bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographical disparities and determinants of infant mortality in Ethiopia: mapping and spatial analysis using EDHS data
Authors: Kefale Berhanu Awoke , Woya Ashenafi Abate , Tekile Abay Kassa , Bantie Getasew Mulat , Wubetu Gizachew Yismaw 
Published: May 2023

Abstract
Background
Infant mortality remains a public health challenge in Ethiopia. Exploring infant mortality will aid in tracking the progress toward achieving sustainable development goals.

Objective
The study aimed to explore the geographical variations and associated factors of infant mortality in Ethiopia.

Method
A total of 11,023 infants from the 2016 Ethiopian Demographic and Health Survey (EDHS) data were extracted and included in the analysis. EDHS used a two-stage cluster sampling design with a census enumeration area as the primary sampling unit and households as the secondary sampling unit. Arc GIS software was used for spatial analysis using clusters for exploring geographical variations in infant mortality. A binary logistic regression was employed using R software to identify the significant determinants of infant mortality.

Results
The study revealed that the spatial distribution of infant mortality was non-random in the country. Infants whose mothers not receiving ANC (AOR = 1.45; 95%CI: 1.17, 1.79), not breastfed status (AOR = 3.94; 95%CI: 3.19, 4.81), poor wealth index (AOR = 1.36; 95%CI: 1.04, 1.77), male infants (AOR = 1.59; 95%CI: 1.29, 1.95), birth order of six or above (AOR = 3.11; 95%CI: 2.08, 4.62), small birth size (AOR = 1.27; 95%CI: 1.26, 1.60), birth spacing [(≤ 24 months (AOR = 2.29; 95%CI: 1.79, 2.92), 25–36 months (AOR = 1.16; 95%CI: 1.12, 1.49)], multiple births (AOR = 6.82; 95%CI: 4.76, 10.81), rural residence (AOR = 1.63; 95%CI: 1.05, 2.77) and regions [Afar (AOR = 1.54; 95%CI: 1.01, 2.36), Harari (AOR = 1.56; 95%CI: 1.04, 2.56), and Somali (AOR = 1.52; 95%CI: 1.03, 2.39)] were the determinants of infant death in Ethiopia.

Conclusions
There is a great geographical disparity in infant mortality rates across regions. Afar, Harari, and Somali regions were verified as hot spot areas. ANC usage, breastfed status, wealth index, sex of the infant, birth order, birth size, birth spacing, birth type, residence, and region were the determinants of infant death in Ethiopia. Therefore, appropriate interventions need to be implemented in the hot spots to alleviate the risk factors for infant mortality.
Short-term environmental nitrogen dioxide exposure and neurology clinic visits for headaches, a time-series study in Wuhan, China
Authors: Xu Haoyue , Xu Min , JC Zheng , Ye Fei , Liu Xiaozhou , Liu Yumin , Jin Xiaoqing 
Published: May 2023

Abstract
Background
Previous studies showed the adverse impacts of air pollution on headache attacks in developed countries. However, evidence is limited to the impact of exposure to air pollutants on headache attacks. In this study, we aimed to explore the impact of nitrogen dioxide (NO2) exposure on neurology clinic visits (NCVs) for headache onsets.

Methods
Records of NCVs for headaches, concentrations of ambient NO2, and meteorological variables were collected in Wuhan, China, from January 1st, 2017, to November 30th, 2019. A time-series study was conducted to investigate the short-term effects of NO2 exposure on daily NCVs for headaches. Stratified analyses were also computed according to season, age, and sex, and the exposure–response (E-R) curve was then plotted.

Results
A total of 11,436 records of NCVs for headaches were enrolled in our study during the period. A 10-μg/m3 increase of ambient NO2 corresponded to a 3.64% elevation of daily NCVs for headaches (95%CI: 1.02%, 6.32%, P = 0.006). Moreover, females aged less than 50 years of age were more susceptible compared to males (4.10% vs. 2.97%, P = 0.007). The short-term effects of NO2 exposure on daily NCVs for headaches were stronger in cool seasons than in warm seasons (6.31% vs. 0.79%, P = 0.0009).

Conclusion
Our findings highlight that short-term exposure to ambient NO2 positively correlated with NCVs for headaches in Wuhan, China, and the adverse effects varied by season, age, and sex.
Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up
Authors: Mikkonen Jani , Luomajoki Hannu , Airaksinen Olavi , Goubert Liesbet , Leinonen Ville 
Published: May 2023

Abstract
Background
Chronic low back pain (CLBP) is a leading cause of disability globally. Exercise therapies are one of the commonly prescribed treatment options for CLBP. The specific exercise therapies for CLBP most commonly target movement dysfunction, but seldom brain-based pain modulation. Exercise therapies with specific breathing techniques (SBTs) have been shown to influence and enhance brain-based structural and functional pain modulation.

Aims and objectives
To assess the feasibility of the SBTs protocol, eligibility criteria, randomization, and dropout rates. To quantify the changes in patient outcome measures and choose the most relevant measure for larger-scale study. To quantify self-adherence levels to home exercise and monitor and record possible pain medication and other treatment modality usage, and adverse events during exercise.

Design
A parallel randomised analyst-blinded feasibility trial with two-month follow-up.

Outcome measures
Feasibility related to aims and objectives. Multiple pain- and health-related patient-reported outcome measures of pain intensity, disability, central sensitization, anxiety, kinesiophobia, catastrophising, self-efficacy, sleep quality, quality of life, and health and well-being status. Exercise adherence, pain medication and other treatment modality usage, and possible adverse events related to exercises will be monitored and recorded.

Methods
Thirty participants will be randomized to movement control exercise with SBTs (15 subjects in experimental group) or movement control exercise without SBTs (15 subjects in control group) in private chiropractic practice setting with two-month follow-up. Trial registration number; NCT05268822.

Discussion
The clinical difference in effectiveness between practically identical exercise programs in uniform study settings with or without SBTs has not been studied before. This study aims to inform feasibility and help determine whether progression to a full-scale trial is worthwhile.
Retinal microvascular changes in diabetic patients with diabetic nephropathy
Authors: Yan Yujie , Yu Liping , Sun Chuan , Zhao Haipeng , Zhang Hongsong , Wang Zhijun 
Published: May 2023

Abstract
Background
To explore the characteristics of retina microvascular changes in patients with diabetic nephropathy (DN) and its risk factors.

Methods
Retrospective, observational study. 145 patients with type 2 diabetic mellitus (DM) and DN were included in the study. Demographic and clinical parameters were obtained from medical records. Presence of diabetic retinopathy (DR), hard exudates (HEs) and diabetic macular edema (DME) were evaluated according to the color fundus images, optical coherence tomography (OCT) and fluorescence angiography (FFA).

Results
DR accounted for 61.4% in type 2 DM patients with DN, of which proliferative diabetic retinopathy (PDR) accounted for 23.6% and sight threatening DR accounted for 35.7%. DR group had significantly higher levels of low-density lipoprotein cholesterol (LDL-C) (p = 0.004), HbA1c (P = 0.037), Urine albumin creatine ratio (ACR) (p < 0.001) and lower level of estimated glomerular filtration rate (eGFR) (P = 0.013). Logistic regression analysis showed DR was significantly associated with ACR stage (p = 0.011). Subjects with ACR stage3 had higher incidence of DR compared with subjects with ACR stage1 (OR = 24.15, 95%CI: 2.06–282.95). 138 eyes of 138 patients were analyzed for HEs and DME, of which 23.2% had HEs in posterior pole and 9.4% had DME. Visual acuity was worse in HEs group than in non-HEs group. There was significant difference in the LDL-C cholesterol level, total cholesterol (CHOL) level and ACR between HEs group and non-HEs group.

Conclusions
A relatively higher prevalence of DR was found in type 2 DM patients with DN. ACR stage could be recognized as a risk factor for DR in DN patients. Patients with DN needs ophthalmic examination more timely and more frequently.
Nurses’ and nursing students’ reasons for entering the profession: content analysis of open-ended questions
Authors: McKenna Lisa , Mambu Ian Ruddy , Sommers Christine L. , Reisenhofer Sonia , McCaughan Julie 
Published: May 2023

Abstract
Background
Global nursing shortages require effective recruitment strategies and understanding of individuals’ motivations to enter the profession. These can be complex and bound by numerous factors such as gender and culture. While much research around this has been conducted, little has been undertaken in non-Western cultures where motivations could be different.

Aim
To explore Indonesian nurses’ and nursing students’ motivations for entering the nursing profession.

Design
Online survey with closed and open-ended questions drawn from two different studies. This paper reports findings from one similar open-ended question.

Methods
As part of two larger surveys, nurses from 13 hospitals across one private health care group and nursing students with clinical experienced enrolled in a baccalaureate nursing program in Indonesia were asked the question, Why do you want to be a nurse? Responses were translated into English and back-translated into Indonesian prior to being subjected to summative content analysis.

Results
In total, 1351 nurses and 400 students provided responses to the question, representing 98.72% and 99.70% respectively of those completing the survey. Both groups were primarily influenced by desire to serve others and God, personal calling and influence of family members and others. Nurses identified a desire to work in the health field and with the sick, in a noble and caring profession.

Conclusions
Nurses and nursing students were motivated by traditional perspectives on nursing. These should be considered in future recruitment activities. However, more research is needed to understand how these factors influence career choice.
Development and psychometric properties of a friendly dietary function assessment scale for home-dwelling people with dementia
Authors: Liu Mei-Yin , Hsiao Hua-Tsen , Chen Yi-Ju , Wang Chi-Jane , Wang Jing-Jy 
Published: May 2023

Abstract
Background
Mealtime difficulties related to cognitive functioning negatively impact a patient’s life during the various stages of dementia, and they typically cause a burden and stress on family caregivers. Most people with dementia live at home alone or are cared for by informal caregivers, typically their spouses or other family members. However, no suitable screening tools for home-dwelling patients with dementia have been developed, nor have measurements focused on executive and self-eating functions. This study aimed to develop and evaluate the psychometric properties of the Dietary Function Assessment Scale (DFAS) for community-dwelling persons with dementia.

Methods
A mixed-method design was used to develop the instrument. Methods included a comprehensive literature review to identify the item pool and an expert panel to assess the initial item pool. We performed convenience sampling of 190 home-dwelling people with dementia for psychometrical evaluation. The psychometric properties tests included item and factor analyses, criterion-related validity testing, internal consistency reliability testing, and defining the optimal cut-off values. The study was conducted from 2018 to 2019.

Results
Items were generated based on an extensive literature review and pre-existing scales related to mealtime and executive functions in persons with dementia. The S-CVI/Ave of the DFAS was 0.89. A Principal Component factor analysis demonstrated seven items, with a two-factor structure accounting for 56.94% of the total variance. The two extracted factors were Self-eating ability and Dietary executive function. The confirmatory factor analysis indicated a good model fit. The criterion-related validity was adequate (r = -0.528, p < 0.01). The reliability of Cronbach’s alpha internal consistency was 0.74, and McDonald’s Omega coefficient was 0.80; the optimal cut-off value of 13 points with an AUC of 0.74 was established to determine poor dietary functioning in persons with dementia.

Conclusion
The DFAS was simple, user-friendly, and a valid and reliable instrument to assess dietary functioning in community-dwelling persons with dementia. This short scale can be helpful for caretakers, who can use it to identify the dietary needs of home-dwelling persons with dementia and improve their care and eating experience.
Prioritising Cochrane reviews to be updated with health equity focus
Authors: Tomlinson Eve , Pardo Pardo Jordi , Sivesind Torunn , Szeto Mindy D , Laughter Melissa , Foxlee Ruth , Brown Michael , Skoetz Nicole , Dellavalle Robert P , VA Franco Juan , Clarke Mike , Krentel Alison , Reveiz Ludovic , Saran Ashrita , Tse Frances , A Wells George , Boyle Robert , Hilgart Jennifer , Ndi Euphrasia Ebai-Atuh , Welch Vivian , Petkovic Jennifer , Tugwell Peter 
Published: May 2023

AbstractBackgroundThe prioritisation of updating published systematic reviews of interventions is vital to prevent research waste and ensure relevance to stakeholders. The consideration of health equity in reviews is also important to ensure interventions will not exacerbate the existing inequities of the disadvantaged if universally implemented. This study aimed to pilot a priority setting exercise based on systematic reviews of interventions published in the Cochrane Library, to identify and prioritise reviews to be updated with a focus on health equity.MethodsWe conducted a priority setting exercise with a group of 13 international stakeholders. We identified Cochrane reviews of interventions that showed a reduction in mortality, had at least one Summary of Findings table and that focused on one of 42 conditions with a high global burden of disease from the 2019 WHO Global Burden of Disease report. This included 21 conditions used as indicators of success of the United Nations Universal Health Coverage in attaining the Sustainable Development Goals. Stakeholders prioritised reviews that were relevant to disadvantaged populations, or to characteristics of potential disadvantage within the general population.ResultsAfter searching for Cochrane reviews of interventions within 42 conditions, we identified 359 reviews that assessed mortality and included at least one Summary of Findings table. These pertained to 29 of the 42 conditions; 13 priority conditions had no reviews with the outcome mortality. Reducing the list to only reviews showing a clinically important reduction in mortality left 33 reviews. Stakeholders ranked these reviews in order of priority to be updated with a focus on health equity.ConclusionsThis project developed and implemented a methodology to set priorities for updating systematic reviews spanning multiple health topics with a health equity focus. It prioritised reviews that reduce overall mortality, are relevant to disadvantaged populations, and focus on conditions with a high global burden of disease. This approach to the prioritisation of systematic reviews of interventions that reduce mortality provides a template that can be extended to reducing morbidity, and the combination of mortality and morbidity as represented in Disability-Adjusted Life Years and Quality-Adjusted Life Years.
Modelling count, bounded and skewed continuous outcomes in physical activity research: beyond linear regression models
Authors: Akram Muhammad , Cerin Ester , Lamb Karen E. , White Simon R. 
Published: May 2023

AbstractBackgroundInference using standard linear regression models (LMs) relies on assumptions that are rarely satisfied in practice. Substantial departures, if not addressed, have serious impacts on any inference and conclusions; potentially rendering them invalid and misleading. Count, bounded and skewed outcomes, common in physical activity research, can substantially violate LM assumptions. A common approach to handle these is to transform the outcome and apply a LM. However, a transformation may not suffice.MethodsIn this paper, we introduce the generalized linear model (GLM), a generalization of the LM, as an approach for the appropriate modelling of count and non-normally distributed (i.e., bounded and skewed) outcomes. Using data from a study of physical activity among older adults, we demonstrate appropriate methods to analyse count, bounded and skewed outcomes.ResultsWe show how fitting an LM when inappropriate, especially for the type of outcomes commonly encountered in physical activity research, substantially impacts the analysis, inference, and conclusions compared to a GLM.ConclusionsGLMs which more appropriately model non-normally distributed response variables should be considered as more suitable approaches for managing count, bounded and skewed outcomes rather than simply relying on transformations. We recommend that physical activity researchers add the GLM to their statistical toolboxes and become aware of situations when GLMs are a better method than traditional approaches for modeling count, bounded and skewed outcomes.
Pangenomic genotyping with the marker array
Authors: Mun Taher , Vaddadi Naga Sai Kavya , Langmead Ben 
Published: May 2023

AbstractWe present a new method and software tool called that applies a pangenome index to the problem of inferring genotypes from short-read sequencing data. The method uses a novel indexing structure called the marker array. Using the marker array, we can genotype variants with respect from large panels like the 1000 Genomes Project while reducing the reference bias that results when aligning to a single linear reference. can infer accurate genotypes in less time and memory compared to existing graph-based methods. The method is implemented in the open source software tool available at https://github.com/alshai/rowbowt.
A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain
Authors: Li Shao-Jun , Zhang Shu-Li , Feng Dan 
Published: May 2023

Abstract
Background
Lumbar facet joint pain is a common disorder. The main symptom is chronic lumbar pain, which can reduce quality of life. Radiofrequency has often been used to treat lumbar facet joint pain. However, the effectiveness of this technique has been controversial. This study was conducted to compare the effectiveness of pulsed radiofrequency (PRF) and radiofrequency denervation (RD) for lumbar facet joint pain.

Methods
One hundred and forty-two patients with lumbar facet joint pain were allocated to two treatment groups: PRF group (N = 72) and RD group (N = 70). Patients enrolled in the study were assessed using a visual analogue scale (VAS), Roland-Morris questionnaire (RMQ), Oswestry disability index (ODI) and Short-Form 36 (SF-36) questionnaire before therapy, 3 months and 12 months later.

Results
There were no significant differences in VAS, RMQ score, ODI score and SF-36 score at 3 months (p > 0.05). Significant differences in pain control were observed in both groups at 12 months (3.09 ± 1.72 vs. 2.37 ± 1.22, p = 0.006). There was a significant difference in RMQ score (11.58 ± 3.58 vs. 8.17 ± 2.34, p < 0.001) and ODI score (43.65 ± 11.01 vs. 35.42 ± 11.32, p < 0.001) at 12 months. The total SF-36 score was higher in the RD group than in the PRF group at 12 months (58.45 ± 6.97 vs. 69.36 ± 6.43, p < 0.001). In terms of complications, skin numbness occurred in three patients. Mild pain such as burning and pinking at the puncture site in two patients. One patient experienced a decrease in back muscle strength and back muscle fatigue. These complications disappeared in 3 weeks without any treatment. There were no serious adverse events in the PRF group.

Conclusion
Radiofrequency is an effective and safe treatment option for patients with lumbar facet joint pain. RD could provide good and lasting pain relief, with significant improvement in lumbar function and quality of life at long-term follow-up.
E3 ubiquitin ligase RNF180 prevents excessive PCDH10 methylation to suppress the proliferation and metastasis of gastric cancer cells by promoting ubiquitination of DNMT1
Authors: Zhang Nannan , Gao Xiaoliang , Yuan Qiangqiang , Fu Xin , Wang Pengliang , Cai Fenglin , Liu Hui , Zhang Jing , Liang Han , Nie Yongzhan , Deng Jingyu 
Published: May 2023

Abstract
Background
Downregulation of certain tumor-suppressor genes (TSGs) by aberrant methylation of CpG islands in the promoter region contributes a great deal to the oncogenesis and progression of several cancers, including gastric cancer (GC). Protocadherin 10 (PCDH10) is a newly identified TSG in various cancers and is downregulated in GC; however, the specific mechanisms of PCDH10 in GC remain elusive. Here, we elucidated a novel epigenetic regulatory signaling pathway involving the E3 ubiquitin ligase RNF180 and DNA methyltransferase 1 (DNMT1), responsible for modulating PCDH10 expression by affecting its promoter methylation.

Results
We revealed that PCDH10 was downregulated in GC cells and tissues, and low PCDH10 expression was correlated with lymph node metastasis and poor prognosis in patients with GC. Additionally, PCDH10 overexpression suppressed GC cell proliferation and metastasis. Mechanistically, DNMT1-mediated promoter hypermethylation resulted in decreased expression of PCDH10 in GC tissues and cells. Further analysis revealed that RNF180 can bind directly to DNMT1 and was involved in DNMT1 degradation via ubiquitination. Additionally, a positive correlation was found between RNF180 and PCDH10 expression and an inverse association between DNMT1 and PCDH10 expression showed considerable prognostic significance.

Conclusion
Our data showed that RNF180 overexpression upregulated PCDH10 expression via ubiquitin-dependent degradation of DNMT1, thus suppressing GC cell proliferation, indicating that the RNF180/DNMT1/PCDH10 axis could be a potential therapeutic target for GC treatment.
Effects of the free healthcare policy on maternal and child health in Burkina Faso: a nationwide evaluation using interrupted time-series analysis
Authors: Ilboudo Patrick Gueswendé , Siri Alain 
Published: May 2023

Abstract
Background
Burkina Faso has recently instituted a free healthcare policy for women and children under five. This comprehensive study examined the effects of this policy on the use of services, health outcomes, and removal of costs.

Methods
Interrupted time-series regressions were used to investigate the effects of the policy on the use of health services and health outcomes. In addition, an analysis of household expenditures was conducted to assess the effects of spending on delivery, care for children, and other exempted (antenatal, postnatal, etc.) services on household expenditures.

Results
The findings show that the user fee removal policy significantly increased the use of healthcare facilities for child consultations and reduced mortality from severe malaria in children under the age of five years. It also has increased the use of health facilities for assisted deliveries, complicated deliveries, and second antenatal visits, and reduced cesarean deliveries and intrahospital infant mortality, although not significantly. While the policy has failed to remove all costs, it decreased household costs to some extent. In addition, the effects of the user fee removal policy seemed higher in districts with non-compromised security for most of the studied indicators.

Conclusions
Given the positive effects, the findings of this investigation support the pursuit of implementing the free healthcare policy for maternal and child care.