding 4000 m, showcasing significant reliability and high precision in SpO2 measurement.
Physician Communication Behaviors on Patient Satisfaction in Primary Care Medical Settings in Bangladesh
Authors: Zakaria Muhammad , Mazumder Subarna , Faisal Hasan Mahmud , Zannat Rubaiya , Haque Md Rejaul , Afrin Tanjina , Cheng Feng , Xu Junfang 
Published: September 2024

Objectives: This study aims at exploring the effects of physicians’ communication behaviors on patients’ satisfaction in primary care medical consultations in Chattogram, Bangladesh. The study used a quantitative research approach designed with a cross-sectional survey. Methods: Data were collected using post-consultation and facilitator administered questionnaire from the patients who visited the physician for medical consultation in different hospitals and clinics in Chattogram city. Seven hundred patients were included as the study participants. A hierarchical linear regression analysis was performed to examine the factors contributing to the outcome variables. Results: A statistically significant difference ( P < .001) appeared regarding patients’ perception of adequate consultation, physicians’ nonverbal behavior, inhibiting behavior and patients’ participating behavior in private and public settings. However, R2 value shows that physicians’ patient-centered behaviors appeared as the stronger predictors of patient satisfaction toward medical interviews, followed by socioeconomic variables of patients and physicians and patients’ participation during the consultation. Presence of a third person with patients during consultation (β = −.05, P = .040), physicians’ private setting of consultation (β = .16, P < .001), physicians’ seniority (β = .05, P = .042), patients’ participating behavior during consultation (β = .20, P < .001), physicians’ nonverbal behavior (β = .10, P < .001), physicians’ inhibiting behavior (β = −.39, P < .001), and physicians’ facilitating behavior with patients (β = .32, P < .001) were reported as the influencing factors of patients’ satisfaction with medical consultation. Conclusion: This study suggests the profound impact of physicians’ patient-centered communication behaviors on patient satisfaction in primary care settings, overshadowing even socioeconomic factors and patient participation.
AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma
Authors: Scherer Julian , Joaquim Andrei , Vaccaro Alex , Kanna Rishi , El-Sharkawi Mohammad , Takahata Masahiko , Aly Mohamed M. , Camino-Willhuber Gaston , Spiegl Ulrich , Oner Cumhur , Canseco Jose A. , Yurac Ratko , Benneker Lorin Michael , Popescu Eugen Cezar , Bransford Richard , Chhabra Harvinder Singh , Kandziora Frank , Neva Marko H. , Schnake Klaus John 
Published: September 2024

Study Design Cross-sectional survey. Objectives Injury classifications are important tools to identify fracture patterns, guide treatment-decisions and aid to identify optimal treatment plans. The AO Spine-DGOU Osteoporotic Fracture (OF) classification system was developed, and the aim of this study was to assess the reliability of this new classification system. Methods 23 Members of the AO Spine Knowledge Forum Trauma participated in the validation process. Participants were asked to rate 33 cases according to the OF classification at 2 time points, 4 weeks apart (assessment 1 and 2). The kappa statistic (κ) was calculated to assess inter-observer reliability and intra-rater reproducibility. The gold master key for each case was determined by approval of at least 5 out of 7 members of the DGOU. Results A total of 1386 ratings (21 raters) were performed. The overall inter-rater agreement was moderate with a combined kappa statistic for the OF classification of 0.496 in assessment 1 and 0.482 in assessment 2. The combined percentage of correct ratings (compared to gold-standard) in assessment 1 was 71.4% and 67.4% in assessment 2. The average intra-rater reproducibility was substantial (κ = 0.74, median 0.76, range 0.55 to 1.00, SD 0.13) for the assessed fracture types. Conclusions The assessed overall inter-rater reliability was moderate and substantial in some instances. The average intra-rater reproducibility is substantial. It seems that appropriate training of the classification system can enhance inter- and intra-rater reliability.
Assessing the Impact of Psychological Readiness on Performance and Symmetry in Functional Testing After ACL Reconstruction in Pediatric and Adolescent Patients
Authors: Mercurio Angela M. , Scott Elizabeth J. , Sugimoto Dai , Christino Melissa A. , Coene Ryan P. , Gossman Emma C. , Cook Danielle L. , Kocher Mininder S. , Kramer Dennis E. , Yen Yi-Meng , Micheli Lyle J. , Milewski Matthew D. 
Published: September 2024

Background: Readiness for return to sports involves both physical and psychological aspects of recovery; however, the relationship between psychological and physical variables after anterior cruciate ligament (ACL) reconstruction (ACLR) is poorly understood. Hypothesis: ACLR patients with a higher psychological readiness would demonstrate better functional testing results at 6 months. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Participants were evaluated at 6 months after ACLR with various patient-reported outcome metrics: Hospital for Special Surgery Pediatric Functional Activity Brief Scale, pediatric or adult International Knee Documentation Committee Questionnaire (IKDC), Patient-Reported Outcomes Measurement Information System (PROMIS) - Psychological Stress Experience and ACL - Return to Sport After Injury (ACL-RSI) scale. Functional testing included quadriceps, hamstrings, and gluteal strength testing; Y-balance test; single-leg single hop, crossover hop, and triple hop tests; and timed 6-m hop test. Pearson correlation coefficient and multivariable regression were used to determine associations between the limb symmetry index (LSI) on functional testing and patient-reported outcomes. Those with LSI deficits <20% (better performance) were compared with those with deficits >20% (worse performance). Results: A total of 229 participants (89 male, 140 female) with a median age of 17 years (range, 10.3-30.6 years) were enrolled. IKDC had a moderate negative correlation with PROMIS - Psychological Stress Experience ( r = -0.39; 95% CI = -0.49, -0.27; P < .001) and a moderate positive correlation with ACL-RSI ( r = 0.55; 95% CI = 0.46, 0.64; P < .001). A total of 151 patients completed functional testing. ACL-RSI demonstrated a positive correlation with single-hop LSI ( r = 0.21; 95% CI = 0.05, 0.35; P = .01) and timed 6-m hop ( r = 0.28; 95% CI, 0.42; P = .001). When adjusting for sex, age, and graft type, patients who had <20% deficit on the single-hop test scored 16.6 points higher on ACL-RSI ( P = .001), and those with <20% deficit on crossover hop testing scored a mean 13.9 points higher on ACL-RSI ( P = .04) Conclusion: Higher psychological readiness for return to sport was associated with better performance and greater symmetry on hop testing 6 months after ACLR, suggesting a potential link between physical and psychological recovery.
Parental Attitudes and Hesitancy About COVID-19 Vaccination Versus Routine Childhood Vaccination in a Selected Hospital in the United Arab Emirates: A Cross-Sectional Study
Authors: Selvam Vijayalakshmi , Hanson Victoria Funmilayo , Pitre Sneha 
Published: September 2024

Background A complex interplay of social and political influences, cultural and religious beliefs, the availability and interpretation of health and scientific information, individual and population experiences with health systems, and government policies contributes to the anxiety about vaccines and their programs that results in vaccine hesitancy. Vaccine hesitancy is becoming a serious threat to vaccination programs; in 2019, the World Health Organization (WHO) listed it as one of the top ten global health threats. The negative impacts of antivaccination movements are blamed for the major portion of the global resistance to vaccination. Objective To evaluate and compare parental attitudes and reluctance regarding routine childhood vaccinations versus COVID-19 vaccines among children in the United Arab Emirates (UAE). Methods A study of 102 parents with children admitted to SAQR Hospital in Ras Al Khaimah, UAE, was conducted using a convenience sample approach in a descriptive cross-sectional study. One-on-one interviews were conducted to gather data using the standardized Vaccine Hesitancy Scale (VHS) questionnaire developed by the WHO. Statistical Package for Social Sciences version 25 was used for data analysis. Results Vaccine-hesitant respondents are also highly resistant to the required proof of vaccination. A statistically significant difference ( P = .000) was observed between parental reluctance to receive the COVID-19 vaccination and routine childhood vaccination. Parental knowledge of the COVID-19 vaccine hesitancy ( P = .001) and confidence ( P = .000) showed a statistically significant correlation. No significant correlation was observed with sociodemographic factors. Conclusion The impact of vaccine hesitancy on herd immunity, social, psychological, and public health strategies to combat vaccine hesitancy was observed in this study with various challenges to overcome in COVID-19 vaccination campaigns. Expanding access to and acceptance of vaccines among parents in low- and middle-income nations, as well as raising vaccination rates among those who express a lack of confidence in vaccines.
Knowledge, Attitudes, and Awareness of Food and Drug Interactions (FDI) Among Nurses on General Medical Wards: A Cross-Sectional Study
Authors: Elajez Reem , Alkhawaja Raja , Kehyayan Vahe , Shukaili Khadija AL , Swallmeh Esmat 
Published: September 2024

Background Food and nutritional supplements can interact with medication and cause drug interaction. Registered nurses play an essential role in patients’ safety related to drug interaction. Objective Explore nurses’ knowledge, attitudes, and awareness regarding food–drug interactions (FDIs). Method A cross-sectional survey was conducted among nurses working in the general medical wards at Hamad General Hospital (HGH) in Qatar. The survey questionnaire comprised 50 multiple-choice questions, encompassing three key sections: (a) demographic details, (b) assessment of FDIs knowledge, and (c) exploration of beliefs, attitudes, and practices concerning FDIs. Results A total of 227 surveys were collected. Nurses’ average score for FDI knowledge across all responses was 20 out of 34 (IQR 16–25). Notably, there were no statistically significant differences in average scores based on respondents’ demographic subgroups. While nurses displayed a high level of knowledge (over 90%) regarding the timing of food and drug intake for proton pump inhibitors, nonsteroidal anti-inflammatory drugs, and thyroid hormones, they exhibited limited awareness of the possible FDIs related to carvedilol and furosemide. Approximately half of the participating nurses (56.4%) rated their FDI knowledge as satisfactory. However, only 42.3% claimed to be always educating patients about FDIs in their daily practice. Two-thirds (67.4%) of respondents believed educating patients about FDIs should primarily fall under the responsibility of pharmacists. Conclusion This study highlights the nurses’ knowledge, attitudes, and beliefs of FDIs. Prompt intervention is required to enhance the nurse's awareness and knowledge in this domain which may impact patient care and drug safety.
Health Professionals’ Knowledge, Perceptions, and Attitudes Toward Baby-Led Weaning: Scoping Review
Authors: Sarreira–de-Oliveira P. , Fernandes S. , Ramalho R. , Loureiro F. 
Published: September 2024

Introduction Baby-led weaning (BLW) is a growing method for parents to introduce food to their kids. As advisers who affect the decisions of parents, health practitioners have significant obligations in this regard. Objective We aim to identify existing literature on the knowledge, perceptions, and attitudes of health professionals toward BLW. Methods We carried out a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. After registering with Open Science Framework, published articles were retrieved from EBSCOhost, PubMed, SciELO, ScienceDirect, Open Grey, and the Portuguese Scientific Open Access Repository. Primary studies with full-text availability in English, Spanish, or Portuguese, and no data publication limitations were included. Results The final sample included seven publications conducted in five countries published between 2012 and 2022. Only one study employed a hybrid methodology showing incongruent practices in parents/health professionals on BLW, whereas most studies employed a quantitative approach. Regarding BLW, it is recognized that there is a dearth of evidence, consensus, and advice. Conclusion Despite benefits, health professionals hesitate to recommend BLW due to insufficient study and safety concerns, warranting more research. Hence, our scoping review demonstrated that BLW is a scientifically under-researched subject, indicating a significant research gap that must be filled in the future.
Systemic sclerosis and acute heart failure in prosthetic heart valve patients: A retrospective analysis
Authors: Khattar Georges , Wei Chapman , Davis Alanna , Saliba Fares , Aoun Laurence , Mourad Omar , Achkar Michel Al , Rosenberg Angela , Grovu Radu , Bradu Stefan , El-Sayegh Suzanne , Mustafa Ahmad 
Published: September 2024

Background: Acute heart failure in patients with prosthetic heart valves is a complex problem with clinical and therapeutic challenges. Systemic sclerosis is a chronic autoimmune disease frequently associated with valvular abnormalities. The association between systemic sclerosis and acute heart failure in patients with prosthetic heart valves remains understudied. Methods: Prosthetic valve patients were extracted from the National Inpatient Sample Database. Baseline patient demographics, comorbidities, and known acute heart failure risk factors were collected from the database using International Classification of Diseases, 10th Revision codes. Patients were subsequently stratified by the diagnosis of systemic sclerosis. The primary outcome was acute heart failure. while secondary outcome included pulmonary outcomes. Univariate and multivariate logistic regression analyses were performed. 1:1 matching was performed to verify our findings. Results: Among 188,615 patients, 235 patients had systemic sclerosis. Systemic sclerosis patients had higher rates of acute heart failure relative to non-systemic sclerosis patients (28.5% vs 22.6%). On multivariate analysis, systemic sclerosis was associated with increased acute heart failure (adjusted OR: 1.38 (1.02–1.85), p = 0.036). After matching, systemic sclerosis was still associated with an increased incidence of acute heart failure (OR: 1.94 (1.25–3.03), p = 0.003). On subgroup analysis, patients with CREST syndrome did not show significantly increased acute heart failure (OR: 1.44 (0.84–2.47), p = 0.184). Patients with systemic sclerosis also showed a significantly higher rate of acute respiratory failure compared to non-systemic sclerosis patients (20.9% vs 13.7%, p = 0.001). Conclusion: Systemic sclerosis may increase the risk for acute heart failure in patients with prosthetic valves. Closer monitoring for heart failure symptoms should be considered in systemic sclerosis patients with prosthetic valves.
Emotional well-being in Charles Bonnet syndrome: exploring associations with negative affect, loneliness and quality of life
Authors: Higgins Bethany , Taylor Deanna , Crabb David , Callaghan Tamsin 
Published: September 2024

Background: Charles Bonnet syndrome (CBS) is a condition characterised by the occurrence of vivid and complex visual hallucinations in individuals with visual impairment. Objective: To explore the relationship between emotional distress and the perceived impact of CBS symptoms on participants’ lives. We tested the hypothesis that heightened negative affect was associated with a more negative appraisal of CBS symptoms, increased self-reported loneliness, and poorer quality of life (QOL). Design: Cross-sectional. Methods: Participants recruited predominantly via vision-related charities rated their hallucinations and their impact on a Likert scale. Loneliness and negative affect were assessed with the Three-Item Loneliness Scale and Positive and Negative Affect Schedule. Health index (EQ-5D-3L) and vision-related QOL (VF-9) were also assessed. Correlation analysis and multi-variable regression determined the relation between survey responses. Results: The majority of 126 respondents (81%) were aged 65+ years and 84% reported active CBS symptoms. Fifty-five percent of respondents rated impact of CBS as negative and no-one rated the impact as ‘very pleasant’. A statistically significant correlation was found between impact of CBS and negative affect ( p ⩽ 0.001; rho = −0.34) and impact of CBS and loneliness ( p = 0.017; rho = −0.21). The relation between negative affect and CBS impact remained statistically significant when accounting for the impact of loneliness and the relationship between loneliness and CBS effect ( p = 0.002, adj R2 = 0.1). A statistically significant correlation between loneliness and negative affect ( p ⩽ 0.001; rho = 0.55) was also found. Conclusion: Respondents experiencing negative emotions were more likely to perceive the impact of CBS symptoms as negative and report greater feelings of loneliness. Negative affect is an important consideration when assessing people with CBS.
Patient perspectives of a fall leading to emergency department visit during the COVID-19 pandemic: A qualitative study in Northern Ontario
Authors: Dorans Jeff , Webber Jodi , Myles Sophia , Chung Winyan , Aceti-Chlebus Victoria , Hopper Katriina 
Published: September 2024

Background and objectives Falls are a leading cause of injury-related emergency department (ED) visits and hospitalizations across Canada and can result in decline in function and quality of life for an older adult. The COVID-19 pandemic placed severe strain on EDs and hospitals across Canada. This study aimed to understand the experience of older adults who presented to the ED as a result of having a fall during a COVID-19 surge. This may help generate hypotheses and ideas about how to provide optimal care in the midst of pandemic-related healthcare system disruption. Methods A purposive sampling strategy identified nine participants over age 65 in a medium population centre in Northern Ontario, Canada. Qualitative semi-structured interviews sought information regarding patient demography and function prior to their fall, the circumstances and communication surrounding their fall, and information about their post-fall recovery. Qualitative thematic analysis of the data was completed. Results Three main themes were identified: patients minimized their fall risk; the challenge of interacting with the healthcare system in a time of limited resources; and complex care navigation and fragmentation within the healthcare system. Discussion Participants were uncertain about the significance of a fall. Post-fall care was directed by the participant, and little coordination or education was provided at the point of contact with the health care system. Participants were hesitant to present to the ED. Participants expressed vulnerability when reflecting on their experience and acknowledged the systemic pressures experienced by their healthcare workers during the COVID-19 pandemic.
Filling Asia’s Infrastructure Investment Gap: The Role of Mega Infrastructure Initiatives
Authors: Wignaraja Ganeshan , Gatti Marco 
Published: September 2024

This article uses the lens of key financial actors to analyse the daunting challenge of Asia’s long-term infrastructure development. It examines three issues: (a) the historic role of infrastructure in Asian economic development; (b) the contribution of mega infrastructure initiatives (MIIs) (e.g., China’s Belt and Road Initiative and Japan’s Partnership for Quality Infrastructure) to filling the region’s large infrastructure investment gap; and (c) the effectiveness of the Asian Development Bank (ADB). While underlining infrastructure investment as a key driver of Asia’s economic miracle and emerging regionalism, the article highlights the region’s large infrastructure investment gap. It shows that MIIs have only partially filled Asia’s large infrastructure investment gap and there is a risk of an Asian ‘noodle bowl’ of multiple overlapping initiatives, which may raise transactions costs for small regional economies. It suggests that ADB’s honest broker and financing roles have helped to bring parties together in regional projects, but ADB operations can be improved. It ends with policy implications. JEL Codes: O16, O19, G20, G23, H54