bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitude, and practice toward allergic rhinitis among parents in Ningbo, China
Authors: Lu Lingya , Feng Jinyan , Zhu Lihua , Chen Aina , Chen Xuenai , Lu Yanming 
Published: May 2024

Abstract
Background
This study examined the knowledge, attitude, and practice (KAP) toward allergic rhinitis (AR) among parents.

Methods
This cross-sectional study enrolled parents of children with AR at Ningbo Hangzhou Bay Hospital between December 2022 and March 2023. A self-administered questionnaire was developed to collect the demographic characteristics, knowledge, attitudes, and practices toward AR.

Results
This study included 480 questionnaires, and 78.33% were mothers. The mean knowledge, attitude, and practice scores were 13.49 ± 6.62 (possible range: 0–24), 33.99 ± 3.40 (possible range: 8–40), and 21.52 ± 3.36 (possible range: 5–26), indicating poor knowledge, positive attitudes, and proactive practice. Multivariable logistic regression analysis showed living in urban areas in Ningbo outside Hangzhou Bay New Zone (OR = 4.33, 95%CI: 1.52–12.34, P = 0.006), living in rural areas in Ningbo (OR = 2.15, 95%CI: 1.00-4.59, P = 0.049), being self-employed (OR = 1.99, 95%CI: 1.00-3.95, P = 0.049), monthly income per capita ≥ 20,000 CNY (OR = 1.89, 95%CI: 1.02–3.47, P = 0.042), child with one biological sibling (OR = 0.48, 95%CI: 0.30–0.78, P = 0.003), and ≥ 6 times hospital visits for AR (OR = 2.32, 95%CI: 1.40–3.86, P = 0.001) were independently associated with adequate knowledge. The knowledge (OR = 1.09, 95%CI: 1.05–1.13, P < 0.001) and ≥ 6 times hospital visits for AR (OR = 1.84, 95%CI: 1.06–3.22, P = 0.032) were independently associated with a positive attitude. The knowledge (OR = 1.08, 95%CI: 1.04–1.13, P = 0.001), attitude (OR = 1.41, 95%CI: 1.28–1.55, P < 0.001), monthly income per capita ≥ 20,000 CNY (OR = 3.59, 95%CI: 1.49–8.65, P = 0.004), no previous hospital visit for AR (OR = 0.35, 95%CI: 0.16–0.78, P = 0.003), and ≥ 6 times hospital visits for AR (OR = 0.40, 95%CI: 0.20–0.81, P = 0.011) were independently associated with the practice scores.

Conclusions
The parents of children with AR had poor knowledge but positive attitudes and proactive practice toward AR. This study has identified a need for specific and reliable information initiatives to be introduced as a means of reducing parental concern and ensuring evidence-based strategies for managing children with AR.
Anterior cruciate ligament femoral side retained stump technique reduces enlargement of the femoral bone tunnel after anterior cruciate ligament reconstruction
Authors: Li Xiaobo , Li Hanlin , Su Jixian , Ding Ran 
Published: May 2024

Abstract
Background
Enlargement of the bone tunnel has become an unavoidable early complication after anterior cruciate ligament (ACL) reconstruction, whether it is a single or double-bundle ACL reconstruction. Preservation of the ACL stump in ACL reconstruction reduces enlargement of the bone tunnel. The purpose of this study was to investigate the question of whether single-bundle ACL reconstruction using the ACL femoral side retained stump technique reduces enlargement of the femoral tunnel.

Methods
Forty patients who underwent single-bundle reconstruction of the ACL were included in this study. The patients were categorized into a Remnant preservation group (Group R) and the Non-remnant preservation group (Group N). In the Remnant preservation group, a high-flexion femoral side retained stump technique was used intraoperatively for the establishment of the femoral side bone tunnel, and in the Non-remnant preservation group, the conventional femoral positioning method was used (we used a femoral positioning drill for localization and drilling of the femoral bone tunnel), and MRI of the operated knee joints was performed at 6 months postoperatively. We measured the internal diameter of the femoral bone tunnel at 5 mm from the intra-articular outlet of the femoral bone tunnel on an MRI scan image perpendicular to the femoral bone tunnel. The size of the tunnel was compared between the intraoperative drilling of the bone tunnel and the size of the bone tunnel at 6 months postoperatively. Postoperative clinical assessment was Lysholm score.

Results
After a 6-month follow-up of 40 patients, the diameter of the femoral tunnel at a distance of 5 mm from the inner opening of the femoral tunnel was 10.96 ± 0.67 mm and 10.11 ± 0.62 mm in patients of group N and group R, respectively, and the difference was statistically significant (P < 0.05).The diameter of the femoral tunnel at 6 months postoperatively in group N and group R compared to the intraoperative bone tunnel increased by 2.58 ± 0.24 mm and 1.94 ± 0.31 mm, and the difference was statistically significant (P < 0.05).The femoral tunnel enlargement rates of group N and group R were 30.94 ± 3.00% and 24.02 ± 5.10%, respectively, and the differences were significant (P < 0.05).

Conclusion
ACL femoral side retained stump technique does not sacrifice the ideal location of the femoral tunnel and is able to preserve the possible benefits of the ACL stump: reduced femoral tunnel enlargement.
Validity of endoscopic ossiculoplasty immediately after its introduction for ossicular chain disruption
Authors: Fukuda Atsushi , Morita Shinya , Hoshino Kimiko , Fujiwara Keishi , Nakamaru Yuji , Homma Akihiro 
Published: May 2024

Abstract
Background
Transcanal endoscopic ear surgery (TEES) reportedly requires a long learning curve and may be associated with more complications and longer operative times than microscopic ear surgery (MES). In this study, we aimed to examine the usefulness and validity of TEES for ossicular chain disruption in the early stages of its introduction in our institution.

Methods
TEES was performed on 11 ears (10 with congenital ossicular chain discontinuity and 1 with traumatic ossicular chain dislocation), and MES was performed with a retroauricular incision on 18 ears (6 with congenital ossicular chain discontinuity and 12 with traumatic ossicular chain dislocation) in a tertiary referral center. Postoperative hearing results, operative times, and postoperative hospital length of stay were retrospectively reviewed. The Mann–Whitney U test and Fisher’s exact test was performed to compare variables between the TEES and MES groups. Pre- and postoperative air- and bone-conduction thresholds and the air–bone gap of each group were compared using the Wilcoxon signed-rank test. The Mann–Whitney U test and Wilcoxon signed-rank was performed to compare the pre- and postoperative air–bone gaps between the diagnoses.

Results
No significant differences in the postoperative air-conduction thresholds, bone-conduction thresholds, air–bone gaps, or incidence of air–bone gap ≤ 20 dB were observed between the TEES and MES groups. The air-conduction thresholds and air–bone gaps of the TEES group significantly improved postoperatively. The air-conduction thresholds and air–bone gaps of the MES group also significantly improved postoperatively. No significant difference was observed in the operative times between the groups (TEES group: median, 80 min; MES group: median, 85.5 min). The TEES group had a significantly shorter postoperative hospital stay (median, 2 days) than the MES group (median, 7.5 days).

Conclusions
TEES was considered appropriate for the treatment of ossicular chain disruption, even immediately after its introduction at our institution. For expert microscopic ear surgeons, ossicular chain disruption may be considered a suitable indication for the introduction of TEES.
The first reported values of microplastics in prostate
Authors: Demirelli Erhan , Tepe Yalçın , Oğuz Ural , Aydın Handan , Kodat Murat , Tok Doğan Sabri , Sönmez Mehmet Giray , Öğreden Ercan 
Published: May 2024

Abstract
Background
Microplastics are ubiquitous, widespread environmental pollutants with unavoidable human exposure. Herein, it was aimed to investigate the presence of microplastics in prostate tissue.

Methods
Prostate tissues from 12 patients who underwent Trans Urethral Resection of the Prostate (TUR-P) were analyzed to investigate the presence of microplastics. Initially, the prostate tissues were analyzed for microplastic particles using a light microscope after extraction. Subsequently, the chemical composition of the particles found in the prostate tissues was characterized using Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) spectrophotometry.

Results
Microplastic particles of various types were detected in 6 out of 12 patients. All detected plastic particles in this study were microplastics, with sizes below 26 μm in size. These microplastics exhibited different shapes as pellets, spheres or fibers. Overall, among the 12 analyzed prostate tissue samples, four different types of plastic were identified in six samples. The most common type of microplastic detected was Polyamide (Nylon 6), found in samples from three patients. Other detected types, Polypropylene, Polyacrylic Acid and Poly (dimethylsiloxane) were each determined in samples from one patient.

Conclusions
This is the first study to demonstrate the presence of microplastics in prostate tissue, serving as an exploratory investigation, which can trigger further research to validate the results in a larger patient cohort.
Clinical effect of chlorhexidine and sodium fluoride on corrosion behavior and surface topography of nitinol orthodontic archwires
Authors: Farrag Osama Gamil Abd El Gawad , Shamaa Nabeel El-Desouky Abou , Elgameay Walaa Elsayed , Bayoumi Dalia A. 
Published: May 2024

Abstract
Background
Alterations in the mechanical properties of the materials utilized in orthodontic appliances could affect the working properties of the appliances, thereby affecting clinical progress and outcome. Numerous studies have confirmed the correlation between alloy corrosion and raised surface roughness, which has a direct impact on the working characteristics of orthodontic archwires.

Methods
Thirty nickel-titanium (NiTi) orthodontic archwires were utilized in this study. Patients were randomly selected and allocated into three groups according to the randomization plan; (The control group): subjects practiced regular oral hygiene; (The fluoride group): subjects used fluoride for intensive prophylaxis; (The chlorhexidine group): subjects used chlorhexidine. Representative samples were evaluated by SEM, and then SEM images with high resolution were examined using Image J software to determine the surface roughness and obtain the results for further statistical analysis.

Results
Our findings indicated a significant difference was found between the three groups regarding the anterior and posterior parts between the control and the two other groups and a non-significant difference between NaF and CHX groups. Overall, the p-value for group comparisons was 0.000 for both parts, indicating a highly significant difference especially between the control and NaF groups.

Conclusion
Mouthwashes containing sodium fluoride demonstrated more significant surface alterations than the control and CHX groups and should be prescribed in accordance with orthodontic materials to reduce side effects.
Key factors in the future of oral and dental health in Iran using scenario writing approach
Authors: Mehrolhassani Mohammad Hossein , Mozhdehifard Mostafa , Rahimisadegh Rohaneh 
Published: May 2024

AbstractBackgroundOral and dental health can significantly impact individuals’ quality of life. The World Health Organization introduces oral health as one of the essential priorities of public health worldwide. Given the lack of studies on the future of oral and dental health in Iran, this study used a futures studies approach to identify the factors in oral and dental health in Iran through scenario writing.MethodsThis study was conducted in three stages including the scenario writing approach, qualitative methods, and exploratory future research. First, potential variables affecting future oral and dental health systems were extracted through interviews. The focus group discussion determined the uncertainty and importance of the variables. Then, the cross-impact balance matrix was imported into the Scenario Wizard software to identify the different states of the scenario generator variables and compatible scenarios were extracted.ResultsSeventy variables were extracted as key variables affecting the future of oral and dental health. Regarding the importance and uncertainty, seventeen variables scored higher and fell into policy and governance, economy and financing, social, service delivery, and technology, serving as five categories of scenario generators. Fifteen scenarios with weak consistency and three with strong consistency were obtained using the Cross-Impact Balance matrix in Scenario Wizard software.ConclusionThe probability of a pessimistic scenario where all five categories of the scenarios were in the worst possible state was higher due to its consistency. The government’s support policies and commitment to oral and dental health were two key factors in the future. Achieving an optimistic and favorable scenario for the future of the country’s oral and dental health system depends on the government and policymakers in the health sector adopting a positive attitude towards the role of oral and dental health services in improving societal health. In this scenario, the five categories of the scenario generators were in the best condition.
Breast cancer and the steadily increasing maternal age: are they colliding?
Authors: Londero Ambrogio P. , Bertozzi Serena , Xholli Anjeza , Cedolini Carla , Cagnacci Angelo 
Published: May 2024

Abstract
Background
Pregnancy-related cancers are mostly breast cancers, and their incidence is likely to increase as a result of the modern trend of delaying childbearing. In particular, advanced maternal age increases breast cancer risk, and younger breast cancer patients are more likely to die and metastasize. This study compared a population with a high incidence of delayed childbearing with another population with a lower mean age at childbirth in order to determine whether breast cancer diagnosis and childbearing age overlap.

Methods
We retrospectively analyzed multiple data sources. The Surveillance, Epidemiology, and End Results (SEER) program, the United States National Center for Health Statistics as part of the National Vital Statistics System, the United Nations Population Division, the GLOBOCAN Cancer Observatory, the CLIO-INFRA project database, the Human Fertility Database, and anonymized local data were used.

Results
As women’s age at delivery increased, the convergence between their age distribution at breast cancer diagnosis and childbearing increased. In addition, the overlap between the two age distributions increased by more than 200% as the average age at delivery increased from 27 to 35 years.

Conclusions
As women’s average childbearing age has progressively risen, pregnancy and breast cancer age distributions have significantly overlapped. This finding emphasizes the need for increased awareness and educational efforts to inform women about the potential consequences of delayed childbearing. By providing comprehensive information and support, women can make more informed decisions about their reproductive health and cancer prevention strategies.
The relationship between personality traits and happiness: the mediating role of emotional regulation
Authors: Shdaifat Emad , Shudayfat Tamadur , Alshowkan Amira 
Published: May 2024

Abstract
Background
Understanding the factors contributing to happiness in the nursing profession is essential, particularly considering the high levels of stress associated with the job. This study aimed to explore the role of emotion regulation in mediating the relationship between personality traits and nurses’ happiness.

Objective
This study aimed to explore the relationship between personality traits and happiness by examining the mediating role of emotion regulation.

Methods
A cross-sectional study was conducted with 324 Jordanian and 408 Saudi nurses. Data, including the Big Five personality traits, happiness levels, and measures of emotional regulation, were collected through an online survey. The model’s fit and explanatory capability were verified by Structural Equation Modeling (SEM) using SmartPLS 3.

Results
In the structural model, agreeableness had a significant effect on happiness, influencing both reappraisal and suppression. Extraversion strongly influences happiness, positively affects reappraisal, and negatively affects suppression. Neuroticism hampers happiness and reappraisal, and has a detrimental effect on suppression. Openness had a positive effect on suppression, whereas consciousness positively affected happiness. Mediation analysis revealed direct effects on happiness, with varying indirect contributions from emotional regulation. Multiple-group analysis revealed no significant differences between Jordan and Saudi Arabia in the association between personality traits and happiness.

Conclusion
The findings emphasize the nuanced effects of agreeableness, extraversion, neuroticism, consciousness, and openness on happiness, mediated by emotional regulation. Implementing specific interventions to improve emotional regulation can increase nurses’ happiness regardless of their personality traits. The lack of significant differences between Jordanian and Saudi nurses implies that these relationships are consistent across cultures, offering valuable information for cross-cultural healthcare interventions.
Care fragmentation and readmission mortality and length of stay before and during the COVID-19 pandemic: data from the National Readmissions Database, 2018–2020
Authors: Turbow Sara , Walker Tiffany , Culler Steven , Ali Mohammed K. 
Published: May 2024

Abstract
Importance
A quarter of all 30-day readmissions involve fragmented care, where patients return to a different hospital than their original admission; these readmissions are associated with increased in-hospital mortality and longer lengths-of-stay (LOS). The stress on healthcare systems at the beginning of the COVID-19 pandemic could worsen care fragmentation and related outcomes.

Objective
To compare fragmented readmissions in 2020 versus 2018–2019 and assess whether mortality and LOS in fragmented readmissions differed in the two time periods.

Design
Observational study

Setting
National Readmissions Database (NRD), 2018–2020

Participants
All adults (> 18 y/o) with 30-day readmissions

Main outcomes and measures
We examined the percentage of fragmented readmissions over 2018–2020. Using unadjusted and adjusted logistic and linear regressions, we estimated the associations between fragmented readmissions and in-hospital mortality and LOS.

Results
24.0–25.7% of readmissions in 2018–2020 and 27.3%-31.0% of readmissions for COVID-19 were fragmented. 2018–2019 fragmented readmissions were associated with 18–20% higher odds of in-hospital mortality compared to nonfragmented readmissions. Fragmented readmissions for COVID-19 were associated with an 18% increase in in-hospital mortality (AOR 1.18, 95% CI 1.12, 1.24). The LOS of fragmented readmissions in March-November 2018–2019 were on average 0.81 days longer, while fragmented readmissions between March-November of 2020 were associated with a 0.88–1.03 day longer LOS.

Conclusions and relevance
A key limitation is that the NRD does not contain information on several patient/hospital-level factors that may be associated with the outcomes of interest. We observed increased fragmentation during COVID-19, but its impact on in-hospital mortality and LOS remained consistent with previous years.
Pivotal functions and impact of long con-coding RNAs on cellular processes and genome integrity
Authors: Sharma Siddhant , Houfani Aicha Asma , Foster Leonard J. 
Published: May 2024

AbstractRecent advances in uncovering the mysteries of the human genome suggest that long non-coding RNAs (lncRNAs) are important regulatory components. Although lncRNAs are known to affect gene transcription, their mechanisms and biological implications are still unclear. Experimental research has shown that lncRNA synthesis, subcellular localization, and interactions with macromolecules like DNA, other RNAs, or proteins can all have an impact on gene expression in various biological processes. In this review, we highlight and discuss the major mechanisms through which lncRNAs function as master regulators of the human genome. Specifically, the objective of our review is to examine how lncRNAs regulate different processes like cell division, cell cycle, and immune responses, and unravel their roles in maintaining genomic architecture and integrity.
A scoping review to create a framework for the steps in developing condition-specific preference-based instruments de novo or from an existing non-preference-based instrument: use of item response theory or Rasch analysis
Authors: Tsui Teresa C. O. , Torres Sofia C. , Bielecki Joanna M. , Mitsakakis Nicholas , Trudeau Maureen E. , Bremner Karen E. , Davis Aileen M. , Krahn Murray D. 
Published: May 2024

Abstract
Background
There is no widely accepted framework to guide the development of condition-specific preference-based instruments (CSPBIs) that includes both de novo and from existing non-preference-based instruments. The purpose of this study was to address this gap by reviewing the published literature on CSPBIs, with particular attention to the application of item response theory (IRT) and Rasch analysis in their development.

Methods
A scoping review of the literature covering the concepts of all phases of CSPBI development and evaluation was performed from MEDLINE, Embase, PsychInfo, CINAHL, and the Cochrane Library, from inception to December 30, 2022.

Results
The titles and abstracts of 1,967 unique references were reviewed. After retrieving and reviewing 154 full-text articles, data were extracted from 109 articles, representing 41 CSPBIs covering 21 diseases or conditions. The development of CSPBIs was conceptualized as a 15-step framework, covering four phases: 1) develop initial questionnaire items (when no suitable non-preference-based instrument exists), 2) establish the dimensional structure, 3) reduce items per dimension, 4) value and model health state utilities. Thirty-nine instruments used a type of Rasch model and two instruments used IRT models in phase 3.

Conclusion
We present an expanded framework that outlines the development of CSPBIs, both from existing non-preference-based instruments and de novo when no suitable non-preference-based instrument exists, using IRT and Rasch analysis. For items that fit the Rasch model, developers selected one item per dimension and explored item response level reduction. This framework will guide researchers who are developing or assessing CSPBIs.