bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sociodemographic inequalities in mortality from drowning in the Baltic countries and Finland in 2000–2015: a register-based study
Authors: Stickley Andrew , Baburin Aleksei , Jasilionis Domantas , Krumins Juris , Martikainen Pekka , Kondo Naoki , Shin Jae Il , Inoue Yosuke , Leinsalu Mall 
Published: June 2023

Abstract
Background
Drowning is an important public health problem. Some evidence suggests that the risk of drowning is not distributed evenly across the general population. However, there has been comparatively little research on inequalities in drowning mortality. To address this deficit, this study examined trends and sociodemographic inequalities in mortality from unintentional drowning in the Baltic countries and Finland in 2000–2015.

Methods
Data for Estonia, Latvia and Lithuania came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, while corresponding data for Finland were obtained from the longitudinal register-based population data file of Statistics Finland. Deaths from drowning (ICD-10 codes W65–W74) were obtained from national mortality registries. Information was also obtained on socioeconomic status (educational level) and urban-rural residence. Age-standardised mortality rates (ASMRs) per 100 000 person years and mortality rate ratios were calculated for adults aged 30–74 years old. Poisson regression analysis was performed to assess the independent effects of sex, urban-rural residence and education on drowning mortality.

Results
Drowning ASMRs were significantly higher in the Baltic countries than in Finland but declined by nearly 30% in all countries across the study period. There were large inequalities by sex, urban-rural residence and educational level in all countries during 2000–2015. Men, rural residents and low educated individuals had substantially higher drowning ASMRs compared to their counterparts. Absolute and relative inequalities were significantly larger in the Baltic countries than in Finland. Absolute inequalities in drowning mortality declined in all countries across the study period except between urban and rural residents in Finland. Changes in relative inequalities were more variable during 2000–2015.

Conclusion
Despite a sharp reduction in deaths from drowning in the Baltic countries and Finland in 2000–2015, drowning mortality was still high in these countries at the end of the study period with a substantially larger risk of death seen among men, rural residents and low educated individuals. A concerted effort to prevent drowning mortality among those most at risk may reduce drownings considerably in the general population.
Remote learning and mental health during the societal lockdown: a study of primary school students and parents in times of COVID-19
Authors: Ye Frank Tian-Fang , Gao Xiaozi , Sin Kuen-Fung , Yang Lan 
Published: June 2023

AbstractBackgroundThe COVID-19 pandemic has brought challenges to families around the world. The prolonged school closures in Hong Kong have forced young students to stay at home and adapt to remote learning for over a year, putting their mental health conditions at risk. Focusing on primary school students and their parents, the main objective of our research is to investigate the socioemotional factors and their associations with mental health conditions.MethodsA total of 700 Hong Kong primary schoolers (mean age = 8.2) reported their emotional experiences, loneliness, and academic self-concept via a user-friendly online survey; 537 parents reported depression and anxiety, perceived child depression and anxiety, and social support. Responses from students and parents were paired to account for the family context. Structural Equation Modeling was used for correlations and regressions.ResultsThe results of students’ responses showed that positive emotional experiences were negatively associated with loneliness and positively related to academic self-concept among students. Furthermore, the paired sample results showed that, during the one-year societal lockdown and remote learning period, the socioemotional factors were associated with mental health conditions among primary school students and their parents. Among our family sample in Hong Kong, evidence supports the unique negative association between students-reported positive emotional experiences and parents-reported child depression and anxiety, as well as between social support and parents’ depression and anxiety.ConclusionsThese findings highlighted the associations between socioemotional factors and mental health among young primary schoolers during the societal lockdown. We thus call for more attention to the societal lockdown and remote learning context, especially since the social distancing practice could be “the new normal” for our society to handle the future pandemic crisis.
Do the instruments used to assess fibromyalgia symptoms according to American College of Rheumatology criteria generate similar scores in other chronic musculoskeletal pain?
Authors: Pontes-Silva André , de Sousa Ana Paula , Dibai-Filho Almir Vieira , de Souza Marcelo Cardoso , DeSantana Josimari Melo , Avila Mariana Arias 
Published: June 2023

Abstract
Background
As with fibromyalgia, several musculoskeletal disorders are characterized by chronic pain, raising a clinical question – do the instruments used to assess fibromyalgia symptoms according to ACR criteria (ACR criteria) generate similar scores in other chronic musculoskeletal pain?

Objective
To compare the symptoms among fibromyalgia and other chronic musculoskeletal pain. Additionally, we also compared the most researched outcomes in fibromyalgia (i.e., present pain at rest and after movement; fatigue; pain severity and impact; function, global impact, and fibromyalgia symptom).

Methods
A cross-sectional study. Participants over 18 years old were included if they presented report of chronic musculoskeletal pain (≥ 3 months) and after that, they were divided into two groups (fibromyalgia and chronic pain). They answered the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), Brief Pain Inventory (BPI), Numerical Pain Rating Scale (NPRS) for pain and fatigue, WPI, and SSS.

Results
A total of 166 participants were included in this study into two independent groups (chronic pain, n = 83; fibromyalgia, n = 83). We observed significant differences (p < 0.05) and large effect sizes (Cohen’s d, ≥ 0.7) in clinical outcomes comparisons between groups (i.e., widespread pain; symptom severity; present pain at rest and after movement; fatigue; pain severity and impact; function, global impact, and fibromyalgia symptoms).

Conclusion
Fibromyalgia patients (2016 ACR criteria) compared to other chronic musculoskeletal pain patients have higher levels of pain (at rest or after movement) and fatigue, greater impairment in both functionality and global impact, and worse symptoms. Therefore, the WPI and SSS instruments should be used exclusively to assess fibromyalgia symptoms.
Association of oral status with frailty among older adults in nursing homes: a cross-sectional study
Authors: Liu Siyue , Guo Yicong , Hu Zhao , Zhou Feixiang , Li Shaojie , Xu Huilan 
Published: June 2023

Abstract
Background
The oral status of an individual is a vital aspect of their overall health. However, older adults in nursing homes have a higher prevalence of frailty and poor oral health, particularly in the context of global aging. The objective of this study is to explore the association between oral status and frailty among older adults residing in nursing homes.

Methods
The study involved 1280 individuals aged 60 and above from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used to evaluate physical frailty, while the Oral Health Assessment Tool was used to assess oral status. The frequency of tooth brushing was classified as never, once a day, and twice or more a day. The traditional multinomial logistic regression model was used to analyze the association between oral status and frailty. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated while controlling for other confounding factors.

Results
The study found that the prevalence of frailty among older adults living in nursing homes was 53.6%, while the prevalence of pre-frailty was 36.3%. After controlling for all potential confounding factors, mouth changes requiring monitoring (OR = 2.10, 95% CI = 1.34–3.31, P = 0.001) and unhealthy mouth (OR = 2.55, 95% CI = 1.61–4.06, P < 0.001) were significantly associated with increased odds of frailty among older adults in nursing homes. Similarly, both mouth changes requiring monitoring (OR = 1.91, 95% CI = 1.20–3.06, P = 0.007) and unhealthy mouth (OR = 2.24, 95% CI = 1.39–3.63, P = 0.001) were significantly associated with a higher prevalence of pre-frailty. Moreover, brushing teeth twice or more times a day was found to be significantly associated with a lower prevalence of both pre-frailty (OR = 0.55, 95% CI = 0.34–0.88, P = 0.013) and frailty (OR = 0.50, 95% CI = 0.32–0.78, P = 0.002). Conversely, never brushing teeth was significantly associated with higher odds of pre-frailty (OR = 1.82, 95% CI = 1.09–3.05, P = 0.022) and frailty (OR = 1.74, 95% CI = 1.06–2.88, P = 0.030).

Conclusions
Mouth changes that require monitoring and unhealthy mouth increase the likelihood of frailty among older adults in nursing homes. On the other hand, those who brush their teeth frequently have a lower prevalence of frailty. However, further research is needed to determine whether improving the oral status of older adults can change their level of frailty.
Reply to “A better interpretation of data regarding the opioid switching to methadone”
Authors: Ding Haiying , Song Yu , Xin Wenxiu , Sun Jiao , Zhong Like , Zhou Qinfei , He Chaoneng , Gong Liyan , Fang Luo 
Published: June 2023

AbstractIn our article ?Methadone switching for refractory cancer pain’ (BMC palliative care, 2022) we explore the efficacy, safety and economics of methadone in treatment of patients with refractory cancer pain in China. Professor Mercadante provided a better interpretation of data regarding the opioid switching to methadone in the Matters Arising. In this article, we answered the questions in Mercadante et al.’s comments one by one.
Influencing factors of knowledge, attitude and behavior in children’s palliative care among pediatric healthcare workers: a cross-sectional survey in China
Authors: Zhu Lihui , Zhang Na , Hu Yaojia , Xu Yi , Luo Tingwei , Xiang Yuqiong , Jiang Sishan , Zhang Zhiqiang , Chen Muhua , Xiong Yuee 
Published: June 2023

Abstract
Background
Palliative care has become a key medical field worldwide. Although research relating to adult palliative care is well-established, less is known about children’s palliative care (CPC). Therefore, this study investigated the knowledge, attitude and behavior of pediatric healthcare workers (PHWs) regarding CPC and analyzed the influencing factors for the implementation and development of CPC.

Methods
A cross-sectional survey of 407 PHWs was carried out in a Chinese province from November 2021 to April 2022. The questionnaire consisted of two parts: a general information form and questions on the knowledge, attitude and behavior of PHWs about CPC. Data were analyzed using t-test, ANOVA and multiple regression analysis.

Results
The total score of the PHWs’ knowledge, attitude and behavior about CPC was 69.98, which was at a moderate level. PHWs’ CPC knowledge, attitude, and behavior are positively correlated.The most important influencing factors were working years, highest education, professional title, job position, marital status, religion, grade of hospital (I, II or III), type of medical institution, experience of caring for a terminally ill child/kinsfolk and total hours of CPC education and training received.

Conclusions
In this study, PHWs in a Chinese province had the lowest scores on the knowledge dimension of CPC, with moderate attitude and behavior and various influencing factors. In addition to professional title, highest education and working years, it is also worth noting that the type of medical institution and marital status also affected the score. Continuing education and training of PHWs in CPC should be emphasized by the administrators of relevant colleges and medical institutions. Future research should start with the above-mentioned influencing factors and focus on setting up targeted training courses and evaluating the post-training effects.
The impact of clinical placement site, community clinic versus tertiary hospital, on midwifery students’ clinical learning experience in Sierra Leone: a cohort study
Authors: Mann Julie , Brooks Meredith B. , Kella Frederica , Euller Laura , Adelman Sara , Sonnie Mustapha , van de Water Brittney 
Published: June 2023

Abstract
Background
In midwifery education, the clinical learning experience (CLE) is a critical component to gaining competency and should comprise greater than 50% of a student’s education. Many studies have identified positive and negative factors affecting students’ CLE. However, few studies have directly compared the difference in CLE based on placement at a community clinic versus a tertiary hospital.

Methods
The aim of this study was to examine how clinical placement site, clinic or hospital, impacts students’ CLE in Sierra Leone. A once 34-question survey was given to midwifery students attending one of four public midwifery schools in Sierra Leone. Median scores were compared for survey items by placement site using Wilcoxon tests. The relationship between clinical placement and student’s experience were assessed using multilevel logistic regression.

Results
Two-hundred students (hospitals students = 145 (72.5%); clinic students = 55 (27.5%) across Sierra Leone completed surveys. Most students (76%, n = 151) reported satisfaction with their clinical placement. Students placed at clinics were more satisfied with opportunities to practice/develop skills (p = 0.007) and more strongly agreed preceptors treated them with respect (p = 0.001), helped improve their skills (p = 0.001), provided a safe environment to ask questions (p = 0.002), and had stronger teaching/mentorship skills (p = 0.009) than hospital students. Students placed at hospitals had greater satisfaction in exposure to certain clinical opportunities including completing partographs (p < 0.001); perineal suturing (p < 0.001); drug calculations/administration (p < 0.001) and estimation of blood loss (p = 0.004) compared to clinic students. The odds of students spending more than 4 h per day in direct clinical care were 5.841 (95% CI: 2.187–15.602) times higher for clinic students versus hospital students. There was no difference between clinical placement sites in regards to number of births students attended (OR 0.903; 95% CI: 0.399, 2.047) or number of births students managed without a preceptor/clinician present (OR 0.729; 95% CI: 0.285, 1.867).

Conclusion
The clinical placement site, hospital or clinic, impacts midwifery students’ CLE. Clinics offered students significantly greater attributes of a supportive learning environment and access to direct, hands-on opportunities for patient care. These findings may be helpful for schools when using limited resources to improve the quality of midwifery education.
Correlated cryo-SEM and CryoNanoSIMS imaging of biological tissue
Authors: Meibom Anders , Plane Florent , Cheng Tian , Grandjean Gilles , Haldimann Olivier , Escrig Stephane , Jensen Louise , Daraspe Jean , Mucciolo Antonio , De Bellis Damien , Rädecker Nils , Martin-Olmos Cristina , Genoud Christel , Comment Arnaud 
Published: June 2023

Abstract

Background

The development of nanoscale secondary ion mass spectrometry (NanoSIMS) has revolutionized the study of biological tissues by enabling, e.g., the visualization and quantification of metabolic processes at subcellular length scales. However, the associated sample preparation methods all result in some degree of tissue morphology distortion and loss of soluble compounds. To overcome these limitations an entirely cryogenic sample preparation and imaging workflow is required.

Results
Here, we report the development of a CryoNanoSIMS instrument that can perform isotope imaging of both positive and negative secondary ions from flat block-face surfaces of vitrified biological tissues with a mass- and image resolution comparable to that of a conventional NanoSIMS. This capability is illustrated with nitrogen isotope as well as trace element mapping of freshwater hydrozoan Green Hydra tissue following uptake of 15N-enriched ammonium.

Conclusion
With a cryo-workflow that includes vitrification by high pressure freezing, cryo-planing of the sample surface, and cryo-SEM imaging, the CryoNanoSIMS enables correlative ultrastructure and isotopic or elemental imaging of biological tissues in their most pristine post-mortem state. This opens new horizons in the study of fundamental processes at the tissue- and (sub)cellular level.

Teaser
CryoNanoSIMS: subcellular mapping of chemical and isotopic compositions of biological tissues in their most pristine post-mortem state.
Improving clinical suspicion of acute mesenteric ischemia among patients with acute abdomen: a cross-sectional study from an intestinal stroke center
Authors: Nuzzo Alexandre , Peoc’h Katell , Vaittinada Ayar Prabakar , Tran-Dinh Alexy , Weiss Emmanuel , Panis Yves , Ronot Maxime , Garzelli Lorenzo , Eloy Philippine , Ben Abdallah Iannis , Castier Yves , Corcos Olivier 
Published: June 2023

Abstract
Background
Early diagnosis of acute mesenteric ischemia (AMI) is essential for a favorable outcome. Selection of patients requiring a dedicated multiphasic computed tomography (CT) scan remains a clinical challenge.

Methods
In this cross-sectional diagnostic study conducted from 2016 to 2018, we compared the presentation of AMI patients admitted to an intestinal stroke center to patients with acute abdominal pain of another origin admitted to the emergency room (controls).

Results
We included 137 patients—52 with AMI and 85 controls. Patients with AMI [median age: 65 years (interquartile range 55–74)] had arterial and venous AMI in 65% and 35% of cases, respectively. Relative to controls, AMI patients were significantly older, more likely to have risk factors or a history of cardiovascular disease, and more likely to present with sudden-onset and morphine-requiring abdominal pain, hematochezia, guarding, organ dysfunction, higher white blood cell and neutrophil counts, and higher plasma C-reactive protein (CRP) and procalcitonin concentrations. On multivariate analysis, two independent factors were associated with the diagnosis of AMI: the sudden-onset (OR = 20, 95%CI 7–60, p < 0.001) and the morphine-requiring nature of the acute abdominal pain (OR = 6, 95%CI 2–16, p = 0.002). Sudden-onset and/or morphine-requiring abdominal pain was present in 88% of AMI patients versus 28% in controls (p < 0.001). The area under the receiver operating characteristic curve for the diagnosis of AMI was 0.84 (95%CI 0.77–0.91), depending on the number of factors.

Conclusions
Sudden onset and the need for morphine are suggestive of AMI in patients with acute abdominal pain and should prompt multiphasic CT scan including arterial and venous phase images for confirmation.
Whose knowledge counts? Involving communities in intervention and trial design using community conversations
Authors: Burgess Rochelle A. , Shittu Funmilayo , Iuliano Agnese , Haruna Ibrahim , Valentine Paula , Bakare Ayobami Adebayo , Colbourn Tim , Graham Hamish R. , McCollum Eric D. , Falade Adegoke G. , King Carina ,   on behalf of the INSPIRING Project Consortium, Ahmed Tahlil , Ahmar Samy , Cassar Christine , Isah Adamu , Osebi Adams , Magama Abdullahi , Seriki Ibrahim , Olowookere Temitayo Folorunso , McCalla Matt , Uchendu Obioma , Salako Julius , Bakare Damola , Olojede Omotayo 
Published: June 2023

AbstractBackgroundCurrent debates in Global Health call for expanding methodologies to allow typically silenced voices to contribute to processes of knowledge production and intervention design. Within trial research, this has typically involved small-scale qualitative work, with limited opportunities for citizens to contribute to the structure and nature of the trial. This paper reports on efforts to move past typical formative trial work, through adaptation of community conversations (CCs) methodology, an action-oriented approach that engages large numbers of community members in dialogue. We applied the CC method to explore community perspectives about pneumonia and managing the health of children under-5 in Northern Nigeria to inform our pragmatic cluster randomised controlled trial evaluating a complex intervention to reduce under-5 mortality in Nigeria.MethodsWe conducted 12 rounds of community conversations with a total of 320 participants, in six administrative wards in Kiyawa Local Government Area, Jigawa state, our intervention site. Participants were male and female caregivers of children under five. Conversations were structured around participatory learning and action activities, using drawings and discussion to reduce barriers to entry. During activities participants were placed in subgroups: younger women (18–30 years of age), older women (31–49 years) and men (18 years above). Discussions were conducted over three 2-h sessions, facilitated by community researchers. Following an initial analysis to extract priority issues and perspectives on intervention structure, smaller focus group discussions were completed with participants in five new sites to ensure all 11 administrative wards in our study site contributed to the design.ResultsWe identified enabling and limiting factors which could shape the future trial implementation, including complex power relationships within households and wider communities shaping women’s health decision-making, and the gendered use of space. We also noted the positive engagement of participants during the CC process, with many participants valuing the opportunity to express themselves in ways they have not been able to in the past.ConclusionsCCs provide a structured approach to deep meaningful engagement of everyday citizens in intervention and trial designs, but require appropriate resources, and commitment to qualitative research in trials.Trial registrationISRCTN39213655. Registered on 11 December 2019.