bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of everyday life during lenient COVID-19 restrictions in Sweden- an interview study
Authors: Lindgren Ingrid , Trulsson Schouenborg Anna , Larsson Caroline , Stigmar Kjerstin 
Published: September 2023

Abstract
Background
Both COVID-19 and its associated societal restrictions have affected individuals’ health and everyday life. In Sweden, more lenient public health restrictions were implemented, with individuals asked to act responsibly in terms of reducing spread of disease. The majority of studies reporting on experiences of Covid-19 restrictions have been in the context of more substantial mandatory rules aimed at reducing social contact, therefore it is important to describe how more lenient restrictions have impacted individuals’ well-being. This study aims to describe perceptions of everyday life during the first wave of the COVID-19 pandemic, perceived by individuals with no underlying medical condition, and living with more lenient public health restrictions in Sweden.

Method
The participants were recruited from individuals who originally had participated in an online survey about life satisfaction, health, and physical activity. Fifteen individuals (median age 49, range 26–76 years, seven women) in various social situations, such as living alone/cohabiting, having children at home, geographical area and size of city were interviewed. Qualitative content analysis was applied to the data.

Results
An overall theme “Both hindrances and opportunities in important life domains were experienced within the same person during lenient Covid-19 restrictions” was derived and covered three categories: “New possibilities of flexibility in work and better health”, “Life went on as usual with minor adjustments” and “Everyday life changed and became more difficult” together with eight subcategories. For most participants, both facilitating and hindering important domains in life were described. Unexpected findings were positive experiences regarding working from home, physical activities, leisure time activities and the balance between work and leisure time. In areas where only minor adjustments were made, life was perceived as going on as before. On the other hand, restrictions increased worries and were perceived to have negative effects on social participation.

Conclusion
The impact of the pandemic and lenient restrictions in Sweden on the participants´ everyday life was multifaceted. Both hindrances and opportunities in important life domains were experienced within the same person. An increased flexibility in work- and leisure activities were perceived having positive effects for health and wellbeing and led to a better balance in life.
A cross-sectional study: family communication, anxiety, and depression in adolescents: the mediating role of family violence and problematic internet use
Authors: Huang Xin-cheng , Zhang Yue-ning , Wu Xiao-yu , Jiang Yang , Cai Hao , Deng Yu-qian , Luo Yuan , Zhao Li-ping , Liu Qin-ling , Luo Sheng-yue , Wang Yan-yan , Zhao Li , Jiang Mao-min , Wu Yi-bo 
Published: September 2023

Abstract
Objective
The objective of this study is to explore the relationship between family communication, family violence, problematic internet use, anxiety, and depression and validate their potential mediating role.

Methods
The study population consisted of Chinese adolescents aged 12 to 18 years, and a cross-sectional survey was conducted in 2022. Structural equation models were constructed using AMOS 25.0 software to examine the factors that influence adolescent anxiety and depression and the mediating effects of problematic internet use and family violence.

Results
The results indicate that family communication was significantly and negatively related to family violence (β = -.494, p < 0.001), problematic internet use (β = -.056, p < .05), depression (β = -.076, p < .01), and anxiety (β = -.071, p < .05). And the finds also indicate that family violence mediated the relationships between family communication and depression (β = -.143, CI: -.198 -.080), and between family communication and anxiety (β = -.141; CI: -.198 -.074). Chain indirect effects between family communication and depression (β = -.051; CI: -.081 -.030) or anxiety (β = -.046; CI: -.080 -.043) via family violence and then through problematic internet use were also found in the present study.

Conclusions
In conclusion, positive family communication is crucial in reducing anxiety and depression in adolescents. Moreover, problematic internet use and family violence mediate the effects of positive family communication on anxiety and depression. Therefore, improving family communication and promoting interventions aimed at reducing family violence and problematic internet use can help reduce anxiety and depression in adolescents, thus promoting their healthy development.
Cultural interventions addressing disparities in the HIV prevention and treatment cascade among Black/African Americans: a scoping review
Authors: Vitsupakorn Shawin , Pierce Nia , Ritchwood Tiarney D. 
Published: September 2023

AbstractCulture is an important determinant of HIV risk and protective behaviors; yet, we know little about how it is integrated in HIV interventions. This scoping review characterizes the integration of culture in HIV prevention and treatment interventions focused on Black/African Americans. We searched MEDLINE, PsycINFO, CINAHL, and Google Scholar for peer-reviewed manuscripts published between July 1, 2011, and June 28, 2021. Twenty-five interventions were identified, with 96% focused on prevention. Most (40%) targeted men who have sex with men or transgender women. Only three were grounded in cultural theory. Although all interventions were labeled “culturally based,” only two explicitly defined culture. Moreover, there was much diversity regarding the ways in which interventions integrated cultural elements, with some conflating race/ethnicity with culture. To improve uptake and HIV-related outcomes, interventions integrating culture are greatly needed. Additionally, HIV interventions purporting to be “culturally based” must include basic information to support rigor and reproducibility.
Efficacy and safety of HIMABERB® Berberine on glycemic control in patients with prediabetes: double-blind, placebo-controlled, and randomized pilot trial
Authors: Panigrahi Antarmayee , Mohanty Susant 
Published: September 2023

Abstract
Background
Prediabetes and diabetes involve alterations in glucose homeostasis, including increased fasting blood glucose and impaired glucose tolerance. Berberine has been identified as a potential regulator of glucose homeostasis with implications on the management of type 2 diabetes mellitus (DM). Given a paucity of data on berberine in prediabetes, evaluation of its effect in individuals with prediabetes may prove clinically valuable.

Objective
The present pilot study aimed to investigate the effect of daily oral berberine on markers of glycemic control and insulin resistance among individuals with prediabetes.

Methods
A randomized, double-blinded, placebo-controlled trial was conducted for 12 weeks among 34 individuals with prediabetes as defined by the American Diabetes Association (fasting plasma glucose (FPG) between 5.6 and 6.9 mmol/L, glycosylated hemoglobin (HbA1c) between 5.7% and 6.4%, or 2-hour 75-gram oral glucose tolerance test (2 h-OGTT) between 7.8 and 11.1 mmol/L). HIMABERB® 500 mg was given three times daily to the treatment group, and placebo was administered three times daily to the control group. Glycemic control markers and physical parameters were evaluated for both groups on days 0, 28, 56, and 84. The glycemic control markers assessed included FPG, fasting insulin (FI), 2 h-OGTT, HbA1c, and homeostatic model assessment-insulin resistance (HOMA-IR). The observed outcomes were analyzed using independent t-test statistics to determine the significance of differences over time after treatment initiation and between treatment and control groups.

Results
Significant decreases in all markers of glycemic control were observed in the treatment group at intermediate time points and the endpoint of the study compared to baseline levels and to the control group. For the treatment group, FPG decreased from 6.75 ± 0.23 mmol/L to 5.33 ± 0.28 mmol/L, FI from 9.81 ± 0.36 to 7.88 ± 0.52 mmol/L, 2 h-OGTT from 10.44 ± 0.52 to 8.12 ± 0.40 mmol/L, HbA1c from 6.40% ± 0.20–5.43% ± 0.21%, and HOMA-IR from 3.61 ± 0.31 to 2.41 ± 0.14. The decreases in glycemic control markers compared to the control group were clinically and statistically significant (p<10− 5). No severe adverse effects, kidney or liver toxicity were detected.

Conclusion
After 12 weeks, berberine (HIMABERB®) intervention in individuals with prediabetes significantly reduced glycemic control markers, with mean FPG and 2 h-OTGG being reduced to below prediabetic thresholds, supporting the investigation of the use of HIMABERB® for delaying progression to diabetes mellitus.

Trial registration
http://ctri.nic.in(CTRI/2021/12/038751) (20/12/2021).
What are the chances? Clinician scientist` career pathways in Germany
Authors: Hendriks Barbara , Reinhart Martin 
Published: September 2023

Abstract
Background
Germany faces a lack of clinician scientists. This problem is widely acknowledged, not just in Germany, as clinician scientists are crucial for medical translation and innovation: trained in medical practice and research they are capable of translating scientific problems into clinical application and vice versa, clinical problems into research. The implementation of nationwide clinician scientist programs (CSPs) in Germany is supposed to solve the lack of trained clinician scientists and, as consequence, to improve the translational relationship between biomedical research and clinical practice. Against the backdrop of an increasing number of CSPs, our study provides early insights into their effectiveness with a focus on what it means to become a clinician scientist and to establish a subsequent career path as a clinician scientist in Germany.

Methods
During a research project that was conducted from 2020 to 2023 and funded by the German Federal Ministry of Education and Research, we studied thirteen CSPs. We developed a qualitative questionnaire and interviewed 36 clinician scientists in training, their program supervisors, as well as policy stakeholders. The goal of the interviews was to identify the key obstacles in establishing a career path for clinician scientists in Germany.

Results
We found three types of challenges for establishing and ensuring long term career paths for clinician scientists: First, local working conditions need to allow for clinician scientists to create and perform tasks that combine research, teaching, patient care and translation synergistically. Protection from the urgency of patient care and from metrics-based performance measures both in the clinic and in research seem key here. Second, a stable career path requires new target positions besides clinic management and senior residency. Third, there is a need for cultural change within university medicine that recognizes and rewards new translation-focused practices.

Conclusion
We find that CSPs improve working conditions for the duration of the program and provide protected time for doing research. After the programs, however, the career paths remain unstable, mainly due to a lack of target positions for clinician scientists. CSPs support the initial development of the clinician scientist’ role, but not in a sustainable way, because the separation of research and patient care is stabilized on an institutional and systemic level. The tasks clinician scientists perform in research remain separate from patient care and teaching, thus, limiting their translational potential. In order to remain a clinician scientist within this differentiated system of university medicine, clinician scientists have to do a significant amount of extra work.
Factors protecting Swiss nurses’ health during the COVID-19 pandemic: a longitudinal study
Authors: Jubin Jonathan , Delmas Philippe , Gilles Ingrid , Oulevey Bachmann Annie , Ortoleva Bucher Claudia 
Published: September 2023

Abstract
Background
The COVID-19 pandemic reached Europe in early 2020 and impacted nurses over a prolonged period, notably causing heavy work overloads. Exposure to sources of stress in such situations is inevitable, which can put nurses’ health at risk. The present study took a salutogenic approach to investigating nurses’ health and the principal factors protecting it found in the literature (i.e., resilience, post-traumatic growth, social support, and certain organizational factors), as well as how those elements evolved from February 2021 to September 2022.

Methods
All nurses working at eight French-speaking Swiss hospitals who accepted to disseminate the study to their employees were invited to complete an online questionnaire at four time points (February 2021, September 2021, March 2022, and September 2022: T0, T1, T2, and T3, respectively) and respond to items measuring their health, factors protecting their health, and their perceived stress levels. Data were analyzed using random-intercept linear regression models.

Results
A cumulated total of 1013 responses were collected over all measurement points (625 responses at T0; 153 at T1; 146 at T2; 89 at T3). Results revealed that nurses’ health had not changed significantly between measurements. However, their perceived stress levels, feelings of being supported by their management hierarchies, and belief that they had the means to deliver a high quality of work all diminished. At every measurement point, nurses’ health was negatively associated with perceived stress and positively associated with resilience, perceived social support, and the belief that they were provided with the means to deliver a high quality of work.

Conclusion
Despite the difficult conditions caused by the pandemic, the factors recognized as protective of nurses’ health played their role. The lack of improvements in nurses’ health in periods when the pandemic’s effects lessened suggests that the pressure they were experiencing did not drop during these moments. This phenomenon may have been due to the need to clear backlogs in scheduled surgery and the work overloads caused by prolonged staff absences and nurses quitting the profession. Monitoring changes in nurses’ health is thus crucial, as is establishing measures that promote factors protective of their health. Organizational factors influencing nurses’ working conditions are also key and should not be neglected.
Protocol: identifying policy, system, and environment change interventions to enhance availability of blood for transfusion in Kenya, a mixed-methods study
Authors: Munoz-Valencia Alejandro , Aridi Jackline O. , Barnes Linda S. , Rudd Kristina E. , Bidanda Bopaya , Epuu Tonny , Kamu Robert , Kivuli Tecla , Macleod Jana , Makanga Cindy M. , Makin Jennifer , Mate Muthoni , Muiru Carolyne Njoki , Murithi Gatwiri , Musa Abdirahaman , Nyagol Hellen , Ochieng Kevin , Rajgopal Jayant , Raykar Nakul P. , Tian Yiqi , Yazer Mark H. , Zeng Bo , Olayo Bernard , Kumar Pratap , Puyana Juan Carlos 
Published: September 2023

Abstract
Background
Safe blood is essential for the care of patients with life-threatening anemia and hemorrhage. Low blood donation rates, inefficient testing procedures, and other supply chain disruptions in blood administration affect patients in low-resource settings across Sub-Saharan countries, including Kenya. Most efforts to improve access to transfusion have been unidimensional, usually focusing on only point along the blood system continuum, and have excluded community stakeholders from early stages of intervention development. Context-appropriate interventions to improve the availability of safe blood at the point of use in low-resource settings are of paramount importance. Thus, this protocol proposes a multifaceted approach to characterize the Kenyan blood supply chain through quantitative and qualitative analyses as well as an industrial engineering approach.

Methods
This study will use a mixed-methods approach in addition to engineering process mapping, modeling and simulation of blood availability in Kenya. It will be guided by a multidimensional three-by-three-by-three matrix: three socioeconomic settings, three components of the blood system continuum, and three levels of urgency of blood transfusion. Qualitative data collection includes one-on-one interviews and focus group discussions with stakeholders across the continuum to characterize ground-level deficits and potential policy, systems, and environment (PSE) interventions. Prospectively-collected quantitative data will be used to estimate blood collection and transfusion of blood. We will create a process map of the blood system continuum to model the response to PSE changes proposed by stakeholders. Lastly, we will identify those PSE changes that may have the greatest impact on blood transfusion availability, accounting for differences across socioeconomic settings and levels of urgency.

Discussion
Identifying and prioritizing community-driven interventions to improve blood supply in low-resource settings are of utmost importance. Varied constraints in blood collection, processing, delivery, and use make each socioeconomic setting unique. Using a multifaceted approach to understand the Kenyan blood supply and model the response to stakeholder-proposed PSE changes may lead to identification of contextually appropriate intervention targets to meet the transfusion needs of the population.
A case report of spontaneous pectoral hematoma in a male with background antiplatelet therapy after severe COVID-19 infection
Authors: Tang Hao , Yan Yan 
Published: September 2023

Abstract
Background
Spontaneous muscle hematoma is a rare complication in hospitalized patients with COVID-19. We present a case of spontaneous pectoral hematoma occurring after COVID-19 infection and anticoagulation therapy.

Case presentation
A 69-year-old male presented to the hospital with a two-week history of shortness of breath and a one-week history of high fever. Despite testing positive for COVID-19, the patient’s symptoms did not improve with two doses of ritonavir-boosted nirmatrelvir (Paxlovid). A chest CT scan revealed pulmonary infection and SpO2 tested between 80% and 85% at rest in local hospital. The patient transferred to our intensive care unit, then received multiple treatments, including high flow nasal oxygen (HFNO), antibiotics, methylprednisolone, IL-6 receptor antagonist monoclonal antibody (tocilizumab), and an increased D-Dimer level leaded to intermediate dose of anticoagulation therapy. However, on the 10th day of hospitalization, the patient developed a hematoma in the left pectoralis major muscle. This was accompanied by hemorrhagic shock, necessitating the administration of norepinephrine, fluid resuscitation, and a blood transfusion. Arterial embolization was performed to manage the bleeding, resulting in stabilization of the patient’s condition. Following discharge, the patient experienced an uneventful recovery over a period of six months.

Conclusions
Severe COVID-19 patients undergoing routine therapeutic anticoagulation may experience fatal bleeding complications. The ideal dosage of anticoagulants for these patients remains uncertain, especially in the patient with a background of anticoagulation or dual antiplatelet therapy. We present a case of spontaneous muscle hematoma accompanied by hemorrhagic shock. The notable reduction in hemoglobin levels indicated significant bleeding, which was confirmed through contrast angiography and cured by arterial embolization. This case underscores the importance of additional research to determine the appropriate utilization of therapeutic anticoagulation in severe COVID-19 patients already undergoing antithrombotic therapy.
First report of bovine viral diarrhea virus subgenotypes 1d and 1e in southern Chile
Authors: Hugues Florence , Cabezas Ignacio , Garigliany Mutien , Rivas Felipe , Casanova Tomás , González Eddy E. , Sánchez Oliberto , Castillo Raúl , Parra Natalie C. , Inostroza-Michael Oscar , Moreno Lucila , Hernández Cristián E. , Toledo Jorge R. 
Published: September 2023

AbstractBovine viral diarrhea virus (BVDV) affects cattle worldwide causing severe productive and economic loss. In this study, we investigated the subgenotypes of BVDV circulating in cattle samples from the Aysén region, an active cattle breeding area located in southern Chile. Partial amplification of the 5' untranslated region (UTR) was performed by polymerase chain reaction (PCR), and twelve samples were analyzed by Sanger sequencing and phylogenetic analysis. Eight samples were identified as belonging to Pestivirus bovis subgenotype 1e, three to 1-b, and one to 1-d. The phylogenetic analyses performed revealed a marked distance between these now-identified strains and those previously reported in the country. These findings support the need to continually expand the analysis of the variability of the viral phylogeny for the currently circulating BVDV strains and to update the vaccines recommended for this livestock area and surrounding areas.
Anatomical landmarks for ankle block
Authors: Nimana K. V. H. , Senevirathne A. M. D. S. R. U. , Pirannavan R. , Fernando M. P. S. , Liyanage U. A. , Salvin K. A. , Malalasekera A. P. , Mathangasinghe Y. , Anthony D. J. 
Published: September 2023

AbstractWe aimed to describe anatomical landmarks to accurately locate the five nerves that are infiltrated to accomplish anaesthesia of the foot in an ankle block. Twenty-four formaldehyde-fixed cadaveric ankles were studied. Photographs of cross sections of the frozen legs, cut at a horizontal plane across the most prominent points of the medial and lateral malleoli, were analysed. The curvilinear distance from the most prominent point of the closest malleolus to each of the five cutaneous nerves and their depth from the skin surface were measured. Sural, tibial, deep peroneal, saphenous and medial dorsal cutaneous nerves were located 5.2 ± 1.3, 9.2 ± 2.4, 7.4 ± 1.9, 2.8 ± 1.1, 2.1 ± 0.6 mm deep to the skin surface. The curvilinear distances from the medial malleolus to the tibial, deep peroneal and saphenous nerves were 32.5 ± 8.9, 62.8 ± 11.1 and 24.4 ± 7.9 mm, respectively. The curvilinear distances from the lateral malleolus to the sural and medial dorsal cutaneous branches of superficial peroneal nerves were 27.9 ± 6.3 and 52.7 ± 7.3 mm, respectively. The deep peroneal nerve was found between the tendons of the extensor hallucis longus and the extensor digitorum longus in the majority of specimens, while the medial dorsal cutaneous nerve was almost exclusively found on the extensor digitorum longus tendon. The sural and tibial nerves were located around halfway between the most prominent point of the relevant malleolus and the posterior border of the Achilles tendon. In conclusion, this study describes easily identifiable, palpable bony and soft tissue landmarks that could be used to locate the nerves around the ankle.