bluuebunny/crossref_metadata_2025_split huggingface dataset:
Junior doctors’ wellbeing at peak and post-peak pandemic: a repeated cross-sectional study
Authors: Doulias T , Thrikandiyur AA , Titus N , Soundararasha K , Coxon A , Amarantidis E , Arulampalam T 
Published: May 2023

Introduction The impact of the COVID-19 pandemic on healthcare professionals has been significant. The aim of this study was to explore the mental state and wellbeing of UK junior doctors at different phases of the initial outbreak. Methods This is a cross-sectional study of UK-based junior doctors’ perceptions of threat and support during and after the first wave of the COVID-19 pandemic. Levels of anxiety, depression, post-traumatic stress disorder symptoms and use of coping mechanisms were explored through a Google questionnaire. Results 196 participants were included in this study (93 in period A and 103 in period B). Junior doctors reported feeling increased risk (p=0.001) and increased fear of contracting the virus (p<0.001) during period A. Increased levels of severe anxiety (Generalized Anxiety Disorder-7 score >15) along with increased cases level of depression (Patient Health Questionnaire-9 score >10) were reported for both periods. Junior doctors described suffering more frequently with flashbacks (p=0.006) and nightmares (p=0.024) in comparison with senior colleagues during period A. During period A, 21.4% of participants felt isolated at work (p<0.001), whereas 13% reported being easily annoyed on a daily basis, 11.7% reported very low morale (p<0.001) and 66% were not aware of any psychological support being available. The use of exercise, peer support and mindfulness apps increased during period B (p=0.023). Conclusions Healthcare systems need to urgently establish robust psychological support mechanisms and infrastructure to protect junior doctors and provide institutional resilience against the adverse consequences of the long physical and mental battle with COVID-19.
Patients’ expectation of postoperative course and satisfaction following cardiac surgery
Authors: Mani K , Luttman J , Nowell J , Carrol A , Jahangiri M 
Published: May 2023

IntroductionIn patients undergoing cardiac surgery, preoperative concerns, expectations of the impact of surgery, anticipated recovery timelines, and pre- and postoperative education, which impact recovery and quality-of-life, are not well documented. These factors are important with the increase in virtual consultations, the availability of internet-based information and increased use of minimally invasive surgical procedures.MethodsPatients who underwent cardiac surgery between January 2016 and December 2019 took part in an online survey examining preoperative concerns, information provision, use of digital channels, satisfaction with surgery, impact on health and resumption of daily activity. 80 patients completed the survey.ResultsThere was a high rate of overall post-surgical satisfaction (86%); 71% of respondents reported an improvement in physical health, 45% in mental health and 70% in their quality-of-life. The usefulness of information provided by the National Health Service varies across different stages of the patient experience. Although approximately 90% of respondents found the information provided at each stage at least ‘somewhat’ helpful, the proportion who found the information ‘very’ helpful was lower (68% for pre-procedure; 55% for post-discharge). The majority (79%) said that they felt prepared for their operation. Survey responses highlighted areas of lower understanding, including survival rate, levels of postoperative pain, duration of hospital stay and when the patient could return to normal physical activity.ConclusionsLevels of satisfaction with the outcomes of heart surgery are high, and the majority of patients report positive health outcomes. However, there is room for improvement in patients’ understanding of survival rate and level of pain post-procedure. There is also a clear desire among patients for a more surgical team-based face-to-face consultation.
The role of cognitive rehabilitation in people with type 2 diabetes: A study protocol for a randomized controlled trial
Authors: Cuevas Heather , Stuifbergen Alexa K. , Hilsabeck Robin C. , Sales Adam , Wood Shenell , Kim Jeeyeon 
Published: May 2023

Today, the prevalence of cognitive dysfunction and the prevalence of diabetes are increasing. Research shows that diabetes increases cognitive impairment risk, and cognitive impairment makes diabetes self-management more challenging. Diabetes self-management, essential to good glycemic control, requires patients to assimilate knowledge about their complex disease and to engage in activities such as glucose self-monitoring and the management of their medications. To test a comprehensive cognitive rehabilitation intervention—the Memory, Attention, and Problem-Solving Skills for Persons with Diabetes (MAPSS-DM) program. Our central hypothesis is that participants who take part in the MAPSS-DM intervention will have improved memory and executive function, increased use of compensatory cognitive skills, and improved self-management. We will also explore the role of glucose variability in those changes. This is a randomized controlled trial. Sixty-six participants with cognitive concerns and type 2 diabetes will be assigned to either the full MAPSS-DM intervention or an active control. Participants will use continuous glucose monitoring pre- and post-intervention to identify changes in glycemic variability. All participants will also be evaluated systematically via questionnaires and neuropsychological tests at three timepoints: baseline, immediately post-intervention, and 3 months post-intervention. This study will fill an important gap by addressing cognitive function in the management of diabetes. Diabetes is related to accelerated cognitive aging, cognitive deficits are related to poorer self-management, and improvements in cognitive performance as a result of cognitive rehabilitation can translate into improved performance in everyday life and, potentially, diabetes self-management. The results of the proposed study will therefore potentially inform strategies to support cognitive function and diabetes self-management, as well as offer new mechanistic insights into cognitive function through the use of continuous glucose monitoring.Trial registration: This study has been registered at ClinicalTrials.gov (NCT04831775).
Facing the challenges of PROM implementation in Dutch dialysis care: Patients’ and professionals’ perspectives
Authors: Sipma Wim S. , de Jong Margriet F. C. , Meuleman Yvette , Hemmelder Marc H. , Ahaus Kees (C.) T. B. 
Published: May 2023

Background
Patient Reported Outcome Measures (PROMs) are increasingly used in routine clinical practice to facilitate patients in sharing and discussing health-related topics with their clinician. This study focuses on the implementation experiences of healthcare professionals and patients during the early implementation phase of the newly developed Dutch set of dialysis PROMs and aims to understand the process of early implementation of PROMs from the users’ perspectives.

Methods
This is a qualitative study among healthcare professionals (physicians and nursing staff: n = 13) and patients (n = 14) of which 12 were receiving haemodialysis and 2 peritoneal dialysis. Semi-structured interviews were used to understand the barriers and facilitators that both professionals and patients encounter when starting to implement PROMs.

Results
The early PROM implementation process is influenced by a variety of factors that we divided into barriers and facilitators. We identified four barriers: patient´s indifference to PROMs, scepticism on the benefits of aggregated PROM data, the limited treatment options open to doctors and organizational issues such as mergers, organizational problems and renovations. We also describe four facilitators: professional involvement and patient support, a growing understanding of the use of PROMs during the implementation, quick gains from using PROMs such as receiving instant feedback and a clear ambition on patient care such as a shared view on patient involvement and management support.

Conclusions
In this qualitative study carried out during the early implementation phase of the Dutch dialysis PROM set, we found that patients did not yet consider the PROM set to be a useful additional tool to share information with their doctor. This was despite the professionals’ primary reason for using PROMs being to improve patient–doctor communication. Furthermore, the perceived lack of intervention options was frustrating for some of the professionals. We found that nurses could be important enablers of further implementation because of their intensive relationship with dialysis patients.
Relationship between physical performance and perception of stress and recovery in daily life post COVID-19—An explorative study
Authors: Zorn Jule , Vollrath Shirin , Matits Lynn , Schönfelder Martin , Schulz Sebastian V. W. , Jerg Achim , Steinacker Jürgen M. , Bizjak Daniel A. 
Published: May 2023

Introduction
COVID-19 is a multi-systemic disease which can target the lungs and the cardiovascular system and can also affect parts of the brain for prolonged periods of time. Even healthy athletes without comorbidities can be psychologically affected long-term by COVID-19.

Objective
This study aimed to investigate athletes’ perceived mental stress and recovery levels in daily life, and their maximal aerobic power, at three different time points, post COVID-19.

Methods
In total, 99 athletes (62.6% male), who had been infected by COVID-19, filled out the Recovery Stress Questionnaire for Athletes (REST-Q-Sport) and completed cardiopulmonary exercise testing (endpoint maximal aerobic power output (Pmax)) at the initial screening (t1: 4 months after infection). Follow-up assessments occurred three (t2, n = 37) and seven months after t1 (t3, n = 19).

Results
Subgroup means from the Recovery category were significantly below the reference value of four at all three time points, except “General Recovery” (3.76 (± 0.96), p = 0.275, d = 0.968) at t3.”Overtiredness” (2.34 (± 1.27), p = 0.020, r = 0.224) was significantly above the reference value of two at t1, while all other Stress subgroups were not significantly different from the reference value or were significantly below the maximum threshold of two at t1, t2 and t3. Spearman’s ρ revealed a negative association between Pmax and the subcategories of stress (ρ = -0.54 to ρ = -0.11, p < 0.050), and positive correlations between Pmax and “Somatic Recovery” (ρ = 0.43, p < 0.001) and “General Recovery” (ρ = 0.23, p = 0.040) at t1. Pmax (t1: 3.83 (± 0.99), t2: 3.78 (± 1.14), β = 0.06, p < 0.003) increased significantly from t1 to t2. In addition, REST-Q-Sport indicated a decrease in "Sleep" (t2 = 2.35 (± 0.62), t3 = 2.28(± 0.61), β = -0.18, p < 0.023) at t3, when compared to t2.

Conclusion
The perceived recovery seems to be negatively affected in post COVID-19 athletes. Physical performance post COVID-19 correlates with both “Emotional and Somatic Stress” and “Somatic and General Recovery”, indicating potential mental and physical benefits of exercise. While it is evident that COVID-19, like other viral infections, may have an influence on physical performance, monitoring stress and recovery perceptions of athletes is critical to facilitate their return-to-sports, while minimizing long-term COVID-19 induced negative effects like the athletic objective and subjective perceived recovery and stress levels.
The choice of region of interest after spinal procedures alters bone mineral density measurements
Authors: Lin Yen-Huai , Chou Che-Shi , Teng Michael Mu Huo 
Published: May 2023

Purpose
Vertebrae affected by artifacts, such as metallic implants or bone cement, should be excluded when measuring the spine bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). Exclusion may be performed using two methods: first, the affected vertebrae are included in the region of interest (ROI) and subsequently excluded from the analysis; second, the affected vertebrae are completely excluded from the ROI. This study aimed to investigate the influence of metallic implants and bone cement on BMD with and without the inclusion of artifact-affected vertebrae in the ROI.

Methods
DXA images of 285 patients, including 144 with spinal metallic implants and 141 who had undergone spinal vertebroplasty from 2018 to 2021, were retrospectively reviewed. Spine BMD measurements were performed when the images were evaluated using two different ROIs for each patient during the same examination. In the first measurement, the affected vertebrae were included in the ROI; however, the affected vertebrae were excluded from the BMD analysis. In the second measurement, the affected vertebrae were excluded from the ROI. Differences between the two measurements were evaluated using a paired t-test.

Results
Among 285 patients (average age, 73 years; 218 women), spinal metallic implants led to an overestimation of bone mass in 40 of 144 patients, whereas bone cement resulted in an underestimation of bone mass in 30 of 141 patients when the first measurement was compared with the second measurement. The opposite effect occurred in 5 and 7 patients, respectively. Differences in results between the inclusion and exclusion of the affected vertebrae in the ROI were statistically significant (p<0.001). Spinal implants or cemented vertebrae included in the ROI might significantly alter BMD measurements. Additionally, different materials were associated with varying modifications in BMD.

Conclusion
The inclusion of affected vertebrae in the ROI may notably alter BMD measurements, even when they are excluded from the analysis. This study suggests that the vertebrae affected by spinal metallic implants or bone cement should be excluded from the ROI.
Социальная зрелость личности среди детерминант здоровьесберегающего поведения
Authors: Егорова Наталия Николаевна , Лавренюк-Исаева Наталья Михайловна , Франц Марина Валерьевна 
Published: May 2023

Работа посвящена изучению факторов, влияющих на склонность индивидов к здоровьесбережению. Исследование базируется на данных репрезентативного социологического исследования, проведенного в Республике Башкортостан в 2015 г., объем выборки — 6264 респондента. Для измерения двух латентных переменных — локус-контроля и склонности к здоровьесбережению — применялась двухпараметрическая логит-модель (2PL), обоснованная в рамках IRT-теории. Влияние разных групп факторов на склонность к здоровьесбережению изучалось с применением регрессионного анализа.
Работа базируется на активно-деятельностном подходе, который рассматривает здоровьесберегающее поведение как процесс, во-первых, протекающий в определенных условиях и требующий для своей реализации определенного набора ресурсов (знаний, времени, денег и т.п.); во-вторых, протекающий осознанно, возможный только при наличии побудительных мотивов и их относительно высокой субъективной актуальности; в-третьих, как организованный и системный, требующий приложения индивидуальных усилий к своему планированию и осуществлению. В связи с этим в анализ были включены шесть групп факторов: демографические, семейные, культурно-образовательные, социально-экономические, побудительно-мотивационные, социальной зрелости. Установлено, что наибольший вклад в объяснение разного уровня склонности индивидов к здоровьесберегающему поведению вносят демографические факторы, при этом особенно велика роль пола. Из факторов социальной зрелости субъекта значимое отрицательное влияние на склонность к здоровьесбережению оказывает неуверенность в завтрашнем дне, значимо положительное — наличие относительно длинного горизонта планирования и интернальный локус-контроль. Результаты теоретического и эмпирического анализа могут быть интересны и полезны специалистам в области управления и экономики в сфере здравоохранения, профильным некоммерческим организациям.
China in Arabic Novels
Authors: Suleiman Nabil 
Published: May 2023

Abstract
This research attempts to study China’s image in contemporary Arabic novels through four modal novels: The Queen Kisses the Dragon Over its Mouth by Amin Zaoui from Algeria, The Fleet of the Sun by Ali Al-Hajri from Qatar, Trilogy of Beidaihe and Spring and Autumn by Hanna Mina from Syria. The researcher seeks to answer the following questions. How was China represented in these novels as others? And how did these novels represent the self? Also, how did these novels delineate the relationships between self and others, from the perspectives of individuals and societies, culturally, politically, and economically? How is the aesthetics of these novels established?
Breaking out of the “Margins”: A Study of Female Characters in Sunset Oasis
Authors: Niu Zimu , Wang Keni 
Published: May 2023

Abstract
Sunset Oasis (2007), the winner of the inaugural International Prize for Arabic Fiction (IPAF) in 2008, remains one of the most important and intricate works by Egyptian writer Bahaa Taher. Based on true historical events, the novel introduces female characters from varied nations and social classes. In spite of their differences, we find these women confined in the “margins” of patriarchal societies portrayed in the novel. This paper intends to shed new light on the circumstances of women imprisoned in the “margins” and on how they struggle against such marginalization. Indeed, women as individuals are unable to confront structural oppression and systematic inequality, as they question and reject the “discipline and punishment” of Patriarchy, and thus display an awareness the readers would applaud as ahead of their time. Hence, their seemingly fruitless endeavor is a glorious defeat.
Why Did the Arabs Not Translate Chinese Thought in Their Golden Age?
Authors: Al Hadi Bilal 
Published: May 2023

Abstract
This research deals with the image of China in the cultural heritage of the Arabs, especially in the writings of famous Arab authors such as Said al-Andalusi, Abu Hayyan al-Tawhidi, Ibn al-Muqaffa’, Al-Jahiz, Ibn al-Nadim and others. It was found that these writings did not mention Chinese thought, and the absence of Chinese thought can be seen as a black hole in the Arab heritage, despite the richness and depth of ancient Chinese thought. The researcher believed that the ancient Arabs did not know Chinese thought, nor did they learn about it through the Chinese language directly, so they concluded that it “did not exist”, and this imaginary non-existence contributed to this deep black hole. However, the situation has changed since the 21st century, when we find increasing direct exposure to Chinese culture, thanks to the increase in cultural exchanges between China and the Arab world, and the steady growth in all fields in Sino-Arab relations.
Research of dynamic phenomena in a model engine stand
Authors: Bogdan Derbiszewski , Marek Wozniak , Jozinkiewicz Damian , Zakrzewski Sergiusz , Kaczmarek Małgorzata , Binkowski Dominik , Obraniak Andrzej , Krzysztof Siczek 
Published: May 2023

Abstract
The highest loads on the elements of the crank–piston system of the internal combustion engine occur during the combustion phase which takes place successively in individual cylinders. Smaller, but also significant, loads occur beyond this phase when dynamic forces begin to play a dominant role. The latter depends on the degree of wear of the engine components. The aim of this article was to analyze the stresses in a model stand for testing dynamic phenomena in an internal combustion engine operating without the combustion process. A stand has been developed which includes a combustion engine driven by an electric motor placed on a mobile frame. The coast-down method was used to estimate the average values of the equivalent moment of inertia of the engine for various cylinder configurations with a lack of compression process due to a significant weakening of the valve springs or significant wear of the valve seats. This lack of compression was simulated on a bench by partially loosening the spark plug mounting. The article presents the values of the determined mean values of the equivalent moment of inertia of the engine and the stress values in the stand frame obtained from its model developed with the use of the finite element method. The obtained values were important from the point of view of the engine dynamics simulation process outside the combustion area and the safe foundation and operation of the stand frame during the experimental tests.
Equality in view of political correctness, cancel culture and other oxymora
Authors: Neuwirth Rostam J. 
Published: May 2023

Abstract“Political correctness” and “cancel culture” are two concepts frequently invoked to control speech and influence debates with a view to establishing greater equality across the globe. Even though their usage has also been met with criticism, there is a strong merit in these attempts, as language change is indicative of wider cognitive changes that are eventually also transformed into changes in the law and society. Based on the wider trend of a rise in so-called “essentially oxymoronic concepts” in public discourses in general and equality debates in particular, this article proposes to analyse the present linguistic trends in order to better understand the deeper causes and related challenges to legal reasoning posed by “political correctness”, “cancel culture” and other terms that have been qualified as oxymora or paradoxes. Based on the view that oxymora and paradoxes are not mere aspects of language but also expressions of deeper layers of human cognition, the article ponders the need not merely to control the external aspects of language use but also to inquire more deeply into the inner workings of the brain and its underlying cognitive processes. In this endeavour it critically examines the dominant modes of dualistic or dichotomized thinking and binary logic, which – when regarded in isolation – appear to cause most discriminatory acts and violations of the principle of equality.
Energy Use Patterns in German Manufacturing from 2003 to 2017
Authors: von Graevenitz Kathrine , Rottner Elisa 
Published: May 2023

Abstract
The manufacturing sector accounts for a substantial share of the German gross domestic product, employment and carbon emissions. Therefore, reducing its energy use and carbon emissions is of crucial importance to Germany’s energy Transition. In this paper, we analyse energy use patterns in German manufacturing between 2003 and 2017, using rich administrative micro-data. We find that although the manufacturing sector has been faced with rising energy costs as a share of total costs, energy use has not declined except briefly during the economic crisis. We also find that energy intensity, and to a larger degree, carbon intensity follow a decreasing trend between 2003 and 2017. The stronger response of the latter variable can be attributed to changes in the fuel mix.