bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient activation in adults attending appointments in general practice: a cross-sectional study
Authors: Hernar Ingvild , Graue Marit , Igland Jannicke , Richards David A. , Riise Hilde Kristin Refvik , Haugstvedt Anne , Kolltveit Beate-Christin Hope 
Published: July 2023

Abstract
Background
Patient activation refers to patients’ knowledge, confidence, skills, ability, beliefs, and willingness to manage their health and healthcare. Patient activation is an essential component of self-management and identifying patient activation levels will identify people at risk for health decline at an earlier stage. We aimed to explore patient activation in among adults attending general practice by (1) investigating differences in patient activation according to characteristics and markers of health-related behaviour; (2) examining the associations of quality of life and satisfaction with health with patient activation; and (3) comparing patient activation between persons with or without type 2 diabetes (T2D) and with or without elevated T2D risk.

Methods
We performed a cross-sectional study and recruited 1,173 adult patients from four Norwegian general practices between May to December 2019. The participants completed a questionnaire containing sociodemographic and clinical variables, the Patient Activation Measure (PAM-13), the quality of life and satisfaction with health items from the WHO Quality of Life-BREF, three questions about exercise (regularity, intensity and exercise time), the Finnish Diabetes Risk Score (FINDRISC) and Body Mass Index. We tested differences between groups and associations using Chi-squared tests, Fisher’s exact tests, t-tests, one-way ANOVAs and Spearman’s rho tests.

Results
The sample’s mean PAM-13 score was 69.8 (0–100) (SD 14.8). In the total population, we found that participants reporting higher patient activation scores also reported more favourable health-related behaviours (exercise and healthy eating). We found positive correlations between the PAM-13 scores and, respectively, the quality of life score and the satisfaction with health score. We found no differences in patient activation between people with or without T2D and those with or without elevated T2D risk.

Conclusions
We found that higher patient activation was associated with favourable health-related behaviours, a better quality of life and better satisfaction with health among adults attending four general practices in Norway. Assessing patient activation has the potential to help general practitioners identify patients who might benefit from closer follow-up in advance of negative health outcomes.
Frail patients who fall and their risk on major bleeding and intracranial haemorrhage. Outcomes from the Fall and Syncope Registry
Authors: Zwart LAR , Germans T , Vogels R , Simsek S , Hemels MEW , Jansen RWMM 
Published: July 2023

Abstract
Background
Major bleeding, and intracranial bleeding specifically, are severe complications related to the use of anticoagulation. To what extent the risk for major bleeding is elevated among frail older people is not well known because they are underrepresented in the randomized clinical trials (RCTs). This study investigates the risk for major bleeding (MB) and intra cranial haemorrhage (ICH) in frail older people who fall.

Methods
All patients 65 years and older visiting the Fall and Syncope Clinic, between November 2011 and January 2020, and underwent a MRI of the brain were eligible. Frailty was assessed with a Frailty Index, based on the accumulation of deficits model. Cerebral small vessel disease was described and evaluated as proposed in the position paper of Wardlaw and colleagues in 2013.

Results
479 patients were included in this analysis. Mean follow-up was 7 years per patient (ranging from 1 month to 8 years and 5 months). 368 patients (77%) were frail. A total of 81 patients used oral anticoagulation (OAC). 17 extracranial MB of which 3 were traumatic and 14 gastrointestinal, and 16 ICH occurred. There was a total of 603.4 treatment years with OAC, and 8 MBs occurred among patients on OAC (bleeding rate 1.32 per 100 treatment years), of which 2 ICHs (bleeding rate 0.33 per 100 treatment years). The risk for extracranial MB was increased by the use of antiplatelet agents (APA) (adjusted OR 6.9, CI 95% 1.2–38.3), and by the use of OAC (adjusted OR 9.8, CI 95% 1.7–56.1). The risk for ICH was only heightened by white matter hyperintensities (WMH) (adjusted OR 3.8, CI 95% 1.0-13.4). The use of APA (adjusted OR 0.9, CI 95% 0.3–3.3) or OAC (adjusted OR 0.6, CI 95% 0.1–3.3) did not elevate the risk for ICH.

Conclusion
In contrast to common belief, frail patients on OAC with repeated falls show a comparable bleeding rate as in the large RCTs, and the use of OAC did not increase the risk for ICH. However, the number of MBs was low, and of ICHs very low, despite extensive follow-up in this registry.
Sociodemographic and lifestyle determinants of multimorbidity among community-dwelling older adults: findings from 346,760 SHARE participants
Authors: Ni Wenqing , Yuan Xueli , Zhang Yan , Zhang Hongmin , Zheng Yijing , Xu Jian 
Published: July 2023

Abstract
Background
This study aimed to investigate the prevalence of multimorbidity and its associated factors among the older population in China to propose policy recommendations for the management of chronic diseases in older adults.

Methods
This study was conducted based on the 2021 Shenzhen Healthy Ageing Research (SHARE), and involved analysis of 346,760 participants aged 65 or older. Multimorbidity is defined as the presence of two or more clinically diagnosed or non self-reported chronic diseases among the eight chronic diseases surveyed in an individual. The Logistic analysis was adopted to explore the potential associated factors of multimorbidity.

Results
The prevalences of obesity, hypertension, diabetes, anemia, chronic kidney disease, hyperuricemia, dyslipidemia and fatty liver disease were 10.41%, 62.09%, 24.21%, 12.78%, 6.14%, 20.52%, 44.32%, and 33.25%, respectively. The prevalence of multimorbidity was 63.46%. The mean count of chronic diseases per participant was 2.14. Logistic regression indicated that gender, age, marriage status, lifestyle (smoking status, drinking status, and physical activity), and socioeconomic status (household registration, education level, payment method of medical expenses) were the common predictors of multimorbidity for older adults, among which, being women, married, or engaged in physical activity was found to be a relative determinant as a protective factor for multimorbidity after the other covariates were controlled.

Conclusion
Multimorbidity is prevalent among older adults in Chinese. Guideline development, clinical management,and public intervention should target a group of diseases instead of a single condition.
Establishment of a multi-parameter prediction model for the functional cure of HBeAg-negative chronic hepatitis B patients treated with pegylated interferonα and decision process based on response-guided therapy strategy
Authors: Tang Qianqian , Ye Jun , Zhang Yafei , Zhang Peixin , Xia Guomei , Zhu Jie , Wei Shaofeng , Li Xu , Zhang Zhenhua 
Published: July 2023

Abstract
Background & aims
This study aimed to establish multivariate prediction models according to a response-guided therapy (RGT) based strategy at baseline and week 12 and 24 of follow-up to predict the functional cure for HBeAg-negative patients with chronic hepatitis B (CHB) treated with pegylated interferonα (PEG-IFNα).

Methods
A total of 242 HBeAg-negative patients with CHB were treated with PEG-IFNα for 52 weeks and followed up for 24 weeks. Responses at the end of follow-up (EOF) were defined as hepatitis B surface antigen (HBsAg) loss, and patients were defined as either responders or non-responders.

Results
The three most meaningful predictors were an age ≤ 40 years, alanine aminotransferase (ALT) levels ≤ 40 U/L, and HBsAg levels ≤ 100 IU/mL at baseline; ALT levels ≥ 80 U/L, anti-HBc levels ≤ 8.42 S/CO, and HBsAg levels ≤ 50 IU/mL at week 12; and ALT levels ≥ 40 U/L, anti-HBc levels ≤ 8.46 S/CO, and HBsAg levels ≤ 0.2 IU/mL at week 24. The response rates of patients with a score of 0–1 and 4–5 at baseline, week 12, and 24 were 13.5%, 7.8%, and 11.7%; and 63.6%, 68.1%, and 98.1%, respectively. At week 12, the cumulative scores were 0–2, 3–4, 5–7, and 8–10 (response rates 5.0%, 18.9%, 41.3%, and 71.4%, respectively). At week 24, the cumulative scores were 0–3, 4–6, 7–10, and 11–15 (response rates: 1.3%, 12.3%, 37.0%, and 92.5%, respectively). At baseline, patients with scores of 0–1 were slightly recommended; at week 12, patients with 0–1 or 0–2 cumulative scores were recommended to stop treatment. At week 24, patients with a score of 0–1 or a cumulative score of 0–6 were recommended to stop treatment.

Conclusion
We established a multi-parameter prediction model for the functional cure of HBeAg-negative patients with CHB treated with PEG-IFNα.
An integrative bioinformatics investigation and experimental validation of chromobox family in diffuse large B-cell lymphoma
Authors: Zhou Fenling , Chen Lu , Lu Peng , Cao Yuli , Deng Cuilan , Liu Gexiu 
Published: July 2023

Abstract
Background
Diffuse large B-cell lymphoma (DLBCL) is one of the most aggressive malignant tumors. Chromobox (CBX) family plays the role of oncogenes in various malignancies.

Methods
The transcriptional and protein levels of CBX family were confirmed by GEPIA, Oncomine, CCLE, and HPA database. Screening of co-expressed genes and gene function enrichment analysis were performed by GeneMANIA and DAVID 6.8. The prognostic value, immune cell infiltration and drug sensitivity analysis of CBX family in DLBCL were performed by Genomicscape, TIMER2.0, and GSCALite database. Confirmatory Tests of CBX family protein expression in DLBCL were performed by immunohistochemistry.

Results
The mRNA and protein expressions of CBX1/2/3/5/6 were higher in DLBCL tissues than control groups. Enrichment analysis showed that the functions of CBX family were mainly related to chromatin remodeling, methylation-dependent protein binding, and VEGF signaling pathway. The high mRNA expressions of CBX2/3/5/6 were identified to be associated with short overall survival (OS) in DLBCL patients. Multivariate COX regression indicated that CBX3 was independent prognostic marker. Immune infiltration analysis revealed that the mRNA expressions of CBX family (especially CBX1, CBX5, and CBX6) in DLBCL were significantly correlated with the infiltration of most immune cells (including B cells, CD8 + T cells, CD4 + T cells, neutrophils, monocytes, macrophages, and Treg cells). Meanwhile, there was a strong correlation between the expression levels of CBX1/5/6 and surface markers of immune cells, such as the widely studied PVR-like protein receptor/ligand and PDL-1 immune checkpoint. Notably, our study found that DLBCL cells with CBX1 over-expression were resistant to the common anti-tumor drugs, but CBX2/5 had two polarities. Finally, we confirmed the higher expressions of CBX1/2/3/5/6 in DLBCL tissues compared with control groups by immunohistochemistry.

Conclusion
We provided a detailed analysis of the relationship between the CBX family and the prognosis of DLBCL. Distinguished from other studies, We found that high mRNA expressions of CBX2/3/5/6 were associated with poor prognosis in DLBCL patients, and Multivariate COX regression indicated that CBX3 was independent prognostic marker. Besides, our study also found an association between the CBX family and anti-tumour drug resistance, and provided a relationship between CBX family expression and immune cell infiltration.
A patient with a Berger’s space filled by silicone oil
Authors: He Shuai , Lin Zenan , Qiu Qinghua 
Published: July 2023

Abstract
Background
To report a case in which silicone oil accidentally entered Berger’s space (BS) after vitrectomy and to explore the effective treatments and possible etiological mechanisms.

Case presentation
A 68-year-old male underwent vitrectomy and silicone oil injection for the treatment of retinal detachment (RD) in the right eye. Six months later, we noticed an unexpected lens-like round translucent substance located behind the posterior lens capsule and diagnosed it as BS filled by silicone oil. Subsequently, we conducted vitrectomy and the drainage of the silicone oil in BS in the second surgery. A 3-month follow-up showed significant anatomic recovery and visual recovery.

Conclusions
Our case report presents a patient with silicone oil entering BS after vitrectomy and provides photographs of BS from a relatively unique perspective. Furthermore, we illustrate the surgical treatment procedure and reveal the possible etiology and prevention method of silicon oil entering BS, which will provide good insights for clinical diagnosis and treatment.
Thyroid function, glycemic control, and diabetic nephropathy in patients with type 2 diabetes over 24 months: prospective observational study
Authors: Iwakura Hiroshi , Takagi Tomoyuki , Inaba Hidefumi , Doi Asako , Ueda Yoko , Uraki Shinsuke , Takeshima Ken , Furukawa Yasushi , Ishibashi Tatsuya , Morita Shuhei , Matsuno Shohei , Nishi Masahiro , Furuta Hiroto , Matsuoka Taka-aki , Akamizu Takashi 
Published: July 2023

Abstract
Background
The higher prevalence of thyroid dysfunction in type 1 diabetes patients has been well established, whereas it is a matter of debate whether that is also observed in type 2 diabetes patients. This study was conducted to reveal whether higher prevalence of thyroid dysfunction is observed in patients with type 2 diabetes.

Methods
We examined thyroid functions and thyroid autoantibodies in 200 patients with type 2 diabetes and 225 controls, with 24 months follow up for those with type 2 diabetes.

Results
Serum free triiodothyronine (fT3) levels and fT3/free thyroxine (fT4) ratio were significantly lower, while fT4 levels were significantly higher in patients with type 2 diabetes. The number of patients with thyroid dysfunction or patients positive for thyroid autoantibodies were not different between the two groups. The fT3/fT4 ratio was positively and negatively correlated with serum c-peptide and HbA1c levels, respectively, suggesting that the difference can be attributable to insulin resistance and diabetic control. In the follow-up observation, we found no significant correlation between basal thyrotropin (TSH), fT3, fT4 or fT3/fT4 ratio with the amounts of changes of HbA1c levels at 12 or 24 months after the basal measurements. There was a negative relationship between TSH levels and eGFR at baseline measurements, but TSH levels did not seem to predict future decline of eGFR levels. No relationship was observed between urine albumin/ g‧cre levels and thyroid function.

Conclusion
Thyroid dysfunction and thyroid autoantibodies were not different in prevalence between patients with type 2 diabetes and controls, although in patients with type 2 diabetes, the fT3/fT4 ratio was decreased. Basal thyroid function did not predict future diabetes control or renal function within 24 months of follow-up.
Improving care seeking behavior toward cervical cancer screening participation among Gwafan community women, North-Central Nigeria
Authors: Ari. Eunice Samuel , Dioso Regidor III Poblete , Sotunsa John Obafemi 
Published: July 2023

Abstract
Introduction
Cervical cancer is the fourth most common cancer in women globally and the second most common cancer in low- to middle-income countries, and its screening rate is yet to reach the 70% WHO target. Most interventions that proved effective in improving screening participation in some communities did not achieve the desired behavioral outcome in some settings.

Aim
This study aimed to evaluate the effectiveness of care-seeking behavior interventions on cervical cancer screening participation.

Method
A pragmatic multiphase mixed methods design was adopted for this study, and three phases of the human-centered design process were used for data collection. Deductive thematic analysis was used for qualitative data, while SPSS was used for quantitative data analysis.

Results
The findings show a significant relationship between participants’ tribes p values (0.03) 0.05 and screening participation. Before the intervention, most (77.4%) were afraid of exposing their private parts; 75.9% were afraid of being diagnosed with cervical cancer; and the majority felt the procedure was embarrassing and painful. Free screening, awareness, and knowledge, offering transport, the use of influencers, and sample collection by a female care provider are among other facilitators to screening. Screening participation improved from 11.2% preintervention to 29.7% postintervention (average mean screening score from 1.890.316 to 1.70000.458). All participants who were screened postintervention said the procedure was not embarrassing or painful and that they were not afraid of the procedure or the screening environment.

Conclusion
In conclusion, screening habits in the community were low before intervention, as this may have resulted from women’s feelings and past experiences with screening services. Sociodemographic variables may not directly predict screening participation. Care-seeking behavior interventions have significantly increased screening participation postintervention.
Correlation between COVID-19-related health anxiety and coping styles among frontline nurses
Authors: Saeedi Maryam , Abedini Zahra , Latif Maryam , Piruzhashemi Masoumeh 
Published: July 2023

AbstractBackgroundThe long-term epidemic of COVID-19 and its recurrence has exposed frontline nurses to mental disorders such as stress and health anxiety. High levels of health anxiety associated with COVID-19 may lead to maladaptive behaviors. There is no agreement on which coping styles are most effective against stress. Therefore, more evidence is required to find better adaptive behaviors. The present study was conducted to investigate the correlation between the level of health anxiety and the type of coping strategies used by frontline nurses fighting COVID-19.MethodsThis is a cross-sectional study that was performed on a convenience sample of 386 nurses who are working in the COVID department from October to December 2020, coinciding with the outbreak of the third COVID-19 peak in Iran. Data were collected through a demographic questionnaire, the short version of the health anxiety questionnaire, and coping inventory for stressful situations. Data were analyzed using independent T-test, U-Mann-Whitney, and Kruskal-Wallis statistical tests with SPSS version 23 software.ResultsThe mean score of nurses’ health anxiety was 17.61 ± 9.26 which was more than the cut-off point for health anxiety and 59.1% of nurses had COVID-19-related health anxiety. The mean score of problem coping style (26.85 ± 5.19), was higher than emotion (18.48 ± 5.63) and avoidance (19.64 ± 5.88) coping styles and nurses mostly used problem-coping strategies to deal with anxiety caused by COVID-19. There was a positive significant correlation between the scores of health anxiety and emotion coping style (r = 0.54; P < 0.001).ConclusionBased on the findings of this study, COVID-19-related health anxiety was high in front-line nurses and those with high health anxiety were more likely to use emotion-based coping strategies, which are ineffective. Therefore, considering strategies to reduce nurses’ health anxiety and holding training programs on effective coping methods in epidemic conditions are recommended.
Association between type 2 diabetes mellitus and depression among Korean midlife women: a cross-sectional analysis study
Authors: Yang You Lee , Im Eun-Ok , Kim Yunmi 
Published: July 2023

Abstract
Background
The prevalence of depression is higher among midlife women, and they have less control over their diabetes during the menopausal transition. However, there is limited evidence on the association between type 2 diabetes mellitus and depression among Korean women in their midlife. This study aimed to examine the association between type 2 diabetes mellitus and depression and explore the levels of awareness and treatment of depression among Korean midlife women with T2DM.

Methods
This is a cross-sectional analysis study conducted using data from the Korea National Health and Nutrition Examination Surveys of 2014, 2016, and 2018. Korean women aged 40–64 years who randomly participated in the surveys were included, and 4,063 midlife women were selected as study participants. The diabetes progression status of the participants was classified into diabetes, pre-diabetes, and non-diabetes. Furthermore, the Patient Health Questionnaire-9 was used for screening depression. Participants’ awareness rate, treatment rate among incident cases of depression, and treatment rate among awareness cases of depression were also analyzed. For data analysis, the Rao–Scott χ2 test, multiple logistic regression, and linear regression were conducted using SAS 9.4 software program.

Results
The prevalence of depression significantly differed between diabetes, pre-diabetes, and non-diabetes groups. However, depression awareness, treatment/incident, and treatment/awareness rates did not differ statistically between the diabetes progression status groups. Compared to the non-diabetes group, diabetes group had a higher odds ratio of depression after adjusting for general and health-related factors. Thus, the diabetes group had significantly higher PHQ-9 scores than the non-diabetes group after adjusting for covariates.

Conclusions
Women in their midlife who have type 2 diabetes mellitus tend to have higher levels of depressive symptoms and are at risk of depression. However, we found no significant differences between diabetes and non-diabetes regarding the awareness and treatment rates of depression in South Korea. We recommend that future studies focus on developing clinical practice guidelines aimed at additional screening and intervention for depression in midlife women with type 2 diabetes mellitus to ensure prompt treatment and improved outcomes.