bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal exposure to ambient air pollution and risk of congenital heart defects in Suzhou, China
Authors: Sun Li , Wu Qianlan , Wang Huiying , Liu Juning , Shao Yan , Xu Rong , Gong Tian , Peng Xiaoju , Zhang Baoli 
Published: January 2023

BackgroundMore and more studies have investigated the association between maternal exposure to ambient air pollution during pregnancy and incidence of congenital heart defects (CHDs), but results are controversial. The aim of this study was to investigate whether maternal exposure to air pollutants (PM10, PM2.5, NO2, CO, SO2) are associated with an increased risk of congenital heart defects in Suzhou city, China.MethodsBased on the birth defect monitoring system of Suzhou city and the Environmental Health Department of Suzhou CDC, the birth defect monitoring data and concentrations of five air pollutants (PM10, PM2.5, NO2, CO, SO2) in Suzhou city from 2015 to 2019 were obtained. The distribution of demographic characteristics of children with birth defects and exposure to air pollutant concentrations during different pregnancy periods were analyzed, Chi-square test was used to analyze whether there were statistical differences in the distribution of parturient woman age, pregnant weeks, times of pregnancy, as well as fetal sex and birth weight among children with congenital heart defects and other defects. Logistic regression model was further established to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the association between exposure to these ambient air pollutants during pregnancy and CHDs.ResultsA total of 5,213 infants with birth defects were recruited in this study from 2015 to 2019, the top five birth defects in Suzhou were syndactyly, congenital heart disease, ear malformation, cleft lip and palate, and hypospadias, and the proportion of congenital heart disease increased. The level of maternal exposures (mean ± sd) was highest in first trimester amongst pregnant women in Suzhou city. Compared to other birth defects, we observed significant increasing associations between PM2.5 exposure during second and third trimester with risk of CHDs, aORs were 1.228 and 1.236 (95% CI: 1.141–1.322, 1.154–1.324 separately) per a 10 μg/m3 change in PM2.5 concentration. Maternal NO2 exposure was significantly associated with CHDs in first trimester (aOR = 1.318; 95% CI: 1.210–1.435).ConclusionsOur study contributes to explore the current state of Suzhou air quality and the association between maternal air pollution exposure and congenital heart defects. Exposure to PM2.5 and NO2 is thought to increase the risk of CHDs, but comprehensive description of these associations will be needed in future studies.
Factors associated with burnout in Polish healthcare workers during the COVID-19 pandemic
Authors: Holas Paweł , Wojtkowiak Natalia , Gambin Małgorzata , Hansen Karolina , Kmita Grażyna , Pisula Ewa , Bargiel-Matusiewicz Kamilla , Łojek Emilia 
Published: January 2023

IntroductionThe COVID-19 pandemic has placed the healthcare system under substantial strain that has caused elevated psychological distress among healthcare workers (HCWs). Previous studies have found a high prevalence of burnout among HCWs exacerbated by the COVID-19 pandemic and have delineated some associated factors, but further research is needed. Little is known, for example, whether the economic status of HCWs or experiencing negative and positive emotions contribute to burnout. The present study was meant to fill this gap.MethodsA total of 412 HCWs (i.e.: nurses - 47%, physicians-28%, psychologists-14%, and other healthcare professionals-11%), aged 21–69 years (M = 36.63; SD = 11.76) participated in a web-based cross-sectional study. Data was collected from June to November 2020. The participants filled out measures assessing two dimensions of burnout (Exhaustion and Disengagement), depression, generalized anxiety, positive and negative emotions, along with the survey evaluating organizational aspects of their work during the pandemic.ResultsBurnout thresholds were met by 54 and 66% of respondents for Disengagement and Exhaustion, respectively, which is high but comparable to levels found in other countries during the pandemic. Similarly to previous work, depression and anxiety were high in HCWs, with 24 % of them being in the risk group for clinical severity of depression and 34% in the risk group for a clinical generalized anxiety disorder (GAD). Regression analysis showed that the intensity of negative emotions was the strongest predictor of Exhaustion, whereas the intensity of positive emotions was the strongest predictor of Disengagement. Depression and GAD symptoms were positively related to Exhaustion, and economic status was inversely related to Disengagement.DiscussionThese results suggest that distress in HCWs during the pandemic was related to symptoms of burnout, whereas higher income and experiencing positive emotions were associated with reduced burnout levels. Our findings call for the development of burnout intervention programs that could build capacities for dealing with depression and other negative emotions and at the same time teach skills on how to increase positive emotions in HCWs.
Completion of the continuum of maternity care and associated factors among women who gave birth in the last 6 months in Chelia district, West Shoa zone, Ethiopia: A community-based cross-sectional study
Authors: Buli Temesgen Daksisa , Wakgari Negash , Ganfure Gemechu , Wondimu Fikadu , Dube Dereje Lemma , Moti Gonfa , Doba Yonas Sagni 
Published: January 2023

BackgroundThe continuum of maternity care is a continuity of care that a woman receives during pregnancy, childbirth, and the postpartum period from skilled providers in a comprehensive and integrated manner. Despite existing evidence regarding maternal healthcare services discretely, the continuum of maternity care and its associated factors are not well-known in Ethiopia.ObjectiveThis study assessed the completion of the maternity continuum of care and associated factors among women who gave birth 6 months prior to the study in the Chelia district.MethodsA community-based cross-sectional study with a stratified random sampling technique was conducted among 428 mothers at 10 randomly selected kebeles. Pretested and structured questionnaires were used to collect data. Bi-variable and multivariable logistic regression analyzes were performed to identify associated factors. Adjusted odds ratio with its 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p-value of &lt;0.05.ResultsIn this study, 92 (21.5%) mothers completed the continuum of maternity care. Secondary and above education of mothers (AOR = 4.20, 95% CI:1.26–13.97), ≤30 min spent on walking by foot (AOR = 4.00, 95% CI: 1.67–9.58), using an ambulance to reach health facility (AOR = 3.68, 95% CI: 1.23–11.06), para ≥5 mothers (AOR = 0.21, 95% CI: 0.05–0.90), planned pregnancy (AOR = 3.29, 95% CI: 1.02–10.57), attending pregnant women's conference (AOR = 13.96, 95% CI: 6.22–31.30), early antenatal care booking (AOR = 3.30, 95% CI: 1.54–7.05), accompanied by partners (AOR = 3.64, 95% CI: 1.76–7.53), and informed to return for postnatal care (AOR = 3.57, 95% CI: 1.47–8.70) were the factors identified.ConclusionIn this study, completion of the maternity continuum of care was low. Therefore, appropriate strategic interventions that retain women in the continuum of maternity care by targeting those factors were recommended to increase the uptake of the continuum of maternity care.
Network meta-analysis of the efficacy of four traditional Chinese physical exercise therapies on the prevention of falls in the elderly
Authors: Cheng Meichao , Wang Ya , Wang Shun , Cao Wenxiao , Wang Xianliang 
Published: January 2023

IntroductionIn recent years, traditional Chinese exercises have been passed down and reformed to play a significant role in the study of interventions for the treatment of falls in older people. However, few studies have evaluated the efficacy of various Chinese traditional exercises in the intervention of falls behavior in the elderly. In this study, four Chinese traditional exercises commonly used in clinical practice were selected as subjects to systematically evaluate the effectiveness of Tai Chi, Ba Duan Jin, Yi Jin Jing and Wu Qin Xi in intervening in the treatment of fall behavior in the elderly.MethodsWe conducted a systematic review in accordance with the PRISMA guidelines. Four published randomized controlled trials (RCTs) of traditional Chinese exercise interventions for the treatment of falls behavior in older adults were searched through authoritative databases such as CNKI, Web of Science, PubMed, EMbase and the Cochrane Library, all from the time of construction to November 2022.ResultsA total of 45 studies with 4 traditional interventions were included. Ba Duan Jin was more effective in improving TUGT [SMD = −1.93 (−2.49, −1.38),P&lt; 0.05] and MFES [SMD = −33.45 (−63.93, −2.97),P&lt; 0.05], while Yi Jin Jing was more effective in enhancing ECLSB [SMD = −0.19 (−5.12, −4.74),P&lt; 0.05] and BBS [SMD = −5.79 (−10.80, −0.78),P&lt; 0.05], both of which showed better effects.DiscussionThe present evidence suggests that all four traditional Chinese body-building exercise therapies have a preventive effect on fall behavior in older adults. In clinical treatment and daily physical exercise, two exercises, BaDuan Jin and Yi Jin Jing, may be preferred to reduce the risk of falls in the elderly, but the exercise regimen of Qigong should be selected scientifically and rationally according to their actual conditions.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#myprospero.
Sleep disorders as a prospective intervention target to prevent drug relapse
Authors: Sun Chao , Wang Xiaojun , Huang Xuetong , Shao Yongcong , Ling Anna , Qi Huanhuan , Zhang Zhuolin 
Published: January 2023

ObjectiveThe high rate of relapse has become the primary obstacle of drug rehabilitation. In this study, we explored the relationship between sleep disorders and relapse inclination in substance users, as well as the potential mediating mechanisms and corresponding interventions.MethodsA total of 392 male substance users were recruited to complete the questionnaires on sleep disorders, quality of life and relapse inclination. On account of this, 60 participants with sleep disorders were randomly screened and allocated to the intervention and control groups. The former received 12 weeks of Health Qigong aimed at treating sleep disorders, whereas the latter performed their regular production work.ResultsSleep disorders had a positive effect on relapse inclination, quality of life was a potential mediator of this relationship, and 12-week Health Qigong designed to treat sleep disorders improved not only their sleep quality but also their overall quality of life, which in turn reduce the tendency to relapse.ConclusionCurrent research not only explores the high-risk factors influencing relapse, but also develops customized intervention strategies, which have theoretical and practical implications for decreasing relapse and increasing abstinence.
Patient-reported experience of clinical care of osteogenesis imperfecta (OI) during the COVID-19 pandemic
Authors: Smyth Debra , Hytiris Monica , Kelday Coreen , McDonnell Ciara , Burren Christine , Gardner Adrian , Mills Lisa , Parekh Susan , Semler Oliver , Stewart Angela , Westerheim Ingunn , Javaid Muhammad Kassim , Osborne Patricia , Ahmed S. Faisal 
Published: January 2023

BackgroundResearch on the effects of the COVID-19 pandemic on people with rare diseases is limited. Few studies compare healthcare throughout the progression of the ongoing pandemic.AimsTo assess the impact of the pandemic on individuals with osteogenesis imperfecta across two consecutive years, understand what challenges were encountered, and analyse the experience of remote consultation.MethodsAn initial survey was distributed following the first lockdown in August 2020, and a second survey in April 2021. The surveys explored four themes- effects on therapy, alternatives to consultation, effect on mental health, and perceived risks of COVID-19.ResultsIn the 2020 survey, of the 110 respondents, 69 (63%) had at least one appointment delayed due to the lockdown, compared with 89 of the 124 respondents (72%) in 2021. Of the 110 respondents in 2020, 57 (52%) had a remote consultation, increasing to 92 of 124 (74%) in the follow-up survey. In the 2020 survey 63 of 91 respondents (69%) expressed anxiety due to lockdown, compared with 76 of 124 (61%) in 2021. The percentage of total respondents expressing a preference for remote consultation was 48% in 2020, increasing to 71% in 2021.ConclusionsThe pandemic has had widespread effects on the mental and physical health of those with OI. These effects, alongside appointment delays, have increased as the pandemic progresses. Encouragingly, the increasing preference for remote consultation may indicate that this could be a viable long-lasting alternative to face-to-face appointments, especially for patients who previously traveled vast distances for specialist care.
Cultural adaptation in television technology for older adults with dementia in care settings
Authors: Wong Karen Lok Yi , Hung Lillian 
Published: January 2023

IntroductionThere is a lack of literature on the cultural adaptation of technologies for dementia care. This paper presents an example of the cultural adaptation of a television video about drinking water for older Chinese adults with dementia in care settings, in Vancouver, Canada.MethodWe refer to the cultural adaptation process (CAP) model to guide the cultural adaptation process by collecting and incorporating feedback from different parties into the culturally adapted video, including Phase 1 local consultations and information gathering, phase 2 iterative testing and adaptation, and phase 3 finalizing adaptation.ResultsWe also referred to the Ecological Validity Model (EVM) to present the adjustments we made to the video from the cultural adaptation. We adjusted the video on seven domains suggested by the EVM: goal, context, content, language, people, concept, and method.DiscussionWe draw attention to the opportunities and challenges of the cultural adaptation of technology into a new community. Based on our lessons, we outline concrete suggestions about what aspects of, and how, cultural adaptation can be made to promote cultural inclusivity in technology development and implementation.
Using robot-assisted stiffness perturbations to evoke aftereffects useful to post-stroke gait rehabilitation
Authors: Chambers Vaughn , Artemiadis Panagiotis 
Published: January 2023

Stroke is a major global issue, affecting millions every year. When a stroke occurs, survivors are often left with physical disabilities or difficulties, frequently marked by abnormal gait. Post-stroke gait normally presents as one of or a combination of unilaterally shortened step length, decreased dorsiflexion during swing phase, and decreased walking speed. These factors lead to an increased chance of falling and an overall decrease in quality of life due to a reduced ability to locomote quickly and safely under one’s own power. Many current rehabilitation techniques fail to show lasting results that suggest the potential for producing permanent changes. As technology has advanced, robot-assisted rehabilitation appears to have a distinct advantage, as the precision and repeatability of such an intervention are not matched by conventional human-administered therapy. The possible role in gait rehabilitation of the Variable Stiffness Treadmill (VST), a unique, robotic treadmill, is further investigated in this paper. The VST is a split-belt treadmill that can reduce the vertical stiffness of one of the belts, while the other belt remains rigid. In this work, we show that the repeated unilateral stiffness perturbations created by this device elicit an aftereffect of increased step length that is seen for over 575 gait cycles with healthy subjects after a single 10-min intervention. These long aftereffects are currently unmatched in the literature according to our knowledge. This step length increase is accompanied by kinematics and muscle activity aftereffects that help explain functional changes and have their own independent value when considering the characteristics of post-stroke gait. These results suggest that repeated unilateral stiffness perturbations could possibly be a useful form of post-stroke gait rehabilitation.
Co-creating a suite of patient decision aids for parents of an infant or young child with differences of sex development: A methods roadmap
Authors: Lightfoot Sophie , Carley Meg , Brinkman William , Gardner Melissa D. , Gruppen Larry D. , Liang Noi , Pinkelman Kendra , Speiser Phyllis W. , Suorsa-Johnson Kristina I. , VanderBrink Brian , Wisniewski Jessica , Sandberg David E. , Stacey Dawn 
Published: January 2023

IntroductionParents and guardians of infants and young children with differences of sex development (DSD) often face numerous health and social decisions about their child’s condition. While proxy health decisions can be stressful in any circumstance, they are further exacerbated in this clinical context by significant variations in clinical presentation, parental lack of knowledge about DSD, irreversibility of some options (e.g., gonadectomy), a paucity of research available about long-term outcomes, and anticipated decisional regret. This study aimed to engage clinicians, parents, and an adult living with DSD to collaboratively co-design a suite of patient decision aids (PDAs) to respond to the decisional needs of parents and guardians of infants and young children diagnosed with DSD.MethodsWe used a systematic co-design process guided by the Ottawa Decision Support Framework and the International Patient Decision Aids Standards (IPDAS). The five steps were: literature selection, establish the team, decisional needs assessment, create the PDAs, and alpha testing.ResultsOur team of health professionals, parents, adult living with DSD and PDA experts, co-designed four PDAs to support parents/guardians of infants or young children diagnosed with DSD. These PDAs addressed four priority decisions identified through our decisional needs assessment: genetic testing, gender of rearing, genital surgery and gonadal surgery. All four PDAs include information for parents about DSD, the options, reasons to choose or avoid each option, and opportunities for parents/guardians to rate the importance of features of each option to clarify their values for these features. Qualitative feedback was positive from our team and when alpha tested with an interprofessional DSD speciality team in a single center.ConclusionsThese PDAs are clinical tools designed to support parents/guardians to be involved in making informed DSD decisions; next steps are to determine parents’ decisional outcomes. While these tools are specific to DSD, the process through which they were co-designed is transferable to co-design of PDAs in other pediatric populations.
Building partnerships: A case study of physical activity researchers and practitioners collaborating to build evidence to inform the delivery of a workplace step count challenge
Authors: Niven Ailsa , Ainge James A. , Allison Mary , Gorely Trish , Kelly Paul , Ozakinci Gozde , Ryde Gemma C. , Tomaz Simone A. , Warne Samuel , Whiteford Victoria , Greenwood Carl 
Published: January 2023

BackgroundWalking is an integral part of Scotland's National Physical Activity Strategy, and the charity Paths for All's Workplace Step Count Challenge is a flagship programme within this strategy to promote physical activity. Effectively promoting physical activity requires collaborative engagement between stakeholders. However, there is limited guidance on how to do this. The aim of this case study is to share an example of a partnership between Paths for All and researchers to inform the development and delivery of the Workplace Step Count Challenge.MethodAn overview of the partnership, example activities, reflections on opportunities and challenges, and suggestions for future partnership working are considered.ResultsThe partnership has evolved and strengthened over time through building trust. Many of the research activities provide an evidence base for the intervention. This work is mutually beneficial providing support for the work of the organisation, and opportunities for researchers to undertake “real world” research, leading to formal outputs and funding. The “real world” nature is challenging to integrate the most robust research designs. Recommendations for developing future partnerships were identified.ConclusionPromoting physical activity effectively requires partnership working, and this paper provides insight into how such partnerships can work to inform future collaborations.
Transcriptome and metabolome profiling provide insights into hormone-mediated enhanced growth in autotetraploid seedlings of banana (Musa spp.)
Authors: Zhan Ni , Li Li , Zhang Liping , He Weidi , Yang Qiaosong , Bi Fangcheng , Deng Guiming , Kiggundu Andrew , Yi Ganjun , Sheng Ou 
Published: January 2023

IntroductionReconstructive breeding based on autotetraploids to generate triploid varieties is a promising breeding strategy in banana (Musa spp.). Therefore understanding the molecular mechanisms underlying the phenotypic differences between the original diploid and its autopolyploid derivatives is of significant importance in such breeding programs of banana.MethodsIn this study, a number of non-chimeric autotetraploid plants, confirmed by flow cytometry and chromosome counting were obtained using colchicine treatment of ‘Pisang Berlin' (AA Group), a diploid banana cultivar highly resistant to Fusarium wilt Tropical Race 4 (Foc TR4) and widely cultivated in Asia.Results and discussionThe autotetraploids showed significant increase in plant height, pseudostem diameter, root length, leaf thickness, leaf area, and leaf chlorophyll content. Transcriptomic analysis indicated that differentially expressed genes were mainly enriched in plant hormone signal transduction, mitogen-activated protein kinase (MAPK) signaling pathway, and carbon fixation in photosynthetic organelles. The genes related to the metabolism, transport or signaling of auxin, abscisic acid (ABA), cytokinin (CTK) and gibberellin (GA), as well as the genes encoding essential enzymes in photosynthetic CO2 fixation were differentially expressed in leaves of autotetraploids and most of them were up-regulated. Metabolomic analysis revealed that the differentially accumulated metabolites were mainly involved in plant hormone signal transduction, porphyrin and chlorophyll metabolism, indole alkaloid biosynthesis, and carbon fixation in photosynthetic organelles. The results therefore, demonstrate that the hormones IAA, ABA, and photosynthetic regulation may play a vital role in the observed enhancement in the autotetraploids. These could be used as molecular and biochemical markers to facilitate the generation of triploid progenies as suitable new varieties for cultivation.