bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ experiences with a community fruit and vegetable box program prescribed by their health provider
Authors: Johnson Jennifer K. , Vingilis Evelyn , Terry Amanda L. 
Published: May 2023

Abstract
Background
Food insecurity is “the state of being without reliable access to a sufficient quantity of affordable, nutritious food”. Observational studies have associated food insecurity with many negative health effects including the development and exacerbations of chronic diseases, higher health care use and increased mortality. Health care providers prescribing food is a growing area of interest and research, however it is not known how patients feel about receiving fruit and vegetable prescriptions (FVRx) from their health provider versus other means of food provision. This pilot study was conducted to explore the experiences and opinions of Canadian adults with food insecurity who were recipients of a FVRx box program prescribed by their health provider.

Methods
Potential participants were recruited to 3 focus groups using flyers included in their monthly food box. Questions were kept open to encourage participation of all group members. The focus groups were audiotaped, transcribed verbatim, and analyzed by the research team using descriptive qualitative research methodology.

Results
Participants described shame and frustration trying to obtain enough food through local food banks. In comparison, they perceived their team dietitian, family physician or addictions physician as directly helping them with their health by prescribing food. The boxed fruit and vegetables were prepared in many ways and often shared to reduce waste and to reduce the food insecurity of extended family members. Positive effects of the FVRx on physical and mental health were reported. Participants believed that follow up with their health provider helped support them and their behavioural changes towards better nutrition. Limitations of the program included lack of choice, non-flexible pick-up times and the program being limited to 6 months. Being able to choose their own fruit and vegetables, instead of receiving a set box, was suggested by most to help meal planning and to increase autonomy.

Conclusions
Health providers prescribing FVRx boxes to adult patients with food insecurity was positively received in this study. Evaluation of similar programs in other regions in Canada and internationally, and comparison of food prescriptions to basic income guarantee programs is recommended.
An application of social marketing for promoting HIV testing in Iran
Authors: Alipour Fatemeh , Shams Mohsen , Maleki Mostafa , Mousavizadeh Ali 
Published: May 2023

Abstract
Background
It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran.

Materials and methods
This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign’s materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared.

Results
Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees.

Conclusion
It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.
Effects of air pollution control policies on intracerebral hemorrhage mortality among residents in Tianjin, China
Authors: Xu Jiahui , Yin Xiaolin , Jiang Tingting , Wang Shiyu , Wang Dezheng 
Published: May 2023

Abstract
Background
Exposure to air pollution is an important risk factor for intracerebral hemorrhage (ICH), which is a major cause of death worldwide. However, the relationship between ICH mortality and air quality improvement has been poorly studied. This study aims to evaluate the impact of the air pollution control policies in the Beijing-Tianjin-Hebei region on ICH mortality among Tianjin residents.

Methods
This study used an interrupted time series analysis. We fitted autoregressive integrated moving average (ARIMA) models to assess the changes in ICH deaths before and after the interventions of air pollution control policies based on the data of ICH deaths in Tianjin collected by the Tianjin Center for Disease Control and Prevention.

Results
Between 2009 and 2020, there were 63,944 ICH deaths in Tianjin, and there was an overall decreasing trend in ICH mortality. The intervention conducted in June 2014 resulted in a statistically significant (p = 0.03) long-term trend change, reducing the number of deaths from ICH by 0.69 (95% confidence interval [CI]: -1.30 to -0.07) per month. The intervention in October 2017 resulted in a statistically significant (p = 0.04) immediate decrease of 25.74 (95% CI: -50.62 to -0.85) deaths from ICH in that month. The intervention in December 2017 caused a statistically significant (p = 0.04) immediate reduction of 26.58 (95% CI: -52.02 to -1.14) deaths from ICH in that month. The intervention in March 2018 resulted in a statistically significant (p = 0.02) immediate decrease of 30.40 (95% CI: -56.41 to -4.40) deaths from ICH in that month. No significant differences were observed in the changes of male ICH mortality after any of the four interventions. However, female ICH deaths showed statistically significant long-term trend change after the intervention in June 2014 and immediate changes after the interventions in December 2017 and March 2018. Overall, the interventions prevented an estimated 5984.76 deaths due to ICH.

Conclusion
During the study period, some interventions of air pollution control policies were significantly associated with the reductions in the number of deaths from ICH among residents in Tianjin. ICH survivors and females were more sensitive to the protective effects of the interventions. Interventions for air pollution control can achieve public health gains in cities with high levels of air pollution.
COVID-19 testing protocols to guide duration of isolation: a cost-effectiveness analysis
Authors: Maya Sigal , Kahn James G. 
Published: May 2023

Abstract
Background
The Omicron variant of SARS-CoV-2 led to a steep rise in transmissions, and emerging variants continue to influence case rates across the US. As public tolerance for isolation abated, CDC guidance on duration of at-home isolation of COVID-19 cases was shortened to five days if no symptoms, with no laboratory test requirement, despite more cautious approaches advocated by other federal experts.

Methods
We conducted a decision tree analysis of alternative protocols for ending COVID-19 isolation, estimating net costs (direct and productivity), secondary infections, and incremental cost-effectiveness ratios. Sensitivity analyses assessed the impact of input uncertainty.

Results
Per 100 individuals, five-day isolation had 23 predicted secondary infections and a net cost of $33,000. Symptom check on day five (CDC guidance) yielded a 23% decrease in secondary infections (to 17.8), with a net cost of $45,000. Antigen testing on day six yielded 2.9 secondary infections and $63,000 in net costs. This protocol, compared to the next best protocol of antigen testing on day five of a maximum eight-day isolation, cost an additional $1,300 per secondary infection averted. Antigen or polymerase chain reaction testing on day five were dominated (more expensive and less effective) versus antigen testing on day six. Results were qualitatively robust to uncertainty in key inputs.

Conclusions
A six-day isolation with antigen testing to confirm the absence of contagious virus appears the most effective and cost-effective de-isolation protocol to shorten at-home isolation of individuals with COVID-19.
The gap height in open wedge high tibial osteotomy is not affected by the starting point of the osteotomy
Authors: Mederake Moritz , Eleftherakis Georgios , Schüll Daniel , Springer Fabian , Maffulli Nicola , Migliorini Filippo , Konrads Christian 
Published: May 2023

Abstract
Introduction
In open-wedge high-tibial-osteotomy (OWHTO), most surgeons use a preoperative planning software and realise that they should match the intraoperative alignment correction with the preoperative plan. We aimed to determine whether there is a difference in osteotomy gap height when starting the OWHTO either 3 or 4 cm distal to the joint line. This should help to clarify whether the osteotomy starting point must exactly match the preoperative planning.

Methods
25 patients with constitutional varus alignment were planned for OWHTO. Long-leg-standing-radiographs and mediCAD-software were used. Osteotomy was planned to a neutral Hip-Knee-Ankle angle (HKA) of 0°. The osteotomy-starting-point was either 3 or 4 cm distal to the medial joint line. The following angles were compared: mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal femoral angle (mLDFA), joint line conversion angle (JCA), mechanical Tibio-Femoral angle (mTFA) or Hip Knee Ankle (HKA) angle.

Results
25 Patients (18 males, 7 females) had a mean age of 62 ± 16.6 years and showed a varus-aligned leg-axis. The HKA was − 5.96 ± 3.02° with a mMPTA of 82.22 ± 1.14°. After osteotomy-planning to a HKA of 0°, the mMPTA was 88.94 ± 3.01°. With a mean wedge height of 8.08 mm when locating the osteotomy 3 cm and a mean wedge height of 8.05 mm when locating the osteotomy 4 cm distal to the joint-line, there was no statistically significant difference (p = 0.7).

Conclusion
When performing an OWHTO aiming towards the tip of the fibula, the osteotomy starting point does not need to exactly match the planned starting-location of the osteotomy. A starting-point 1 cm more distal or proximal than previously determined through the digital planning does not alter the size of the osteotomy gap needed to produce the desired amount of correction.
Guidance of adjuvant instillation in intermediate-risk non-muscle invasive bladder cancer by drug screens in patient derived organoids: a single center, open-label, phase II trial
Authors: Seiler Roland , Egger Martin , De Menna Marta , Wehrli Saskia , Minoli Martina , Radić Martina , Lyatoshinsky Pavel , Hösli Raphael , Blarer Jennifer , Abt Dominik , Kruithof-de Julio Marianna 
Published: May 2023

Abstract
Background
In intermediate-risk non-muscle invasive bladder cancer (NMIBC) clinical guidelines suggest an adjuvant instillation with a chemotherapeutic agent. However, the agent and regimen are not clearly defined. Worldwide, less than 15% of patients receive this adjuvant chemotherapeutic instillation. We recently developed a pipeline for the generation of patient derived organoids (PDO) in NMIBC. In this phase II trial, we aim to use our in vitro pipeline to select the most effective drug for chemotherapeutic instillation in NMIBC patients.

Methods
Patients with first diagnosis of intermediate-risk NMIBC that are directed to transurethral resection of bladder tumor (TURBT) are enrolled. During TURBT, tumor is sampled, and specimens are directed to generate PDO. Once the PDO are formed, drug screens on them for Epirubicin, Mitomycin C, Gemcitabine and Docetaxel are performed. The drug with the highest antitumor activity in vitro will then be selected for 6 adjuvant intravesical instillations once weekly. Thereafter, patients are followed according to clinical guidelines by cystoscopy.

Discussion
The aim of this trial is to use drug screens in PDO to precise treatment selection for adjuvant instillation therapies in patients with intermediate-risk NMIBC. The ultimate goal of this trial is to reduce the risk of cancer recurrence. In the future, we aim to conduct clinical multicenter trials with an increased sample size, a broader panel of compounds and a focus on the reduction of cancer recurrence by precision delivery of care.
Trial registration NCT05024734.
Stress distribution and fracture resistance of green reprocessed polyetheretherketone (PEEK) single implant crown restorations compared to unreprocessed PEEK and Zirconia: an in-vitro study
Authors: Emam Marwa , Arafa Ahmed Mohamed 
Published: May 2023

Abstract
Background
It is unclear which crown materials are optimum to disperse the generated stresses around dental implants. The objective of this study is to assess stress distribution and fracture resistance of green reprocessed Polyetheretherketone (PEEK) in comparison to un-reprocessed PEEK and zirconia single implant crown restorations.

Methods
Twenty crowns (n = 20) were obtained, five from zirconia and fifteen from pressed PEEK that were subdivided into 3 groups of five specimens each (n = 5) according to weight% of reprocessed material used. A 100% new PEEK was used for the first group, 50% new and 50% reprocessed PEEK were used for the second group, and a 100% reprocessed PEEK was used for the third group. Epoxy resin model with dental implant in the second mandibular premolar was constructed with strain gauges located mesially and distally to the implant to record strain while a load of 100 N was applied with 0.5 mm/min then specimens of all groups were vertically loaded till failure in a universal testing machine at cross head speed 1 mm/min. Data was statistically analyzed by using One-way Analysis of Variance (ANOVA) followed by Post-hoc test when ANOVA test is significant.

Results
No significant difference between strain values of tested groups (p = 0.174) was noticed. However, a significant difference between fracture resistance values was noticed where the zirconia group recorded a significantly higher value (p < 0.001).

Conclusions
Implant restorative materials with different moduli of elasticity have similar effects regarding stresses distributed through dental implant and their surrounding bone. Reprocessed PEEK implant restorations transmit similar stresses to dental implant and surrounding bone as non-reprocessed PEEK and zirconia restorations. Zirconia failed at higher load values than all tested PEEK restorations but all can be safely used in the posterior area as crown restorations for single implants.

Clinical relevance
Applying “green dentistry” principles may extend to include reprocessing of pressed PEEK restorative materials without affecting the material’s shock absorption properties.
Rural-urban disparities in preventive breast and cervical cancer screening among women with early-onset dementia
Authors: Xu Wendy Y. , Raver Eli , Jung Jeah , Li Yiting , Thai Gaby , Lee Sunmin 
Published: May 2023

Abstract
Background
The early onset of Alzheimer’s disease and related dementias (ADRD) before age 65 can introduce life and health care complications. Preserving an early-onset ADRD patient’s daily functioning longer and delaying declines in health from non-ADRD conditions become important preventive goals. This study examined the differences in utilization of preventive cancer screenings between patients with and without early-onset ADRD, and compared utilization of the screenings in rural versus urban areas among women with early-onset ADRD in the United States.

Methods
We conducted a cross-sectional study of women aged 40 to 64 years eligible for mammogram and cervical cancer screenings using commercial insurance claims from 2012 to 2018. We measured the use of biennial mammogram among women 50 to 64 years old, and the use of triennial Pap smear test among women 40 to 64 years old. We used inverse probability weighted logistic regressions to estimate the odds of receiving preventive cancer screenings by the presence of early-onset ADRD or cognitive impairments (CI). We used multivariable logistic regressions to estimate the odds of receiving preventive cancer screenings by rural or urban residence among women with early-onset ADRD/CI.

Results
Among 6,349,308 women in the breast cancer screening sample (mean [SD] age, 56.52 [4.03] years), 36,131 had early-onset ADRD/CI (mean [SD] age, 57.99 [3.98] years). Among 6,583,088 women in the cervical cancer screening sample (mean [SD] age, 52.37 [6.81] years), 30,919 had early-onset ADRD/CI (mean [SD] age, 55.79 [6.22] years). Having early-onset ADRD/CI was associated with lower utilization of mammogram (OR: 0.92, 95% CI: 0.90–0.95). No significant difference was observed in Pap smear screening (OR: 0.99, 95% CI: 0.96–1.02) between patients with and without early-onset ADRD/CI. Among patients with early-onset ADRD/CI, those in rural areas were less likely than those in urban areas to have mammograms (OR: 0.91, 95% CI: 0.85–0.97) and Pap smears (OR: 0.65, 95% CI: 0.61–0.71).

Conclusions
The observed pattern of rural-urban differences in cancer screening in our study emphasizes the need for efforts to promote evidence-based, individualized decision-making processes in the early-onset ADRD population.
Cultural competence of nursing educators at medical universities of 2nd regional planning in Iran
Authors: Majnoon Sahand , Yates Vivian M. , Asgarpour Hossein , Mirza Aghazadeh Attari Ahmad , Lotfi Mojgan 
Published: May 2023

Abstract
Background
One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals’ health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran.

Methods
The current research was a descriptive and survey study framed within Campinha-Bacote’s cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software.

Results
The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates’ interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants’ responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants’ responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73.

Conclusions
The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran.
The relationship between succession and intellectual capital with entrepreneurship in hospitals
Authors: Rafiei Shoaib , Mehrtak Mohammad , Amerzadeh Mohammad , Rafiei Sima , Moosavi Saeideh , Kalhor Rohollah 
Published: May 2023

Abstract
Background
The hospital environment is very dynamic and faces many internal and external changes. Healthcare knowledge and technology are developing at a swift pace. This study investigated the relationship between succession and intellectual capital with entrepreneurship at the Qazvin University of Medical Sciences hospital, Iran.

Methods
The number of employees working in six hospitals was 2256, and according to Morgan’s table, the required number of samples was 331. We distributed three hundred sixty-five questionnaires considering 10% of sample loss. We used a multi-stage stratified sampling method. In the first stage, each hospital was considered a stratum. After that, occupational groups were considered the next stratum within each hospital, and based on the ratio, the required number of samples for each occupational group was randomly selected. We used the Sobel test to investigate the mediating role of intellectual capital and the structural equation model to fit the research model.

Results
Succession aspects, including culturalization, meritocracy, job promotion path, and the role of senior managers, have a positive and significant effect on intellectual capital. Succession is only effective on intellectual capital and does not affect the personnel’s entrepreneurship directly or through intellectual capital.

Conclusion
Conducting training classes and intervention programs and using localized succession models can create a suitable platform for increasing organizational creativity and entrepreneurship, motivating the hospitals’ personnel, and increasing intellectual capital.