bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social support and cognitive activity and their associations with incident cognitive impairment in cognitively normal older adults
Authors: Ma Tianpei , Liao Jiaqiang , Ye Yuguo , Li Jiayuan 
Published: January 2024

Abstract
Objectives
To explore the associations of social support, and cognitive activity with cognitive impairment incidence, and further examine the mediation effect of cognitive activity on the association between social support and cognitive impairment incidence based on a nationwide elderly Chinese cohort.

Methods
We collected the participants from an ongoing cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 9394 older adults aged 65 or more years and free of cognitive impairment who participated in the CLHLS between 2008 and 2018 were included. The information on social support and cognitive activity was collected through a questionnaire. The incident cognitive impairment cases were identified through the Mini-Mental State Examination scale (MMSE). Cox proportional hazard regression models were conducted to calculate the hazard ratios (HRs) and 95% confidence interval (CI) of social support and cognitive activity associated with cognitive impairment. We used casual mediation models to assess the indirect association of cognitive activities underlying the association between social support and cognitive impairment.

Results
The adjusted HRs (95% CI) of incident cognitive impairment were 0.956 (0.932 to 0.980), and 0.895 (0.859 to 0.933) associated with per 1 score increase in social support and cognitive activity score, respectively. Better adherence to social support was associated with a higher cognitive activity score (adjusted β = 0.046, 95% CI[0.032–0.060]). The baseline cognitive activity, as well as the mean cognitive activity at baseline and during the first follow-up wave, mediate the association between social support and the incidence of cognitive impairment, accounting for 11.4% and 12.6% of the total association, respectively. The participants who were aged 80 years or older, or those with mild daily functional limitations gained more benefits in the development of cognitive activity related to social support, leading to a reduction in the risks of cognitive impairment.

Conclusion
The results of this nationwide cohort provide consistent evidence linking social support, and cognitive activity to reduced risk of subsequent cognitive impairment incidence. These findings provide additional evidence to inform the social strategies to prevent cognitive impairment incidence in elderly people.
Multi-organ dysfunction and outcomes in pregnancy associated COVID-19 infection – descriptive review of pathological findings
Authors: Turdybekova Ya.G. , Kopobayeva I.L. , Turmukhambetova A. A. , Kamyshanskiy Y.K. 
Published: January 2024

Abstract
Objective(s)
Comparative clinical and morphological characterization of lesions of the vascular and nervous system in cases of maternal death associated with COVID-19.

Study design
The study included autopsy in 12 cases of maternal death with a positive intravital result for SARS-CoV-2 by reverse transcription polymerase chain reaction. For histopathology, tissue samples were taken from the internal organs of each patient. Pieces of organs were fixed and stained according to the standard protocol. The relative number of microvessels with vasculitis and fibers of the peripheral nervous system with infiltration by immune cells was studied. All morphological changes were classified depending on the severity of the damage.

Results
The average age of patients with a fatal outcome was 35 ± 4.4 years. Time to death after onset of symptoms averaged 16 ± 4.4 days. Dystrophic lesions (necrosis and apoptosis) of the villous and extravillous trophoblast and decidual tissue were observed in the studied placentas. Histopathological signs of mild and severe lesions of the peripheral nervous system in the organs of the gastrointestinal tract were detected in 2 (16.7%) and 10 (83.3%) cases, respectively, in the myocardium in 4 (33.3%) and 8 (66.7%) cases. Histopathological signs of severe damage to the microvascular bed in the organs of the gastrointestinal tract were registered in 9 (75%) cases.

Conclusion(s)
The main clinical feature of this cohort was that death occurred in a long-term period, in most cases with a negative PCR. The histopathological pattern was a non-acute injury with an immune component of the microvascular bed and the autonomic nervous system with predominant damage to the myocardium and intestines.

What does this study add to the clinical work
This study makes it possible to even better study the immunopathological profile in organs and tissues in pregnant women with a fatal outcome when affected by a viral infection, in particular Covid-19. This knowledge can be used when humanity encounters other viral pandemics in the future.
Fronto-temporal cortical grey matter thickness and surface area in the at-risk mental state and recent-onset schizophrenia: a magnetic resonance imaging study
Authors: Rasser Paul E. , Ehlkes Tim , Schall Ulrich 
Published: January 2024

Abstract
Background
Studies to date examining cortical thickness and surface area in young individuals At Risk Mental State (ARMS) of developing psychosis have revealed inconsistent findings, either reporting increased, decreased or no differences compared to mentally healthy individuals. The inconsistencies may be attributed to small sample sizes, varying age ranges, different ARMS identification criteria, lack of control for recreational substance use and antipsychotic pharmacotherapy, as well as different methods for deriving morphological brain measures.

Methods
A surfaced-based approach was employed to calculate fronto-temporal cortical grey matter thickness and surface area derived from magnetic resonance imaging (MRI) data collected from 44 young antipsychotic-naïve ARMS individuals, 19 young people with recent onset schizophrenia, and 36 age-matched healthy volunteers. We conducted group comparisons of the morphological measures and explored their association with symptom severity, global and socio-occupational function levels, and the degree of alcohol and cannabis use in the ARMS group.

Results
Grey matter thickness and surface areas in ARMS individuals did not significantly differ from their age-matched healthy counterparts. However, reduced left-frontal grey matter thickness was correlated with greater symptom severity and lower function levels; the latter being also correlated with smaller left-frontal surface areas. ARMS individuals with more severe symptoms showed greater similarities to the recent onset schizophrenia group. The morphological measures in ARMS did not correlate with the lifetime level of alcohol or cannabis use.

Conclusions
Our findings suggest that a decline in function levels and worsening mental state are associated with morphological changes in the left frontal cortex in ARMS but to a lesser extent than those seen in recent onset schizophrenia. Alcohol and cannabis use did not confound these findings. However, the cross-sectional nature of our study limits our ability to draw conclusions about the potential progressive nature of these morphological changes in ARMS.
Effectiveness of theory-based educational interventions of promoting oral health among elementary school students
Authors: Shirahmadi Samane , Bashirian Saeed , Soltanian Ali Reza , Karimi-shahanjarini Akram , Vahdatinia Farshid 
Published: January 2024

Abstract
Background
The aim of the present study was to determine the effect of oral health education programs on the oral health of primary school students.

Methods
In this randomized controlled trial study, 190 elementary fifth-grade female students were chosen using the multistage cluster sampling method. In this study, the Plaque Index (PI), Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index (CPI), tooth brushing using fluoride toothpaste, dental flossing frequency and factors affecting them were determined according to social cognitive theory (SCT). Interventions were implemented using the play method and with the help of three pamphlets, five posters, a celebration of oral health, and the creation of a Telegram group. Data were analyzed using descriptive statistics indexes, t tests, paired sample t tests, chi-square tests, and Pearson correlation tests.

Results
The results showed that 3 months after the intervention, compared to before the intervention, the percentage of participants in the intervention group who brushed their teeth twice or more per day increased by 48.5%, and the percentage of participants who used dental floss at least once per day increased by 64.2%. The rate of gum bleeding decreased by 6.3%. The good OHI-S rate increased by 44.4%. Dental plaque decreased by 38.1%.

Conclusion
The results demonstrated that a gamification design can be effective and useful in promoting the oral health of students.

Trial registration
registration timing: retrospective, registration date: 18/10/2022, registration number: IRCT20141128020129N2.
Health challenges and facilitators of arbaeen pilgrimage: a scoping review
Authors: Moulaei Khadijeh , Bastaminejad Saiyad , Haghdoost AliAkbar 
Published: January 2024

Abstract
Background
The Arbaeen Pilgrimage, a momentous religious journey drawing millions of participants annually, presents a profound spiritual experience. However, amidst its significance lie various health challenges that pilgrims encounter along the way. Addressing these challenges is vital to ensure the well-being of participants and the success of this extraordinary event. In light of this, the aim of this study is to examine the health challenges of the Arbaeen Pilgrimage, identify facilitators for solving these challenges, and propose effective solutions to enhance the overall pilgrimage experience for all involved.

Methods
The scoping review was performed by searching databases such as Web of Science, PubMed, Scopus, and Google Scholar search engine with a focus on the keywords “Arbaeen”, “Arbaeen walk” and “Arbaeen pilgrimage”. The search was not constrained by a specific time limitation in the databases. Data from studies were extracted using a data extraction form consisting of 9 fields. The selection of articles and data extraction were carried out by two researchers, adhering to predefined inclusion and exclusion criteria. Any disagreements were resolved through consultation with a third researcher. The study was reported following the PRISMA checklist.

Results
Out of 1619 retrieved articles, 9 were finally included in this study. All these studies were published since 2017 and conducted in Iraq and Iran. In total, 101 health challenges and facilitators were identified, comprising 61 challenges and 40 facilitators. The challenges with the highest frequency included “infectious disease outbreaks” (n = 7), “Poor management of Iraq’s health system in waste collection and disposal” (n = 4), “Rising incidence of walking injuries among pilgrims (e.g., burns, fractures, lacerations, wounds, and blisters)” (n = 4), and “Insufficient knowledge about personal and public health“(n = 4). The most important facilitators to solving the challenges were: “Customized pilgrim training and addressing their issues, with a focus on vital practices” (n = 6), “Coordinating mass gathering stakeholders, including health ministries and organizations” (n = 4), and “Implementing an agile syndromic system for rapid surveillance and identification of contagious illnesses” (n = 4).

Conclusion
The article discusses health challenges faced during the Arbaeen Pilgrimage and proposes facilitative measures for participants’ well-being. It emphasizes the significance of addressing health risks in large gatherings and suggests incorporating measures for a safer and enjoyable pilgrimage experience. Overall, understanding and managing these health factors can lead to a successful execution of the Arbaeen Pilgrimage, benefiting the physical and spiritual well-being of all involved.
Novel subgroups of obesity and their association with outcomes: a data-driven cluster analysis
Authors: Takeshita Saki , Nishioka Yuichi , Tamaki Yuko , Kamitani Fumika , Mohri Takako , Nakajima Hiroki , Kurematsu Yukako , Okada Sadanori , Myojin Tomoya , Noda Tatsuya , Imamura Tomoaki , Takahashi Yutaka 
Published: January 2024

Abstract
Background
Obesity is associated with various complications and decreased life expectancy, and substantial heterogeneity in complications and outcomes has been observed. However, the subgroups of obesity have not yet been clearly defined. This study aimed to identify the subgroups of obesity especially those for target of interventions by cluster analysis.

Methods
In this study, an unsupervised, data-driven cluster analysis of 9,494 individuals with obesity (body mass index ≥ 35 kg/m2) was performed using the data of ICD-10, drug, and medical procedure from the healthcare claims database. The prevalence and clinical characteristics of the complications such as diabetes in each cluster were evaluated using the prescription records. Additionally, renal and life prognoses were compared among the clusters.

Results
We identified seven clusters characterised by different combinations of complications and several complications were observed exclusively in each cluster. Notably, the poorest prognosis was observed in individuals who rarely visited a hospital after being diagnosed with obesity, followed by those with cardiovascular complications and diabetes.

Conclusions
In this study, we identified seven subgroups of individuals with obesity using population-based data-driven cluster analysis. We clearly demonstrated important target subgroups for intervention as well as a metabolically healthy obesity group.
No correlation to collagen synthesis disorders in patients with Perthes’ disease: a nationwide Swedish register study of 3488 patients
Authors: Lindblad M , Bladh M , Björnsson-Hallgren H , Sydsjö G , Johansson T 
Published: January 2024

Abstract
Background
Mutations of the COL2A1 gene have been identified in patients with Perthes’ disease. Several studies have hypothesised a connection between Perthes’ disease and collagen synthesis disorders, especially COL2A1-related disorders, but no large studies on the subject have been made. The aim of this study was thus to discover if there is a connection between patients presenting with Perthes’ disease, and collagen synthesis disorders. A secondary aim was to see if the children with both disorders had less optimal birth characteristics than the rest.

Methods
Swedish national registers were used to collect data on children diagnosed with Perthes’ disease or a collagen synthesis disorder. These registers include all births in Sweden, and data from both outpatient and in-hospital visits. A wide range of data is included besides diagnoses. All children with follow-up data to the age of 15 years were included. Pearson’s chi-square was used for analysis. Statistical significance was further analysed with Fisher’s Exact Test.

Results
In total, 3488 children with either diagnosis were included. 1620 children had only Perthes disease, while 1808 children had only a collagen synthesis disorder. Five children were found to have both the diagnosis Perthes’ disease and a collagen synthesis disorder. One child was large for their gestational age and none of the children had a low birthweight. Two of the children were moderately preterm.

Conclusions
The distinct lack of overlap in such a large body of material raises doubt about a connection between the presentation of Perthes’ disease and collagen synthesis disorders, either COL2A1-related or not. We could not find an overrepresentation of less optimal birth characteristics either.
Cross cultural adaptation, reliability and validity of the Persian version of the university of Wisconsin running injury and recovery index
Authors: Sheikhi Bahram , Akbari Hadi , Heiderscheit Bryan 
Published: January 2024

Abstract
Background
The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed to evaluate running ability after a running-related injury. The aim of this study was to translate and cross-culturally adapt the UWRI into Persian (UWRI-Persian) and to investigate its psychometric properties in patients with a running-related injury.

Methods
The UWRI-Persian was translated using the Beaton guidelines. One hundred and seventy-three native Persian patients with running-related injuries were participated in the study. The exploratory factor analysis was carried out using the principal component analysis method with Varimax rotation. The construct validity of the UWRI-Persian was evaluated using the Pearson correlation with the pain self-efficacy questionnaire (PSEQ), Tampa scale for Kinesiophobia (TKS), and visual analogue scale (VAS). Test-retest reliability was tested among 64 patients who completed the form again after seven days.

Results
The UWRI-Persian showed excellent internal consistency for total score (α = 0.966). An excellent internal consistency (α = 0.922) was shown for psychological response and good internal consistency (α = 0.887) for running progression. The interclass correlation coefficient for the UWRI-Persian total scores was 0.965 (95% CI, 0.942 to 0.979), indicating high intra-rater reliability. The UWRI-Persian showed a moderate correlation with the PSEQ (r = 0.425) and the TSK (r = 0.457) and a weak correlation with the VAS (r = 0.187). These findings suggest no floor or ceiling effects.

Conclusions
The UWRI is a reliable and valid tool for Persian-speaking patients with running-related injuries. The UWRI was successfully translated from English to Persian and demonstrated good to excellent internal consistency, validity and reliability with no floor or ceiling effects.
Faculty of sports science students, physical education teachers, and athletes’ level of knowledge and attitude about mouthguards
Authors: Soğukpınar Önsüren Aslı , Eroğlu Hüseyin , Aksoy Cemil 
Published: January 2024

AbstractObjectivesTraumatic dental injury occurs during sports competitions, training, and practice and can be prevented by the use of mouthguards. For this reason, this study aimed to evaluate the knowledge and attitudes of sports science faculty students, physical education teachers, and athletes about mouthguards.MethodsFive hundred thirty-two participants were reached via social media. In the questionnaire consisting of 20 questions, questions about the sociodemographic characteristics of the participants were asked in part 1, and questions about their level of knowledge and attitudes about the mouthguards were asked in part 2. Descriptive statistical analysis and a chi-square test were used to evaluate the data.ResultsThe number of people who think that mouthguards protect the athlete from traumatic dental injury is 381 (71.6%). The number of people who think that mouthguards affect the performance of the athlete is positively 228 (42.9%). To protect against traumatic dental injury, 51.48% of the participants preferred the custom-made; 39.3% of them preferred the boil-bite; 33.22% of them preferred the standard/stock type mouth guard; and 22.96% of them preferred the helmet, and 18.26% of them preferred the face mask.ConclusionsThe knowledge and attitude of sports science faculty students, physical education teachers, and athletes are low about mouthguards. Since these people who are engaged in sports have a high exposure to traumatic dental injuries, education should be given to increase their awareness about mouthguards.
Experiences of nursing students who are victims of dating violence: a qualitative study
Authors: Barroso-Corroto Esperanza , Laredo-Aguilera José Alberto , Cobo-Cuenca Ana Isabel , Carmona-Torres Juan Manuel 
Published: January 2024

Abstract
Background
Dating Violence (DV) is a type of Intimate Partner Violence that occurs between young people, and they are those behaviours that cause physical, sexual or psychological harm.

Objective/aim
To know the experience of university students around dating violence.

Design and methods
Qualitative study with a phenomenological approach was conducted through semi-structured individual interviews with nursing students’ victims of dating violence with the same starting categories. The public involve in this study were nursing students who freely agreed to participate in the interviews and gave their informed consent.

Results
Eleven nursing students participated, the sample was heterogeneous for gender and sexual diversity. Obtaining results about their experience with dating violence, manifestations of dating violence and cyber violence in their relationships, consequences, formal and informal help seeking and proposals for help as nursing students, among others.

Conclusion
Dating violence is a serious problem that seriously affects the victims and requires the creation of prevention programs. The experiences of university students about DV are mainly painful experiences, with serious consequences for those involved, needing help from their close environment and professional help to overcome the problems generated by their partners.

Implications
It is important due to the high prevalence of this phenomenon, also among nursing students, to provide key points to future health professionals and victims of dating violence on the correct way to act against violence due to lack of knowledge on the subject. This study clarifies the experiences of dating violence and how to offer help to victims from the informal and professional sphere.

Trial registration
This study was approved by the Ethics Committee of Clinical Research of the Health Area of Talavera de la Reina (Toledo) with code 01/2021.
Driving the implementation of hospital examination reservation system through hospital management
Authors: Wang Qi , Ma Yingjie , Mao Jian , Song Jingyan , Xiao Mingzhao , Zhao Qinghua , Yuan Fang , Hu Lei 
Published: January 2024

Abstract
Background
Hospital Examination Reservation System (HERS) was designed for reducing appointment examination waiting time and enhancing patients’ medical satisfaction in China, but implementing HERS would encounter many difficulties. This study would investigate the factors that influence patients’ utilization of HERS through UTAUT2, and provide valuable insights for hospital managements to drive the effective implementation of HERS. It is helpful for improving patients’ medical satisfaction.

Methods
We conducted a survey through the Sojump platform, targeting patients were who have already used HERS. We collected questionnaire information related to factors behavior intention, performance expectancy, and effort expectancy. Subsequently, we employed a structural equation model to analyze the factors influencing patients’ utilization of HERS.

Results
A total of 394 valid questionnaires were collected. Habit was the main direct positive factor influencing the behavioral intention of HERS (β = 0.593; 95%CI: 0.072, 1.944; P = 0.002), followed by patient innovation (β = 0.269; 95%CI: 0.002, 0.443; P < 0.001), effort expectancy (β = 0.239; 95%CI: -0.022, 0.478; P = 0.048). Patient innovation and facilitating conditions also have an indirect effect on behavioral intention. Perceived privacy exposure has a significantly negative effect on behavioral intention (β=-0.138; 95%CI: -0.225, -0.047; P < 0.001). The above variables explained 56.7% of the variation in behavioral intention.

Conclusions
When HERS is implemented in hospitals, managements should arrange volunteers to guide patients to bring up the habit and solve the using difficulties, and managements could invite patients with high innovation to recommend HERS to others, what’s more, it is a valid way to retain the old form of appointment to pass the transition period to the new system. HERS utilization and patients’ medical satisfaction will be enhanced through the guidance of hospital management means.