bluuebunny/crossref_metadata_2025_split huggingface dataset:
A call for a fragility fractures centralised care pathway in Australia: A qualitative study among healthcare professionals
Authors: Ho An N T , Robinson Ann , Brandis Susan J 
Published: August 2023

Introduction Osteoporosis remains unrecognised and untreated in patients with fragility fractures, which leads to higher mortality rate, increasing social and economic burden related to subsequent fractures. However, the presence of a coordinated and centralised care pathway for fragility fractures is lacking. The purpose of this paper is to explore the perspectives of health professionals regarding the current management for distal radius fragility fractures, how the care pathway can be optimised for patients with distal radius fragility fractures, and where occupational therapists can contribute. Methods This paper uses a phenomenological qualitative methodology with selective and purposeful sampling, consisting of health professionals from an Australian Health Service ( N  =  20). Online surveys ( N  =  18) and semi-structured interviews ( N  =  16) were conducted. Content analysis was applied, followed by thematic analysis to identify emerging themes. Results Eighteen health professionals participated in the presurvey of which 16 were interviewed. The identified themes presented the gaps in the knowledge and awareness of fragility fractures and osteoporosis, as well as a lack of coordination in the system, especially the referral process. Discussion These findings are consistent with previous studies which also highlight the importance of communication, coordination, collaboration, cooperation, responsibility, and a population approach in achieving integrated care. This study contributes to the global call for a centralised and coordinated care pathway for fragility fractures. The study explores personal experiences of health professionals who expressed interest in fragility fractures management. Exploring patients’ perspectives on their journey of fragility fractures management provides opportunity for future research.
Effect of Dynamic Pressure Feedback Orifice on Stability of Cartridge-Type Hydraulic Pilot-Operated Relief Valve
Authors: Yin Yaobao , Wang Dong , Fu Junyong , Jian Hong-chao 
Published: August 2023

AbstractCurrent research on pilot-operated relief valve stability is primarily conducted from the perspective of system dynamics or stability criteria, and most of the existing conclusions focus on the spool shape, damping hole size, and pulsation frequency of the pump. However, the essential factors pertaining to the unstable vibration of relief valves remain ambiguous. In this study, the dynamic behavior of a pilot-operated relief valve is investigated using the frequency-domain method. The result suggests that the dynamic pressure feedback orifice is vital to the dynamic characteristics of the valve. A large orifice has a low flow resistance. In this case, the fluid in the main spring chamber flows freely, which is not conducive to the stability of the relief valve. However, a small orifice may create significant flow resistance, thus restricting fluid flow. In this case, the oil inside the main valve spring chamber is equivalent to a high-stiffness liquid spring. The main mass–spring vibration system has a natural frequency that differs significantly from the operating frequency of the relief valve, which is conducive to the stability of the relief valve. Good agreement is obtained between the theoretical analysis and experiments. The results indicate that designing a dynamic pressure feedback orifice of an appropriate size is beneficial to improving the stability of hydraulic pilot-operated relief valves. In addition, the dynamic pressure feedback orifice reduces the response speed of the relief valve. This study comprehensively considers the stability, rapidity, and immunity of relief valves and expands current investigations into the dynamic characteristics of relief valves from the perspective of classical control theory, thus revealing the importance of different parameters.
First filter feeding in the Early Triassic: cranial morphological convergence between Hupehsuchus and baleen whales
Authors: Fang Zi-Chen , Li Jiang-Li , Yan Chun-Bo , Zou Ya-Rui , Tian Li , Zhao Bi , Benton Michael J. , Cheng Long , Lai Xu-Long 
Published: August 2023

AbstractModern baleen whales are unique as large-sized filter feeders, but their roles were replicated much earlier by diverse marine reptiles of the Mesozoic. Here, we investigate convergence in skull morphology between modern baleen whales and one of the earliest marine reptiles, the basal ichthyosauromorph Hupehsuchus nanchangensis, from the Early Triassic, a time of rapid recovery of life following profound mass extinction. Two new specimens reveal the skull morphology especially in dorsal view. The snout of Hupehsuchus is highly convergent with modern baleen whales, as shown in a morphometric analysis including 130 modern aquatic amniotes. Convergences in the snout include the unfused upper jaw, specialized intermediate space in the divided premaxilla and grooves around the labial margin. Hupehsuchus had enlarged its buccal cavity to enable efficient filter feeding and probably used soft tissues like baleen to expel the water from the oral cavity. Coordinated with the rigid trunk and pachyostotic ribs suggests low speeds of aquatic locomotion, Hupehsuchus probably employed continuous ram filter feeding as in extant bowhead and right whales. The Early Triassic palaeoenvironment of a restrictive lagoon with low productivity drove Hupehsuchus to feed on zooplankton, which facilitated ecosystem recovery in the Nanzhang-Yuan’an Fauna at the beginning of the Mesozoic.
Primary care engagement in health system change: a scoping review of common barriers and effective strategies
Authors: Taglione Michael Sergio , Brown Judith Belle 
Published: August 2023

Abstract
Background
The complexity of health systems necessitates coordination between a multitude of stakeholders to enact meaningful change. Primary care physicians are a crucial partner to engage, as their investment and participation are critical to the success of any system-level initiative. The aim of this scoping review is to identify common barriers and effective strategies when engaging primary care physicians in designing and implementing health system change.

Methods
A scoping review was performed. A literature search was performed in March 2020 using five databases. 668 unique articles were identified and underwent a title and abstract review. 23 articles met criteria for full text review and 10 met final inclusion criteria. A backward citation analysis identified two articles. 12 articles underwent data extraction and thematic analysis.

Results
Several barriers to engagement were identified including a lack of trust between primary care physicians and decision-makers, strong professional physician identity, clinically irrelevant and complex proposals, and a lack of capacity and supports. Described strategies to overcome these barriers included building trust and relationships, contextual engagement strategies, working with physician leadership, enabling open and intentional communication channels, designing clinically relevant and straightforward initiatives, and considering financial incentives.

Conclusions
Barriers to primary care engagement should be addressed with contextually designed strategies and a focus on relationship building, collaborative efforts, and implementing relevant and feasible initiatives. Further research should explore how to best develop relationships with primary care, working with collective voices of primary care physicians, and to better understanding the impact of financial incentives on engagement.
Identifying cellular senescence associated genes involved in the progression of end-stage renal disease as new biomarkers
Authors: Xi Yu-jia , Guo Qiang , Zhang Ran , Duan Guo-sheng , Zhang Sheng-xiao 
Published: August 2023

Abstract
Background
Cellular senescence plays an essential role in the development and progression of end-stage renal disease (ESRD). However, the detailed mechanisms phenomenon remains unclear.

Methods
The mRNA expression profiling dataset GSE37171 was taken from the Gene Expression Omnibus (GEO) database. The cell senescence-associated hub genes were selected by applying protein–protein interaction (PPI), followed by correlation analysis, gene interaction analysis, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. We next explored the relationships of hub genes with miRNAs, TFs, and diseases. The absolute abundance of eight immune cells and two stromal cells were calculated by MCPcount and the correlation of hub genes with these ten cells was analyzed. Lasso was used to selecting for trait genes. ROC curves and DCA decision curves were used to assess the accuracy and predictive power of the trait genes.

Results
A total of 65 cellular senescence signature genes were identified among patients and controls. The PPI network screened out ten hub genes. GO and KEGG indicated that ten hub genes were associated with ESRD progression. Transcription factor gene interactions and common regulatory networks of miRNAs were also identified in the datasets. The hub genes were significantly correlated with immune cells and stromal cells. Then the lasso model was constructed to screen out the five most relevant signature genes (FOS, FOXO3, SIRT1, TP53, SMARCA4). The area under the ROC curve (AUC) showed that these five characteristic genes have good resolving power for the diagnostic model.

Conclusions
Our findings suggested that cellular senescence-associated genes played an important role in the development of ESRD and immune regulation.
Secondary immunoglobulin A nephropathy with gross hematuria leading to rapidly progressive glomerulonephritis following severe acute respiratory syndrome coronavirus 2 vaccination: a case report
Authors: Fukuda Miyako , Kaneko Tomohiro , Kawai Takahiro , Ishii Hiromasa , Shimizu Akira 
Published: August 2023

Abstract
Background
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been followed by many reports of the development and relapse of autoimmune diseases associated with SARS-CoV-2 vaccination. Some of these reports have involved relapse or onset of immunoglobulin A (IgA) nephropathy following SARS-CoV-2 vaccination. Here, we report on a patient with IgA nephropathy who presented with gross hematuria and rapidly progressive glomerulonephritis following SARS-CoV-2 vaccination.

Case presentation
A 63-year-old male patient with a history of habitual tonsillitis underwent bilateral tonsillectomy. He had a history of alcoholic cirrhosis of the liver and microscopic hematuria and proteinuria were indicated during a health checkup 2 years before hospital admission. He developed hematuria after the SARS-CoV-2 vaccination, which led to rapidly progressive glomerulonephritis, for which he was hospitalized. A renal biopsy led to the diagnosis of IgA nephropathy. Although pulse steroid therapy during his condition resulted in hepatic encephalopathy, three courses combined with mizoribine improved his renal function.

Conclusion
SARS-CoV-2 mRNA vaccines activate T cells, which are involved in the pathophysiology of IgA nephropathy. Therefore, this case suggests that the exacerbation of IgA nephropathy by the vaccine favors the vasculitis aspect of the disease.
Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran
Authors: Dadipoor Sara , Alavi Azin , Kader Zainab , Mohseni Shokrollah , Eshaghi Sani Kakhaki Hadi , Shahabi Nahid 
Published: August 2023

Abstract
Background
Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs.

Methods
A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15–49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant.

Results
A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants’ age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior.

Conclusions
The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.
Cetuximab as first-line treatment for metastatic colorectal cancer (mCRC): a model-based economic evaluation in Indonesia setting
Authors: Putri Septiara , Saldi Siti Rizny F. , Khoe Levina Chandra , Setiawan Ery , Megraini Amila , Santatiwongchai Benjarin , Nugraha Ryan R. , Permanasari Vetty Y. , Nadjib Mardiati , Sastroasmoro Sudigdo , Armansyah Armansyah 
Published: August 2023

AbstractObjectivesTo assess the cost-effectiveness of cetuximab in combination with chemotherapy fluorouracil, oxaliplatin, and leucovorin (FOLFOX) or fluorouracil, irinotecan and leucovorin (FOLFIRI) compared to standard chemotherapy alone as a first-line treatment for metastatic colorectal cancer (mCRC) with positive KRAS wild type patients in Indonesia.MethodsA cost-utility analysis applying Markov model was constructed, with a societal perspective. Clinical evidence was derived from published clinical trials. Direct medical costs were gathered from hospital billings. Meanwhile, direct non-medical costs, indirect costs, and utility data were collected by directly interviewing patients. We applied 3% discount rate for both costs and outcomes. Probabilistic sensitivity analysis was performed to explore the model’s uncertainty. Additionally, using payer perspective, budget impact analysis was estimated to project the financial impact of treatment coverage.ResultsThere was no significant difference in life years gained (LYG) between cetuximab plus FOLFOX/FOLFIRI and chemotherapy alone. The incremental QALY was only one month, and the incremental cost-effectiveness ratio (ICER) was approximately IDR 3 billion/QALY for cetuximab plus chemotherapy. Using 1–3 GDP per capita (IDR 215 million or USD 14,350) as the current threshold, the cetuximab plus chemotherapy was not cost-effective. The budget impact analysis resulted that if cetuximab plus chemotherapy remain included in the benefits package under the Indonesian national health insurance (NHI) system, the payer would need more than IDR 1 trillion for five years.ConclusionsThe combination of cetuximab and chemotherapy for mCRC is unlikely cost-effective and has a substantial financial impact on the system.
Profiling and factors associated with glaucoma diagnostic practice in sub-Saharan Africa-a cross sectional study of Nigerian and Ghanaian optometrists
Authors: Ocansey Stephen , Ekure Edgar , Osuagwu Uchechukwu L. , Ekpenyong Bernadine N. , Ovenseri-Ogbomo Godwin , Kyeremeh Sylvester , Ogbuehi Kelechi C. , Agho Kingsley E. , Mashige Khathutshelo P. , Ndep Antor O. , Naidoo Kovin S. ,   Centre for Eye Care, Public Health Intervention Initiative (CEPHII)
Published: August 2023

AbstractBackgroundGhana and Nigeria are the two countries in Africa that currently run the Doctor of Optometry (OD) program in sub-Saharan Africa (SSA). Optometrists in these countries are licensed to provide glaucoma care. Despite the clinically relevant practice guidelines for glaucoma, there is no data on the practice patterns for glaucoma eye care in SSA, a region with the highest prevalence of glaucoma. This study aimed to profile glaucoma diagnosis adherence to practice guidelines among optometrists in two neighbouring anglophone countries (Nigeria and Ghana).MethodsA web-based cross-sectional survey of practising optometrists was conducted in both countries. Each country data was weighted to reflect the total number of licensed and practising optometrists at the time of this survey. Descriptive analyses were performed against demography and practice factors using survey commands to adjust for sampling weights when estimating confidence intervals (CI) around prevalence estimates. Simple and multiple logistic regression analyses were performed to identify factors associated with glaucoma diagnosis.ResultsA total of 493 optometrists (238, 48.3% and 255, 51.7%) from Ghana and Nigeria respectively, responded to the survey-the first to document and compare the glaucoma diagnostic criteria between optometrists in Ghana and Nigeria. More Ghanaian than Nigerian optometrists diagnosed glaucoma and over 90% in both countries reported that they frequently performed either tonometry, visual field testing, or fundus examination during glaucoma diagnosis. Ghanaian optometrists were significantly more likely to diagnose glaucoma than Nigerian optometrists (adjusted odd ratio, AOR = 6.15, 95%CI:1.63–23.15,P = .007). Optometrists who have practiced for more than 10 years (AOR = 7.04; 95%CI:1.74–28.47,P = .006) and private practice optometrists (AOR = 3.33; 95%CI:1.13–9.83,P = .03) were more likely to diagnose glaucoma.ConclusionsThe study provides information for evaluating glaucoma assessment for optometrists in both countries. Optometrists in both countries are reasonably well-equipped to diagnose glaucoma and are practicing at an adequate level, but with room for improvement.
Perinatal factors impacting echocardiographic left ventricular measurement in small for gestational age infants: a prospective cohort study
Authors: Elmakaty Ibrahim , Amarah Ahmed , Henry Michael , Chhabra Manoj , Hoang Danthanh , Suk Debbie , Ron Nitin , Dygulska Beata , Sy Farrah , Gudavalli Madhu B. , Nadroo Ali M. , Narula Pramod , Gad Ashraf 
Published: August 2023

Abstract
Introduction
Infants born small for gestational age (SGA) have an increased risk of developing various cardiovascular complications. While many influencing factors can be adjusted or adapt over time, congenital factors also have a significant role. This study, therefore, seeks to explore the effect of perinatal factors on the left ventricular (LV) parameters in SGA infants, as assessed immediately after birth.

Methods and materials
This single-center prospective cohort study, conducted between 2014 and 2018, involved healthy SGA newborns born > 35 weeks’ gestation, delivered at New York-Presbyterian Brooklyn Methodist Hospital, and a gestational age (GA)-matched control group of appropriate for gestational age (AGA) infants. Data analysis was performed using multivariate linear regression in STATA.

Results
The study enrolled 528 neonates, 114 SGA and 414 AGA. SGA infants exhibited a mean GA of 38.05 weeks (vs. 38.54), higher male representation (69.3% vs. 51.5%), lower birth weight (BW) (2318g vs 3381g), lower Apgar scores at birth, and a higher rate of neonatal intensive care unit admission compared to AGA infants (41.2% vs.18.9%; p<0.001). Furthermore, SGA infants were more likely to be born to nulliparous women (63.16% vs. 38.16%; p<0.001), with lower body mass index (BMI) (29.8 vs. 31.7; p=0.004), a lower prevalence of gestational maternal diabetes (GDM) (14.9 % vs. 35.5%; p<0.001), and a higher prevalence of preeclampsia (18.4 % vs. 6.52%; p<0.001). BW was identified as the most significant predictor affecting most LV parameters in this study (p<0.001), except shortening fraction, asymmetric interventricular septal hypertrophy and Inter-ventricular septal thickness/LV posterior wall ratio (IVS/LVPW). Lower GA (coefficient = -0.09, p=0.002), insulin use in GDM (coefficient = 0.39, p=0.014), and low APGAR scores at 1 minute (coefficient = -0.07, p<0.001) were significant predictors of IVS during diastole (R-squared [R2]=0.24). High maternal BMI is marginally associated with LVPW during systole (R2=0.27, coefficient = 0.01, p=0.050), while male sex was a significant predictor of LV internal dimension during diastole (R2=0.29, p=0.033).

Conclusion
This study highlights the significant influence of perinatal factors on LV parameters in SGA infants, with BW being the most influential factor. Although LV morphology alone may not predict future cardiovascular risk in the SGA population, further research is needed to develop effective strategies for long-term cardiovascular health management in this population.
Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study
Authors: Zhang Teng , Liu Meilin , Min Fanli , Wei Wei , Liu Yuan , Tong Jiao , Meng Qian , Sun Lizhou , Chen Xu 
Published: August 2023

Abstract
Background
Fear of childbirth (FOC) is a prevalent issue among pregnant women and significantly relates to adverse outcomes for the mother and child. However, it is not clear the prevalence and risk factors of FOC among pregnant women in a region with a moderate level of economic development in China. The aim of this study was to investigate the prevalence and risk factors of FOC among pregnant women in the third trimester of pregnancy in Lianyungang city, Eastern China.

Methods
A cross-sectional survey was conducted from December 2022 to February 2023 among pregnant women in the third trimester who met the inclusion criteria and visited Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China. A structured questionnaire including sociodemographic characteristics, clinical characteristics, FOC, family function, doctor-patient communication, social support, general self-efficacy, anxiety, depression, insomnia symptoms, and quality of life was used to collect data. A multiple linear regression model was used to identify predictors of FOC.

Results
This study included 535 pregnant women in the third trimester. The mean score of FOC was 30.67 ± 10.18, and the median score was 29.00. The prevalence of FOC was 56.64%. Multiple linear regression analysis revealed that pregnant women with electronic screen exposure time more than 5 h per day (β = 2.02, 95%CI: 0.50–3.53, P < 0.05), no history of cesarean section (β = 2.66, 95%CI: 0.61–4.71, P < 0.05), likes sour food or hates greasy food (β = 1.75, 95%CI: 0.00-3.50, P < 0.05), anxiety (β = 0.50, 95%CI: 0.21–0.80, P < 0.05) and depression (β = 0.30, 95%CI: 0.04–0.57, P < 0.05) were more likely to have a greater level of FOC than their counterparts. However, a significantly lower level of FOC was observed in pregnant women who were multipara (β=-1.64, 95%CI: -3.27–0.01, P < 0.05), not worrying about delivery without family members (β=-3.75, 95%CI: -5.26–2.25, P < 0.001), had good family function (β=-0.32, 95%CI: -0.64–0.00, P < 0.05) and doctor-patient communication (β=-0.33, 95%CI: -0.64–0.02, P < 0.05).

Conclusions
The prevalence of FOC was high in Lianyungang city, Eastern China. FOC is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of FOC in the third trimester of pregnancy, and to pay attention to pregnant women with risk factors for FOC.