bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does refining an intervention based on participant feedback increase acceptability? An experimental approach
Authors: Keyworth Chris , Quinlivan Leah , Leather Jessica Z. , O’Connor Rory C. , Armitage Christopher J. 
Published: August 2023

Abstract
Background
Participant feedback is an important consideration for increasing intervention acceptability, yet whether incorporating such feedback actually improves acceptability is rarely tested.

Purpose
The present study describes a theory-based approach to assessing whether refining an intervention based on participant feedback increases acceptability.

Methods
Three hundred and ninety-three UK adults who had previously self-harmed were exposed to the same intervention at baseline and, six months later, were randomly allocated to receive either: (a) the same version of the intervention (control group), or (b) a version of the intervention that had been refined following participant feedback (experimental group). The main outcome measure was acceptability ratings for each of the seven domains specified in the Theoretical Framework of Acceptability (TFA).

Results
Mixed ANOVAs, with control versus experimental group as the between-participants factor and time (baseline versus follow-up) as the within participants factor showed no significant changes in acceptability.

Conclusions
The null effects reported here imply that participants found both the original and modified versions of the intervention equally acceptable, and that our process of refining an intervention based on participant feedback did not impact on acceptability. Nevertheless, we have operationalised a robust approach for examining whether participant feedback impacts on the acceptability of an intervention. Further research is required to understand better how participant feedback should be incorporated into the development of healthcare interventions.
Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors
Authors: Yazbeck Gabriella , Malaeb Diana , Shaaban Hamid , Sarray El Dine Abir , Hallit Souheil , Hallit Rabih 
Published: August 2023

Abstract
Background
Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, but the condition is still underdiagnosed. The high of rate of unidentified IBS by patients can be related to different factors. The aim of this study is to assess the rate of unidentified IBS among Lebanese adults and investigate the role of socio-demographic factors, anxiety, depression, insomnia and eating attitudes on IBS diagnosis.

Methods
A cross-sectional study was conducted among Lebanese adults older than 18 years between June 2022 and December 2022, using a self-reporting questionnaire distributed via social media.

Results
A total of 425 participants was enrolled in the study with around 184 (46.8%) having a possible unidentified IBS. Higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.08) were significantly associated with higher odds of having possible unidentified IBS whereas a higher household crowding index (aOR = 0.67) was significantly associated with lower odds of having possible IBS. The correlation of eating attitudes with cigarette smoking (aOR = 1.33; p = .025; 95% CI 1.04; 1.70) and insomnia severity with cigarette smoking (aOR = .89; p = .023; 95% CI .80; .98) were significantly associated with the presence of possible IBS. In nonsmokers, higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.10) were significantly associated with higher odds of having possible IBS. In smokers, higher BMI (aOR = .78) was significantly associated with lower odds of having possible IBS, whereas higher eating attitudes scores (more inappropriate eating) (aOR = 1.40) were significantly associated with higher odds of having possible IBS.

Conclusion
The study highlighted the implication of raising awareness about IBS among the Lebanese population to promote early diagnosis and minimize the rate of unidentified IBS by patients. Initiation of appropriate treatment plans, tailored symptomatic management approach, and diet programs should be highly encouraged.
How safe are intra-articular corticosteroid injections to the hip?
Authors: Streck Laura Elisa , Braun Sebastian , Spilo Kimi , Boettner Cosima Sue , Brenneis Marco , Boettner Friedrich 
Published: August 2023

Abstract
Background
Intra-articular corticosteroid injections (ICSI) are an effective symptomatic treatment for osteoarthritis of the hip. However, the safety of ICSI has been questioned and a relatively high risk for septic arthritis, rapidly progressive osteoarthritis (RPIO) and periprosthetic joint infections (PJI) in patients undergoing subsequent total hip arthroplasty (THA) have been suggested.

Methods
This is a retrospective evaluation of 682 hips that underwent ICSI with 40 mg of Triamcinolone for primary osteoarthritis of the hip. All ICSI were performed using sterile techniques, the number of ICSI in each hip and the cumulative corticosteroid dosage were assessed. Pre- and post-injection radiographs were compared to identify cases with RPIO. Native joint septic arthritis, surgical site infections and PJI were identified by chart review.

Results
4 hips (0.6%) developed RPIO 2–4 months following ICSI. The cumulative Triamcinolone dose was not associated with the development of RPIO (p = 0.281). 1 case was diagnosed with septic arthritis and treated with staged THA, there were no signs of infection at a 5 years follow-up. 483 hips (75.7%) underwent THA, including 199 hips with THA less than 3 months following ICSI and 181 hips with > 1 ICSI prior to THA. There were 3 superficial surgical site infections/wound dehiscence and no PJI.

Conclusion
The rate of RPIO was 0.6%. The current findings suggest that if ICSI is performed under sterile conditions, the risk for septic arthritis or PJI following THA, even in patients with multiple ICSI or ICSI within 3 months prior to surgery, is minimal.
Students’ perception of e-learning during the Covid-19 pandemic: a survey study of Iranian nutrition science students
Authors: Eslamian Ghazaleh , Khoshnoodifar Mehrnoosh , Malek Shirin 
Published: August 2023

AbstractBackgroundCOVID–19 pandemic caused university closures, which created learning challenges for students worldwide. Switching to online educational systems had significant impact on students’ performances. The current study aims to investigate the perception of university students from the Nutrition Science department regarding e-learning in Iran.MethodsThe design of the study is cross-sectional. Data were collected through online surveys from Iranian students from the Nutrition Sciences Department. Stratified random sampling was used to randomly select 955 participants. A self-administered validated questionnaire was used for data collection. Descriptive statistics, Analysis of Variance (ANOVA) and Chi-Square tests were used for analysis of the data.ResultsResults revealed that 67.2% of students didn’t have any former experience of e-learning. About 38.3% had moderate levels of Information Technology (IT) skills. Our results revealed that based on students’ responses, being able to stay at home was one of the most common benefits of e-learning (39.1%). However, the most common challenge that students faced was related to technical problems (39.6%). When compared to e-learning, most students preferred face-to face type of learning. Students believed that this method no only increased their knowledge but also their skills and social competence as compared to e-learning. Only 28% of students rated e-learning as enjoyable. Furthermore, acceptance of online based education was statistically associated with students’ degree level.ConclusionIn conclusion, students reported both advantages and disadvantages of e-learning but still reported that face-to-face learning is considered the most effective form of learning.
Influence of Basic Health Care Provision Fund in improving primary Health Care in Kano state, a descriptive cross-sectional study
Authors: Ibrahim Zainab Auwalu , Konlan Kennedy Diema , Moonsoo Yoon , Kwetishe Paul , Ryu Jongsoo , Ro Da Sol , Kim So Yoon 
Published: August 2023

Abstract
Background
The Basic Health Care Provision Fund (BHCPF) is a direct financial investment that funds Primary Healthcare (PHC) to improve the quality of services. This study assessed the influence of the BHCPF in improving PHC services.

Methods
A descriptive cross-sectional study was conducted among PHC workers in 100 facilities randomly selected from the 484 designated PHCs for implementing the BHCPF project in Kano state. Using multiple sampling methods, 200 healthcare workers in PHC facilities were selected and assisted by trained data collectors to respond to the questionnaires. Chi-square analysis was used to show associated factors, while binary regression analysis was used to determine the relationship between factors influencing the BHCPF implementation in PHC.

Result
The findings showed healthcare workers had higher awareness (61.7%) and good utilization (57.1%) of BHCPF. Challenges of the BHCPF implementation were insufficiently skilled health professionals (85%), lack of data management capacity (52.6%), low community participation and awareness (52.0%), delay in releasing funds (60.7%), poor infrastructure (87.8%), and weak financial management and accountability system (58.2%). Healthcare professionals having a diploma were four times more likely to have the National Health Management Information System (NHMIS) in their facilities (AOR = 4.955, 95% CI = 1.120–21.036; P-value 0.035) than those without. Primary healthcare facilities were two times more likely to have the NHMIS (AOR = 2.549, 95% CI = 1.167–5.566: P-value 0. 019) than health post.

Conclusion
The factors that influenced PHC facilities to promote the implementation of BHCPF included: periodic evaluation of the facilities, availability of functional storage facilities, and improving the standard of care in PHC facilities. There is a need for retraining healthcare workers and creating more community awareness of the BHCPF.
Healthcare leaders’ and elected politicians’ approach to support-systems and requirements for complying with quality and safety regulation in nursing homes – a case study
Authors: Magerøy Malin Rosell , Braut Geir Sverre , Macrae Carl , Wiig Siri 
Published: August 2023

Abstract
Background
Healthcare leaders play an important and complex role in managing and handling the dual responsibility of both Health, Safety and Environment (HSE) for workers and quality and patient safety (QPS). There is a need for better understanding of how healthcare leaders and decision makers organize and create support structures to handle these combined responsibilities in practice. The aim of this study was to explore how healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS in a Norwegian nursing home context. Moreover, we explore how they interpret, negotiate, and manage the dual responsibility and possible tensions between employee health and safety, and patient safety and quality of service delivery.

Methods
The study was conducted in 2022 as a case study exploring the experience of healthcare leaders and elected politicians in five municipalities responsible for providing nursing homes services in Norway. Elected politicians (18) and healthcare leaders (11) participated in focus group interviews (5) and individual interviews (11). Data were analyzed using inductive thematic analysis.

Results
The analysis identified five main themes explaining how the healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS:
1. Establish frameworks and room for maneuver in the work with HSE and QPS.
2. Create good routines and channels for communication and collaboration.
3. Build a culture for a health-promoting work environment and patient safety.
4. Create systems to handle the possible tensions in the dual responsibility between caring for employees and quality and safety in service delivery.
5. Define clear boundaries in responsibility between politics and administration.

Conclusions
The study showed that healthcare leaders and elected politicians who are responsible for ensuring sound systems for quality and safety for both patients and staff, do experience tensions in handling this dual responsibility. They acknowledge the need to create systems and awareness for the responsibility and argue that there is a need to better separate the roles and boundaries between elected politicians and the healthcare administration in the execution of HSE and QPS.
The association between triglyceride glucose index and arthritis: a population-based study
Authors: Yan Yuxin , Zhou Liyu , La Rui , Jiang Ming , Jiang Dinghua , Huang Lixin , Xu Wu , Wu Qian 
Published: August 2023

Abstract
Objectives
Insulin resistance is a well-established contributor to inflammation; however, the specific association between the triglyceride glucose (TyG) index, a biomarker reflecting insulin resistance, and arthritis remains unexplored. As a result, the main aim of this study was to examine the correlation between the TyG index and arthritis.

Methods
This observational study used data from the National Health and Nutrition Examination Survey (NHANES), which was conducted between 2007 and 2018. To investigate the relationship between the TyG index and arthritis, various statistical analyses were employed, including weighted multivariable logistic regression analysis, subgroup analysis, curve fit analysis, and threshold effect analysis.

Results
In total, 14,817 patients were enrolled in the trial, with 4,191 individuals (28.29%) diagnosed with arthritis. An increased risk of arthritis was found to be significantly correlated with higher TyG index values (odds ratio OR = 1.15, 95% confidence interval CI: 1.07–1.23), according to the results of multivariable logistic regression analysis after full adjustment. Subgroup analysis and interaction tests further indicated that the TyG index exhibited an additive effect when combined with other established risk factors, including age (OR = 1.29; 95% CI: 1.17–1.41), body mass index (BMI) (OR = 1.43; 95% CI: 1.24–1.69), and diabetes (OR = 1.20; 95% CI: 1.11–1.31). Additionally, curve fit analysis and threshold effect analysis demonstrated a nonlinear relationship with a breakpoint identified at 8.08 µmol/L.

Conclusion
The TyG index was positively correlated with arthritis in adults under 60 years of age in the United States who had normal weight and no diabetes. Further large-scale prospective studies are warranted for a comprehensive analysis of the role of the TyG index in arthritis.
GREM1 is a potential biomarker for the progression and prognosis of bladder cancer
Authors: Jiang Peng-cheng , Xu Li-zhe , Ning Jin-zhuo , Cheng Fan 
Published: August 2023

Abstract
Background
Gremlin-1 (GREM1) is a protein closely related to tumor growth, although its function in bladder cancer (BCa) is currently unknown. Our first objective was to study the GREM1 treatment potential in BCa.

Methods
BCa tissue samples were collected for the detection of GREM1 expression using Western blot analysis and Immunofluorescence staining. Association of GREM1 expression with clinicopathology and prognosis as detected by TCGA (The Cancer Genome Atlas) database. The functional investigation was tested by qRT-PCR, western blot analysis, CCK-8, cell apoptosis, wound healing, and transwell assays. The interaction between GREM1 and the downstream PI3K/AKT signaling pathway was assessed by Western blot analysis.

Results
GREM1 exhibited high expression in BCa tissues and was linked to poor prognosis. Stable knockdown of GREM1 significantly inhibited BCa cell (T24 and 5637) proliferation, apoptosis, migratory, invasive, as well as epithelial-mesenchymal transition (EMT) abilities. GREM1 promotes the progression in BCa via PI3K/AKT signaling pathway.

Conclusion
Findings demonstrate that the progression-promoting effect of GREM1 in BCa, providing a novel biomarker for BCa-targeted therapy.
The multi-omics analyses of acsl1 reveal its translational significance as a tumor microenvironmental and prognostic biomarker in clear cell renal cell carcinoma
Authors: Yang Yang , Liang Jiayu , Zhao Junjie , Wang Xinyuan , Feng Dechao , Xu Hang , Shen Yu , Zhang Yaowen , Dai Jindong , Wang Zhipeng , Wei Qiang , Liu Zhenhua 
Published: August 2023

Abstract
Background
Clear cell renal cell carcinoma (ccRCC) is the dominant subtype of kidney cancer. Dysregulation of long-chain acyl-CoA synthetase 1 (ACSL1) is strongly implicated in undesirable results in varieties of cancers. Nevertheless, the dysregulation and associated multi-omics characteristics of ACSL1 in ccRCC remain elusive.

Methods
We probed the mRNA and protein profiles of ACSL1 in RCC using data from the Cancer Genome Atlas, Gene Expression Omnibus, the Human Protein Atlas (HPA), and Clinical Proteomic Tumor Analysis Consortium (CPTAC) and verified them in our patient cohort and RCC cell lines. Correlations between ACSL1 expression and clinicopathological features, epigenetic modification and immune microenvironment characteristics were analyzed to reveal the multi-omics profile associated with ACSL1.

Results
ACSL1 was down-regulated in ccRCC tissues compared to adjacent normal tissues. Lower expression of ACSL1 was linked to unfavorable pathological parameters and prognosis. The dysregulation of ACSL1 was greatly ascribed to CpG island-associated methylation modification. The ACSL1 high-expression subgroup had enriched fatty acid metabolism-related pathways and high expression of ferroptosis-related genes. In contrast, the ACSL1 low-expression subgroup exhibited higher immune and microenvironment scores, elevated expression of immune checkpoints PDCD1, CTLA4, LAG3, and TIGIT, and higher TIDE scores. Using data from the GDSC database, we corroborated that down-regulation of ACSL1 was associated with higher sensitivity towards Erlotinib, Pazopanib, and PI3K-Akt-mTOR-targeted therapeutic strategies.

Conclusion
Taken together, our findings point to ACSL1 as a biomarker for prognostic prediction of ccRCC, identifying the tumor microenvironment (TME) phenotype, and even contributing to treatment decision-making in ccRCC patients.
Improved weed segmentation in UAV imagery of sorghum fields with a combined deblurring segmentation model
Authors: Genze Nikita , Wirth Maximilian , Schreiner Christian , Ajekwe Raymond , Grieb Michael , Grimm Dominik G. 
Published: August 2023

Abstract
Background
Efficient and site-specific weed management is a critical step in many agricultural tasks. Image captures from drones and modern machine learning based computer vision methods can be used to assess weed infestation in agricultural fields more efficiently. However, the image quality of the captures can be affected by several factors, including motion blur. Image captures can be blurred because the drone moves during the image capturing process, e.g. due to wind pressure or camera settings. These influences complicate the annotation of training and test samples and can also lead to reduced predictive power in segmentation and classification tasks.

Results
In this study, we propose , a combined deblurring and segmentation model for weed and crop segmentation in motion blurred images. For this purpose, we first collected a new dataset of matching sharp and naturally blurred image pairs of real sorghum and weed plants from drone images of the same agricultural field. The data was used to train and evaluate the performance of on both sharp and blurred images of a hold-out test-set. We show that outperforms a standard segmentation model that does not include an integrated deblurring step, with a relative improvement of $$13.4 \%$$

13.4
%

in terms of the Sørensen-Dice coefficient.

Conclusion
Our combined deblurring and segmentation model is able to accurately segment weeds from sorghum and background, in both sharp as well as motion blurred drone captures. This has high practical implications, as lower error rates in weed and crop segmentation could lead to better weed control, e.g. when using robots for mechanical weed removal.
The cost effectiveness of intensity-modulated radiation therapy and three-dimensional conformal radiotherapy in the treatment of head and neck cancers
Authors: Varmaghani Mehdi , Amiri Malihe , Ebrahimpour Hossein , Salek Roham , Javan-Noughabi Javad 
Published: August 2023

Abstract
Purpose
Intensity-modulated radiotherapy is developed as a replacement for 3-dimensional conformal radiation therapy. Considering the difference in costs and effectiveness of these interventions, the aim of this study was to compare the cost effectiveness of intensity-modulated radiation therapy and three-dimensional conformal radiotherapy in the treatment of head and neck cancer in east of Iran.

Methods
A Markov model including six states based on xerostomia and dysphagia was developed to estimate the incremental cost effectiveness ratio from the perspective of societal. Cost and quality of life data were collected from 97 respondents via a checklist and EuroQol-5Dimension questionnaire. The robustness of results was examined by deterministic and probabilistic sensitivity analysis. All analysis were conducted with Treeage software.

Results
The results of this study showed that the cost and quality adjusted life years for 3-dimensional conformal radiation therapy were 9209.76 and 3.63 respectively. However, the cost and quality adjusted life years for intensity-modulated radiotherapy were 12562.90 and 3.17 respectively. Therefore, 3-dimensional conformal radiation therapy produced 0.45 more quality adjusted life years than intensity-modulated radiotherapy and saved $3353. According to the incremental cost effectiveness ratio, 3-dimensional conformal radiation therapy as compared to intensity-modulated radiotherapy saved $7367.27 per quality adjusted life years. These results confirmed by sensitivity analysis.

Conclusion
This study concluded that in the treatment of head and neck cancer, the 3-dimensional conformal radiation therapy method appears to be cost-effective when compared with intensity-modulated radiotherapy.