bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Garden type I incomplete femoral neck fracture really exist in older adults? To evaluate the stability and consistency of Garden classification
Authors: Cai Zhencun , Zhang Zelin , Ren Lixuan , Piao Chengzhe , Xiang Liangbi 
Published: July 2022

AbstractBackgroundAccurate classification of femoral neck fracture (FNF) is crucial for treatment plan and therapeutic outcomes. Garden classification is commonly used in the clinic, but its stability and consistency remain controversial. The aim of this study was to evaluate the stability and consistency of Garden classification based on X and CT images, and to analyze whether it is valid for Garden I in the elderly.MethodsX-ray and CT images from 886 elderly patients with FNF were collected, four orthopaedic surgeons and four radiologists evaluated these images independently, and determined the fracture type based on Garden classification. Three months later, The exercise was repeated and the results were compared based on 4 types Garden classification (I, II, III and IV) and 3 types Garden classification (I + II, III and IV). Kappa was used to measure inter- and intraobserver agreement. The patients with Garden I incomplete FNF confirmed by 8 observers together based on images combined with medical history were compared with the intraoperative results.ResultsFour types Garden classification, there was little consistency inter- and intraobservers (Kappa from 0.18 to 0.43) based on X-ray images, while professors consistency (0.56 to 0.76) was higher than residents (0.28 to 0.35) based on CT. 3 types Garden classification showed almost perfect agreement inter- and intraobservers, which ranged from 0.76 to 0.90. Totally 52 patients were diagnosed as Garden I, 38 of whom underwent arthroplasty. All surgical cases showed complete fracture during operation.ConclusionsThere was low consistency and repeatability in 4 types Garden classification (I, II, III and IV), while 3 types Garden classification (I + II, III and IV) had high consistency among observers. In the elderly, all undisplaced femoral neck fracture may be Garden II, no Garden I.
International, multi-disciplinary, cross-section study of pain knowledge and attitudes in nursing, midwifery and allied health professions students
Authors: Mankelow Jagjit , Ryan Cormac G. , Taylor Paul C. , Casey Maire-Brid , Naisby Jenni , Thompson Kate , McVeigh Joseph G. , Seenan Chris , Cooper Kay , Hendrick Paul , Brown Donna , Gibson William , Travers Mervyn , Kennedy Norelee , O’Riordan Cliona , Martin Denis 
Published: July 2022

Abstract
Background
Persistent pain is a highly prevalent, global cause of disability. Research suggests that many healthcare professionals are not well equipped to manage pain, and this may be attributable at least in part to undergraduate education. The primary aim of this study was to quantify and compare first and final year nursing, midwifery and allied health professional (NMAHP) students’ pain related knowledge and attitudes. The secondary aim was to explore what factors influence students’ pain related knowledge and attitudes.

Methods
In this cross-sectional study, 1154 first and final year healthcare students, from 12 universities in five different countries completed the Revised Neurophysiology of Pain Quiz (RNPQ) [knowledge] and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) [attitudes].

Results
Physiotherapy was the only student group with statistically and clinically improved pain related knowledge [mean difference, 95% CI] (3.4, 3.0 to 3.9, p = 0.01) and attitudes (-17.2, -19.2 to 15.2, p = 0.01) between first and final year. Pain education teaching varied considerably from course to course (0 to 40 h), with greater levels of pain related knowledge and attitudes associated with higher volumes of pain specific teaching.

Conclusions
There was little difference in pain knowledge and attitudes between all first and final year NMAHP students other than physiotherapy. This suggests that for most NMAHP disciplines, undergraduate teaching has little or no impact on students’ understanding of pain. There is an urgent need to enhance pain education provision at the undergraduate level in NMAHPs.

Trial Registration
The study protocol was prospectively registered at ClinicalTrials.Gov NCT03522857.
Anesthesia students’ perception of the educational environment and academic achievement at Debre Tabor University and University of Gondar, Ethiopia: a comparative cross-sectional study
Authors: Negash Tadese Tamire , Eshete Million Tesfaye , Hanago Getu Ataro 
Published: July 2022

Abstract
Background
Excellence in Anesthesia education has been advocated to meet the current and future needs of the society. Educational environment plays significant role in determining students’ learning and academic achievement. This study assessed the perception of Anesthesia students on their educational environment and it association with their academic achievement at Debre Tabor University and University of Gondar.

Methods
A comparative cross-sectional study design was employed on 3rd and 4th year students. Dundee Ready Educational Environment Measure (DREEM) was used to assess students’ perception on their educational environment. Perceived performance, Cumulative Grade Point Average (CGPA) and 100 MCQ items were used to assess the academic achievement of the students. An independent t-test was used to assess the differences in the perception of educational environment and academic achievements. Bivariate and multivariable linear regressions were fitted to assess the relationship between perception on educational environment and academic achievement. A P-value of less than 0.05 was used to declare the statistical significance.

Result
A total of 123 students (91 from University of Gondar and 32 from Debre Tabor University) were participated on this study. The study showed no statistically significant differences between the groups on the perception of students on the educational environment on DREEM total and subscale scores, and academic achievements. However, there were statistically significant differences in some items of the educational environment measures. On multivariable linear regression; entrance exam result, students’ perception of teachers, students’ academic self –perception and students’ social self-perception showed positive correlation with students’ academic achievement (ß = 0.003 & P = 0.04, ß = 0.009 & P = 0.9, ß = 0.06 & P = 0.42, ß = 0.06 & P = 0.39, ß = 0.14 & P = 0.015 and ß = 0.13 & P = 0.023) respectively.

Conclusion
The perception of students on the educational environment was found to be more positive and there was no statistically significant differences in total and domains of DREEM scores and academic achievement of students between the two institutions. Entrance exam result and more positive perception of the educational environment were positively associated with academic achievement of students.
Municipal healthcare professionals’ interprofessional collaboration during older patients’ transitions in the municipal health and care services: a qualitative study
Authors: Eika Marianne , Hvalvik Sigrun 
Published: July 2022

Abstract
Background
Interprofessional collaboration is vital to assist patients towards a healthy transition in the municipal health and care services. However, no study has so far investigated municipal health care providers’ inter-professional collaboration during older patients’ transition in the municipal health and care services. The aim of this study is therefore to describe and explore what influence health care providers’ inter-professional collaboration within and across municipal facilities during older patients’ transitions in the municipal health and care services.

Method
The study has a descriptive, interpretive design. Focus group interviews and individual interviews with municipal health care providers different professions were performed.

Results
Municipal health care providers’ inter-professional collaboration during older patients transitions in the municipal health and care services was challenging. Two main themes were identified: The patient situation itself and Professional. Personal, and Practical circumstances. The results show that the municipal priority of patients staying at home as long as possible facilitated inter-professional collaboration across the short-term care facility and the home care services. Inter-professional collaboration across facilities with the long-term care facility was downgraded and health care providers in this facility had to cope as best they could.

Conclusion
Prioritising and facilitating inter-professional collaboration between the short-term care facility and the home care services, contributed to health care providers experiencing doing a proper and safe patient assistance. Yet, this priority was at a cost: Health care providers in the long-term care facility, and in particular registered nurses felt squeezed and of less worth in the municipal health and care services. It was a strain on them to experiencing unplanned and often rushed patient transition into long-term care facility. To focus on municipal inter-professional and inter-facility collaboration during patients in transition to long-term care placement is vital to maintain the patients, and the health care providers working in these facilities.
What does family involvement in care provision look like across hospital settings in Bangladesh, Indonesia, and South Korea?
Authors: Park J. Y. , Pardosi J. F. , Islam M. S. , Respati T. , Chowdhury K. , Seale H. 
Published: July 2022

Abstract
Background
Family members provide care whilst staying in the patient’s room across a range of cultural settings, irrespective of resource availability in many Asian countries. This has been reported as a contributing factor to the spread of several outbreaks, including COVID-19. Despite these reports, very little is known about the risk of healthcare-associated infection (HAI) transmission related to the involvement of family and private carers in the clinical setting. As a starting point to understanding this issue, this study aimed to provide insights regarding the patient care activities undertaken by family and private carers and the guidance provided to these carers around infection control measures in hospitals located in Bangladesh, Indonesia, and South Korea.

Method
A qualitative study involving 57 semi-structured interviews was undertaken in five tertiary level hospitals across the selected countries. Two groups of individuals were interviewed: (1) patients and their family carers and private carers; and (2) healthcare workers, including doctors, nurses, hospital managers and staff members. Drawing upon the principles of grounded theory, an inductive approach to data analysis using thematic analysis was adopted.

Results
Five main themes were generated from the analysis of the data: (1) expectation of family carers staying with a patient; (2) residing in the patient’s environment: (3) caring activities undertaken by family carers; (4) supporting and educating family carers and (5) communication around healthcare-associated infection and infection prevention and control.

Conclusion
Based on the types of activities being undertaken, coupled with the length of time family and private carers are residing within the clinical setting, coupled with an apparent lack of guidance being given around IPC, more needs to be done to ensure that these carers are not being inadvertently exposed to HAI’s or other occupational risks.
Expanding access to substance use services and mental health care for people with HIV in Alabama, a technology readiness assessment using a mixed methods approach
Authors: Eaton Ellen F. , Burgan Kaylee , McCollum Greer , Levy Sera , Willig James , Mugavero Michael J. , Reddy Sushanth , Wallace Eric , Creger Tom , Baral Stefan , Fogger Susanne , Cropsey Karen 
Published: July 2022

Abstract
Background
Alabama is one of seven priority states for the National Ending the HIV Epidemic Initiative due to a large rural burden of disease. Mental health (MH) and substance use disorders (SUD) represent obstacles to HIV care in rural areas lacking Medicaid expansion and infrastructure. Evidence-informed technologies, such as telehealth, may enhance SUD and MH services but remain understudied in rural regions.

Methods
We conducted a readiness assessment using a mixed methods approach to explore opportunities for enhanced SUD and MH screening using electronic patient reported outcomes (ePROs) and telehealth at five Ryan White HIV/AIDS Program-funded clinics in AL. Clinic providers and staff from each site (N = 16) completed the Organizational Readiness to Implement Change (ORIC) assessment and interviews regarding existing services and readiness to change. People with HIV from each site (PLH, N = 18) completed surveys on the acceptability and accessibility of technology for healthcare.

Results
Surveys and interviews revealed that all clinics screen for depression annually by use of the Patient Health Questionnaire-9 (PHQ9). SUD screening is less frequent and unstandardized. Telehealth is available at all sites, with three of the five sites beginning services due to the COVID-19 pandemic; however, telehealth for MH and SUD services is not standardized across sites. Results demonstrate an overall readiness to adopt standardized screenings and expand telehealth services beyond HIV services at clinics. There were several concerns including Wi-Fi access, staff capacity, and patients’ technological literacy.
A sample of 18 people with HIV (PWH), ages 18 to 65 years, participated in surveys; all demonstrated adequate technology literacy. A majority had accessed telehealth and were not concerned about it being too complicated or limiting communication. There were some concerns around lack of in-person interaction and lack of a physical exam and high-quality care with telehealth.

Conclusion
This study of PWH and the clinics that serve them reveals opportunities to expand SUD and MH services in rural regions using technology. Areas for improvement include implementing routine SUD screening, expanding telehealth while maintaining opportunities for in-person interaction, and using standardized ePROs that are completed by patients, in order to minimize stigma and bias.
Design and evaluation of a new mobile application to improve the management of minor ailments: a pilot study
Authors: Mikhael Ehab Mudher , Al-Hamadani Fadya Yaqoob , Hadi Ali Mohammed 
Published: July 2022

Abstract
Background
Seeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.

Methods
The scientific content of the application was based on the information in the symptoms in the pharmacy and British National Formulary books. The design and content of the application were approved by two experts. Thereafter, the application was built for Android mobiles using flutter technology and dart language. A pre-post pilot study was conducted to assess outcomes associated with use of the application, including user acceptance and appropriateness of clinical recommendations. Fifteen students from the College of Pharmacy/University of Baghdad who had an Android mobile participated in this study. Two different scenarios about diarrhea were used during the pilot study, in which the researcher acted as a patient (SP) and the participant student as a pharmacist.

Results
After using the application, the number of questions asked by the participated student to the SP was significantly increased to about double. Additionally, providing the SP with appropriate non-pharmacological and pharmacological therapy along with optimum counseling and education were also significantly improved. All study participants agreed on the application’s ease of use and ability to reduce diagnosis and medication errors.

Conclusions
The implementation of the newly developed mobile application, diarrhea management step by step, was associated with improvements in assessment and recommended treatments for diarrhea cases with good acceptance by a pilot sample of pharmacy students at Baghdad University.
A novel SCN9A gene variant identified in a Chinese girl with paroxysmal extreme pain disorder (PEPD): a rare case report
Authors: Hua Yi , Cui Di , Han Lin , Xu Lu , Mao Shanshan , Yang Cuiwei , Gao Feng , Yuan Zhefeng 
Published: July 2022

Abstract
Background
Paroxysmal extreme pain disorder (PEPD) is a rare autosomal dominant hereditary disease, characterized by paroxysmal burning pain in the rectum, eyes or mandible and autonomic nervous symptoms, including skin redness and bradycardia. PEPD is a sodium channel dysfunctional disorder caused by SCN9A gene variants. It occurs mainly in Caucasians and only one case has been reported in the Chinese population. Here, we report the second PEPD case in a Chinese indivisual.

Case presentation
A 2 years and 6 months old girl initially presented with non-epileptic tonic seizures at 7 days after birth. Her clinical symptoms in order of presentation were non-epileptic tonic seizures, harlequin color change and pain. Genetic analysis showed the patient carried a heterozygous variant c.4384T>A (p.F1462I) in the SCN9A gene, which was speculated to cause PEPD symptoms. After administrating carbamazepine, the symptoms were relieved and the patient's condition improved. However, the patient’s mother, who carries the same SCN9A variant as her daughter, only showed bradycardia and sinus arrest but no PEPD-related pain.

Conclusions
This is the second PEPD case reported in the Chinese population. With the discovery of a novel variant in SCN9A, we expanded the genotype spectrum of PEPD. This is the first case suggesting that the clinical presentations of SCN9A-associated PEPD may show inter familial phenotypic diversity. In the future of clinical diagnosis, patients with triggered non-epileptic tonic seizures or pain and harlequin color change should be considered for PEPD and proper and prompt treatment should be given.
Nilotinib modulates LPS-induced cognitive impairment and neuroinflammatory responses by regulating P38/STAT3 signaling
Authors: Kim Jieun , Lee Hyun-ju , Park Jin-Hee , Cha Byung-Yoon , Hoe Hyang-Sook 
Published: July 2022

Abstract
Background
In chronic myelogenous leukemia, reciprocal translocation between chromosome 9 and chromosome 22 generates a chimeric protein, Bcr-Abl, that leads to hyperactivity of tyrosine kinase-linked signaling transduction. The therapeutic agent nilotinib inhibits Bcr-Abl/DDR1 and can cross the blood–brain barrier, but its potential impact on neuroinflammatory responses and cognitive function has not been studied in detail.

Methods
The effects of nilotinib in vitro and in vivo were assessed by a combination of RT-PCR, real-time PCR, western blotting, ELISA, immunostaining, and/or subcellular fractionation. In the in vitro experiments, the effects of 200 ng/mL LPS or PBS on BV2 microglial cells, primary microglia or primary astrocytes pre- or post-treated with 5 µM nilotinib or vehicle were evaluated. The in vivo experiments involved wild-type mice administered a 7-day course of daily injections with 20 mg/kg nilotinib (i.p.) or vehicle before injection with 10 mg/kg LPS (i.p.) or PBS.

Results
In BV2 microglial cells, pre- and post-treatment with nilotinib altered LPS-induced proinflammatory/anti-inflammatory cytokine mRNA levels by suppressing AKT/P38/SOD2 signaling. Nilotinib treatment also significantly downregulated LPS-stimulated proinflammatory cytokine levels in primary microglia and primary astrocytes by altering P38/STAT3 signaling. Experiments in wild-type mice showed that nilotinib administration affected LPS-mediated microglial/astroglial activation in a brain region-specific manner in vivo. In addition, nilotinib significantly reduced proinflammatory cytokine IL-1β, IL-6 and COX-2 levels and P38/STAT3 signaling in the brain in LPS-treated wild-type mice. Importantly, nilotinib treatment rescued LPS-mediated spatial working memory impairment and cortical dendritic spine number in wild-type mice.

Conclusions
Our results indicate that nilotinib can modulate neuroinflammatory responses and cognitive function in LPS-stimulated wild-type mice.
Sexual and reproductive health services utilization and associated factors among adolescents attending secondary schools
Authors: Abdurahman Chaltu , Oljira Lemessa , Hailu Saba , Mengesha Melkamu Merid 
Published: July 2022

Abstract
Background
Sexual and reproductive health (SRH) is referring to physical and emotional wellbeing and includes the ability to be free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV/AIDS, and all forms of sexual violence and coercion. SRH is the main services packages that prevent and reduce adolescent reproductive health risks and problems. While the government of Ethiopia has undertaken several measures to improve SRH services, there was limited data on utilization among adolescents and associated factors.

Objective
To assess utilization of SRH services and associated factors among adolescents attending secondary schools in Haramaya District, Eastern Ethiopia.

Methods
A school-based cross-sectional study was conducted among adolescent students aged 15–19 years. A total of 692 adolescents were selected using a multi-stage sampling from two randomly selected secondary schools, each from rural and urban settings, in Haramaya district where 642 provided complete data and included in the analysis. A structured, pretested, and self-administered questionnaire was used to collect data. Data entry was conducted using Epi Data version 3.1 and exported to STATA version 16 for analysis. Bivariable and multivariable binary logistic regression were used to identify factors associated with school adolescents’ utilization of SRH. Statistically significant associations are declared at P-value < 0.05.

Result
A total of 642 completed the survey questionnaire, constituting a response rate of 92.7% (642/692). Male adolescents accounted 63.7% and the mean age of respondents was 17.71 years. Among those who completed the survey, 23.5% (95% CI: 20–26.8) utilized SRH services. Adolescents who were exposed to SRH information (adjusted odds ratio (AOR) = 2.11, 95% CI: 1.22–3.6), aware of SRH service providing facility (AOR = 1.83, 95% CI: 1.12–3.0) and SRH service components (AOR = 2.76, 95%, CI: 1.53–4.97), and distance from SRH facilities (AOR = 2.28, 95%, CI: 1.13–4.62) were significantly associated with the utilization of SRH services.

Conclusion
Nearly one-in-four secondary school adolescents (23.5%) utilized SRH services. Targeted promotion of SRH providing facilities and SRH service components aimed at awareness creation could improve adolescents’ utilization of SRH services. Improved SRH services utilization among adolescents who were far from SRH services providing facilities needs further investigation.