bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observation and assessment of the immediate use of a silicon hydrogel contact lens after transepithelial corneal cross linking: a prospective study
Authors: Liu Liu , Fukuyama Teruko , Han Tian , Zhang Zhe , Jiang Lin , Ding Yanlan , Zhou Xingtao , Wang Jifang 
Published: November 2023

Abstract
Background
Transepithelial corneal crosslinking (CXL) is a novel surgical approach for the treatment of keratoconus, which is a bilateral asymmetrical ophthalmological disease accompanied by progressive corneal ectasia. Silicon hydrogel (SiH) contact lenses have been extensively used in clinical ophthalmologic medicine, as a postoperative ophthalmological intervention. However, the ideal lens application duration after transepithelial CXL remains uncertain. Here, we aimed to investigate the effects and comfort of immediate corneal contact lens use after transepithelial CXL for keratoconus.

Methods
In this prospective study, 60 patients with keratoconus who underwent transepithelial CXL treatment were enrolled from September 2021 to January 2023 with a male:female ratio of 39:21, and an average age of 25.42 ± 5.47 years. The patients were divided randomly into two groups: group A contained 30 patients wearing silicone hydrogel contact lenses for 7 days postoperatively, and group B contained 30 patients wearing the same contact lenses for 3 days.
Ten subjective ophthalmologic symptoms were surveyed by the patients, including pain, photophobia, foreign body sensation, tearing, burning, blurred vision, dry eyes, difficulty opening the eyes, astringency, and stinging. Ophthalmologic signs, including corneal edema and conjunctival congestion, were recorded by a single clinician on postoperative days 1, 3, and 7.

Results
Each surgical procedure was readily performed without complications, and both groups postoperative day 7 (P = 0.04), where group B scored (0.01 ± 0.41) lesser than group A (0.12 ± 0.29), whilst corneal edema in both groups recorded significantly different on postoperative days 5 and 7 (group A demonstrated the result of 0.17 ± 0.14 and 0.08 ± 0.11 for the respective days, whereas group B indicated 0.10 ± 0.13 and 0.03 ± 0.07 at the corresponding times).

Conclusions
Immediate use of silicone hydrogel corneal lenses after transepithelial CXL effectively alleviates postoperative ocular distress, particularly with a three-day use period as the ideal duration.
The L-shaped association of mid-upper arm circumference with all-cause and cause-specific mortality in US adults: a population-based prospective cohort study
Authors: Hou Xinran , Hu Jie , Wang E. , Guo Qulian , Zhang Xian , Yang Minjing , Liu Zhuoyi , Wang Jian , Song Zongbin 
Published: November 2023

Abstract
Background
The arm circumference is a feasible and reliable indicator in evaluating the nutritional status of children. However, its application in general adults has yet to be thoroughly investigated.

Objective
This study aimed to evaluate the association between mid-upper arm circumferences (MUACs) and mortality in general adults.

Methods
The nationally representative cohort from the National Health and Nutrition Examination Survey (1999—2018) was analyzed with mortality information obtained through linkage to the National Death Index. The baseline MUACs were collected as exposure. Survey-weighted Cox proportional hazard regressions were performed to estimate the hazard ratios (HRs) and 95% confidential intervals (CIs) of mortality risk for individuals with different MUACs. Restricted cubic spline analyses were performed to examine the nonlinear association of MUAC with all-cause and cause-specific mortality.

Results
A total of 52,159 participants were included in this study. During a median follow-up time of 117 months, 7157 deaths were documented, with leading causes of cardiovascular disease (CVD), cancer, and respiratory disease. Individuals in the first quartile (Q1) of MUAC tended to have higher all-cause mortality risk than the rest after full adjustment. Similarly, CVD mortality risk in Q1 was higher than that in the second quartile (Q2) and the third quartile (Q3); respiratory mortality risk in Q1 was higher than in Q2. MUAC was non-linearly associated with all-cause mortality and CVD mortality. Individuals in Q1 MUAC (≤ 29.3) tended to have higher all-cause mortality risk, with HRs (95% CIs) estimated to be 0.76 (0.67–0.87) for Q2 (29.4, 32.5), 0.69 (0.59–0.81) for Q3 (32.6, 36.0), and 0.59 (0.46–0.75) for Q4 (≥ 36.1) after adjustment of demographic, lifestyle, and comorbidity covariates. Similarly, compared with Q1, HRs (95% CIs) for CVD mortality were estimated to be 0.73 (0.58–0.93) for Q2 and 0.57 (0.43–0.47) for Q3; HRs (95% CIs) for respiratory mortality was estimated to be 0.57 (95% CI, 0.37–0.87) for Q2 with other differences not significant.

Conclusion
The MUAC was inversely associated with long-term mortality in general adults in the United States and may serve as a valuable measurement in adult health evaluations.
Adult female callers’ characteristics and mental health status: a retrospective study based on the psychological assistance hotline in Hangzhou
Authors: Wei Yating , Song Haidong 
Published: November 2023

Abstract
Objective
This study aims to analyze the basic characteristics and mental health status of adult female callers to the psychological assistance helpline in Hangzhou City, in order to provide targeted services for effectively intervening in the psychological crises of this group.

Methods
Data from adult female callers to a helpline in Hangzhou City were collected between 2019 and 2022, encompassing demographic information and discussed issues. The data were analyzed according to age groups, marital status, and call times. The mental health status of the adult female population was measured by two indicators—mood status and suicide risk.

Results
The study included 15,580 adult female callers. Among them, 52.2% were aged 30 and below, 62.1% were unmarried, and 42.6% were from other provinces. The primary types of calls were related to mental health (56.5%), romantic relationships (11%), and marriage/family issues (13%). Adults aged 30 and below had more consultations about romantic relationships, work, and study-related issues compared to those over 30. Those over 30 sought more advice on marriage/family and child education. Younger callers displayed higher levels of depression and suicide risk compared to older callers. Unmarried callers had a higher proportion of moderate depression and suicide risk than married callers. Higher education levels were associated with lower depression levels (OR = 0.631,95%CI:0.439–0.906, P = 0.013) and high-risk proportions (OR = 0.328,95%CI:0.147–0.733, P = 0.007). Late evening callers had a higher high-risk proportion (OR = 5.326,95%CI:2.633–10.775, P < 0.001), and employed individuals had lower high-risk proportions compared to unemployed callers (OR = 0.536,95%CI:0.320–0.897, P = 0.018).

Conclusion
The mental health status of female callers aged 30 and below, unemployed individuals, and those calling in the latter part of the night have relatively poorer mental health and are more likely to be at risk for suicide, which needs to be taken seriously, and more professional and targeted intervention services need to be enhanced in the hotline.
The association between walking pace and hand grip strength with the risk of chronic obstructive pulmonary disease: a bidirectional Mendelian randomization study
Authors: Qiu Peng , Chen Mingxian , Lv Shuaibing , Xie Juanjuan , Wu Junyu 
Published: November 2023

Abstract
Background
Chronic Obstructive Pulmonary Disease (COPD) currently ranks as the third leading cause of mortality worldwide, imposing substantial burdens on societal and individual health. Amongst health research tools, walking pace (WP) and hand grip strength (HGS) are cornerstones, extensively associated with diverse health conditions. However, the intricate interplay between these factors and COPD risk remains ambiguous. This study aims to elucidate the causal association of WP, HGS, with COPD risk through a bidirectional Mendelian randomization (MR) approach.

Methods
Bidirectional MR analysis was performed using Genome-wide association study (GWAS) data of European individuals for WP, HGS, and COPD. Inverse Variance Weighted (IVW) served as the primary MR analysis approach. To supplement the IVW findings, four additional MR methods [MR-Egger, weighted median, maximum likelihood, simple median] were used. To assess heterogeneity and pleiotropy, sensitivity analyses were performed. In addition, multivariate MR (MVMR) analysis was used to assess causality after adjustment for potential confounders.

Results
IVW method results show a significant negative association between WP and COPD risk in both initial (genome-wide threshold, odds ratio (OR) = 0.21, 95% confidence interval (CI) 0.09–0.51, P = 5.06 × 10− 4) and secondary (locus-wide threshold, OR = 0.27, 95%CI: 0.18–0.41, P = 4.88 × 10− 10) MR analysis. The reverse MR analysis suggested that COPD also diminishes WP. Additionally, a causal risk reduction for COPD with right HGS (OR = 0.74, 95% CI: 0.58–0.94, P = 1.44 × 10− 2) was only found in secondary MR analysis. The outcomes of the four additional MR methods also suggested similar causal relationships, and sensitivity analyses endorsed their robustness. Lastly, the MVMR analysis demonstrated that the WP’s effect on reducing COPD risk persisted independently of potential confounding variables.

Conclusion
A bidirectional causal relationship exists between typical WP and COPD risk. Conversely, a decrease in right HGS is unidirectionally associated with an increased risk of COPD. The study suggests that WP may serve as a predictive factor for COPD or as a simple evaluative indicator for prognosis.
Improvement of parents’ oral health knowledge by a school-based oral health promotion for parents of preschool children: a prospective observational study
Authors: Shan Zhiyi , Liao Chongshan , Lu Jiajing , Yeung Cindy Po Wan , Li Kar Yan , Gu Min , Chu Chun Hung , Yang Yanqi 
Published: November 2023

Abstract
Background
Parents of preschool children have inadequate oral health knowledge in Hong Kong. Parents play a critical role in preschool children’s dietary patterns and oral health behaviors. A school-based oral health promotion (OHP) for parents of preschoolers was developed and investigated.

Objectives
The objective of this study was to evaluate effects of the school-based OHP for parents of preschool children on parents’ oral health knowledge and preschool children’s early childhood caries (ECC).

Materials and methods
This was a quasi-experimental study. Parents of preschool children were divided into the intervention group (IG) and the control group (CG) according to their own selection. Parents in the IG participated in a structured school-based OHP workshop, while those in the CG did not attend the OHP workshop. Parents in both groups were invited to complete a questionnaire assessing their oral health knowledge before (T0), one month after (T1), and twelve months after (T2) the OHP workshop. Preschool children’s caries was examined via dmft score at T0 and T2.

Results
Parents’ oral health knowledge was negatively correlated with preschool children’s dmft scores (R = -0.200, P < 0.001). Oral health knowledge was significantly improved in IG (P < 0.001) but not in CG (P = 0.392) at T1. Both groups experienced a significant improvement in oral health knowledge from T0 to T2 (P < 0.001). Parents’ oral health knowledge in the IG was significantly higher compared to the CG at T1 (P < 0.001), but difference in the scores at T2 between the two groups showed no significant difference (P = 0.727). No significant difference was found in changes in children’s dmft score from T0 to T2 between the IG and CG (p = 0.545).

Conclusion
Preschool children’s high ECC is associated with the limited oral health knowledge of their parents. The school-based OHP workshop for parents increased parents’ oral health knowledge within one month. This positive effect was maintained for twelve months and can be extended to a larger scale in the school setting.
Dental professionals’ views on motivational interviewing for the prevention of dental caries with adolescents in central Norway
Authors: Lassemo Eva , Rodd Helen D. , Skeie Marit Slåttelid , Johnsen Jan-Are K. , Nermo Hege , Sand Kari , Eftedal Randi Krog , Fagerhaug Tone Natland , Jasbi Arefe , Marshman Zoe , Dahllöf Göran , Høiseth Marikken 
Published: November 2023

Abstract
Background
Establishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients.

Methods
As part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level.

Results
A total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists.

Conclusions
A high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.
Evaluation of cortical and trabecular bone structure of the mandible in patients using L-Thyroxine
Authors: Gulec Melike , Tassoker Melek , Erturk Mediha 
Published: November 2023

Abstract
Background
Long-term use of L-Thyroxine (LT4), the synthetic thyroxine hormone used for thyroid hormone replacement therapy, is an important risk factor for osteoporosis. The aim of this study was to investigate the differences between mandibular cortical index (MCI) and trabecular bone fractal dimension (FD) values on panoramic radiographs of patients using LT4 and control subjects.

Methods
A total of 142 female patients, 71 cases and 71 controls, were analyzed in the study. Ages were matched in case and control groups and the mean age was 36.6 ± 8.2 (18 to 50) years. MCI consisting of C1 (Normal Mandibular Cortex), C2 (Moderately Resorbed Mandibular Cortex) and, C3 (Severely Resorbed Cortex) scores was determined for case and control groups. Fractal analysis was performed using ImageJ on selected regions of interest from the gonial and interdental regions. The box-count method was used to calculate FD values. Wilcoxon signed-rank test, Mann-Whitney U test, and Spearman correlation analysis were applied to compare the measurements. Statistical significance of differences was established at P < 0.05 level.

Results
FD values did not show statistically significant differences between case and control groups (p > 0.05). The mean FD in the right gonial region was 1.38 ± 0.07 in the case group and 1.38 ± 0.08 in the control group (p = 0.715). The mean FD in the right interdental region was 1.37 ± 0.06 in the cases and 1.36 ± 0.06 in the control group (p = 0.373). The mean FD in the left gonial region was 1.39 ± 0.07 in the cases and 1.39 ± 0.07 in the control group (p = 0.865). The mean FD in the left interdental region is 1.37 ± 0.06 in the cases and 1.38 ± 0.05 in the control group (p = 0.369). The most common MCI score was C1, with 62% in the cases and 83.1% in the control group. MCI scores showed a statistically significant difference between cases and controls (p = 0.016, p < 0.05). While the C2 score was higher in the cases, the C1 score was higher in the controls.

Conclusions
LT4 use was not associated with the FD of mandibular trabecular bone, but was associated with MCI values of cortical bone. Further studies on larger samples with different imaging modalities and image processing methods are needed.
A confirmatory factor analysis of the Iranian version of the interpersonal communication skills scale among healthcare professionals
Authors: Salahshouri Arash , Fathi Sheida , Jiba Mostafa , Mohamadian Hashem , Kordzanganeh Jafar 
Published: November 2023

AbstractBackgroundIdentifying healthcare professionals’ (HCPs) communication skills is crucial to improving patient outcomes. Iranian HCPs’ interpersonal communication skills (ICS) were validated using a culturally appropriate and indigenous scale.Materials and methodsIn November and December 2021, convenience sampling was used to collect data from 170 HCPs. Seven factors were covered by the questionnaire, which consisted of 30 items. In order to validate the scale, first- and second-order confirmatory factor analyses (CFA) were performed. Various indices were used during the CFA, including Goodness of Fit Index (GFI), Adjusted Goodness of Fit (AGFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), Standardized Root Mean Square Residual (SRMR), and Root Mean Square Error of Approximation (RMSEA). The Fornell-Larcker Criterion was used to assess discriminant validity. We analyzed the data in Lisrel 8.8 and SmartPLS 3.2.8.ResultsAccording to the Q2-index obtained from the blindfold test, the model had 44% predictive power. First-order CFA results showed acceptable indices (χ2 = 767.17; DF = 375; CFI = 0.98; GFI = 0.82; AGFI = 0.80; NFI = 0.97; SRMR = 0.22; RMSEA = 0.068). Furthermore, the second-order measurement model demonstrated adequate and desirable fit indices (χ2 = 797.24; DF = 381; CFI = 0.98; GFI = 0.82; AGFI = 0.78; NFI = 0.97; SRMR = 0.059; RMSEA = 0.068). General and listening skills were ranked highest in the importance-performance map analysis (IPMA).ConclusionHCPs could benefit from this scale as it can assist them in developing ICS. It is recommended that skills training programs be replicated among different populations to evaluate their effectiveness.
Cost-effectiveness of bringing a nurse into an Italian genetic day clinic: a before and after study
Authors: Mordenti Marina , Tremosini Morena , Locatelli Manuela , Gnoli Maria , Forni Cristiana , Pedrini Elena , Boarini Manila , Sangiorgi Luca 
Published: November 2023

Abstract
Background
Only a few studies explore the role of nurses in genetic counselling and genetic health care, and none of them is related to orphan diseases. In addition, few studies address the issue of finding variables that might affect the economy of a service or perform a cost-effectiveness analysis of a having genetic nurse at a unit.

Methods
A multidisciplinary panel of experts working in the hospital was set up to identify sensitive indicators and remove confounding variables. This panel evaluated efficiency and effectiveness indicators and drafted a questionnaire to estimate patient perception of the quality of the service. Data were captured from different sources, including the hospital patient database and a web-accessible platform for data collection. More than 600 clinical evaluations of 400 patients were considered, and economic parameters were studied by applying Porter’s Time-Driven Activity-Based Costing methodology to evaluate costs and outcomes. Additionally, an anonymous, semi-structured, paper-and-pencil interview questionnaire was given to patients at their periodic follow-ups.

Results
The results showed an increase in the quality of patient management, more accurate data capturing, and higher quality ambulatory care. In fact, approximately 70% of the respondents reported positive changes. In addition, a parallel economic analysis explored indicators influencing economic impact, and outcomes showed positive results with the quality of outcomes improving more compared to the increase in costs.

Conclusions
The variety of evaluated issues highlighted that having a nurse in a genetic service and at day clinic activities resulted in better access, better scheduling, more satisfaction, and proved to be a cost-effective solution for patients affected by rare diseases.
The causal relationship between physical activity, sedentary time and idiopathic pulmonary fibrosis risk: a Mendelian randomization study
Authors: Lei Wanyang , Yang Mei , Yuan Ziyu , Feng Runlin , Kuang Xiao , Liu Zhiqiang , Deng Zongqi , Hu Xianglin , Tai Wenlin 
Published: November 2023

Abstract
Background
Several observational studies have found that physical inactivity and sedentary time are associated with idiopathic pulmonary fibrosis (IPF) risk. However, the causality between them still requires further investigation. Therefore, our study aimed to investigate the causal effect of physical activity (PA) and sedentary time on the risk of IPF via two-sample Mendelian randomization (MR) analysis.

Methods
Multiple genome-wide association study (GWAS) data involving individuals of European ancestry were analyzed. The datasets encompassed published UK Biobank data (91,105–377,234 participants) and IPF data (2018 cases and 373,064 controls) from FinnGen Biobank. The inverse variance weighting (IVW) method was the primary approach for our analysis. Sensitivity analyses were implemented with Cochran’s Q test, MR-Egger regression, MR-PRESSO global test, and leave-one-out analysis.

Results
Genetically predicted self-reported PA was associated with lower IPF risk [OR = 0.27; 95% CI 0.09–0.82; P = 0.02]. No causal effects of accelerometry-based PA or sedentary time on the risk of IPF were observed.

Conclusions
Our findings supported a protective relationship between self-reported PA and the risk for IPF. The results suggested that enhancing PA may be an effective preventive strategy for IPF.