bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and antimicrobial resistance trends of Acinetobacter species in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data
Authors: Thomsen Jens , Abdulrazzaq Najiba M. , AlRand Hussain ,   The UAE AMR Surveillance Consortium
Published: January 2024

IntroductionAcinetobacter spp., in particular A. baumannii, are opportunistic pathogens linked to nosocomial pneumonia (particularly ventilator-associated pneumonia), central-line catheter-associated blood stream infections, meningitis, urinary tract infections, surgical-site infections, and other types of wound infections. A. baumannii is able to acquire or upregulate various resistance determinants, making it frequently multidrug-resistant, and contributing to increased mortality and morbidity. Data on the epidemiology, levels, and trends of antimicrobial resistance of Acinetobacter spp. in clinical settings is scarce in the Gulf Cooperation Council (GCC) and Middle East and North Africa (MENA) regions.MethodsA retrospective 12-year analysis of 17,564 non-duplicate diagnostic Acinetobacter spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010–2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET.1ResultsSpecies belonging to the A. calcoaceticus-baumannii complex were mostly reported (86.7%). They were most commonly isolated from urine (32.9%), sputum (29.0%), and soft tissue (25.1%). Resistance trends to antibiotics from different classes during the surveillance period showed a decreasing trend. Specifically, there was a significant decrease in resistance to imipenem, meropenem, and amikacin. Resistance was lowest among Acinetobacter species to both colistin and tigecycline. The percentages of multidrug-resistant (MDR) and possibly extensively drug-resistant (XDR) isolates was reduced by almost half between the beginning of the study in 2010 and its culmination in 2021. Carbapenem-resistant Acinetobacter spp. (CRAB) was associated with a higher mortality (RR: 5.7), a higher admission to ICU (RR 3.3), and an increased length of stay (LOS; 13 excess inpatient days per CRAB case), as compared to Carbapenem-susceptible Acinetobacter spp.ConclusionCarbapenem-resistant Acinetobacter spp. are associated with poorer clinical outcomes, and higher associated costs, as compared to carbapenem-susceptible Acinetobacter spp. A decreasing trend of MDR Acinetobacter spp., as well as resistance to all antibiotic classes under surveillance was observed during 2010 to 2021. Further studies are needed to explore the reasons and underlying factors leading to this remarkable decrease of resistance over time.
Health teachers’ ethical conflict experiences in the COVID-19 situation: a qualitative content analysis
Authors: Lim Kyoung Mi , Sok Sohyune 
Published: January 2024

BackgroundIn the context of the COVID-19 pandemic, health teachers who are responsible for the health of school staff and students are experiencing many ethical conflicts, and research on this is needed.ObjectiveThis study was to investigate and explore the ethical conflicts experienced by health teachers during the COVID-19 pandemic situation.MethodsThis was a qualitive study using directed content analysis applied to the four principles of biomedical ethics. Study participants were a total of 26 health teachers in Seoul, South Korea. In-depth individual interviews were conducted with 14 health teachers, and focus group interviews were conducted with the other 12 (2 teams with each 6 persons). Data were collected between May–June 2022, and analyzed using a deductive approach among the qualitative content analysis of Elo and Kyngäs. This study satisfied the four aspects of credibility, transferability, dependability, and confirmability presented by Guba and Lincoln (1989) to secure the reliability of qualitative research.ResultsThe ethical conflicts related to the four principles of biomedical ethics advocated by Beauchamp and Childress (autonomy, non-maleficence, beneficence, and justice), and the ethical conflicts in which overlap with the two principles of autonomy and non-maleficence, and the ethical conflicts related to miscellaneous matters or relationships, which were not included in the four principles, were investigated as the main 6 categories of ethical conflicts experienced by health teachers. Based on this, 10 generic categories and 17 subcategories were derived.ConclusionThis study could be used as primary data for policy development and intervention research. Such engagements can help identify ethical conflicts faced by health teachers in infectious disease crises, thus improving their ability to cope.
Prevalence of depression, anxiety in China during the COVID-19 pandemic: an updated systematic review and meta-analysis
Authors: Bin Xiang , Qu Ke-Yi , Wang Yu-Hao , Chen Li , Xiong Yan-Jie , Wen Jin Fu , Wei Hua-Bo , Bing Tan , Dan Chun-Yan , Zhu Jia-Quan 
Published: January 2024

BackgroundMental health risks associated with the aftermath of the COVID-19 pandemic are often overlooked by the public. The aim of this study was to investigate the effects of the COVID-19 pandemic on depression and anxiety disorders in China.MethodsStudies were analyzed and extracted in accordance with the PRISMA 2020 flowchart. The studies were screened and extracted using electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov according to the predefined eligibility criteria. The Cochrane Review Manager software 5.3.1 was used for data analysis and the risk of bias assessment.ResultsAs of 2023, a total of 9,212,751 Chinese have been diagnosed with COVID-19 infection. A total of 913,036 participants in 44 studies were selected following the eligibility criteria, the statistical information of which was collected for meta-analysis. The pooled prevalence of depression and anxiety were 0.31 (95% CI: 0.28, 0.35; I2 = 100.0%, p &lt; 0.001) and 0.29 (95% CI: 0.23, 0.36; I2 = 100.0%, p &lt; 0.001), respectively. After performing a subgroup analysis, the prevalence of depression among women, healthcare workers, students, and adolescents was 0.31 (95% CI: 0.22, 0.41), 0.33 (95% CI: 0.26, 0.44), 0.32 (95% CI: 0.26, 0.39), and 0.37 (95% CI: 0.31, 0.44), respectively.ConclusionThe prevalence of depression and anxiety among the Chinese was overall high. Monitoring and surveillance of the mental health status of the population during crises such as sudden global pandemics are imperative.Systematic review registrationhttps://clinicaltrials.gov/, identifier [CRD42023402190].
Demographic and socioeconomic factors associated with cervical cancer screening among women in Serbia
Authors: Djordjevic Slavica , Boricic Katarina , Radovanovic Snezana , Simic Vukomanovic Ivana , Mihaljevic Olgica , Jovanovic Verica 
Published: January 2024

ObjectivesEffective reduction of cervical cancer incidence and mortality requires strategic measures encompassing the implementation of a cost-effective screening technology. Serbia has made significant strides, introducing organized cervical cancer screening in 2012. However, various impediments to screening implementation persist. The aim of the study was to estimate the socioeconomic factors associated with cervical cancer screening among women in Serbia.MethodsData from 2019 National Health Survey of the population of Serbia were used in this study. The study is cross sectional survey on a representative sample of the population of Serbia. Present total number of participants analyzed in survey 6,747.ResultsIn Serbia, 67.2% of women have done a Pap test at any time during their lives, of which 46.1% of women have undergone cervical cancer screening in the past 3 years. About a quarter of women have never undergone a Pap test in their life (24.3%). The probability of never having a Pap test have: the youngest age group (15–24 years) is 1.3 times more likely than the oldest age group (OR = 1.31), unmarried women 0.3 times more often than married women (OR = 0.37), respondents with basic education 0.9 times more often than married women (OR = 0.98), the women of lower socioeconomic status 0.5 times more often than respondents of high socioeconomic status (OR = 0.56).ConclusionEnhancement of the existing CCS would be the appropriate public health approach to decrease the incidence and mortality of cervical cancer in the Republic of Serbia.
Subjective well-being patterns in older men and women without someone to confide in: a latent class analysis approach
Authors: Meng Dijuan , Sun Chang 
Published: January 2024

ObjectiveThis study aimed to identify the latent subtypes of subjective well-being (SWB) and associated factors in older adults without a confidant in China.MethodsThe data came from the most recent (seventh) wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cross-sectional study included 350 older adults who lacked a close confidant. We utilized latent class analysis and multiple logistic regression models to examine the latent SWB subtypes and associated factors.ResultsThree distinct patterns of SWB were identified: the very low SWB class (32%), the medium-low SWB class (46%), and the low evaluative and high affective SWB class (22%). The results indicated that compared to the low evaluative and high affective SWB class, respondents who self-rated their health as not good, currently drank alcohol and rated their financial status as poor/very poor were more likely to be in the very low SWB class, while those who participated in social activities were less likely to be in the very low SWB class. Respondents who had limitations in instrumental activity of daily living (IADL) and rated their financial status as poor/very poor were more likely to be in the medium-low SWB class. However, gender did not affect SWB patterns.ConclusionOur findings highlight awareness of the heterogeneity of SWB in older adults without close confidants and provide valuable information for the development of tailored intervention programs to improve their well-being.
Fatal crashes and rare events logistic regression: an exploratory empirical study
Authors: Xiao Yuxie , Lin Lulu , Zhou Hanchu , Tan Qian , Wang Junjie , Yang Yi , Xu Zhongzhi 
Published: January 2024

ObjectiveFatal road accidents are statistically rare, posing challenges for accurate estimation through the classic logit model (LM). This study seeks to validate the efficacy of a rare events logistic model (RELM) in enhancing the precision of fatal crash estimations.MethodsBoth LM and RELM were employed to examine the relationship between pertinent risk factors and the incidence of fatal crashes. Crash-injury datasets sourced from Hillsborough County, Florida served as the empirical basis for evaluating the performance metrics of both LM and RELM.ResultsThe analysis revealed that RELM yielded more accurate predictions of fatal crashes compared to LM. Receiver operating characteristic (ROC) curves were constructed, and the area under the curve (AUC) for each model was computed to offer a comparative performance assessment. The empirical evidence notably favored RELM over LM as substantiated by superior AUC values.ConclusionThe study offers empirical validation that RELM is demonstrably more proficient in predicting fatal crashes than the LM, thereby recommending its application for nuanced traffic safety analytics.
Effect of educational intervention based on protection motivation theory on preventive behaviors of respiratory infections among hospital staff
Authors: Rakhshani Tayebeh , Nikeghbal Sepahdar , Kashfi Seyyed Mansour , Kamyab Amirhossein , Harsini Pooyan Afzali , Jeihooni Ali Khani 
Published: January 2024

BackgroundHospital staff represent a vulnerable population for respiratory diseases. Consequently, the implementation of training programs becomes imperative as a preventive measure against such infections in these populations. The current study was conducted to examine the impact of an educational intervention based on the Protection Motivation Theory (PMT) on preventive behaviors for respiratory infections among a group of hospital staff.MethodsThis experimental study involves a sample of 150 hospital staff from Gachsaran City, Iran, in 2021–2022. The sampling technique involved the utilization of a random assignment approach to allocate individuals into two distinct groups: the experimental group, consisting of 75 participants, and the control group, also including 75 individuals. The data collection instrument was a questionnaire designed in accordance with the PMT. This questionnaire was administered to both the experimental and control groups prior to the intervention as well as two months following the intervention. The intervention program consisted of a total of five sessions, each lasting for 60 min, for the experimental group. These sessions were conducted on a weekly basis over a period of two and a half months. Specifically, there were two sessions held every month and one session held every two weeks. Following the completion of the program, the data was entered into SPSS-24 statistical software for analysis using paired t-tests, independent t-tests, and chi-square tests.ResultsThe results indicated that prior to the intervention, there was no significant difference between the two groups in terms of perceived vulnerability constructs (p = 0.25), perceived severity (p = 0.63), perceived response (p = 0.32), and perceived reward (p = 0.11). Besides, there was no considerable distinction in perceived self-efficacy (p = 0.84), perceived response cost (p = 0.33), fear (p = 0.45), behavior motivation (p = 0.51), knowledge (p = 92), or vaccination behavior (p = 0.12) before the educational intervention. However, a significant change was noticed in each of the mentioned variables between the two groups after the intervention (p &lt; 0.05).ConclusionThe results of this study indicated that the implementation of an educational intervention grounded in the PMT yields positive outcomes in enhancing preventative behaviors pertaining to respiratory infections. Hence, it is recommended to utilize an intervention grounded in this theory among hospital staff as a viable approach to mitigating the occurrence of respiratory infections.
Effects of the inclusion of physical activity in secondary education academic classes on educational indicators and health markers: rationale and methods of the ACTIVE CLASS study
Authors: González-Pérez María , Sánchez-Oliva David , Grao-Cruces Alberto , Cano-Cañada Enrique , Martín-Acosta Fátima , Muñoz-González Raúl , Bandera-Campos Francisco J. , Ruiz-Hermosa Abel , Vaquero-Solís Miguel , Padilla-Moledo Carmen , Conde-Caveda Julio , Segura-Jiménez Víctor , González-Ponce Inmaculada , García-Calvo Tomás , Castro-Piñero José , Camiletti-Moirón Daniel 
Published: January 2024

BackgroundIncreasing physical activity (PA) levels and reducing sedentary behaviors in children and adolescents is a need, especially in schools. Active breaks and physically active learning are examples of two emerging methodologies that have been shown to be effective in increasing PA levels and additionally produce improvements in children’s educational markers. However, the evidence in adolescents is very limited. This paper presents the design, measurements, and interventions implemented in the ACTIVE CLASS study, whose objectives are: (i) evaluate the effects of two interventions on PA levels, sedentary time, health-related physical fitness academic indicators, cognition, and markers of psychological health among secondary education students; (ii) evaluate teachers’ and students’ experiences about the implementation of these the two school-based PA intervention.MethodsA randomized controlled study is conducted with a total of 292 students aged 12–14 years old from six schools (7th and 8th grade) in Spain (three in Cadiz and three in Caceres). One school from each study provinces is randomly assigned to either the active break intervention group, the physically active learning intervention group, or the control group. The interventions have a duration of 16 weeks. Nine main measurement categories are assessed: PA and sedentary time, health-related physical fitness, academic indicators, cognition, psychological health, motivational variables, dietary patterns, sociodemographic characteristics, as well as qualitative information through semi-structured individual interviews and focus groups. Three independent measurements of evaluation are distinguished: pre-intervention, post-intervention (week 16) and retention measurement (4 weeks after the intervention). For quantitative variables, descriptive, correlational, regression and repeated measures ANOVA will be applied.DiscussionTo the best of our knowledge, the ACTIVE CLASS study is the first of its kind in Spain to evaluate the effects of incorporating active breaks and physically active learning in secondary education. In addition, this project provides important information on the effects of two school-based PA intervention arms on educational variables and health markers in adolescents. This will provide valuable and innovative training to the educational community, enabling them to implement teaching methodologies that have the potential to enhance academic performance and improve the quality of life for their students.Clinical trial registrationclinicaltrials.gov, NCT05891054.
Predicting the risk of hospital readmissions using a machine learning approach: a case study on patients undergoing skin procedures
Authors: Adhiya Jigar , Barghi Behrad , Azadeh-Fard Nasibeh 
Published: January 2024

IntroductionEven with modern advancements in medical care, one of the persistent challenges hospitals face is the frequent readmission of patients. These recurrent admissions not only escalate healthcare expenses but also amplify mental and emotional strain on patients.MethodsThis research delved into two primary areas: unraveling the pivotal factors causing the readmissions, specifically targeting patients who underwent dermatological treatments, and determining the optimal machine learning algorithms that can foresee potential readmissions with higher accuracy.ResultsAmong the multitude of algorithms tested, including logistic regression (LR), support vector machine (SVM), random forest (RF), Naïve Bayesian (NB), artificial neural network (ANN), xgboost (XG), and k-nearest neighbor (KNN), it was noted that two models—XG and RF—stood out in their prediction prowess. A closer inspection of the data brought to light certain patterns. For instance, male patients and those between the ages of 21 and 40 had a propensity to be readmitted more frequently. Moreover, the months of March and April witnessed a spike in these readmissions, with ~6% of the patients returning within just a month after their first admission.DiscussionUpon further analysis, specific determinants such as the patient's age and the specific hospital where they were treated emerged as key indicators influencing the likelihood of their readmission.
Acoustic stimulation during slow wave sleep shows delayed effects on memory performance in older adults
Authors: Wunderlin Marina , Zeller Céline J. , Wicki Korian , Nissen Christoph , Züst Marc A. 
Published: January 2024

IntroductionIn young healthy adults, phase-locked acoustic stimulation (PLAS) during slow wave sleep (SWS) can boost over-night episodic memory consolidation. In older adults, evidence is scarce and available results are inconsistent, pointing toward reduced PLAS-effectiveness. We argue that multiple stimulation nights are required for effects to unfold in older individuals to compensate for age-related reductions in both SWS and memory performance. We test this assumption in a longitudinal within-subject design.MethodsIn a larger previous project, older adults participated in a three-night intervention receiving either real-PLAS (STIM group) or sham-PLAS (SHAM group). Encoding and immediate recall of face-occupation pairs was administered on the evening of the first intervention night (session one), with feedback-based retrievals ensuing on all following mornings and evenings across the intervention. To test for the benefit of the real-PLAS over sham-PLAS intervention within participants, 16 older adults [agemean: 68.9 (SD: 3.7)] were re-invited receiving the real-PLAS intervention exclusively. This resulted in a SHAMSTIM group (n = 9; T1: sham-PLAS intervention, T2: real-PLAS intervention) and a STIMSTIM group (n = 7; T1 and T2: real-PLAS intervention).ResultsWhile the STIMSTIM group exhibited highly similar responses during T1 and T2, the SHAMSTIM group exhibited a significantly higher increase in memory performance at T2 (real-PLAS) compared to T1 (sham-PLAS). These gains can be attributed to the late stages of the experiment, after three nights of real-PLAS, and remained stable when correcting for changes in baseline sleep quality (PSQI) and baseline cognitive ability (Montreal Cognitive Assessment) between T1 and T2.ConclusionsWe show that in older adults, PLAS-induced memory effects are delayed and manifest over the course of a three-night-PLAS intervention. Our results might explain the lack of effects in previous PLAS studies, where memory performance was solely assessed after a single night of PLAS.
The Mediating Role of Digital Competence in the Associations Between the Factors Affecting Healthcare Utilization and Access to Care
Authors: Heponiemi Tarja , Kaihlanen Anu-Marja , Virtanen Lotta , Kainiemi Emma , Saukkonen Petra , Koponen Päivikki , Koskinen Seppo , Elovainio Marko 
Published: January 2024

Objectives: To examine with a population-based longitudinal survey design whether poor health, longstanding activity limitation, impaired cognitive functioning, mental distress, or loneliness predict poor access to healthcare and whether digital competence mediates these associations.Methods: The data were from the longitudinal FinHealth -survey gathered in Finland in 2017 and 2020 including 3,771 respondents (57.1% women). Linear regression analyses were used to examine the associations of factors affecting healthcare utilization with access to care adjusted for age, sex, and education. Counterfactual causal mediation framework was used to examine the mediating role of digital competence in the relationships among these factors and access to healthcare.Results: Factors affecting healthcare utilization were associated with poor access to care and these associations were partly mediated by low digital competence. Low digital competence mediated 12%, 9% and 8%, of the associations of impaired cognitive functioning, longstanding activity limitation, and loneliness with poor access to care, respectively.Conclusion: According to our results, one way to improve the access to healthcare among vulnerable groups could be to improve their digital competence.