bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Study on the Thoracodorsal Artery Perforator Flap in Breast-Conserving Reconstruction of T2 Breast Cancer
Authors: Li Shuang-Qi , Zheng Zi-Fang , Li Hang , Zhang Jin-Fan , Zheng Yan , Lin Li-Sheng 
Published: October 2023

Background Breast-conserving surgery combined with oncoplastic breast surgery has become the standard surgical treatment for early breast cancer. Objective The purpose of this study was to investigate the safety and efficacy of the thoracodorsal artery perforator flap (TDAPF) in breast-conserving reconstruction of T2 breast cancer. Methods Thirty patients with T2 breast cancer admitted to our hospital from January 2019 to December 2020 were enrolled to receive pedicled TDAPF for repairing breast defects after breast-conserving surgery. Intraoperative conditions, postoperative complications, and shape satisfaction after breast reconstruction were recorded. Results The operation was successfully completed in all 30 patients, with an operation time of 177.77 ± 24.39 min, bleeding of 44.17 ± 7.67 mL, and length of hospital stay of 5.23 ± .97 d. There was no deformity or seroma at the donor site. Breast shape recovered well after operation. After operation, one patient had fat liquefaction in the recipient site, which healed well after wound treatment. The incidence of postoperative complications was 3.33%. Postoperative follow-up lasted 16-28 months, with a median of 22 months. The Breast-Q score for breast satisfaction was 61.83 ± 12.87 at 6 months after operation, compared to 62.07 ± 11.78 before operation ( P > .05). Conclusions TDAPF, featuring a high survival rate, moderate flap area, fewer postoperative complications, and high satisfaction with breast shape after operation. For east asian women with moderate breast size, TDAPF is a safe, effective choice for repairing defects in breast-conserving surgery for T2 breast cancer.
Maternal health and maternal health service utilization among female sex workers: A scoping review
Authors: Moore Brandi E , Govaerts Lauren , Kapadia Farzana 
Published: October 2023

Background: High proportions of female sex workers (FSWs) become pregnant and have children. Many FSWs are at increased risk of maternal health complications due to factors such as poverty, violence, and healthcare barriers. Despite this, FSWs’ maternal health and use of maternal health services (MHS) receive limited attention. Objectives: The objectives of this scoping review are to (1) synthesize existing data on FSWs’ maternal health and MHS utilization and (2) assess the state of peer-reviewed literature on FSWs’ maternal health in regard to methodological approaches and reported outcomes. Eligibility criteria: Included articles were peer-reviewed, published in English, and reported empirical data on FSWs for outcomes related to antenatal care, pregnancy, and labor complications, postnatal and delivery care, and/or barriers to MHS. Sources of evidence: Article searches were conducted in PubMed, Web of Science, Global Health, Sociological Abstracts, Sociological Index, PsychInfo, and CINAHL Charting methods: Information extracted from eligible articles included publication year, study design, location, sample size, outcome measures, and findings. The “Three Delays” model was used to synthesize findings on barriers to MHS as relevant to phase I, II, or III delays. Results: Eighteen publications met the eligibility criteria. Studies were conducted in 11 countries and primarily reported quantitative data from cross-sectional surveys. The most frequently reported outcome was antenatal care utilization (n = 14), whereas few studies reported findings related to postnatal care and breastfeeding counseling (n = 2). Across publications, there was a substantial range in the proportion of FSWs who reported accessing different types of MHS. Conclusion: Literature on FSWs’ maternal health is limited and heterogenous. More research is needed that specifically focuses on measuring outcomes related to FSWs’ maternal health and examines associated factors. Such work can inform future research directions and public health interventions for FSWs—a population of marginalized women whose maternal health has been overlooked in existing efforts.
Prevalence and sociodemographic correlates of urinary incontinence in Japanese women: A web-based cross-sectional study
Authors: Onishi Aki , Shibata Ai 
Published: October 2023

Background: Epidemiological studies on urinary incontinence that used a validated international standard questionnaire are limited in Japan, and few studies have examined the sociodemographic and behavioral correlates of urinary incontinence. Objective: The aim of this study was to estimate the prevalence of urinary incontinence according to the Japanese version of the International Consultation on Incontinence Questionnaire-Short Form, and its sociodemographic and behavioral correlates among Japanese women. Design: A web-based cross-sectional study. Methods: A randomly sampled cross-sectional Internet survey was conducted in Japan among 3030 women aged 20–64 years. The International Consultation on Incontinence Questionnaire-Short Form score, sociodemographic, body mass index, medical and childbirth history, practice of pelvic floor muscle training, and medical care use were obtained. Descriptive statistics, the chi-square test, and forced-entry logistic regression analysis were used in data analysis. Results: Participants’ average age was 43.4 years, and the response rate was 32.9%. The prevalence of urinary incontinence was 25.5%, and it increased with age. Stress urinary incontinence was the most common subtype (57.4%), followed by urge urinary incontinence (20.3%) and mixed urinary incontinence (16.7%). Less than 5% of those with urinary incontinence had experience with pelvic floor muscle training and medical care use. Middle-aged and older (p < 0.001), overweight and obesity (p < 0.001), vaginal delivery status (p < 0.001), low back pain (p = 0.008), and previous pelvic floor muscle training engagement (p < 0.001) were significantly associated with urinary incontinence. Conclusion: Increasing population awareness of urinary incontinence from an early age and developing effective interventions for the identified at-risk groups, such as the middle-aged and older, those with overweight and obesity, and those with previous pregnancies, are urgently needed.
Effectiveness of occupational therapy-led computer-aided interventions on function among adults with conditions of the hand, wrist, and forearm: A systematic literature review and meta-analysis
Authors: Sheerin Margo , Morrissey Ann-Marie , Galvin Rose , Ryan Damien , Carey Leonora , Robinson Katie 
Published: October 2023

Introduction Upper extremity injuries are common, and often treated by occupational therapists. The need to evaluate the effectiveness of occupational therapy interventions to guide practice is pertinent. This systematic review and meta-analysis investigate the effectiveness of occupational therapy-led computer-aided interventions among adults with conditions of the hand, wrist, and forearm. Methods A systematic literature search of five databases was undertaken for randomized studies examining occupational therapy-led computer-aided interventions for the treatment of hand, wrist, and forearm conditions. The primary outcome was function, with secondary outcomes of pain, grip and pinch strength. The quality of the included studies was independently assessed using the Cochrane Risk of Bias V2 tool. Meta-analyses were completed. Results Three randomized controlled trials were included with 176 participants. One study reported on app use on a tablet and two studies reported on computer gaming. Participants had a variety of hand and wrist diagnoses, treated both conservatively and operatively. There is limited evidence demonstrating that computer-based interventions are as effective as other occupational therapy-led interventions in improving function, pain, grip and pinch strength post-intervention, including small effect size following meta-analysis: grip strength (Fixed Effects Model, SMD 0.13, 95% CI 2.63; –2.36, I2 = 0%) and pinch strength (Fixed Effects Model, SMD –0.12, 95% CI 1.25; -1.50, I2 = 11%). Conclusions Limited evidence was found to support the use of computer-aided interventions for adults with a hand, wrist or forearm injury. Further high-quality research is recommended inclusive of a broader range of technologies and a broader range of clinical and patient-reported outcome measures.
Carotid web arising in the common carotid artery and adjacent to a transverse process of the cervical spine: A case report
Authors: Naito Gomi Masanori , Iwasaki Koichi , Sasaki Isao 
Published: October 2023

Background and importance A carotid web (CaW) is an intraluminal membrane-like filling defect typically located in the posterior wall of the proximal internal carotid artery and is increasingly recognized as a potential cause of embolic stroke. We herein reported a case of a CaW that has an unusual location at the CCA; furthermore, an elongated transverse process of the cervical spine was adjacent to the CaW at the CCA. Clinical presentation An 87-year-old woman with a history of minor stroke underwent thorough radiological examinations of her CCA lesion. Radiological examinations, including duplex ultrasonography, digital subtraction angiography (DSA), computed tomography, and magnetic resonance angiography, revealed that the morphological characteristics of the lesion were compatible with those of a typical CaW except for its location at the CCA. Furthermore, three-dimensional DSA revealed that the lesion was adjacent to the transverse process of the sixth cervical spine (C6), suggesting mechanical damage by the spinal transverse process as a possible pathogenesis of this CaW. Conclusion This is the rare case of a CaW located in the CCA, far from the carotid bulb. Arterial dissection due to mechanical damage by the spinal transverse process may be a possible causative mechanism of the CaW in the present case.
Effect of curfew from the COVID-19 pandemic on amblyopia treatment in children in Saudi Arabia
Authors: Bokhary Kholoud A , Hakami Khoulla A , El-Hiti Gamal A , Fahmy Rania M 
Published: October 2023

Background: Amblyopia was defined as a reduction in the best-corrected visual acuity in one or both eyes with the presence of amblyogenic factors. Objective: The aim of this work was to investigate the effect of curfews resulting from the COVID-19 pandemic on amblyopia treatment in children. Design: A prospective longitudinal study. Methods: The study was conducted in pediatric ophthalmology clinics at a tertiary hospital in Riyadh, Saudi Arabia. Children aged 3–9 years who underwent amblyopia treatment from September 2020 to May 2021 were recruited. Visual acuity data were collected from the subjects’ record files for the first visits prior to the curfew and from the clinics for the second visits after the curfew had ended. Results: A total of 97 children with amblyopia (strabismic, anisometropic, mixed, and visual deprivation) were included. In all, 15 children did not attend the clinic for follow-up visits after the outbreak of COVID-19. The follow-up visits for most of the participants took place 4–5 months after the first visit. No significant difference in visual acuity in the amblyopic eye was found between the first and second visits ( p > 0.05). No significant correlation was noted between the baseline difference in visual acuity at the first and second visits and the duration of the amblyopia treatment between the two visits. The adjusted model shows a variation of 0.18% according to the duration between the two visits. Conclusion: The findings showed no significant difference in visual acuity in amblyopic eyes between the first and second visits (before and after the COVID-19 curfew), although visual acuity was clinically improved.
Paternal postnatal depression and associated factors: Community-based cross-sectional study
Authors: Wedajo Lema Fikadu , Alemu Solomon Seyife , Tola Melese Adugna , Teferi Shelema Mengistu 
Published: October 2023

Introduction: Paternal postnatal depression is a type of depression that occurs among male partners after childbirth. Although the problem has a multidimensional impact, there is limited data in low-income countries, including Ethiopia. Therefore, this study aimed to uncover this problem in the study setting. Objective: To assess paternal postnatal depression and associated factors. Method and study period: A community-based cross-sectional study was employed from April 1 to 30, 2023, among 423 fathers in Mattu Town, Southwest Ethiopia. A face-to-face interviewer administered a structured questionnaire prepared by the Open Data Kit tool. The study participants were selected by simple random sampling techniques. A binary and multivariable logistic regression analysis was used. Both crude and adjusted odds ratios with a 95% confidence interval were calculated, and a p-value of less than 0.05 was used. Result: Among 423 fathers, 412 participated, making the response rate 97.40%. The prevalence of paternal postnatal depression was 29.37% (95% confidence interval: 24.95%, 31.25). The poor wealth index (adjusted odds ratio (AOR): 1.67; 95% confidence interval: 1.88, 3.14), loneliness (AOR: 1.81; 95% confidence interval: 1.20, 3.20), poor social support (AOR: 6.08; 95% confidence interval: 2.55, 14.48), feeling of family income stress (AOR: 3.22; 95% confidence interval: 1.89, 5.50), and history of adverse pregnancy outcome (AOR: 3.00; 95% confidence interval: 1.62, 0.59) were significant associated factors at p-value less than 0.05. Conclusions: The study identified nearly 3 in 10 fathers suffering from paternal postnatal depression. Therefore, the Ministry of Health and other concerned bodies should focus on this population group to alleviate it. In addition, health professionals and extension workers should provide evidence-based care plans based on the identified factors.
Continuity of care in primary healthcare settings among patients with chronic diseases in Saudi Arabia
Authors: Almalki Ziyad S , Alahmari Abdullah K , Alajlan Sarah AA , Alqahtani Abdulhadi , Alshehri Ahmed M , Alghamdi Saleh A , Alanezi Adel A , Alawaji Basil K , Alanazi Tareq A , Almutairi Rawan A , Aldosari Saad , Ahmed Nehad 
Published: October 2023

Introduction: Maintaining continuity of care is one of the most critical components of providing great care in primary health care. This study aimed to explore continuity of care and its predictors in primary healthcare settings among patients with chronic diseases in Saudi Arabia. Method: Face-to-face cross-sectional interviews were conducted with patients with chronic diseases who had at least four visits to primary care facilities in Riyadh, Saudi Arabia, between November 1, 2022 and March 3, 2023. We determined patients’ continuity of care levels using the Bice–Boxerman continuity of care index. A Tobit regression model was used to determine the effects of several factors on the continuity of care index. Results: The interviews were conducted with 193 respondents with chronic diseases of interest. The mean continuity of care index of the entire sample was 0.54. Those with asthma had the highest median continuity of care index at 0.75 (interquartile range, 0.62–0.75), whereas those diagnosed with thyroid disease had a much lower continuity of care index (0.47) (interquartile range, 0.3–0.62). Tobit regression model findings showed that employed respondents with poorer general health had a negative effect on continuity of care index levels. By contrast, a higher continuity of care index was significantly associated with elderly respondents, urban residents, and those diagnosed with dyslipidemia, diabetes, hypertension, or asthma. Conclusions: According to our findings, the continuity of care level in Saudi Arabia’s primary healthcare setting is low. The data demonstrate how continuity of care varies among study group characteristics and that improving continuity of care among chronic disease patients in Saudi Arabia is multifaceted and challenging, necessitating a coordinated and integrated healthcare delivery approach.
The effects of information framing on self-protective behavior: Evidence from the COVID-19 vaccine uptake
Authors: Zhang Wei , Mei Jie , Evans Richard , Wu Hong 
Published: October 2023

Objectives The Healthy China 2030 strategy outlines the government's plans for healthcare reform, emphasizing the need for increased awareness about infectious diseases to prevent and fight future infections. Information campaigns can be used as a medium to raise awareness and encourage citizens’ willingness to protect themselves against diseases, such as COVID-19. Extant studies have found that individual health behavior decision-making can be changed under different information frames. However, limited evidence is available about emerging infectious diseases. Based on the Prospect Theory and Theory of Planned Behavior, the impact of information frames on self-protective behavior—vaccination against COVID-19 is investigated in this study. Methods A 2(gain/loss frame)*2(factual/emotional frame) intergroup experimental design was designed to explore the effects of different information frames. 228 valid participants in China were recruited and the experiment was performed online. Results First, the gain frame was more effective in promoting public self-protection behavior than the loss frame under information frame intervention. Compared with the factual frame, the emotional frame is more effective in reducing individual risk perception. Second, perceptual behavior control has masking effects on self-protection behavior under the influence of the gain/loss frame. Third, age, subjective norms, attitudes, and the gain frame, have predictive effects on self-protection behavior. Conclusions This study provides empirical evidence on the impact of information framing interventions on public self-protection behavior during the COVID-19 pandemic and provides important practical implications for public administrators and media practitioners.
Willing and unwilling digital cyborg assemblages: University students talk about mental health apps
Authors: Van Der Poll Ryan , Coetzee Bronwyne , Bantjes Jason 
Published: October 2023

Objective Explore how students talk about mental health mobile applications (i.e., apps). Methods Data collected in focus group interviews with 51 students (all self-identifying as having mental health problems) and analysed using inductive thematic content analysis. Results Participants describe mental health apps as an anti-dote to the loss of control, vulnerability, helplessness, impotence, isolation, conspicuousness, and shame which characterise their experience of mental illness. They describe the on-campus clinic as inaccessible and associated with “serious” problems, while configuring psychologists and psychotherapy as out of reach, scarce, formal, structured and anxiety provoking. In contrast, they imagine mental health apps as informal, relaxed, inviting, and accessible. Participants expressed openness and optimism about using apps to improve their mental health. They idealise technology as a means to connect effortlessly, anonymously, and informally, as well as learn skills, assert agency, and act responsibly. They also articulate reluctance to trust technology, show cognisance of participating in a capitalist economy, demonstrate scepticism about the legitimacy of mental health apps, and call for regulation, thereby resisting the position of responsible neoliberal subjects. Conclusion Participants express ambivalence towards mental health apps without surrendering to either technophobia or technophilia. They express faith in technologies’ potential to support mental health while questioning the implicit assumption that people are competent to manage their own mental health. In talking about mental health apps students reproduce broader cultural discourses (including techno-optimism, techno-solutionism, somatopiamism, neo-liberalism, responsibilisationism, technoscepticism, and discourses about neuroplasticity and self-help) thus presenting themselves as both willing and unwilling digital cyborgs.
Impact of Optimal Fenestration Size on Outcomes of High-Risk Fontan Patients
Authors: Miwa Koji , Iwai Shigemitsu , Kanaya Tomomitsu , Kawai Shota 
Published: October 2023

Background We aimed to analyze mid-term outcomes of the fenestrated Fontan procedure, focusing on the fenestration size. Methods We retrospectively reviewed the outcomes of the fenestrated Fontan procedure. Among 165 patients who underwent the Fontan procedure from 2011 to 2021, fenestration was created in 27 patients with the highest risks, including those with hypoplastic left heart syndrome, hypoplastic pulmonary arteries, heterotaxy syndrome with high pulmonary vascular resistance, and pulmonary arterial pressure >15 mm Hg. The patients underwent the procedure at a median age of three years (body weight, 11.4 kg; body surface area, 0.54 m2). Fenestration sizes were 3.5 to 5 mm. Results Spontaneous fenestration closure occurred within one year postoperatively in nine patients. Among them, three experienced Fontan failure, necessitating refenestration. Although fenestration size did not differ, the size corrected by body surface area at the time of surgery was smaller in patients with fenestration closure (6.4 mm/m2 vs 8.3 mm/m2, P < .05). Patients with a fenestration <7 mm/m2 were more likely to have fenestration closure within one year postoperatively, and those with a fenestration >9 mm/m2 were more likely to have severe desaturation and require home oxygen therapy following discharge. Conclusions Spontaneous fenestration closure affected the frequency of Fontan complications. A very small fenestration size corrected by body surface area was a significant risk factor for spontaneous closure. Conversely, a very large fenestration size corrected by body surface area resulted in severe desaturation. The optimal fenestration size to prevent early spontaneous closure and severe desaturation is approximately 8 mm/m2.
Exploring the Impact of Supermarket Store Layout and Atmospheric Elements on Consumer Behavior: A Field Research Study in Greece
Authors: Mantratzis P. , Tsiotras G. , Tsironis Loukas K. , Gotzamani K. 
Published: October 2023

The highly competitive retail industry pushes retailers to seek strategies like creating atmospheric in-store experiences to boost consumer satisfaction and encourage return visits. Store atmosphere and layout design influence consumer decision-making, perception, and satisfaction. Factors such as building design, customer patterns, merchandise mix, and proximity requirements impact consumer perception and store layout. This article investigates the effect of supermarket chains’ layouts on consumer behavior, focusing on atmospheric elements. A Greek field study involving 205 participants assessed perceptions and attitudes toward supermarket layouts and design elements. Results suggest that retail environment characteristics impact emotional reactions, which in turn influence impulse buying behavior. Emphasizing the importance of a superior customer experience throughout the purchasing process, the study identifies key atmospheric elements affecting consumer behavior in supermarkets. The article concludes by discussing implications for retail marketers and suggesting future research directions.