bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors conditioning pain control and reduction in post-cesarean section parturients: a cross-sectional study
Authors: Pilewska-Kozak Anna Bogusława , Dziurka Magdalena , Bałanda –Bałdyga Agnieszka , Monist Marta Joanna , Kopiel Ewelina , Jurek Krzysztof , Łęcka Anna Francesca , Dobrowolska Beata 
Published: May 2024

Abstract
Background
Pain experienced by women in the perinatal period constitutes a complex and multifaceted phenomenon. The aim of the study was to assess conditions of pain locus of control and pain reduction in post-cesarean section parturients.

Materials and methods
A cross-sectional quantitative study with convenience sampling was performed among 175 hospitalized post-cesarean section women in hospitals in Eastern Poland in accordance with the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) statement. A self-design questionnaire regarding general information and obstetrics/gynaecology medical interview, The Pain Coping Strategies Questionnaire (CSQ) and The Beliefs about Pain Control Questionnaire (BPCQ) were used. The inclusion criteria were as follows (1) age of ⩾18 years old; (2) cesarean section (CS); (3) period from the 13th hour to the end of the 72nd hour after the procedure; and (4) informed consent. The data was analyzed with IBM SPSS Statistics.

Results
Internal locus of control (M = 14.02) was provided the highest value by the parturients and followed by chance events (M = 12.61) and doctors’ power (M = 12.18). Dominant coping with pain strategies in the post-cesarean parturients were coping self-statements (M = 19.06), praying or hoping (M = 18.86). The parturients assessed their pain coping (M = 3.31) strategies along with pain reduction (M = 3.35) at the moderate level. Higher pain control was correlated with cognitive pain coping strategies (β = 0.305; t = 4.632; p < 0.001), internal pain control β = 0.191; t = 2.894; p = 0.004), cesarean section planning (β = -0.240; t = -3.496; p = 0.001) and past medical history of CS (β = 0.240; t = 3.481; p = 0.001). The skill of reduction of pain was positively associated with cognitive pain coping strategies (β = 0.266; t = 3.665; p < 0.001) and being in subsequent pregnancy (β = 0.147; t = 2.022; p = 0.045). Catastrophizing and hoping were related to lower competences of coping with pain (B = − 0.033, SE = 0.012, β = − 0.206, T = -2.861).

Conclusions
The study allowed for identification and better comprehension of factors conditioning pain control and pain reduction in parturients after the cesarean section. Furthermore, a stronger belief that pain can be dealt with is found in the parturients characterized by cognitive pain coping strategies and internal pain locus of control. The skill of reduction of pain is related to cognitive coping strategy and procreation status.
Cost-effectiveness of ivosidenib versus chemotherapy for previously treated IDH1-mutant advanced intrahepatic cholangiocarcinoma in Taiwan
Authors: Chen Kuei-An , Huang Wei-Ming , Chen Eric Yi-Ting , Ho Pei-Kuan , Chueh Chen-Han , Wen Yu-Wen , Chen Ming-Huang , Chiang Nai-Jung , Tsai Yi-Wen 
Published: May 2024

Abstract
Background
International guidelines recommend ivosidenib followed by modified FOLFOX (mFOLFOX) for advanced intrahepatic cholangiocarcinoma (ICC) with isocitrate dehydrogenase 1 (IDH1) mutations. Taiwan National Health Insurance covers only fluorouracil/leucovorin (5-FU/LV) chemotherapy for this ICC group, and there has been no prior economic evaluation of ivosidenib. Therefore, we aimed to assess ivosidenib’s cost-effectiveness in previously treated, advanced ICC-presenting IDH1 mutations compared with mFOLFOX or 5-FU/LV.

Methods
A 3-state partitioned survival model was employed to assess ivosidenib’s cost-effectiveness over a 10-year horizon with a 3% discount rate, setting the willingness-to-pay threshold at 3 times the 2022 GDP per capita. Efficacy data for Ivosidenib, mFOLFOX, and 5-FU/LV were sourced from the ClarIDHy, ABC06, and NIFTY trials, respectively. Ivosidenib’s cost was assumed to be NT$10,402/500 mg. Primary outcomes included incremental cost-effectiveness ratios (ICERs) and net monetary benefit. Deterministic sensitivity analyses (DSA) and probabilistic sensitivity analyses (PSA) were employed to evaluate uncertainty and explore price reduction scenarios.

Results
Ivosidenib exhibited ICERs of NT$6,268,528 and NT$5,670,555 compared with mFOLFOX and 5-FU/LV, respectively, both exceeding the established threshold. PSA revealed that ivosidenib was unlikely to be cost-effective, except when it was reduced to NT$4,161 and NT$5,201/500 mg when compared with mFOLFOX and 5-FU/LV, respectively. DSA underscored the significant influence of ivosidenib’s cost and utility values on estimate uncertainty.

Conclusions
At NT$10,402/500 mg, ivosidenib was not cost-effective for IDH1-mutant ICC patients compared with mFOLFOX or 5-FU/LV, indicating that a 50–60% price reduction is necessary for ivosidenib to be cost-effective in this patient group.
Construction and validation of a novel tumor morphology immune inflammatory nutritional score (TIIN score) for intrahepatic cholangiocarcinoma: a multicenter study
Authors: Zhang Haofeng , Huang Guan , Li Qingshan , Wang Yanbo , Yang Zhenwei , Chen Pengyu , Yuan Hao , Chen Kunlun , Meng Bo , Yu Haibo 
Published: May 2024

Abstract
Background
Tumor morphology, immune function, inflammatory levels, and nutritional status play critical roles in the progression of intrahepatic cholangiocarcinoma (ICC). This multicenter study aimed to investigate the association between markers related to tumor morphology, immune function, inflammatory levels, and nutritional status with the prognosis of ICC patients. Additionally, a novel tumor morphology immune inflammatory nutritional score (TIIN score), integrating these factors was constructed.

Methods
A retrospective analysis was performed on 418 patients who underwent radical surgical resection and had postoperative pathological confirmation of ICC between January 2016 and January 2020 at three medical centers. The cohort was divided into a training set (n = 272) and a validation set (n = 146). The prognostic significance of 16 relevant markers was assessed, and the TIIN score was derived using LASSO regression. Subsequently, the TIIN-nomogram models for OS and RFS were developed based on the TIIN score and the results of multivariate analysis. The predictive performance of the TIIN-nomogram models was evaluated using ROC survival curves, calibration curves, and clinical decision curve analysis (DCA).

Results
The TIIN score, derived from albumin-to-alkaline phosphatase ratio (AAPR), albumin–globulin ratio (AGR), monocyte-to-lymphocyte ratio (MLR), and tumor burden score (TBS), effectively categorized patients into high-risk and low-risk groups using the optimal cutoff value. Compared to individual metrics, the TIIN score demonstrated superior predictive value for both OS and RFS. Furthermore, the TIIN score exhibited strong associations with clinical indicators including obstructive jaundice, CEA, CA19-9, Child–pugh grade, perineural invasion, and 8th edition AJCC N stage. Univariate and multivariate analysis confirmed the TIIN score as an independent risk factor for postoperative OS and RFS in ICC patients (p < 0.05). Notably, the TIIN-nomogram models for OS and RFS, constructed based on the multivariate analysis and incorporating the TIIN score, demonstrated excellent predictive ability for postoperative survival in ICC patients.

Conclusion
The development and validation of the TIIN score, a comprehensive composite index incorporating tumor morphology, immune function, inflammatory level, and nutritional status, significantly contribute to the prognostic assessment of ICC patients. Furthermore, the successful application of the TIIN-nomogram prediction model underscores its potential as a valuable tool in guiding individualized treatment strategies for ICC patients. These findings emphasize the importance of personalized approaches in improving the clinical management and outcomes of ICC.
A case report of classic galactosemia with a GALT gene variant and a literature review
Authors: Wang Yong-cai , Lan Lian-cheng , Yang Xia , Xiao Juan , Liu Hai-xin , Shan Qing-wen 
Published: May 2024

Abstract
Background
Galactosemia is an autosomal recessive disorder resulting from an enzyme defect in the galactose metabolic pathway. The most severe manifestation of classic galactosemia is caused by galactose-1-phosphate uridylyltransferase (GALT) deficiency, and this condition can be fatal during infancy if left untreated. It also may result in long-term complications in affected individuals.

Case presentation
This report describes a patient whose initial clinical symptoms were jaundice and liver dysfunction. The patient’s liver and coagulation functions did not improve after multiple admissions and treatment with antibiotics, hepatoprotective and choleretic agents and blood transfusion. Genetic analysis revealed the presence of two variants in the GALT gene in the compound heterozygous state: c.377 + 2dup and c.368G > C (p.Arg123Pro). Currently, the variant locus (c.377 + 2dup) in the GALT gene has not been reported in the Human Gene Mutation Database (HGMD), while c.368G > C (p.Arg123Pro) has not been reported in the Genome Aggregation Database (GnomAD) nor the HGMD in East Asian population. We postulated that the two variants may contribute to the development of classical galactosemia.

Conclusions
Applications of whole-exome sequencing to detect the two variants can improve the detection and early diagnosis of classical galactosemia and, more specifically, may identify individuals who are compound heterozygous with variants in the GALT gene. Variants in the GALT gene have a potential therapeutic significance for classical galactosemia.
Trust in primary health care and COVID-19 vaccine uptake among Iranian pediatric: a web-based cross-sectional survey
Authors: Sarbazi Ehsan , Masoudi Nazanin , Mehri Ahmad , Esfanjani Robab Mehdizadeh , Azizi Hosein , Soleimanpour Maryam , Pouraghaei Mahboub , Soleimanpour Hassan 
Published: May 2024

Abstract
Background
Children are the most vulnerable group to diseases. Thus, it’s critical to evaluate parents’ or guardians’ willingness to vaccinate their children. This study aims to investigate the prevalence and predictors of pediatric COVID-19 vaccination in Iran and its relationship with trust in the Primary Health Care (PHC) system.

Method
A cross-sectional online survey of 549 Iranian parents was conducted between January and March 2023. This study collected data from all provinces of Iran using a questionnaire shared on Google Forms and various social media platforms. After considering various background factors, we used a multivariable logistic regression model. This model explored how trust in the PHC system and parent-related and child-related factors were related to parents’ vaccine uptake for their children.

Results
Of 549 parents aged between 19 and 67 years (median = 38 years), 65.2% (358) were female. The prevalence of vaccine uptake among parents was 46.8%. After adjusting for background features, child’s age (adjusted odds ratio [AOR] 0.81, 95% CI 0.71–0.91), vaccine doses (1-dose: AOR 14.72, 95% CI 6.44–33.65, 2-dose: AOR 32.54, 95% CI 15.22–69.57), child’s disease (AOR 5.31, 95% CI 2.19–12.85), and trust in PHC (AOR 1.01, 95% CI 1.00–1.02) were associated with parental uptake of the COVID-19 vaccine.

Conclusions
The findings of this study suggest that the child’s age, vaccine doses received, diseases, and trust in PHC are significant predictors of parental uptake of the COVID-19 vaccine for children in Iran. The results can be used in service planning regarding children’s COVID-19 vaccination.
Factors influencing risk perception during Public Health Emergencies of International Concern (PHEIC): a scoping review
Authors: Yin Jason Dean-Chen , Lui Juliana Nga-Man 
Published: May 2024

AbstractThe unknownness and dread potential of a risk event shapes its perceived risk. A public health emergency of international concern (PHEIC) declaration by the World Health Organisation (WHO) is a signal for such an event. Understanding perceived risk then shapes risk-avoiding behaviours, important for health prevention. The review aims to consolidate the determinants of risk perception during a PHEIC, underscoring the need for grounding in context and theory. Studies published from 2010 until end-2020, searching PubMed, PsycINFO, MedlinePlus, PubPsych, and CINAHL, were included. Studies with only biological conceptualisations of risk, or no association to risk perception, were excluded. A total of 65 studies were included. Quality of the cross-sectional studies was assessed using Newcastle Ottawa Scale (NOS), yielding an average of 5.4 stars (out of 10). Factors were classified into three broad categories – individual, contextual, and media. Individual risk factors include emotions; beliefs, trust, and perceptions; immutable physical traits (sex, age, ethnicity); mutable traits (education, income, etc.); and knowledge, with no definitive correlation to risk perception. Contextual traits include pandemic experience, time, and location, with only time negatively correlated to risk perception. Media traits include exposure, attention, and framing of media, with no clear association to risk perception. One limitation is excluding a portion of COVID-19 studies due to censoring. Still, this lack of consensus highlights the need to better conceptualise “risk perception”. Specifying the context and timing is also important since jurisdictions experience different outbreaks depending on outbreak histories. Using theories to ground risk perception research assists with these tasks.
Process evaluation of implementation of the early stages of a whole systems approach to obesity in a small Island
Authors: MacKinlay Brittney , Heneghan Kate , Potts Alexandra J. , Radley Duncan , Sanders George , Walker Ian F. 
Published: May 2024

Abstract
Background
The small Atlantic island of St Helena is a United Kingdom Overseas Territory (UKOT) with a high prevalence of childhood obesity (over a quarter of 4–5 and 10–11 year olds) and, anecdotally, adulthood obesity and its associated health detriments. St Helena have taken a whole systems approach to obesity (WSAO) to address the issue. A WSAO recognises the factors that impact obesity as a complex system and requires a ‘health in all policies’ approach. UK academic and public health technical support was provided to the local St Helena delivery team. This process evaluation sought to explore the early stages of the WSAO implementation and implications for the transferability of the approach to other small island developing states and UKOT.

Methods
Data was collected via eight semi-structured interviews, paper based and online surveys, and document analysis. Thematic analysis was used to analyse the data.

Results
The analysis identified three factors which aided the first phase of WSAO implementation: (1) senior leaders support for the approach; (2) the academic support provided to establish and develop the approach; and (3) effective adaptation of UK Government resources to suit the local context. Key challenges of early implementation included: maintaining and broadening stakeholder engagement; limited local workforce capacity and baseline knowledge related to obesity and systems thinking; and limited capacity for support from the UK-based academic team due to contract terms and COVID-19 restrictions.

Conclusions
Early stages of implementation of a WSAO in a UKOT can be successful when using UK’s resources as a guide and adapting them to a small island context. All participants recommended other small islands adopt this approach. Continued senior support, dedicated leadership, and comprehensive community engagement is needed to progress implementation and provide the foundation for long-term impact. Small island developing states considering adopting a WSAO should consider political will, senior level buy-in and support, funding, and local workforce knowledge and capacity to enable the best chances of successful and sustainable implementation.
Estimating thoracic kyphosis without information on upper thoracic kyphosis: an observational study on 455 patients examined by EOS imaging
Authors: Ghandhari Hasan , Javanbakht Mohammad , Nikouei Farshad , Shakeri Mohammadreza , Cegolon Luca , Motalebi Mohsen 
Published: May 2024

Abstract
Background
Physiological thoracic kyphosis (TK) allows sagittal balance of human body. Unlike lumbar lordosis (LL), TK has been relatively neglected in the literature. EOS is an imaging technique employing high-sensitivity xenon particles, featured by low-dose exposure combined with high accuracy compared to conventional radiography. The aim of this study was to investigate predictors of TK in patients with phyiological spine morphology using EOS imaging.

Methods
EOS images of 455 patients without spinal anomalies were retrospectively assessed for TK (T1- T12), upper thoracic kyphosis (UTK, T1-T5), lower thoracic kyphosis (LTK, T5-T12), LL (L1-S1) and pelvic incidence (PI). The latter curves were measured by two researchers separately and the average of the two measurements was used for further analysis.
Spearman non-parametric correlation was estimated for age, PI, LL, LTK, UTK and TK. Multiple robust linear regression analysis was employed to estimate TK, controlling for the effect of age, sex, LL and LTK.

Results
The mean age of patients was 28.3 ± 19.2 years and 302 (66.4%) of them were females. The mean TK, UTK and LTK was 45.5° ± 9.3, 16 ± 7.4° and 29.7° ± 8.9, respectively. The mean UTK in people under 40 years of age was 17.0° ± 7.2, whereas for patients 40+ years old it was 13.6° ± 7.4. At univariable analysis TK positively correlated with UTK (p<0.001), LTK (p<0.001) an LL (p<0.001). At multivariable linear regression TK increased with LTK (RC = 0.67; 95%CI: 0.59; 0.75) or LL (RC = 0.12; 95%CI: 0.06; 0.18), whereas it decreased with age (RC = -0.06; 95%CI: -0.09;—0.02).

Conclusion
If EOS technology is available, the above linear regression model could be used to estimate TK based upon information on age, sex, LL and LTK. Alternatively, TK could be estimated by adding to LTK 17.0° ± 7.4 for patients < 40 years of age, or 13.6° ± 7.4 in patients 40 + years old. The evidence from the present study may be used as reference for research purposes and clinical practice, including spine examination of particular occupational categories or athletes.
Impact of self-assessment on dental student’s performance in pre-clinical conservative dentistry course
Authors: Mittal Priya , Jadhav Ganesh R. , Pawar Mansing , Banerjee Sitikantha , Wangaskar Sneha , Di Blasio Marco , Cervino Gabriele , Minervini Giuseppe 
Published: May 2024

Abstract
Background
Self-assessment (SA) is an interactive course that endorses the accomplishment of learning objectives through learners’ identification of insufficiencies in their didactic knowledge and pre-clinical skills. This study was planned to determine whether there is any improvement in the faculty assessment (FA) score following the implementation of SA in the Pre-clinical Conservative Dentistry Course.

Methods
Fifty-four first-semester dental students were given an introductory lecture followed by a demonstration for Class I Cavity Preparation in typhodont mandibular first molar. At the end of the demonstration, the Scoring Rubric (SR) was explained point-wise in the prepared cavities. During the next session, all students performed Class I cavity preparation and they were given an assessment sheet to enter their scores (SA1). All teeth were evaluated by the Grading Faculties in a blinded manner (FA1). Each participant was explained the difference in their respective SA1 from FA1 and their queries were resolved individually. During the next sessions, Students and Grading Faculties followed the same protocol and scores were recorded as SA2, FA2, SA3 and FA3.

Results
The mean score of SA1 was significantly higher than that of FA1 (p < 0.001). However, no significant difference was obtained between SA and FA in the second (p = 0.352) and third (p = 0.434) assessments. In contrast with first assessment, mean marks obtained in FA were higher compared to SA in both second and third assessments. There was a statistically significant improvement in mean marks obtained by the students over time (p < 0.001).

Conclusion
SA endorsed student-faculty communication and enhanced student’s poise and technical skills in operative pre-clinical dentistry.
Application of personalized templates in minimally invasive management of coronal dens invaginatus: a report of two cases
Authors: Li Mingming , Wang Guosong , Zhu Fangzhi , Jiang Han , Yang Yingming , Cheng Ran , Hu Tao , Zhang Ru 
Published: May 2024

Abstract
Background
Treating the coronal dens invaginatus (CDI) with pulp infection commonly involves the removal of invagination, which increases the risk of perforation and fracture, and compromises the tooth structure. Minimally invasive endodontic management of CDI is highly recommended. This report describes two cases of type II CDI with the application of personalized templates.

Case presentation
Two cases of type II CDI, affecting the main root canal in a maxillary canine and a lateral incisor, were diagnosed. A guided endodontics (GE) approach was applied. Cone-beam computed tomography and intraoral scans were imported and aligned in a virtual planning software to design debridement routes and templates. The MICRO principle (which involves the aspects of Mechanical (M) debridement, Irrigation (I), Access cavities (C), Rectilinear routes (R), and Obstruction (O)) was proposed for designing optimal debridement routes for future applications. The templates were innovatively personalized and designed to preserve the tooth structure maximally while effectively debriding the root canal. Root canal treatment with supplementary disinfection was then performed. The follow-up of the two patients revealed favorable clinical and radiographic outcomes.

Conclusions
The GE approach could be a feasible method for preserving healthy dental structure while effectively debriding the root canal, thereby achieving successful and minimally invasive endodontic treatment for CDI.