bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and psychometric validation of substance abuse prevention Questionnaire based on the multi-theory model: construct validity and reliability
Authors: Afshani Alireza , Mahmoodabad Seyed Saeed Mazloomy , Ardian Nahid , Pourmovahed Zahra , Yoshany Nooshin , Goodarzi-Khoigani Masoomeh 
Published: March 2023

Abstract
Background
The present study determined the validity and reliability of the substance abuse prevention questionnaire based on the multi-theory model among the people of Yazd, central Iran.
Methods
This cross-sectional descriptive-analytical psychometric research was conducted on 391 Akramiyeh, Yazd residents using a systematic sampling method in 2021. First, a questionnaire was prepared based on the results of a qualitative study and the constructs of a multi-theory model, and its face validity was confirmed. Having collected the data, the validity and reliability of the questionnaire were determined with SPSS using factor analysis, internal consistency, convergent validity, and Cronbach's α.
Results
The factor loading of all items was more than 0.5 and was in the desired range. The results obtained from confirmatory factor analysis based on parameter estimation showed that in all seven constructs of the questionnaire, the relevant items had a significant relationship with each latent variable (P < 0.001). All factor loadings were higher than 0.4 and Cronbach's α coefficient was calculated as 0.940 for the entire questionnaire. The highest factor loading (27%) was related to the construct of change in the social environment. Regarding substance abuse prevention behavior, the construct of participatory dialogue played a role by 9.58%, the constructs of emotional transformation by 7.98%, change in the physical environment by 5.95%, behavioral confidence by 3.3%, and practicing for change by 3.16%.
Conclusion
The substance abuse prevention questionnaire based on the multi-theory model has acceptable validity and reliability and can be effective in predicting factors and designing interventions aimed at preventing substance abuse among young people.
A Unique case of Bilateral Nanophthalmos and Pigmentary Retinal Abnormality with Unilateral Angle closure glaucoma and Optic Disc Pit
Authors: Garg Prerna , Kumar Brajesh , Dubey Suneeta 
Published: March 2023

Abstract
Background
Microophthalmos or ‘dwarf eye’ is characterized by an axial length 2 standard deviation less than age-matched controls. It is classified into nanophthalmos, relative anterior microphthalmos, and posterior microphthalmos based on the anterior segment: posterior segment ratio. Nanophthalmos classically occurs in association with optic disc drusen, foveoschisis, and retinitis pigmentosa, as an autosomal recessive syndrome linked to s mutations in the MFRP gene. We report a sporadic case of bilateral nanophthalmos and pigmentary retinopathy with angle closure glaucoma and optic disc pit in one eye. We believe this to be the first case presenting with optic disc pit in association with nanophthalmos.
Case presentation
A 56-year-old female presented with bilateral small eyes, high hypermetropia, shallow anterior chamber depth, increased lens thickness, mid-peripheral retinal flecks, and macular edema. She also had high intraocular pressure in the right eye, with a disc cupping of 0.9 with an Optic disc pit. The macular edema in the right eye was found to occur in association with the Optic disc pit, whereas, in the left eye, it was associated with intra-retinal hemorrhages and diagnosed as macular branch retinal vein occlusion secondary to hypertension. She was started on anti-glaucoma medications in both eyes and planned for Anti-VEGF injection in the left eye.
Conclusion
This case report is unique as it reports an association of Nanophthalmos with Optic Disc pit, with an associated angle closure glaucoma in the same eye, an association which has never been previously reported in the literature.
Analysis of core stability and rehabilitation intervention of traditional exercise therapy on patients with CLBP
Authors: Xu Fei 
Published: March 2023

Abstract
Objective: The purpose of this study was to compare the test results of traditional exercise therapy before and after training, to observe the functional changes of core stability of patients with CLBP, and to provide a reference for the analysis of the core stability function and the evaluation of rehabilitation efficacy for CLBP.
Methods: 72 patients with CLBP (CNLBP) were recruited and screened, with 36 patients (17 males and 19 females) as the experimental group (CLBP), and 36 patients (13 males and 23 females) as the control group (Non group). Two groups of subjects completed the Y-balance test. The CNLBP group participated in a 12-week intervention training, and after the training, the Y-balance test was performed again. The Y balance test on the left and right sides includes 10 indicators, which were A/Limb, PM/Limb, PL/Limb, SUM, and COMPOSITE. The differences between the CLBP group and the Non group, the left and right bilateral differences within the group, and the differences before and after the intervention training in the CLBP group were compared and analyzed.
Results: (1) Before the intervention training, there was no difference between the CLBP group and the Non group, and there was no difference between the left and right sides in each group. There was a difference in the left and right bilateral indicators in the two groups which showed an imbalance; (2) After 12 weeks of training, the test values in all directions in the CLBP group were significantly improved (P<0.05, P<0.01, P<0.001); (3) After 12 weeks of training, the difference between the left and right bilateral tests in the CLBP group decreased.
Conclusion: 12 weeks of intervention training can improve all-round dynamic core stability and improve bilateral imbalance in patients with CLBP.
Improving nurses’ competencies in disaster risk management in a specialized trauma hospital in Iran: Outcome of an online training program
Authors: Farokhzadian Jamileh , Farahmandnia Hojjat , Tavan Asghar , Eskici Gülcan Taskiran , Goki Faezeh Soltani 
Published: March 2023

Abstract
Background
Nurses’ incompetency in disaster risk management can have many negative consequences during disasters, so it is important to prepare nurses and improve their competencies in disaster risk management. This study aimed to evaluate the impact of an online training program on nurses' competencies disaster risk management.
Method
This interventional study was conducted on nurses working in a specialized trauma hospital affiliated with Kerman University of Medical Sciences in southeastern Iran in 2022. Eighty-one nurses were randomly assigned into two interventions (n = 42) and control groups (n = 39). The intervention group received an online training program in four sessions, and both groups electronically completed the demographic questionnaire and the nurses’ perceptions of disaster core competencies scale (NPDCC) before and one month after the intervention.
Results
The study results showed no significant difference in disaster competency scores between the two groups before the intervention (p < 0.51), but the NPDCC score in the intervention group was statistically significant after the intervention compared to before the intervention (p < 0.02) and no statistically significant difference was observed between the two groups after the intervention (p < 0.16).
Conclusion
The study results indicated that the online training program improved nurses’ competencies in the intervention group, so we suggest continuous practical exercises and maneuvers in addition to online training to improve their competencies in disaster risk management.
The underestimation and overestimation accuracy in MRI and SWE compare with the radical prostatectomy, Validation technique using tissue-mimicking phantom
Authors: Alshomrani Faisal , Alsaedi Basim , Wei Cheng , Gandy Stephen , Szewczyk-Bieda Magdalena , Wilson Jennifer , Huang Zhihong , Nabi Ghulam 
Published: March 2023

Abstract
Over the last few years, a number of studies have quantified the limitation of the MRI in quantifying the prostate lesion compared with radical prostatectomy; therefore, the aim of this paper was to assess the size measurements of the prostate cancer lesions by MRI, and SWE compared with radical prostatectomy and to validate the findings by a tissue mimicking phantoms. This study used 16 prostate cancer tissue-mimicking phantoms to obtain preclinical data. We then focused on 31 patients who have undergone mpMRI, SWE, and radical prostatectomy between September 2016 and December 2017. The T-test was used to assess how the significant difference between the imaging modalities MRI, SWE, and the gold standard in clinical and preclinical. Statistically, there was a significant difference between the size measurement of MRI and SWE compared with radical prostatectomy. However, there was no significant difference in pre-clinical when these modalities were compared with the phantom. SWE evidenced a higher detection of prostate cancer compared with MRI since out of the 102 tumours reported by the pathologist, only 57 tumours were reported by the radiologists through MRI, and 72 tumours were reported by the SWE. Both MRI and SWE showed significant differences in the size measurements of the prostate cancer lesions compared with the radical prostatectomy, but SWE showed a higher detection of smaller lesions (less than 10 mm) compared with MRI.
Risk Factors of Pelvic Floor Dysfunction in Postpartum Period: a Cross-Section Study
Authors: Jing Xinyu , Gong Jie , Yang Biru , Wang Yaozheng , Wang Minjia 
Published: March 2023

Abstract
Introduction: Pelvic floor dysfunction (PFD) is most commonly dysfunctions in women, it has been reported to affect 23% to 49% of women according to an epidemiological report. PFDs have many consequences, such as pain, embarrassment, social isolation, and a decreased quality of life (QOL). Thus, this study aims to understand which factors are associated with the development of postpartum pelvic floor dysfunction and determine the degree of such dysfunctions to provide theoretical and data support for clinical diagnosis and treatment of this disorder.
Method: Puerperal women were recruited between September to November of 2021 by an online survey platform called WenjuanXing. And the demographic characteristics and PFDs related questionnaire were be collected and analyzed. Multivariate logistic regression analyses were conducted to identify the risk factors of postpartum PFDs in postpartum women.
Result: A total of 1226 participants were included, the incidence of urinary incontinence (UI), pelvic organ prolapse (POP) and anal incontinence (AI) was 79.6%, 70.7% and 67.4%, respectively. Multivariate logistic regression analyses shown that body mass index (BMI) more than 28 (OR: 2.591, 95% CI: 1.016-6.607), gestational diabetes (OR: 1.541, 95% CI: 1.011-2.348, P=0.044), prenatal incontinence (OR: 2.63, 95% CI: 0.405-0.982), vaginal delivery (OR: 1.521, 95% CI: 0.35-0.774), episiotomy (OR: 1.595, 95% CI: 1.093-2.326) were the risk factors of postpartum UI. BMI more than 28 (OR: 2.337, 95% CI: 1.086-5.029), smoking in pregnancy (OR: 1.434, 95% CI: 0.241-0.78), vaginal delivery (OR: 1.663, 95% CI: 0.473-0.93) were the risk factors of the POP, however, BMI less than 18.5(OR: 546, 95% CI: 0.337-0.885) was considered as a protective factor for POP in statistical methods. BMI less than 18.5 (OR: 0.555, 95% CI: 0.344-0.895) was only the protective factor of Colorectal-Anal Distress Inventory (CRADI).
Conclusion: According to our data, we conclude that the BMI >28, gestational diabetes, prenatal incontinence, vaginal delivery, and episiotomy are risk factors for postpartum UI. In addition to the above risk factors, smoking has also been found to be a risk factor for POP. However, we found no risk factors for AI. Additionally, we found that BMI <18.5 is a protective factor of AI and POP.
The 21-gene recurrence score assay improved MDT compliance in HR+/ HER2- breast cancer patients：An analysis of 2323 patients
Authors: Li Liangqiang , Yu Jing , Shen Kunwei , Chen Xiaosong 
Published: March 2023

Abstract
The 21-gene Recurrence Score (RS) could guide adjuvant chemotherapy decisions in multidisciplinary treatment (MDT) of early breast cancer patients. This study aimed to evaluate the influence of the 21-gene RS assay on patients’ compliance with MDT and its association with disease outcome. Patients diagnosed with pN0-1, hormonal receptor-positive, human epidermal growth factor receptor-2 (HER2)-negative breast cancer between January 2013 and June 2019 were enrolled. The logistic regression model was used to identify the parameters associated with treatment adherence. Prognostic indicators were evaluated by using cox proportional hazard models. After the assay, patients were less likely to violate the treatment plan (14.9% vs. 23.1%, P <0.001), and higher compliance rates were observed for chemotherapy (P = 0.042), radiotherapy (P = 0.012), and endocrine therapy (P <0.001). Multivariable analysis demonstrated that the 21-gene RS assay (OR = 1.43, 95% CI = 1.09-1.88, P = 0.009) was independently associated with MDT compliance. Moreover, compliance to MDT was independently associated with better disease-free survival (HR = 0.43, 95% CI 0.29-0.64, P < 0.001), regardless of 21-gene RS assay (interaction P = 0.842).The 21-gene RS assay improved the MDT compliance rate in early breast cancer patients. Adherence to MDT was associated with a better prognosis.
Ultrasound assessment of gastric content in patients undergoing laparoscopic cholecystectomy after preoperative oral carbohydrates: A prospective, randomized controlled, double-blind study
Authors: Ge Yali , Shen Dejuan , Gao Ju , Zhang Yang , Xin Chao , Mu Zihan , Wu Keting 
Published: March 2023

Abstract
Background: Cholelithiasis patients present with delayed stomach emptying due to pathophysiological abnormalities in the gastrointestinal system. We analyzed the gastric volume and nature after drinking preoperative oral carbohydrates in patients undergoing laparoscopic cholecystectomy via ultrasonography.
Methods: One hundred patients who had been scheduled for elective laparoscopic cholecystectomy were enrolled and randomized into the traditional fasting group (Control group, n=50) and the carbohydrate group (CHO group, n=50). Patients in the Control group fasted solids and drink from midnight, the day before surgery. Patients in the CHO group received 800 ml and 400 ml of oral carbohydrates 11 h and 3 h before anesthesia induction, respectively. At 2 h after oral carbohydrates (T1), all patients underwent an ultrasound examination of residual gastric contents; if the patients had a full stomach, the assessment was performed again 1 h later (T2). A stomach containing solid contents or >1.5 mL/kg of liquid was considered "full". The primary outcome was full stomach incidences at the above time points. The secondary outcomes included gastric antral CSA in the right lateral decubitus (RLD) and semi-sitting positions, as well as gastric volume (GV), GV per weight (GV/kg), and Perla's grade at T1.
Results: Compared with the Control group, the incidence of entire stomach was significantly high in the CHO group 2 h after oral carbohydrates. At the T1 time point, 6 patients (13.3%) in the Control group and 14 patients (30.4%) in the CHO group presented with a full stomach (95% confidence interval [CI], [0.96 to 5.41], P = 0.049). At T2, 3 patients (6.7%) in the Control group and 4 patients (8.7%) in the CHO group had a full stomach, with no marked differences between the two groups (95% CI, [0.31 to 5.50], P=0.716). Compared with the Control group, CSA in the semi-sitting and RLD positions, GV and GV/W were significantly high in the CHO group at T1 (P<0.05). The median (interquartile range) of the Perlas grade was 1(0-1) in the Control group and 1(1-1.25) in the CHO group (P =0.004).
Conclusion: Cholecystectomy patients experience a 2 h delay in gastric emptying after receiving preoperative carbohydrates. However, when preoperative carbohydrates were consumed up to 3 h before anesthesia, as assessed by gastric ultrasonography, gastric emptying incidences were comparable between the CHO and the midnight fasting group. In LC patients, the fasting window for oral carbohydrates before surgery should be adequately prolonged.
Trial registration: The study registered on the Chinese Clinical Trial Registry (www.chictr.org.cn), Clinical Trials identifier ChiCTR2200055245 (04/01/2022).
Use of Antiplatelet and Lipid Lowering Agent Therapies as Primary Cardiovascular Disease Prevention Strategy and their Determinant Factors among Type 2 Diabetes Mellitus Patients in University of Gondar Comprehensive Specialized Hospital, Gondar: A Prospective Cross- sectional Study
Authors: Solomon Tewodros , Tadesse Sumeya , Tewabe Abebech , Tsehay Tessema 
Published: March 2023

Abstract
Background: Patients with type 2 diabetes mellitus have two to four times increased risk of cardiovascular events compared with those without diabetes. Anti-platelet therapy and lipid lowering therapies have a significant contribution to prevent primary cardiovascular disease to achieve optimal patient outcomes.
Objective: This study aimed to assess the use of antiplatelet and lipid lowering agent therapies as primary cardiovascular disease prevention strategies and their determinant factors among type 2 diabetes mellitus patients in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.
Methods: A prospective cross sectional study was conducted among 405 type 2 diabetes mellitus patients selected using a systematic random sampling method. Semi-structured questionnaire and data abstraction format were used for data collection. The data was collected from May 1 – July 30, 2022. The data was entered into Epidata version 3 and exported to SPSS version 25.0 statistical packages. Multivariable binary logistic regression analysis was done for identifying factors associated with use antiplatelet and lipid lowering agent. Statistical significance was declared at 95% confidence interval.
Result:Out of 405 study participants, the majority of study participants 301 (74.3%) had low (<10%) 10-year cardiovascular disease risk and moderate risk was 75 (18.5%). Statin was used for 180 (44.4%) of the study participants. While 81mg aspirin was used for 38 participants. About 58.8% using statin appropriately while 89.9% of them using aspirin appropriately. Ages between 65 - 69 years old (AOR = 3.76, 95% CI: 1.33- 10.61), taking alcohol (AOR = 0.38, 95%: 0.23 - 0.64), being hypertensive (AOR = 2.30, 95%CI: 1.38-3.86) and using two or more glucose lowering agent (AOR = 4.60, 95%CI: 2.72- 7.78) were significantly associated with use of statin. On the other hand, use of more than one glucose lowering agent (AOR = 4.36, 95%CI: 1.64 - 11.61) and being hypertensive (AOR = 3.34, 95%CI: 1.24 - 8.96) were associated with the use of aspirin.
Conclusion:The appropriate indication of lipid lowering agent was low. So, this population is at high potential risk for the development cardiovascular disease and predisposed to unwanted medication side effects. Also, aspirin was used for 10% of patients who were scored under high risk, which implicates these populations are at high risks for bleeding and Reye syndrome, despite the low benefit. These results emphasize the necessity of considering the cardiovascular disease risk of the patients and apply an appropriate measure for primary prevention.
An alternative raw material for Portland cement clinker preparation: Meta-schist
Authors: Korkmaz Abdul Vahap , Hacıfazlıoğlu Hasan 
Published: March 2023

Abstract
This study investigates the use of meta-schist as an alternative base material to cement clay in clinker production. First, the mineralogical differences between the reference cement clay, rich in silica but poor in iron and aluminium and the meta schist, rich in aluminium and iron and relatively poor in silica, were revealed by the XRD method. Two raw meal samples were prepared, one with ordinary raw materials (limestone and clay) ((RM)/Ref) and the other with meta-schist ((RM)/M) as a reference sample. The effects on the reactivity of the raw mix samples were evaluated on the basis of the unreacted lime content in the samples sintered at 1200, 1300, 1350, 1400 and 1450 °C. Then, two different clinker samples were produced by sintering the two raw mixtures at 1450°C. The relationships between the internal structures of the clinker samples determined by polarizing microscope (amount of porosity, distribution, grain structure of silicate phase crystals and variation of equivalent crystal diameters) were investigated. In addition, setting time, compressive strength and expandability properties of cement mortars produced with both clinker samples were tested. The microstructures of the mortar samples were examined on the 2nd, 7th and 28th days by scanning electron microscopy. It was observed that the meta-schist clinker contains less free CaO than the reference clinker at different temperatures. Both clinkers have similar proportions of alite and microstructures of alite and belite are identical in terms of crystal size and composition. At the same time, the distribution of the liquid phase is more uniform in the reference cement. Using meta-schist, low-temperature and low-cost Portland cement clinker can be produced without additional regulatory materials and blending.
The Influence of Maritime Continent Deforestation on El Niño-Southern Oscillation: Insights from Idealized Modeling Experiments
Authors: Yu Jin-Yi , LEE TING HUI , LIN YONG FU , Lo Min-hui 
Published: March 2023

Abstract
During the past two decades, the Maritime Continent (MC) has experienced increased deforestation1,2. Using hundred-year long ensemble idealized deforestation experiments conducted with the fully-coupled Community Earth System Model (CESM) V1.2, here we show that the MC deforestation have a potential to alter the complexity (i.e., event-to-event differences) of the El Niño-Southern Oscillation (ENSO) in terms of its spatial pattern and temporal evolution. The deforestation model run increases the occurrences of Central Pacific El Niño and multi-year La Niña events compared to the control experiment. This change in ENSO complexity is caused by the strengthening effect of MC deforestation on subtropical ENSO dynamics. Conventional tropical ENSO dynamics influence ENSO occurrence and evolution through variations in the tropical Pacific thermocline and related tropical ocean-atmosphere interactions. However, subtropical ENSO dynamics govern the ENSO through coupling processes originated from the subtropical North Pacific. The MC deforestation in our idealized experiment accompanies an anomalous local overturning, which further alters the mean strength of the North Pacific subtropical high and strengthens subtropical ENSO dynamics. Therefore, MC deforestation has the potential to make the El Niño more complex and less predictable.