bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of prolonged PPE use on Canadian health professionals
Authors: LeBlanc Kimberley , Woo Kevin , Wiesenfeld Lorne , Bresnai-Harris Julia , Heerschap Corey , Butt Britney , Chaplain Valérie , Wiesenfeld Samantha 
Published: August 2022

Aim: To explore the impact that prolonged use of personal protective equipment (PPE) has on the skin integrity of Canadian health professionals. Method: A descriptive, pan-Canadian, cross-sectional, online survey was carried out to explore the type and prevalence of PPE-related skin injury among Canadian health professionals. Convenience sampling was used to disseminate the online survey link to health professionals. Results: There were responses from 757 health professionals. Masks worn included surgical masks (90%), a combination of surgical or N95/KN95 masks (7.7%) and an N95/KN95 mask alone (2.7%). Responses showed 84.6% of providers always wear a mask while at work with 38.5% wearing the same mask all shift; 90% of participants wore protective eye wear. Complications included soreness or pressure injuries behind the ears (70%), new or worsening acne (52%), a runny nose or sneezing (45%), itching (39%), and dry skin (37%). Hand issues included dry skin (53%), red skin (30%), itching (26%), broken skin (20%), rash (16%), and dermatitis (11%) – 51% of respondents did not moisturise their hands. Complications related to gown use included itching (6%), moisture-associated skin damage (5.5%), feeling claustrophobic (4.5%), and new or worsening acne (3%). Increased perspiration due to PPE was experienced in 87.5% of respondents. Some 43% of respondents noted their mental health became worse due to wearing PPE for prolonged periods. Conclusion: These findings should be used in the development of guidelines to prevent and manage PPE-related skin injuries among health professionals. Education for professionals should focus on skin protection, prevention of PPE-related skin complications and support for mental health issues.
The increasing incidence of visceral leishmaniasis relapse in South Sudan: A retrospective analysis of field patient data from 2001–2018
Authors: Naylor-Leyland Gabriel , Collin Simon M. , Gatluak Francis , den Boer Margriet , Alves Fabiana , Mullahzada Abdul Wasay , Ritmeijer Koert 
Published: August 2022

BackgroundVisceral Leishmaniasis (VL) is endemic in South Sudan, manifesting periodically in major outbreaks. Provision of treatment during endemic periods and as an emergency response is impeded by instability and conflict. Médecins Sans Frontières (MSF) has provided health care in South Sudan since the late 1980’s, including treatment for 67,000 VL patients. In recent years, MSF monitoring data have indicated increasing numbers of VL relapse cases. A retrospective analysis of these data was performed in order to provide insight into the possible causes of this increase.Methodology/Principal findingsProgramme monitoring data from the MSF hospital in Lankien, Jonglei State, South Sudan, for the period 2001–2018 were analysed to detect trends in VL relapse as a proportion of all VL cases presenting to MSF treatment centres. Routinely collected patient-level data from relapse and primary VL cases treated at all MSF sites in South Sudan over the same period were analysed to describe patient characteristics and treatments received. VL relapse as a proportion of all VL cases increased by 6.5% per annum (95% CI 0.3% to 13.0%, p = 0.04), from 5.2% during 2001–2003 to 14.4% during 2016–2018. Primary VL and VL relapse patients had similar age, sex and anthropometric characteristics, the latter indicating high indices of undernutrition which were relatively constant over time. Clinical factors (Hb, spleen size, and VL severity score) also did not vary substantially over time. SSG/PM was the main treatment regimen from 2001–2018, used in 68.7% of primary and 70.9% of relapse VL cases; AmBisome was introduced in 2013, received by 22.5% of primary VL and 32.6% of VL relapse cases from 2013–2018.ConclusionIncreasing incidence of VL relapse in South Sudan does not appear to be explained by changes in patient characteristics or other factors. Our data are concerning and may indicate an emergence of treatment-resistant parasite strains, decreasing the effectiveness of treatment regimens. This warrants further investigation as a causal factor. New chemical entities that will enable safe and highly effective short-course oral treatments for VL are urgently needed.
Real world effectiveness of digital mental health services during the COVID-19 pandemic
Authors: Prescott Maximo R. , Sagui-Henson Sara J. , Welcome Chamberlain Camille E. , Castro Sweet Cynthia , Altman Myra 
Published: August 2022

Background
The COVID-19 pandemic created an unprecedented need for mental health services that can be remotely delivered. Digital mental health services that offer personalized care recommendations hold promise to efficiently expand service, but evidence of the effectiveness of digitally delivered mental health care in real-world settings remains limited.

Methods
A retrospective cohort of adults (N = 1,852) receiving care through a digital mental health platform with elevated depressive symptoms during the COVID-19 pandemic was analyzed to estimate changes in subjective well-being and clinical improvement in depressive symptoms (using the World Health Organization-Five [WHO-5] Well-Being Index), as well as compare the relative effectiveness and cost of different care utilization patterns.

Results
The average improvement in WHO-5 score was 10.1 points (CI: 9.3–10.9, p<0.001) at follow-up, which constituted a medium effect size (d = 0.73). The odds of clinical improvement in depressive symptoms were significantly greater among those who utilized telecoaching (aOR = 2.45, 95%CI: 1.91–3.15, p < .001), teletherapy (aOR = 2.01, 95%CI: 1.57–2.57, p < .001), and both services (aOR = 2.28, 95%CI: 1.67–3.11, p < .001) compared to those who only utilized assessments, adjusting for baseline WHO-5 score, age, sex, and number of days between baseline and follow-up assessments. The average estimated cost of care for telecoaching was $124 per individual, which was significantly less than teletherapy ($413) or both services ($559).

Conclusion
Digitally delivered care with a therapist and/or coach was effective in improving subjective well-being and clinical improvement in depressive symptoms. Although clinical outcomes were similar across utilization patterns, the cost of care was lowest among those utilizing telecoaching.
Gender norms and women’s empowerment as barriers to facility birth: A population-based cross-sectional study in 26 Nigerian states using the World Values Survey
Authors: Litorp Helena , Kågesten Anna , Båge Karin , Uthman Olalekan , Nordenstedt Helena , Fagbemi Mariam , Puranen Bi , Ekström Anna-Mia 
Published: August 2022

Background
Central and western Africa struggle with the world’s lowest regional proportion of facility birth at 57%. The aim of the current study was to compare beliefs related to maternal health care services, science/technology, gender norms, and empowerment in states with high vs. low proportions of facility birth in Nigeria.

Methods
Face-to-face interviews were performed as part of a nationally representative survey in Nigeria using a new module to measure values and beliefs related to gender and sexual and reproductive health and rights collected as part the 2018 World Values Survey. We compared beliefs related to maternal health care services, science/technology, gender norms, and empowerment between Nigerian states with facility birth proportions > 50% vs. < 25% as presented in the 2018 Nigerian Demographic Health Survey report. Pearson’s chi-squared test, the independent t-test, and univariable and multivariable logistic and linear regression were used for analyses. Results were also stratified by gender.

Results
Among the 1,273 participants interviewed, 653 resided in states with high and 360 resided in states with low proportions of facility birth. There were no significant differences between the groups in perceived safety of facility birth (96% vs. 94%) and confidence in antenatal care (91% vs 94%). However, in states with low proportions of facility birth, participants had higher confidence in traditional birth attendants (61% vs. 39%, adjusted odds ratio [aOR] 2.1, [1.5–2.8]), men were more often perceived as the ones deciding whether a woman should give birth at a clinic (56% vs. 29%, aOR 2.4 [1.8–3.3]), and participants experienced less freedom over their own lives (56% vs. 72%, aOR 0.56 [0.41–0.76]). Most differences in responses between men and women were not statistically significant.

Conclusions
In order to increase facility births in Nigeria and other similar contexts, transforming gender norms and increasing women’s empowerment is key.
Diagnosis of temporomandibular disorders using artificial intelligence technologies: A systematic review and meta-analysis
Authors: Jha Nayansi , Lee Kwang-sig , Kim Yoon-Ji 
Published: August 2022

Background
Artificial intelligence (AI) algorithms have been applied to diagnose temporomandibular disorders (TMDs). However, studies have used different patient selection criteria, disease subtypes, input data, and outcome measures. Resultantly, the performance of the AI models varies.

Objective
This study aimed to systematically summarize the current literature on the application of AI technologies for diagnosis of different TMD subtypes, evaluate the quality of these studies, and assess the diagnostic accuracy of existing AI models.

Materials and methods
The study protocol was carried out based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA). The PubMed, Embase, and Web of Science databases were searched to find relevant articles from database inception to June 2022. Studies that used AI algorithms to diagnose at least one subtype of TMD and those that assessed the performance of AI algorithms were included. We excluded studies on orofacial pain that were not directly related to the TMD, such as studies on atypical facial pain and neuropathic pain, editorials, book chapters, and excerpts without detailed empirical data. The risk of bias was assessed using the QUADAS-2 tool. We used Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) to provide certainty of evidence.

Results
A total of 17 articles for automated diagnosis of masticatory muscle disorders, TMJ osteoarthrosis, internal derangement, and disc perforation were included; they were retrospective studies, case-control studies, cohort studies, and a pilot study. Seven studies were subjected to a meta-analysis for diagnostic accuracy. According to the GRADE, the certainty of evidence was very low. The performance of the AI models had accuracy and specificity ranging from 84% to 99.9% and 73% to 100%, respectively. The pooled accuracy was 0.91 (95% CI 0.76–0.99), I2 = 97% (95% CI 0.96–0.98), p < 0.001.

Conclusions
Various AI algorithms developed for diagnosing TMDs may provide additional clinical expertise to increase diagnostic accuracy. However, it should be noted that a high risk of bias was present in the included studies. Also, certainty of evidence was very low. Future research of higher quality is strongly recommended.
Facilitators and barriers of relatives’ involvement in nursing care decisions and self-care of patients with acquired brain injury or malignant brain tumour: A scoping review protocol
Authors: Guldager Rikke , Loft Mia Ingerslev , Nordentoft Sara , Aadal Lena , Poulsen Ingrid 
Published: August 2022

Introduction
Involving relatives can contribute to better quality of care and treatment, and lead to higher satisfaction with hospitalisation in the patients, relatives and healthcare professionals. Nurses play an important role in developing a trusting relationship and facilitating relatives’ involvement, since they are around the patient and relatives all day. Thus, involvement is central to the nursing practice. However, involving relatives seems complex and multifaceted with many possible facilitators and barriers to nurses.’

Objective
The objective of this scoping review is to identify and map the available evidence concerning possible facilitators and barriers to nurses involving relatives in the course of treating disease in individuals who have sustained an acquired brain injury or malignant brain tumour in all settings.

Methods and analysis
The proposed scoping review will be performed following the Joanna Briggs Institute’s (JBI) methodology for scoping reviews. Indexed and grey literature in English, Scandinavian or German languages from 2010 to the present will be considered. The searches will be conducted using bibliographic databases: Medline (via PubMed), CINAHL (via EBSCO) and EMBASE (via OVID). Two reviewers will independently screen the studies and determine if their title, abstract and full text meet the study’s inclusion criteria. In case of disagreement, a third and fourth reviewer will be consulted. A customised data extraction form will be used to extract data from the included studies. The results will be presented in tabular form, accompanied by a narrative summary related to the objective of the present scoping review. This scoping review will consider studies that involve nurses caring for individuals with an acquired brain injury or malignant brain tumour in all settings (community, primary care, health care centres, hospital and long-term care institutions). Studies will be included if they describe any kind of facilitators or barriers to involving relatives, and the review will consider all study designs.
Swimming performance, physiology, and post-activation performance enhancement following dryland transition phase warmup: A systematic review
Authors: McKenzie Max R. , McKean Mark R. , Doyle Danielle P. , Hogarth Luke W. , Burkett Brendan J. 
Published: August 2022

BackgroundIn swimming, the period between the end of the swimming warmup and the beginning of competition is critical to performance, here termed the transition phase. Several options are available during this phase, necessitating a systematic review to understand if optimal strategies exist.ObjectivesTo synthesise and critically evaluate the current literature investigating land-based warmup interventions on subsequent performance in competitive swimmers.MethodsA search of three electronic databases (PubMed, EBSCO SPORTDiscus and Web of Science) was conducted to identify original studies until February 2022. Selection criteria dictated that (i) a control condition was used, (ii) participants were ≥ 15 years of age, (iii) a pool-based warmup was done prior to the land-based warmup. A total of 25 articles met the selection criteria.ResultsReducing the transition phase duration by at least half led to consistently faster time-trial times of between 1.1–1.5% for all included studies. Passive warmups using clothing interventions resulted in mostly faster time-trial’s of 0.4–0.8% with increases in skin temperature frequent, though little change occurred in core temperature. The methodology of passive respiratory warmups were vastly different with positive time-trial’s effects ranging between 0.9–1.1% for two studies, though one reported no meaningful difference. Active warmups led to consistently faster time-trial’s between 0.7–0.9%, though the unpinning factors are not clear. Warmups which combined passive and active options frequently led to faster time-trial’s between 0.8–3%. Upper and combined limb post-activation performance enhancement led to mostly unfavourable time-trial changes. Lower limb exclusive protocols results were inconsistent, with limited beneficial effects on time-trial or start performance reported following plyometric protocols. However, there does appear merit in heavier loaded lower limb protocols.ConclusionEach of a reduced transition phase length, and passive, active or combination warmup have demonstrated improvements in swimming performance. Conversely, PAPE protocols should be used with caution, especially when including the upper limbs.
Clinical reasoning education in the clerkship years: A cross-disciplinary national needs assessment
Authors: Gold Jonathan G. , Knight Christopher L. , Christner Jennifer G. , Mooney Christopher E. , Manthey David E. , Lang Valerie J. 
Published: August 2022

Background
Improving clinical reasoning education has been identified as an important strategy to reduce diagnostic error—an important cause of adverse patient outcomes. Clinical reasoning is fundamental to each specialty, yet the extent to which explicit instruction in clinical reasoning occurs across specialties in the clerkship years remains unclear.

Method
The Alliance for Clinical Education (ACE) Clinical Reasoning Workgroup and the Directors of Clinical Skills Courses (DOCS) Clinical Reasoning Workgroup collaborated to develop a clinical reasoning needs assessment survey. The survey questionnaire covered seven common clinical reasoning topics including illness scripts, semantic qualifiers, cognitive biases and dual process theory. Questionnaires were delivered electronically through ACE member organizations, which are primarily composed of clerkship leaders across multiple specialties. Data was collected between March of 2019 and May of 2020.

Results
Questionnaires were completed by 305 respondents across the six organizations. For each of the seven clinical reasoning topics, the majority of clerkship leaders (range 77.4% to 96.8%) rated them as either moderately important or extremely important to cover during the clerkship curriculum. Despite this perceived importance, these topics were not consistently covered in respondents’ clerkships (range 29.4% to 76.4%) and sometimes not covered anywhere in the clinical curriculum (range 5.1% to 22.9%).

Conclusions
Clerkship educators across a range of clinical specialties view clinical reasoning instruction as important, however little curricular time is allocated to formally teach the various strategies. Faculty development and restructuring of curricular time may help address this potential gap.
Is it time to change the approach of mental health stigma campaigns? An experimental investigation of the effect of campaign wording on stigma and help-seeking intentions
Authors: Hazell Cassie M. , Fixsen Alison , Berry Clio 
Published: August 2022

Introduction
Mental health stigma causes a range of diverse and serious negative sequelae. Anti-stigma campaigns have largely aligned with medical theories and categorical approaches. Such campaigns have produced some improvements, but mental health stigma is still prevalent. The effect of alternative theoretical perspectives on mental health within anti-stigma campaigns has not been tested. Moreover, we do not know their effect on help-seeking intentions.

Methods
We conducted an online experimental pre-post study comparing the effects of two anti-stigma campaign posters on mental health stigma and help-seeking intentions. One poster adhered to the medical, categorical approach to mental health, whereas the other poster portrayed mental health problems in line with a non-categorical, continuous perspective.

Results
After controlling for familiarity with the campaign poster, country of residence and pre-test scores, we found no significant between-group differences in terms of help-seeking intentions and all stigma attitudes except for danger-related beliefs. That is, those who viewed the non-categorical poster reported an increased perception that people with mental health problems are dangerous.

Discussion
Our largely null findings may suggest the equivalence of these posters on stigma and help-seeking intentions but may also reflect the brevity of the intervention. Our findings concerning danger beliefs may reflect a Type I error, the complexities of stigma models, or the adverse effects of increased perceived contact. Further research is needed to test the effects of differing mental health paradigms on stigma and help-seeking intentions over a longer duration.
Postural displacement induced by electrical stimulation; A new approach to examine postural recovery
Authors: Tahayori Behdad , Tahayori Bahman , Mehdizadeh Alireza , Koceja David M. 
Published: August 2022

Background
Controlling upright posture entails acute adjustments by the neuromuscular system to keep the center of mass (COM) within the limits of a relatively small base of support. Sudden displacement of the COM triggers several strategies and balance recovery mechanisms to prevent excessive COM displacement.

New method
We have examined and quantified a new approach to induce an internal neuromuscular perturbation in standing posture on 15 healthy individuals to provide an insight into the mechanism of loss of balance (LOB). The method comprises eliciting an H-reflex protocol while subjects are standing which produces a contraction in soleus and gastrocnemius muscles. We have also defined analytical techniques to provide biomarkers of balance control during perturbation. We used M-Max unilaterally or bilaterally and induced a forward or sideway perturbation. The vector analysis and the Equilibrium Point calculations defined here can quantify the amplitude, direction, and evolution of the perturbation.

Results
Clear patterns of loss of balance due to stimulation was observed. Compared to quiet standing, the density of the EPs substantially increased in the perturbation phase. Leftward stimulation produced significantly higher number of EPs compared to the bilateral stimulation condition which could be due to the fact that the left leg was the nondominant side in all our subjects.

Comparison and conclusion
In this study we provide a proof-of-concept technique for examining recovery from perturbation. The advantage of this technique is that it provides a safe perturbation, is internally induced at the spinal cord level, and is free from other factors that might complicate the recovery analysis (e.g., locomotion and the integration of the spinal pattern generator and cutaneous pathways in mediating changes). We have shown that the perturbation induced by this method can be quantified as vectors. We have also shown that the density of instantaneous equilibrium points (EPs) could be a good biomarker for defining and examining the perturbation phase. Thus, this protocol and analysis provides a unique individual assessment of recovery which can be used to assess interventions. Finally, given that the maximal motor response is used as the perturbation (e.g., M-max) it is highly reliable and reproducible within an individual patient.
Research on reform and breakthrough of news, film, and television media based on artificial intelligence
Authors: Li Xiaojing 
Published: August 2022

Abstract
With the development of technology, news media and film and television media are spreading faster and faster, and at the same time, the spread of rumors is also accelerated. This article briefly describes the application of artificial intelligence in news media and film and television media using a back-propagation neural network (BPNN) algorithm to reform refutation of rumors in news media and film and television media, and compared it with K-means and support vector machine algorithms in simulation experiments. The results showed that the BPNN-based rumor recognition model had better recognition performance and shorter recognition time; it was more accurate in recognizing Weibo texts that were complete and faster in recognizing bullet screen comments that were short; the BPNN-based rumor recognition model also had the lowest false detection cost and performed stably when being used in actual Weibo platform and bullet screen video website.