bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perseverance, partnerships and passion: ingredients for successful local government policy to promote healthy and sustainable diets
Authors: Barbour Liza R. , Woods Julie L. , Brimblecombe Julie K. 
Published: September 2023

Abstract
Background
Local government authorities are well-placed to invest in evidence-based food policies that promote a population-wide shift to healthy and sustainable diets. This study describes the contextual factors that facilitated or impeded policy-making related to healthy and sustainable diets within a ‘best-performing’ local government in Victoria, Australia.

Methods
Guided by the Consolidated Framework for Implementation Research (CFIR), data from semi-structured interviews with individuals involved in developing the City of Greater Bendigo’s Food System Strategy were analysed using the seven-stage Framework Method.

Results
Semi-structured interviews (n = 24) were conducted with City of Greater Bendigo employees (n = 15) and key stakeholders working for local organisations (n = 6) or at a state or national level (n = 3). Interviewees mostly held positions of leadership (n = 20) and represented diverse areas of focus from health (n = 7), food systems (n = 4) and planning and public policy (n = 3). Data analysis revealed 12 cross-cutting themes; eight facilitating factors and four impeding factors. Facilitating factors included perseverance, community engagement, supportive state policy, effective leadership, a global platform and networks, partnerships, workforce capacity and passion, and the use of scientific evidence. Impeding factors included access to secure, ongoing financial resources, prohibitive state and federal policy, COVID-related disruptions to community engagement and competing stakeholder interests. Overall, this study suggests that the City of Greater Bendigo’s success in developing an evidence-based local food system policy is built upon (i) a holistic worldview that embraces systems-thinking and credible frameworks, (ii) a sustained commitment and investment throughout the inner-setting over time, and (iii) the ability to establish and nurture meaningful partnerships with community groups, neighbouring local government areas and state-level stakeholders, built upon values of reciprocity and respect.

Conclusions
Despite insufficient resourcing and prohibitive policy at higher levels of government, this ‘best performing’ local government in Victoria, Australia developed an evidence-based food system policy by employing highly skilled and passionate employees, embracing a holistic worldview towards planetary health and harnessing global networks. Local government authorities aspiring to develop integrated food policy should nurture a workforce culture of taking bold evidence-informed policy action, invest in mechanisms to enable long-standing partnerships with community stakeholders and be prepared to endure a ‘slow-burn’ approach.
Community focus groups about a COVID-19 individual risk assessment tool: access, understanding and usefulness
Authors: Keval Aliyah , Titi Mohammad , Saleh Hadi Omar , Young Staci , Gomez Julia Dickson , Atanasov Vladimir , Black Bernard , Meurer John 
Published: September 2023

AbstractTo make informed COVID-19 related decisions, individuals need information about their personal risks and how those risks may vary with specific demographic and health characteristics. The Fight COVID Milwaukee web-based risk assessment tool allows for assessment of COVID-19 mortality risk as a function of personal and neighborhood characteristics. The purpose of this study is to explore public understanding of this risk assessment tool and risk perception through community focus groups. Individuals were recruited from the general adult population in Milwaukee County, Wisconsin, USA, to participate in nine online focus groups where the risk assessment tool was presented for feedback. Three main themes were identified in the focus groups regarding the web-based risk assessment tool: some challenges in accessibility, variable ease of understanding, and personal usefulness but uncertain value for others. This paper explores how members of the community interpret individual risk assessments and life expectancy estimations, and how these vary with age, gender, race/ethnicity, socioeconomic status, and pre-existing comorbidities.
Automated Item Generation: impact of item variants on performance and standard setting
Authors: Westacott R. , Badger K. , Kluth D. , Gurnell M. , Reed M. W. R. , Sam A. H. 
Published: September 2023

AbstractBackgroundAutomated Item Generation (AIG) uses computer software to create multiple items from a single question model. There is currently a lack of data looking at whether item variants to a single question result in differences in student performance or human-derived standard setting. The purpose of this study was to use 50 Multiple Choice Questions (MCQs) as models to create four distinct tests which would be standard set and given to final year UK medical students, and then to compare the performance and standard setting data for each.MethodsPre-existing questions from the UK Medical Schools Council (MSC) Assessment Alliance item bank, created using traditional item writing techniques, were used to generate four ‘isomorphic’ 50-item MCQ tests using AIG software. Isomorphic questions use the same question template with minor alterations to test the same learning outcome. All UK medical schools were invited to deliver one of the four papers as an online formative assessment for their final year students. Each test was standard set using a modified Angoff method. Thematic analysis was conducted for item variants with high and low levels of variance in facility (for student performance) and average scores (for standard setting).ResultsTwo thousand two hundred eighteen students from 12 UK medical schools participated, with each school using one of the four papers. The average facility of the four papers ranged from 0.55–0.61, and the cut score ranged from 0.58–0.61. Twenty item models had a facility difference > 0.15 and 10 item models had a difference in standard setting of > 0.1. Variation in parameters that could alter clinical reasoning strategies had the greatest impact on item facility.ConclusionsItem facility varied to a greater extent than the standard set. This difference may relate to variants causing greater disruption of clinical reasoning strategies in novice learners compared to experts, but is confounded by the possibility that the performance differences may be explained at school level and therefore warrants further study.
Strategies to improve hidden curriculum in nursing and medical education: a scoping review
Authors: Hosseini Amin , Ghasemi Elham , Nasrabadi Alireza Nikbakht , Sayadi Leila 
Published: September 2023

Abstract
Background
The importance of hidden curriculum cannot be neglected in education. Despite much research in the field, there have been limited studies on HC improvement in nursing and medical education. This scoping review aimed to determine the scope of strategies to improve HC in nursing and medical education.

Method
PubMed, EBSCO/Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Web of Science, Proquest and Persian-language databases of Magiran and SID were searched in January 2023 without a time filter. According to the PRISMA flow diagram, two independent reviewers selected the records that fit the inclusion and exclusion criteria via title and abstract screening. Next, the reviewers studied the full texts of the related articles. The data extracted from the selected articles were tabulated and ultimately synthesized.

Findings
Out of the eight examined studies, published from 2017 to 2022, only one was in the field of nursing and seven were in medicine. The central strategies were implementing new curricula to replace the previous ones, utilizing team-based clinical clerkship, proposing a HC improvement model, implementation a case-based faculty development workshop, implementation longitudinal and comprehensive educational courses, and incorporating an educational activity into a small group program.

Conclusion
Students and faculty members familiarization on the topic of HC, implementing new curricula, utilizing team-based clerkship, and using comprehensive models were among the HC improvement strategies. Focusing on upgrading the learning environment, particularly the clinical settings, can also be helpful in HC improvement.
Reasons for resistance to change in nursing: an integrative review
Authors: Cheraghi Rozita , Ebrahimi Hossein , Kheibar Nasrin , Sahebihagh Mohammad Hasan 
Published: September 2023

Abstract
Background
Change is a very complex and multifaceted phenomenon that is intertwined with the understanding of nursing practice, so, resistance to change in nursing can be considered as an important challenge. Knowing the reasons for this resistance can help in solving it in nursing. Therefore, the present study was conducted with the aim of investigating the reasons for resistance to change in nursing as an integrated review.

Methods
This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, CINAHL, and Scopus were searched using the keywords; “Resistance”, “Change”, “Nursing”, “Resistance to Change” and their Persian equivalents in the time range of 2000 to January 2023. After applying inclusion criteria and assessing the articles using Bowling’s Quality Assessment Tool, finally, 15 papers were included from 2964.

Results
After reviewing and critically appraisal of the qualified articles, the findings were placed in three main categories including; (1) individual factors, (2) interpersonal factors, and (3) organizational factors and six subcategories.

Conclusion
Undoubtedly, change is an integral component in nursing care, and resistance to it is the result of a set of individual, interpersonal and organizational factors that change managers should pay special attention to in order to make changes due to the reasons of this resistance, and the development process of developing changes in the clinical field is easily possible.
Malaria epidemiological characteristics and control in Guangzhou, China, 1950–2022
Authors: Chen Yuehua , Zhang Hao , Chen Haiyan , Fan Lirui , Xu Conghui , Xu Jianmin , Chen Shouyi , Chen Kuncai , Wei Yuehong 
Published: September 2023

Abstract
Background
Malaria was once widespread in Guangzhou, China. However, a series of control measures have succeeded in eliminating local malaria infections. Based on the analysis of the characteristics of malaria epidemics in Guangzhou, China, from 1950 to 2022, the changes and effectiveness of malaria control strategies and surveillance management in Guangzhou from 1950 to 2022 are described.

Methods
Data on malaria prevention and treatment in Guangzhou from 1950 to 2022 were collected, and descriptive epidemiological methods were used to analyse the prevalence of malaria, preventive and control measures taken, and the effectiveness of prevention and treatment in different periods. Data on malaria cases were obtained from the Guangzhou Centre for Disease Control and Prevention (CDC) and the China Communicable Disease Reporting System.

Results
The development of the malaria control system in Guangzhou has gone through four periods: 1. High malaria prevalence (1950–1979), 2. Intensive prevention and control stage (1980–2000), 3. Consolidating gains in malaria control (2001–2008), and 4. Preventing reestablishment of transmission (2009–2022). During Period 1, only medical institutions at all levels and the local CDCs, the Guangzhou CDC participated in the malaria prevention and control system, establishing a three-tier health system on malaria prevention and control. During Period 2, other types of organizations, including the agricultural sector, schools and village committees, the construction department and street committee, are involved in the malaria control system. During Period 3, more and more organizations are joining forces to prevent and control malaria. A well-established multisectoral malaria control mechanism and an improved post-elimination surveillance management system are in place. Between 1950 and 2022, a total of 420,670 cases of malaria were reported. During Period 1, there was an epidemic of malaria in the early 1950s, with an annual incidence rate of more than 10,000/100,000, including a high rate of 2887.98/100,000 in 1954. In Period 2 malaria was gradually brought under control, with the average annual malaria incidence rate dropping to 3.14/100,000. During Period 3, the incidence rate was kept below 1/100,000, and by 2009 local malaria infections were eliminated.

Conclusion
For decades, Guangzhou has adopted different malaria control strategies and measures at different epidemic stages. Increased collaboration among civil organizations in Guangzhou in malaria control has led to a significant decline in the number of malaria cases and the elimination of indigenous malaria infections by 2009.The experience of Guangzhou can guide the development of malaria control strategies in other cities experiencing similar malaria epidemics.
Training non-specialists in teaching recovery techniques (TRT) to help traumatised children in humanitarian settings: a qualitative analysis of experiences gained from 20 years of practice
Authors: Heltne Unni Marie , Sarkadi Anna , Lien Lars , Dybdahl Ragnhild 
Published: September 2023

Abstract
Background
Although several manuals and guidelines have been developed to enhance the quality of task-sharing interventions, it remains challenging to train non-professional personnel in mental health and psychosocial support. Practitioners must translate general recommendations into practical applications to make them relevant in demanding contexts. However, limited research exists on practical experiences with standardised programmes in the field.

Aim
To explore how experiences gained from the training of first-line health providers in a low-threshold intervention for children with trauma symptoms may guide implementation of such interventions in local communities in low-income countries. Method: We summarise 20 years of experience in the training of first-line health providers, teachers, and school counsellors in providing a low-threshold intervention. The intervention is called teaching recovery techniques (TRT), developed by the Children and War Foundation (CAW). Field notes containing notes from trainings and oral, informal feedback from participants are analysed using thematic analysis, a method well-suited for identifying, analysing, and reporting patterns, or themes, within data in qualitative research.

Findings
The analysis showed three main themes/ challenges: (1) Who can conduct the TRT intervention? (2) What form and content should the training take? (3) How can the intervention be used in a responsible way to follow the ‘do no harm’ principle? We discuss the implications of the findings for trainings in scalable interventions and further research.
Identification of metabolic biomarkers associated with nonalcoholic fatty liver disease
Authors: Jiang Hua , Hu Yang , Zhang Zhibo , Chen Xujia , Gao Jianpeng 
Published: September 2023

Abstract
Background
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease. Metabolism-related genes significantly influence the onset and progression of the disease. Hence, it is necessary to screen metabolism-related biomarkers for the diagnosis and treatment of NAFLD patients.

Methods
GSE48452, GSE63067, and GSE89632 datasets including nonalcoholic steatohepatitis (NASH) and healthy controls (HC) analyzed in this study were retrieved from the Gene Expression Omnibus (GEO) database. First, differentially expressed genes (DEGs) between NASH and HC samples were obtained. Next, metabolism-related DEGs (MR-DEGs) were identified by overlapping DEGs and metabolism-related genes (MRG). Further, a protein–protein interaction (PPI) network was developed to show the interaction among MR-DEGs. Subsequently, the “Least absolute shrinkage and selection operator regression” and “Random Forest” algorithms were used to screen metabolism-related genes (MRGs) in patients with NAFLD. Next, immune cell infiltration and gene set enrichment analyses (GSEA) were performed on these metabolism-related genes. Finally, the expression of metabolism-related gene was determined at the transcription level.

Results
First, 129 DEGs related to NAFLD development were identified among patients with nonalcoholic steatohepatitis (NASH) and healthy control. Next, 18 MR-DEGs were identified using the Venn diagram. Subsequently, four genes, including AMDHD1, FMO1, LPL, and P4HA1, were identified using machine learning algorithms. Moreover, a regulatory network consisting of four genes, 25 microRNAs (miRNAs), and 41 transcription factors (TFs) was constructed. Finally, a significant increase in FMO1 and LPL expression levels and a decrease in AMDHD1 and P4HA1 expression levels were observed in patients in the NASH group compared to the HC group.

Conclusion
Metabolism-related genes associated with NAFLD were identified, containing AMDHD1, FMO1, LPL, and P4HA1, which provide insights into diagnosing and treating patients with NAFLD.
Gallbladder cancer mimicking perihilar cholangiocarcinoma—considerable rate of postoperative reclassification with implications for prognosis
Authors: Nooijen Lynn E. , Gustafsson-Liljefors Maria , Erdmann Joris I. , D’Souza Melroy A. , Gilg Stefan , Villard Christina , Jansson Hannes 
Published: September 2023

Abstract
Background
For some patients undergoing resection under the suspicion of a perihilar cholangiocarcinoma (pCCA), postoperative diagnosis may differ from the preoperative diagnosis. While a postoperative finding of benign bile duct stricture is known to affect 3–15% of patients, less has been described about the consequences of finding other biliary tract cancers postoperatively. This study compared pre- and postoperative diagnoses, risk characteristics, and outcomes after surgery for suspected pCCA.

Methods
Retrospective single-center study, Karolinska University Hospital, Stockholm, Sweden (January 2009–May 2017). The primary postoperative outcome was overall survival. Secondary outcomes were disease-free survival and postoperative complications. Survival analysis was performed by the Kaplan–Meier method.

Results
Seventy-one patients underwent resection for suspected pCCA. pCCA was confirmed in 48 patients (68%). Ten patients had benign lesions (14%), 2 (3%) were diagnosed with other types of cholangiocarcinoma (CCA, distal n = 1, intrahepatic n = 1), while 11 (15%) were diagnosed with gallbladder cancer (GBC). GBC patients were older than patients with pCCA (median age 71 versus 58 years, p = 0.015), with a large proportion of patients with a high tumor extension stage (≥ T3, 91%).
Median overall survival was 20 months (95% CI 15–25 months) for patients with pCCA and 17 months (95% CI 11–23 months) for patients with GBC (p = 0.135). Patients with GBC had significantly shorter median disease-free survival (DFS), 10 months (95% CI 3–17 months) compared 17 months (95% CI 15–19 months) for patients with pCCA (p = 0.010).

Conclusions
At a large tertiary referral center, 15% of patients resected for suspected pCCA were postoperatively diagnosed with GBC. Compared to patients with pCCA, GBC patients were older, with advanced tumors and shorter DFS. The considerable rate of re-classification stresses the need for improved preoperative staging, as these prognostic differences could have implications for treatment strategies.
Double burden of vulnerability for refugees: conceptualization and policy solutions for financial protection in Iran using systems thinking approach
Authors: Shahabi Saeed , Etemadi Manal , Hedayati Maryam , Bagheri Lankarani Kamran , Jakovljevic Mihajlo 
Published: September 2023

AbstractIntroductionIran is host to one of the world’s largest and longest-standing refugee populations. Although Iran has initiated a basic health insurance scheme for refugees throughout the country since September 2015, the population coverage of this scheme is very low, and various factors have caused a significant percentage of refugees to still lack insurance coverage and often face financial hardships when receiving health services. In response, this study aimed to understand barriers to insurance coverage among refugees in Iran and propose effective policies that can address persistent gaps in financial protection.MethodsThis qualitative study was conducted in two phases. First, a review of policy documents and interviews with participants were conducted to investigate the common barriers and facilitators of effective insurance coverage for refugees in Iran. Then, a systems thinking approach was applied to visualize the common variables and interactions on the path to achieving financial protection for refugees.ResultsFindings showed that various factors, such as (1) household-based premium for refugees, (2) considering a waiting time to be eligible for insurance benefits, (3) determining high premiums for non-vulnerable groups and (4) a deep difference between the health services tariffs of the public and private service delivery sectors in Iran, have caused the coverage of health insurance for non-vulnerable refugees to be challenging. Furthermore, some policy solutions were found to improve the health insurance coverage of refugees in Iran. These included removing household size from premium calculations, lowering current premium rates and getting monthly premiums from non-vulnerable refugees.ConclusionsA number of factors have caused health insurance coverage to be inaccessible for refugees, especially non-vulnerable refugees in Iran. Therefore, it is necessary to adopt effective policies to improve the health financing for the refugee with the aim of ensuring financial protection, taking into account the different actors and the interactions between them.
Cost-effectiveness analysis of robot-assisted gait training in patients with bilateral spastic cerebral palsy
Authors: Klobucká Stanislava , Klobucký Robert , Valovičová Katarína , Šiarnik Pavol , Kollár Branislav 
Published: September 2023

Abstract
Background
To date, there have been no published studies evaluating the cost-effectiveness of robot-assisted gait training (RAGT) in adolescent and adult patients with cerebral palsy (CP). The study´s aim was to analyse the cost-effectiveness of RAGT versus conventional kinesiotherapy (CON) from the health care provider’s perspective.

Methods
We expressed the cost-effectiveness of RAGT in the Lokomat® system after analysing the costs and effects of RAGT and conventional therapy through the Incremental Cost-Effectiveness Ratio (ICER) based on a bicentric randomized controlled study, in which we demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP.

Results
According to the calculated ICER ratio for Lokomat®, an additional improvement per unit of effect (1% in GMFM), compared to conventional therapy, results in an average cost increase of EUR70.38 per patient in a therapeutic block consisting of 20 TUs (Therapeutic Units).

Conclusion
However, from the comprehensive analysis of the results and evaluation of the long-term effects, it follows that RAGT applied in adolescent and adult patients with bilateral spastic CP is not only more effective in terms of evaluation of monitored clinical parameters, but in the long term it is also more cost-effective compared to conventional therapy.