bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnitude and determinant of healthcare-seeking behavior for childhood acute respiratory tract infections in Ethiopia: a cross-sectional study
Authors: Aragaw Fantu Mamo , Teklu Rediet Eristu , Alemayehu Meron Asmamaw , Derseh Nebiyu Mekonnen , Agimas Muluken Chanie , Shewaye Daniel Alayu , Birhanie Atalay Liknaw , Tsega Sintayehu Simie , Argaw Girum Shibeshi , Tesfaye Amensisa Hailu 
Published: January 2024

Abstract
Background
Acute respiratory infections (ARIs) remain a major public health concern which become the leading cause of mortality and morbidity in children under the age of five. A large percentage of childhood deaths and complications can be avoided by seeking proper medical care. Therefore, this study aimed to assess the magnitude, and individual and community-level determinants of mothers’ healthcare-seeking behavior for their children under the age of five who had ARI symptoms in Ethiopia.

Method
A secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Surveys(EDHS) with a total weighted sample of 643 under-five children who had ARI symptoms within two weeks of the survey. Due to the hierarchical nature of the EDHS data, a multi-level logistic regression model was used to identify the individual and community-level factors influencing mothers’ health care-seeking behavior for their children with ARI symptoms. In the multivariable multilevel analysis, those variables with a p-value < 0.05 were considered to be significant predictors of the outcome variable.

Results
Healthcare-seeking behavior among mothers or caregivers for children with symptoms of ARIs was 32.61% (95% CI: 29.08–36.33%) in Ethiopia. The ICC in the null model indicated that about 55% of the total variability of treatment-seeking behavior was due to differences between clusters. Child aged > 24 months [AOR = 0.35; 0.19–0.63], having primary education [AOR = 3.25; 1.27–8.32], being media exposed [AOR = 2.49; 1.15, 5.38], female household head[AOR = 3.90; 1.35, 11.24], and delivery at health institution[AOR = 2.24; 1.00, 5.01] were significant predictors of health care seeking behavior of mother for their children with ARI symptoms.

Conclusion
There is poor treatment-seeking behavior for children with symptoms of ARI in Ethiopia with significant community level variations. The multilevel logistic regression analysis showed that improving mothers’ education, women’s empowerment, facilitating institutional delivery and media accessibility are critical to promoting health-seeking behaviors among mothers or caregivers of under-five children with ARI symptoms. Hence, concerned bodies should design targeted interventions that increase mothers’ or caregivers’ treatment-seeking behavior for childhood ARI to reduce child morbidity and mortality.
Treatment-related problems in neonates receiving parenteral nutrition: risk factors and implications for practice
Authors: Akour Amal , Gharaibeh Lobna , El Khatib Omar , Hammour Khawla Abu , AlTaher Noor , AbuRuz Salah , Barakat Muna 
Published: January 2024

Abstract
Objectives
Parenteral nutrition (PN) can be associated with several treatment-related problems (TRPs) and complications in neonatal settings. Thus, understanding the extent and type of these problems and related factors is pivotal to prevent negative consequences of these preparations. Thus, the aim of this study is to assess factors affecting TRPs in neonatal patients receiving PN.

Methods
This was a retrospective chart review of neonates receiving PN in NICU and other wards. We collected their demographics, and laboratory workup. TRPs related to PN preparations as well as their pharmacotherapy were the primary outcomes.

Results
Medical charts of 96 neonate were reviewed. The most encountered TRPs related to patients’ pharmacotherapy were the lack of frequent monitoring (34.2%) and low dose (17.5%). For PN-related TPRs, a mismatch between patients’ nutritional needs and PN composition was observed in third of the patients. Statistically significant positive correlations between number of medications during hospital stay and number of reported TRPs [(r = 0.275, p < 0.01) and (r = 0.532, p < 0.001)] were observed.

Conclusion
In neonates who receive parenteral nutrition (PN), TRPs are often observed. These problems primarily arise from issues in patients’ pharmacotherapy, namely monitoring and dosing. Identifying the risk factors for these TRPs emphasizes the full and effective integration of clinical pharmacists into the healthcare team, which can serve as a potential preventive strategy to lower the occurrence of TRPs.
The prevalence and severity of loneliness and deficits in perceived social support among who have received a ‘personality disorder’ diagnosis or have relevant traits: a systematic review
Authors: Ikhtabi Sarah , Pitman Alexandra , Maconick Lucy , Pearce Eiluned , Dale Oliver , Rowe Sarah , Johnson Sonia 
Published: January 2024

Abstract
Background
Loneliness and struggles with unmet social needs are a common experience among people with ‘personality disorder’ diagnoses/traits. Given the impact of loneliness and poor perceived social support on mental health, and the importance of a sense of belonging for recovery, a systematic review examining the prevalence/severity of loneliness and deficits in perceived social support among people with ‘personality disorder’ diagnoses/traits is an essential step towards developing an intervention targeting the social needs of people with diagnoses/traits ‘personality disorder’. Despite an extensive literature on loneliness and deficits of perceived social support among people with ‘personality disorder’ diagnosis/traits, to date there has been no systematic review of this evidence.

Method
We conducted a systematic review synthesising quantitative data on the prevalence/severity of loneliness and deficits of perceived social support among people with diagnoses/traits of ‘personality disorder’ in comparison with other clinical groups and the general population. We searched Medline, Embase, PsycINFO, Web of Social Science, Google scholar and Ethos British Library from inception to December 2021. We conducted quality appraisals using the Joanna Briggs Critical appraisal tools and rated the certainty of evidence using the Grading of Recommendation, Assessment, Development and Evaluation approach. A narrative synthesis was used describing the direction and strength of associations prioritising high quality studies.

Findings
A final set of 70 studies are included in this review, most of which are cross-sectional studies (n = 55), based in the United States (51%) and focused on community samples. Our synthesis of evidence found that, across all types of ‘personality disorders’ (except ‘narcissistic personality’ traits), people with traits associated with ‘personality disorder’ or meeting criteria for a diagnosis of ‘personality disorder’, have higher levels of loneliness, lower perceived relationship satisfaction, and poorer social support than the general population or other clinical samples.

Conclusion
The quality of evidence is judged as low quality. However, given the distressing nature of loneliness and the known negative effects of loneliness on mental health and recovery, it is important for future research to explore mechanisms by which loneliness may exacerbate ‘personality disorder’ symptoms and the impact this has on recovery.
Variations of plasma oxidative stress levels in male patients with chronic schizophrenia. Correlations with psychopathology and matrix metalloproteinase-9: a case-control study
Authors: Yang Haidong , Zhang Caiyi , Yang Man , Liu Junjun , Zhang Yuting , Liu Dongliang , Zhang Xiaobin 
Published: January 2024

Abstract
Background
Accumulating evidence has indicated that oxidative stress (OS) and matrix metalloproteinase-9 (MMP-9) may contribute to the mechanism of schizophrenia. In the present study, we aimed to evaluate the associations of OS parameters and MMP-9 levels with psychopathological symptoms in male chronic schizophrenia patients.

Methods
This study was an observational, cross-sectional, retrospective case-control study. Plasma hydrogen peroxide (H2O2), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), serum matrix metalloproteinase-9 (MMP-9), and tissue inhibitors of metalloproteinases-1 (TIMP-1) levels were assayed in 80 male patients with chronic schizophrenia and 80 matched healthy controls. Schizophrenia symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). Multivariate regression was used to analyze relationships between OS parameters and MMP-9, and clinical symptoms.

Results
Our results demonstrated that levels of antioxidant enzymes, SOD, GSH-Px, H2O2, and MDA were significantly decreased, whereas CAT and MMP-9 levels were increased in patients with schizophrenia, when compared with healthy controls (all P < 0.05). In schizophrenia patients, correlation analyses showed that H2O2 levels were significantly and positively correlated with PANSS positive scores, CAT and MDA levels were significant negatively correlated with PANSS negative scores and PANSS total scores, and MDA levels were significantly positively correlated with MMP-9 levels (all P < 0.05). However, we did not find that MMP-9 played an interaction role between OS parameters and PANSS total scores and subscales scores (all P > 0.05).

Conclusions
Our results showed that alterations of plasma OS parameters in male patients with chronic schizophrenia were associated with psychopathology and MMP-9, suggesting that OS and neuroinflammation may play important role in the mechanism of schizophrenia.
Socioeconomic inequalities in health-related functioning among people with type 2 Diabetes: longitudinal analyses in the Maastricht Study
Authors: Meisters Rachelle , Albers Jeroen , Sezer Bengisu , de Galan Bastiaan E. , Eussen Simone J. P. M. , Stehouwer Coen D. A. , Schram Miranda T. , van Greevenbroek Marleen M. J. , Wesselius Anke , Koster Annemarie , Bosma Hans 
Published: January 2024

Abstract
Background
Type 2 diabetes mellitus (T2DM) is a common chronic disease that disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have increased risk of T2DM and people with a low SEP and T2DM have higher HbA1c-levels compared to people with T2DM and high SEP. The aim of this study is to analyze longitudinal socioeconomic differences in health-related functioning in people with T2DM.

Methods
Longitudinal data from 1,537 participants of The Maastricht Study with T2DM were used (32.6% female, mean (SD) age 62.9 (7.7) years). SEP was determined by baseline measures of education, occupation and income. Health-related functioning (physical, mental and social) was measured with the Short-Form Health Survey and the Impact on Participation and Autonomy survey (all scored from 0 to 100). Associations of SEP and health-related functioning were studied annually over a 10-year period (median (IQR) 7.0 (5.0) years, baseline 2010–2018) using linear mixed methods adjusting for demographics, HbA1c-levels and lifestyle factors.

Results
Participants with a low SEP had significantly worse health-related functioning compared to those with a high SEP. For example, participants with low income had lower scores for physical (-4.49[CI -5.77;-3.21]), mental (-2.61[-3.78,-1.44]) and social functioning (-9.76[-12.30;-7.23]) compared to participants with high income on a scale from 0 to 100. In addition, participants with a low education significantly declined more over time in mental (score for interaction education with time − 0.23[-0.37;-0.09]) and social functioning (-0.44[-0.77;-0.11]) compared to participants with high education. Participants with low and intermediate incomes significantly declined more over time in physical functioning (-0.17 [-0.34, -0.01 and − 0.18 [-0.36, 0.00]) compared to participants with high income.

Conclusions
Among people with T2DM, those with a lower SEP had worse health-related functioning in general than people with a higher SEP. Additionally, people with T2DM and low education developed poorer mental and social functioning over time compared to people with T2DM and high education. People with T2DM and low or intermediate income declined more in physical functioning over time than those with high incomes. In addition to HbA1c-levels and lifestyle patterns, more attention is needed for socioeconomic differences in health-related functioning for people living with T2DM.
Users’ experience with health-related content on YouTube: an exploratory study
Authors: Mohamed Fatma , Shoufan Abdulhadi 
Published: January 2024

Abstract
Background
This study focuses on health-related content (HRC) on YouTube and addresses the issue of misinformation on this platform. While previous research centered on content evaluations by experts, this study takes a user-centered approach and aims to explore users’ experiences with and perceptions of HRC videos and to establish links between these perceptions and some socio-demographic characteristics including age, gender, profession, and educational level.

Methods
A quantitative research design was used in the study. 3,000 YouTube users responded to a 35-item anonymous questionnaire to collect information about the content they watch toward decision-making, their perceptions of the usefulness and bias of this content, what they identify as quality indicators for HRC, and what they recommend to improve the quality of such content on YouTube. The data were analyzed using descriptive statistics, frequency, and correlation analyses.

Results
The results reveal that 87.6 percent (n=2630) of the participants watch HRC on YouTube, and 84.7 percent (n=2542) make decisions based on what they watch. Exercise and bodybuilding videos are the most popular, with over half of the participants watching them. 40 percent of the users watch YouTube videos to decide whether to consult a doctor or adopt specific health-related practices. In contrast to evaluations by experts in previous studies, most respondents perceive HRC videos on YouTube as useful and do not find connections between video quality and surface features like the number of views and likes. Weak or no correlations were observed between the perceived usefulness of HRC videos and age, gender, profession, or educational level. Participants’ recommendations for enhancing HRC quality align with previous research findings.

Conclusions
Users turn to YouTube not only for health information but also as a decision-making tool. Combined with their generally positive attitudes towards content quality on this platform, this can have significant consequences for their health. Follow-up studies are needed to get more insights into decision-making behaviors and how users assess their decisions in retrospect.
The learning curve for laparoscopic pancreaticoduodenectomy by a proficient laparoscopic surgeon: a retrospective study at a single center
Authors: Wang Heng , Gao Xin , Liu Meng , Kong Xiaohan , Sun HongRui , Niu Zheyu , Ma Chaoqun , Zhu Huaqiang , Lu Jun , Zhou Xu , Gao Hengjun , Yang Faji , Song Xie 
Published: January 2024

Abstract
Background
To explore the learning curve of single center laparoscopic pancreaticoduodenectomy (LPD) and evaluate the safety and efficacy of the operation at different stages.

Methods
A detailed review was conducted on the clinical data of 120 cases of laparoscopic pancreatoduodenectomy performed by the same surgeon between June 2018 and June 2022. Cases that did not provide insights into the learning curve of the procedure were excluded. The cumulative sum (CUSUM) analysis and the best fitting curve methods were employed to delineate the learning curve based on operation time and intraoperative blood loss. The study further evaluated the number of surgeries required to traverse the learning curve. Outcome measures, including operation time, intraoperative blood loss, length of stay, complications, and other relevant indicators, were extracted and compared across different phases of the learning curve.

Result
The maximum turning point of the fitting curve was found in 35 cases by the cumulative sum method of operation time, after which the learning curve could be considered to have passed. The fitting curve obtained by the cumulative sum method of intraoperative blood loss was stable in 30 cases and proficient in 60 cases, which was basically consistent with the fitting curve of operation time. Taking 35 cases as the boundary, the learning curve is divided into learning improvement stage and mastering stage. There was no statistical significance in the general data of the two stage patients (P > 0.05). Hospitalization days decreased from 19 to 15 days (P < 0.05);Pancreatic fistula decreased from 20.0% of grade B and 8.6% of grade C to 7.1% of grade B and 3.5% of grade C (P < 0.05), and the operative time decreased from (376.9 ± 48.2) minutes to (294.4 ± 18.7) minutes (P < 0.05). Intraoperative blood loss decreased from 375 to 241 ml (P < 0.05).

Conclusion
Thirty-five patients with LPD can reach the proficiency stage and the perioperative indexes can be improved.
Traumatic bilateral acetabular fracture secondary to high-energy trauma in healthy adults
Authors: Kenmegne Guy Romeo , Zou Chang , Lin Yixiang , Yin Yijie , Huang Shenbo , Fang Yue 
Published: January 2024

Abstract
Background
Bilateral acetabular fracture is a very rare presentation among the trauma patients, as the pattern and the degree of the forces required to fracture both acetabula is very unique. The primary purpose of this study is to report a series of adult patients presenting with post-traumatic bilateral acetabular fracture without any history of pathological or metabolic bone disease.

Patients and methods
In this retrospective study, 18 cases of traumatic bilateral acetabular fracture were included. There was predominance of both column (four patients on left and six on right) followed by anterior column (two patients left and four on right) and posterior wall (three patients left and right). They were treated surgically through open reduction and internal fixation. All cases were followed up for at least 13 months. Matta’s criteria were used for radiological evaluation on plain radiographs. Functional outcome was evaluated using the Merle d’Aubigne and postel score at final follow-up.

Results
No patients were lost during the follow-up period; there was one case of surgical site infection. There were three cases of postoperative osteoarthritis, one case of heterotrophic ossification, one case of persistent sciatic nerve palsy and one case of lateral femoral cutaneous nerve palsy. The radiological evaluation according to Matta’s criteria revealed anatomic reduction in 12 patients, imperfect reduction in three patients while other three patients had poor reduction. According to modified Merle d’Aubigne and Postel score, 10 cases were rated as excellent, five cases as good and three cases presented fair (one case) to poor (two cases) results.

Conclusion
We report an unusual case series of bilateral acetabular fracture successfully managed surgically with good clinical outcome. With the increasing incidence of route traffic accidents, such cases would probably be recurrent in the upcoming years.
Appropriate medication use in Dutch terminal care: study protocol of a multicentre stepped-wedge cluster randomized controlled trial (the AMUSE study)
Authors: van Hylckama Vlieg M.A.M. , Pot I.E. , Visser H.P.J. , Jong M.A.C. , van der Vorst M.J.D.L. , van Mastrigt B.J. , Kiers J.N.A. , van den Homberg P.P.P.H. , Thijs-Visser M.F. , Oomen-de Hoop E. , van der Heide A. , van der Kuy P.H.M. , van der Rijt C.C.D. , Geijteman E.C.T. 
Published: January 2024

Abstract
Background
Polypharmacy is common among patients with a limited life expectancy, even shortly before death. This is partly inevitable, because these patients often have multiple symptoms which need to be alleviated. However, the use of potentially inappropriate medications (PIMs) in these patients is also common. Although patients and relatives are often willing to deprescribe medication, physicians are sometimes reluctant due to the lack of evidence on appropriate medication management for patients in the last phase of life. The aim of the AMUSE study is to investigate whether the use of CDSS-OPTIMED, a software program that gives weekly personalized medication recommendations to attending physicians of patients with a limited life expectancy, improves patients’ quality of life.

Methods
A multicentre stepped-wedge cluster randomized controlled trial will be conducted among patients with a life expectancy of three months or less. The stepped-wedge cluster design, where the clusters are the different study sites, involves sequential crossover of clusters from control to intervention until all clusters are exposed. In total, seven sites (4 hospitals, 2 general practices and 1 hospice from the Netherlands) will participate in this study. During the control period, patients will receive ‘care as usual’. During the intervention period, CDSS-OPTIMED will be activated. CDSS-OPTIMED is a validated software program that analyses the use of medication based on a specific set of clinical rules for patients with a limited life expectancy. The software program will provide the attending physicians with weekly personalized medication recommendations. The primary outcome of this study is patients’ quality of life two weeks after baseline assessment as measured by the EORTC QLQ-C15-PAL questionnaire, quality of life question.

Discussion
This will be the first study investigating the effect of weekly personalized medication recommendations to attending physicians on the quality of life of patients with a limited life expectancy. We hypothesize that the CDSS-OPTIMED intervention could lead to improved quality of life in patients with a life expectancy of three months or less.

Trial registration
This trial is registered at ClinicalTrials.gov (NCT05351281, Registration Date: April 11, 2022).