bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of perinatal anxiety assessment measures: a cognitive interview study
Authors: Meades Rose , Sinesi Andrea , Williams Louise R. , Delicate Amy , Cheyne Helen , Maxwell Margaret , Alderdice Fiona , Jomeen Julie , Shakespeare Judy , Yuill Cassandra , Ayers Susan , Best Catherine , Hann Agnes , Salmon Debra , Uddin Nazihah , Walker James , Gilbody Simon ,   the MAP Study Team
Published: July 2024

Abstract
Background
Anxiety in pregnancy and postpartum is highly prevalent but under-recognised. To identify perinatal anxiety, assessment tools must be acceptable, relevant, and easy to use for women in the perinatal period.

Methods
To determine the acceptability and ease of use of anxiety measures to pregnant or postpartum women (n = 41) we examined five versions of four measures: the Generalised Anxiety Disorder scale (GAD) 2-item and 7-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS). Cognitive interviews were used to examine ease of comprehension, judgement, retrieval and responding.

Results
All measures were acceptable. Some items were deemed less relevant to the perinatal period e.g., difficulties sleeping. Ease of comprehension, judgement, retrieval and responding varied, with all measures having strengths and weaknesses. The SAAS and CORE-10 had the lowest mean number of problematic components. The GAD had the highest mean number of problematic components​. Non-binary response options were preferred. Preferences for time frames (e.g. one week, one month) varied. Qualitative data provides in-depth information on responses to each measure.

Conclusions
Findings can be used to inform clinical guidelines and research on acceptable anxiety assessment in pregnancy and after birth.
Non-genetic factors and breast cancer: an umbrella review of meta-analyses
Authors: Yiallourou Anneza , Pantavou Katerina , Markozannes Georgios , Pilavas Antonis , Georgiou Andrea , Hadjikou Andria , Economou Mary , Christodoulou Neophytos , Letsos Konstantinos , Khattab Elina , Kossyva Chrystalleni , Constantinou Maria , Theodoridou Melanie , Piovani Daniele , Tsilidis Konstantinos Κ. , Bonovas Stefanos , Nikolopoulos Georgios K. 
Published: July 2024

Abstract
Background
Previous research has found associations between various non-genetic factors and breast cancer (BrCa) risk. This study summarises and appraises the credibility of the available evidence on the association between non-genetic factors and BrCa risk.

Methods
We conducted an umbrella review of meta-analyses. Medline, Scopus, and the Cochrane databases were systematically searched for meta-analyses examining non-genetic factors and BrCa incidence or mortality. The strength of the evidence was graded in four categories (i.e., weak, suggestive, highly suggestive, convincing).

Results
A total of 781 meta-analyses from 280 publications were evaluated and graded. We included exposures related to anthropometric measurements, biomarkers, breast characteristics and diseases, diet and supplements, environment, exogenous hormones, lifestyle and social factors, medical history, medication, reproductive history, and pregnancy. The largest number of examined associations was found for the category of diet and supplements and for exposures such as aspirin use and active smoking. The statistically significant (P-value < 0.05) meta-analyses were 382 (49%), of which 204 (53.4%) reported factors associated with increased BrCa risk. Most of the statistically significant evidence (n = 224, 58.6%) was graded as weak. Convincing harmful associations with heightened BrCa risk were found for increased body mass index (BMI), BMI and weight gain in postmenopausal women, oral contraceptive use in premenopausal women, increased androstenedione, estradiol, estrone, and testosterone concentrations, high Breast Imaging Reporting and Data System (BIRADS) classification, and increased breast density. Convincing protective factors associated with lower BrCa risk included high fiber intake and high sex hormone binding globulin (SHBG) levels while highly suggestive protective factors included high 25 hydroxy vitamin D [25(OH)D] levels, adherence to healthy lifestyle, and moderate-vigorous physical activity.

Conclusions
Our findings suggest some highly modifiable factors that protect from BrCa. Interestingly, while diet was the most studied exposure category, the related associations failed to reach higher levels of evidence, indicating the methodological limitations in the field. To improve the validity of these associations, future research should utilise more robust study designs and better exposure assessment techniques. Overall, our study provides knowledge that supports the development of evidence-based BrCa prevention recommendations and guidance, both at an individual level and for public health initiatives.

Trial registration
PROSPERO CRD42022370675.
Clinical characteristics and outcome of critically ill children referred to a tertiary hospital in Indonesia: a prospective observational study
Authors: Rusmawatiningtyas Desy , Oktaria Vicka , Pudjiadi Antonius H , Makrufardi Firdian , Woensel Job. B.M. van 
Published: July 2024

Abstract
Background
The clinical characteristics of pediatric critically ill patients who need referral to a tertiary hospital is often unknown in resource limited settings where constraints in diagnosis capacity, resources, and infrastructures are common. There is a need to increase insight in the characteristics of these patients for capacity building strengthening and appropriate resource allocation. The aim of this study was to describe the clinical characteristics and outcomes of critically ill children who are referred to a tertiary referral teaching hospital in Yogyakarta.

Methods
A prospective observasional study was carried out from July 1st, 2022 -January 31st, 2023 which included all critically ill pediatric patients who were referred through the Integrated Referral System (SISRUTE) to the Pediatric Intensive Care Unit (PICU) of dr. Sardjito hospital. We excluded patients who were referred with a request for admission to the PICU, but were not admitted to the PICU due to their stable condition and lack of the need for intensive care.

Result
During the study period, we received 1046 emergency referral requests for pediatric patients via SISRUTE, of those, 562 (53.7%) patients were critically ill. The reasons of PICU referral request were the need of solely intensive care 504 (89.7%), the need of multidisciplinary team care, including intensive care 57 (10.1%) and parents request 1 (0.3%). The pre-referral emergency diagnosis was shock 226 (40.3%), respiratory distress/failure 151 (26.7%), central nervous system (CNS) dysfunction 135 (24.1%), trauma 33 (5.9%) and sepsis 17 (3%). Of the 562 critically ill PICU referral requests, 473 (84.2%) requests were accepted. One hundred and eighty-one (58.7%) patients were finally admitted to the PICU, 125 (40.3%) admitted to our regular ward due to stable condition, 4 (1.3%) patients died in Emergency Departement (ED). The remaining accepted patients on request did not arrive in our facility due to various reasons. The mean (SD) response time was 9.1 (27.6) minutes. The mean (SD) transfer time was 6.45 (4.73) hours. Mean (SD) PICU and hospital length of stay was 6.7 (8.3) days and 10.2 (9.2) days respectively. PICU and hospital mortality was 24.3% and 29.7%, respectively.

Conclusion
The mortality rate for critically ill pediatric patients referred to a tertiary PICU still high, with shock being the most common pre-referral emergency diagnosis. There is a discrepancy between the referring hospital’s and the referral hospital’s indication for PICU admission. The time required to reach the referral hospital is quite lengthy.
Exploring anesthesiology nurse’ presenteeism in China: cross-sectional study
Authors: Jianlan Ren , Mei Yuan , Chunyan Yang , Rendie Xie , Yiping Bai , Li Liu 
Published: July 2024

Abstract
Background
The department of anesthesiology is the main battlefield for the treatment of acute and critical patients, with high work risk and high work pressure. Due to the particularity of the working environment and nature of work, medical staff have become a group with a high incidence of occupational exhaustion and presenteeism.

Objective
To investigate the current status of presenteeism among anesthesiology nurses in China and to analyze the related influencing factors.

Methods
Three hundred twelve anesthesiology nurses in Sichuan Province were surveyed by means of general data questionnaire, presenteeism scale, work-family conflict scale, perceived social support scale, occupational commitment scale and stress resistance scale from September to November 2023 by convenience sampling method.

Results
The total score of presenteeism was (14.67 ± 3.92), the score of work-family conflict was (45.44 ± 15.90), the score of professional commitment was (87.28 ± 14.30), and the score of perceived social support was (66.04 ± 12.78). The evaluation score of stress resistance was (73.35 ± 11.54). The results of multivariate analysis showed that age, education, mode of employment, position, overtime hours per week, work-family conflict, perceived social support and stress resistance were the factors that affected the presenteeism of anesthesiology nurses, which could explain 44.1% of the total variation. The position ( β = 0.296, P < 0.001), overtime hours per week (h) ( β = 0.271, P < 0.001), perceived social support ( β = -0.279, P < 0.001) turned out as the stronger predictors of presenteeism.

Conclusion
The presenteeism of anesthesiology nurses is at a high level and needs to be further improved. Clinical nursing managers should pay attention to the physical and mental health and special needs of anesthesiology nurses. Interventions are made according to the main influencing factors, so as to reduce the incidence of presenteeism and improve the quality and safety of surgery.
Development of a novel percutaneous digital flexible nephroscope: its use and application
Authors: Luo Hongbo , Yuan Yuan , Shi Haibo , Hu Chuanqing , Hu Xun , Luo Linlin , Wang Cong , Luo Pengcheng , Wang Lei 
Published: July 2024

Abstract
Background
Renal calculi are one of the most frequent diseases in urology, and percutaneous nephrolithotomy (PCNL) being the gold standard for treating renal calculi larger than 2 cm. However, traditional rigid nephroscope cannot bend, presents significant limitations during PCNL. This study aims to develop a novel digital flexible nephroscope for PCNL and verify its safety and efficacy using 3D printed models and ex vivo porcine kidney models, providing new equipment for PCNL.

Methods
Based on the determined technical parameters, the novel digital flexible nephroscope was manufactured. First, 3D-printed model and ex vivo porcine kidney models were utilized to simulate the PCNL procedures. Then, the traditional rigid nephroscope and the novel digital flexible nephroscope were utilized to simulate the PCNL procedures on 10 ex vivo porcine kidneys for comparison. We observed and recorded the renal calyces visualized and accessed by both the traditional rigid nephroscope and the novel digital flexible nephroscope.

Results
In both the 3D printing and ex vivo porcine kidney models, the novel percutaneous digital flexible nephroscope smoothly entered the renal collecting system through the percutaneous renal tract. It freely changed angles to reach most target calyces, demonstrating significant advantages over the traditional rigid nephroscope.

Conclusion
The successful development of the novel percutaneous digital flexible nephroscope allows it to be used either independently or as an adjunct in complex stone cases, providing more effective and safer surgical equipment for percutaneous nephrolithotomy.
Rare presentation of maxillary osteonecrosis and tooth exfoliation induced by herpes zoster infection in a 29-year-old Chinese male: a case report and literature review
Authors: Sun Jian , Zhao ZhenPeng , He Jianfeng 
Published: July 2024

Abstract
Background
We present a case of a 29-year-old male patient without immunodeficiency who suffered from rapid osteonecrosis and tooth exfoliation resulting from herpes zoster (HZ) infection in the left maxillary branch of the trigeminal nerve. Various complications associated with shingles infections have been reported, cases of osteonecrosis and tooth exfoliation due to HZ infection among young people without immunodeficiency are rare. In this case, we focus on the particular manifestation of HZ infection.

Case presentation
The patient presented with clusters of erythema and papules, along with non-hemorrhagic blisters on the left face and the loss of the left upper incisor. All lesions were localized to the left side of the face without exceeding the midline. After receiving antibacterial and antiviral treatment, successful control over the infection was achieved; however, he experienced the loss of all upper teeth on the left side except for the first and second upper left molars.

Conclusion
This case highlights that rapid osteonecrosis and tooth exfoliation may occur among young individuals without immunodeficiency after HZ infection. HZ infection of the face should be taken very seriously to obtain prompt treatment to prevent the rare complications of bone necrosis and tooth loss as much as possible.
Challenges and solutions of medical residency: the example of Iran
Authors: Rahimi Behrooz , Nemati Ali , Tadayon Behzad , Samadpour Mahmood , Biglarkhani Amin 
Published: July 2024

Abstract
Background
Medical residency constitutes a highly demanding and taxing phase in the professional journey of physicians. Factors such as low income, excessive workloads, and uncertainty regarding their career trajectory can contribute to diminished job satisfaction among residents. Neglecting this issue can have enduring negative effects on the quality and quantity of healthcare services provided. This research aims to explore the challenges encountered during medical residency and propose viable solutions.

Methods
In this qualitative study conducted in 2023, interviews were employed to identify challenges, facilitators, barriers, and potential solutions associated with transitioning from residency to a job. In the qualitative section, a purposive selection process led to the inclusion of 26 interviewees, and for the Delphi method, 17 experts were purposefully chosen at three hierarchical levels: macro (Ministry of Health), intermediate (university), and executive (hospital). Qualitative data underwent analysis using a conceptual framework, while Delphi data were subjected to quantitative analysis.

Results
The qualitative analysis revealed five general themes with 13 main categories and 70 sub-categories as challenges, two general themes as facilitators, and barriers to the transition from residency to a job. Additionally, eight main categories with 52 interventions were identified as solutions to overcome these barriers. In the Delphi stage, the number of proposed solutions was streamlined to 44 interventions. The most significant challenges identified in this study included high workload during residency, low income, career-related uncertainties, issues related to welfare services, and challenges in education and communication.

Conclusion
The decline in residents’ willingness, coupled with the substantial work and financial pressures they face, poses a serious threat to the healthcare system, necessitating significant reforms. Transitioning from residency to a full-fledged job emerges as a potential avenue to address a substantial portion of the expressed needs. Implementing these reforms demands resolute determination and collaboration with sectors beyond the healthcare system, integrated into a comprehensive national healthcare plan that considers the country’s capabilities.
A glaucoma micro-stent with diverging channel and stepped shaft structure based on microfluidic template processing technology
Authors: Wang Chen , Wang Fule , Liao Yunru , Zuo Chengguo , Lin Mingkai , Wang Kemin , Ren Dongni , Zhang Hongbo , Yin Ruixue 
Published: July 2024

Abstract
Background
Minimally invasive glaucoma surgery (MIGS) has experienced a surge in popularity in recent years. Glaucoma micro-stents serve as the foundation for these minimally invasive procedures. Nevertheless, the utilization of these stents still presents certain short-term and long-term complications. This study aims to elucidate the creation of a novel drainage stent implant featuring a diverging channel, produced through microfluidic template processing technology. Additionally, an analysis of the mechanical properties, biocompatibility, and feasibility of implantation is conducted.

Results
The stress concentration value of the proposed stent is significantly lower, approximately two to three times smaller, compared to the currently available commercial XEN gel stent. This indicates a stronger resistance to bending in theory. Theoretical calculations further reveal that the initial drainage efficiency of the gradient diverging drainage stent is approximately 5.76 times higher than that of XEN stents. Notably, in vivo experiments conducted at the third month demonstrate a favorable biocompatibility profile without any observed cytotoxicity. Additionally, the drainage stent exhibits excellent material stability in an in vitro simulation environment.

Conclusions
In summary, the diverging drainage stent presents a novel approach to the cost-effective and efficient preparation process of minimally invasive glaucoma surgery (MIGS) devices, offering additional filtering treatment options for glaucoma.
Fast fabrication of “all-in-one” injectable hydrogels as antibiotic alternatives for enhanced bacterial inhibition and accelerating wound healing
Authors: Xin Juan , Yang Zhangyou , Zhang Shurong , Sun Lili , Wang Xin , Tang Yang , Xiao Yan , Huang Honglin , Li Wei 
Published: July 2024

AbstractSkin wound infection has become a notable medical threat. Herein, the polysaccharide-based injectable hydrogels with multifunctionality were developed by a simple and fast gelation process not only to inactivate bacteria but also to accelerate bacteria-infected wound healing. Sodium nitroprusside (SNP) loaded PCN-224 nanoparticles were introduced into the polymer matrix formed by the dynamic and reversible coordinate bonds between Ag+ with carboxyl and amino or hydroxyl groups on carboxymethyl chitosan (CMCS), hydrogen bonds and electrostatic interactions in the polymer to fabricate SNP@PCN@Gel hydrogels. SNP@PCN@Gel displayed interconnected porous structure, excellent self-healing capacity, low cytotoxicity, good blood compatibility, and robust antibacterial activity. SNP@PCN@Gel could produce reactive oxygen species (ROS) and NO along with Fe2+, and showed long-term sustained release of Ag+, thereby effectively killing bacteria by synergistic photothermal (hyperthermia), photodynamic (ROS), chemodynamic (Fenton reaction), gas (NO) and ion (Ag+ and -NH3+ in CMCS) therapy. Remarkably, the hydrogels significantly promoted granulation tissue formation, reepithelization, collagen deposition and angiogenesis as well as wound contraction in bacteria-infected wound healing. Taken together, the strategy represented a general method to engineer the unprecedented photoactivatable “all-in-one” hydrogels with enhanced antibacterial activity and paved a new way for development of antibiotic alternatives and wound dressing.
Graphical abstract
Perspectives of key interest groups regarding supervised Consumption sites (SCS) and novel virtual harm reduction services / overdose response hotlines and applications: a qualitative Canadian study
Authors: Seo Boogyung , Rioux William , Teare Adrian , Rider Nathan , Jones Stephanie , Taplay Pamela , Ghosh S. Monty 
Published: July 2024

Abstract
Background
Supervised consumption sites (SCS) and overdose prevention sites (OPS) have been implemented across Canada to mitigate harms associated with illicit substance use. Despite their successes, they still contend with challenges that limit their accessibility and uptake. Overdose response hotlines and apps are novel virtual technologies reminiscent of informal “spotting” methods that may address some of the limitations. Here, we strove to qualitatively examine the factors that may encourage or deter utilization of these virtual services and SCS.

Methods
A total of 52 participants across Canada were recruited using convenience and snowball sampling methods. These included people with lived and living experience of substance use, family members of people with lived experience, healthcare providers, community harm reduction workers, and virtual harm reduction operators. Semi-structured telephone interviews were conducted and inductive thematic analysis was performed to identify the themes pertaining to SCS and virtual harm reduction.

Results
Participants viewed overdose response hotline and apps as an opportunity to consume substances without being hindered by logistical barriers (e.g., wait times), fear of law enforcement, invasion of privacy, and more. They also noted that these virtual services provided more flexibility for clients who opt for routes of consumption that are not supported by SCS, such as smoking. Overall, SCS was perceived to be better than virtual services at facilitating social connection, providing additional resources/referrals, as well as prompt response to overdose.

Conclusion
In sum, participants viewed SCS and virtual services as filling different needs and gaps. This study adds to a growing body of literature which informs how virtual harm reduction services can serve as useful adjunct to more standard harm reduction methods.
Cuproptosis, the novel type of oxidation-induced cell death in thoracic cancers: can it enhance the success of immunotherapy?
Authors: Zhao Ruiwen , Sukocheva Olga , Tse Edmund , Neganova Margarita , Aleksandrova Yulia , Zheng Yufei , Gu Hao , Zhao Deyao , Madhunapantula SabbaRao V. , Zhu Xiaorong , Liu Junqi , Fan Ruitai 
Published: July 2024

AbstractCopper is an important metal micronutrient, required for the balanced growth and normal physiological functions of human organism. Copper-related toxicity and dysbalanced metabolism were associated with the disruption of intracellular respiration and the development of various diseases, including cancer. Notably, copper-induced cell death was defined as cuproptosis which was also observed in malignant cells, representing an attractive anti-cancer instrument. Excess of intracellular copper leads to the aggregation of lipoylation proteins and toxic stress, ultimately resulting in the activation of cell death. Differential expression of cuproptosis-related genes was detected in normal and malignant tissues. Cuproptosis-related genes were also linked to the regulation of oxidative stress, immune cell responses, and composition of tumor microenvironment. Activation of cuproptosis was associated with increased expression of redox-metabolism-regulating genes, such as ferredoxin 1 (FDX1), lipoic acid synthetase (LIAS), lipoyltransferase 1 (LIPT1), dihydrolipoamide dehydrogenase (DLD), drolipoamide S-acetyltransferase (DLAT), pyruvate dehydrogenase E1 subunit alpha 1 (PDHA1), and pyruvate dehydrogenase E1 subunit beta (PDHB)). Accordingly, copper-activated network was suggested as an attractive target in cancer therapy. Mechanisms of cuproptosis and regulation of cuproptosis-related genes in different cancers and tumor microenvironment are discussed in this study. The analysis of current findings indicates that therapeutic regulation of copper signaling, and activation of cuproptosis-related targets may provide an effective tool for the improvement of immunotherapy regimens.
Graphical Abstract