bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of pattern and multifocal electroretinogram for macular evaluation in patients with multiple sclerosis treated with fingolimod
Authors: Abdelgawad Randa H. , Abdel Wadood Yasmine Z. , Seif Mohamed Y.S. , Sultan Mahmoud A. , Zamzam Dina A. , Aboud Safaa A.M. 
Published: January 2025

Objective
To detect the role of pattern electroretinogram (PERG) and multifocal electroretinogram (MfERG) for macular function evaluation in patients with relapsing–remitting multiple sclerosis (RR-MS) treated by fingolimod.

Patients and methods
This prospective research was carried out on 25 patients with RR-MS (50 eyes), treated by fingolimod, with no ophthalmic disorders or complaints before the onset of the treatment, including no history of optic neuritis. PERG, MfERG, and spectral domain optical coherence tomography were performed before then 3 and 6 months after the treatment.

Results
Best-corrected visual acuity (BCVA) significantly decreased in third and sixth months compared to baseline (P<0.001). Central macular thickness showed nonsignificant change. PERG waveform abnormalities were detected in 2.5% of patients at third month (P=0.9) and 27.5% in sixth month (P<0.001). PERG P50 amplitude nonsignificantly decreased in third month (P=0.6), then significantly decreased at sixth month (P=0.021). PERG N95 amplitude showed no significant difference (P=0.345). MfERG revealed nonsignificant decrease of P1 amplitude of all five rings at third and sixth months. The duration of MS had significant negative correlations with BCVA, amplitude, and amplitude change of P1 of both ring 1 and ring 2.

Conclusion
Treatment with fingolimod for 6 months led to a significant reduction in BCVA and PERG responses and a slight decrease in P1 amplitude of MfERG before detection of any structural macular changes by optical coherence tomography. This indicates the role of PERG and MfERG as biomarkers for the early detection of macular function alteration in RR-MS fingolimod-treated cases.
The Impact of Listening to Quran Recitation during Pain-Inducing Procedure among Patients Receiving Mechanical Ventilation Support: An Interventional Study
Authors: Rababa Mohammad , Al-Sabbah Shatha , Hayajneh Audai 
Published: January 2025

Background:
Pain experienced by intubated patients is caused by several extrinsic sources, including nursing care procedures such as endotracheal suctioning. Several nonpharmacological therapies, including listening to Quran recitation, have never been tested for their pain relief effects among intubated patients, despite these therapies being cost-effective, easy to implement, and free of adverse effects. This study aimed to examine the pain-relieving effect of listening to Quran recitation during pain-inducing procedures in patients receiving mechanical ventilation support.

Materials and Methods:
This pilot study used an experimental design with 32 intubated patients at King Abdullah University Hospital in Irbid, Jordan. The Behavioral Pain Scale and Ramsay Sedation Scale were used to assess pain levels and sedation, and physiologic parameters were monitored before and during endotracheal suctioning.

Results:
The findings showed significant differences in Behavioral Pain Scale (BPS) scores and heart rate measures between the intervention and control groups after controlling for the level of sedation. The patients in the intervention group scored lower pain and HR measures than those in the control group (F5,26 = 11.47, p < 0.001).

Conclusions:
The findings showed significant improvement in the levels of pain and heart rate measures among intubated patients who are exposed to Quran recitation. Complementary medicine is essential to the healthcare plans of critically ill patients and their families. Holy Quran recitation has been reported to be a useful nonpharmacological intervention for critically ill Muslim patients.
Maternal Mortality Determinants in Rural Kenya: An Audit of Three Hospitals
Authors: Masaba Brian Barasa , Mmusi-Phetoe Rose M. , Rono Bernard , Muthiani Daniel Kyalo , Taiswa Jonathan , Ojiambo Stephenie Lydia , Moraa Damaris , Moturi John Kennedy 
Published: January 2025

Background:
Global health agencies advocate that no mother should die while giving life, more so from preventable causes. However, there are persistently high maternal mortalities in various regions with a current global maternal mortality ratio of 211/100,000 live births. This study sought to investigate the causes and determinants of maternal mortality.

Materials and Methods:
A four-year retrospective, cross-sectional study was conducted in three tertiary hospitals within Migori county in Kenya. Data were extracted from 101 maternal mortality records from January 1, 2016 to December 31, 2019.

Results:
Leading complications were hemorrhage 34.70%, eclampsia 20.80%, and sepsis 15.80%. Mothers who were unmonitored using partograph, had reactive HIV status, were in the postpartum period, were referred from periphery facilities, and low socioeconomic levels were most vulnerable.

Conclusions:
Improvement in healthcare systems to enable optimal care to mothers diagnosed with leading complications and socioeconomically empowering women in Migori county is urgently needed.
Association of Thyroid Function Test Values with Prepregnancy Body Mass Index and Gestational Weight Gain: A Systematic Review of Literature Reviews
Authors: Goodarzi-Khoigani Masoomeh , Ardakani Tayebe Shojaddni , Shirazi Maryam 
Published: January 2025

Background:
Gestational Weight Gain (GWG) is an important indicator affecting pregnancy outcome, and thyroid hormones are also weight regulators. Researchers showed that thyroid hormones were correlated to prepregnancy Body Mass Index (BMI) and GWG. However, the normal ranges of thyroid parameters and GWG depend on the trimester of measurement. Therefore, we systematically reviewed the current knowledge on the association between thyroid function tests and prepregnancy BMI and GWG.

Materials and Methods:
This review was finally conducted on nine articles, while Google Scholar and databases such as Scopus, Medline, Cochrane Library, ISI Web of Science, Science Direct, and ProQuest were searched to find English articles from October 2022 to June 2023.

Results:
Thyroid-Stimulating Hormone (TSH) was positively correlated with prepregnancy BMI, while Free Thyroxine (FT4) was inversely correlated. TSH was positively related to weight gain and BMI in the first trimester, while the relationship was negative for FT4. Free Triiodothyronine (FT3) had a positive relationship with BMI in the first trimester (p = 0.004). Furthermore, TSH level was not associated with GWG in the second and third trimesters, while FT4 was inversely correlated with GWG. FT3 also increased with BMI in the second trimester and not in the third trimester (p < 0.001). Finally, there was a positive correlation between thyroid peroxidase autoantibodies values and prepregnancy BMI as well as maternal BMI, but the data were inconsistent.

Conclusions:
Determining the relationship between thyroid hormone levels and prepregnancy BMI and/or GWG may help researchers and clinicians manage weight gain and/or thyroid function in pregnancy.
Predictors of Fetal Attachment, Anxiety, Stress, and Worry in Unintended Pregnancies in the Primary Care Center in Southern Iran
Authors: Tahmasebi Hajar , Nimota Ruth Nukpezah , Fournier Andrew , Marznaki Zohreh Hosseini , Parviniannasab Ali Mohammad , Keshavarzi Fatemeh 
Published: January 2025

Background:
Despite the prevalence of unintended pregnancies, little is known about the connections between psychosocial and sociodemographic characteristics. This study explored the predictors of fetal attachment, worry, anxiety, and stress in unintended pregnancies.

Materials and Methods:
This descriptive, cross-sectional study was conducted on 229 father and mother pairs from two primary healthcare centers in Fars province in southern Iran. Data were collected in a face-to-face survey using the Parents Fetal Attachment Scale, Spielberger State-Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), Perceived Stress Scale (PSS), and Parental Worry Scale. The participants were selected using the two-stage random cluster sampling method from November 2022 to February 2023. Data were analyzed in SPSS software using binary logistic and multiple linear regression tests.

Results:
According to the findings, education level and previous parenting experience were found to have a statistically significant effect on the attachment levels of mothers (F4,224 = 5.14; p < 0.05). However, there was no statistically significant difference between the perceived stress of mothers and fathers (p > 0.05). Previous parenting experience significantly affected mothers’ anxiety (odd ratio: 3.20; p < 0.05). The age variable had a significant relationship with the mothers’ perceived stress (p < 0.05).

Conclusions:
According to the results, unwanted pregnancy had a significant relationship with fetal attachment, anxiety, stress, and worry. It is recommended that to enhance the mental health of couples who have experienced unintended pregnancy, a platform should be provided for the development of their psychosocial environment.
Comparison of Stress, Anxiety, and Depression Levels in Nurses in Specialized and General Ward
Authors: Khani Mahdi , Ahmadi Fazlollah , Rasekhi AliAkbar , Mohammadpour Yousef 
Published: January 2025

Background:
Nurses are exposed to higher stress, anxiety, and depression due to the nature of their work. Considering the differences between specialized and general hospital units, this article focuses on comparing the levels of stress, anxiety, and depression among nurses in these two types of units.

Materials and Methods:
This descriptive-analytical study was conducted in 2023 on 135 nurses in specialized units and 219 nurses in general units selected through stratified random sampling out of 1681 nurses. For this study, 6 public hospitals in the West Azerbaijan province of Iran were selected. Data were collected through a demographic questionnaire and the Depression, Anxiety, Stress Scales-21 (DASS-21) and analyzed using SPSS software. A significance level of 0.05 was considered for this study.

Results:
This study reported that stress, anxiety, and depression affected 72.04%, 46.33%, and 53.68% of nurses, respectively, with mild to extremely-severe intensity levels. No significant differences were observed in stress, anxiety, and depression between specialized and general units (p > 0.05). Among specialized units (ICU, CCU, and dialysis ward), dialysis unit nurses had significantly lower depression scores (p < 0.05). Additionally, a significant correlation existed between demographic variables and DASS-21 constructs (p > 0.05).

Conclusions:
The similarities among nurses in specialized and general units outweigh the observed differences. Given the high prevalence of stress, anxiety, and depression among nurses and the negative correlation with job satisfaction, managers should improve job satisfaction to support nurses’ mental health.
Investigating the Impact of the Direct Observation of Procedural Skills Assessment on the Learning and Satisfaction of the Operating Room Students of Neyshabur University of Medical Sciences, Iran, in 2022
Authors: Ebrahimpour-Sadagheyani Hassan , Saadati Seyede M. , Tatari Farin 
Published: January 2025

Background:
The assessment of learners is a fundamental element in medical science curricula. The Direct Observation of Procedural Skills (DOPS) exam is a valuable way to assess clinical skills. The present study aimed to assess the clinical skills of operating room students of Neyshabur University of Medical Sciences, Iran, using the DOPS exam, and determine the effect of the exam on the learning and satisfaction of the learners.

Materials and Methods:
The current study was a semi-experimental study that used a single-group posttest study design. The statistical sample included 30 operating room students. The 5 skills were selected for assessment and the assessment checklist was designed by the researcher and approved by the expert panel. Moreover, 3 researcher-made questionnaires were used to examine the students’ skills and opinions regarding facilitating learning and their satisfaction with the DOPS examination. Mann-Whitney, Kruskal-Wallis, and Wilcoxon tests were used to analyze the data.

Results:
The results showed that there was a significant difference between the scores of the students in the first and second examinations (z = -4.243, p < 0.001), and the students› scores increased significantly on the second examination. The learners were satisfied with the way the DOPS exam was conducted, and their satisfaction score of this exam was 90.7 out of 120. Furthermore, students agreed that this exam affected learning facilitation. Their score on the effectiveness of this exam was 93.9/120.

Conclusions:
Although the DOPS examination is one of the clinical assessment methods for learners, it can be used as an instructional tool in the learning process.
The Effect of The Mental Health Literacy Promotion Program on Emotion Regulation Strategies of Family Caregivers of Patients with Chronic Psychiatric Disorders in Isfahan, Iran
Authors: Pirallahi Zeynab , Alavi Mousa , Akbari Mohammad , Aliyari Najme 
Published: January 2025

Background:
Emotion regulation strategies help family caregivers of chronic psychiatric patients to manage caring behaviors. However, evidence pointed out problems and therefore a need to execute respective programs to improve emotion regulation for caregivers. This study aimed to investigate the effectiveness of mental health literacy promotion programs on emotion regulation strategies of family caregivers of chronic psychiatric patients.

Materials and Methods:
This is a clinical trial study, with two-group pretest–post-test design with a follow-up period conducted in 2023. Sixty family caregivers of chronic psychiatric patients were randomly allocated to intervention control groups. Data collection was done using a demographic characteristics questionnaire and Gross and John’s Emotion Regulation Scale. The mental health literacy promotion program was implemented for the intervention group in six sessions weekly. Immediately and 1 month after the last meeting, the questionnaires were completed. The data were analyzed using Chi-squared and Fisher’s exact tests, Mann–Whitney test, and analysis of covariance by SPSS-22. The significance level was set to 0.05.

Results:
The results showed that the frequency distribution of demographic variables in the control and test groups had no statistically significant difference (p > 0.05). The intervention had significant effects on the mean score of emotion regulation strategies, and its subscales included re-evaluation and suppression of family caregivers of chronic psychiatric patients in both the post-test and follow-up periods (p < 0.001).

Conclusions:
According to improving the emotion regulation of family caregivers of chronic psychiatric patients through the mental health literacy promotion program, it is suggested to use this program to achieve the desired emotion regulation.
The Effect of an Educational Program Based on Behavioral Intention Model on Childbearing in Women During the Covid 19 Pandemic
Authors: Seifi Somayeh , Kohan Shahnaz , Boroumandfar Zahra 
Published: January 2025

Background:
Currently, fertility and childbearing rates in Iran are below the replacement level (1.2 children), and Iranian families have a low propensity to have children. The COVID-19 pandemic will also have a negative impact on the decision of couples to have children. The present study was conducted with the aim of investigating the effectiveness of an educational program on women’s childbearing intention under the conditions of the COVID-19 pandemic.

Materials and Methods:
This study was a clinical trial with a pretest–posttest design, conducted on 80 women (control group = 40 and intervention group = 40) in comprehensive health centers in 2019. The educational program was delivered to the intervention group in 3 sessions. The data collection tools included the Attitudes to Fertility and Childbearing Scale (AFCS), Demographic Information Questionnaire, and researcher-made fertility intention questionnaire. Data were analyzed using t-test, Mann–Whitney, Chi-square test, ANOVA, Bonferroni post hoc test, and Wilcoxon test.

Results:
The women in the intervention group were in the age range of 18 to 44 years and in the control group were in the age range of 19 to 44 years. The results showed that the mean scores of attitude toward fertility and intention to have children after training were significantly different between the two groups. However, after the training, it was significantly higher in the intervention group than in the control group (F1,67 = 1037, p < 0.001).

Conclusions:
It seems that the implementation of the use of theoretical models can be effective in the informed decision of families, especially women, for childbearing.
Effect of Web-Based Education on Self-efficacy and Self-care Ability in Heart Failure Patients
Authors: Vatmasari Ratih Arum , Putra Kuswantoro Rusca , Windarwati Heni 
Published: January 2025

Background:
Self-care prevents rehospitalization and reduces mortality from heart failure. The self-care of heart failure patients is influenced by their sense of self-efficacy. Traditional educational methods are time-consuming, require patients to meet with health experts, and frequently cannot be accessed remotely. A web-based educational platform might be one of the innovations included in the development of health education for people with heart failure. The aim of this study is to determine the effect of web-based education on self-efficacy and self-care ability in heart failure patients.

Materials and Methods:
This study design is quasi-experimental. The study sample consisted of 80 individuals with heart failure with New York Heart Association (NYHA) II-IV classes and separated into two groups: the intervention group (n = 40) and the control group (n = 40). The sampling technique used in this study is consecutive sampling. Self-care is measured using the Self-Care Heart Failure Instrument version. A pre-test was administered before the intervention, and post-test and follow-up were administered two weeks after the intervention. The control group received information leaflets and the intervention group received web-based education.

Results:
The results showed that the main group effect was significant, indicating a significant increase self-care (F1,80 = 2769, p < 0.001) and self-efficacy (F1,67 = 1600, p < 0.001) in the intervention group after web-based education and two weeks follow-up.

Conclusions:
Web-based education is more effective in increasing self-efficacy and self-care abilities among heart failure patients. Providing education via a web-based platform in phases and continuously can promote healthy behaviors.
Early Clinical Deterioration Risk Assessment in Inpatient Units of a Public University Hospital
Authors: de Souza Esteves Mariana , de Araujo Lourenço Laura B. , de Jesus Meszaros Mariana , de Freitas Neves Silva Michele , São-João Thais 
Published: January 2025

Background:
Clinical deterioration occurs due to changes in vital signs, which can be identified early to prevent negative outcomes. We used the NEWS2 system to assess the potential for early clinical deterioration in adult inpatient units at a public university hospital in southeastern Brazil.

Materials and Methods:
This was an exploratory study conducted at a public hospital in southeastern Brazil, following the guidelines of the Reporting of Strengthening Observational Studies in Epidemiology (STROBE) initiative. Data was collected from January to April 2021, involving 251 inpatients. A questionnaire was used to gather sociodemographic and clinical data, and the Brazilian version of NEWS2 was used to assess the risk of clinical deterioration. Data analysis included descriptive analyses, linear correlation tests, and comparative tests.

Results:
The average NEWS2 score was 2.9 points among 251 patients, indicating a moderate level of care complexity and recommending assessment by a registered nurse every 4–6 hours. There was no significant correlation between age and NEWS2 score, but the NEWS2 score was significantly higher for men.

Conclusions:
This study highlights the necessity of using robust assessment tools to evaluate the risk of early clinical deterioration, enabling clinicians to manage patient conditions effectively.
Perceived Sexual Health Needs of Older Women: A Systematic Review
Authors: Saadatmand Farzaneh , Beigi Marjan , Heidari Zahra , Savabi-Esfahani Mitra 
Published: January 2025

Background:
Maintaining and promoting sexual health in older women requires paying attention to and meeting their sexual health-related needs. This study aimed to determine older women’s perceived sexual health needs through a systematic review.

Materials and Methods:
In this systematic review, studies conducted from the beginning of 2000 to August 28, 2022, were searched in Databases, Scopus, Web of Science, SID, Pub Med, and Google Scholar as a research engine. To access all English articles, keywords such as sexual health, sexual performance, sexual intercourse, sexual, need, demand, and women and their possible combinations were used using “AND” and “OR” operators. This research was implemented based on the criteria of the PRISMA checklist. The articles were evaluated using the STROBE and COREQ checklists. The thematic synthesis method was used to synthesize the data.

Results:
The sexual health needs of older women were categorized into four groups: restoration of violated sexual rights, elimination of age discrimination (ageism), promotion of sexual health literacy, and providing sexual health services.

Conclusions:
The sexual needs of older women have been neglected due to prevailing social structures of many countries, stigma, gender discrimination, and lack of sexual health literacy. In addition to the need for social and emotional support to adapt to the conditions of old age, these women need to achieve sexual rights, improve sexual health literacy, and receive health services.
Psychotherapies for treating dissociative and conversion disorder
Authors: Kumari Dolly , Chaudhury Suprakash , Ranjan Rupesh , Priyamvada Richa 
Published: January 2025

ABSTRACT
Dissociative and conversion disorder is characterized by severe physical and sensory symptoms that are unexplained by neurological or medical reasons. However, symptoms do not have a medical explanation but these are very real and not feigning the symptoms. It produces severe detrimental effects on patients’ daily functioning and social and occupational life like other mental illnesses. Severe distress and traumatic life circumstances are identified as the main causes of this illness, which are converted into symptoms in individuals. Patients showed ignorance of his symptoms even though these were severe and distressful which was called La-belle indifference. However, it was not shown by many patients, so it was removed from the diagnostic criteria of this illness. Dissociative conversion disorder is associated with many other mental health conditions like anxiety disorder and depression. Cognitive behavior therapy and psychoanalysis therapy are helpful in the treatment of this disorder.