bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a risk score for predicting inconsistent condom use with women among men who have sex with men and women
Authors: Chen Lin , Jiang Tingting , Wang Hui , Hong Hang , Ge Rui , Tang Huiling , Wang Shanling , Xu Ke , Chai Chengliang , Ma Qiaoqin , Jiang Jianmin 
Published: April 2023

Abstract
Background
Men who have sex with men and women (MSMW) are the most important bridge population for HIV transmission. Condom use plays an important role for HIV infection. However the predictors for condom ues with females are not well characterized.

Methods
This was a cross-sectional study. Participants were enrolled by four community-based organizations (CBOs) by offline (bathrooms, bars), and online (gay applications, chat room) from April to December 2019. Electronic questionnare was fulfilled after a face-to-face training led by CBOs. We identified predictors of inconsistent condom use with females by creating a risk score based on regression coefficients. We externally validated this score via an independent cross-sectional survey conducted in Zhejiang Province in 2021. A total of 917, 615 MSMW were included in analysis in 2019 and 2021, seperately.

Results
Among 917 MSMW, 73.2% reported heterosexual behavior in the prior 6 months and 38.3% reported inconsistent condom use with females (ICUF) over that time. Compared with heterosexual/unsure MSMW, bisexual MSMW reported more male and female sex partners, higher proportion of inconsistent condom use with males, less commercial sex with males (p < 0.05). Four risky predictors of ICUF were identified: Duration of local residence ≦6 months; more than one male partner in the prior 6 months; inconsistent condom use with males in the prior 6 months; and never heard post-exposure prophylaxis (PEP). The proportions of respondents indicating ICUF in the low- (0), medium- (2–4) and high-risk (6–20) groups (according to our risk scoring system) were 11.7% (14/120), 26.9% (96/357), and 78.1% (125/160), respectively (Ptrend < 0.001). In the validation survey, the respective proportions of those reporting ICUF were 13.4% (15/112), 17.8% (24/185) and 87.3% (96/110) (Ptrend < 0.001).

Conclusions
We developed and validated a predictive risk score for ICUF among MSMW; four factors were identified, of which inconsistent condom use with men was the most important. Risk reduction intervention programs should focus on MSM who report inconsistent condom use with males, never heard PEP, having multiple partners and living in local less than 6 months.
Smokers’ strategies to reduce tobacco spending: self-reported use and differences across subgroups. Findings from the International Tobacco Control (ITC) Netherlands Survey
Authors: Geboers Cloé , Candel Math J. J. M. , Nagelhout Gera E. , de Vries Hein , van den Putte Bas , Fong Geoffrey T. , Willemsen Marc C. 
Published: April 2023

AbstractBackgroundThe cost of tobacco is one of the most reported reasons for smoking cessation. Rather than quitting, smokers can use also strategies to reduce tobacco expenditure while continuing smoking, such as smoking less or using price-minimising strategies. The Netherlands announced to increase the price of a pack cigarettes from seven (2018) to ten euros (2023), to reduce tobacco prevalence and consumption. This study explores the self-reported strategies to reduce tobacco spending among Dutch smokers, and whether this differed per age, income, and education. Additionally, we analysed among quitters in these subgroups whether price played a role in their decision to quit.MethodsCross-sectional survey data from the International Tobacco Control (ITC) Netherlands Wave 2 (September–November 2020,N = 1915) was used. Strategies to reduce spending among smokers (N = 1790) were: reducing consumption, bulk buying, switching to cheaper products or buying from low-taxed sources. These were collapsed into: reducing consumption (solely or in combination with other behaviours), solely price-minimising behaviours (such as buying cheaper brands), or no strategies to reduce spending. Associations between strategies and characteristics were analysed through multinomial and binary logistic regression models. Second, we explored which subgroups were more likely to report that price played a role in their decision to quit among quitters (N = 125).ResultsThe majority of smokers used strategies to reduce tobacco spending: 35.6% reduced consumption and 19.3% used solely price-minimising strategies. 82.1% of quitters reported that price played a role in their decision to quit. Low-income individuals were more likely to report price as a reason for quitting and reduce consumption, but also to buy cheaper products. Highly nicotine dependent smokers were more likely to use price-minimising behaviours, and less likely to reduce consumption.ConclusionsThe majority reported using strategies to reduce spending or that price played a role in their decision to quit. Reducing consumption was the most reported strategy. Low-income smokers were more likely to reportedly reduce consumption, buy cheaper products, or quit. Price policies have the potential to reduce socioeconomic inequalities in smoking. To discourage price-minimising behaviours, such as switching to cheaper products, reducing price differences between products should be prioritized.
Evaluation of surgical outcomes and prognostic factors of second primary lung cancer based on a systematic review and meta-analysis
Authors: Zhao Jie , Shen Zhenghai , Huang Yunchao , Zhao Guangqiang , Wang Wei , Yang Yantao , Zhou Chen , Ye Lianhua 
Published: April 2023

Abstract
Background
Although surgery has been widely applied for SPLC therapy, there is still no uniform treatment approach. Whether SPLC and primary lung cancer have similar prognostic characteristics remains controversial. Herein, based on a systematic review and meta-analysis, we aimed to enucleate the influences of diverse surgical strategies and underlying prognostic factors on the prognosis of patients with both the first primary lung cancer and SPLC underwent surgical resection.

Methods
A comprehensive and systematic literature search was implemented in three databases (MEDLINE, EMBASE, and Cochrane), and eligible studies were screened following inclusion and exclusion criteria. Meanwhile, we extracted the hazard ratios (HR) together with 95% confidence intervals (CI) for each prognostic factor, either directly or indirectly, from the enrolled literature.

Results
Eleven studies (published between 2000 and 2022) were included in this study, including 1,131 SPLC patients. The overall survival (OS) exhibited no difference between patients with lobectomy and sublobar resection after SPLC (HR: 0.87, 95%CI: 0.62–1.21, P = 0.41). The patients after completion pneumonectomy had a poor prognosis (HR: 1.85, 95% CI: 1.34–2.55, P < 0.01). Poor prognostic factors after SPLC surgery included synchronous SPLC (HR: 3.38, 95%CI: 1.53–7.46, P < 0.01), tumor diameter > 2 cm (HR: 2.44, 95%CI: 1.73–3.44, P < 0.01), solid predominant in CT morphology (HR: 3.08, 95% CI: 1.14–8.33, P = 0.03), lymph node metastasis (HR: 2.79, 95%CI: 1.40–5.56), and smoking (HR: 2.37, 95%CI: 1.08–26.82, P < 0.01). Tumor disease-free interval (DFI), tumor histological type, and gender had no impact on the prognosis of patients received SPLC surgery.

Conclusions
Patients with SPLC, especially those with poor cardiopulmonary function reserve, should be prioritized for sublobar resection for treatment. These patients should also try to avoid completion pneumonectomy. Patients with synchronous SPLC, tumor diameter > 2 cm, solid predominant in CT morphology, lymph node metastasis, and smoking had a poor prognosis. Meanwhile, SPLC has similar prognostic characteristics with single primary lung cancer. However, the study has some limitations and more evidence is warranted to verify the findings.
Quality of life in patients with primary hyperparathyroidism before and after parathyroidectomy: long term single center experience
Authors: Ionova T. I. , Buzanakov D. M. , Chernikov R. A. , Efremov S. M. , Gladkova I. N. , Nikitina T. P. , Sleptsov I. V. , Zolotoukho A. V. , Bubnov K. A. , Skvortsov V. V. , Vinogradova A. A. , Rusakov V. F. 
Published: April 2023

Abstract
Background
Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by a parathyroid tumor or hyperplasia, which is often accompanied with quality of life (QoL) impairment. A parathyroidectomy (PTX) is the preferred standard treatment for PHPT patients. In this single center study we aimed to evaluate the impact of PHPT on patient’s QoL and identify QoL changes at early and long-term follow-up after surgery.

Methods
All the patients underwent routine PTX with the removal of the suspected hyperparathyroid gland(s). Patients filled out generic QoL questionnaire RAND SF-36, specific questionnaire PHPQoL and specific symptom assessment questionnaire PAS upon admission to the hospital before surgery, at 3 months, 12 months and 24 months after surgery.

Results
A total of 92 patients with PHPT (median age was 56 years, 95.7% females) were included in the study. Before PTX patient’s QoL by SF-36 scores was significantly lower as compared to healthy controls (p < 0.01). Almost 40% of patients had poor or very poor QoL. The most frequent symptoms by PAS before surgery were as follows: tiredness (97.8% of patients), weakness (94.6%), forgetfulness (94.6%), mood changes (90%), feeling “blue”/depression (88%), joint pains (83.3%), headaches (80.2%), constant irritability (77.2%), bone pains (75%), thirst (70.7%) and trouble getting out of a chair (67.4%). The half of the patients had moderate-to-severe (≥ 40 scores) tiredness, weakness, joint pains, forgetfulness, as well as mood changes. Post-operative QoL changes were analysed in the group of 72 patients. After surgery there was significant improvement in QoL by all scales of SF-36 questionnaire, excluding bodily pain, and the PHPQoL total score (GEE, p < 0.01) as compared with their values before surgery. Also severity of tiredness, mood changes, weakness and forgetfulness significantly decreased after surgery as compared to their baseline values (GEE, p < 0.05). Decreased mental component of QoL by PHPQoL (OR = 0.927, 95%CI = 0.874–0.984, p = 0.013) predicted improved QoL after surgery.

Conclusions
Patients with PHPT demonstrated significantly impaired QoL in physical, psychological and social functioning as well experienced a wide profile of common PHPT symptoms. Successful PTX was accompanied with remarkable QoL improvement and decrease in subjective symptoms for at least 24 months after surgery.
How do former medical and nursing undergraduates describe their learning on an interprofessional training Ward 12–18 months later? – A retrospective qualitative analysis
Authors: Mink Johanna , Zurek Bianka , Götsch Burkhard , Mihaljevic André L. , Mitzkat Anika , Trierweiler-Hauke Birgit , Mahler Cornelia 
Published: April 2023

Abstract
Background
Interprofessional training wards (IPTWs) seem to deliver good results in terms of development of interprofessional competencies. However, evidence of long-term effects of these training wards on learners’ competency development is lacking and little is known about retrospective evaluation of IPTWs. Therefore, this study aimed to explore the retrospective evaluation of competency development and interprofessional collaboration of former undergraduates 12 or more months after a placement on an IPTW.

Methods
Eight follow-up interviews were conducted with four nursing and four medical professionals 12–18 months after they had finished a placement on an ITPW throughout their vocational training. Interviews were translated verbatim and analysed deductively and inductively based on qualitative content analysis.

Results
The qualitative content analyses deductively identified two main categories regarding the research question, namely the uniqueness of the programme and interprofessional competencies developed by the Interprofessional Education Collaborative. Sub categories were identified inductively, representing the perceived competency development and the learning opportunities on the IPTW as compared to other clinical placements throughout vocational training and in transition to practice. Interviewees seemed to have developed competencies that are important for interprofessional collaboration such as communication, roles and responsibilities, as well as competencies in patient care and management. Considered beneficial for learning were the opportunity to work self-responsibly and the interprofessional collaboration on the IPTW, both of which were neither possible in almost any other placement nor in transition to practice.

Conclusion
Findings show that IPTWs can be sufficient in competency development and role clarification and are perceived positively by learners, but structures in clinical practice can impede sustaining competency development and efficient interprofessional collaboration.
Students engagement using polls in virtual sessions of physiology, pathology, and pharmacology at King Saud bin Abdulaziz University for Health Sciences during COVID-19 pandemic: a cross-sectional study
Authors: Bawazeer Mona Abubakr , Aamir Saima , Othman Fatmah , Alkahtani Reem 
Published: April 2023

Abstract
Background
Active involvement of students in class using technology is associated with effective learning and understanding. This work intended to analyze the impact of interactive teaching on medical students’ engagement, learning, performance, understanding and attendance in virtual classes of physiology, pathology, and pharmacology during COVID-19 pandemic.

Methods
A descriptive cross-sectional study was carried out at college of medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh during January-April 2022. Third- and fourth-year medical students filled a self-reported questionnaire that assessed students’ engagement, understanding, performance, and attendance during the sessions of three courses within the curriculum. The Chi-square test or Fisher’s exact test was used to compare the difference between the survey responses.

Results
A total of 184/234 questionnaires were completed and returned, with an overall response rate of 78.6%. Fifty-five percent of the participants were involved at least more than 5 times in polls during the class. Majority (86.9%), of the students agreed on enjoying participation in polls during the class, and 88.9% recommended the utilization of the polls again. Participation in polls improved understanding and performance of 88%, and 63% of students respectively. In addition, 38% were neutral regarding attendance improvement and spending more time for the class. Around 53% students agreed that polls improved their grades.

Conclusion
In conclusion, this study showed that there is an impact of using interactive polls in virtual classes in medical students at KSAU-HS. It is recommended to continue using polls in all subjects in on-site sessions. This will be a great preface step toward switching the traditional teaching to the interactive teaching using flipped classroom strategy in the future.
The fudan tinnitus relieving system application for tinnitus management
Authors: Tang Dongmei , Wang Haiyan , Gu Dantong , Ye Lei , Sun Shan , Li Huawei 
Published: April 2023

Abstract
Objective
Tinnitus is a highly prevalent hearing disorder, and the burden of tinnitus diagnosis and treatment is very heavy, especially in China. In order to better benefit the majority of tinnitus patients, we developed a new mobile app based on our patented invention – named the Fudan Tinnitus Relieving System (FTRS) – for tinnitus management. The FTRS app aims to alleviate patients’ tinnitus symptoms using customized sound therapy, to evaluate the treatment effect, to provide a doctor-patient communication platform, and to support tinnitus rehabilitation and auditory health.

Methods
In this study, we introduced the major functions of the FTRS app, analyzed the geographical distribution of users around China, and performed an analysis on the demographic and clinical characteristics of patients with tinnitus, including age and tinnitus position, duration, frequency, and severity in both men and women based on the user information collected by the FTRS. The data for 22,867 participants (males: 13,715; females: 9,152) were included in the statistical analysis.

Results
The FTRS app has been popular with tinnitus patients since its launch in May 2018 with its integrated pitch-matching test, individualized sound therapy, follow-up assessment, and provision of easy-to-understand science and education for tinnitus. The users were located throughout Mainland China but primarily concentrated in Shanghai, Jiangsu, Zhejiang, Guangdong, and Shandong provinces. We observed gender differences regarding age and tinnitus frequency, severity, and position among the app’s users. The FTRS has not only facilitated patients’ access to treatment at times and places that are convenient for them, but also provides a large amount of data based on user feedback in order to support clinical tinnitus research.

Conclusions
Compared with traditional face-to-face medical treatment, the FTRS greatly reduced medical costs and enabled patients with tinnitus to arrange their own treatment times. At the same time, the FTRS has provided standardized tinnitus data that have laid a foundation for clinical research on tinnitus. However, because of differences in the popularity and utilization of smart devices, FTRS user data might only reflect the situation of tinnitus patients who can effectively use smart devices. Therefore, the findings of this study need to be interpreted with caution.
Cost of exome analysis in patients with intellectual disability: a micro-costing study in a French setting
Authors: Soilly AL , Robert-Viard C , Besse C , Bruel AL , Gerard B , Boland A , Piton A , Duffourd Y , Muller J , Poë C , Jouan T , El Doueiri S , Faivre L , Bacq-Daian D , Isidor B , Genevieve D , Odent S , Philip N , Doco-Fenzy M , Lacombe D , Asensio ML , Deleuze JF , Binquet C ,   DISSEQ Investigators Group, Arpin S , Blanchet P , Blesson S , Boute-Benejean O , Busa T , Colin E , Coubes C , Devillard F , Edery P , El Chehadeh S , Fradin M , Goldenberg A , Guerrot A-M , Herenger Y , Houcinat N , Jean-Marcais N , Jouk P. S. , Lambert L , Lavillaureix A , Legendre M , Leheup B , Manouvrier S , Mercier S , Moutton S , Nizon M , Pasquier L , Petit F , Pinson L , Poirsier C , Pons L , Putoux A , Quelin C , Renaud M , Rossi M , Sorlin A , Spodenkiewicz M , Thevenon J , Toutain A , Van-Gils J , Vanlerberghe C , Verloes A , Vincent M , Vincent-Delorme C , Willems M , Ziegler A , Thauvin-Robinet C , Lejeune C 
Published: April 2023

Abstract
Background
With the development of next generation sequencing technologies in France, exome sequencing (ES) has recently emerged as an opportunity to improve the diagnosis rate of patients presenting an intellectual disability (ID). To help French policy makers determine an adequate tariff for ES, we aimed to assess the unit cost per ES diagnostic test for ID from the preparation of the pre-analytical step until the report writing step and to identify its main cost drivers.

Methods
A micro-costing bottom-up approach was conducted for the year 2018 in a French setting as part of the DISSEQ study, a cost-effectiveness study funded by the Ministry of Health and performed in collaboration with the GAD (Génétique des Anomalies du Développement), a genetic team from the Dijon University Hospital, and a public sequencing platform, the Centre National de Recherche en Génomique Humaine (CNRGH). The analysis was conducted from the point of view of these two ES stakeholders. All of the resources (labor, equipment, disposables and reagents, reusable material) required to analyze blood samples were identified, collected and valued. Several sensitivity analyses were performed.

Results
The unit nominal cost per ES diagnostic test for ID was estimated to be €2,019.39. Labor represented 50.7% of the total cost. The analytical step (from the preparation of libraries to the analysis of sequences) represented 88% of the total cost. Sensitivity analyses suggested that a simultaneous price decrease of 20% for the capture kit and 50% for the sequencing support kit led to an estimation of €1,769 per ES diagnostic test for ID.

Conclusion
This is the first estimation of ES cost to be done in the French setting of ID diagnosis. The estimation is especially influenced by the price of equipment kits, but more generally by the organization of the centers involved in the different steps of the analysis and the time period in which the study was conducted. This information can now be used to define an adequate tariff and assess the efficiency of ES.

Trial registration
ClinicalTrials.gov identifier NCT03287206 on September 19, 2017.
Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study
Authors: Fernandes Quinhas , Augusto Orvalho , Machai Helena , Pfeiffer James , Carone Marco , Pinto Norton , Carimo Naziat , Ramiro Isaías , Gloyd Stephen , Sherr Kenneth 
Published: April 2023

Abstract
Introduction
Overall, resilient health systems build upon sufficient, qualified, well-distributed, and motivated health workers; however, this precious resource is limited in numbers to meet people’s demands, particularly in LMICs. Understanding the subnational distribution of health workers from different lens is critical to ensure quality healthcare and improving health outcomes.

Methods
Using data from Health Personnel Information System, facility-level Service Availability and Readiness Assessment, and other sources, we performed a district-level longitudinal analysis to assess health workforce density and the ratio of male to female health workers between January 2016 and June 2020 across all districts in Mozambique.

Results
22 011 health workers were sampled, of whom 10 405 (47.3%) were male. The average age was 35 years (SD: 9.4). Physicians (1025, 4.7%), maternal and child health nurses (4808, 21.8%), and nurses (6402, 29.1%) represented about 55% of the sample. In January 2016, the average district-level workforce density was 75.8 per 100 000 population (95% CI 65.9, 87.1), and was increasing at an annual rate of 8.0% (95% CI 6.00, 9.00) through January 2018. The annual growth rate declined to 3.0% (95% CI 2.00, 4.00) after January 2018. Two provinces, Maputo City and Maputo Province, with 268.3 (95% CI 186.10, 387.00) and 104.6 (95% CI 84.20, 130.00) health workers per 100 000 population, respectively, had the highest workforce density at baseline (2016). There were 3122 community health workers (CHW), of whom 72.8% were male, in January 2016. The average number of CHWs per 10 000 population was 1.33 (95% CI 1.11, 1.59) in 2016 and increased by 18% annually between January 2016 and January 2018. This trend reduced to 11% (95% CI 0.00, 13.00) after January 2018. The sex ratio was twice as high for all provinces in the central and northern regions relative to Maputo Province. Maputo City (OR: 0.34; 95% CI 0.32, 0.34) and Maputo Province (OR: 0.56; 95% CI 0.49, 0.65) reported the lowest sex ratio at the baseline. Encouragingly, important sex ratio improvements were observed after January 2018, particularly in the northern and central regions.

Conclusion
Mozambique made substantial progress in health workers’ availability during the study period; however, with a critical slowdown after 2018. Despite the progress, meaningful shortages and distribution disparities persist.