bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between gender, psychosocial factors, pain, health literacy and health-related quality of life in parents of Norwegian adolescents one year into the COVID-19 pandemic
Authors: Rohde Gudrun , Helseth Sølvi , Hagen Milada , Mikkelsen Hilde Timenes , Skarstein Siv , Haraldstad Kristin 
Published: April 2024

Abstract
Background
Stress impacts healthy behaviours and may influence life and health-related quality of life (HRQOL). A stressful event occurred when the COVID-19 pandemic hit in March 2020. The present study aims to explore possible gender differences in stress, psychosocial factors (self-efficacy, self-esteem, loneliness), pain, HL, and HRQOL in parents of adolescents one year into the COVID-19 pandemic, and to explore possible associations between gender, demographic and psychosocial factors, pain, HL, and HRQOL.

Methods
Parents of adolescents aged 16–17 took part in the study from January to February 2021, when the COVID-19 pandemic was ongoing. Data on socio-demographics, stress, self-efficacy, self-esteem, pain, HL, loneliness, and HRQOL were collected. HRQOL was assessed using RAND-36.

Results
Among the 320 parents from the general population, the mean age was 47.6 (standard deviation (SD) = 4.6) years, 81% were mothers, 79% were married or cohabiting, 81% had a university degree, and the majority worked full time (78%) or part time (13%). The average pain score was low, 0.48 (95% CI [0.43–0.54]). However, 50% of the parents reported persistent pain and more mothers reported persistent pain compared to fathers (53% vs. 37%). The parents’ mean (SD) score for RAND-36 was 52.1 (95% CI [51.2–53.0]) for the physical component summary (PCS) score and 51.0 (95% CI [50.0–52.1]) for the mental component summary (MCS) score. Mothers reported significantly lower scores for all the eight RAND-36 domains and the PCS and MCS scores. Adjusting for gender, age, living condition, education, pain, HL, self-efficacy and loneliness, we revealed no associations between stress and RAND-36-PCS. University education of four years or more was positively associated (B = 3.29, 95% CI: [0.78–5.80]) with RAND-36-PCS, while persistent pain was negatively associated (B = -7.13, CI: [-9.20– -5.06]). We identified a strong negative association between RAND-36-MCS and stress (B = -43.11, CI: [-48.83– -37.38]) and a positive association with older age (B = 0.21, CI: [ 0.04, 0.39)].

Conclusion
One year into the COVID-19 pandemic, we identified a strong negative association between stress and mental HRQOL, while pain was strongly negatively associated with physical HRQOL.
Forces required to dynamize sliding screws in gamma nail and selfdynamizable internal fixator
Authors: Mitkovic Milan M , Korunovic Nikola D , Milenkovic Sasa S , Stojiljkovic Predrag M , Manic Miodrag T , Trajanovic Miroslav D 
Published: April 2024

Abstract
Background
Single limb support phase of the gait-cycle in patients who are treated for a pertrochanteric fracture is characterized by transversal loads acting on the lag screw, tending to block its dynamization. If the simultaneous axial force overcomes transversal loads of the sliding screw, the dynamization can still occur.

Methods
Biomechanical investigation was performed for three types of dynamic implants: Gamma Nail, and two types of Selfdynamizable Internal Fixators (SIF) – SIF-7 (containing two 7 mm non-cannulated sliding screws), and SIF-10 (containing one 10 mm cannulated sliding screw). Contact surface between the stem and the sliding screws is larger in SIF implants than in Gamma Nail, as the stem of Gamma Nail is hollow. A special testing device was designed for this study to provide simultaneous application of a controlled sliding screws bending moment and a controlled transversal load on sliding screws (Qt) without using of weights. Using each of the implants, axial forces required to initiate sliding screws dynamization (Qa) were applied and measured using a tensile testing machine, for several values of sliding screws bending moment. Standard least-squares method was used to present the results through the linear regression model.

Results
Positive correlation between Qt and Qa was confirmed (p < 0.05). While performing higher bending moments in all the tested implants, Qa was higher than it could be provided by the body weight. It was the highest in Gamma Nail, and the lowest in SIF-10.

Conclusions
A larger contact surface between a sliding screw and stem results in lower forces required to initiate dynamization of a sliding screw. Patients treated for a pertrochanteric fracture by a sliding screw internal fixation who have longer femoral neck or higher body weight could have different programme of early postoperative rehabilitation than lighter patients or patients with shorter femoral neck.
Comparative evaluation and patient satisfaction with an electrical impedance-based device versus digital radiography in the estimation of remaining dentin thickness in carious posterior permanent teeth: (Diagnostic accuracy study)
Authors: Abd ElAziz Rawda H. , Ragab Rasha A. , Elzayat Ghada A. 
Published: April 2024

Abstract
Background
Accurate assessment of remaining dentin thickness (RDT) is paramount for restorative decisions and treatment planning of vital teeth to avoid any pulpal injury. This diagnostic accuracy study compared the validity and patient satisfaction of an electrical impedance based device Prepometer™ (Hager & Werken, Duisburg, Germany) versus intraoral digital radiography for the estimation of remaining dentin thickness in carious posterior permanent teeth.

Methods
Seventy patients aged 12–25 years with carious occlusal or proximal permanent vital posterior teeth were recruited. Tooth preparation was performed to receive an adhesive restoration. Pre- and post-excavation RDT were measured radiographically by two calibrated raters using the paralleling periapical technique. Prepometer™ measurements were performed by the operator. Patients rated their satisfaction level with each tool on a 4-point Likert scale and 100 mm visual analog scale (VAS). Inter and intragroup comparisons were analyzed using signed rank test, while agreement between devices and observations was tested using weight kappa (WK) coefficient.

Results
the intergroup comparisons showed that, before and after excavation, there was a significant difference between measurements made by both techniques (p < 0.001). After excavation, there was a weak agreement between measurements (WK = 0.2, p < 0.001), whereas before excavation, the agreement was not statistically significant (p = 0.407). Patients were significantly more satisfied with Prepometer™ based on scales and VAS (p < 0.001).

Conclusion
Prepometer™ could be a viable clinical tool for determining RDT with high patient satisfaction, while radiographs tended to overestimate RDT in relation to the Prepometer™.
Maternal satisfaction with delivery service and associated factors among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia
Authors: Alemu Endale Megersa , Kaso Abdene Weya , Obsie Girma Worku , Fessaha Hiwot Zelalem , Agero Gebi 
Published: April 2024

Abstract
Background
Maternal satisfaction during delivery services is considered an important indicator of the quality of healthcare in a hospital setting and determines the uptake of services during subsequent pregnancies. However, there is limited information on the magnitude of women’s satisfaction during delivery services in the study area. Thus, this study aimed to assess factors associated with maternal satisfaction with delivery services among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia.

Method
A facility-based cross-sectional study was conducted at public hospitals in Guji Zone from December 1, 2020, to January 30, 2021. Two hundred forty-nine women who gave birth at public hospitals were recruited by a systematic random sampling technique. The collected data were entered into the Epi Info 7 software and then exported to SPSS Version 26 for analysis. A logistic regression model was employed to identify the association between independent variables and maternal satisfaction during delivery services. A P-value less than 0.05 and an Adjusted Odds Ratio with 95% CI was computed to determine the strength of the association between these variables.

Result
In this study, 138(55.4%), 95% CI (49.1–61.7) women were satisfied with delivery. Mothers who delivered through cesarean section (AOR = 2.92, 95% CI: 1.34–6.33), privacy assured (AOR = 3.14, 95% CI: 1.76–5.59), shorter duration of labor (AOR = 2.82, 95% CI: 1.64–4.62), waiting time ≤ 30 min (AOR = 5.15,95% CI:1.99–13.32) and normal fetal outcome (AOR = 2.63, 95% CI:1.42–4.85) were associated with mothers satisfaction with delivery care services.

Conclusion
The overall magnitude of women’s satisfaction with delivery services is low, which is below the national client satisfaction target of ≥ 85%. Factors such as mode of delivery, assured privacy, short duration of labor, waiting time ≤ 30 min, and good fetal outcome were significantly associated with women’s satisfaction with delivery services. Therefore, healthcare providers should provide better management during intrapartum childbirth or emergency obstetric care to improve fetal outcomes during delivery services. In addition, health facility managers should avail infrastructure that helps to maintain the privacy of women who give birth in the facility.
Anxiety, depression, and stress: a comparative study between couples with male and female infertility
Authors: Khalesi Zahra Bostani , Kenarsari Fatemeh Jafarzadeh 
Published: April 2024

Abstract

Background and aim
Although infertility as a significant cause of marital crises is prevalent almost equally in men and women, infertile women are under more pressure and distress than infertile men. Therefore, this study was conducted aiming to compare anxiety, depression, and stress between couples with male and female infertility.

Methods
In this descriptive-analytical cross-sectional study, 40 couples (n = 80) with male infertility and 40 couples (n = 80) with female infertility were referred to the infertility clinic of Al-Zahra Educational and Medical Center, Rasht, Iran. Eligible infertile couples were selected by convenience sampling method. The data collection tool was a two-part questionnaire consisting of a demographic information form and a short form of the standard Depression Anxiety Stress Scale-21 (DASS-21). Data analysis was carried out using descriptive and inferential statistical tests at a significant level of p < 0.05.

Results
The severity of depression, anxiety, and stress also had a statistically significant difference between men and women. The severity of depression was mild in 57.5% of infertile women and moderate in 40% of infertile men. The severity of anxiety was moderate in 42.5% of infertile women and mild in 57.5% of infertile men. The severity of stress was Severe in 37.5% of infertile women and mild in 40% of infertile men. There was a statistically significant difference between infertile women and men in terms of depression (t=-4.213, df = 1619, p < 0.001), anxiety (t=-7.261, df = 2274, p < 0.001), and stress (t=-9.046, df = 2308, p < 0.001) subscales, and the total scores (t=-7.709, df = 2315, p < 0.001). The depression, stress and anxiety levels were higher in infertile women than in healthy women with infertile spouses. This difference was statistically significant (p < 0.01). The depression, anxiety, and stress levels were significantly different between infertile men and healthy men with infertile wives (p < 0.001).

Conclusion
The results of this study indicated that depression, anxiety, and stress were more prevalent in infertile women than in infertile men. The severity levels of depression, anxiety, and stress in the wives of infertile men were higher than those in the spouses of infertile women.
Promotion of self-directed learning abilities among Chinese medical students through preparing for career calling and enhancing teaching competencies in medical education: a cross-sectional study
Authors: Zhao Chen-xi , Wang Zi-jiao , Yang Xiao-jing , Ma Xing , Cui Ying , Zhang Yan-xin , Cheng Xin-hui , Zhang Shu-e , Guo Qing-feng , Cao De-pin 
Published: April 2024

Abstract
Background
Medical students face a heavy burden as they are tasked with acquiring a vast amount of medical knowledge within a limited time frame. Self-directed learning (SDL) has become crucial for efficient and ongoing learning among medical students. However, effective ways to foster SDL ability among Chinese medical students are lacking, and limited studies have identified factors that impact the SDL ability of medical students. This makes it challenging for educators to develop targeted strategies to improve students’ SDL ability. This study aims to assess SDL ability among Chinese medical students and examine the effects of career calling and teaching competencies on SDL ability, as well as the possible mechanisms linking them.

Methods
Data were collected from 3614 respondents (effective response rate = 60.11%) using cross-sectional online questionnaires and analyzed using IBM SPSS Statistics 22.0. The questionnaire comprised a Demographic Characteristics Questionnaire, Self-directed Learning Ability Scale (Cronbach’s alpha = 0.962), Teaching Competencies Scale, and Career Calling Scale.

Results
The average SDL ability score of Chinese medical students was 3.68 ± 0.56, indicating a moderate level of SDL ability. The six factors of the Self-directed Learning Ability Scale—self-reflection, ability to use learning methods, ability to set study plans, ability to set studying objectives, ability to adjust psychological state, and willpower in studying—accounted for 12.90%, 12.89%, 12.39%, 11.94%, 11.34%, and 8.67% of the variance, respectively. Furthermore, career calling was positively associated with SDL learning ability (β = 0.295, p < 0.001), and SDL learning ability was positively associated with teaching competencies (β = 0.191, p < 0.01). Simple slope analysis showed that when the level of teaching competencies was higher, the influence of career calling on SDL ability was stronger.

Conclusions
Chinese medical students’ SDL ability has room for improvement. Medical students could strengthen their willpower in studying by setting milestones goals with rewards, which could inspire their motivation for the next goals. Teachers should guide students to learn experience to improve students’ reflective ability. Educators play a crucial role in bridging the gap between career calling education and SDL ability enhancement, highlighting the significance of optimal teaching competencies. Colleges should focus on strengthening teachers’ sense of career calling and teaching competencies.
Understanding antibiotic knowledge, attitudes, and practices: a cross-sectional study in physicians from a Colombian region, 2023
Authors: Taborda Juan Camilo Morales , Guzmán Juan Carlos Montaño , Higuita-Gutiérrez Luis Felipe 
Published: April 2024

Abstract
Background
Antibiotic resistance has been identified as a global health threat. Knowledge, attitudes, and inappropriate prescription practices of antibiotics by physicians play a crucial role in this problem. In Colombia, research addressing this issue is scarce.

Methods
A cross-sectional study involving 258 physicians was conducted. A scale with questions on sociodemographic aspects, level of education, satisfaction with antibiotic education received, and knowledge, attitudes, and practices was administered. The scale was designed for each item to be analyzed individually or as a total score ranging from 0 to 100 (0 being the lowest and 100 the highest).

Results
31.5% of physicians rated the education received on antibiotics as fair to poor. The knowledge score was 80.1 (IQR 70.5–87.5); however, 25.2% agreed to some extent that amoxicillin is useful in treating most respiratory infections, and 15% agreed that antibiotics are effective in treating upper respiratory infections. Attitudes scored 80.2 (IQR 75.0-86.5), with 99% stating that bacterial resistance is a public health problem in Colombia, but only 56.9% considering it a problem affecting their daily practice. Practices scored 75.5 (IQR 68.8–81.2), and 71.7% affirmed that if they refuse to prescribe antibiotics to a patient who does not need them, the patient can easily obtain them from another physician. General practitioners were found to have lower scores in all three indices evaluated.

Conclusion
The study reveals enduring misconceptions and concerning practices in antibiotic prescription, particularly among general practitioners. Enhancing knowledge necessitates the implementation of continuous medical education programs that focus on updated antibiotic guidelines, and resistance patterns. Fostering positive attitudes requires a culture of trust and collaboration among healthcare professionals. Practical enhancements can be realized through the establishment of evidence-based prescribing guidelines and the integration of regular feedback mechanisms. Moreover, advocating for the inclusion of antimicrobial stewardship principles in medical curricula is crucial, emphasizing the significance of responsible antibiotic use early in medical education.
Changes in intention to use an interprofessional approach to decision-making following training: a cluster before-and-after study
Authors: Taqif Hajar , Adisso Lionel , Gomes Souza Lucas , Dofara Suélène Georgina , Ghio Sergio Cortez , Rivest Louis-Paul , Légaré France 
Published: April 2024

Abstract
Background
Health professionals in home care work in interprofessional teams. Yet most training in decision support assumes a one-on-one relationship with patients. We assessed the impact of an in-person training session in interprofessional shared decision-making (IP-SDM) on home care professionals’ intention to adopt this approach.

Methods
We conducted a secondary analysis of a cluster stepped-wedge trial using a before-and-after study design. We collected data among home care professionals from November 2016 to February 2018 in 9 health and social services centers in Quebec, Canada. The intervention was an in-person IP-SDM training session. Intention to engage in IP-SDM pre- and post-session (dependent variable) was compared using a continuing professional development evaluation scale (CPD-Reaction) informed by the Godin’s Integrated Behavioral Model for health professionals. We also assessed socio-demographic and psychosocial variables (beliefs about capabilities, beliefs about consequences, social influence and moral norm). We performed bivariate and multivariate analysis to identify factors influencing post-intervention intention. We used the STROBE reporting guidelines for observational studies to report our results.

Results
Of 134 respondents who provided complete pairs of questionnaires (pre- and post-), most were female (90.9%), mean age was 42 (± 9.3) years and 66.9% were social workers. Mean intention scores decreased from 5.84 (± 1.19) to 5.54 (± 1.35) (Mean difference = -0.30 ± 1.16; p = 0.02). Factors associated with higher intention post-intervention were social influence (ß = 0.34, p = 0.01) and belief about capabilities (ß = 0.49, p < 0.01).

Conclusion
After in-person IP-SDM training, healthcare professionals’ intention to engage in IP-SDM decreased. However, the scope of this decrease is probably not clinically significant. Due to their association with intention, beliefs about capabilities, which translate into having a sense of self-competency in the new clinical behavior, and social influences, which translate into what important others think one should be doing, could be targets for future research aiming to implement IP-SDM in home care settings.
How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France
Authors: Griesser Anna , Mzoughi Manel , Bidmon Sonja , Cherif Emna 
Published: April 2024

Abstract
Background
Electronic health records (EHR) are becoming an integral part of the health system in many developed countries, though implementations and settings vary across countries. Some countries have adopted an opt-out policy, in which patients are enrolled in the EHR system following a default nudge, while others have applied an opt-in policy, where patients have to take action to opt into the system. While opt-in systems may exhibit lower levels of active user requests for access, this contrasts with opt-out systems where a notable percentage of users may passively retain access. Thus, our research endeavor aims to explore facilitators and barriers that contribute to explaining EHR usage (i.e., actively accessing the EHR system) in two countries with either an opt-in or opt-out setting, exemplified by France and Austria.

Methods
A qualitative exploratory approach using a semi-structured interview guideline was undertaken in both countries: 1) In Austria, with four homogenously composed group discussions, and 2) in France, with 19 single patient interviews. The data were collected from October 2020 to January 2021.

Results
Influencing factors were categorized into twelve subcategories. Patients have similar experiences in both countries with regard to all facilitating categories, for instance, the role of health providers, awareness of EHR and social norms. However, we highlighted important differences between the two systems regarding hurdles impeding EHR usage, namely, a lack of communication as well as transparency or information security about EHR.

Conclusion
Implementing additional safeguards to enhance privacy protection and supporting patients to improve their digital ability may help to diminish the perception of EHR-induced barriers and improve patients’ health and commitment in the long term.

Practical implications
Understanding the differences and similarities will help to develop practical implications to tackle the problem of low EHR usage rates in the long run. This problem is prevalent in countries with both types of EHR default settings.
Characterizing the polygenic overlap and shared loci between rheumatoid arthritis and cardiovascular diseases
Authors: Sun Xiaohui , Qian Yu , Cheng Weiqiu , Ye Ding , Liu Bin , Zhou Dan , Wen Chengping , Andreassen Ole A. , Mao Yingying 
Published: April 2024

Abstract
Background
Despite substantial research revealing that patients with rheumatoid arthritis (RA) have excessive morbidity and mortality of cardiovascular disease (CVD), the mechanism underlying this association has not been fully known. This study aims to systematically investigate the phenotypic and genetic correlation between RA and CVD.

Methods
Based on UK Biobank, we conducted two cohort studies to evaluate the phenotypic relationships between RA and CVD, including atrial fibrillation (AF), coronary artery disease (CAD), heart failure (HF), and stroke. Next, we used linkage disequilibrium score regression, Local Analysis of [co]Variant Association, and bivariate causal mixture model (MiXeR) methods to examine the genetic correlation and polygenic overlap between RA and CVD, using genome-wide association summary statistics. Furthermore, we explored specific shared genetic loci by conjunctional false discovery rate analysis and association analysis based on subsets.

Results
Compared with the general population, RA patients showed a higher incidence of CVD (hazard ratio [HR] = 1.21, 95% confidence interval [CI]: 1.15–1.28). We observed positive genetic correlations of RA with AF and stroke, and a mixture of negative and positive local genetic correlations underlying the global genetic correlation for CAD and HF, with 13 ~ 33% of shared genetic variants for these trait pairs. We further identified 23 pleiotropic loci associated with RA and at least one CVD, including one novel locus (rs7098414, TSPAN14, 10q23.1). Genes mapped to these shared loci were enriched in immune and inflammatory-related pathways, and modifiable risk factors, such as high diastolic blood pressure.

Conclusions
This study revealed the shared genetic architecture of RA and CVD, which may facilitate drug target identification and improved clinical management.