bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of digital capacity-related factors influencing health promotion participation and active aging of older adults residing in rural areas in South Korea: A structural equation model
Authors: Lee Hocheol , Nam Hae Kweun , Zhao Bo , Jeong Hee Ra , Lim Subean , Chun Ayoung , Kim Min Kyoung , Kim Dong Hyun , Aung Myo Nyein , Koyanagi Yuka , Nam Eun Woo 
Published: January 2024

Objective This study aimed to identify the correlation between digital capacity, health promotion participation, and active aging of older people living in rural areas in South Korea to assess the factors influencing participation in programs for health promotion and active aging. Methods Data were collected through a 1:1 face-to-face survey using a structured questionnaire from 13 February to 24 February 2023 during the older individuals’ visits in the senior citizen welfare centers and senior citizen centers in the region. The Measuring Digital Skills questionnaire used to assess the digital competence of South Korean individuals was employed in this study. To confirm the structural relationship between digital capacity and health promotion participation and active aging in the older population aged 65 years and older based on the collected data, a structural equation modeling analysis was performed. Results Active health promotion participation had a positive effect on active aging. The pathway that older adults in Korea can led to participation in health promotion and active aging in the current situation is not mainly through the digital competency whereas mobile internet skill showed positive influneces. Conclusions In the digital era and super-aged society, various programs are provided to older individuals to enhance the utilization of smartphones. However, education and programs for strengthening digital capacity should be organized to explain the advantages of digital use and to inform of the dangers of addiction to ensure healthy aging through social participation and exchange both online and offline.
Are Medical School Curricula Adapting With Their Students? A Survey on How Medical Students Study and How it Relates to USMLE Step 1 Scores
Authors: Halperin Scott J. , Zhu Justin R. , Francis John S. , Grauer Jonathan N. 
Published: January 2024

OBJECTIVES Over the years, medical schools have evolved their curricula in response to the medical field, faculty, and students. The current study aims to examine how medical students study, what resources they most commonly use, and how it relates to United States Medical Licensing Examination (USMLE) Step 1 scores. METHODS A cross-sectional survey study of United States medical students was distributed via social media, GroupMe school chats, and school listservs from September 8, 2020, to December 12, 2020. The survey gathered data including, demographic and school information, resources students, time spent using each resource, and USMLE Step 1 scores. RESULTS The survey was completed by 560 students from 102 different United States medical schools. Study guides as online resources (83.2%) were mostly used, lecture (82.5%), Anki (spaced repetition flashcards, 68.3%), and school-organized sessions (workshops, labs, and small groups) (60.7%). Of the students surveyed, 90% attended schools with a recorded lecture option. Only 54% of these students watched their lectures live. When watched online, the average watching speed was 1.75 ± 0.4× with a mode of 2× speed. In examining different medical school styles, schools with a 1.5-year preclinical curriculum had higher USMLE Step 1 scores (244.5 ± 15.6 vs 236.9 ± 16.2, P-score = .024) compared to schools that did not (1- or 2-year preclinical curriculum). CONCLUSION Medical students seem to be using third-party resources in addition to their medical school curriculums. Because students are already broadly using these, medical schools could allow their curriculums to reference, require, or complement third-party online resources. Additionally, because of their increased cost, medical schools could consider ways to alleviate the cost on medical students as a means of equitable support. Lastly, Step 1 scores significantly correlated with schools with a 1.5-year preclinical curriculum, although the exact reasoning for this remains uncertain.
The Lived Experiences of Pregnant and Parenting Women in Recovery Toward Medication Treatment for Opioid Use Disorder
Authors: Titus-Glover Doris , Shaya Fadia T. , Welsh Christopher , Roane Lynnee 
Published: January 2024

Background: Maternal misuse of prescription opioids and illicit drugs such as, heroin and non-pharmaceutical fentanyl analogs has increased in the last 2 decades and one in 5 women reported misuse of opioids. Medications for opioid use disorder (MOUD) are recommended for treating pregnant women with opioid use disorder (OUD). MOUD is effective in reducing cravings and negative outcomes, yet treatment is underutilized and varies in integration and intensity of resources across health systems. Exploring perceptions of MOUD delivery among pregnant/parenting women promises to uncover and address the underlying challenges to treatment, a perspective that may be different for providers and stakeholders. Therefore, our main purpose is to elicit patients’ experiences and perceptions of MOUD, associated access to treatment, and availability of supportive resources during pregnancy/postpartum to inform OUD treatment. Methods: Through a qualitative research approach we gathered data from individual interviews/focus group discussions for this pilot study. Pregnant and postpartum parenting women ( n = 17) responded to questions related to perceptions of MOUD, access to treatment, and availability of social and psychosocial resources. Data were collected, transcribed, and coded (by consensus) and emerging themes were analyzed using grounded theory methodology. Results: Emerging themes revealed positive uptake and perceptions of MOUD, continuing gaps in knowledge, negative impact of stigmatization, and limited access to programs and resources. Supportive relationships from family, peers, healthcare providers and child welfare staff, and co-located services were perceived as positive motivators to recovery. Conclusions: Through the unique lenses of women with lived experience, this study revealed several themes that can be transformative for women. Overall perceptions of MOUD were positive and likely to facilitate uptake and promote positive recovery outcomes. Bridging knowledge gaps will reduce anxieties, fears about neonatal opioid withdrawal syndrome and adverse maternal outcomes. Additionally, a deeper understanding of stigmatization and relationships can inform an integrated patient-centered approach to OUD treatment.
Preparing Physicians to Treat Addiction: Inclusion of Dedicated Addiction Training During Internal Medicine Residency
Authors: Canver Bethany , Liptak Alayna , Clark Katie , Tetrault Jeanette M. , Holt Stephen R. 
Published: January 2024

Background: Physicians in internal medicine lack comfort and skills required to diagnose and treat substance use disorder (SUD). Formal training in substance use treatment within primary care training has traditionally been inconsistent and sparse. The purpose of this study is to assess the impact of a longitudinal experiential addiction curriculum on the attitudes and experiences of graduates from a primary care/internal medicine residency program that included formal addiction didactics, rotations in an outpatient addiction clinic embedded within the resident primary care clinic, and exposure to addiction medicine faculty across treatment settings. Methods: A survey was emailed to all graduates from a single academic primary care residency program who graduated between 2016 and 2018 (n = 53). The survey assessed pharmacotherapy for SUD prescribing patterns, comfort with SUD pharmacotherapy, overall comfort treating SUD, experience correcting stigmatizing language, and providing guidance to colleagues on the care of patients with SUD. A subset of respondents (n = 14) were interviewed regarding their experience with the residency program’s addiction medicine curriculum and its impact on their current clinical practice. Results: Sixty percent (n = 28) of graduates responded to the survey. All respondents felt comfortable using medications to treat SUD. Eighty-four percent perceived themselves as more comfortable using pharmacotherapy to treat SUD than their colleagues. Qualitative interviews revealed that this addiction medicine training shaped participants’ attitudes toward patients with SUD and imparted them with the skills to address stigmatizing language. Participants described how they have become ambassadors of addiction medicine in their workplace and a resource to colleagues with less comfort in the management of SUD. Conclusion: Graduates of a primary care/internal medicine residency with a dedicated addiction medicine curriculum are comfortable prescribing pharmacotherapy for SUD, taking an active role in reducing SUD-related stigma, and serving as a resource for colleagues.
Childhood Aggressive Behavior and Adolescent Substance Use Initiation
Authors: Satybaldiyeva Nora , Delker Erin , Bandoli Gretchen 
Published: January 2024

Background: Drug and alcohol use before the age of 14 is associated with adverse outcomes over the life course. While previous studies have identified numerous sociodemographic characteristics associated with youth substance use initiation, few have examined the relationship between behavioral characteristics, such as childhood aggression, and substance use initiation in adolescence. Methods: This longitudinal study consisted of 2985 children from the Future of Families and Child Wellbeing Study. Aggression was measured using primary caregiver report when the children were about the age of 9 and cigarette, alcohol, and marijuana use was measured using the child report when the children were age 9 and age 15. Separate multivariable Poisson regression models were fitted for each substance use initiation outcome. Results: Childhood aggression was positively associated with the initiation of cigarette and marijuana use in adolescence (aRR = 2.3 [95% CI = 1.5,3.4] and aRR = 1.3 [95% CI = 1.1,1.6], respectively). Childhood aggression was not associated with adolescent alcohol use initiation (aRR = 1.2 [95% CI = 0.9,1.5]). Conclusions: The presence of aggressive behavior in childhood was associated with the initiation of cigarette and marijuana use in adolescence. These results may be used to identify children at higher risk of cigarette and marijuana use, who may benefit from additional monitoring for substance use initiation.
Molecular characterisation of Pinus sylvestris (L.) in Ireland at the western limit of the species distribution
Authors: Belton Samuel , Cubry Philippe , Roche Jenni R. , Kelleher Colin T. 
Published: January 2024

AbstractBackgroundScots pine (Pinus sylvestrisL.) underwent significant population declines across much of northwest Europe during the mid-to-late Holocene and was thought to have become extirpated in Ireland from about 400 AD. However, most extant populations are plantations reintroduced from Scotland. Others are naturalised therefrom and one in Western Ireland is a putative relict. In this paper, Scots pine in Ireland are genetically described for the first time.ResultsUsing two mitochondrial (mtDNA) loci, eight chloroplast (cpSSR) and 18 nuclear (nSSR) loci, the genetic composition and diversity of 19 Irish Scots pine populations is described and compared to other European populations. All trees sampled in Ireland were fixed for mitotypea, which is the most common across northwest Europe. By contrast, cpSSR (HCP= 0.967) and nSSR (He= 0.540) variation was high, and comparable with estimates for other regions across the species range. Differentiation at both sets of loci were similarly low (cpSSRFST= 0.019; nSSRFST= 0.018), but populations from continental Europe were significantly differentiated from all Irish populations based on nSSR variation.ConclusionsAll Irish Scots pine are likely part of a common Irish-Scottish gene pool which diverged from continental Scots pine following post-glacial recolonisation. A high genetic diversity and an absence of evidence of inbreeding suggests the regional decline of Scots pine did not critically reduce allelic variation. The post-glacial relationship between Irish and Scottish pine is discussed, and a suggestion from recent palaeoecological work that reintroduced Scots pine be managed as a native species is now further supported by genetic data.
Genome-wide identification, evolution, and role of SPL gene family in beet (Beta vulgaris L.) under cold stress
Authors: Xue Guoxing , Wu Weijiao , Fan Yue , Ma Chao , Xiong Ruiqi , Bai Qing , Yao Xin , Weng Wenfeng , Cheng Jianping , Ruan Jingjun 
Published: January 2024

Abstract
Background
SPL transcription factors play vital roles in regulating plant growth, development, and abiotic stress responses. Sugar beet (Beta vulgaris L.), one of the world’s main sugar-producing crops, is a major source of edible and industrial sugars for humans. Although the SPL gene family has been extensively identified in other species, no reports on the SPL gene family in sugar beet are available.

Results
Eight BvSPL genes were identified at the whole-genome level and were renamed based on their positions on the chromosome. The gene structure, SBP domain sequences, and phylogenetic relationship with Arabidopsis were analyzed for the sugar beet SPL gene family. The eight BvSPL genes were divided into six groups (II, IV, V, VI, VII, and VIII). Of the BvSPL genes, no tandem duplication events were found, but one pair of segmental duplications was present. Multiple cis-regulatory elements related to growth and development were identified in the 2000-bp region upstream of the BvSPL gene start codon (ATG). Using quantitative real-time polymerase chain reaction (qRT-PCR), the expression profiles of the eight BvSPL genes were examined under eight types of abiotic stress and during the maturation stage. BvSPL transcription factors played a vital role in abiotic stress, with BvSPL3 and BvSPL6 being particularly noteworthy.

Conclusion
Eight sugar beet SPL genes were identified at the whole-genome level. Phylogenetic trees, gene structures, gene duplication events, and expression profiles were investigated. The qRT-PCR analysis indicated that BvSPLs play a substantial role in the growth and development of sugar beet, potentially participating in the regulation of root expansion and sugar accumulation.
Impact of residual coronary lesions on outcomes of myocardial infarction patients with multi-vessel disease
Authors: Ahmed Tarek A. N. , Othman Amr A. A. , Demitry Salwa R. , Elmaghraby Khaled M. 
Published: January 2024

Abstract
Background
The residual burden of coronary artery disease (CAD) after percutaneous coronary intervention (PCI) drew a growing interest. The residual SYNTAX Score (rSS) was a strong prognostic factor of adverse events and all-cause mortality in patients who underwent PCI. In addition, the SYNTAX Revascularization Index (SRI), a derivative of rSS, was used to figure out the treated proportion of CAD and could be used as a prognostic utility in PCI for patients with multi-vessel disease (MVD).

Purpose
We aimed at the assessment of the use of rSS and the SRI as predictors of in-hospital outcomes and up to two-year cumulative follow-up outcomes in patients with MVD who had PCI for the treatment of ST-Elevation Myocardial Infarction (STEMI) or Non-STEMI (NSTEMI).

Methods
We recruited 149 patients who had either STEMI or NSTEMI while having MVD and received treatment with PCI. We divided them into tertiles based on their rSS and SRI values. We calculated baseline SYNTAX Score (bSS) and rSS using the latest version of the calculator on the internet, and we used both scores to calculate SRI. The study end-points were In-hospital composite Major Adverse Cardiovascular Events (MACE) and its components, in-hospital death, and follow-up cumulative MACE up to 2 years.

Results
Neither rSS nor SRI were significant predictors of in-hospital adverse events, while female sex, hypertension, and left ventricular ejection fraction were independent predictors of in-hospital MACE. At the two-year follow-up, Kaplan-Meyer analysis showed a significantly increased incidence of MACE within the third rSS tertile (rSS > 12) compared to other tertiles (log rank p = 0.03). At the same time, there was no significant difference between the three SRI tertiles. Unlike SRI, rSS was a significant predictor of cumulative MACE on univariate Cox regression (HR = 1.037, p < 0.001). On multivariate Cox regression, rSS was a significant independent predictor of two-year cumulative MACE (HR = 1.038, p = 0.0025) along with female sex, hypertension, and left ventricular ejection fraction. We also noted that all patients with complete revascularization survived well throughout the entire follow-up period.

Conclusions
Neither rSS nor SRI could be good predictors of in-hospital MACE, while the rSS was a good predictor of MACE at two-year follow-up. Patients with rSS values > 12 had a significantly higher incidence of cumulative MACE after 2 years. The best prognosis was achieved with complete revascularization.
Investigate the relationship between obstructive sleep apnea and cardiac arrhythmia after CABG surgery
Authors: Mohammadi Somayeh , Paryad Ezzat , Khanghah Atefeh Ghanbari , Leili Ehsan Kazemnezhad , Noveiri Marzieh Jahani Sayad 
Published: January 2024

AbstractBackground and objectiveHeart rhythm disorder is one of the most common problems after coronary artery bypass graft surgery. Various factors, such as the history of sleep apnoea before the operation, may aggravate the occurrence of this disorder. The present study was conducted to determine the relationship between sleep apnoea before surgery and heart rhythm disorder after surgery in patients undergoing coronary Artery Bypass Grafting in 2019.MethodsThis analytical cross-sectional study was conducted on 192 patients who were selected by sequential sampling. The research tool included demographic information, a checklist of heart rhythm disorders, and the Berlin sleep apnoea questionnaire. Descriptive statistics and the Chi-square test, Fisher's exact test, Mann–Whitney’s U-test, and logistic regression were used to analyze the data.ResultsA total of 71.35% of the samples were male, and the mean age of the participants was 57.8 ± 7.5 years. Also, 46.0% of the samples had sleep pane and 21.35% had rhythm disorder. The most frequent heart rhythm disorder in patients with obstructive sleep apnoea was atrial fibrillation. There was a significant relationship between the occurrence of rhythm disorder and a history of smoking (P = 0.021), and the regression model showed that a history of smoking is the only variable related to the occurrence of rhythm disorder after coronary Artery Bypass Grafting (P = 0.005, CI 95%: 6.566–1.386, OR = 3.017).ConclusionsThe results showed that there is no statistically significant relationship between sleep apnea and rhythm disorder after coronary artery bypass surgery.
Randomized controlled trials on promoting self-care behaviors among informal caregivers of older patients: a systematic review and meta-analysis
Authors: Liu Huanran , Lou Vivian W. Q. , Xu Shicheng 
Published: January 2024

Abstract
Background
Informal caregivers of older patients often neglect their self-care, despite the mental and physical health effects of caregiving. Randomized controlled trials (RCTs) on self-care interventions for informal caregivers are lacking, making it difficult to determine effective strategies. This systematic review explored the definition and categories of self-care RCTs for informal caregivers and a meta-analysis was conducted to determine the effectiveness of these interventions.

Methods
Seven databases (Scopus, Web of Science, MEDLINE, PubMed, ProQuest, CINAHL, and Embase) were searched for articles in English reporting on self-care intervention outcomes for informal caregivers of patients aged 60 years or older. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Subgroup, sensitivity, and publication bias analyses were conducted.

Results
Eighteen studies were included in the systematic review, of which fifteen studies were included in the meta-analysis. RCTs lacked a clear definition of self-care, mainly focused on promoting physical and mental health and individual capacity, and neglected disease prevention. The interventions focused on self-management for health and individual agency, with less attention on health literacy, decision-making capacity, self-monitoring for health status, and linkage to the health system. Meta-analysis results showed that RCTs had a small effect on reducing anxiety (SMD = -0.142, 95% CI [-0.302, 0.017], p = .081) but a significant effect on reducing depression (SMD = -0.214, 95% CI [-0.353, -0.076], p = .002). Country and type of caregiver significantly contributed to the effect of reducing caregivers’ depression in subgroup analysis.

Conclusions
Studies on caregiver-centered self-care interventions are limited, resulting in a lack of a clear definition and comprehensive intervention. RCTs indicated a small effect on informal caregivers’ mental health, and interventions should consider both mental and physical health. More evidence is needed on the effectiveness of self-care interventions for informal caregivers’ anxiety and physical health.
Long-term symptoms after SARS-CoV-2 infection in a cohort of hospital employees: duration and predictive factors
Authors: Gruber Rosalie , Montilva Ludewig María Verónica , Weßels Christina , Schlang Gerlinde , Jedhoff Svenja , Herbrandt Swetlana , Mattner Frauke 
Published: January 2024

AbstractPurposeTo evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyse risk factors for long-lasting COVID-19 sequelae among a cohort of hospital employees (HEs).MethodsWe conducted a survey regarding persistent COVID-19 related symptoms with all HEs from three medical centres in Cologne, Germany, who were tested SARS-CoV-2 PCR positive from March 2020 until May 2021. Duration of symptoms and possible risk factors for protracted COVID-19 course were analysed.ResultsOf 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] 1.05; 95% confidence interval (95%CI) 1.01–1.09; p = 0.019). The occurrence of breathlessness within the first ten days (OR 7.89; 95%CI 1.87–41.43; p = 0.008), an initial Ct value under 30 (OR 3.36; 95%CI 1.22–9.94; p = 0.022) as well as the occurrence of anosmia or ageusia within the first ten days (OR 3.01; 95%CI 1.10–8.84; p = 0.037) showed a statistically significant association with increased odds of illness duration over 90 days.ConclusionAbout half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Predictive factors could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future.