bluuebunny/crossref_metadata_2025_split huggingface dataset:
The practice of key essential nutrition actions among pregnant women in southwest Ethiopia: implications for optimal pregnancy outcomes
Authors: Mudasir Shamil , Muktar Ebrahim , Oumer Abdu 
Published: February 2024

Abstract
Background
Nutrition during pregnancy is a major determinant of human health and child development, and the role of promoting essential nutrition actions (ENA) is of a paramount importance for the health of the mother and newborn. However, the practice of ENA could be hampered by many factors, which need to be understood for tailored actions. This study assessed the practice of key ENAs and associated factors among pregnant mothers in southwest Ethiopia.

Method
A community-based cross-sectional study was employed among 373 pregnant mothers. A simple random sampling method was used to select the study participants. The data was entered into EpiData Manager and exported to SPSS version 21 for analysis. A bivariable logistic regression was conducted to explore the association between independent variables and the outcome variable. Variables with p-values less than 0.25 during bivariable analysis were entered into a multivariable logistic regression model. Level of statistical significance was declared at a p-value below 0.05. The crude and adjusted odds ratios, along with the 95% CI, were estimated to measure the strength of the association between the dependent variables and independent variables.

Result
In this study, 373 pregnant mothers have participated, with a response rate of 97%. A total of 275 (73.7%; 95% CI: 68.9–78.0) women practiced key essential nutrition actions at optimal level. Monthly household income of 2500 ETB (AOR = 0.45, 95% CI: 0.23, 0.89), rural residence (AOR = 2.31, 95% CI: 1.25, 4.4), and poor knowledge of key ENA messages (AOR = 3.36, 95% CI: 1.81, 6.26) were factors that were significantly associated with poor practice of key ENA messages.

Conclusions
The practice of key ENA messages was poor and closely linked to household income, residence, and knowledge of pregnant women’s on ENA key messages. Therefore, nutritional intervention with a focus on intensified nutritional counseling is needed for better adoption of key ENA practices.
Antibiotic prophylaxis with piperacillin–tazobactam reduces organ/space surgical site infection after pancreaticoduodenectomy: a retrospective and propensity score-matched analysis
Authors: Yang Yifei , Sheng Jianjie , Cai Zhenghua , Zhu Linxi , Lu Chenglin , Mao Liang , Qiu Yudong , Fu Xu 
Published: February 2024

Abstract
Background
The occurrence of surgical site infection (SSI) after pancreaticoduodenectomy (PD) is still relatively high. The aim of this retrospective study is to evaluate the efficacy of piperacillin-tazobactam as perioperative prophylactic antibiotic on organ/space SSI for patients underwent PD.

Methods
Four hundred seven consecutive patients who underwent PD between January 2018 and December 2022 were enrolled and analyzed retrospectively. The univariate and multivariate analysis were used to identify independent risk factors of organ/space SSI. Postoperative complications were compared between the two groups according to the use of prophylactic antibiotics by a ratio of 1:1 propensity score-matched (PSM) analysis.

Results
Based on perioperative prophylactic antibiotic use, all 407 patients were divided into the ceftriaxone group (n = 192, 47.2%) and piperacillin–tazobactam group (n = 215, 52.8%). The rate of organ/space SSI was 31.2% with the choice of perioperative antibiotics (OR = 2.837, 95%CI = 1.802–4.465, P < 0.01) as one of independent risk factors. After PSM, there were similar baseline characteristics among the groups. Meanwhile, the piperacillin–tazobactam group had a significant lower rate of organ/space SSI compared to the ceftriaxone group both before and after PSM(P < 0.05).

Conclusions
The adoption of piperacillin–tazobactam as perioperative prophylaxis for patients underwent PD reduced organ/space SSI significantly.
How the social media impact women’s psychological well-being in the patriarchal structure? The moderating effect of social capital
Authors: He Liu , Firdaus Amira , Gong Jiankun , Dharejo Nasrullah , Aksar Iffat Ali 
Published: February 2024

Abstract
Background
Despite technological, political and economic progress, Pakistan is still a traditionally patriarchal society, and cultural norms curb women’s freedom of socialization, which contributes to poor mental health. The digital technology spaces are rampant with male dominance, and offline cultural behaviours are replicated. Therefore, the current research in Pakistan intends to focus solely on women, their social media uses and the consequent impact on their psychological well-being. Furthermore, the mediation role of social capital is explored, which is linked to women’s socialization. In virtual communication, women can expand their connection or remain limited to known people.

Methods
An online survey collected 240 responses from women social media users. The questionnaire was divided into demographics, social media use patterns like access, online time, frequency of use, social media uses, online social capital and psychological well-being. The obtained responses were statistically analyzed using Smart PLS.

Results
Pakistani women use social media extensively; however, their uses are culturally influenced. The women use social media and socialize online but do not openly disclose their personalities and emotions to extend the connection. They seek information only from acquaintances and do not trust newly developed online contacts. Therefore, the mediation role of bonding social capital is significant, referring to the importance of close ties and trust in psychological well-being. Though virtual spaces provide an opportunity for bridging social capital, women use social media for socialization; however, it doesn’t contribute to women’s psychological well-being.

Conclusion
Despite the higher penetration of digital technologies, cultural power still rules in developing countries like Pakistan. Social media uses are gender- and culturally specific, contributing to psychological well-being and developing social capital. The results from Pakistani society recommend ensuring a secure digital experience for women to get maximum benefits from social media and enhance their psychological well-being.
How an agreement with restriction of unhealthy food marketing and sodium taxation influenced high fat, salt or sugar (HFSS) food consumption
Authors: Jindarattanaporn Nongnuch , Phulkerd Sirinya , Chamratrithirong Aphichat , Soottipong Gray Rossarin , Pattaravanich Umaporn , Loyfah Nutnicha , Thapsuwan Sasinee , Thongcharoenchupong Natjera 
Published: February 2024

Abstract
Background
Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating.

Methods
The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake.

Results
Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption.

Conclusion
Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement.
High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis
Authors: Biks Gashaw Andargie , Shiferie Fisseha , Tsegaye Dawit Abraham , Asefa Wondwossen , Alemayehu Legese , Wondie Tamiru , Zelalem Meseret , Lakew Yohannes , Belete Kidist , Gebremedhin Samson 
Published: February 2024

Abstract
Background
Globally, according to the World Health Organization (WHO) 2023 report, more than 14.3 million children in low- and middle-income countries, primarily in Africa and South-East Asia, are not receiving any vaccinations. Ethiopia is one of the top ten countries contributing to the global number of zero-dose children.

Objective
To estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia.

Methods
A cross-sectional vaccine coverage survey was conducted in June 2022. The study participants were mothers of children aged 12–35 months. Data were collected using the CommCare application system and later analysed using Stata version 17. Vaccination coverage was estimated using a weighted analysis approach. A generalized estimating equation model was fitted to determine the predictors of zero-dose children. An adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of 0.05 or less was considered statistically significant.

Results
The overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR = 2.78; 95% CI: 1.70, 4.53], poorer [AOR = 1.96; 95% CI: 1.02, 3.77]), single marital status [AOR = 2.4; 95% CI: 1.7, 3.3], and maternal age (15–24 years) [AOR = 1.2; 95% CI: 1.1, 1.3] were identified as key determinant factors of zero-dose children in the study settings. Additional factors included fewer than four Antenatal care visits (ANC) [AOR = 1.3; 95% CI: 1.2, 1.4], not receiving Postnatal Care (PNC) services [AOR = 2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR = 3.7; 95% CI: 2.6, 5.4], women-headed household [AOR = 1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR = 1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR = 1.7; 95% CI: 1.2, 2.5].

Conclusion
In the study settings, the prevalence of zero-dose children is very high. Poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilizing antenatal or post-natal services are the important predictors. Therefore, it is recommended to target tailored integrated and context-specific service delivery approach. Moreover, extend immunization sessions opening hours during the evening/weekend in the city administrations to meet parents’ needs.
Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo
Authors: Ngaboyeka Gaylord , Bisimwa Ghislain , Neven Anouk , Mwene-Batu Pacifique , Kambale Richard , Ongezi Emmanuel , Chimanuka Christine , Ntagerwa Joseph , Balolebwami Serge , Mulume Francis , Battisti Oreste , Dramaix Michèle , Donnen Philippe 
Published: February 2024

Abstract
Background
Little is known about the use of mid-upper arm circumference for age (MUACZ) for diagnosing of severe acute malnutrition (SAM) and its correlation with WHZ (weight-for-height Z-score) in an area endemic for severe acute malnutrition (SAM) and with a high prevalence of kwashiorkor. Our study aims to analyze the concordance between the diagnostic criteria of SAM in a region presenting these characteristics.

Methods
We analyzed a database of children admitted from 1987 to 2008 for the management of SAM in Eastern Democratic Republic of Congo. Anthropometric indicators (z-score) were calculated and classified into 3 categories according to WHO standards. Cohen’s kappa coefficient (κ) was calculated to assess the concordance between these indicators.

Results
Out of the 9969 selected children aged 6 to 59 months, 30.2% had nutritional edema, 70.1% had a height-for-age (HAZ) z-score <-2, 11.5% WHZ<-3 z-score, 14.9% had a MUAC < 115 mm and 21.8% had a MUACZ <-3 z-score. With the classic combination WHZ and MUAC, 36% of children with SAM had both criteria at the same time and MUAC alone being the indicator that recruited more children with SAM (77%) compared with 65% with WHZ only. By replacing MUAC with MUACZ, 34% of SAM children fulfilled both criteria, WHZ and MUACZ. MUACZ alone recruited more children with SAM (88%) compared with 46% with WHZ alone. Considering these three indicators together, MUACZ remained the indicator that recruited more children with SAM (85%). WHZ and MUAC showed a moderate agreement [ κ (95% CI) = 0.408(0.392–0.424)], WHZ and MUACZ a weak agreement [ κ (95% CI) = 0.363(0.347–0.379)] and MUAC and MUACZ a good agreement [ κ (95% CI) = 0.604 (0.590–0.618)].

Conclusion
Adjusting MUAC according to age improves its effectiveness in identifying severe acute malnutrition. With low concordance, MUAC and WHZ remain complementary in our context. MUACZ proves to be crucial, especially in the presence of kwashiorkor and chronic malnutrition, becoming a valuable tool for assessing severe acute malnutrition in our context.
The mediating role of children’s intergenerational support in association between grandparenting and cognitive function among middle-aged and older Chinese: findings from the CHARLS cohort study
Authors: Hou Xuebei , Luo Yujun , Yang Fen , Zhu Xinhong , Gao Xiaolian , Wang Wenqiang , Qiao Guiyuan , Zhou Jing 
Published: February 2024

Abstract
Objectives
With the world’s population increasing in age, there has been a significant rise in the prevalence of cognitive impairment and dementia among individuals. This study aims to investigate the association between grandparenting and cognitive function among middle-aged and older Chinese using data from 2011 to 2018 China Health and Retirement Longitudinal Study (CHARLS). Additionally, the study seeks to explore the potential mediating effect of intergenerational support from children on this relationship, using data from the CHARLS 2011 database.

Methods
5254 participants were recruited at the baseline survey in CHARLS 2011. Subsequently, a follow-up survey was conducted over 8 years, from CHARLS 2011 to 2018, with 1472 individuals completing the follow-up survey. The CHARLS included surveys on grandparenting and cognitive assessments. Grandparenting was categorized as yes and no. The assessment of cognitive function involved the evaluation of episodic memory and mental intactness. The present study used cross-sectional and longitudinal analyses to examine the relationship between grandparenting and cognitive function. The bootstrap method assessed the mediating effect of children’s intergenerational support.

Results
The results of both cross-sectional and longitudinal studies indicated a positive association between grandparenting and cognitive function in middle-aged and older Chinese (B = 0.138, p < 0.05; B = 0.218, p < 0.05). Children’s emotional and economic support played intermediary roles between grandparenting and cognitive function.

Conclusion
The results emphasized the significance of policymakers considering the consequences of intergenerational care and family support when formulating and executing social service policies targeted at the middle-aged and older population in China.
A population based study on human papillomavirus infection and associated risk factors among women of the remote South Andaman Island, India
Authors: Parvez Rehnuma , Vijayachari Paluru , Thiruvengadam Kannan , Roy Avijit , Saha Mrinmoy Kumar , Ramasamy Jawahar , Vins Alwin , Biswas Lipika , Vaz Alvencia , Kaur Harpreet , Nagarajan Muruganandam 
Published: February 2024

Abstract
Background
Human papillomavirus (HPV) is associated with cervical cancer and cervical dysplasia worldwide. Data on HPV prevalence in a region is important because it serves as a predictor of the likelihood of the population in that particular region acquiring cervical cancer. Moreover, with the availability of effective vaccines, the public health system must be aware of the preponderance of HPV to implement the vaccine. The present study was designed to understand the prevalence of HPV and associated factors among the women of South Andaman Island.

Methods
A cross-sectional study was conducted among married women of reproductive age (18–59 years) from South Andaman District from 2018 to 2022. Cervical scrapes were collected from participants after obtaining informed written consent for HPV molecular testing (HPV DNA) such as PCR assay. Demographic data was collected using a standard questionnaire and statistical analyses were performed to determine the associated factors.

Results
The study showed prevalence of HPV as 5.9%(95% CI: 3.9–7.9) and prevalence of HR-HPV16 was 4.1% (95% CI 2.6 – 5.5) and HR-HPV18 prevalence was 1.8(95% CI: 0.6–3). The independent factors associated the HPV positivity were age above 55 years, menopause, post-menopausal bleeding, blood-stained vaginal discharge and loss of weight. Age was associated with all HPV infections among the South Andaman women.

Conclusions
HPV 16 was reported as the predominant high risk HPV type circulating among women of South Andaman. Cervical cancer and precancerous lesions were significantly associated with HPV positivity and High risk HPV 16. Based on the knowledge of the risk factors associated with HPV, implementation of stronger public health awareness and prophylactic HPV vaccination is crucial among the women of this remote island.
Impact of familiarity with the format of the exam on performance in the OSCE of undergraduate medical students – an interventional study
Authors: Neuwirt Hannes , Eder Iris E. , Gauckler Philipp , Horvath Lena , Koeck Stefan , Noflatscher Maria , Schaefer Benedikt , Simeon Anja , Petzer Verena , Prodinger Wolfgang M. , Berendonk Christoph 
Published: February 2024

Abstract
Background
Assessments, such as summative structured examinations, aim to verify whether students have acquired the necessary competencies. It is important to familiarize students with the examination format prior to the assessment to ensure that true competency is measured. However, it is unclear whether students can demonstrate their true potential or possibly perform less effectively due to the unfamiliar examination format. Hence, we questioned whether a 10-min active familiarization in the form of simulation improved medical students´ OSCE performance. Next, we wanted to elucidate whether the effect depends on whether the familiarization procedure is active or passive.

Methods
We implemented an intervention consisting of a 10-min active simulation to prepare the students for the OSCE setting. We compared the impact of this intervention on performance to no intervention in 5th-year medical students (n = 1284) from 2018 until 2022. Recently, a passive lecture, in which the OSCE setting is explained without active participation of the students, was introduced as a comparator group. Students who participated in neither the intervention nor the passive lecture group formed the control group. The OSCE performance between the groups and the impact of gender was assessed using X2, nonparametric tests and regression analysis (total n = 362).

Results
We found that active familiarization of students (n = 188) yields significantly better performance compared to the passive comparator (Cohen´s d = 0.857, p < 0.001, n = 52) and control group (Cohen´s d = 0.473, p < 0.001, n = 122). In multivariate regression analysis, active intervention remained the only significant variable with a 2.945-fold increase in the probability of passing the exam (p = 0.018).

Conclusions
A short 10-min active intervention to familiarize students with the OSCE setting significantly improved student performance. We suggest that curricula should include simulations on the exam setting in addition to courses that increase knowledge or skills to mitigate the negative effect of nonfamiliarity with the OSCE exam setting on the students.
Evaluation of the effectiveness of using flipped classroom in puncture skills teaching
Authors: Zhang Weihao , Jiang Miao , Zhao Wei , Li Shuai , Li Fan , Feng Feifei , Wang Yongjing , Li Yan , Liu Lan 
Published: February 2024

Abstract
Background
The effectiveness of flipped classroom (FC) on puncture skills in medical education is still uncertain. This study aimed to assess the role of the FC model in puncture skills and investigate the acceptance and approval of FC among medical students and instructors.

Methods
A mixed research approach of quasi-experimental research design and descriptive qualitative research was conducted in September 2022 for one month, using an FC teaching method that combined instructional videos and group learning. The study participants were 71 fifth-year medical students from two classes at a Chinese medical school and four instructors. The medical students were randomly divided into two groups: the traditional classroom (TC) group (Group A) and the FC group (Group B). For teaching, Group B used FC, and Group A used PowerPoint-based TC. The effectiveness of the two teaching models was assessed with Objective Structured Clinical Examination (OSCE), and questionnaires were distributed to the medical students and instructors after the assessment. Two independent sample t-tests were used to analyse the differences in demographic data and the OSCE scores of the two groups of medical students.

Results
Group B scored higher in puncture skills than Group A, especially regarding abdominal puncture (p = 0.03), thoracentesis (p < 0.001), bone marrow puncture (p < 0.001) and average performance of puncture skills (p < 0.001). For lumbar puncture, no difference in skill scores was observed between groups A and B (p > 0.409). The medical students thought that the FC improved their self-learning ability and helped them acquire knowledge. Regarding the OSCE of their skills, most medical students thought that it was more innovative and objective than traditional examinations and that it was better for assessing their overall abilities. Both the FC and OSCE were supported by the medical students. The instructors were also satisfied with the students’ performance in the FC and supported the teaching model, agreeing to continue using it.

Conclusions
This study shows that FC teaching that combines instructional videos and group learning is a reliable and well-received teaching method for puncture skills, which supplements and expands existing teaching methods in the medical field.