bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive function of children with biliary atresia after primary living donor liver transplantation
Authors: Wang Tingge , Hu Yan , Zhang Zhanzhan , Dai Xiaoke , Zhang Mingman , He Yan , Li Yingcun 
Published: June 2024

Abstract
Background
The survival rate of children with biliary atresia (BA) after liver transplantation (LT) is significantly improved, and their quality of life has attracted much attention.This study aimed to investigate the cognition and its influencing factors in children with BA after primary living donor LT (BA-pLDLT) during infancy.

Methods
Children with BA were recruited 6 months after pLDLT at Children’s Hospital of Chongqing Medical University (2018–2022). Demographic and clinical data were collected from the health information system. Cognition was assessed using the Chinese version of the Griffiths Mental Development scale (GMDS-C). Multivariate linear regression were used to analyze the influencing factors of their cognitive function.

Results
In total, 57 children with BA-pLDLT, aged 5.00(3.90–9.30) months at transplantation and 25.00(14.00-60.80) months at evaluation were included. The general developmental quotient (89.02 ± 12.07) and motor, language, eye-hand coordination, performance, and practical reasoning quotients of these children were significantly lower than the normative mean values of GMDS-C(P < 0.05). Of the 57 children, 16 (28.07%) had borderline developmental delay (DQ between 70 and 84), 3 (5.26%) had developmental delay (DQ < 70), and 11(19.29%) had language delay. Reoperation for biliary or vascular complications after pLDLT was a risk factor for decreased general development quotient and motor quotient and lower ZW at assessment was associated with decline motor quotient.

Conclusion
Children with BA-pLDLT have varying degrees of developmental delays in early life. Reoperation and nutritional deficiencies had adverse effects on cognitive development.
Development and validity evidence on the scale of perceived social support for university students (EPSSEU) during the period of social restrictions
Authors: Bruno Thaís Calcagno Vidon , Custódio Isis Danyelle Dias , de Menezes-Junior Luiz Antônio Alves , Meireles Adriana Lúcia , Neves Ana Cláudia Morito , Barroso Sabrina Martins , Carraro Júlia Cristina Cardoso 
Published: June 2024

Abstract
Aim
This study aims to validate a Perceived Social Support Scale for University Students (EPSSEU) during periods of social restrictions, by focusing on family and university support.

Subject and methods
This cross-sectional study was conducted with undergraduate students from a public higher education institution. The college students who participated in the study—1353 at baseline and 378 after 6 months—answered a virtual questionnaire containing questions on: sociodemographic and lifestyle data, items proposed for the EPSSEU, Satisfaction with Social Support Scale (ESSS), and Depression, Anxiety and Stress Scale (DASS-21). Exploratory factor analysis, Cronbach’s alpha reliability analysis, as well as discriminant, convergent, and known-group validations were performed.

Results
The results showed two factors support from: i) the university and ii) friends and family— which explained 61.82% of the variance in the data. The EPSSEU showed good reliability (Cronbach’s alpha = 0.796) as well as validity, with higher scores among individuals without depression, anxiety, or stress.

Conclusion
The EPSSEU shows adequate psychometric qualities and may be a useful instrument for assessing university students’ social support in pandemics, social distancing, and remote teaching contexts.
Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population
Authors: Mazhnaya Alyona , Geurts Brogan , Brigida Krestina , Bakieva Shokhista , Sadirova Shakhlo , Witzigmann Annika , Musabaev Erkin , Brandl Michael , Weishaar Heide , Dudareva Sandra , Bcheraoui Charbel El 
Published: June 2024

Abstract
Introduction
In the World Health Organization European Region, an estimated 14 million people live with a chronic hepatitis B virus infection (HBV), and 12 million are affected by a hepatitis C virus infection (HCV). Uzbekistan bears a major burden of HBV and has one of the highest HCV prevalence in the region. Following a presidential decree in May 2022, significant funds were allocated to the viral hepatitis (VH) elimination program in Uzbekistan. The program expands VH testing to reach 500,000 people annually during 2022–2025 as part of the VH elimination strategy that includes the provision of free testing and affordable treatment. Exploring the existing barriers and facilitators to VH testing is pivotal for informing these interventions.

Methods
This study uses a cross-sectional qualitative design to identify and explore the barriers and facilitators to VH testing among the general population in Uzbekistan. We collected data during October-November 2022 through semi-structured interviews with 12 key informants (KIs) and 7 focus group discussions with two target populations: the general population and healthcare workers (HCW) in Tashkent, Uzbekistan.

Results
Following the capability-opportunity-motivation-behavior model (COM-B model) as a framework for the analysis, we identified major capability barriers to VH testing primarily linked to low health literacy and limited knowledge about VH types, symptoms, transmission, testing and treatment. Physical opportunity barriers included the time and financial costs associated with testing, diagnostics, and treatment. Sociocultural opportunity barriers involved anticipated negative reactions and stigmatization, particularly affecting women. Motivational barriers included a reluctance to be tested when asymptomatic and a general fear of receiving positive test results. The involvement of healthcare workers in promoting VH awareness and motivating the general population emerged as a facilitator.

Conclusions
A multi-pronged approach is recommended to achieve VH testing goals among the general population, focusing on raising awareness and health literacy and creating an enabling environment that ensures easy accessibility and minimizing VH testing-associated costs.
The low health literacy in Latin America and the Caribbean: a systematic review and meta-analysis
Authors: de Jesus Patricia Romualdo , Bianchini Bianca Vendruscolo , Ziegelmann Patrícia Klarmann , Dal Pizzol Tatiane da Silva 
Published: June 2024

Abstract
Background
Health literacy (HL) impacts people’s health and well-being. In Latin America and the Caribbean (LAC), there are no general estimates of the prevalence of low HL. This study aimed to estimate the prevalence of low HL among citizens of LAC and identify the tools used to measure it.

Methods
We included observational studies quantifying the prevalence of low HL in people living in LAC. We searched PubMed, CINAHL, EMBASE, ERIC, LILACS, PsycINFO, Redalyc, SciELO, Web of Science, PQDT, and the reference lists of the included studies in June 2023. Two reviewers independently conducted the selection, extraction, and risk of bias assessment using the JBI Critical Appraisal Tools. Meta-analysis of proportions using random effects models was used to summarize the prevalence of low HL estimated. This prevalence was measured in each study using different classification methods: word recognition items, reading and numeracy comprehension items, and self-reported comprehension items.

Results
Eighty four studies involving 23,914 participants from 15 countries were included. We identified 23 tools to assess HL, and most of the studies were carried out in health services. The pooled prevalence of low HL were 44.02% (95%CI: 36.12–52.24) for reading and numeracy comprehension items, 50.62% (95%CI: 41.82–59.39) for word recognition items, and 41.73% (95%CI: 31.76–52.43) for self-reported comprehension items.

Conclusion
Despite the variability in the prevalence of low HL and a diversity of tools, the average of low HL is of concern. Almost half of the participants in the included studies have low HL. Most of the studies targeted users of healthcare services. Further research investigating the prevalence of low HL in the general population and actions focused on health education, communication, and information are necessary.

Trial registration
PROSPERO (CRD42021250286).
The role of familial factors and neuroticism in the association between exposure to offensive behaviors at work and long-term sickness absence due to common mental disorders - a prospective twin study
Authors: Wijkander Maria , Svedberg Pia , Narusyte Jurgita , Alaie Iman , Lindfors Petra , Xu Tianwei , Magnusson Hanson Linda L. 
Published: June 2024

Abstract
Objectives
The aim of this study was to investigate associations between exposure to work-related violence/threats and harassment, and future sickness absence (SA) due to common mental disorders (CMDs), taking familial factors (shared genetics and early-life environment) and neuroticism into account.

Methods
The study sample included 8795 twin individuals from the Swedish Twin Project of Disability Pension and Sickness Absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE). Self-reported work-related violence and/or threats as well as work-related harassment (including bullying) and national register data on SA due to CMDs were analyzed using standard logistic regression, and conditional logistic regression among complete twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses.

Results
Exposure to work-related violence/threats was associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children, education, type of living area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52–2.95). Higher odds of SA due to CMDs were also found for exposure to harassment (OR 1.52, 95% CI 1.10–2.11) and a combined indicator of exposure to violence/threats and/or harassment (OR 1.98, 95% CI 1.52–2.59), compared with the unexposed. Analyses of twins discordant on exposure, using the unexposed co-twin as reference, showed reduced ORs. These ORs were still elevated but no longer statistically significant, potentially due to a lack of statistical power. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, indicating higher odds of SA due to CMDs in the group scoring lower on neuroticism.

Conclusions
Exposure to work-related offensive behaviors was associated with SA due to CMDs. However, the results indicated that these associations may be partly confounded by familial factors. In addition, an interaction between exposure and neuroticism was suggested. Thus, when possible, future studies investigating associations and causality between offensive behaviors at work and mental health-related outcomes, should consider familial factors and neuroticism.
Multilevel analysis of intimate partner violence and associated factors among reproductive-age women: Kenya demographic and health survey 2022 data
Authors: Melkam Mamaru , Fentahun Setegn , Rtbey Gidey , Andualem Fantahun , Nakie Girum , Tinsae Techilo , Kassa Mulat Awoke , Fente Bezawit Melak 
Published: June 2024

Abstract
Introduction
Intimate partner violence is a human rights violation that often involves violence against women, which appears to be the most prevalent type of abuse. Intimate partner violence is a major global public health issue that includes physical, emotional, and sexual violence. The prevalence of intimate partner violence in Africa is high. The burden of intimate partner violence among reproductive-age women is high in Kenya. Therefore, the main aim of this study is to determine the associated factors of intimate partner violence among reproductive-age women at the individual and community level from the recent Demographic and Health Survey (DHS) 2022 data of Kenya.

Methods
The Kenya National Demographic and Health Survey data of 2022 was used for this study. The overall sample size for this study was 14,612, which focused on women aged 15 to 49 years who had ever been partnered and responded to the domestic violence module. Multilevel logistic regression models to determine the prevalence and associated factors at the individual and community level with intimate partner violence with a 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR).

Result
The overall prevalence of intimate partner violence was 41.1% with a 95% CI (40.07%, 42.60. Male-headed households, poorest and middle wealth status, partner alcohol use, separated/widowed current marital status, and low education of women were statistically significantly associated with intimate partner violence at the individual level variables in this study.

Conclusions
The prevalence of intimate partner violence was high. Educating women, reducing partner alcohol use, and improving the economic status of women, were crucial in mitigating the burden of intimate partner violence. The intimate partners are supposed to respect the rights of women.
Application of AI-assisted MRI for the identification of surgical target areas in pediatric hip and periarticular infections
Authors: Liu Yuwen , Chen Lingyu , Fan Mingjie , Zhang Tao , Chen Jie , Li Xiaohui , Lv Yunhao , Zheng Pengfei , Chen Fang , Sun Guixin 
Published: June 2024

Abstract
Objective
To develop an AI-assisted MRI model to identify surgical target areas in pediatric hip and periarticular infections.

Methods
A retrospective study was conducted on the pediatric patients with hip and periarticular infections who underwent Magnetic Resonance Imaging(MRI)examinations from January 2010 to January 2023 in three hospitals in China. A total of 7970 axial Short Tau Inversion Recovery (STIR) images were selected, and the corresponding regions of osteomyelitis (label 1) and abscess (label 2) were labeled using the Labelme software. The images were randomly divided into training group, validation group, and test group at a ratio of 7:2:1. A Mask R-CNN model was constructed and optimized, and the performance of identifying label 1 and label 2 was evaluated using receiver operating characteristic (ROC) curves. Calculation of the average time it took for the model and specialists to process an image in the test group. Comparison of the accuracy of the model in the interpretation of MRI images with four orthopaedic surgeons, with statistical significance set at P < 0.05.

Results
A total of 275 patients were enrolled, comprising 197 males and 78 females, with an average age of 7.10 ± 3.59 years, ranging from 0.00 to 14.00 years. The area under curve (AUC), accuracy, sensitivity, specificity, precision, and F1 score for the model to identify label 1 were 0.810, 0.976, 0.995, 0.969, 0.922, and 0.957, respectively. The AUC, accuracy, sensitivity, specificity, precision, and F1 score for the model to identify label 2 were 0.890, 0.957, 0.969, 0.915, 0.976, and 0.972, respectively. The model demonstrated a significant speed advantage, taking only 0.2 s to process an image compared to average 10 s required by the specialists. The model identified osteomyelitis with an accuracy of 0.976 and abscess with an accuracy of 0.957, both statistically better than the four orthopaedic surgeons, P < 0.05.

Conclusion
The Mask R-CNN model is reliable for identifying surgical target areas in pediatric hip and periarticular infections, offering a more convenient and rapid option. It can assist unexperienced physicians in pre-treatment assessments, reducing the risk of missed and misdiagnosis.
Temporal dynamics of gait function in acute cervical spinal cord injury
Authors: Okayasu Hiroki , Hayashi Tetsuo , Yokota Kazuya , Kawano Osamu , Sakai Hiroaki , Morishita Yuichiro , Masuda Muneaki , Kubota Kensuke , Ito Hiroshi , Maeda Takeshi 
Published: June 2024

Abstract
Background
Following spinal cord injury (SCI), gait function reaches a post-recovery plateau that depends on the paralysis severity. However, the plateau dynamics during the recovery period are not known. This study aimed to examine the gait function temporal dynamics after traumatic cervical SCI (CSCI) based on paralysis severity.

Methods
This retrospective cohort study included 122 patients with traumatic CSCI admitted to a single specialized facility within 2 weeks after injury. The Walking Index for Spinal Cord Injury II (WISCI II) was estimated at 2 weeks and 2, 4, 6, and 8 months postinjury for each American Spinal Injury Association Impairment Scale (AIS) grade, as determined 2 weeks postinjury. Statistical analysis was performed at 2 weeks to 2 months, 2–4 months, 4–6 months, and 6–8 months, and the time at which no significant difference was observed was considered the time at which the gait function reached a plateau.

Results
In the AIS grade A and B groups, no significant differences were observed at any time point, while in the AIS grade C group, the mean WISCI II values continued to significantly increase up to 6 months. In the AIS grade D group, the improvement in gait function was significant during the entire observation period.

Conclusions
The plateau in gait function recovery was reached at 2 weeks postinjury in the AIS grade A and B groups and at 6 months in the AIS grade C group.
Maximum surgical blood ordering schedule for elective surgical procedures in Omdurman teaching hospital, Sudan
Authors: Khalifa Mohanad , Elhassan Eman , Ibrahim Faisal 
Published: June 2024

Abstract
Background
The need for blood during a surgical procedure is greater than what blood banks are able to provide. There is an excessive amount of blood being ordered for elective surgeries, surpassing the actual requirements. Only 30% of the cross matched blood is actually used in these surgeries. The accuracy of estimating the transfusion needs before a surgical procedure can be determined by looking at the cross match to transfusion ratio and the transfusion index. “These indicators play a crucial role in developing the maximum surgical blood ordering schedule; in this study, these indicators were tested.”

Aim of study
Is to determine the efficiency of blood ordering and transfusion practices for patients undergoing elective surgeries.

Methods
This study is a prospective cross-sectional hospital-based study done at Omdurman Teaching Hospital-Sudan. Conducted for the duration of 6 months period from July to December 2019.The study participants were patients who underwent elective surgical procedures in general surgery and Urology departments as total coverage sample over a period of study duration. Ethical clearance obtained from ethical committee of Sudan Medical Specialization Board.

Results
Two hundreds seven patients included in this study, the amount of blood units requested were 443-unit, cross matching for 98.6% (n 437) of units were done. Only 100 unit were Transfused (22,8%). The calculated CT ratio was 4.4, transfusion index was 1.6 and transfusion probability was 29.9%.

Conclusion
Transfusion probability and transfusion index of the present study were optimal but comparatively higher than the standard guidelines as most of the cross matched blood was not utilized.
Effect of liver transplants with retrograde reperfusion on early postoperative recovery of liver function and its risk factors
Authors: Shen Jiajia , Wang Ming , Yang Chengkai , Cai Qiucheng , Jiang Yi , Zhang Xiaojin 
Published: June 2024

Abstract
Background
The purpose of this study was to investigate effect of liver Transplants (LT) with retrograde reperfusion on early postoperative recovery of liver function and its risk factors.

Methods
We conducted a retrospective analysis of clinical data from 136 liver transplantation (LT) patients at the 900th Hospital of the Chinese People’s Liberation Army Joint Support Army, covering the period from January 2015 to January 2021. All participants provided informed consent, adhering to medical ethics guidelines. Patients were stratified into two groups based on the liver perfusion technique used: retrograde reperfusion (RTR, n = 108) and initial portal reperfusion (IPR, n = 28). Our study focused on a subset of 23 patients from each group to compare postoperative liver function recovery. The final analysis included 86 RTR and 28 IPR cases after excluding 8 RTR patients who underwent initial hepatic artery reperfusion and 14 who received simultaneous hepatic artery and portal vein reperfusion. Further subdivision within the RTR group identified 19 patients with early hepatic allograft dysfunction (EAD) and 67 without, allowing for an assessment of the influence of preoperative and intraoperative parameters, as well as perfusion methods, on EAD incidence post-LT.

Results
Alanine aminotransferase (ALT) was 329 (211 ~ 548) and 176 (98 ~ 282) U/L on the 3rd and 7th day after RTR, respectively, which was significantly lower than 451 (288 ~ 918) and 251 (147 ~ 430) U/L in the IPR group (Z =-1.979, -2.299, P = 0.048, 0.021). Aspartate aminotransferase (AST) on postoperative days 3, 5, and 7 was 252 (193, 522), 105 (79, 163), and 93 (41, 135) U/L in the RTR group, respectively; it was also significantly lower than 328 (251, 724), 179 (129, 306), and 150 (91, 200)U/L in the IPR group (Z=-2.212, -3.221, -2.979; P = 0.027, 0.001, 0.003). Logistic regression analysis showed that MELD score was an independent risk factor for EAD after LT.

Conclusion
RTR LT is more favorable for patients’ early postoperative liver function recovery. For patients undergoing LT for RTR, preoperative MELD score was an independent risk factor for their postoperative development of EAD.
Study on the disinfection effect of chlorine dioxide disinfectant (ClO2) on dental unit waterlines and its in vitro safety evaluation
Authors: Yue Cao , Yuya Hu , Zhihuan Liu , Zimo Wang , Jianying Feng 
Published: June 2024

Abstract
Background
Ensuring the safety of dental unit waterlines (DUWLs) has become a pivotal issue in dental care practices, focusing on the health implications for both patients and healthcare providers. The inherent structure and usage conditions of DUWLs contribute to the risk of biofilm formation and bacterial growth, highlighting the need for effective disinfection solutions.The quest for a disinfection method that is both safe for clinical use and effective against pathogens such as Staphylococcus aureus and Escherichia coli in DUWLs underscores the urgency of this research.

Materials
Chlorine dioxide disinfectants at concentrations of 5, 20, and 80 mg/L were used to treat biofilms of S. aureus and E. coli cultured in DUWLs. The disinfection effectiveness was assessed through bacterial counts and culturing. Simultaneously, human skin fibroblast cells were treated with the disinfectant to observe changes in cell morphology and cytotoxicity. Additionally, the study included corrosion tests on various metals (carbon steel, brass, stainless steel, aluminum, etc.).

Results
Experimental results showed that chlorine dioxide disinfectants at concentrations of 20 mg/L and 80 mg/L significantly reduced the bacterial count of S. aureus and E. coli, indicating effective disinfection. In terms of cytotoxicity, higher concentrations were more harmful to cellular safety, but even at 80 mg/L, the cytotoxicity of chlorine dioxide remained within controllable limits. Corrosion tests revealed that chlorine dioxide disinfectants had a certain corrosive effect on carbon steel and brass, and the degree of corrosion increased with the concentration of the disinfectant.

Conclusion
After thorough research, we recommend using chlorine dioxide disinfectant at a concentration of 20 mg/L for significantly reducing bacterial biofilms in dental unit waterlines (DUWLs). This concentration also ensures satisfactory cell safety and metal corrosion resistance.