bluuebunny/crossref_metadata_2025_split huggingface dataset:
One stage anterior sagittal sphincter saving anorectoplasty (ASSSARP) for the repair or rectovestibular fistula: mid and long-term outcome in two tertiary centers
Authors: Elbatarny Akram M. , Shehata Sherif M. K. , Ashour Mohamed H.M. , Abo-Halawa Nezar A. 
Published: October 2024

Abstract
Purpose
This is a retrospective study of one-stage anterior sagittal sphincter saving anorectoplasty (ASSSARP) for repairing rectovestibular fistula (RVF) including operative details and postoperative complications, functional and cosmetic outcome.

Patients and methods
Records of 41 cases of RVF, managed between April 2010 and September 2019 by one-stage ASSSARP, were reviewed. Preoperative preparation, both early and late postoperative care & complications, hospital stay, and functional & cosmetic outcomes were reported.

Results
The mean age was 6.6 months. Vaginal tear occurred in 5/41 cases, and distal rectal tears in 4/41 cases. Thirteen patients suffered mild superficial wound inflammation; while Skin dehiscence; occurred in five patients. No colostomy or redo was needed. The mean hospital stay was 6.1 days. Mean follow-up was 43.13 months; (Range; 24–100 months). Subclinical anal stricture was detected in six patients. Constipation occurred in 14 cases. Soiling grade I occurred in five patients. Thirty-two patients reached past the age of three years; two of whom showed cough/diarrhea incontinence.

Conclusion
One-stage ASSSARP is safe and gives functional and cosmetic results comparable to other techniques. It provides better access during RVF repair. The avoidance of muscle incision protects against muscle breakdown, if infection sets in, and thus against incontinence. It avoids the morbidity, cost and psychological burden of performing a three-stage repair.
The role of mood in shaping reactions to smoking cessation messages among adults who smoke: a multimodal investigation
Authors: Stevens Elise M. , Lee Donghee N. , Stevens Hannah , Sadasivam Rajani S. 
Published: October 2024

Abstract
Introduction
Mood-tailored communications may help increase the effectiveness of smoking cessation messaging interventions. We used both self-report and psychophysiological measures to test the impact of mood on responses to cessation messages in adults who smoke.

Methods
In a two-part (crowdsourcing and psychophysiological studies) study, the impact of 30 smoking cessation messages comprised of five themes (i.e., financial, health, quality-of-life, challenges in quitting, motivation to quit) were tested. In a crowdsourcing study, participants (N = 600) were randomly placed into one of three mood induction tasks (i.e., positive, negative, neutral), and then viewed the smoking cessation messages. After each message, they were asked to self-report their motivation to quit, message receptivity, and the perceived relevance of the messages. In an in-lab, psychophysiological study, participants (N = 42) completed the same tasks as the crowdsourcing participants but were monitored for heart rate, skin conductance, and eye-tracking while viewing the cessation messages. Using a multi-attribute decision-making model (MADM) using outcomes from both studies, messages were ranked for each mood state.

Results
The top messages for participants in the positive mood condition included the challenges in quitting, financial costs/rewards, and motivations to quit themes. The top messages for participants assigned to the negative mood condition included the challenges in quitting, quality-of-life, and financial costs/rewards themes. For participants in the neutral mood condition, messages in the challenges in quitting and quality of life themes performed best.

Conclusions
Variations in the preferences of messages and themes by mood condition suggest that mood-tailored communication may increase the effectiveness of smoking cessation messages.
Micro-XCT analysis of anatomical features and dimensions of the incisive canal: implications for dental implant treatment in the anterior maxilla
Authors: Todorovic Vladimir S. , Beetge Mia-Michaela , Kleyn Judy , Hoffman Jakobus , van Zyl Andre W. 
Published: October 2024

Abstract
Background
This study used micro-focus X-ray Computed Tomography (micro-XCT) to examine the anatomical differences and dimensions of the maxillary incisive canal (MIC) in a South African population. The accurate imaging yielded dependable results that support earlier research and enhance anterior maxilla surgery planning. Furthermore, these anatomical features are compared between various racial and gender groupings in the study.

Methods
Using a micro-XCT scanner, 108 human cadaver skulls from the Pretoria Bone Collection were scanned and included in the study. Advanced volume rendering software was employed for measuring the MIC length, diameter, shape, and the buccal bone wall measurements in relation to the MIC.

Results
Significant anatomical variation in the size and shape of the MIC was identified in the population, with variations seen between racial and gender groups. The incisive foramen (ICO) mean diameter was 6.61 mm, and the MIC length varied from 4.96 to 20.10 mm. There were significant differences in the buccal alveolar bone height between different ethnic groups and gender. Regarding morphological patterns in coronal and sagittal views, single canals were more common in the black population while Y-shaped canals were more common in the white population. The study also introduced a new metric by measuring the mean distances between teeth #11 and #21 and the ICO (1.83 mm and 1.88 mm respectively).

Conclusions
The complex anatomical differences of the MIC in a South African population were clarified. Clinicians should be aware of tooth sockets in near proximity to the MIC and perform accurate preoperative assessment using sophisticated 3-D imaging and preferable guided implant placement in the anterior maxilla.
Determinants of nursing students’ satisfaction with blended learning
Authors: Hassan Eman Arafa , Mohamed Ahlam Mahmoud , Eltaib Fatma Abdou , Khaled Asmaa Mohammed Saad 
Published: October 2024

Abstract
Background
Blended learning, a pedagogical approach combining traditional classroom instruction with online components, has gained prominence in nursing education. While offering numerous benefits, student satisfaction with blended learning remains a critical concern. This study contributes to the existing literature by providing a comprehensive evaluation of the determinants influencing nursing students’ satisfaction with this innovative educational modality. By examining a wide range of factors, including sociodemographic characteristics, academic factors, and environmental influences, this research offers valuable insights for educators to optimize blended learning experiences in nursing education.

Methods
A descriptive cross-sectional research design was conducted. This study investigates the factors influencing nursing students’ satisfaction with blended learning at Alexandria University, Egypt, where blended learning programs have been integrated into the curriculum primarily through the Microsoft Teams platform. A convenient sample of 1266 nursing students from both bachelor and technical educational institutions participated in the study from September 2023 to the end of December 2023. Data were collected using an online survey containing two measurement tools: the Blended Learning Satisfaction Scale and the Environmental Facilitators and Barriers to Student Persistence in Online Courses scale. Statistical analyses, including descriptive statistics and backward multiple linear regression, were conducted to identify factors that are associated with the satisfaction of nursing students’ with blended learning.

Results
Findings indicate that factors such as age, gender, income, employment status, access to suitable internet sources, academic year, computer literacy, preferred learning method, and perceptions of environmental facilitators significantly influence satisfaction scores (all p < 0.001). The overall regression model, with an adjusted R² of 0.31, signifies that 31% of the variance in satisfaction scores is explained collectively by the previously mentioned variables (F = 21.21, p < 0.001).

Conclusion
Students’ sociodemographic variables, preference for blended learning, and perception of environmental facilitators such as encouragement to enroll in the course significantly influence nursing students’ satisfaction levels with blended learning. However, limitations in the current study such as self-report bias, convenient sampling, and cross-sectional design limit the generalizability and causal inferences of these findings.
International survey of people living with chronic conditions (PaRIS survey): effects of general practitioner non-participation on the representativeness of the Norwegian patient data
Authors: Bjertnaes Oyvind , Skudal Kjersti E. , van den Berg Michael J. , Porter Ian , Holmboe Olaf , Norman Rebecka M. , Iversen Hilde H. , Ellingsen-Dalskau Lina H. , Valderas Jose M. 
Published: October 2024

Abstract
Background
The International Survey of People living with Chronic Conditions (OECD-PaRIS survey), aims to systematically gather patient-reported experiences (PREMs) and - outcomes (PROMs) and potential predictors for these outcomes for persons with chronic conditions as well as information from professionals about health care provided. In such patient surveys, the advantages of a multilevel (nested) approach in which patients are sampled ‘within providers’ need to be balanced against the potential for bias if patient populations from participating GPs significantly differ from those of non-participating GPs. The objective was to assess the effects of general practitioner (GP) non-participation on the representativeness of the Norwegian patient data of the International Survey of People living with Chronic Conditions (OECD-PaRIS survey).

Methods
To test all aspects of the first main PaRIS survey, it was preceded by a field trial which this paper reports on the Norwegian part of. For the Norwegian part of the field trial in 2022, we randomly sampled and surveyed 75 GPs and 125 patients 45 years and older for each GP, regardless of whether their GP were also participating in the study. GPs were sampled from a national register that included all GPs. The surveys were primarily digital, but we sent postal questionnaires to non-digital patients and non-responding digital patients. We compared GP and patient characteristics as well as patient-reported experiences and outcomes according to GP participation status in bivariate analysis, supplemented with multiple linear regressions with PREMs/PROMs as dependent variables and participation status as independent adjusting for significant patient factors.

Results
17 of 75 sampled GPs participated (22.7%), of which 993 of 2,015 patients responded (49.3%). 3,347 of 7,080 patients of non-responding GPs answered (47.3%). Persons with chronic conditions from participating GPs reported significantly better patient-centred coordinated care (p = 0.017), overall experiences with the GP office the last 12 months (p = 0.004), mental well-being (p = 0.039) and mental health (p = 0.013) than patients from non-participating GPs. The raw differences between participating and non-participating GPs on patient-reported experiences and – outcomes varied from 1.5 to 2.9 points on a 0-100 scale, and from 2.2 to 3.0 after adjustment for case-mix.

Conclusions
The Norwegian field trial indicates that estimates based on participants in the PaRIS survey may modestly overestimate patient-reported experiences and -outcomes at the aggregated level and the need for more research within and across countries to identify and address this potential bias.
Altered RBC deformability in diabetes: clinical characteristics and RBC pathophysiology
Authors: Ebenuwa Ifechukwude , Violet Pierre-Christian , Tu Hongbin , Lee Casey , Munyan Nicholas , Wang Yu , Niyyati Mahtab , Patra Kartick , Wilkins Kenneth J. , Parrow Nermi , Levine Mark 
Published: October 2024

Abstract
Background
Reduced red blood cell deformability (RBCD) is associated with diabetic vascular complications, but early pathophysiological RBC changes and predictive demographic and clinical factors in populations with diabetes are unclear. An understanding of early diabetes-specific RBC changes associated with impaired RBCD is essential in investigating mechanisms that predispose to diabetic vascular complications.

Methods
We conducted an outpatient cross-sectional study of participants in a well-controlled diabetes cohort (N81) and nondiabetic controls (N78) at the National Institutes of Health. First, between-group differences in RBCD measures were assessed with shear stress-gradient ektacytometry. Differences in structural RBC parameters were assessed using osmotic gradient ektacytometry and NaCl osmotic fragility. Functional RBC changes were assessed using hemoglobin-oxygen dissociation: p50.

Results
All shear-stress gradient RBCD measures were significantly altered in the diabetes cohort vs. nondiabetic controls, even after adjustment for confounding covariates (p < 0.001). Adjusted for diabetes-status and demographic factors, significant predictors of reduced RBCD included older age, Black race, male gender, hyperglycemia, and vascular complications (all p < 0.05). Reduced RBCD was also associated with aberrant osmotic-gradient parameters, with a left-shift on osmotic gradient profile indicative of dehydrated RBCs in diabetes. A structure-function relationship was observed with reduced RBCD associated with reduced osmotic fragility (P < 0.001) and increased hemoglobin-oxygen dissociation (P < 0.01).

Conclusions
Findings suggest impaired RBCD incurs similar demographic and clinical risk factors as diabetic vascular disease, with early pathophysiological RBC changes indicative of disordered RBC hydration in diabetes. Findings provide strong evidence for disordered oxygen release as a functional consequence of reduced RBCD.
Clinical trial number: NCT00071526.
Impact of physical activity levels on the association between air pollution exposures and glycemic indicators in older individuals
Authors: Park Hyunji , Kim Sun Young , Jang Heeseon , Ha Yae Won , Yun Young Mi , Kim Kwang Joon , Rhee Yumie , Kim Hyeon Chang , Kim Chang Oh , Cho Jaelim 
Published: October 2024

Abstract
Background
Air pollution may exacerbate diabetes-related indicators; however, the longitudinal associations between air pollutant concentrations and glycemic markers remain unclear. In this prospective cohort study, we examined the longitudinal associations between air pollution and glycemic indicators among older individuals with normoglycemia at baseline and determined whether these associations differed according to changes in physical activity levels.

Methods
Overall, 1,856 participants (mean age, 70.9 years) underwent baseline and 4-year follow-up surveys. We used linear mixed-effect models to examine the associations between previous 1-year exposures to air pollutants and glycemic indicators. We further investigated associations between previous 5-year exposures to air pollutants and glycemic indicators after the inverse probability of treatment weighting (IPTW). We explored effect modifications by the level of physical activity maintenance and changes in metabolic equivalent of task (METs) for physical activity.

Results
Levels of particulate matter with aerodynamic diameters ≤ 10 μm (PM10) and ≤ 2.5 μm, and nitrogen dioxide (NO2) were significantly associated with increased fasting blood glucose, Hemoglobin A1c, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) values. After IPTW, the associations remained significant for PM10 and NO2. The positive associations of NO2 with insulin and HOMA-IR remained significant in the maintained inactive group, but not in the maintained moderate-to-vigorous active group. The positive associations of PM10 or NO2 with insulin and HOMA-IR remained significant in the group with increased METs, but not in those with decreased METs. In the post-hoc analysis of non-linear relationships between an increase in METs and glycemic indicators, insulin and HOMA-IR remarkably increased in the higher PM10 and NO2 exposure group from the point of 12,000 and 13,500 METs-min/week increase, respectively.

Conclusions
We demonstrated longitudinal associations between air pollution exposures and increased insulin resistance in older individuals. Maintaining moderate-to-vigorous physical activity may mitigate the adverse effects of air pollution on insulin resistance. In older individuals dwelling in highly polluted areas, an increase of less than 12,000 METs-min/week may be beneficial for insulin resistance.
Patterns of care contacts in the final year of life among opioid overdose fatalities in southern Sweden: a latent class analysis
Authors: Johnson Björn , Andersson Lisa , Jacobsson Helene , Khoshnood Ardavan M. 
Published: October 2024

Abstract
Background
Understanding the heterogeneity of opioid overdose fatalities is critical to developing effective preventive interventions. This study examines patterns of care contacts among people who subsequently died from opioid overdose. The aim was to identify distinct groups of deceased individuals, based on their contacts with different care agencies in their last year of life.

Methods
A retrospective registry study was conducted in Skåne, Southern Sweden. All recorded opioid overdose fatalities during the study period were included, n = 191. Latent class analysis was used to identify patterns of care contacts in the last year of life.

Results
Three distinct classes were identified: “Few care contacts,” with limited interaction with any services; “Social service contacts,” comprising individuals who predominantly had contacts with the social services and, to a lesser extent, with prison and probation services; and “Numerous care contacts,” with extensive contacts with both healthcare and social services. The “few care contacts” class comprises about half of the population. This is an important finding, since this group has not been clearly visible in previous research. The analysis indicates significant gaps in service provision, particularly regarding substance use treatment and mental health support.

Conclusions
Using a person-centred approach, this article offers a novel way of analysing care contacts among people who subsequently died from opioid overdose. The identification of distinct groups, particularly a large group of people with minimal contact with the community care system, highlights the need for more targeted outreach and support work. Developing targeted interventions in emergency and inpatient care settings may provide an opportunity to reach the group with few care contacts.
Beneficiaries’ satisfaction with community-based health insurance services and associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Bayked Ewunetie Mekashaw , Toleha Husien Nurahmed , Zewdie Segenet , Mekonen Asnakew Molla , Workneh Birhanu Demeke , Kahissay Mesfin Haile 
Published: October 2024

Abstract
Background
The viability of community-based health insurance programs depends on beneficiary satisfaction, and healthcare systems evaluate performance through patient reports and ratings to ensure effectiveness and service quality. To our knowledge, Ethiopia lacks national pooled data on the satisfaction of community-based health insurance beneficiaries and related factors. As a result, this review aimed to evaluate the level of beneficiaries’ satisfaction with the scheme’s services and associated factors in Ethiopia.

Methods
Database searches on Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar were conducted on September 1st, 2022. Thirteen studies were chosen for review from the search results. Checklists from the Joan Briggs Institute were used to evaluate the risk of bias for the included studies. The data were extracted using a 2019 Microsoft Excel spreadsheet and analyzed using Stata 17. The odds ratios at p-values less than 0.05 with a 95% confidence interval were used to evaluate the effect estimates.

Results
The pooled satisfaction of beneficiaries with community-based health insurance was found to be 66.0% (95% CI = 57-76%) and was found to be influenced by socio-demographic, health service-related, the scheme’s related factors, and the beneficiaries’ knowledge of it. The beneficiary satisfaction levels were highest in the Amhara region, at 69.0% (95% CI = 59-79%), followed by Southern Nations Nationalities and Peoples' Region (SNNPR) at 67.0% (95% CI = 40-94%), Oromia at 63.0% (95% CI = 58-68%), and Addis Ababa at 53.0% (95% CI = 45-62%).

Conclusion
Even though there was a moderate level of satisfaction, there are indications that the quality of health services and the coverage of the entire population lag behind, necessitating greater efforts to achieve universal health coverage.
An estimation of global genetic prevalence of PLA2G6-associated neurodegeneration
Authors: Kurtovic-Kozaric Amina , Singer-Berk Moriel , Wood Jordan , Evangelista Emily , Panwala Leena , Hope Amanda , Heinrich Stefanie M. , Baxter Samantha , Kiel Mark J. 
Published: October 2024

Abstract
Background
PLA2G6-associated neurodegeneration (PLAN) comprises three diseases with overlapping features: infantile neuroaxonal dystrophy (INAD), atypical neuroaxonal dystrophy (atypical NAD), and PLA2G6-related dystonia-parkinsonism. INAD is an early onset disease characterized by progressive loss of vision, muscular control, and mental skills. The prevalence of PLA2G6-associated diseases has not been previously calculated.

Methods
To provide the most accurate prevalence estimate, we utilized two independent approaches: database-based approach which included collecting variants from ClinVar, Human Gene Mutation Database (HGMD) and high confidence predicted loss-of-function (pLoF) from gnomAD (Rare Genomes Project Genetic Prevalence Estimator; GeniE), and literature-based approach which gathered variants through Mastermind Genomic Search Engine (Genomenon, Inc). Genetic prevalence of PLAN was calculated based on allele frequencies from gnomAD, assuming Hardy–Weinberg equilibrium.

Results
In the PLA2G6 gene, our analysis found 122 pathogenic, 82 VUS, and 15 variants with conflicting interpretations (pathogenic vs VUS) between two approaches. Allele frequency was available for 58 pathogenic, 42 VUS, and 15 conflicting variants in gnomAD database. If pathogenic and/or conflicting variants are included, the overall genetic prevalence was estimated to be between 1 in 987,267 to 1 in 1,570,079 pregnancies, with the highest genetic prevalence in African/African-American (1 in 421,960 to 1 in 365,197) and East-Asian (1 in 683,978 to 1 in 190,771) populations.

Conclusion
Our estimates highlight the significant underdiagnosis of PLA2G6-associated neurodegeneration and underscores the need for increased awareness and diagnostic efforts. Furthermore, our study revealed a higher carrier frequency of PLA2G6 variants in African and Asian populations, stressing the importance of expanded genetic sequencing in non-European populations to ensure accurate and comprehensive diagnosis. Future research should focus on confirming our findings and implementing expanded sequencing strategies to facilitate maximal and accurate diagnosis, particularly in non-European populations.