bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of antenatal simulation-based learning on satisfaction and self-confidence levels among Thai undergraduate nursing students during the COVID-19 pandemic: a mixed-method study
Authors: Kuesakul Kornkanok , Nuampa Sasitara , Pungbangkadee Rudee , Ramjan Lucie , Ratinthorn Ameporn 
Published: March 2024

Abstract
Background
During the COVID-19 pandemic, simulation-based learning (SBL) serves as an alternative teaching strategy for nursing students facing restricted access to antenatal clinical practicum. However, the factors predicting nursing students’ satisfaction, self-confidence, and their learning experiences remain unclear.

Objective
To identify factors predict satisfaction and self-confidence and explore the learning experiences of antenatal SBL.

Methods
A Mixed methods research of the cross-sectional study design and descriptive qualitative research was conducted. A total of 100 third year nursing students who finished the Maternity-Newborn Nursing and Midwifery Practice course using antenatal simulation-based learning were invited to complete the online questionnaires. A total of seven questionnaires were administered, including a demographic questionnaire, the Attitude Scale toward Simulation-Based Education (SBE), the Professional Identity Scale for Nursing Students, the Perceived Stress Scale, the Evaluation of Teaching Competencies Scale, the Simulation Design Scale: Student Version, and the Student Satisfaction and Self-Confidence in Learning. The 20 nursing students who completed survey were asked to participate a qualitative focus group discussion. Multiple regression analysis was performed to investigate predictors, while qualitative data were analyzed using content analysis.

Results
The quantitative results showed high levels of satisfaction (mean = 20.55, SD = 3.17) and self-confidence (mean = 32.44, SD = 4.76) after completing the antenatal SBL. In regression analysis, attitude toward SBE (Beta = 0.473, t = 5.376, p < 0.001) and attitude toward antenatal care simulation design (Beta = 0.338, t = 2.611, p < 0.011) were significantly associated with a high level of satisfaction with antenatal SBL, which accounted for 44.0% of the variance explained in satisfaction. Only attitude toward SBE was significantly associated with a high level of self-confidence in antenatal SBL (Beta = 0.331, t = 3.773, p < 0.001), which accounted for 45.0% of the variance explained in self-confidence. The qualitative results generated four themes: (1) positive attitude toward antenatal simulation; (2) turning reassurance into confidence; (3) I am really happy to learn; and (4) being a good nurse motivates and stresses me.

Conclusions
Antenatal SBL is an effective teaching strategy that can support nursing students to build clinical confidence. Creating a positive learning environment allows students to have a positive attitude and experience with simulations.
Governance models for historical hospitals: evidence from Italy
Authors: Giusti Martina , Vannini Ilaria Elisa , Persiani Niccolò 
Published: March 2024

AbstractMany hospitals and health care organizations over the centuries have inherited handcrafts of artistic value, objects of worships, donations from pilgrims, votive offerings, legates as a result of their centuries-old activity in the social and health care of their community. The value of these artistic assets and the role in the territory of these hospitals have transformed them into cultural heritage over time, introducing the issue of the coexistence of cultural and care management. Therefore, the aim of this paper is to identify governance models of what we will call historical hospitals, that is, hospitals that because of their history, their assets, and their artistic heritage, far from being places only dedicated to provision of health care services represent cultural heritage. To pursue this research objective, five Italian historical hospitals were selected and identified as significant case studies for their historic and artistic relevance. Through the analysis of these case studies the paper identifies models of governance of historical hospitals and the reasons of their adoption.
Workforce wellbeing centres and their positive role for wellbeing and presenteeism in healthcare workers during the COVID-19 pandemic: secondary analysis of COVID-Well data
Authors: Blake Holly , Mancini Helen , Coyne Emma , Cooper Joanne , Stanulewicz-Buckley Natalia 
Published: March 2024

Abstract
Background
Supported wellbeing centres established during the COVID-19 pandemic provided high quality rest spaces and access to peer-to-peer psychological first aid for healthcare workers (HCWs). The centres were well accessed and valued by HCWs, but their relationship with wellbeing and job-related factors is not well established. The aim of this study was to explore the relationship between wellbeing centre use, HCWs wellbeing and job-related factors (job stressfulness, job satisfaction, presenteeism, turnover intentions).

Methods
Secondary analysis of data from 819 HCWs from an acute hospital trust who completed an online survey in April-July 2020, as part of the COVID-Well study. Measures included the Warwick Edinburgh Mental Wellbeing Scale, and four single-item global measures of job stressfulness, job satisfaction, presenteeism and turnover intentions. ANCOVA models and regression analyses were conducted on these data.

Results
HCWs who had not accessed the wellbeing centres had lower wellbeing (β = 0.12, p < .001), higher job stressfulness (β = − 0.22, p < .001), lower job satisfaction (β = 0.39, p < .001), higher presenteeism (β = − 0.22, p < .001) and were of younger age (β = 0.09, p = .002). Centre use was associated with wellbeing irrespective of job stressfulness. Those reporting presenteeism and who accessed the centre (M = 3.30, SE = 0.04) had higher wellbeing than those who accessed the centre but did not report presenteeism (M = 3.06, SE = 0.04) (F(1, 791) = 18.65, p < .001, ηp2 = 0.02). Centre use was not significantly associated with turnover intentions (B = − 0.30, p = .13; Wald = 2.26; odds = 0.74), while job stress and job satisfaction showed significant effects.

Conclusions
Accessing wellbeing centres was associated with higher wellbeing of HCWs, particularly for those reporting presenteeism. Therefore, the centres may have provided greatest respite and restoration for those present at work but not in optimal health. Younger workers were disproportionately affected in terms of wellbeing, and targeted support for this population is needed. Strategies to decrease presenteeism and maximise job satisfaction are urgently required. Healthcare organisations should provide rest spaces and psychological support to HCWs for the long-term, as part of a systems-wide approach to improving workforce health and wellbeing.
Adjuvant screening of the Senecavirus A inactivated vaccine in mice and evaluation of its immunogenicity in pigs
Authors: Zhang Jinyong , Wang Peng , Li Zhuoxin , Xie Yubiao , Jin Ningyi , Zhang He , Lu Huijun , Han Jicheng 
Published: March 2024

Abstract
Background
Senecavirus A (SVA) causes an emerging vesicular disease (VD) with clinical symptoms indistinguishable from other vesicular diseases, including vesicular stomatitis (VS), foot-and-mouth disease (FMD), and swine vesicular disease (SVD). Currently, SVA outbreaks have been reported in Canada, the U.S.A, Brazil, Thailand, Vietnam, Colombia, and China. Based on the experience of prevention and control of FMDV, vaccines are the best means to prevent SVA transmission.

Results
After preparing an SVA inactivated vaccine (CH-GX-01-2019), we evaluated the immunogenicity of the SVA inactivated vaccine mixed with Imject® Alum (SVA + AL) or Montanide ISA 201 (SVA + 201) adjuvant in mice, as well as the immunogenicity of the SVA inactivated vaccine combined with Montanide ISA 201 adjuvant in post-weaned pigs. The results of the mouse experiment showed that the immune effects in the SVA + 201 group were superior to that in the SVA + AL group. Results from pigs immunized with SVA inactivated vaccine combined with Montanide ISA 201 showed that the immune effects were largely consistent between the SVA-H group (200 µg) and SVA-L group (50 µg); the viral load in tissues and blood was significantly reduced and no clinical symptoms occurred in the vaccinated pigs.

Conclusions
Montanide ISA 201 is a better adjuvant choice than the Imject® Alum adjuvant in the SVA inactivated vaccine preparation, and the CH-GX-01-2019 SVA inactivated vaccine can provide effective protection for pigs.
Association and mediation between educational attainment and respiratory diseases: a Mendelian randomization study
Authors: Lan Guohui , Xie Mengying , Lan Jieli , Huang Zelin , Xie Xiaowei , Liang Mengdan , Chen Zhehui , Jiang Xiannuan , Lu Xiaoli , Ye Xiaoying , Xu Tingting , Zeng Yiming , Xie Xiaoxu 
Published: March 2024

Abstract
Background
Respiratory diseases are a major health burden, and educational inequalities may influence disease prevalence. We aim to evaluate the causal link between educational attainment and respiratory disease, and to determine the mediating influence of several known modifiable risk factors.

Methods
We conducted a two-step, two-sample Mendelian randomization (MR) analysis using summary statistics from genome-wide association studies (GWAS) and single nucleotide polymorphisms (SNPs) as instrumental variables for educational attainment and respiratory diseases. Additionally, we performed a multivariable MR analysis to estimate the direct causal effect of each exposure variable included in the analysis on the outcome, conditional on the other exposure variables included in the model. The mediating roles of body mass index (BMI), physical activity, and smoking were also assessed.

Findings
MR analyses provide evidence of genetically predicted educational attainment on the risk of FEV1 (β = 0.10, 95% CI 0.06, 0.14), FVC (β = 0.12, 95% CI 0.07, 0.16), FEV1/FVC (β = − 0.005, 95% CI − 0.05, 0.04), lung cancer (OR = 0.54, 95% CI 0.45, 0.65) and asthma (OR = 0.86, 95% CI 0.78, 0.94). Multivariable MR dicated the effect of educational attainment on FEV1 (β = 0.10, 95% CI 0.04, 0.16), FVC (β = 0.07, 95% CI 0.01, 0.12), FEV1/FVC (β = 0.07, 95% CI 0.01, 0.01), lung cancer (OR = 0.55, 95% CI 0.42, 0.71) and asthma (OR = 0.88, 95% CI 0.78, 0.99) persisted after adjusting BMI and cigarettes per day. Of the 23 potential risk factors, BMI, smoking may partially mediate the relationship between education and lung disease.

Conclusion
High levels of educational attainment have a potential causal protective effect on respiratory diseases. Reducing smoking and adiposity may be a target for the prevention of respiratory diseases attributable to low educational attainment.
Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review
Authors: Farabaugh Ronald , Hawk Cheryl , Taylor Dave , Daniels Clinton , Noll Claire , Schneider Mike , McGowan John , Whalen Wayne , Wilcox Ron , Sarnat Richard , Suiter Leonard , Whedon James 
Published: March 2024

Abstract
Background
The cost of spine-related pain in the United States is estimated at $134.5 billion. Spinal pain patients have multiple options when choosing healthcare providers, resulting in variable costs. Escalation of costs occurs when downstream costs are added to episode costs of care. The purpose of this review was to compare costs of chiropractic and medical management of patients with spine-related pain.

Methods
A Medline search was conducted from inception through October 31, 2022, for cost data on U.S. adults treated for spine-related pain. The search included economic studies, randomized controlled trials and observational studies. All studies were independently evaluated for quality and risk of bias by 3 investigators and data extraction was performed by 3 investigators.

Results
The literature search found 2256 citations, of which 93 full-text articles were screened for eligibility. Forty-four studies were included in the review, including 26 cohort studies, 17 cost studies and 1 randomized controlled trial. All included studies were rated as high or acceptable quality. Spinal pain patients who consulted chiropractors as first providers needed fewer opioid prescriptions, surgeries, hospitalizations, emergency department visits, specialist referrals and injection procedures.

Conclusion
Patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management. The included studies were limited to mostly retrospective cohorts of large databases. Given the consistency of outcomes reported, further investigation with higher-level designs is warranted.
Repeatability quantification of brain diffusion-weighted imaging for future clinical implementation at a low-field MR-linac
Authors: Rabe Moritz , Dietrich Olaf , Forbrig Robert , Niyazi Maximilian , Belka Claus , Corradini Stefanie , Landry Guillaume , Kurz Christopher 
Published: March 2024

Abstract
Background
Longitudinal assessments of apparent diffusion coefficients (ADCs) derived from diffusion-weighted imaging (DWI) during intracranial radiotherapy at magnetic resonance imaging-guided linear accelerators (MR-linacs) could enable early response assessment by tracking tumor diffusivity changes. However, DWI pulse sequences are currently unavailable in clinical practice at low-field MR-linacs. Quantifying the in vivo repeatability of ADC measurements is a crucial step towards clinical implementation of DWI sequences but has not yet been reported on for low-field MR-linacs. This study assessed ADC measurement repeatability in a phantom and in vivo at a 0.35 T MR-linac.

Methods
Eleven volunteers and a diffusion phantom were imaged on a 0.35 T MR-linac. Two echo-planar imaging DWI sequence variants, emphasizing high spatial resolution (“highRes”) and signal-to-noise ratio (“highSNR”), were investigated. A test–retest study with an intermediate outside-scanner-break was performed to assess repeatability in the phantom and volunteers’ brains. Mean ADCs within phantom vials, cerebrospinal fluid (CSF), and four brain tissue regions were compared to literature values. Absolute relative differences of mean ADCs in pre- and post-break scans were calculated for the diffusion phantom, and repeatability coefficients (RC) and relative RC (relRC) with 95% confidence intervals were determined for each region-of-interest (ROI) in volunteers.

Results
Both DWI sequence variants demonstrated high repeatability, with absolute relative deviations below 1% for water, dimethyl sulfoxide, and polyethylene glycol in the diffusion phantom. RelRCs were 7% [5%, 12%] (CSF; highRes), 12% [9%, 22%] (CSF; highSNR), 9% [8%, 12%] (brain tissue ROIs; highRes), and 6% [5%, 7%] (brain tissue ROIs; highSNR), respectively. ADCs measured with the highSNR variant were consistent with literature values for volunteers, while smaller mean values were measured for the diffusion phantom. Conversely, the highRes variant underestimated ADCs compared to literature values, indicating systematic deviations.

Conclusions
High repeatability of ADC measurements in a diffusion phantom and volunteers’ brains were measured at a low-field MR-linac. The highSNR variant outperformed the highRes variant in accuracy and repeatability, at the expense of an approximately doubled voxel volume. The observed high in vivo repeatability confirms the potential utility of DWI at low-field MR-linacs for early treatment response assessment.
Comparison of outcomes after total hip arthroplasty between patients with osteonecrosis of the femoral head in Association Research Circulation Osseous stage III and stage IV: a five-year follow-up study
Authors: Wang Tianyu , Wu Dongwei , Li Chengsi , Cheng Xinqun , Yang Zhenbang , Zhang Yingze , Zhu Yanbin 
Published: March 2024

Abstract
Background
No large cohort study has evaluated the surgical outcomes of THA between different stages of ONFH patients. This study aimed to compare the surgical outcomes of ONFH patients who underwent THA in ARCO stage III versus IV, in terms of operative parameters, one-year hip function assessments and postoperative at least five-year complications, to inform optimized management of ONFH.

Method
From our prospectively collected database, 876 patients undergoing THA between October 2014 and April 2017 were analyzed and divided into ARCO stage III group (n = 383) and ARCO stage IV group(n = 493). Details of demographics, medical record information, adverse events and clinical scores of both groups were collected and compared. Proper univariate analysis was used for the analysis.

Result
There were no statistically significant differences in baseline characteristics between the two groups. Compared to ARCO stage IV patients, ARCO stage III patients showed a shorter operative time (p < 0.01), less bleeding (p < 0.01), fewer one-year readmissions (p = 0.026) and complications (p = 0.040), and significantly higher HHS (p < 0.01) one year after THA. In addition, ARCO stage IV patients seem more likely to suffer prosthesis dislocation (p = 0.031).

Conclusion
Although ARCO stage IV patients in the study cohorts appeared to suffer more one-year complications, no significant difference was observed at long-term follow-up. Enhanced clinical guidance on preventing early prosthesis dislocation may help improve the prognosis of final-stage ONFH patients.
Investigating the in vitro antibacterial efficacy of composite bone cement incorporating natural product-based monomers and gentamicin
Authors: Kan Yu-Chen , Guo Rui , Xu Yang , Han Lu-Yang , Bu Wen-Han , Han Long-Xu , Chu Jian-Jun 
Published: March 2024

Abstract
Objective
The objective of this study is to investigate the impact of four natural product extracts, namely, aloe-emodin, quercetin, curcumin, and tannic acid, on the in vitro bacteriostatic properties and biocompatibility of gentamicin-loaded bone cement and to establish an experimental groundwork supporting the clinical utility of antibiotic-loaded bone cements (ALBC).

Methods
Based on the components, the bone cement samples were categorized as follows: the gentamicin combined with aloe-emodin group, the gentamicin combined with quercetin group, the gentamicin combined with curcumin group, the gentamicin combined with tannic acid group, the gentamicin group, the aloe-emodin group, the quercetin group, the curcumin group, and the tannic acid group. Using the disk diffusion test, we investigated the antibacterial properties of the bone cement material against Staphylococcus aureus (n = 4). We tested cell toxicity and proliferation using the cell counting kit-8 (CCK-8) and examined the biocompatibility of bone cement materials.

Results
The combination of gentamicin with the four natural product extracts resulted in significantly larger diameters of inhibition zones compared to gentamicin alone, and the difference was statistically significant (P < 0.05). Except for the groups containing tannic acid, cells in all other groups showed good proliferation across varying time intervals without displaying significant cytotoxicity (P < 0.05).

Conclusion
In this study, aloe-emodin, quercetin, curcumin, and tannic acid were capable of enhancing the in vitro antibacterial performance of gentamicin-loaded bone cement against S. aureus. While the groups containing tannic acid displayed moderate cytotoxicity in in vitro cell culture, all other groups showed no discernible cytotoxic effects.
Metabolic, cognitive and neuromuscular responses to different multidirectional agility-like sprint protocols in elite female soccer players – a randomised crossover study
Authors: Raeder Christian , Kämper Meike , Praetorius Arthur , Tennler Janina-Sophie , Schoepp Christian 
Published: March 2024

Abstract
Purpose
Resistance to fatigue is a key factor in injury prevention that needs to be considered in return-to-sport (RTS) scenarios, especially after severe knee ligament injuries. Fatigue should be induced under game-like conditions. The SpeedCourt (SC) is a movement platform for assessing multidirectional sprint performance, typical of game-sports, due to change-of-direction movements in response to a visual stimulus. Designing adequate fatigue protocols requires the suitable arrangement of several loading variables such as number of intervals, sprint distance or work/relief ratio (W:R). Therefore, this study analysed the acute fatigue effects of different SC protocols on metabolic load, cognitive function and neuromuscular performance.

Methods
Eighteen female soccer players (mean ± SD; age: 23.1 ± 4.6 years) of the 1st German Division participated in this randomised, crossover study. Using a random allocation sequence, players completed four volume-equated protocols differing in W:R and sprint distance per interval (P1:12 × 30 m, W:R = 1:2 s; P2:12 × 30 m, W:R = 1:3 s; P3:18 × 20 m, W:R = 1:2 s; P4:18 × 20 m, W:R = 1:3 s). Pre- and post-exercise, metabolic load was measured per blood lactate concentration (BLaC), cognitive function per reaction time (RT), and neuromuscular performance including multiple rebound jumps (MRJ height, primary outcome variable; Reactive Strength Index, RSI) and 5 m sprint times (SP5).

Results
Repeated-measures ANOVA revealed significant main time effects (p < .05) with improved performance post-exercise in RT (504 vs. 482 ms, d = 1.95), MRJ height (24.0 vs. 24.8 cm, d = 0.77), RSI (1.39 vs. 1.43, d = 0.52), and SP5 (1.19 vs. 1.17 s, d = 0.56). There was significant main time (p < .001) and time x protocol interaction effects in BLaC (p < .001). P1 induced higher BLaC values (4.52 ± 1.83 mmol/L) compared to P2 (3.79 ± 1.83 mmol/L; d = 0.74) and P4 (3.12 ± 1.83 mmol/L; d = 1.06), whereas P3 (4.23 ± 1.69 mmol/L) elicited higher BLaC values compared to P4 (d = 0.74).

Conclusion
All protocols caused an improved cognitive function and neuromuscular performance. The former may be related to enhanced noradrenergic activation or exercise specificity which induced an improved stimulus processing. The latter may be explained by a possible post-activation performance enhancement effect on jump and sprint performance. A shorter relief duration in W:R as opposed to sprint distance per interval produced higher BLaC values. The protocols may serve as reference data for improved RTS decision-making in elite female soccer players.

Trial registration
Deutsches Register Klinischer Studien (DRKS), No.: DRKS00033496, Registered 19. Februar 2024, Retrospectively Registered.