bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social determinants of health and emergency department visits among older adults with multimorbidity: insight from 2010 to 2018 National Health Interview Survey
Authors: Lim Arum , Benjasirisan Chitchanok , Liu Xiaoyue , Ogungbe Oluwabunmi , Himmelfarb Cheryl Dennison , Davidson Patricia , Koirala Binu 
Published: April 2024

Abstract
Background
Multimorbidity is prevalent among older adults and is associated with adverse health outcomes, including high emergency department (ED) utilization. Social determinants of health (SDoH) are associated with many health outcomes, but the association between SDoH and ED visits among older adults with multimorbidity has received limited attention. This study aimed to examine the association between SDoH and ED visits among older adults with multimorbidity.

Methods
A cross-sectional analysis was conducted among 28,917 adults aged 50 years and older from the 2010 to 2018 National Health Interview Survey. Multimorbidity was defined as the presence of two or more self-reported diseases among 10 common chronic conditions, including diabetes, hypertension, asthma, stroke, cancer, arthritis, chronic obstructive pulmonary disease, and heart, kidney, and liver diseases. The SDoH assessed included race/ethnicity, education level, poverty income ratio, marital status, employment status, insurance status, region of residence, and having a usual place for medical care. Logistic regression models were used to examine the association between SDoH and one or more ED visits.

Results
Participants’ mean (± SD) age was 68.04 (± 10.66) years, and 56.82% were female. After adjusting for age, sex, and the number of chronic conditions in the logistic regression model, high school or less education (adjusted odds ratio [AOR]: 1.10, 95% confidence interval [CI]: 1.02–1.19), poverty income ratio below the federal poverty level (AOR: 1.44, 95% CI: 1.31–1.59), unmarried (AOR: 1.19, 95% CI: 1.11–1.28), unemployed status (AOR: 1.33, 95% CI: 1.23–1.44), and having a usual place for medical care (AOR: 1.46, 95% CI 1.18–1.80) was significantly associated with having one or more ED visits. Non-Hispanic Black individuals had higher odds (AOR: 1.28, 95% CI: 1.19–1.38), while non-Hispanic Asian individuals had lower odds (AOR: 0.71, 95% CI: 0.59–0.86) of one or more ED visits than non-Hispanic White individuals.

Conclusion
SDoH factors are associated with ED visits among older adults with multimorbidity. Systematic multidisciplinary team approaches are needed to address social disparities affecting not only multimorbidity prevalence but also health-seeking behaviors and emergent healthcare access.
Modified Q-type purse-string suture duodenal stump embedding method for laparoscopic gastrectomy for gastric cancer
Authors: Sun Longhe , Wang Wei , Zhou Jiajie , Ji Lili , Zhao Shuai , Fu Yayan , Li Ruiqi , Wang Jie , Qian Chunhua , Sun Qiannan , Wang Daorong 
Published: April 2024

Abstract
Objective
This study introduced the modified Q-type purse-string suture duodenal stump embedding method, a convenient way to strengthen the duodenum, and compared it to the conventional one to assess its efficacy and safety.

Methods
This retrospective analysis examined 612 patients who received laparoscopic gastrectomy for gastric Cancer at a single center. The patients were divided into Not Reinforced Group (n = 205) and Reinforced Group (n = 407) according to the surgical approach to the duodenal stump. The reinforced group was further divided into a modified Q-type purse-string suture embedding method group (QM, n = 232) and a conventional suture duodenal stump embedding method group (CM, n = 175) according to the methods of duodenal stump enhancement. Clinicopathological characteristics, operative variables, and short-term complications were documented and analyzed.

Results
The incidence of duodenal stump leakage(DSL) in the Not Reinforced Group was higher compared to the Reinforced Group, although the difference was not statistically significant [2.4% (5/205) vs 0.7% (3/407), p = 0.339]. Additionally, the Not Reinforced Group exhibited a higher rate of Reoperation due to DSL compared to the Reinforced Group [2 (1.0%) vs. 0, p = 0.046], with one patient in the Not Reinforced Group experiencing mortality due to DSL [1 (0.5%) vs 0, p = 0.158]. Subgroup analysis within the Reinforced Group revealed that the modified Q-type purse-string suture embedding group (QM) subgroup demonstrated statistically significant advantages over the conventional suture embedding group (CM) subgroup. QM exhibited shorter purse-string closure times (4.11 ± 1.840 vs. 6.05 ± 1.577, p = 0.001), higher purse-string closure success rates (93.1% vs. 77.7%, p = 0.001), and greater satisfaction with purse-string closure [224 (96.6%) vs 157 (89.7%), p = 0.005]. No occurrences of duodenal stump leakage were observed in the QM subgroup, while the CM subgroup experienced two cases [2 (1.1%)], though the difference was not statistically significant. Both groups did not exhibit statistically significant differences in secondary surgery or mortality related to duodenal stump leakage.

Conclusion
Duodenal Stump Leakage (DSL) is a severe but low-incidence complication. There is no statistically significant relationship between the reinforcement of the duodenal stump and the incidence of DSL. However, laparoscopic reinforcement of the duodenal stump can reduce the severity of fistulas and the probability of Reoperation. The laparoscopic Q-type purse-string suture duodenal stump embedding method is a simple and effective technique that can, to some extent, shorten the operation time and enhance satisfaction with purse-string closure. There is a trend towards reducing the incidence of DSL, thereby improving patient prognosis to a certain extent.
Current updates relating to treatment for interstitial cystitis/bladder pain syndrome: systematic review and network meta-analysis
Authors: Park Jae Joon , Kim Kwang Taek , Lee Eun Ji , Chun Joey , Lee Serin , Shim Sung Ryul , Kim Jae Heon 
Published: April 2024

Abstract
Background
Despite the publication of several meta-analyses regarding the efficacy of certain therapies in helping individuals with interstitial cystitis (IC) / bladder pain syndrome (BPS), these have not provided a comprehensive review of therapeutic strategies. The study aimed to determine the efficacy of various therapies for IC/BPS and identify potential moderating factors using randomized controlled trials (RCTs).

Methods
We queried the PubMed, Cochrane, and Embase databases to identify prospective RCTs using inclusion criteria: 1) patients diagnosed with IC, 2) interventions included relevant treatments, 3) comparisons were a specified control or placebo, 4) outcomes were mean differences for individual symptoms and structured questionnaires. The pairwise meta-analysis and network meta-analysis (NMA) were performed to compare the treatments used in IC/BPS. Hedges’ g standardized mean differences (SMDs) were used for improvement in all outcomes using random-effects models. Efficacy outcomes included individual symptoms such as pain, frequency, urgency, and nocturia, as well as structured questionnaires measuring IC/BPS symptoms.

Results
A comprehensive literature search was conducted which identified 70 RCTs with 3,651 patients. The analysis revealed that certain treatments, such as instillation and intravesical injection, showed statistically significant improvements in pain and urgency compared to control or placebo groups in traditional pairwise meta-analysis. However, no specific treatment demonstrated significant improvement in all outcomes measured in the NMA. The results of moderator analyses to explore influential variables indicated that increasing age was associated with increased nocturia, while longer follow-up periods were associated with decreased frequency.

Conclusion
This systematic review and meta-analysis provide insights into the efficacy of various treatments for IC. Current research suggests that a combination of therapies may have a positive clinical outcome for patients with IC, despite the fact that treatment for this condition is not straightforward.

Trial registration
PROSPERO CRD42022384024
Evaluation of compressive strength, microhardness and solubility of zinc-oxide eugenol cement reinforced with E-glass fibers
Authors: Hamdy Tamer M. 
Published: April 2024

AbstractBackgroundZinc-oxide eugenol (ZOE) cements are among the most used temporary materials in dentistry. Although ZOE has advantages over other temporary fillers, its mechanical strength is weaker, so researchers are working to improve it. E-glass fibers have emerged as promising reinforcing fibers in recent years due to their strong mechanical behavior, adequate bonding, and acceptable aesthetics.ObjectivesTo evaluate and compare the compressive strength, surface microhardness, and solubility of the ZOE and those reinforced with 10 wt.% E-glass fibers.MethodsA total of 60 ZEO specimens were prepared; 30 specimens were reinforced with 10 wt.% E-glass fibers, considered modified ZOE. The characterization of the E-glass fibers was performed by XRF, SEM, and PSD. The compressive strength, surface microhardness, and solubility were evaluated. Independent sample t-tests were used to statistically assess the data and compare mean values (P ≤ 0.05).ResultsThe results revealed that the modified ZOE showed a significantly higher mean value of compressive strength and surface microhardness while having a significantly lower mean value of solubility compared to unmodified ZOE (P ≤ 0.05).ConclusionThe modified ZOE with 10 wt.% E-glass fibers had the opportunity to be used as permanent filling materials.
Detecting white spot lesions on post-orthodontic oral photographs using deep learning based on the YOLOv5x algorithm: a pilot study
Authors: Ozsunkar Pelin Senem , Özen Duygu Çelİk , Abdelkarim Ahmed Z , Duman Sacide , Uğurlu Mehmet , Demİr Mehmet Rıdvan , Kuleli Batuhan , Çelİk Özer , Imamoglu Busra Seda , Bayrakdar Ibrahim Sevki , Duman Suayip Burak 
Published: April 2024

Abstract
Background
Deep learning model trained on a large image dataset, can be used to detect and discriminate targets with similar but not identical appearances. The aim of this study is to evaluate the post-training performance of the CNN-based YOLOv5x algorithm in the detection of white spot lesions in post-orthodontic oral photographs using the limited data available and to make a preliminary study for fully automated models that can be clinically integrated in the future.

Methods
A total of 435 images in JPG format were uploaded into the CranioCatch labeling software and labeled white spot lesions. The labeled images were resized to 640 × 320 while maintaining their aspect ratio before model training. The labeled images were randomly divided into three groups (Training:349 images (1589 labels), Validation:43 images (181 labels), Test:43 images (215 labels)). YOLOv5x algorithm was used to perform deep learning. The segmentation performance of the tested model was visualized and analyzed using ROC analysis and a confusion matrix. True Positive (TP), False Positive (FP), and False Negative (FN) values were determined.

Results
Among the test group images, there were 133 TPs, 36 FPs, and 82 FNs. The model’s performance metrics include precision, recall, and F1 score values of detecting white spot lesions were 0.786, 0.618, and 0.692. The AUC value obtained from the ROC analysis was 0.712. The mAP value obtained from the Precision-Recall curve graph was 0.425.

Conclusions
The model’s accuracy and sensitivity in detecting white spot lesions remained lower than expected for practical application, but is a promising and acceptable detection rate compared to previous study. The current study provides a preliminary insight to further improved by increasing the dataset for training, and applying modifications to the deep learning algorithm.

Clinical revelance
Deep learning systems can help clinicians to distinguish white spot lesions that may be missed during visual inspection.
CGRP neuropeptide levels in patients with endometriosis-related pain treated with dienogest: a comparative study
Authors: Chaichian Shahla , Firoozabadi Ziba Dehghan , Rokhgireh Samaneh , Tahermanesh Kobra , Kashi Abolfazl Mehdizadeh , Govahi Azam , Minaeian Sara , Mehdizadeh Mehdi , Ajdary Marziyeh 
Published: April 2024

Abstract
Background and objective
Endometriosis (EM) involves the peripheral nervous system and causes chronic pain. Sensory nerves innervating endometriotic lesions contribute to chronic pain and influence the growth phenotype by releasing neurotrophic factors and interacting with nearby immune cells. Calcitonin gene-related peptide (CGRP), a pain-signaling neurotransmitter, has a significant role. This study examines the effect of Dienogest (DNG), a hormone therapy used for managing EM -related pain, on serum CGRP levels in EM patients.

Materials and methods
The Visual Analog Scale (VAS) assessed pain in diagnosed EM. individuals. Serum samples were obtained to measure CGRP concentration. Participants received a 2 mg/day oral dose of DNG for six months as prescribed treatment. Additional serum samples were collected after this period to measure CGRP levels.

Results
In the EM group, 6.7%, 33.3%, and 20% had ovarian EM, ovarian plus uterosacral, and ovarian plus bladder, respectively. The EM group showed higher CGRP serum levels than the control group (80.53 ± 16.13 vs. 58.55 ± 6.93, P < 0.0001). Still, after drug administration, CGRP serum levels significantly decreased compared to pre-treatment levels (69.66 ± 11.53 vs. 80.53 ± 16.13, P < 0.05). The EM group showed higher pain compared to the control group (7.93 ± 1.58 vs. 0.13 ± 0.35, P < 0.0001), but after drug administration, pain significantly decreased compared to pre-treatment levels (1.00 ± 2.00 vs. 7.93 ± 1.58, P < 0.05).

Conclusion
DNG administration reduces pain and serum CGRP levels in EM patients, offering the potential for innovative treatments and tailored options. Understanding neurotransmitter roles and drug effects can aid in discovering more effective modulators for these pathways.
Ethnobotanical assessment of antidiabetic medicinal plants in District Karak, Pakistan
Authors: Nazar Amina , Adnan Muhammad , Shah Syed Majid , Bari Ahmed , Ullah Riaz , Tariq Akash , Ahmad Nisar 
Published: April 2024

Abstract
Background
Diabetes is a leading health disorder and is responsible for high mortality rates across the globe. Multiple treatment protocols are being applied to overcome this morbidity and mortality including plant-based traditional medicines. This study was designed to investigate the ethnomedicinal status of plant species used to treat diabetes in District Karak, Pakistan.

Materials and methods
A semi-structured survey was created to collect data about traditionally used medicinal plants for diabetes and other ailments. The convenience sampling method was applied for the selection of informants. The collected data was evaluated through quantitative tools like frequency of citation (FC), relative frequency of citation (RFC), informant consensus factor (FIC), fidelity level (FL), and use value (UV).

Results
A total of 346 local informants were selected for this research. Out of them, 135 participants were men and 211 participants were women. Overall 38 plant species belonging to 29 plant families were used to treat diabetes. The most dominant plant family was Oleaceae having 11 species. Powder form (19%) was the most recommended mode of preparation for plant-based ethnomedicines. Leaves (68%) were the most frequently used parts followed by fruit (47%). The highest RFC was recorded for Apteranthes tuberculata (0.147). The maximum FL was reported for Apteranthes tuberculata (94.4) and Zygophyllum indicum (94.11) for diabetes, skin, and wounds. Similarly, the highest UV of (1) each was found for Brassica rapa, Melia azedarach, and Calotropis procera. Based on documented data, the reported ailments were grouped into 7 categories. The ICF values range between 0.89 (diabetes) to 0.33 (Cardiovascular disorders).

Conclusion
The study includes a variety of antidiabetic medicinal plants, which are used by the locals in various herbal preparations. The species Apteranthes tuberculata has been reported to be the most frequently used medicinal plant against diabetes. Therefore, it is recommended that such plants be further investigated in-vitro and in-vivo to determine their anti-diabetic effects.
Factors influencing non-conveyance care encounters in the ambulance service, registered nurses experiences - a qualitative study
Authors: Granlund L. , Brännström I , Lindström V 
Published: April 2024

Abstract
Background
There is a notable variation in the percentage of non-conveyed patients within the ambulance service. Discharging patients at the scene includes a risk of adverse events, and both patients and ambulance clinicians experience the complexity of non-conveyance. Therefore, this study aimed to describe factors influencing the care encounter when care in the ambulance service concludes with non-conveyance.

Method
A qualitative study design employing the critical incident technique for data collection through individual interviews, and a qualitative analysis based on Fridlund et al. descriptions was utilized. The study conforms to the COREQ checklist for reporting qualitative research.

Results
Fourteen Registered Nurses (RN) described 30 incidents and various factors were identified as influencing the care encounter. The factors included communication, sharing information, maintaining a secure and confident approach, organizational aspects, applying person-centered care in collaboration with the patient, relatives, and other caregivers, and an overall understanding of the patient’s entire situation. These factors were integrated into the RNs’ decision-making process for non-conveyance.

Conclusion
The decision-making process for non-conveyance by RNs is a multifaceted approach that incorporates several factors. Communication, sharing of information, maintaining a secure and confident approach, organizational aspects, applying person-centered care in collaboration with the patient, relatives, and other caregivers, and a comprehensive understanding of the patient’s entire situation. These findings have the potential to contribute to the development of guidelines supporting the RNs working in the ambulance service in their decisions regarding non-conveyance. Further research is needed on the patient’s and relatives’ perspective on non-conveyance otherwise, patient participation and partnership in person-centered care are not possible to achieve.
Coping strategies used by undergraduate first-year nursing students during transition from basic to higher education: a qualitative study
Authors: Gause Gopolang , Sehularo Leepile Alfred , Matsipane Molekodi Jacob 
Published: April 2024

Abstract
Background
The undergraduate first year of a nursing program is regarded as a difficult and challenging part of the nursing course, due to the variation experienced in the transition from basic to higher education compared to other first-year courses. This causes stress, which could contribute to students’ lack of coping with the transition to the university. These challenges call for coping strategies to ensure resilience among this cohort of undergraduate nursing students.

Methods
An exploratory descriptive qualitative research design was adopted to assess the coping mechanisms used by first-year nursing students during transition from basic to higher education. Data was gathered through four online focus group discussions which were conducted using the Microsoft Teams app, with participants purposefully selected from the two campuses where the study was conducted. The focus group discussions were recorded and transcribed verbatim for analysis. Data was analysed by the researcher and the co-coder using qualitative content data analysis.

Findings
Three categories emerged from the data: experiences of transition from basic to higher education, coping with transition from basic to higher education, and recommendations for coping with transition from basic to higher education. Participants expressed that they use the following six coping strategies during the transition from basic to higher education: adaptive coping, appraisal-focused coping, emotion-focused coping, problem-focused coping, social coping, and seeking help from mentors.

Conclusions
Transition from basic to higher education is challenging for undergraduate first-year nursing students. The study suggests that there is a need to standardize and contextualize the support measures for undergraduate first-year nursing students during their transition from basic to higher education in order to enhance their ability to cope.
Reliability and validity evaluation of the Chinese version of the gender misconceptions of men in nursing (GEMINI) scale among nursing students
Authors: Xu Huameng , Liang Chunguang , Kong Jie , Chen Qing , Zhao Ying , Zhang Fan 
Published: April 2024

Abstract
Background
Misconceptions about male nurses not only exacerbate the gender imbalance in the nursing profession but also negatively impact male nurses embarking on their careers. Currently, no tool exists to measure the gender biases toward males in nursing among nursing students in China. Consequently, the primary objective of this study is to assess the validity and reliability of the Chinese translation of the Gender Misconceptions of Men in Nursing (GEMINI) scale among nursing students.

Methods
This cross-sectional study involved 1,102 nursing students from China who participated online. We utilized the Brislin translation technique with a forward-backward approach. To determine the factor structure within the Men in Nursing Gender Misconceptions Scale’s Chinese version, both exploratory (EFA) and confirmatory factor analysis (CFA) were applied. The scale’s internal consistency was measured through the Cronbach’s alpha coefficient, corrected item-total correlation, and a retest reliability assessment.

Results
The scale showed a content validity index of 0.938 and a retest reliability of 0.844. EFA indicated a two-factor structure for the translated instrument. CFA revealed a chi-square/degree of freedom of 3.837, an incremental fit index (IFI) of 0.952, a goodness-of-fit index (GFI) of 0.910, a comparative fit index (CFI) of 0.952, and an RMSEA of 0.073, all of which were within acceptable limits. The scale’s Cronbach’s α was 0.953, and the corrected item-total correlations ranged between 0.539 and 0.838. Gender-based misconceptions about men in nursing among students appeared to be influenced by their gender and whether they considered a nursing program as their first choice when applying for a major. Misconceptions about male nurses are greater among men and those who do not consider nursing programs as their first choice when applying for a major.

Conclusions
The Chinese adaptation of the GEMINI scale showcased high reliability and validity. It stands as a potential instrument to gauge gender misconceptions concerning male nurses among Chinese nursing students.