bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare providers’ knowledge and clinical practice surrounding shigellosis — DocStyles Survey, 2020
Authors: Haston Julia C. , Ford Laura , Vanden Esschert Kayla L. , Plumb Ian D. , Logan Naeemah , Francois Watkins Louise K. , Garcia-Williams Amanda G. 
Published: December 2023

Abstract
Background
Shigellosis is an acute diarrheal disease transmitted through contaminated food, water, objects, poor hand hygiene, or sexual activity. Healthcare providers (HCP) may not be aware of the multiple routes of Shigella transmission, populations at increased risk, or importance of antibiotic susceptibility testing (AST). This study assessed HCP knowledge and clinical practices regarding shigellosis and antibiotic resistance.

Methods
Porter Novelli Public Services administered a web-based survey (Fall DocStyles 2020) to HCP in the United States. Pediatricians, primary care physicians, nurse practitioners, and physician assistants completed questions about knowledge and clinical practice of acute diarrhea and shigellosis.

Results
Of 2196 HCP contacted, 1503 responded (68% response rate). Most identified contaminated food (85%) and water (79%) as routes of Shigella transmission; fewer recognized person-to-person contact (40%) and sexual activity (18%). Men who have sex with men (MSM) were identified as being at risk for shigellosis by 35% of respondents. Most reported counseling patients to wash hands (86%) and avoid food preparation (77%) when ill with shigellosis; 29% reported recommending avoiding sex. Many HCP reported treating shigellosis empirically with ciprofloxacin (62%) and azithromycin (32%), and 29% reported using AST to guide treatment.

Conclusions
We identified several gaps in shigellosis knowledge among HCP including MSM as a risk group, person-to-person transmission, and appropriate antibiotic use. Improving HCP education could prevent the spread of shigellosis, including drug-resistant infections, among vulnerable populations.
Making prediabetes visible in primary health care: a qualitative study of health care professionals’ perspectives
Authors: Harcke Katri , Graue Marit , Skinner Timothy Charles , Olsson Christina B. , Saleh-Stattin Nouha 
Published: December 2023

Abstract
Background
People with prediabetes are at high risk of developing type 2 diabetes and its complications, such as cardiovascular diseases and premature mortality. Primary prevention and health maintenance are therefore imperative. Evidence has shown that prediabetes can be prevented or delayed with behavioural change, mainly in eating habits and physical activity. Interventions that use a person-centered approach can lead to improvements in self-management, quality of life, and health outcomes. Nevertheless, there is a need for further research that engages healthcare professionals and people with prediabetes in constructing and implementing preventive programs. The purpose of this study is to explore and describe how healthcare professionals perceive prediabetes, the current challenges in its detection and treatment, and what is needed to improve quality of care.

Methods
This qualitative study was conducted in Region Stockholm. A total of 26 primary health care professionals participated in individual interviews: 15 diabetes nurses and/or district nurses, five general practitioners, five dietitians, and one physiotherapist. Interview transcripts were analyzed with qualitative content analysis.

Results
The analysis revealed two main themes that emphasize the need to make prediabetes more visible in primary health care. Despite the healthcare professionals’ engagement and their motivation to improve prediabetes care, ad hoc practices and the absence of clear screening guidelines and referral pathways made it harder to focus on primary prevention. Supporting professionals in implementing structured care for people with prediabetes might encourage more efficient interprofessional collaboration and contribute to better strategies for promoting behavioural change.

Conclusions
Establishing prediabetes care guidelines, supporting health care professionals´ knowledge and skills in prediabetes care, and implementing interprofessional referral pathways are some steps to enhance prediabetes detection and care precedence in primary health care. These steps could lead to more preventive care and ensure patient safety and health care equity.
Drug-related problems in hospitalized patients with chronic kidney diseases and clinical pharmacist interventions
Authors: Zhang Su , Zhang Guo-bing , Huang Ping , Ren Yan , Lin Bo , Shao Yan-fei , Ye Xiao-lan 
Published: December 2023

Abstract
Background
Patients with chronic kidney disease (CKD) are at high risk of drug-related problems (DRPs) because of extensive comorbidities and pharmacokinetic changes. This study aimed to identify DRPs and possible contributing factors in hospitalized patients with CKD, and evaluate the efficacy of the clinical pharmacist services in detection and intervention of DRPs in a large general hospital in Zhejiang Province, eastern China.

Methods
With the approval of the Ethics Committee, patients with CKD admitted to the nephrology ward from January to December 2020 were enrolled in this prospective study. The clinical pharmacist identified and intervened the DRPs during hospitalization. The DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) DRP classification system, and all data were statistically analyzed using Statistical Package for Social Science (SPSS) version 26.0.

Results
A total of 914 patients with CKD were included, with 463 DRPs observed among 420 (45.95%) participants; the average DRP per patient was 0.51 (standard deviation [SD], 0.60) before pharmacist intervention. Treatment safety accounted for the highest proportion of problems (43.84%), followed by treatment efficacy, accounting for 43.20%. Drug selection was the most common cause of DRPs (60.26%), and antibiotics and cardiovascular agents were the most common drugs associated with DRPs (32.84% and 28.66%, respectively). A total of 85.53% of pharmaceutical intervention recommendations were followed, and 84.23% of DRPs were completely resolved after intervention by the clinical pharmacist. The proportion of patients who experienced DRPs decreased to 7.77%, with an average of 0.08 (SD 0.28) DRPs during hospitalization after pharmacist’s intervention. Significant contributing factors for DRPs were CKD stage 4, number of comorbid diseases, number of prescribed medications, and hospitalization days in both the univariate and multivariate logistic regression models.

Conclusion
DRPs are common among hospitalized patients with CKD in China. CKD stage 4, the number of comorbidities, use of multiple prescription drugs, and extended length of hospital stay are contributing factors for DRPs. Even only one clinical nephrology pharmacist in the nephrology ward, clinical pharmacist can play an important role in facilitating the identification of DRPs in patients with CKD and assisting physicians resolve DRPs in this single center study in China.
Comparing the influence of big data resources on medical knowledge recall for staff with and without medical collaboration platform
Authors: Yuan JunYi , Mi Linhui , Wang SuFen , Cheng Yuejia , Hou Xumin 
Published: December 2023

Abstract
Background
This study aims to examine how big data resources affect the recall of prior medical knowledge by healthcare professionals, and how this differs in environments with and without remote consultation platforms.

Method
This study investigated two distinct categories of medical institutions, namely 132 medical institutions with platforms, and 176 medical institutions without the platforms. Big data resources are categorized into two levels—medical institutional level and public level—and three types, namely data, technology, and services. The data are analyzed using SmartPLS2.

Results
(1) In both scenarios, shared big data resources at the public level have a significant direct impact on the recall of prior medical knowledge. However, there is a significant difference in the direct impact of big data resources at the institutional level in both scenarios. (2) In institutions with platforms, for the three big data resources (the medical big data assets and big data deployment technical capacity at the medical institutional level, and policies of medical big data at the public level) without direct impacts, there exist three indirect pathways. (3) In institutions without platforms, for the two big data resources (the service capability and big data technical capacity at the medical institutional level) without direct impacts, there exist three indirect pathways.

Conclusions
The different interactions between big data, technology, and services, as well as between different levels of big data resources, affect the way clinical doctors recall relevant medical knowledge. These interaction patterns vary between institutions with and without platforms. This study provides a reference for governments and institutions to design big data environments for improving clinical capabilities.
The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study
Authors: Sadeghi Mohammad , Nematollahi Monirsadat , Farokhzadian Jamileh , Khoshnood Zohreh , Eghbalian Mostafa 
Published: December 2023

Abstract
Introduction
Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students.

Method
This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students’ Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests.

Results
The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05).

Conclusion
The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.
Professional identity and sense of coherence affect the between compassion fatigue and work engagement among Chinese hospital nurses
Authors: Zhang Yiming , Peng Qianwen , Dong Wanglin , Hou Cui , Chen Chaoran 
Published: December 2023

Abstract
Background
With the continuous improvement of people’s health needs, the public’s requirements for medical care are also getting higher and higher. Work engagement is a positive psychological state related to the work. It is very important to maintain nurses’ work engagement, however, due to many factors, the level of nurses’ work engagement is not high and nursing managers should identify the influencing factors of work engagement, and take positive measures to fully improve nurses’ work engagement.

Objectives
To explore the influence of compassion fatigue, professional identity and sense of coherence on nurses’ work engagement.

Methods
From January 2022 to June 2022, convenience sampling was used to select clinical nurses from 9 tertiary hospitals in Henan Province of China as the research objects for a questionnaire survey. Statistical methods included descriptive statistical analysis, Pearson correlation analysis and the PROCESS Macro Model 4 and 7 in regression analysis.

Results
The results showed that compassion fatigue was significantly negatively correlated with sense of coherence, professional identity and work engagement (P<0.01), professional identity was significantly positively correlated with sense of coherence and work engagement (P<0.01), and there was a significant positive correlation between sense of coherence and work engagement (P<0.01). Professional identity played a partial mediating role between compassion fatigue and work engagement, accounting for 46.40% of the total effect; meanwhile, sense of coherence moderated the effect of compassion fatigue on professional identity and formed a moderated mediation model.

Conclusions
Compassion fatigue has a negative predictive effect on nurses’ work engagement. Professional identity and sense of coherence further explained the relationship of compassion fatigue on compassion fatigue and work engagement through mediating and moderating effects.
Association of metabolic dysfunction-associated fatty liver disease with systemic atherosclerosis: a community-based cross-sectional study
Authors: Zhang Yanli , Xia Zhang , Cai Xueli , Su Xin , Jin Aoming , Mei Lerong , Jing Jing , Wang Suying , Meng Xia , Li Shan , Wang Mengxing , Wei Tiemin , Wang Yongjun , He Yan , Pan Yuesong 
Published: December 2023

Abstract
Background
Data are limited on the association of metabolic dysfunction-associated fatty liver disease (MAFLD) with systemic atherosclerosis. This study aimed to examine the relationship between MAFLD and the extent of atherosclerotic plaques and stenosis, and presence of polyvascular disease (PolyVD).

Methods
In this cross-sectional study, MAFLD was diagnosed based on the presence of metabolic dysfunction (MD) and fatty liver disease (FLD). MAFLD was divided into three subtypes: MAFLD with diabetes mellitus (DM), MAFLD with overweight or obesity (OW), as well as MAFLD with lean/normal weight and at least two metabolic abnormalities. Atherosclerosis was evaluated, with vascular magnetic resonance imaging for intracranial and extracranial arteries, thoracoabdominal computed tomography angiography for coronary, subclavian, aorta, renal, iliofemoral arteries, and ankle-brachial index for peripheral arteries. The extent of plaques and stenosis was defined according to the number of these eight vascular sites affected. PolyVD was defined as the presence of stenosis in at least two vascular sites.

Results
This study included 3047 participants, with the mean age of 61.2 ± 6.7 years and 46.6% of male (n = 1420). After adjusting for potential confounders, MAFLD was associated with higher extent of plaques (cOR, 2.14, 95% CI 1.85–2.48) and stenosis (cOR, 1.47, 95% CI 1.26–1.71), and higher odds of presence of PolyVD (OR, 1.55, 95% CI 1.24–1.94) as compared with Non-MAFLD. In addition, DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD (All P < 0.05). However, lean-MAFLD was only associated with the extent of atherosclerotic plaques (cOR, 1.63, 95% CI 1.14–2.34). As one component of MAFLD, FLD per se was associated with the extent of plaques and stenosis in participants with MAFLD. Furthermore, FLD interacted with MD to increase the odds of presence of systemic atherosclerosis (P for interaction ≤ 0.055).

Conclusions
MAFLD and its subtypes of DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD. This study implicated that FLD might be a potential target of intervention for reducing the deleterious effects of MAFLD on systemic atherosclerosis.
Impact of population based indoor residual spraying in combination with mass drug administration on malaria incidence and test positivity in a high transmission setting in north eastern Uganda
Authors: Ronald Mulebeke , Humphrey Wanzira , Adoke Yeka , Jean-Pierre Van Geertruyden 
Published: December 2023

Abstract
Background
Mass drug administration (MDA) and indoor residual spraying (IRS) are potent malaria burden reduction tools. The impact of combining MDA and IRS is not well documented. We evaluated the impact of MDA + IRS compared to IRS alone at a high transmission site in Eastern Uganda.

Methods
A quasi-experimental study was implemented in Toroma and Kapujan subcounties in north eastern Uganda. Both subcounties received four rounds of IRS using primiphos-methyl (Acttellic SC300) 6–8 months apart from December 2016 to December 2018. Eligible residents of Kapujan simultaneously received MDA using dihydroartemesinin-piperaquine (DHA-PQ). Health facility data was used to monitor malaria case incidence rate and test positivity rates.

Results
In the MDA + IRS arm, malaria incidence dropped by 83% (IRR: 0·17 (0.16–0.18); p < 0.001) in children under 5 year and by 78% (IRR: 0·22 (0.22–0.23); p < 0.001) in persons aged ≥ 5 years from the pre-intervention to the intervention period. In the IRS arm malaria incidence dropped by 47% (IRR: 0.53 (0.51, 0.56); p < 0.001) in children under 5 years and by 71% 0.29 (0.28, 0.30); p < 0.001) in persons aged ≥ 5 years. A drastic drop occurred immediately after the intervention after which cases slowly increased in both arms. Malaria test positivity rate (TPR) dropped at a rate of 21 (p = 0.003) percentage points per 1000 persons in the MDA + IRS arm compared to the IRS arm. There was a mean decrease of 60 (p-value, 0.040) malaria cases among children under five years and a mean decrease in TPR of 16·16 (p-value, 0.001) in the MDA + IRS arm compared to IRS arm.

Interpretation
MDA significantly reduced malaria burden among children < 5 years however the duration of this impact needs to be further investigated.
An intersectional analysis of long COVID prevalence
Authors: Cohen Jennifer , van der Meulen Rodgers Yana 
Published: December 2023

AbstractBackgroundLong COVID symptoms – which include brain fog, depression, and fatigue – are mild at best and debilitating at worst. Some U.S. health surveys have found that women, lower income individuals, and those with less education are overrepresented among adults with long COVID, but these studies do not address intersectionality. To fill this gap, we conduct an intersectional analysis of the prevalence and outcomes of long COVID in the U.S. We posit that disparities in long COVID have less to do with the virus itself and more to do with social determinants of health, especially those associated with occupational segregation and the gendered division of household work.MethodsWe use 10 rounds of Household Pulse Survey (HPS) data collected between June 2022 and March 2023 to perform an intersectional analysis using a battery of descriptive statistics that evaluate (1) the prevalence of long COVID and (2) the interference of long COVID symptoms with day-to-day activities. We also use the HPS data to estimate a set of multivariate logistic regressions that relate the odds of having long COVID and activity limitations due to long COVID to a set of individual characteristics as well as intersections by sex, race/ethnicity, education, and sexual orientation and gender identity.ResultsFindings indicate that women, some people of color, sexual and gender minorities, and people without college degrees are more likely to have long COVID and to have activity limitations from long COVID. Women have considerably higher odds of developing long COVID compared to men, a disparity exacerbated by having less education. Intersectional analysis by gender, race, ethnicity, and education reveals a striking step-like pattern: college-educated men have the lowest prevalence of long COVID while women without college educations have the highest prevalence. Daily activity limitations are more evenly distributed across demographics, but a different step-like pattern is present: fewer women with degrees have activity limitations while limitations are more widespread among men without degrees. Regression results confirm the negative association of long COVID with being a woman, less educated, Hispanic, and a sexual and gender minority, while results for the intersectional effects are more nuanced.ConclusionsResults point to systematic disparities in health, highlighting the urgent need for policies that increase access to quality healthcare, strengthen the social safety net, and reduce economic precarity.
A novel “prime and pull” strategy mediated by the combination of two dendritic cell-targeting designs induced protective lung tissue-resident memory T cells against H1N1 influenza virus challenge
Authors: Wang Zhannan , He Yingkai , Wang Wenfeng , Tian Yawen , Ge Chongbo , Jia Futing , Zhang Tongyu , Zhang Gerui , Wang Mingyue , Gong Jinshuo , Huang Haibin , Wang Jianzhong , Shi Chunwei , Yang Wentao , Cao Xin , Zeng Yan , Wang Nan , Qian Aidong , Jiang Yanlong , Yang Guilian , Wang Chunfeng 
Published: December 2023

AbstractVaccination is still the most promising strategy for combating influenza virus pandemics. However, the highly variable characteristics of influenza virus make it difficult to develop antibody-based universal vaccines, until now. Lung tissue-resident memory T cells (TRM), which actively survey tissues for signs of infection and react rapidly to eliminate infected cells without the need for a systemic immune reaction, have recently drawn increasing attention towards the development of a universal influenza vaccine. We previously designed a sequential immunization strategy based on orally administered Salmonella vectored vaccine candidates. To further improve our vaccine design, in this study, we used two different dendritic cell (DC)-targeting strategies, including a single chain variable fragment (scFv) targeting the surface marker DC-CD11c and DC targeting peptide 3 (DCpep3). Oral immunization with Salmonella harboring plasmid pYL230 (S230), which displayed scFv-CD11c on the bacterial surface, induced dramatic production of spleen effector memory T cells (TEM). On the other hand, intranasal boost immunization using purified DCpep3-decorated 3M2e-ferritin nanoparticles in mice orally immunized twice with S230 (S230inDC) significantly stimulated the differentiation of lung CD11b+ DCs, increased intracellular IL-17 production in lung CD4+ T cells and elevated chemokine production in lung sections, such as CXCL13 and CXCL15, as determined by RNAseq and qRT‒PCR assays, resulting in significantly increased percentages of lung TRMs, which could provide efficient protection against influenza virus challenge. The dual DC targeting strategy, together with the sequential immunization approach described in this study, provides us with a novel “prime and pull” strategy for addressing the production of protective TRM cells in vaccine design.