bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trachoma: an underdiagnosed disease revealed by a survey carried out at Jaú, São Paulo
Authors: Schaal Luisa Fioravanti , Meneghim Roberta Lilian Fernandes de Sousa , Ferraz Lucieni Cristina Barbarini , Padovani Carlos Roberto , Victoria Cassiano , Schellini Silvana Artioli 
Published: January 2024

Abstract
Background
Trachoma is a notifiable disease in the state of São Paulo– Brazil. However, in Jaú, a municipality located in this state, in the last 10 years there are no records of cases. This study purpose is to assess if there are cases of inflammatory trachoma in schoolchildren aged 1 to 9 years in the municipality of Jaú as well if it is possible to detect clusters areas of the disease to establish elimination programs.

Methods
An epidemiological study was performed in 2018, involving a stratified random sample of schoolchildren aged 1- to 9-year-old, from public day care centers and elementary schools in the municipality of Jaú. A trachoma screening following the criteria of the World Health Organization (WHO) and the distribution of cases was assessed using geoprocessing.

Results
Four thousand-six hundred-nineteen children from 44 elementary schools were examined, and 126 children with active trachoma were detected, with an adjusted prevalence rate of 2.65%. The prevalence was higher (3.01%) in children aged 6- to 9-year-old compared to children aged 1-to 5-year-old (2.42%). There were clusters with a higher concentration of positive cases of the disease in three schools located in the neighborhoods with lower socioeconomic conditions.

Conclusion
Inflammatory trachoma still present in children aged 1- to 9-year-old in the city of Jaú. The positive cases were located mainly in areas with low socioeconomic conditions. Health promotion with active search and periodical treatment must be planned to fight this important blinding cause, that persists in our municipality.
Process evaluation of a parent-child communication intervention for adolescent sexual and reproductive health in Uganda
Authors: Fernandes Danielle , Kemigisha Elizabeth , Achen Dorcus , Akatukwasa Cecilia , Ruzaaza Gad Ndaruhutse , Coene Gily , Delobelle Peter , Nyakato Viola N. , Michielsen Kristien 
Published: January 2024

Abstract
Background
Previous initiatives concerning adolescent sexual and reproductive health (SRH) education in Low-or-Middle Income Countries (LMICs) have been limited by cultural norms and misinformation perpetuated within families. Responding to the paucity of research on the implementation of SRH interventions in LMICs and limited knowledge regarding their mechanisms, this study undertakes a process evaluation of a parent-focused intervention to promote parent-adolescent communication about SRH in Uganda.

Methods
This paper explores the implementation, contextual factors and mechanisms of impact of the intervention, using the Medical Research Council (MRC) guidelines for process evaluations. Implementation was evaluated through indicators of dose, fidelity and adaptations, acceptability and feasibility. The contextual factors and mechanisms of impact were evaluated to refine the intervention’s causal assumptions. Data was collected during April - October 2021 in South-Western Uganda using a mixed-methods approach, including document analysis, intervention observations, interviews, focus group discussions and most significant change stories.

Results
The acceptability of the intervention was related to its community engagement, the strong rapport with delivery agents, and individual characteristics of participants. Five contextual factors influencing implementation were highlighted; (i) cultural norms, (ii) perceptions about youth SRH, (iii) poverty, (iv) Covid-19 pandemic, and (v) prior research projects in the community. When considering the intervention’s mechanisms of impact, four causal pathways were identified; (i) Awareness of SRH needs helped parents overcome stigma, (ii) Parenting skills training improved SRH communication, (iii) Group learning stimulated shared parenting, and (iv) Group learning improved co-parenting.

Conclusion
The paper presented three key learnings and corresponding recommendations for future research. Firstly, implementation success was credited to meaningful community engagement which improved acceptability and uptake. Secondly, the complex influences of contextual factors highlighted the need for contextual analysis in research studies to inform intervention design. Finally, this evaluation recognised the interplay between mechanisms of impact and suggested further research consider such combined impacts when designing intervention content.
Knowledge, attitude, and practice of patients with major depressive disorder on exercise therapy
Authors: Cheng Junxiang , Feng Yaoqing , Liu Zhifen , Zheng Dandan , Han Hong , Liu Na , Liu Shasha , Zhao Juan , Li Xiaole , Han Shifan 
Published: January 2024

Abstract
Background
This study aimed to explore the knowledge, attitude, and practice (KAP) toward exercise therapy of patients with major depressive disorder (MDD).

Methods
This cross-sectional study was conducted at the First Hospital of Shanxi Medical University between April and October 2023 in patients with MDD. A self-designed questionnaire was used to evaluate the KAP (Cronbach’s α = 0.787). The minimum-maximum scores were 2–23 for knowledge, 11–55 for attitude, and 7–35 for practice.

Results
A total of 494 valid questionnaires were analyzed. The mean KAP dimension scores were 15.39 ± 3.34/23 (66.91%), 36.54 ± 19.33/55 (66.44%), and 19.33 ± 5.22/35 (55.23%), indicating poor knowledge, negative attitude, and weak practice. Multivariable logistic regression analysis showed that female (OR = 0.613, 95%CI: 0.376-1.000, P = 0.050), urban residence (OR = 0.443, 95%CI: 0.259–0.758, P = 0.003), suburban residence (OR = 0.047, 95%CI: 0.016–0.138, P < 0.001), higher income (OR = 3.889–7.928, all P < 0.001), and unclear self-reported depression level (OR = 0.078, 95%CI: 0.027–0.221, P < 0.001) were independently associated with the knowledge scores. Knowledge scores (OR = 1.102, 95%CI: 1.022–1.188, P = 0.011), female gender (OR = 0.437, 95%CI: 0.246–0.776, P = 0.005), city (OR = 0.410, 95%CI: 0.226–0.744, P = 0.003), married (OR = 3.577, 95%CI: 1.751–7.650, P < 0.001), higher income (OR = 0.065–0.392, both P < 0.050), depressive trend (OR = 2.640, 95%CI: 1.110–6.278, P = 0.028), high depression score level (OR = 0.176, 95%CI: 0.104-0.300, P < 0.001), and unclear self-reported depression score (OR = 0.023, 95%CI: 0.007–0.076, P < 0.001) were independently associated with the attitude scores. Finally, knowledge scores (OR = 1.130, 95%CI: 1.051–1.215, P = 0.001), attitude scores (OR = 1.199, 95%CI: 1.124–1.280, P < 0.001), and city (OR = 0.583, 95%CI: 0.352–0.965, P = 0.036) were independently associated with the practice scores. The structural equation modeling analysis showed that knowledge, but not attitude (β = 0.103, P = 0.092) or practice (β = 0.034, P = 0.603), influenced the depression level (β=-0.074, P < 0.001); attitude influenced practice (β = 0.369, P < 0.001).

Conclusion
The KAP toward exercise among MDD patients is poor in Shanxi. Females, people living in urban or suburban areas, with lower income, and self-reported unclear depression levels should be targeted by education interventions.
Association between thymic hyperplasia and serum calcium level in Graves’ disease
Authors: Zeng Jing , Li Lan , Wei Dong 
Published: January 2024

Abstract
Background
Graves' disease increases bone resorption in hyperthyroidism, leading to elevated serum calcium levels and a negative bone balance. Thymic hyperplasia is observed in some Graves' disease patients. What's more, there have been a few reports of increased serum calcium and severe osteoporosis induced by Graves’ disease with thymic hyperplasia. It remains unclear whether Graves’ disease with thymic hyperplasia is associated with higher serum calcium levels. Our study aimed to investigate the possibility of elevated serum calcium levels and aggravated bone mobilization in Graves’ disease patients with thymic hyperplasia.

Methods
Newly diagnosed and untreated patients with Graves' disease (n = 96) were enrolled. They were divided into two groups based on the incidental detection of thymic hyperplasia during imaging. Albumin, alkaline phosphatase, calcium, free triiodothyronine, free thyroxine, thyroid-stimulating hormone, and thyrotrophin receptor antibody (TRAb) were measured, and a computerized tomography of the chest was obtained.

Results
Patients with Graves’ disease who had thymic hyperplasia were notably younger (P=0.018) and exhibited higher serum calcium levels (P=0.001) compared to those with Graves’ disease without thymic hyperplasia. In the multiple regression analysis, thymic hyperplasia, TRAb, and female gender were significant variables associated with elevated serum calcium levels in patients with Graves' disease, collectively accounting for 31.7% of the variation in serum calcium.

Conclusions
Graves’ disease patients with thymic hyperplasia showed higher serum calcium levels. thymic hyperplasia, TRAb, and female gender were found to be correlated with increased serum calcium levels in Graves’ disease, suggesting a potential association between thymic hyperplasia and bone mobilization in Graves’ disease.
Non-invasive ventilation in the care of patients with chronic obstructive pulmonary disease with palliative care needs: a scoping review
Authors: Steindal Simen A. , Hofsø Kristin , Aagaard Hanne , Mariussen Kari L. , Andresen Brith , Christensen Vivi L. , Heggdal Kristin , Wallander Karlsen Marte-Marie , Kvande Monica E. , Kynø Nina M. , Langerud Anne Kathrine , Ohnstad Mari Oma , Sørensen Kari , Larsen Marie Hamilton 
Published: January 2024

Abstract
Background
Patients with severe chronic obstructive pulmonary disease (COPD) could have palliative care (PC) needs because of unmet needs such as dyspnoea. This may lead to anxiety and may have an impact on patients’ ability to perform daily activities of living. PC can be started when patients with COPD have unmet needs and can be provided alongside disease-modifying therapies. Non-invasive ventilation (NIV) could be an important measure to manage dyspnoea in patients with COPD in need of PC. A scoping review was conducted to gain an overview of the existing research and to identify knowledge gaps. The aim of this scoping review was to systematically map published studies on the use of NIV in patients with COPD with PC needs, including the perspectives and experiences of patients, families, and healthcare professionals (HCPs).

Methods
This review was conducted following the framework of Arksey and O’Malley. The reporting of the review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The review protocol was published. AMED, CINAHL, Embase, MEDLINE, PEDro, and PsycInfo were searched from inception to November 14, 2022. The included studies had to report the perspectives and experiences of COPD patients, relatives, and HCPs regarding NIV in the care of patients with COPD with PC needs. In pairs, the authors independently assessed studies’ eligibility and extracted data. The data were organised thematically. The results were discussed in a consultation exercise.

Results
This review included 33 papers from 32 studies. Four thematic groupings were identified: preferences and attitudes towards the use of NIV; patient participation in the decision-making process of NIV treatment; conflicting results on the perceived benefits and burdens of treatment; and heterogenous clinical outcomes in experimental studies. Patients perceived NIV as a ‘life buoy’ to keep them alive. Many patients wanted to take part in the decision-making process regarding NIV treatment but expressed varying degrees of inclusion by HCPs in such decision-making. Conflicting findings were identified regarding the perceived benefits and burdens of NIV treatment. Diversity in heterogeneous clinical outcomes were reported in experimental studies.

Conclusions
There is a need for more studies designed to investigate the effectiveness of NIV as a palliative measure for patients with COPD with PC needs using comprehensive outcomes. It is especially important to gain more knowledge on the experiences of all stakeholders in the use of home-based NIV treatment to these patients.
Exploring medical students’ perceptions of empathy after cinemeducation based on Vygotsky’s theory
Authors: Salajegheh Mahla , Sohrabpour Amir Ali , Mohammadi Elaheh 
Published: January 2024

AbstractBackgroundMedical students’ empathy toward patients with Alzheimer’s is rarely found in formal medical curricula. Based on Vygotsky’s theory, watching films and reflection can be considered as effective methods to improve empathy. The present study aimed to explore medical students’ perceptions of empathy toward patients with Alzheimer after participating in an educational program by using interactive video based on Vygotsky’s theory.MethodsThis qualitative study was conducted at Tehran University of Medical Sciences in 2022. The population included all 40 medical students. Firstly, the Still Alice movie which is about the feelings of a professor who was diagnosed with Alzheimer’s disease was shown to the students. Secondly, the students reflected on their experiences of watching the movie. Thirdly, a session was held for group discussion on the subject of the movie, the patient’s feelings, the doctor’s attitude, the social environment surrounding the patient shown in the movie, and the necessity of empathy toward patients with Alzheimer’s disease. The reflection papers were analyzed using the conventional qualitative content analysis method.ResultsAfter analyzing 216 codes from 38 reflection papers, four categories, including communication with a patient with Alzheimer’s, understanding the patient with Alzheimer’s as a whole, medical science development, and the student’s individual ideology, were extracted.ConclusionReflection and group discussion after watching movie by providing opportunities for social interaction about personal interpretations will lead to active role in enhancing empathy. Based on the perceptions of the medical students, they gained a perspective to consider the patient as a whole and pay attention to establishing a proper relationship with the patient.
Implementation of remote home care: assessment guided by the RE-AIM framework
Authors: Oelschlägel Lina , Moen Anne , Dihle Alfhild , Christensen Vivi L. , Heggdal Kristin , Österlind Jane , Steindal Simen A. 
Published: January 2024

Abstract
Background
Welfare technology interventions have become increasingly important in home-based palliative care for facilitating safe, time-efficient, and cost-effective methods to support patients living independently. However, studies evaluating the implementation of welfare technology innovations are scarce, and the empirical evidence for sustainable models using technology in home-based palliative care remains low. This study aimed to report on the use of the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to assess the implementation of remote home care (RHC) a technology-mediated service for home-living patients in the palliative phase of cancer. Furthermore, it aimed to explore areas of particular importance determining the sustainability of technologies for remote palliative home-based care.

Methods
A secondary analysis of data collected by semi-structured interviews with patients with cancer in the palliative phase, focus groups, and semi-structured interviews with healthcare professionals (HCPs) experienced with RHC was performed. A deductive reflexive thematic analysis using RE-AIM dimensions was conducted.

Results
Five themes illustrating the five RE-AIM dimensions were identified: (1) Reach: protective actions in recruitment - gatekeeping, (2) Effectiveness: potential to offer person-centered care, (3) Adoption: balancing high touch with high tech, (4) Implementation: moving towards a common understanding, and (5) Maintenance: adjusting to what really matters. The RE-AIM framework highlighted that RHC implementation for patients in the palliative phase of cancer was influenced by HCP gatekeeping behavior, concerns regarding abandoning palliative care as a high-touch specialty, and a lack of competence in palliative care. Although RHC facilitated improved routines in patients’ daily lives, it was perceived as a static service unable to keep pace with disease progression.

Conclusions
A person-centered approach that prioritizes individual needs and preferences is necessary for providing optimal care. Although technologies such as RHC are not a panacea, they can be integrated as support for increasingly strained health services.
Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes
Authors: Borges Maria Carolina , Clayton Gemma L. , Freathy Rachel M. , Felix Janine F. , Fernández-Sanlés Alba , Soares Ana Gonçalves , Kilpi Fanny , Yang Qian , McEachan Rosemary R. C. , Richmond Rebecca C. , Liu Xueping , Skotte Line , Irizar Amaia , Hattersley Andrew T. , Bodinier Barbara , Scholtens Denise M. , Nohr Ellen A. , Bond Tom A. , Hayes M. Geoffrey , West Jane , Tyrrell Jessica , Wright John , Bouchard Luigi , Murcia Mario , Bustamante Mariona , Chadeau-Hyam Marc , Jarvelin Marjo-Riitta , Vrijheid Martine , Perron Patrice , Magnus Per , Gaillard Romy , Jaddoe Vincent W. V. , Lowe William L. , Feenstra Bjarke , Hivert Marie-France , Sørensen Thorkild I. A. , Håberg Siri E. , Serbert Sylvain , Magnus Maria , Lawlor Deborah A. 
Published: January 2024

Abstract
Background
Higher maternal pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and perinatal outcomes. However, whether these associations are causal remains unclear.

Methods
We explored the relation of maternal pre-/early-pregnancy BMI with 20 pregnancy and perinatal outcomes by integrating evidence from three different approaches (i.e. multivariable regression, Mendelian randomisation, and paternal negative control analyses), including data from over 400,000 women.

Results
All three analytical approaches supported associations of higher maternal BMI with lower odds of maternal anaemia, delivering a small-for-gestational-age baby and initiating breastfeeding, but higher odds of hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, gestational diabetes, pre-labour membrane rupture, induction of labour, caesarean section, large-for-gestational age, high birthweight, low Apgar score at 1 min, and neonatal intensive care unit admission. For example, higher maternal BMI was associated with higher risk of gestational hypertension in multivariable regression (OR = 1.67; 95% CI = 1.63, 1.70 per standard unit in BMI) and Mendelian randomisation (OR = 1.59; 95% CI = 1.38, 1.83), which was not seen for paternal BMI (OR = 1.01; 95% CI = 0.98, 1.04). Findings did not support a relation between maternal BMI and perinatal depression. For other outcomes, evidence was inconclusive due to inconsistencies across the applied approaches or substantial imprecision in effect estimates from Mendelian randomisation.

Conclusions
Our findings support a causal role for maternal pre-/early-pregnancy BMI on 14 out of 20 adverse pregnancy and perinatal outcomes. Pre-conception interventions to support women maintaining a healthy BMI may reduce the burden of obstetric and neonatal complications.

Funding
Medical Research Council, British Heart Foundation, European Research Council, National Institutes of Health, National Institute for Health Research, Research Council of Norway, Wellcome Trust.
Mosquito odour-baited mass trapping reduced malaria transmission intensity: a result from a controlled before-and-after intervention study
Authors: Debebe Yared , Tekie Habte , Dugassa Sisay , Hopkins Richard J. , Hill Sharon Rose , Ignell Rickard 
Published: January 2024

Abstract
Background
Conventional vector control strategies have significantly reduced the malaria burden. The sustainability of these methods is currently challenged. Odour-based traps are emerging technologies that can complement the existing tools. Implementation of odour-based traps for mass trapping is limited due to the restricted range of vectors caught with available carbon dioxide-dependent lures, and the lack of comprehensive field studies. The objective of this study was to assess the impact of odour-mediated mass trapping targeting outdoor vectors, using a synthetic cattle urine lure that attracts a wide range of vector species in a variety of physiological states, on malaria prevalence and entomological parameters to determine malaria transmission intensities.

Methods
A controlled before-and-after study was conducted in two rural communities in southern Ethiopia. Baseline monthly entomological and seasonal cross-sectional malaria prevalence surveys were conducted in both communities for a year. Then, mass trapping of mosquitoes was conducted in one of the villages, while the monthly entomological surveillance and seasonal malaria prevalence surveys continued in both villages. Generalised linear mixed models were constructed and tested to determine which factors were significantly affected by the intervention.

Results
Mass trapping contributed to the reduction of the population of the principal malaria vector, Anopheles arabiensis, and the associated entomological indicators, the human bite rate (HBR) and the entomological inoculation rate (EIR), in the intervention village compared to the control village. The intervention village had an average HBR by An. arabiensis of 3.0 (95% CI 1.4–4.6) during the peak malaria transmission season, compared to 10.5 (95% CI − 0.5–21.5; P < 0.0001) in the control village. The intervention village (mean 0.02, 95% CI − 0.05–0.4.8) had a daily EIR eight times lower than the control village (mean 0.17, 95% CI), which likely contributed to the reduced malaria prevalence in the intervention community following its introduction by ca. 60% (95% CI 55–63).

Conclusions
The combined use of odour-based mass trapping and conventional control strategies coincided with a reduction of human-vector contact and malaria prevalence, providing support for odour-baited technologies as a viable option for next-generation vector control tools. Further cluster-randomised control studies are recommended in different eco-epidemiological settings with varying malaria transmission intensities.