bluuebunny/crossref_metadata_2025_split huggingface dataset:
What about neurodiversity among nurses? A cross-sectional exploration of work environment and health among nurses with ADHD and/or autism
Authors: Hedlund Åsa , Jordal Malin 
Published: February 2025

Background Employees who have ADHD and/or autism frequently encounter difficulties in their workplace and with their health. Nevertheless, there is a dearth of research focusing on nurses who have ADHD and/or autism, even though the nursing profession presents various significant organizational and social challenges that may potentially have an impact on nurses with ADHD and/or autism. Objective The aim of the present study was to describe and examine associations between work environment, perceived health and satisfaction with given care among nurses who have ADHD and/or autism. Methods Recruitment of participants took place through Swedish social media groups, and data collection was carried out via a web-based questionnaire. A total of 99 nurses who self-reported a diagnosis of ADHD and/or autism were included in the study. Descriptive statistics, binary correlations and linear regression analyses were conducted to analyze the data. Results The nurses reported high quantitative demands at work, low sense of social community and managerial social support, low perceived health and high satisfaction with given care. Regarding associations between variables, nurses with more inattention (ADHD trait) reported higher quantitative demands at work, and nurses with more social anxiety (autistic trait) reported lower perceived health. Conclusions Among nurses with ADHD and/or autism, the organizational and social work environment and health are challenging, and these challenges seem to be partly connected to the ADHD and autistic traits. However, patient care was perceived to work well. More research is needed to evaluate how the perceived health of nurses with ADHD/autism can be improved.
Impact of return-to-work pathway on vocational outcomes following severe acquired brain injury: A secondary analysis of the VIP1.0 trial
Authors: Gates Thomas M , McRae Philippa , Daher Maysaa , Simpson Grahame K 
Published: February 2025

Background Most research into vocational re-integration following severe acquired brain injury (ABI) has focused on returning to pre-injury employment. While there is significant demand for new employment post-ABI, much less is known about this return-to-work (RTW) pathway. Objective To compare and contrast the clinical profiles and outcomes achieved through vocational rehabilitation (VR) following severe ABI according to RTW pathway. Methods Secondary data analysis of the Vocational Intervention Program efficacy trial (VIP1.0). Participants with severe ABI undertaking a VR program were re-classified into two RTW pathway groups: return to pre-injury employment (Fast-Track; FT) or obtaining new employment (New-Track; NT). Competitive employment status (Yes/No) and clinician ratings of disability and participation were collected pre- and post-intervention and at 3-month follow-up. Results 47 (46%) participants undertook a FT pathway and 55 (54%) a NT pathway. Compared to FT, NT participants were less educated, more likely to be single, further post-injury, already attempted to RTW unsuccessfully post-injury, and less likely to complete the VR intervention. For both pathways, employment rates improved from pre- to post-intervention and remained stable at follow-up. While FT was associated with high RTW success (post-intervention: 89%; follow-up: 88%), a significant minority of NT participants also achieved competitive employment (post-intervention: 34%; follow-up: 45%). FT participants were also rated as demonstrating greater improvements in work-related participation from pre- to post-intervention than NT. Conclusions Despite its challenges, VR interventions targeting new employment can lead to beneficial RTW outcomes for many individuals unable to return to their previous employer following severe ABI.
A narrative review on the application of Delphi and fuzzy Delphi techniques in the cement industry
Authors: Khorshidikia Samane , Rismanchian Masoud , Habibi Ehsanollah 
Published: February 2025

Background The Delphi technique and its fuzzy variant are widely employed across various sectors, including industrial applications, for eliciting expert consensus and identifying priorities. Despite its prevalence, there is limited literature on its application within the cement industry. Objective This review aims to explore and introduce the applications of the Delphi technique and fuzzy Delphi technique specifically within the cement industry context. Methods A narrative review was conducted focusing on studies between 2015 and 2024 that utilized the Delphi technique in the cement industry. The review included identifying primary areas of application such as assessing environmental impacts and prioritizing performance indicators crucial for industry stability and growth. Results The review revealed that the Delphi technique is predominantly used in the cement industry to assess environmental effects associated with the production process. Additionally, it serves to identify and prioritize key performance indicators that influence industry sustainability and development. Conclusions The findings underscore the significance of the Delphi technique and its fuzzy variant in facilitating consensus among experts in the cement industry. Future research should continue exploring these methodologies to enhance decision-making processes and address emerging challenges within the sector.
Salivary biomarkers as indicators of occupational fatigue
Authors: Mahdavi Neda , Shafiee Motlagh Masoud , Ranjbar Akram , Ghaffari Fateme , Faridan Mohammad , Tajik Leila , Mokhayeri Yaser , Heidarimoghadam Rashid 
Published: February 2025

Background To properly manage fatigue, it is essential to employ reliable evaluation techniques with little workplace involvement. Objective The purpose of this study was to investigate the applicability of salivary biomarker analysis as a tool for assessing weariness. Methods 32 workers (15 office employees and 17 industrial workers) were included in this research after meeting the inclusion and exclusion criteria and receiving informed permission from the participants. The levels of fatigue was then assessed using salivary biomarker analysis kits and a hand dynamometer. Results Except Grip Force (GF) at a significance level of 0.1 (p-value: 0.07), other variables had no significant alteration between two occupational groups. The superoxide dismutase (SOD) activity and GF of both job groups had a non-significant downward trend, while the total thiol group (TTG) and lipid peroxides (LPO) of both groups demonstrated a non-significant upward trend. Biomarkers in saliva, such as total antioxidant capacity (TAC), Catalase (CAT), and Tumor Necrosis Factor-alpha (TNF-α), can potentially be considered as differentiators of fatigue between cognitive and physical occupations. Conclusions In sub-maximal activities, such as occupational tasks, alterations in some biomarkers, including LPO and SOD, may effectively indicate signs of physical fatigue.Obviously, this is only a preliminary study, and subsequent research should be carried out to acertain these basic findings.
Factors influencing sleep quality in healthcare workers: The mediating role of depression and anxiety symptoms
Authors: Luo Minrui , Chen Fengqiong , Liu Xiao , Ye Mengliang 
Published: February 2025

Background Numerous research has investigated the impact of depression and anxiety symptoms, occupational stress, work hours on sleep quality. Nevertheless, the interrelationships between these variables remain poorly understood. Objective The objective of this study is to examine the factors that influence sleep quality, to elucidate the relationships between them and to examine the extent to which depressive and anxiety symptoms act as mediators in the aforementioned relationships. Methods A cross-sectional survey was conducted to obtain information about medical personnel in Chongqing, China. The Depressive Symptom Scale, Anxiety Symptom Scale and Sleep Quality Scale developed by the Chinese Center for Disease Control and Prevention were used to assess the status of depression, anxiety and sleep quality, respectively. Structural equation modeling was employed to investigate the factors that influence sleep quality. Results The detection rate of poor sleep quality among healthcare workers in Chongqing was 57.9%, analyzed by structural equation modeling, the direct effects of anxiety and depressive symptoms on sleep quality were −0.328, −0.221 and fully mediated the relationship between socio-economic status, weekly working hours and occupational tension and sleep quality. Social support, demands and payments had higher effects on sleep quality of −0.167, −0.176 respectively. Conclusions The factors affecting sleep quality were identified as weekly working hours, working age, socioeconomic status, and occupational tension. The sub-dimensions of occupational tension that played a decisive role were social support, demands, and payments. The association between the aforementioned variables and sleep quality was fully mediated by depression and anxiety symptoms.
Investigation of the performance's effects on performance-related musculoskeletal pain, finger grip strength, finger dexterity, and hand grip strength in violinists
Authors: Kecelioglu Sule , Topdemir Turhan Ebru , Kaya Mutlu Ebru , Narin Aral Selnur 
Published: February 2025

Background Musicians are performing artists, and parameters such as strength and dexterity are required for their performance. In violinists, who the instrument group with a high prevalence of performance-related musculoskeletal pain (PRMP), the effects of performance on PRMP and these parameters, and the correlation between these parameters and PRMP are also intriguing. Objective To investigate the effects of performance on PRMP, finger grip strength, finger dexterity, and hand grip strength in violinists and also to provide perspective on parameters correlated with PRMP. Methods This study included 78 violinists (mean age: 22.50 ± 2.87, 55 Female-23 Male). Violinists were evaluated for PRMP with the Numeric Rating Scale, finger grip strength with the pinch meter, finger dexterity with the Purdue Pegboard Test, and hand grip strength with the hand dynamometer. Musicians were evaluated on two separate days: 1) during rest and one week later, 2) after playing the Concerto in B Minor (post-performance). Results Post-performance, there was an improvement in PRMP and finger grip strength and a decrease in finger dexterity. There was no change in hand grip strength. PRMP was only correlated with left-hand grip strength, and the explanatory power of left-hand grip strength was low. Conclusions Contrary to the literature, there was a decrease in PRMP post-performance in young violinists. It is noteworthy that finger grip strength increased while finger dexterity decreased. Left-hand grip strength may contribute to the reduction of PRMP. It is clear that more research is needed on musician health and that clear conclusions are still far off.
Effect of electroacupuncture for early ankle osteoarthritis: A randomized controlled trial using three-dimensional gait analysis
Authors: Jiang Cai , Xia Libin , Li Hai , Ke Xiaohua , Li Sicheng , Wang Jiaqi , Yao Zizhe , Huang Dunbing , Lin Zhonghua 
Published: February 2025

Background Ankle osteoarthritis (AOA) is a prevalent condition that affects joint function, often leading to pain, inflammation, and impaired mobility, significantly impacting patients’ quality of life. Objective This study explores the effects of electroacupuncture treatment on clinical outcomes and gait characteristics in patients with ankle osteoarthritis (AOA). Methods A total of 78 patients with AOA were randomly divided into a experiment group and a control group. The control group was treated with strength training, and the experiment group was additionally treated with electroacupuncture. The Ankle Osteoarthritis Scale (AOS), American Foot and Ankle Society's Ankle and Hindfoot Scale (AOFAS-AHS), and the 3D Motion Analysis System were used before and after the intervention to assess the clinical outcomes and changes in kinematic parameters in the AOA patients before and after therapy. Results After treatment, the differences in intra-group comparisons and inter-group comparisons of AOS scores, AOFAS-AHS scores, stride length, stride length, single-support phase, and gait variable scores (GVS) of ankle dorsiflexion-plantarflexion of the patients in the experiment group were statistically significant; the differences in inter-group comparisons of GVS scores of hip rotation of the patients in the experiment group were statistically significant; and the differences in the gait profile scores (GPS) and gait deviation indices of the patients in the experiment group were statistically significant. The differences in the intra-group comparisons were statistically significant. The within-group comparisons of AOS score, AOFAS-AHS score, GPS score and GVS score of ankle dorsiflexion-plantarflexion were statistically significant in the control group patients. Conclusions Electroacupuncture has shown promise as an adjunctive therapy for patients with AOA, offering a more holistic rehabilitation strategy. By improving joint mobility and optimizing gait mechanics, electroacupuncture can effectively reduce pain, facilitate the restoration of normal gait patterns, and enhance patients’ overall quality of life.
Effects of instrument-assisted manipulation and mobilization with movement in chronic non-specific low back pain: A randomized controlled trial
Authors: Erol Erkan , Burak Mustafa , Elbasan Bülent 
Published: February 2025

Background Low back pain is the third most reported complaint after headache and chronic fatigue, and more than 80% of the population will experience low back pain at some point in their lives. Objectıve We conducted this study to investigate the effects of instrument-assisted manipulation (IAM) and mobilization with movement (MWM) on joint range of motion (ROM), pain, proprioception, endurance, back awareness, and disability in individuals with chronic nonspecific low back pain (CNSLBP). Methods 51 participants with CNSLBP were randomized to one of three groups: (1) MWM; (2) IAM; or (3) core exercise. Joint ROM, pain, proprioception, endurance, back awareness, and disability were assessed at baseline, week 2 and 6. Results Joint ROM and activity pain scores increased in all groups (p < 0.05). Both activity and resting pain improved in the MWM group (p < 0.001; p = 0.004). Most measures related to proprioception improved in the MWM group (p = 0.005; p = 0.016; p = 0.016). Endurance increased in all groups, but the flexor endurance increase was higher in the MWM group (p < 0.05). Back awareness and disability increased in all groups (p < 0.05), but disability increased most in MWM group (p = 0.022). Conclusıons MWM could effectively improve pain, proprioception, endurance, and disability.
Optimal Target Angle in Oblique Diaphyseal Osteotomy of the Fifth Metatarsal for Symptomatic Bunionette: A Retrospective Analysis
Authors: Ikuta Yasunari , Nakasa Tomoyuki , Kawabata Shingo , Ishibashi Saori , Sakurai Satoru , Moriwaki Dan , Adachi Nobuo 
Published: February 2025

Background: The effects of the osteotomy angle during oblique diaphyseal osteotomy of the fifth metatarsal on the clinical outcomes remain unclear. This study aimed to clarify the clinical and radiographic outcomes of this procedure, with a focus on the intraoperative osteotomy angle. Methods: This retrospective study included 30 female patients who underwent oblique diaphyseal osteotomy of the fifth metatarsal with single-screw fixation for symptomatic bunionette (36 feet, mean age, 68.3 years; mean follow-up, 22.5 months). The angles between the osteotomy line and the fifth metatarsal and screw insertion axes were measured as the osteotomy and screw insertion angles, respectively. Receiver operating characteristic curve analysis was performed to determine the cutoff value for the osteotomy angle. The metatarsophalangeal angle (MTPA) and intermetatarsal angle (IMA) between the fourth and fifth metatarsals were measured on dorsoplantar images. The Japanese Society for Surgery of the Foot (JSSF) scale was scored at the preoperative and final follow-up visits. Results: Screw backout was identified in 14 feet (38.9 %). The osteotomy and screw insertion angles were 35.9 and 62.2 degrees in the screw backout group and 24.6 and 71.2 degrees in the control group, respectively ( P < .05). The osteotomy angle >31.1 degrees was a cutoff value of postoperative screw backout (sensitivity, 0.79; specificity, 0.96; area under the curve, 0.92). The mean MTPA and IMA were 21.0 and 12.3 degrees preoperatively and 9.3 and 8.2 degrees at the final follow-up, respectively. The mean JSSF scale score improved significantly from 59.9 to 95.3. Conclusion: The osteotomy angle was greater and the screw was inserted more shallowly against the osteotomy line in the screw backout group compared with the control group. The optimal target angle of the osteotomy line to the fifth metatarsal axis should be <30 degrees intraoperatively for single-screw fixation.
Severe gastrointestinal adverse reactions including perforation, ulceration, hemorrhage, and obstruction: A fumaric acid ester class new safety risk
Authors: Kim Tiffany , Brinker Allen , Croteau David , Lee Paul R , Baldassari Laura E , Pimentel-Maldonado Daniela , Stevens Jessica , Phipps Christine , Hughes Alice , Lyons Erica , Finkelstein Laura H , Munoz Monica A 
Published: February 2025

Background: Although gastrointestinal (GI) adverse reactions (ARs) were commonly observed in registrational clinical trials of fumarate acid ester (FAE) drugs for the treatment of multiple sclerosis, serious GI reactions were uncommon. Objective: The objective of the study is to describe the serious GI ARs that supported the post-market safety labeling change for FAE drugs. Methods: Review of the FDA Adverse Events Reporting System (FAERS) database and published medical literature was conducted to identify cases of serious GI events in patients taking FAE drugs. Results: Forty-nine cases of GI ARs with clinical events of perforation, ulceration, hemorrhage, or obstruction causally associated with FAE drug use were identified. Most cases occurred within 4 months of FAE drug initiation and required hospitalization. Ten of the cases required red blood cell transfusions, nine cases required surgical intervention, and two cases resulted in a fatal outcome. Conclusion: Review of postmarketing reports supported the identification of a class association between FAE drugs and serious GI ARs. As these reactions have implications for prescribing decisions and patient management, a safety labeling change was issued to add serious GI reactions to the Warnings and Precautions section of the prescribing information for FAE drugs.
Social cohesion and COVID-19 mortality in different periods of the pandemic: variable efficacy of trust in civil services
Authors: Chuang Ying-Chih , Chen Rong-Xian , HSU Hsueh-Wen , Lee Peng-Hua 
Published: February 2025

Aims: Social cohesion has been reported to influence various health outcomes positively. However, inconsistent results were reported regarding the effects of social cohesion dimensions on the COVID-19 mortality rate (MR). Most studies have indicated that trust in civil services but not participating in social activities reduces COVID-19 mortality, possibly because of the highly contagious nature of this disease. In this study, we investigated how the effects of various dimensions of social cohesion on COVID-19 MR vary across different phases of the pandemic. Methods: This study used data from 86 countries participating in the 2017–2020 World Values Survey. The measures of social cohesion were identified by aggregating responses to the country level. COVID-19 MR was calculated—using data from the European Centre for Disease Prevention and Control—separately for three distinct periods during the pandemic: 13 January 2020–8 November 2020; 9 November 2020–5 September 2021; and 6 September 2021–20 June 2022. An exploratory factor analysis (EFA) was conducted to identify the dimensions of social cohesion, and negative binomial regression models were constructed to analyze data for each period. Results: The EFA results revealed three dimensions of social cohesion: social participation and inclusion, health service equality, and trust in civil services and democracy. COVID-19 MR was negatively associated with trust in civil services and democracy during the early two periods and with social participation and inclusion during the late period. Conclusions: Each social cohesion dimension uniquely contributed to reducing the COVID-19 MR in different pandemic periods.
Economic burden of Huntington’s disease: A systematic review
Authors: Gokhale Pooja , Villa Zapata Lorenzo 
Published: February 2025

Background Huntington's disease (HD) is an autosomal dominant neurodegenerative disease, characterized by progressive motor, cognitive, and psychiatric symptoms. The disease poses a significant social and economic burden. Objective This systematic review aims to characterize the global economic burden by analyzing the direct, indirect, and total costs associated with HD. Methods A comprehensive literature search was conducted across PubMed/MEDLINE, Web of Science, and Cochrane Library from inception to June 2024. The titles and abstracts were screened independently by two reviewers and full-text, English-language articles assessing direct, indirect, and/or total costs of HD were included. The costs were converted to annual costs in 2024 United States Dollars (USD). Results Out of the initial 608 de-duplicated articles, 19 full-text articles were included. The articles spanned 44 years, from 1980 to 2024. The studies covered a total of 15 countries. Annual costs in 2024 USD ranged significantly by region: Americas ($2542-$90,515), Europe ($40,000-$215,020), Asia ($1915-$7132), and Oceania ($3678-$8721). The highest costs were reported in Norway ($171,842) and the UK ($215,020), while Asian countries reported substantially lower costs (China: $6469; South Korea: $6305; Taiwan: $1915-$7132). Conclusions The global economic burden of HD varies substantially across regions, influenced by prevalence rates, healthcare systems, and reporting methodologies. Study limitations include heterogeneous cost reporting methods, potential underestimation in cost conversions, and lack of disease severity stratification. Standardizing cost-of-illness study methodologies and developing specific quality assessment tools would enhance cross-study comparability and improve resource allocation globally.