bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual outcome of various dose of glucocorticoids treatment in nonarteritic anterior ischemic optic neuropathy– a retrospective analysis
Authors: Zhao Fang-Fang , Chen Yun , Li Tai-Ping , Wang Yun , Lin Hong-Jie , Yang Jian-Feng , Chen Lan , Tan Shao-Ying , Liang Jia-Jian , Cen Ling-Ping 
Published: March 2024

Abstract
Background and purpose
The objective of this investigation was to assess the therapeutic efficacy of distinct glucocorticoid therapy dosages in the management of acute nonarteritic anterior ischemic optic neuropathy (NAION).

Materials and methods
This retrospective, unmasked, and non-randomized study included a total of 85 patients. The patients were categorized into four groups: Group 1 (control) consisted of 15 patients who did not receive glucocorticoids, Group 2 included 16 patients administered with oral prednisone at a dosage of 1 mg/kg/d for 14 days, Group 3 comprised 30 patients who received 250 units of methylprednisolone once daily for 3 days, followed by oral prednisone at a dosage of 1 mg/kg/d for 11 days, and Group 4 encompassed 24 patients who received 500 units of methylprednisolone once daily for 3 days, followed by oral prednisone at a dosage of 1 mg/kg/d for 11 days. The best-corrected visual acuity (BCVA) was assessed at baseline and the final follow-up (> 7 days post-treatment). The changes in visual acuity between baseline and the 7–14 day follow-up, as well as between baseline and the concluding appraisal, were employed as metrics for assessing the extent of visual enhancement.

Results
No significant differences were noted in the final visual outcomes or in the changes between final visual acuity and baseline across the four groups. In Group 1 (control), the best-corrected visual acuity (BCVA) remained unchanged during final follow-ups compared to baseline. Conversely, the intervention groups exhibited statistically significant enhancements in BCVA during final follow-up (p = 0.012, p = 0.03, and p = 0.009 for Group 2, Group 3, and Group 4, respectively) when compared to baseline. During the 7–14 day follow-up, there was a significant difference in the changes between baseline BCVA and follow-up BCVA across the groups (p = 0.035). Go a step further by Bonferroni correction for multiple comparisons, group 4 showed a greater change in vision compared with group1 (p = 0.045).

Conclusion
Our study on acute nonarteritic anterior ischemic optic neuropathy (NAION) showed no significant final visual outcome differences. Nevertheless, Groups 2, 3, and 4 demonstrated improved best-corrected visual acuity (BCVA) during the final follow-up. Notably, a 500-unit dose of methylprednisolone resulted in short-term BCVA enhancement. This suggests potential consideration of 500 units of methylprednisolone for short-term NAION vision improvement, despite its limited long-term impact.
Determinants and outcomes of health-promoting lifestyle among people with schizophrenia
Authors: Fan Yu , Zhou Liang , Chen Xiyuan , Su Jinghua , Zhong Shaoling 
Published: March 2024

AbstractBackgroundHealthy lifestyle is an important protective factor of developing cardiovascular disease in people with schizophrenia. However, little is known about the determinants of lifestyle and its contribution to metabolic syndrome. This study aimed to explore the influencing factors of health-promoting lifestyle (HPL) and its association with metabolic syndrome among people with schizophrenia.MethodsA cross-sectional study was conducted in twenty-two primary health centers of Guangzhou, China between December 2022 and April 2023. A total of 538 patients with schizophrenia were recruited through convenience sampling. Self-administered scales, questionnaires, and clinical data were collected. Scales and questionnaires included social-demographic information, Health-Promoting Lifestyles Profile (HPLP-C), UCLA Loneliness Scale (ULS), and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Cluster analyses were used to divide participants into two groups based on the distribution characteristics of HPLP-C scores. Logistic regression models were used to identify factors associated with HPL and the association between HPL and metabolic syndrome.ResultsThere were 271 participants in the high HPL group and 267 participants in the low HPL group. Logistic regression analysis revealed that loneliness posed a risk factor for high HPL, while high education and moderate-vigorous physical activity served as protective factors for high HPL. Low HPL was a risk factor for the prevalence of metabolic syndrome.ConclusionsPromotion of high education literacy and a physically active lifestyle should be priority targets in the health management of schizophrenia. Primary healthcare providers can play a pivotal role in assisting patients to mitigate metabolic syndrome by reinforcing healthy lifestyle strategies.
Prevalence and risk factors for diabetic foot complications among people living with diabetes in Harare, Zimbabwe: a cross-sectional study
Authors: Kuguyo Oppah , Mukona Doreen Macherera , Chikwasha Vasco , Gwanzura Lovemore , Chirenda Joconiah , Matimba Alice 
Published: March 2024

AbstractBackgroundDiabetic foot disease (DF) is a common diabetes-related complication; however, the prevalence and associated risk factors for DF are not well characterised among people living with diabetes (PLWD) in Zimbabwe. This may suggest the unavailability of adequate strategies to diagnose and treat DF in the country. This study aimed to determine the prevalence of DF and associated risk factors for PLWD in Harare, Zimbabwe.MethodsThis was a cross-sectional study, employing a quantitative approach. In total, 352 PLWD were recruited from 16 primary care clinics in Harare. Sociodemographic and clinical data were collected via face-to-face interviews and clinical records reviews. The DF screening included an evaluation for peripheral neuropathy, ankle-brachial index (ABI), ulceration, and amputation. Self-administered questionnaires were used to assess knowledge, attitudes, and practices (KAPs), and KAP was scored using Bloom’s cut-off. Chi-Square goodness-of-fit tests were performed, and regression analyses were used for association analysis. The threshold for significance wasp < 0.05.ResultsThis group included 82 men and 279 women, with a combined mean age of 57.9 ± 14 years. Twenty one (~ 26%) men and 41 (15%) women had type 1 diabetes. The diabetes type distribution significantly differed by gender (p < 0.001). Oral hypoglycaemics (71%) were most commonly administered for management. DF was observed in 53% (95% CI = 50–56) of PLWD. Other DF symptoms observed were abnormal ABI (53%), peripheral neuropathy (53%), foot ulceration (17%) and amputation (3%). Peripheral neuropathy increased the risk of ulceration (OR = 1.7; 95% CI = 1.1–2.6; p = 0.019), while insulin use was protective against amputation (OR = 0.1; 95% CI = 0.1–0.9;p = 0.049). Most (87%) of the participants demonstrated good DF knowledge and the importance of adhering to medication to prevent DF. However, 96% did not know that smoking was a risk factor for DF. Nearly two-thirds (63%) demonstrated poor attitudes and practices. Poor attitudes and practices were not predictors of DF ulceration risk (p > 0.05).ConclusionThis study showed that there was a high prevalence of DF (53%) in PLWD in Zimbabwe, and insulin use was protective against DF. There is an urgent need for policy revisions to include foot screening in routine primary care and increasing insulin use for PLWD to prevent complications such as DF as an integral part of primary care.
Identifying determinants of varenicline adherence using the Theoretical Domains framework: a rapid review
Authors: Minian Nadia , Wong Melissa , Hafuth Sowsan , Rodak Terri , Rahimi Alma , Gjomema Dea , Rose Jonathan , Zawertailo Laurie , Ratto Matt , Selby Peter 
Published: March 2024

Abstract
Background
Adhering to varenicline has been shown to significantly improve the chances of successfully quitting smoking, with studies indicating a twofold increase in 6-month quit rates. However, despite its potential benefits, many individuals struggle with maintaining good adherence to varenicline; thus there is a need to develop scalable strategies to help people adhere. As a first step to inform the development of an intervention to improve adherence to varenicline, we conducted a rapid literature review to identify: 1) modifiable barriers and facilitators to varenicline adherence, and 2) behaviour change techniques associated with increased adherence to varenicline.

Methods
We searched MEDLINE, Embase, APA PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials for relevant studies published between 2006 and 2022. Search terms included “varenicline,” “smoking cessation,” and "adherence," and their respective subject headings and synonyms. We screened and included studies reporting modifiable determinants of adherence to varenicline and then assessed quality, extracted modifiable determinants and mapped them to the Theoretical Domains Framework version 2 and the Behaviour Change Technique Taxonomy version 1.

Results
A total of 1,221 titles were identified through the database searches; 61 met the eligibility criteria. Most of the studies were randomized controlled trials and predominantly focused on barriers to varenicline. Only nine studies explicitly mentioned behaviour change techniques used to help varenicline adherence. Eight domains were identified as barriers to varenicline adherence (behavioural regulation, memory, goals, intentions, beliefs about capabilities, beliefs about consequences, optimism/pessimism, and environmental context) and five as facilitators (knowledge, behavioural regulation, beliefs about capabilities, social influences, and environmental context).

Conclusions
This study identifies barriers and facilitators that should be addressed when developing a complex adherence intervention tailored to patients’ needs based on modifiable determinants of medication adherence, some of which are under- used by existing adherence interventions. The findings from this review will inform the design of a theory-based healthbot planned to improve varenicline adherence in people undergoing smoking cessation treatment.

Systematic review registration
This study was registered with PROSPERO (# CRD42022321838).
Exploring determinants of sex and family history-based disparity in type 2 diabetes mellitus prevalence among clinical patients
Authors: Alrashed Fahad Abdulaziz , Iqbal Muhammad , Alsubiheen Abdulrahman M , Ahmad Tauseef 
Published: March 2024

AbstractBackgroundType 2 diabetes mellitus represents a multifaceted disorder characterized by intricate pathophysiological mechanisms, encompassing diminished insulin secretion, augmented hepatic glucose production, and heightened insulin resistance. This study aims to assess the sex (Male and Female only) and family history-based differences in the prevalence of T2DM and explore the determinants contributing to this disparity among clinical patients.Subjects and methodsThe study encompassed a diverse pool of clinical patients, encompassing both individuals with diabetes and those without the condition, who had previously sought medical attention for clinical checkups at healthcare centers. The collected data included essential parameters such as blood pressure, weight, height, smoking habits, educational background, and physical activity levels. To ensure methodological rigor and data accuracy, blood pressure measurements adhered to the stringent guidelines set forth by the World Health Organization.ResultsParticipants of the present study reported diabetes, among which notable findings emerged regarding health indicators. It was observed that the prevalence of high blood pressure, obesity, and high blood cholesterol exhibited a statistically significant increase among the female participants, underscoring the sex-based disparities in these health parameters. The male population aged 60 or older, the presence of a family history of DM accentuated this risk, resulting in a striking 3.1 times higher prevalence compared to females, who exhibited a 2.4 times higher risk (OR = 2.4,p = 0.0008). This intriguing relationship between diabetes and cholesterol levels was not limited to sex. Both male (OR = 2.47) and female (OR = 2.1) diabetes patients displayed highly significant associations with cholesterol levels. The risk of T2DM was significantly associated with triglycerides in both sexes (1.58 times higher in males, and 1.71 times higher in females).ConclusionsThe significance of hypertension as a comorbidity in T2DM, highlighting sex-specific associations and the potential impact of a family history of diabetes on blood pressure. Our findings emphasize the importance of considering lipid profiles, obesity, and their sex-specific associations when assessing and managing diabetes risk. Comprehensive diabetes care should include strategies for lipid control, weight management, and cardiovascular risk reduction, tailored to the individual’s sex and specific risk profile.
Correlation of geopolitics, education, democracy with COVID-19 vaccination rate
Authors: Chakhunashvili Konstantine , Chakhunashvili Davit G. , Kvirkvelia Eka , Toria Tornike , Basilaia Liza , Gorjomeladze Tsira 
Published: March 2024

Abstract
Introduction
Vaccine hesitancy is an ongoing problem and determining the factors that increase the vaccination rate in various countries of the world might be useful for further implementation of efficient public health policies and negating anti-vaccination campaigns.

Materials and methods
Human Development Index (HDI), Education Index (EI), Democracy Index (DI), COVID-19 vaccination rates, COVID-19 data were collected from public sources such as UNDP - Human Development Reports, UNESCO - Education Index, Economist Intelligence, WHO– COVID-19 Dashboard, Our World In Data, The Financial Times COVID-19 Dashboard. Statistical analysis such as Pearson correlation, and linear regression analyses were done to determine a relation between the above-mentioned indices and COVID-19 vaccination rates (1-dose, 2-dose, booster, and combined).

Results
HDI had the strongest positive correlation with the vaccination rates (1-dose– r (181) = 0.632, p < 0.001, 2-dose– r (181) = 0.671, p < 0.001, booster– r (181) = 0.718, p < 0.001, combined– 0.703, p < 0.001). EI (1-dose– r (177) = 0.560, p < 0.001, 2-dose– r (177) = 0.599, p < 0.001, booster– r (177) = 0.642, p < 0.001, combined– 0.626, p < 0.001), DI (1-dose– r (163) = 0.445, p < 0.001, 2-dose– r (163) = 0.479, p < 0.001, booster– r (163) = 0.534, p < 0.001, combined– 0.508, p < 0.001), as well as Geographic location (1-dose– η (Eta) = 0.610 p < 0.001, 2-dose– η (Eta) = 0.633 p < 0.001, booster– η (Eta) = 0.657, p < 0.001, combined– η (Eta) = 0.645, p < 0.001) had positive correlation with vaccination rates.

Conclusion
There is a strong positive correlation of COVID-19 vaccination rates with HDI and EI.
Development and validation of the physician self-efficacy to manage emotional challenges Scale (PSMEC)
Authors: Weurlander Maria , Wänström Linda , Seeberger Astrid , Lönn Annalena , Barman Linda , Hult Håkan , Thornberg Robert , Wernerson Annika 
Published: March 2024

Abstract
Background
Medical students experience emotional challenges during their undergraduate education, often related to work-based learning. Consequently, they may experience feelings of uncertainty and self-doubt, which can negatively affect their well-being. Therefore, it is crucial to support students’ development of their ability to manage distressful situations. Self-efficacy beliefs may be a central aspect of supporting them in this development, and have been shown to relate to resilient factors such as students’ motivation, learning, and well-being.

Methods
We constructed a scale to measure medical students’ physician self-efficacy to manage emotional challenges during work-based learning, the PSMEC scale. The aim of the present study was to evaluate some of the psychometric properties of the PSMEC scale. The scale consists of 17 items covering five subscales: (1) medical knowledge and competence, (2) communication with difficult patients and delivering bad news, (3) being questioned and challenged, (4) educative competence in patient encounters, and (5) ability to establish and maintain relationships with healthcare professionals. Data were collected from 655 medical students from all seven medical schools in Sweden. To investigate the scale’s dimensionality and measurement invariance with regard to gender and time in education, single and multiple group confirmatory factor models were estimated using techniques suitable for ordered categorical data. Measures of Cronbach’s alpha were calculated to evaluate internal consistency.

Results
The scale showed good internal consistency on both the global dimension and the five subdimensions of self-efficacy. In addition, the scale was shown to be measurement invariant across genders and times in education, indicating that the scale means of male and female medical students and the scale means of students at the middle and end of their education can be compared.

Conclusions
The physician self-efficacy to manage emotional challenges scale demonstrated satisfactory psychometric properties, with regards to dimensionality, internal consistency, and measurement invariance relating to gender and time in education, and this study supports the usefulness of this scale when measuring self-efficacy in relation to emotional challenges.
Comparison of gamification and role-playing education on nursing students’ cardiopulmonary resuscitation self-efficacy
Authors: Khaledi Ata , Ghafouri Raziyeh , Anboohi Sima Zohari , Nasiri Malihe , Ta’atizadeh Mohsen 
Published: March 2024

AbstractBackgroundCardiopulmonary resuscitation (CPR) is one of the most fundamental skills a nursing student should be trained in. Gamification in education involves using game elements to increase motivation, engagement, and personalization of the learning process. The gamification method creates competition among students using various methods, comparing to the role-playing method which is a teaching method that allows individuals to actively engage in simulated scenarios. Therefore, this research aimed to compare the effect of CPR education using gamification and role-playing on the self-efficacy of nursing students.MethodsThis research was a quasi-experimental intervention type with three groups. A total of 154 nursing students participated in this study and were divided into intervention with role-playing (n = 53), gamification (n = 60) and conventional (lecture) (n = 41) groups. In the conventional method, CPR skills were taught to students using practical exercises. In the role-playing method, after training with moulages, a scenario was presented, and students were assigned roles. In the gamification method, after training with moulages, a scenario was presented, and after that, Kahoot software was used to create a sense of competition and excitement in the game. Self-efficacy scores were measured before and after interventions. Self-efficacy in CPR, knowledge, and skills of nursing students in CPR were assessed in each of the three groups using The Basic Resuscitation Skills Self- Efficacy Scale.ResultsIn the present study, 154 nursing students, including 92 females and 62 males, participated. There was a statistically significant difference in the mean self-efficacy scores before and after training in both the gamification and role-playing groups (P < 0.05). There was a statistically significant difference in the mean self-efficacy scores among the three groups (gamification, role-playing, and lecture) (P < 0.05).ConclusionBased on results it can be concluded that the teaching method used in CPR training affects the self-efficacy of CPR. Active methods, have a greater impact on CPR self-efficacy.
Plasma metabolites and risk of seven cancers: a two-sample Mendelian randomization study among European descendants
Authors: Chen Yaxin , Xie Yufang , Ci Hang , Cheng Zhengpei , Kuang Yongjie , Li Shuqing , Wang Gang , Qi Yawen , Tang Jun , Liu Dan , Li Weimin , Yang Yaohua 
Published: March 2024

Abstract
Background
While circulating metabolites have been increasingly linked to cancer risk, the causality underlying these associations remains largely uninterrogated.

Methods
We conducted a comprehensive 2-sample Mendelian randomization (MR) study to evaluate the potential causal relationship between 913 plasma metabolites and the risk of seven cancers among European-ancestry individuals. Data on variant-metabolite associations were obtained from a genome-wide association study (GWAS) of plasma metabolites among 14,296 subjects. Data on variant-cancer associations were gathered from large-scale GWAS consortia for breast (N = 266,081), colorectal (N = 185,616), lung (N = 85,716), ovarian (N = 63,347), prostate (N = 140,306), renal cell (N = 31,190), and testicular germ cell (N = 28,135) cancers. MR analyses were performed with the inverse variance-weighted (IVW) method as the primary strategy to identify significant associations at Bonferroni-corrected P < 0.05 for each cancer type separately. Significant associations were subjected to additional scrutiny via weighted median MR, Egger regression, MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO), and reverse MR analyses. Replication analyses were performed using an independent dataset from a plasma metabolite GWAS including 8,129 participants of European ancestry.

Results
We identified 94 significant associations, suggesting putative causal associations between 66 distinct plasma metabolites and the risk of seven cancers. Remarkably, 68.2% (45) of these metabolites were each associated with the risk of a specific cancer. Among the 66 metabolites, O-methylcatechol sulfate and 4-vinylphenol sulfate demonstrated the most pronounced positive and negative associations with cancer risk, respectively. Genetically proxied plasma levels of these two metabolites were significantly associated with the risk of lung cancer and renal cell cancer, with an odds ratio and 95% confidence interval of 2.81 (2.33–3.37) and 0.49 (0.40–0.61), respectively. None of these 94 associations was biased by weak instruments, horizontal pleiotropy, or reverse causation. Further, 64 of these 94 were eligible for replication analyses, and 54 (84.4%) showed P < 0.05 with association patterns consistent with those shown in primary analyses.

Conclusions
Our study unveils plausible causal relationships between 66 plasma metabolites and cancer risk, expanding our understanding of the role of circulating metabolites in cancer genetics and etiology. These findings hold promise for enhancing cancer risk assessment and prevention strategies, meriting further exploration.