bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity Habits Among Physicians: Data From the Athens Medical Association
Authors: Lampsas Stamatios , Marinos Georgios , Lambrinos Dimitrios , Theofilis Panagiotis , Gialamas Ioannis , Pantelidis Panteleimon , Zakynthinos George E , Kalogera Vasiliki , Pililis Sotirios , Korakas Emmanouil , Lambadiari Vaia , Papavassiliou Kostas A. , Oikonomou Evangelos , Siasos Gerasimos 
Published: July 2024

Background: Physicians’ exercise habits vary across different medical specialties and health service infrastructure. We assessed physicians’ exercise performance according to the recommendations of the 2020 European Society of Cardiology Guidelines. Methods: This cross-sectional study comprised 742 physicians of the Athens Medical Association (AMA), Greece. Utilizing a self-administered questionnaire, physicians’ exercise habits, demographics, specialty, and infrastructure [Hellenic National Health care System (HNHS) or Private System (PS)] were assessed. Subjects were categorized: Moderate-intensity weekly exercise ≥150 min. (Group A); Moderate-intensity weekly exercise <150 min. (Group B). Results: 53.4% of AMA members met the recommended exercise criteria, averaging 240 ± 285 min./week. Significant differences were noted between Group A and B in male sex (58.3% vs 43.1%, P < 0.001), Body Mass Index (24.7 ± 3.8 kg/m2 vs 26.2 ± 4.7 kg/m2, P < 0.001), Smoking (17.4% vs 23.5%, P = 0.04), Diabetes Mellitus (6.6% vs 11.8%, P = 0.01), and activity monitoring wearables usage (45.2% vs 29.8%, P < 0.001). Significantly more doctors in the PS categorized in Group A ( P = 0.008). After adjustment for confounders, HNHS reported 33% decreased odds of achieving the exercise recommendations compared to PS (Odds Ratio: 0.676; 95% CI: 0.484-0.943, P = 0.03). Conclusion: Several factors affect adherence of AMA members to exercise goals. HNHS AMA doctors are less adherent to exercise recommendations, emphasizing the need to strengthen prevention strategies.
Pregnancy-related maternal mortality in the state of Georgia: Timing and causes of death
Authors: Kondracki Anthony J , Li Wei , Mokhtari Manouchehr , Muchandi Bhuvaneshwari , Ashby John A , Barkin Jennifer L 
Published: July 2024

Background: The maternal mortality rate in the United States is high and disparities among non-Hispanic White and non-Hispanic Black women remain. In the State of Georgia, the pregnancy-related death rate is among the worst in the nation. Objective: To examine current pregnancy-related deaths in the State of Georgia using measures of timing and cause-specific mortality across maternal sociodemographic characteristics. Design: This cross-sectional study of pregnancy-related deaths in Georgia was based on 2016–2019 maternal mortality data obtained from the Georgia Department of Public Health. Methods: Our study analysis involved complete-case data of maternal deaths identified as pregnancy-related deaths ( n = 129). Statistical analyses included two distinct population-level measures: (a) timing (i.e. during pregnancy, 0 to 60 days, 61 to 180 days, and 181 to 365 days postpartum) and (b) cause-specific deaths patterned by sociodemographic groups of women and by rural and urban county of residence. Categorical variables were compared using the Chi square or Fisher’s exact test and presented as numbers and percentages. A post hoc power analysis was conducted to inform whether there was sufficient power to detect statistically significant effects given available sample sizes. Results: Among a total of 129 pregnancy-related deaths, 30 (23.3%) deaths occurred during pregnancy and 63 (48.8%) deaths occurred within the first 60 days postpartum. Pregnancy-related deaths were disproportionally common among non-Hispanic Black, 25 to 34 years old, and poorly educated women. Three leading underlying causes, cardiomyopathy (22.7%), hemorrhage (21.6%), and cardiovascular or coronary disease (20.4%), accounted for about 65% of all pregnancy-related deaths. Mental health conditions were common causes of death among non-Hispanic White women during pregnancy and in late postpartum. Conclusion: Continued monitoring, collecting and analyzing reliable data will help identify root causes and find ways to eliminate the disproportionate burden of pregnancy-related deaths in the State of Georgia.
The association between the insurance provider and rates of surgical stabilization for the treatment of glenohumeral dislocation: A nationwide retrospective analysis
Authors: Alex Albright J , Barhouse Patrick S , Byrne Rory A , Jayachandran Nishant , Khatri Surya , Andra Keaton , Testa Edward J , Daniels Alan H , Owens Brett D 
Published: July 2024

Background Public insurance has recently been associated with a decreased likelihood of receiving surgery to address glenohumeral instability in several state-specific analyses. The purpose of this study is to expand this literature and analyze this association in a nationwide sample. Methods A national insurance claims database was used to identify shoulder dislocations between 2011 through 2019. Patients were stratified by insurance status (Medicaid or commercial) and age (5–24, 25–44, and 45–64 years). Billing codes were used to identify surgical stabilization and recurrent dislocations. Multivariable logistic regression was performed to compare the likelihood of surgical stabilization and recurrent instability. Results Of 292 672 patients, those with Medicaid were 48% less likely to receive surgery within 30 days, 32% less likely within 1 year, and 31% less likely within 2 years of their dislocation. When compared to those with commercial insurance, patients aged 45–64 years with Medicaid were the least likely to undergo surgery to address their shoulder instability (OR = 0.51, 95% CI, 0.40–0.65, p < 0.001). Conclusion Patients with Medicaid insurance are less likely to have their glenohumeral dislocation managed surgically, highlighting the limited healthcare access of patients with Medicaid insurance.
Clinical Predictors of Cisplatin Chemoradiation-Induced Ototoxicity in HPV-Positive Oropharyngeal Squamous Cell Carcinoma: A Case-Control Study
Authors: Lee John JW. , Alamleh Salahaldin , Zhan Luna Jia , Hueniken Katrina , Mahler Mary B. , Billfalk-Kelly Astrid , Davies Joel , Brown M. Catherine , Spreafico Anna , Huang Shao Hui , Hope Andrew , Xu Wei , Goldstein David P. , Liu Geoffrey 
Published: July 2024

Background Cisplatin-based chemoradiation is a standard treatment for many patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC), an etiologically distinct subset of head and neck cancer. Although associated with good long-term survival, clinical risk factors for ototoxicity have been understudied in this population. This study aimed to evaluate clinical predictors associated with ototoxicity in HPV-positive OPSCC patients treated with cisplatin chemoradiation. Methods This retrospective case-control study included 201 adult patients (>18 years) with histologically confirmed HPV-positive OPSCC who received cisplatin chemoradiation as their primary treatment from 2001 and 2019 at a single tertiary cancer center. Ototoxicity was determined using baseline and follow-up audiometry and the Common Terminology Criteria for Adverse Events v5.0 grading criteria (Grade ≥2). Multivariable logistic regression [adjusted odds ratio (aOR)] identified significant predictors that increased the odds of ototoxicity. Results A total of 201 patients [165 males; median (IQR) age, 57 (11) years] were included in the study. The incidence of ototoxicity in the worst ear was 56.2%, with the greatest hearing loss occurring at high frequencies (4-8 kHz), resulting in a loss of 12.5 dB at 4 to 6 kHz and 20 dB at 6 to 8 kHz. High-dose cisplatin administration compared to weekly administration [aOR 4.93 (95% CI: 1.84-14.99), P = .003], a higher mean cochlear radiation dose [aOR 1.58 (95% CI: 1.12-2.30), P = .01], smoking history [aOR 2.89 (95% CI: 1.51-5.63), P = .001], and a 10 year increase in age [aOR 2.07 (95% CI: 1.25-3.52), P = .006] were each independently associated with increased odds of ototoxicity. Conclusions Clinical predictors of ototoxicity in HPV-positive OPSCC patients treated with cisplatin-based chemoradiation include the use of a high-dose cisplatin regimen, higher cochlear radiation doses, a history of smoking, and older age. With the rising incidence of this malignancy in Western countries and overall improved survivorship, our research motivates future studies into risk stratification and earlier interventions to mitigate and reduce the risk of ototoxicity.
Effects of Etanercept on Experimental Osteoarthritis in Rats: Role of Histone Deacetylases
Authors: Wen Zhi-Hong , Tang Chi-Chieh , Lin Yen-You , Yao Zhi-Kang , Hsieh Shih-Peng , Gar-Hwa-Lai  , Chen Wu-Fu , Jean Yen-Hsuan 
Published: July 2024

Objective Mounting evidence suggests that histone deacetylases (HDAC) inhibitors reduce cartilage destruction in animal models of osteoarthritis (OA). Tumor necrosis factor (TNF)-α-blocking treatment for OA may provide effective joint protection by slowing joint damage. To investigate the effects of intraperitoneal administration of etanercept (a TNF-α inhibitor) on OA development in rats and changes in the nociceptive behavior of rats and expression of HDACs, RUNX2, and MMP13 in cartilage. Methods Induction of OA in Wistar rats was accomplished through anterior cruciate ligament transection (ACLT). One or five milligrams (mg) of etanercept was administered intraperitoneally for 5 consecutive weeks after ACLT to the ACLT + etanercept (1 and 5 mg/kg) groups. Nociceptive behavior and changes in knee joint width were analyzed. Cartilage was evaluated histologically and immunohistochemically. Results ACLT + etanercept significantly improved mechanical allodynia and weight-bearing distribution compared to ACLT alone. In OA rats treated with etanercept, cartilage degeneration and synovitis were significantly less pronounced than those in ACLT rats. OA-affected cartilage also showed reduced expression of HDAC 6, 7, RUNX-2, and MMP-13 in response to etanercept but increased expression of HDAC4. Conclusion Our study demonstrated that etanercept therapy (1) attenuated the development of OA and synovitis in rats, (2) reduced nociception, and (3) regulated chondrocyte metabolism, possibly by inhibiting cell HDAC6 and HDAC7, RUNX2, and MMP13 and increasing HDAC4 expression. Based on new evidence, etanercept may have therapeutic potential in OA.
Patient educational materials on non-steroidal anti-inflammatory drugs
Authors: Goh Bandy Qiuling , Lim Cynthia Ciwei , Kai Xuan Toh Sheila , Lee Puay Hoon , Tan Ngiap Chuan 
Published: July 2024

Introduction Effectiveness of Patient Education Materials (PEMs) on NSAIDs is subjected to whether the patient is able to read and comprehend the information provided. This study assessed the readability, understandability and actionability of English-language NSAID-related PEMs targeted at patients or caregivers in Singapore. Methods PEMs obtained from healthcare institutions in Singapore and from two frequently used internet search engines using search terms “NSAID” or “non-steroidal anti-inflammatory drug” were analysed by two reviewers using Flesch-Kincaid Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG) to assess the readability of the PEMs. Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and United Kingdom Association for Accessible Formats (UKAAF) was used to assess the PEMs’ understandability, actionability and physical properties. Results All 74 PEMs that were reviewed, except one, were assessed to be beyond readability of the general population which was defined as grade 6 and below. Their mean FKGL and SMOG scores were 13.3 ± 2.8 and 14.4 ± 2.1 respectively. There were no significant differences in the FKGL ( p = .20) and SMOG scores ( p = .52) between local and non-local PEMs. The PEMs satisfied majority of UKAAF’s requirements. The PEMs’ understandability and actionability scores were 80.5 ± 8.0% and 52.5 ± 19.0% respectively. Conclusions Current NSAIDs-related PEMs are pegged too high at a level for a significant portion of population in Singapore to read and comprehend the information for them to take appropriate actions to ensure safe use of NSAIDs to manage their medical conditions. However, they are generally well-designed to facilitate reading of the materials.
Patients’ perspectives on a programme to reduce emergency department use for low acuity conditions
Authors: Goh Wan Xi , Ong Rebecca Hui Shan , Rebello Salome Antonette , Goh Priscilla Sook Kheng , Ahmad Edris Atikah , How Choon How , Tiruchittampalam Mohan , Oh Hong Choon , Lim Steven Hoon Chin 
Published: July 2024

Background Emergency Department (ED) crowding is a global public health issue with low-acuity ED attendances (LAA) being widely identified as contributors to the issue. A primary care partnership programme, GPFirst, was developed to encourage low-acuity patients to visit their General Practitioners (GP) first, instead of the ED. We utilised a qualitative approach to gain an understanding of participants’ perceptions of GPFirst, their health-seeking behaviours, and explore recommendations for enhancing GPFirst. Methods A qualitative study design, underpinned by an interpretivist approach, was employed. Purposive sampling was used to recruit 12 GPFirst patients from a single tertiary care centre for semi-structured interviews. These interviews were analysed using Braun and Clarke’s reflexive thematic analysis. Results Participants’ age ranged from 25 to 63 years old. Four themes were identified. Firstly, “ perceptions of GPs”, described the variations in participants’ perceptions about GPs. Secondly, “patients’ expectations of GPFirst”, noted the ED fee subsidy and prioritisation of ED care as key expectations of GPFirst. Thirdly, “facilitators and barriers to utilising GPFirst” highlighted the facilitators and barriers that influenced participants’ health-seeking behaviours and finally “recommendations for programme improvement” offered strategies for improvements. Conclusion This is the first qualitative study to examine participants’ perceptions of GPFirst. Recommendations may inform future programme redesign to optimise patient experience and facilitate programme uptake, contributing to overall efforts to reduce ED crowding locally. Future research may consider exploring GPFirst providers’ perspectives to elicit facilitators and barriers in implementation.
Impact of High-Quality Higher Education on Public Good: Evidence From Corporate Philanthropy of Listed Companies in China
Authors: Zhou (周晓岚) Xiaolan , Wu (吴凯霖) Kailin 
Published: July 2024

Purpose The study uses the data of listed companies in China from 2012 to 2020 to investigate the impact of top managers’ high-quality university educational backgrounds and their native places on Chinese enterprises’ participation in public good. Design/Approach/Methods A linear regression method was used. Findings Higher education plays an important role in the promotion of public good. From the perspective of behavior and intensity, high-quality higher education highlights a unique role in the depth and intensity of corporate philanthropy. There is regional heterogeneity among top managers in promoting enterprises’ participation in public good: Top managers born in Midwest China are more likely to promote enterprises’ participation in public good. Originality/Value This study empirically tested the theoretical results of past domain-specific research, focusing on the impact of top managers’ background (education and place of origin) on the engagement of listed companies in public good. It proposes a set of innovative and comprehensive indicators to measure companies’ engagement in public good, and explores the influence of managers’ higher education quality on the firm's engagement in economic and educational causes, as well as the level of such engagement.
Examining China's “Double Reduction” Policy: Promises and Challenges for Balanced and Quality Development in Compulsory Education
Authors: Chen (陈丽翠) Licui , Lin (林双木) Shuangmu 
Published: July 2024

Purpose This study provides an overview of the “double reduction” policy promulgated in 2021, through which the Chinese government attempts to relieve the burden of excessive school homework and off-campus tutoring for students in compulsory education. Design/Approach/Methods This study draws on policy documents and relevant literature to interpret policy origins, core values, and major measures. The positive effects and challenges faced in implementing policies for the balanced and high-quality development of compulsory education were analyzed. Findings Students’ academic burden is deeply rooted in Chinese historical and sociocultural contexts. The “double reduction” policy shows the Chinese government's strong aspiration to promote holistic education for students and pursue the universal provision of balanced, high-quality school education. Despite some positive effects at the implementation level, challenges remain unaddressed. To achieve a policy vision, it calls for a deep reflection on the high-stakes examination system and collective efforts from stakeholders within or outside the education system. Originality/value This study helps elucidate the “double reduction” policy and compulsory education development in China.
Effects of Frailty Syndrome on Osteoporosis, Focusing on the Mediating Effect of Muscle Strength and Balance in Community-Dwelling Older Adults (≥60 years) in Iran: Results From the Amirkola Health and Aging Project Cohort Study
Authors: Shamsalinia Abbas , Hosseini Seyed Reza , Bijani Ali , Ghadimi Reza , Kordbageri Mohammad Reza , Saadati Kiyana , Ghaffari Fatemeh 
Published: July 2024

Introduction For older adults, maintaining muscle strength and balance is crucial to preserve an upright posture and independently manage their basic activities of daily living (ADL). This study aimed to examine whether muscle strength and balance mediate the relationship between frailty syndrome (FS) and osteoporosis in a large sample of community-dwelling older adults. Material and Methods This cross-sectional study is part of the second phase (2016-2017) of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. Data from 2018 older adults were collected by a trained person using bone mineral density (BMD), frailty index, activities of daily living (ADL), instrumental activities of daily living (IADL), handgrip strength (HGS), quadriceps muscle strength (QMS), Berg Balance Scale (BBS), and Timed Up and Go test (TUG test) and analyzed using analysis of variance, chi-square, and path analysis tests. Results The mean indices of femoral neck BMD and lumbar spine BMD, HGS, QMS, BBS, ADL, and IADL were lower in the frail older adults than in the pre-frail and non-frail older adults. In addition, the mean TUG test level was higher in the frail older adults than in the non-frail and pre-frail older adults. The results of the present study have indicated that frailty is significantly related to osteoporosis, and that balance and muscle strength can predict osteoporosis; these variables play a mediating role in the relationship between frailty and osteoporosis. Conclusion From the results of the present study, it can be concluded that frailty may increase the odds of osteoporosis. The results of the current study have indicated that balance (BBS and TUG test) and muscle strength (HGS and QMS) are associated with osteoporosis and these variables play a mediating role in the relationship between frailty and osteoporosis.
Transiliac-Transsacral Screw Fixation is Superior to Lumbopelvic Stabilization in the Treatment of Minimally Displaced Sacral H-/U-Type Fragility Fractures
Authors: Gewiess Jan , Roth Ysaline Emilie , Heini Paul , Benneker Lorin M. , Albers Christoph Emanuel 
Published: July 2024

Study Design Retrospective Cohort Study. Objectives To compare the outcomes and complications of transiliac-transsacral screw fixation (TIS) and lumbopelvic fixation (LPS), the 2 most common fixation methods for nondisplaced and minimally displaced H-/U- type sacral fragility fractures. Methods Medical records of patients treated with TIS or LPS for nondisplaced and minimally displaced H-/U-type sacral fragility fractures at 2 level A trauma centers between 2012 and 2022 were analyzed. Postoperative low back pain and mobility levels were assessed as primary outcomes before discharge and at 6 weeks and 6 months postoperatively. Surgery time, blood loss, and surgical complication rates were assessed as secondary outcomes. Statistical analyses consisted of Fisher’s exact tests for frequency distributions and Mann-Whitney-U tests and t-tests for group comparisons. Results 52 patients undergoing TIS (mean age: 78 ± 9 years) and 36 patients undergoing LPS (74 ± 10 years) with no discrepancy in demographic parameters were identified. There were no differences in low back pain levels between the 2 groups before surgery, before discharge, at 6 weeks postoperatively, and at 6 months postoperatively ( P > 0.05). There were no differences in mobility levels before surgery, before discharge, at 6 weeks postoperatively, and at 6 months postoperatively ( P > 0.05). Duration of surgery was shorter after TIS (36 ± 13 min) compared to LPS (113 ± 31 min) ( P < 0.0001). Intraoperative blood loss was lower for TIS (median <20 mL) compared to LPS (median 125 mL) ( P < 0.0001). Postoperative radiculopathy was less frequent after TIS (n = 1) compared to LPS (n = 3) ( P > 0.05). Median length of stay was shorter after TIS (11 days) compared to LPS (14 days) ( P < 0.05). Rates of reoperations directly related to the index surgery were lower after TIS (n = 2) compared to LPS (n = 10) ( P < 0.01). Implant failures were observed only after LPS (n = 1). Conclusion Patients with nondisplaced and minimally displaced H-/U- type sacral fragility fractures may preferably be treated using TIS, as it is equivalent to LPS in terms of low back pain reduction and restoration of mobility, but allows for shorter operative time, less blood loss and lower reoperation rates. Prospective randomized studies should be conducted to substantiate our findings and develop distinct treatment recommendations.