bluuebunny/crossref_metadata_2025_split huggingface dataset:
In it for the long haul: the complexities of managing overweight in family practice: qualitative thematic analysis from the Health eLiteracy for Prevention in General Practice (HeLP-GP) trial
Authors: Paine Katrina , Parker Sharon , Denney-Wilson Elizabeth , Lloyd Jane , Randall Sue , McNamara Carmel , Nutbeam Don , Osborne Richard , Saito Shoko , Harris Mark 
Published: February 2023

Abstract
Background
Australia has one of the highest rates of overweight and obesity in the developed world, and this increasing prevalence and associated chronic disease morbidity reinforces the importance of understanding the attitudes, views, and experiences of patients and health providers towards weight management interventions and programs. The purpose of this study was to investigate patients, family practitioners and family practice nurses’ perceptions and views regarding the receipt or delivery of weight management within the context of the HeLP-GP intervention.

Methods
A nested qualitative study design including semi-structured interviews with family practitioners (n = 8), family practice nurses (n = 4), and patients (n = 25) attending family practices in New South Wales (n = 2) and South Australia (n = 2). The patient interviews sought specific feedback about each aspect of the intervention and the provider interviews sought to elicit their understanding and opinions of the strategies underpinning the intervention as well as general perceptions about providing weight management to their patients. Interviews were recorded and transcribed verbatim, and coding and management conducted using NVivo 12 Pro. We analysed the interview data using thematic analysis.

Results
Our study identified three key themes: long-term trusting and supportive relationships (being ‘in it for the long haul’); initiating conversations and understanding motivations; and ensuring access to multi-modal weight management options that acknowledge differing levels of health literacy. The three themes infer that weight management in family practice with patients who are overweight or obese is challenged by the complexity of the task and the perceived motivation of patients. It needs to be facilitated by positive open communication and programs tailored to patient needs, preferences, and health literacy to be successful.

Conclusions
Providing positive weight management in family practice requires ongoing commitment and an open and trusting therapeutic relationship between providers and patients. Behaviour change can be achieved through timely and considered interactions that target individual preferences, are tailored to health literacy, and are consistent and positive in their messaging. Ongoing support of family practices is required through funding and policy changes and additional avenues for referral and adjunctive interventions are required to provide comprehensive weight management within this setting.
The application of new complex indicators in the detection of urine
Authors: Li Ying-xiang , Li Yang , Bao Si-yu , Xue Ning , Ding Xiao-qiang , Fang Yi 
Published: February 2023

Abstract
Background
Accurate diagnosis and assessment of hematuria is crucial for the early detection of chronic kidney disease(CKD). As instability of urinary RBC count (URBC) often results with clinical uncertainty, therefore new urinary indexes are demanded to improve the accuracy of diagnosis of hematuria. In this study, we aimed to investigate the benefit of applying new complex indicators based on random urine red blood cell counts confirmed in hematuric kidney diseases.

Methods
All patients enrolled underwent renal biopsy, and their clinical information was collected. Urinary and blood biomedical indexes were implemented with red blood cell counts to derive complex indicators. Patients were divided into two groups (hematuria-dominant renal histologic lesions and non-hematuria-dominant renal histologic lesions) based on their renal pathological manifestations. The target index was determined by comparing the predictive capabilities of the candidate parameters for hematuric kidney diseases. Hematuria stratification was divided into four categories based on the scale of complex indicators and distributional features. The practicality of the new complex indicators was demonstrated by fitting candidate parameters to models comprising demographic information.

Results
A total of 1,066 cases (678 hematuria-dominant renal histologic lesions) were included in this study, with a mean age of 44.9 ± 15 years. In differentiating hematuria-dominant renal histologic lesion from the non-hematuria-dominant renal histologic lesion, the AUC value of “The ratio of the random URBC to 24-h albumin excretion” was 0.76, higher than the standard approach of Lg (URBC) [AUC = 0.744] (95% Confidence interval (CI) 0.712 ~ 0.776). The odds ratio of hematuria-dominant renal histologic lesion (Type I) increased from Q2 (3.81, 95% CI 2.66 ~ 5.50) to Q4 (14.17, 95% CI 9.09 ~ 22.72). The predictive model, composed of stratification of new composite indexes, basic demographic characteristics, and biochemical parameters, performed best with AUC value of 0.869 (95% CI 0.856–0.905).

Conclusion
The new urinary complex indicators improved the diagnostic accuracy of hematuria and may serve as a useful parameter for screening hematuric kidney diseases.
Effect of direct endovascular treatment versus standard bridging therapy in large artery anterior circulation stroke (DEVT): 18-month follow-up of a randomized controlled trial
Authors: Ruan Zhongfan , Luo Xiaojun , Liu Yongkang , Li Fengli , Liu Jincheng , Zi Wenjie 
Published: February 2023

Abstract
Background
Two trials in Chinese population showed that endovascular treatment (EVT) alone was noninferior to alteplase follow by EVT at 90 days. However, results of long-term clinical outcomes remain unknown. We reported the results of prespecified 18-month analysis of the DEVT trail.

Materials and methods
We assessed clinical outcomes 18 months after patients were randomly assigned to receive EVT alone or bridging therapy for acute ischemic stroke (AIS). The primary outcome was the proportion of functional independence [modified Rankin scale (mRS), 0–2] at 18 months. Secondary outcomes included all-cause mortality and the quality of life at 18 months as measured by means of a health utility index according to the European Quality of Life 5-Dimension 5-level scale (EQ-5D-5L). Kaplan-Meier event curves were used to investigate the risk of mortality in participants with EVT alone or bridging therapy.

Results
Among 234 patients (EVT alone, n = 116; bridging therapy, n = 118) in the DEVT trial, only 231 (98.7%) patients were extended follow-up to 18 months. A total of 60 (51.7%) patients in the EVT alone achieved functional independence vs 56 (47.5%) patients in the bridging therapy (difference, 4.3%; 1-sided 97.5% CI, − 8.4% to ∞, P for noninferiority =0.014). No significant between-group difference was detected in EQ-5D-5L score (0.81 vs 0.73; difference, 0; 95% CI, 0 to 0.005). The cumulative mortality was 27.6% in the EVT alone and 28.8% in the bridging therapy.

Conclusion
At 18 months follow-up, EVT alone was noninferior to bridging therapy regarding favorable functional outcome in patients with AIS.

Trial registration
Trial was registered on Chinese Clinical Trial Registry (ChiCTR-IOR-17013568) on 27/11/2017.
An integrated strategy for deciding open versus laparoscopic hepatectomy for resectable primary liver cancer
Authors: Fu Yizhen , Yang Zhenyun , Hu Zili , Yang Zhoutian , Chen Jinbin , Wang Juncheng , Zhou Zhongguo , Xu Li , Chen Minshan , Zhang Yaojun 
Published: February 2023

Abstract
Background
Laparoscopic liver resection (LLR) is now widely performed in treating primary liver cancer (PLC) and yields equal long-term and superior short-term outcomes to those of open liver resection (OLR). The optimal surgical approach for resectable PLC (rPLC) remains controversial. Herein, we aimed to develop a nomogram to determine the most appropriate resection approach for the individual patient.

Methods
Patients with rPLC who underwent hepatectomy from January 2013 to December 2018 were reviewed. Prediction model for risky surgery during LLR was constructed.

Results
A total of 900 patients in the LLR cohort and 423 patients in the OLR cohort were included. A history of previous antitumor treatment, tumor diameter, tumor location and resection extent were independently associated with risky surgery of LLR. The nomogram which was constructed based on these risk factors demonstrated good accuracy in predicting risky surgery with a C index of 0.83 in the development cohort and of 0.76 in the validation cohort. Patients were stratified into high-, medium- or low-risk levels for receiving LLR if the calculated score was more than 0.8, between 0.2 and 0.8 or less than 0.2, respectively. High-risk patients who underwent LLR had more blood loss (441 ml to 417 ml) and a longer surgery time (183 min to 150 min) than those who received OLR.

Conclusions
Patients classified into the high-risk level for LLR instead undergo OLR to reduce surgical risks and complications and patients classified into the low-risk level undergo LLR to maximize the advantages of minimally invasive surgery.

Trial registration
This study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2100049446).
“Of course, you get depression in this situation”: Explanatory Models (EMs) among Afghan refugees in camps in Northern Greece
Authors: Lavdas Michalis , Guribye Eugene , Sandal Gro Mjeldheim 
Published: February 2023

AbstractBackgroundAfghan refugees and asylum seekers constitute one of the largest groups that live in camp settings in Greece. While they experience psychological distress, they are facing significant barriers in accessing appropriate mental health care. Explanatory Models (EMs) provide a context-sensitive framework for understanding the differences between health professionals, refugees and NGOs that operate on the field. This study aims at further understanding how Afghan refugees perceive and explain depression and largely psychological distress, and how this influences their choices for coping strategies and help-seeking.MethodsThis qualitative study included six vignette-based semi-structured focus-group discussions with Afghan refugees and asylum-seekers (totalN = 19, 12 female and 7 male) residing largely in camp settings in Northern Greece. The vignette describes a fictional person with symptoms of depression in line with DSM-5 and ICD-10 criteria. The interviews were recorded, transcribed, and analysed through template analysis.ResultsEMs for depression are explained through Pre-migration Traumatic Experiences (PMTE) and Post-migration Living Difficulties (PMLD) relating to camp settings. Female participants identified gender-based and domestic violence as contributing to psychological distress while males highlighted conflict and persecution. Life in the camp with associated inactivity, and uncertainty for the future, was perceived as a significant risk factor for psychological distress among females and males. In terms of coping strategies, females tended to focus on mobilizing collective resources within the camp (e.g. safe space for women facilitating emotional support), while males advocated for self-empowerment and solution-oriented coping. The value of engagement in peer helper-roles was highlighted.ConclusionsThe results highlight the potential value of community-based psychosocial approaches to support and promote mental health within camp settings. Additionally, they may inform policies and practices regarding access to appropriate mental health care for Afghan refugees. Further research is needed to establish the efficiency of such interventions in this context.
Experiences of Every Mind Matters, Public Health England’s adult mental health literacy campaign: a qualitative interview study
Authors: Stuart Ruth , Shah Prisha , Olive Rachel Rowan , Trevillion Kylee , Henderson Claire 
Published: February 2023

Abstract
Background
Every Mind Matters (EMM) is a publicly funded health campaign, launched in England in 2019, to equip adults to look after their mental health, and that of others, by offering online information about common problems: anxiety, low mood, sleep, and stress. This study is one component of an independent evaluation of EMM conducted by the NIHR Mental Health Policy Research Unit. Its aim is to explore individuals’ experiences of the EMM campaign and website.

Methods
Four researchers, including three with lived experience of using mental health services, conducted 20, one-off, semi-structured, online interviews with a range of adult participants, including a sample of EMM users and a purposively recruited sub-sample known to have severe or long-term mental health conditions. A codebook thematic analysis was undertaken, and four main themes were identified.

Findings
There was an expectation from the name Every Mind Matters that its advice would address everyone. Almost all participants had experience of mental distress and looked to EMM for help with a current problem for themselves. All participants were complimentary about the EMM website and found it to be user-friendly (theme 1) and personalised (theme 2) especially the interactive feature Your Mind Plan quiz which responds with suggested actions to improve wellbeing and follows up with reminder emails. A few participants found the website information and/or Mind Plan suggestions to be life changing. Some participants wanted EMM to better acknowledge the contexts in which they live (theme 3) such as the limitations of health conditions and health services, and difficulties of crowded housing, social policy, and climate change. Many participants would like EMM to do more (theme 4), offer more interactivity, more choice, more information about available treatments, and more stratified advice to cover more severe mental health conditions.

Conclusion
EMM is available to all, including people with common or severe mental disorders. In the context of overwhelmed mental health services, people with severe mental illness expect more from EMM than advice about common problems. EMM could build on its success by extending its remit to address a wider range of needs so that everyone is included.
Impact of ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses: a cross-sectional study
Authors: Kim Haengsuk , Kim Hyunjung , Oh Younjae 
Published: February 2023

Abstract
Background
While several studies have been performed on turnover intention among nurses, limited studies have considered the ethical perspectives on turnover intention among haemodialysis nurses. The purpose of this study was to clarify the impact of ethical factors, namely ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses.

Methods
This cross-sectional research was conducted between July and August 2017. A total of 148 haemodialysis nurses were invited to participate in the study by convenience sampling from 11 general and university hospitals in South Korea. Data were analysed using SPSS for t-test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression analysis.

Results
In the final regression model, the adjusted R-squared significantly explained 34.6% of the variance in turnover intention (F = 22.534, p < .001) when moral distress related to physician practice (β = 0.310, p = .001) and ethical climate related to the hospital climate (β = − 0.253, p = .003) and manager (β = − 0.191, p = .024) were included. Following the stepwise multiple regression process, all subdomains related to moral sensitivity were excluded due to no statistical significance in the final regression model.

Conclusion
To reduce turnover intention among haemodialysis nurses, hospitals and managers should pay attention to haemodialysis nurses’ moral distress originating from physicians’ practice and improve their ethical climate. Additionally, it is required that the impact of moral sensitivity on turnover among nurses working in diverse care settings be examined further.
COVID-19 versus applied infection control policies in a Major Transplant Center in Iran
Authors: Shafiekhani Mojtaba , Niknam Tahmoores , Tara Seyed Ahmad , Mardani Parviz , Mirzad Jahromi Khatereh , Jafarian Sedigheh , Arabsheybani Sara , Negahban Halimeh , Hamzehnejadi Majid , Zare Zahra , Ghaedi Ghalini Khadijeh , Ghasemnezhad Ali , Akbari Mahmoud , Shahriarirad Reza , MalekHosseini Seyed Ali 
Published: February 2023

Abstract
Background
Since Shiraz Transplant Center is one of the major transplant centers in Iran and the Middle East, this study was conducted to evaluate outcomes of the applied policies on COVID-19 detection and management.

Methods
During 4 months from March to June 2020, patient's data diagnosed with the impression of COVID-19 were extracted and evaluated based on demographic and clinical features, along with the length of hospital stay and expenses.

Results
Our data demonstrated that a total of 190 individuals, with a median age of 58, were diagnosed with COVID-19 during the mentioned period. Among these, 21 patients had a positive PCR test and 56 patients had clinical symptoms in favor of COVID-19. Also, 113 (59%) patients were classified as mild based on clinical evidence and were treated on an outpatient basis. Furthermore, 81 out of 450 cases (18%) of the healthcare workers at our center had either PCR of clinical features in favor of COVID-19. The mortality rate of our study was 11% and diabetes mellitus, hypertension were considered risk factors for obtaining COVID-19 infection. The direct cost of treatment and management of patients with COVID-19 amounted to 2,067,730,919 IRR, which considering the 77 patients admitted to Gary Zone per capita direct cost of treatment each patient was 26,853,648 IRR.

Conclusion
We demonstrated that the COVID-19 pandemic had a noticeable influence on our transplant center in aspects of delaying surgery and increased hospital costs and burden. However, by implanting proper protocols, we were able to was able to provide early detection for COVID-19 and apply necessary treatment and prevention protocols to safeguard the patients under its coverage, especially immunocompromised patients.
Effects of pitavastatin on atherosclerotic-associated inflammatory biomarkers in people living with HIV with dyslipidemia and receiving ritonavir-boosted atazanavir: a randomized, double-blind, crossover study
Authors: Srichatrapimuk Sirawat , Wongsa Artit , Sungkanuparph Somnuek , Kiertiburanakul Sasisopin , Tassaneetrithep Boonrat , Phuphuakrat Angsana 
Published: February 2023

Abstract
Background
Chronic inflammation has been described in people living with HIV (PLHIV) receiving antiretroviral therapy (ART) despite viral suppression. Inflammation associated non-communicable diseases, including atherosclerosis, are becoming recognized complication of HIV infection. We studied the effect of pitavastatin on atherosclerotic-associated inflammatory biomarkers in PLHIV receiving ART.

Methods
A randomized, double-blind, crossover study was conducted in HIV-infected persons with dyslipidemia and receiving atazanavir/ritonavir (ATV/r) to evaluate the effect of 2 mg/day pitavastatin treatment versus placebo. High-sensitivity CRP (hs-CRP), cytokines, and cellular markers in PLHIV receiving 12 weeks of pitavastatin or placebo were investigated.

Results
A total of 24 HIV-infected individuals with a median (interquartile range) age of 46 (41–54) years were recruited, and the median CD4 T cell count was 662 (559-827) cells/mm3. The median duration of ATV/r use was 36 (24–48) months. Significant change in levels of basic fibroblast growth factor (FGF) between pitavastatin treatment and placebo at week 12 from baseline was observed (27.1 vs. 20.5 pg/mL; p=0.023). However, there were no significant changes from baseline of hs-CRP and other plasma cytokine levels at week 12 of pitavastatin or placebo. Regarding cellular markers, percentages of HLA-DR+CD38-CD4+ T cells and PD1+CD4+ T cells significantly decreased from baseline in PLHIV receiving pitavastatin for 12 weeks, as compared to placebo (− 0.27 vs. 0.02%; p=0.049 and − 0.23 vs. 0.23%; p=0.022, respectively).

Conclusions
Pitavastatin treatment increases basic FGF levels, and lowers HLA-DR+CD38-CD4+ T cells, and PD1+CD4+ T cells. Further study on the effects of pitavastatin on preventing cardiovascular diseases in PLHIV should be pursued.
Changes in homegardens in relocation villages, a case study in the Baiku Yao area in Southern China
Authors: Hu Renchuan , Xu Chuangui , Nong You , Luo Binsheng 
Published: February 2023

Abstract
Background
Baiku Yao is an ancient branch of the Yao people in China who have the custom of maintaining homegardens. The local government has relocated some villagers to improve their livelihood. To study the characteristics of Baiku Yao homegardens and the impact of relocation, we conducted an ethnobotanical study on homegardens in the relocated villages of Huaili and Yaozhai and in the ancient villages of Yaoshan and Duonu from January 2019 to May 2022.

Method
Data on homegarden plants were collected through semi-structured interviews with homegarden households. A total of 4 villages (i.e., two relocated and two ancient villages) were selected for detailed investigation. In each village, 60 homegardens were chosen randomly. In addition, the RFC index and Jaccard value were used to analyze and evaluate the homegarden plants we recorded.

Result
The study recorded a total of 213 species of homegarden plants with approximately 11 functions. Baiku Yao homegardens are small in size but rich in species and functions, and their utilization efficiency is extremely high. The Jaccard value shows that the homegarden plants in Huaili and Yaozhai have the highest similarity. Neighborhood sharing and market purchasing are the two most important sources of local homegarden plants. Additionally, medicine and food are the two most important uses of homegarden plants. Ornamental plants also play a significant part, especially in relocated villages. The comparisons indicate that the diversity of homegarden plants in the investigated ancient villages is better preserved than in relocated villages. Due to frequent exchanges between the villages and the outside world, Yaoshan Village, as an older relocated village, maintains a good traditional culture in its homegardens. As a newly relocated village, Duonu Community has developed a complicated homegarden system with only much less plant diversity. The development of local tourism has also impacted the composition of homegarden plants. The study found that plants such as Zea mays, Morus alba, and Capsicum annuum are closely related to local life and livelihood.

Conclusion
The traditional knowledge of homegarden plants in investigated ancient villiages maintained good diversity and has been affected much less by the modernization and tourism industry development compared to the relocated villages. The composition of homegarden plants is closely connected to the local livelihood. In the future development of Baiku Yao communities, protecting homegarden plant diversity and functional diversity is crucial.