bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between preoperative frailty and myocardial injury after noncardiac surgery in geriatric patients: study protocol for a prospective, multicentre, real-world observational, cohort trial
Authors: Sun Yongtao , Guo Na , Zhang Min , Liu Mengjie , Gao Zhongquan , Sun Tao , Gao Xiaojun , Xu Lingling , Zhang Haixia , Wei Chuansong , Liu Peng , Liu Yang , Zhang Xiaoning , Guo Yongle , Chen Lina , Zhou Zheng , Su Zhenqiang , Hu Yanmei , Shi Xin , Huang Linlin , Wang Yuelan 
Published: March 2024

Abstract
Introduction
Frailty has become a worldwide health burden that has a large influence on public health and clinical practice. The incidence of frailty is anticipated to increase as the ageing population increases. Myocardial injury after noncardiac surgery (MINS) is associated with short-term and long-term mortality. However, the incidence of MINS in frail geriatric patients is unknown.

Methods and analysis
This prospective, multicentre, real-world observational cohort study will be conducted at 18 designated centres in China from January 2023 to December 2024, with an anticipated sample size of 856 patients aged 65 years and older who are scheduled to undergo noncardiac surgery. The primary outcome will be the incidence of MINS. MINS is defined as a fourth-generation plasma cardiac troponin T (cTnT) concentration ≥ 0.03 ng/mL exhibited at least once within 30 days after surgery, with or without symptoms of myocardial ischaemia. All data will be collected via electronic data acquisition.

Discussion
This study will explore the incidence of MINS in frail patients. The characteristics, predictive factors and 30-day outcomes of MINS in frail patients will be further investigated to lay the foundation for identifying clinical interventions.

Clinical trial registration
https://beta.clinicaltrials.gov/study/NCT05635877, NCT05635877.
Associations of physical activity intensity, frequency, duration, and volume with the incidence of sarcopenia in middle-aged and older adults: a 4-year longitudinal study in China
Authors: Zhao Xiaoguang , Liu Dongxue , Zhang Hongjun , Shen Shaoshuai , Zhang Naipeng , Pan Yihan , Fu Chao , Wang Wenjiao , Ren Hang , Pan Xiaopeng 
Published: March 2024

Abstract
Background
Physical activity (PA) plays an important role in the process of several chronic diseases. It may be also associated with the incidence of sarcopenia. This study aimed to determine the association of PA from different components including frequency, duration, intensity, and volume with the incidence of sarcopenia in middle-aged and older adults.

Methods
This study used data from the China Health and Retirement Longitudinal Study in 2011 and 2015. A total of 3,760 individuals aged ≥ 40 years were involved in this study. Sarcopenia was diagnosed using muscle mass, strength and physical performance according to the Asian Working Group for Sarcopenia. PA information including frequency, duration, intensity, and volume was obtained by a self-reported questionnaire. Logistic regression analysis was employed to examine the association between PA and the incidence of sarcopenia at 4-year follow-up.

Results
The incidence of sarcopenia was 5.9% during the 4-year follow-up. Compared to sedentary individuals, those taking 1–2 days or more per week, or a minimum of 10 min each time on vigorous-intensity PA (VPA) had a lower incidence of sarcopenia. Adults spending 3 days or more each week, a minimum of 30 min each time, or 150 min or more per week on moderate-intensity PA (MPA) had a lower presence of sarcopenia than sedentary adults. Adults taking 3 days or more per week, at least 30 min each time, or 150 min or more each week on light-intensity PA (LPA) tended to have a lower incidence of sarcopenia than sedentary individuals. Sensitivity analyses confirmed the robustness of the findings after removing persons with hypertension, dyslipidemia, or diabetes.

Conclusions
These findings suggest that the frequency, duration, and volume of VPA or MPA are negatively associated with the presence of sarcopenia. Participation in LPA tends to have a lower incidence of sarcopenia in middle-aged and older adults.
Cultural adaptation, validation and evaluation of the psychometric properties of Childbirth Experience Questionnaire version 2.0 in the Spanish context
Authors: Machín-Martín Elisabet , González-de la Torre Héctor , Bordón-Reyes Haridian , Jeppesen-Gutiérrez Julia , Martín-Martínez Alicia 
Published: March 2024

AbstractBackgroundSeveral instruments have been designed to assess the childbirth experience. The Childbirth Experience Questionnaire (CEQ) is one of the most widely used tools. There is an improved version of this instrument, the Childbirth Experience Questionnaire (CEQ 2.0), which has not been adapted or validated for use in Spain. The aim of present study is to adapt the CEQ 2.0 to the Spanish context and evaluate its psychometric properties.MethodsThis research was carried out in 2 stages. In the first stage, a methodological study was carried out in which the instrument was translated and back-translated, content validity was assessed by 10 experts (by calculating Aiken's V coefficient) and face validity was assessed in a sample of 30 postpartum women. In the second stage, a cross-sectional study was carried out to evaluate construct validity by using confirmatory factor analysis, reliability evaluation (internal consistency and temporal stability) and validation by known groups.ResultsIn Stage 1, a Spanish version of the CEQ 2.0 (CEQ-E 2.0) was obtained with adequate face and content validity, with Aiken V scores greater than 0.70 for all items. A final sample of 500 women participated in Stage 2 of the study. The fit values for the obtained four-domain model were RMSEA = 0.038 [95% CI: 0.038–0.042], CFI = 0.989 [95% CI: 0.984–0.991], and GFI = 0.990 [95% CI: 0.982–0.991]. The overall Omega and Cronbach's Alpha coefficients were 0.872 [95% CI: 0.850–0.891] and 0.870 [95% CI: 0.849–0.890] respectively. A coefficient of intraclass correlation of 0.824 [95% CI: 0.314–0.936] (p ≤ 0.001) and a concordance coefficient of 0.694 [95% CI: 0.523–0.811] were obtained.ConclusionsThe Spanish version of CEQ 2.0 (CEQ-E 2.0), has adequate psychometric properties and is a valid, useful, and reliable instrument for assessing the childbirth experience in Spanish women.
Awareness and healthcare seeking behavior of neonatal danger signs, and predictor variables among mothers/caregivers in four developing regional state of Ethiopia
Authors: Dida Nagasa , Abute Lonsako , Dejene Tariku , Yadate Tolasa , Geleta Temesgen , Sharma Rachana , Mon Hnin Su , Simireta Tesfaye , Addisu Hailemariam 
Published: March 2024

Abstract
Introduction
: Mothers/caregivers should be aware of a newborn’s danger signs and promptly seek medical attention. Hence, this study assessed mothers’/caregivers’ awareness, healthcare seeking behaviors for neonatal danger signs and their determinants in the developing regional state of Ethiopia.

Methods
A community-based cross-sectional study was employed among mothers/caregivers of neonates in the developing regional state of Ethiopia. The sample was determined in collaboration with the Central Statistics Agency of Ethiopia. Stratified multi-stage cluster sampling was used to recruit the sample. Data were collected through an interviewer administered structured questionnaire using a tablet computer. Descriptive statistics and binary logistic regression were applied to identify determinants of awareness and treatment-seeking behavior for neonatal danger signs.

Results
The result of the study showed that nearly one-third (32.7%) of the respondents had a good level of awareness of neonatal danger signs, and 69.0% of the respondents had good healthcare-seeking practice about neonatal danger signs. Regional state (Benishangul-Gumuz) [AOR = 1.61; 95% CI (1.09, 2.39)], Muslim’s [AOR = 1.75; 95% CI (1.20, 2.55)] and permission to travel to a health facility [AOR = 0.48; 95% CI (0.37, 0.63)] were determinants of mothers’/caregivers’ awareness about neonatal danger signs. Antenatal care (ANC) attendance and institutional delivery were shown to have a positive association with neonatal healthcare seeking (AOR = 2.14 and AOR = 2.37, respectively).

Conclusion
In Ethiopia’s developing regional states, mothers/caregivers were remarkably unaware of neonatal danger signs. Region, religion, mothers’/caregivers’ age, and need for permission to travel to a health facility were predictor variables for neonatal danger sign awareness. Better healthcare seeking practices, which are determined by ANC attendance and institutional delivery, are observed in these regions. Federal and regional governments should give these regions due attention. Moreover, regional health bureaus and health professionals should tackle the problem by focusing on the identified factors.
Smoke exposure, hemoglobin levels and the prevalence of anemia: a cross-sectional study in urban informal settlement in Southern Ghana
Authors: Appiah-Dwomoh Cyril , Tettey Prudence , Akyeampong Enoch , Amegbor Prince , Okello Gabriel , Botwe Paul K. , Quansah Reginald 
Published: March 2024

Abstract
Background
In sub-Saharan African cities, more than half of the population lives in informal settlements. These settlements are close to smoky dumpsites, industrial plants, and polluted roads. Furthermore, polluting fuels remain their primary sources of energy for cooking and heating. Despite evidence linking smoke and its components to anaemia, none of these studies were conducted on populations living in urban informal settlements. This study investigated the risks of anemia/mean Haemoglobin (HB) levels in an informal settlement in Accra, Ghana. Exposure to smoke was examined across various sources, encompassing residences, neighborhoods, and workplaces.

Methods
The study was a facility-based cross-sectional design among residents at Chorkor, an informal settlement in the Greater Accra region of Ghana. A questionnaire was administered at a community hospital during an interview to gather data on sources of smoke exposure in the household, in the neighbourhood, and in the workplace. A phlebotomist collected blood samples from the participants after the interview to assess their anaemia status.

Results
The population (n = 320) had a high prevalence of anemia, with 49.1% of people fitting the WHO’s definition of anemia, while the average HB level was 12.6 ± 2.1 g/dL. Anemia was associated with the number of different types of waste burnt simultaneously [(1 or 2: prevalence ratio (PR): 95% confidence interval (CI), 1.14, 0.99–1.28: 3+: 1.16, 1.01–1.63, p-for-trend = 0.0082)], fuel stacking [(mixed stacking: 1.27, 1.07–1.20: dirty stacking:1.65, 1.19–2.25, p-for-trend = 0.0062)], and involvement in fish smoking (1.22, 0.99–1.06). However, the lower limit of the CIs for number of different forms of garbage burned simultaneously and engagement in fish smoking included unity. Reduced mean HB levels were associated with the number of different types of waste burnt simultaneously [(1 or 2: regression coefficient (β): 95% confidence interval (CI), -0.01, -0.97- -0.99: 3+: -0.14, -0.77- -0.05)], current smoker [(yes, almost daily: -1.40, -2.01- -0.79: yes, at least once a month: -1.14, -1.79- -0.48)], Second-Hand-Smoking (SHS) (yes, almost daily: -0.77, -1.30- -0.21), fuel stacking [(mixed stacking-0.93, -1.33–0.21: dirty stacking-1.04, -1.60- -0.48)], any smoke exposure indicator in the neighbourhood (-0.84, -1.43- -0.25), living close to a major road (-0.62, -1.09- -0.49), and fish smoking (-0.41,-0.93- -0.12).

Conclusion
Although the cross-sectional design precludes causality, smoke exposure was associated with mean HB levels and anaemia among populations living in informal settlements.
Trust in federal COVID-19 vaccine oversight and parents’ willingness to vaccinate their children against COVID-19: a cross-sectional study
Authors: Yu Hyunmin , Bauermeister José A. , Oyiborhoro Ufuoma , Aryal Subhash , Lipman Terri H. , Tan Andy S. L. , Glanz Karen , Villarruel Antonia M. , Bonett Stephen 
Published: March 2024

Abstract
Background
Over half of the youth population in the United States, aged 6 months to 17 years, have not received the Coronavirus Disease 2019 (COVID-19) vaccine. Given parents’ central role in vaccinating their children, we examined associations between parents’ trust of the federal oversight of COVID-19 vaccine safety and their willingness to vaccinate their children against COVID-19.

Methods
This cross-sectional study included 975 parents of minor children residing in Philadelphia who completed the online survey between September 2021 and February 2022. Trust was measured using a four-point Likert scale ranging from ‘do not trust’ to ‘fully trust’ for two variables: (1) trust in federal oversight of COVID-19 vaccine safety for children and (2) trust in federal oversight of COVID-19 vaccine safety for the general public. A multiple logistic regression evaluated associations between trust and parents’ willingness to vaccinate their children, which was measured on a five-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree.’ The analysis was adjusted for race/ethnicity, age, sexual orientation, gender, education, insurance, and parents’ vaccination status.

Results
Analyses included 975 parents whose children had not previously been vaccinated against COVID-19 (mean age 36.79, standard deviation 6.4; 42.1% racial/ethnic minorities; 93.2% heterosexual; and 73.7% with a college degree). Greater trust regarding federal oversight of COVID-19 vaccine safety for children [adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.13–2.04] and for the public (aOR = 1.58, 95% CI: 1.17–2.14) were each associated with increased willingness to have their child vaccinated against COVID-19. Unvaccinated parents had decreased willingness compared to parents who had received at least one dose of the vaccine (aOR = 0.14, 95% CI: 0.04–0.41). College-graduate parents exhibited increased willingness compared to those without a college degree (aOR = 2.07, 95% CI: 1.52–2.81). Non-heterosexual parents showed increased willingness compared to heterosexual parents (aOR = 2.30, 95% CI: 1.20–4.76).

Conclusions
Trust in federal COVID-19 vaccine oversight was associated with parental willingness to vaccinate their children against COVID-19 among parents whose children have not yet been vaccinated. Identifying and addressing causes of mistrust are crucial next steps to promote child vaccination. Intervention efforts to address trust gaps should remain a public health priority.
Vitamin C deficiency can lead to pulmonary hypertension: a systematic review of case reports
Authors: Hemilä Harri , de Man Angelique M.E. 
Published: March 2024

Abstract
Background
In the early literature, unintentional vitamin C deficiency in humans was associated with heart failure. Experimental vitamin C deficiency in guinea pigs caused enlargement of the heart. The purpose of this study was to collect and analyze case reports on vitamin C and pulmonary hypertension.

Methods
We searched Pubmed and Scopus for case studies in which vitamin C deficiency was considered to be the cause of pulmonary hypertension. We selected reports in which pulmonary hypertension was diagnosed by echocardiography or catheterization, for any age, sex, or dosage of vitamin C. We extracted quantitative data for our analysis. We used the mean pulmonary artery pressure (mPAP) as the outcome of primary interest.

Results
We identified 32 case reports, 21 of which were published in the last 5 years. Dyspnea was reported in 69%, edema in 53% and fatigue in 28% of the patients. Vitamin C plasma levels, measured in 27 cases, were undetectable in 24 and very low in 3 cases. Diet was poor in 30 cases and 17 cases had neuropsychiatric disorders. Right ventricular enlargement was reported in 24 cases. During periods of vitamin C deficiency, the median mPAP was 48 mmHg (range 29–77 mmHg; N = 28). After the start of vitamin C administration, the median mPAP was 20 mmHg (range 12–33 mmHg; N = 18). For the latter 18 cases, mPAP was 2.4-fold (median) higher during vitamin C deficiency. Pulmonary vascular resistance (PVR) during vitamin C deficiency was reported for 9 cases, ranging from 4.1 to 41 Wood units. PVR was 9-fold (median; N = 5) higher during vitamin C deficiency than during vitamin C administration. In 8 cases, there was direct evidence that the cases were pulmonary artery hypertension (PAH). Probably the majority of the remaining cases were also PAH.

Conclusions
The cases analyzed in our study indicate that pulmonary hypertension can be one explanation for the reported heart failure of scurvy patients in the early literature. It would seem sensible to measure plasma vitamin C levels of patients with PH and examine the effects of vitamin C administration.
The relationship between pregnancy and temporomandibular disorder (TMD) through diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: a case-control cross-sectional study
Authors: Minervini Giuseppe , Marrapodi Maria Maddalena , La Verde Marco , Meto Aida , Siurkel Yuliia , Cicciù Marco , Russo Diana 
Published: March 2024

Abstract
Introduction
This study focuses on temporomandibular disorders (TMDs), which affect the temporomandibular joint and related muscles and have multiple causes. Recent studies have examined the connection between menstrual cycles, estrogen levels, and TMDs, but results are inconsistent, highlighting the need for more research. The aim is to explore the prevalence of TMDs in pregnant women and consider how hormonal changes during pregnancy might influence these disorders.

Methods
In this cross-sectional case-control study, we compared 32 pregnant women with 35 non-pregnant women. We evaluated several TMD-related factors such as pain levels, chronic pain classification, scores on the Jaw Functional Limitation Scale-20 and Oral Behaviors Checklist, and psychological health. We used various statistical methods including descriptive statistics, chi-square tests, linear regression, and adjustments for multiple comparisons to analyze the data.

Results
Pregnant women showed different pain perceptions, generally reporting less pain and lower severity. Nonetheless, these differences were not uniform across all TMD-related measures. Linear regression did not find a consistent link between pregnancy and TMD scores, except for chronic pain grade, which was not significant after adjusting for multiple comparisons. There was a significant relationship between depression and TMD severity, emphasizing the need to consider mental health in TMD evaluations.

Discussion
The findings suggest that pregnancy is neither a risk nor a protective factor for TMD. Differences in pain perception, functional status, and psychological health were observed in pregnant women but were not consistent for all TMD-related aspects. The role of estrogen in TMJ health and TMD risk is complex and requires further study. The research highlights the necessity of including mental health, especially depression, in TMD assessments. More comprehensive research with larger sample sizes is essential to better understand the connections between pregnancy, TMD, and hormones, aiming to improve TMD management in pregnant women and others.
Utilization of routine health data and its determinants among healthcare workers in public health facilities of harari region, eastern Ethiopia
Authors: Ayele Gudeta , Abera Admas , Ayele Angefa , Gudina Daniel , Firdisa Dawit 
Published: March 2024

Abstract
Background
Routine health information is the pillar of the planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and program improvement. Little is known about evidence-based actions to successively advance the use of information for decision making. Therefore, this study aimed to assess the level and determinants of routine health data utilization among health workers in public health facilities in the Harari region, Ethiopia.

Methods
An institutional-based cross-sectional study design was used from June 1 to July 31, 2020. A total of 410 health care providers from two hospitals and five health centers were selected using a simple random sampling technique. Data were collected through a structured questionnaire complemented by an observational checklist. The collected data were thoroughly checked, coding, and entered into Epi-data version 4.6 before being transferred to Stata version 14 for analysis. Frequency and cross-tabulations were performed. To measure factors associated with routine use of health data, bivariate and multivariate logistic regression analyzes were performed. The odds ratio with a 95% CI was calculated, and then a p-value of less than 0.05 was considered significant.

Result
The general utilization of routine health data was 65.6%. The use of routine health data was significantly associated with healthcare workers who had a positive attitude towards data [AOR = 4 (2.3–6.9)], received training [AOR = 2.1 (1.3–3.6)], had supportive supervision [AOR = 3.6 (2.1–6.2)], received regular feedback [AOR = 2.9 (1.7–5.0)] and perceived a culture of information use [AOR = 2.5 (1.3–4.6)].

Conclusions
Sixty percent of health professionals had used routine health data utilization. Training, supervision, feedback, and the perceived culture of information were independently associated with the use of routine health data utilization. Therefore, it is critical to focus on improving data utilization practices by addressing factors that influence the use of routine health data.
Satisfaction with clinical pathway implementation versus job performance of clinicians: empirical evidence on the mediating role of work engagement from public hospitals in Sichuan, China
Authors: Li Junlong , Ao Lu , Pan Jay 
Published: March 2024

AbstractBackgroundThe job performance of clinicians is a clear indicator of both hospital capacity and the level of hospital service. It plays a crucial role in maintaining the effectiveness and quality of medical care. Clinical pathways are a systematic method of quality improvement successfully recommended by broader healthcare systems. Since clinicians play a key role in implementing clinical pathways in public hospitals, this study aims to investigate the effect of the satisfaction of clinicians in public hospitals with clinical pathway implementation on their job performance.MethodsA cross-sectional study design was used. Questionnaires were administered online. A total of 794 clinicians completed the questionnaires in seven tertiary public hospitals in Sichuan Province, China, of which 723 were valid for analysis. Questionnaires contained questions on social demographic characteristics, satisfaction with clinical pathway implementation, work engagement, and job performance. Structural Equation Model (SEM) was used to test the hypotheses.ResultsThe satisfaction of clinicians in public hospitals with clinical pathway implementation was significantly positively correlated with work engagement (r = 0.570,P < 0.01) and job performance (r = 0.522,P < 0.01). A strong indirect effect of clinicians’ satisfaction with clinical pathway implementation on job performance mediated by work engagement was observed, and the value of this effect was 0.383 (boot 95%CI [0.323, 0.448]).ConclusionThe satisfaction of clinicians in public hospitals with clinical pathway implementation not only directly influences their job performance, but also indirectly affects it through the mediating variable of work engagement. Therefore, managers of public hospitals need to pay close attention to clinicians’ evaluation and perception of the clinical pathway implementation. This entails taking adequate measures, such as providing strong organizational support and creating a favorable environment for the clinical pathway implementation. Additionally, focusing on teamwork to increase clinicians’ satisfaction can further enhance job performance. Furthermore, managers should give higher priority to increasing employees’ work engagement to improve clinicians’ job performance.