bluuebunny/crossref_metadata_2025_split huggingface dataset:
The link between intrauterine adhesions and impaired reproductive performance: a systematic review of the literature
Authors: Hooker Angelo B. , de Leeuw Robert A. , Emanuel Mark Hans , Mijatovic Velja , Brolmann Hans A. M. , Huirne Judith A.F. 
Published: November 2022

AbstractBackgroundIntrauterine adhesions (IUAs) are one of the main reproductive system diseases in women worldwide. Fusion between the injured opposing walls leads to partial-to-complete obliteration of the cavity and/or cervical canal. The main clinical manifestations in case of IUAs are menstrual disturbances, cyclic pain and reproductive disorders. The reproductive outcomes of women with IUAs remain limited and inefficient compared to women without IUAs, even after adhesiolysis. An exact understanding of the underlying mechanisms and processes to explain the compromised reproductive performance and outcomes in case of IUAs are lacking.MethodsA systematic literature review of MEDLINE-PubMed (1966 to January 2022) and EMBASE (1974 to January 2022) was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported underlying causes, related mechanisms and processes to explain the association between IUAs and impaired reproductive performance, pregnancy and obstetric complications.ResultsAfter an extensive review of the literature, 58 articles were identified reporting underlying mechanisms to explain the association between IUAs and impaired fertility. Intrauterine scarring influences the process of fertilization, reproductive performance and ultimately reproductive outcome. IUAs can disturb the cervico-utero-tubal sperm transport and result in an avascular and unresponsive endometrium with decreased receptivity and thickness. Abnormal decidualization and abnormal trophoblastic infiltration leads to placental attachment disorders. Moreover, the risk for premature delivery, intrauterine fetal growth restriction and fetal anomalies is increased in case of IUAs.ConclusionThe impact of IUAs on reproductive performance, even after adhesiolysis, is becoming more apparent. The postulated mechanisms to explain the association are related to sperm transport, embryo implantation and placentation. Prevention, by preserving the basal layer of the endometrium is essential. Effective and evidence-based strategies for the prevention of endometrial injury and formation of IUAs, are urgently needed.
Resilience and prenatal mental health in Pakistan: a qualitative inquiry
Authors: Bhamani Shireen Shehzad , Arthur David , Van Parys An-Sofie , Letourneau Nicole , Wagnild Gail , Premji Shahirose Sadrudin , Asad Nargis , Degomme Olivier 
Published: November 2022

AbstractBackgroundWomen in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.MethodsThe exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A total of 17 semi-structured interviews were conducted with pregnant women, purposefully selected with heterogeneous characteristics to explore diverse perspectives, while symptoms of depression were quantified by the Edinburgh Postnatal Depression Scale before the interview. Verbatim transcriptions were coded openly and merged into categories and themes.ResultA total of six themes emerged from in-depth thematic analysis: 1) purpose of life, 2) dealing with emotions, 3) believing in yourself, 4) optimistic approach, 5) strengthening support and relationship and 6) spirituality and humanity. Women agreed that these characteristics could help them improve their mental health.ConclusionIn conclusion, these themes were the core components of pregnant women’s resilience which ultimately could help to promote prenatal mental health. These pave a pathway towards developing culturally and contextually resilience interventions aimed at enhancing mental health of pregnant women which then may improve neonatal and family mental wellbeing.
Association between niacin and mortality among patients with cancer in the NHANES retrospective cohort
Authors: Ying Hongan , Gao Lijie , Liao Nansheng , Xu Xijuan , Yu Wenfeng , Hong Weiwen 
Published: November 2022

Abstract
Background
The vitamin niacin is used as a lipid-regulating supplement, but it is unknown whether niacin has a positive influence on cancer prognosis. In this study, we examine the relationship between niacin intake and mortality among patients with cancer.

Methods
Our study utilized all available continuous data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. Multivariable Cox regression models were applied in order to investigate dietary niacin intake’s association with mortality. We compared the survival probability between groups of low and high niacin intake by plotting Kaplan-Meier curves. An analysis of subgroups was used to investigate heterogeneity sources.

Results
A total of 3504 participants were included in the cohort, with 1054 deaths. One thousand eight hundred forty-seven participants (52.3%) were female, 2548 participants (73.4%) were white, and the mean age (SE) was 65.38 years (0.32). According to multivariate logistic regression analysis, niacin intake was negatively associated with mortality outcomes in patients with cancer, with P values below 0.05 in all models. In subgroup analyses based on sex, age, and BMI, the association persisted. The Kaplan-Meier curves indicate that high niacin intake groups have better survival rates than low intake groups. Niacin supplementation improved cancer mortality but not all-cause mortality.

Conclusion
According to our study, higher dietary niacin intake was associated with lower mortality in cancer patients. Niacin supplements improved cancer survival rates, but not all causes of mortality.
Multidimensional self-rating biological rhythm disorder and its association with depression and anxiety symptoms among adolescents aged 11–23 years: a school-based cross-sectional study from China
Authors: Zeng Xin , Chen Yiyang , Zhang Qian , Jin Yexin , Song Yalin , Xue Kunyu , Lou Hao , Li Ran , Lou Xiaomin , Wang Xian 
Published: November 2022

Abstract
Background
Depression and anxiety are topical concerns worldwide, especially among adolescents. Besides, biological rhythm disorder as a candidate mechanism for mood disorders is highly prevalent, but relevant research among adolescents in China is presently limited. We conducted the present study to investigate the distribution of multi-dimensional self-rating biological rhythm disorder and the association of self-rating biological rhythm disorders with depression and anxiety symptoms among Chinese adolescents in different academic stages.

Methods
In the cross-sectional study, 3693 students aged 11–23 from Zhengzhou City, Henan Province, China were included. The Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) were used to evaluate symptoms of depression and anxiety, respectively. Additionally, the Self-Rating of Biological Rhythm Disorder for Adolescents (SBRDA) was used to assess status of biological rhythm disorders. Multivariate logistic regression was developed to explore factors potentially associated with symptoms of depression and anxiety stratified by academic stages.

Results
Among all participants, 44.14 and 36.15% suffered from depression and anxiety symptoms, respectively. On average, participants scored 74.66 ± 19.37 on the measure of total biological rhythm disorder. Adjusted for demographic confounding factors, the logistic regression analysis showed higher scores of total biological rhythm disorder were associated with more severe depression (OR = 14.38, 95%CI: 11.38–18.16) and anxiety symptoms (OR = 11.63, 95%CI: 9.14–14.81). The similar results were also found in the stratified analysis by academic stages.

Conclusions
Self-rating biological rhythm disorders are significantly associated with depression and anxiety symptoms among adolescents. Discrepancy across academic stages should also be taken into account in establishing public health strategies.
The 14-item short health anxiety inventory (SHAI-14) used as a screening tool: appropriate interpretation and diagnostic accuracy of the Swedish version
Authors: Österman Susanna , Axelsson Erland , Lindefors Nils , Hedman-Lagerlöf Erik , Hedman-Lagerlöf Maria , Kern Dorian , Svanborg Cecilia , Ivanov Volen Z. 
Published: November 2022

Abstract
Background
The 14-item Short Health Anxiety Inventory (SHAI-14) is a common measure of health anxiety but its screening properties have not been studied. The aims of this study were to evaluate the SHAI-14 as a screening instrument, identify cut-offs for clinically significant health anxiety and investigate which scores correspond to different severity levels.

Method
The study included 1729 psychiatric patients and 85 healthy controls. Participants completed the SHAI-14 and underwent a diagnostic interview. Cut-off scores were evaluated in three scenarios to approximate screening 1) in a psychiatric clinic, 2) in a low prevalence setting and, 3) of healthy volunteers (cut-off for remission). Receiver operating characteristics were used. Classification of severity was based on the distribution of SHAI-14 scores reported by patients with clinically significant health anxiety.

Results
The area under the curve (AUC) values were high in all scenarios (above 0.95). The optimal cut-off scores on the SHAI-14 were 22 in the psychiatric context, 29 in a setting with low prevalence of psychiatric disorders and 18 versus healthy controls. SHAI-14 scores of 0–27 represented no or mild health anxiety, 28–32 moderate health anxiety and 33–42 substantial health anxiety.

Conclusion
Brief self-report measures used as screening instruments are a simple way of gathering information about the presence of specific symptoms and thus a way to detect the likelihood of a diagnosis. The SHAI-14 shows evidence of good diagnostic utility in both clinical and non-clinical settings. However, which cut-off score is to be used, depends on the intended purpose and the setting where the cut-off is used.
The association between academic stress, social support, and self-regulatory fatigue among nursing students: a cross-sectional study based on a structural equation modelling approach
Authors: Yuhuan Zhang , Pengyue Zheng , Dong Chen , Qichao Niu , Dong Pang , Anqi Song , Hongbo Jiang , Zhixin Di 
Published: November 2022

Abstract
Background
Emphasizes the state of academic stress, social support, and self-regulatory fatigue on the physical and mental development of Chinese nursing students, the purpose of this study was to investigate the relationship between these variables and the mediating role of social support in academic stress and self-regulatory fatigue among a group of undergraduate nursing students in Heilongjiang Province, China, in order to provide a theoretical basis for working to reduce nursing students’ self-regulatory fatigue.

Methods
In this cross-sectional study, 1703 nursing students from various academic years completed the scales of social support, academic stress, and self-regulatory fatigue. In the end, there were 797 valid questionnaires, for a recovery rate of 46.80%. For statistical analysis, the independent t-test, Kruskal Wallis test, and Pearson correlation coefficient were used. In addition, we undertake analyses using structural equation modeling.

Results
The bulk of nursing students, or 81.4%, are between the ages of 19 and 21. Eighty percent were females. The bulk (93.0%) was comprised of freshmen. Academic stress, social support, and self-regulatory fatigue had total scores of 111.28 ± 29.38, 37.87 ± 6.70, and 45.53 ± 5.55,respectively. Academic stress was correlated with social support and self-regulatory fatigue (all p < 0.001). Social support was an intermediate variable (p < 0.001), with an intermediate effect value of 0.122, representing 32.35% of the total effect.

Conclusion
Academic pressure is associated with an increase in self-regulatory fatigue, mediated by social support. Educational administrators should pay attention to the social support and resource supplement of nursing students, the adjustment and compensatory development of nursing students’ physical and mental resources, the advancement of nursing students’ internal resource adjustment, and the reduction of their self-regulatory fatigue.
Knowledge, attitude, and practice of evidence-based medicine among resident physicians in hospitals of Syria: a cross-sectional study
Authors: Alabdullah Muhammad Nour , Alabdullah Hadi , Kamel Sondos 
Published: November 2022

AbstractBackgroundEvidence-based medicine (EBM) is to integrate the best research evidence with our clinical expertise, circumstances, and unique values of our patient. However, there are no studies about using EBM in clinical practice among resident doctors in Syria. In this study, we aimed to evaluate the self-reported knowledge, attitude and practice (KAP) of EBM by resident doctors throughout different teaching hospitals in Syria.MethodsThe study is a cross-sectional. A self-reported online questionnaire was used to collect data about KAP of EBM from 214 resident physicians working in secondary and tertiary teaching hospitals. The study was conducted between September 2021 and February 2022. All data were analyzed using SPSS, and non-parametric statistical tests were used to identify the correlation between different variables and make the necessary comparisons.ResultsTwo hundred and fourteen physicians responded to the questionnaire with a response rate of 85.6%. The overall mean scores of KAP of EBM were 59.2, 74.3 and 53.9%, respectively. The participants displayed a low level of awareness of resources and statistical terms used in EBM. The most well-known resources for residents were Up To Date and PubMed. Among the participants, pediatric residents achieved the highest score in practicing EBM, while family medicine residents scored the lowest score.ConclusionThe overall impression about the KAP of EBM among Syrian residents was as following: weak awareness, neutral attitude and poor practice of EBM. Training workshops should be set up to teach residents the skills needed to move from opinion-based practice to evidence-based practice.
Cost of hospital services in India: a multi-site study to inform provider payment rates and Health Technology Assessment
Authors: Chauhan Akashdeep Singh , Guinness Lorna , Bahuguna Pankaj , Singh Maninder Pal , Aggarwal Vipul , Rajsekhar Kavitha , Tripathi Surbhi , Prinja Shankar 
Published: November 2022

AbstractThe 'Cost of Health Services in India (CHSI)' is the first large scale multi-site facility costing study to incorporate evidence from a national sample of both private and public sectors at different levels of the health system in India. This paper provides an overview of the extent of heterogeneity in costs caused by various supply-side factors.A total of 38 public (11 tertiary care and 27 secondary care) and 16 private hospitals were sampled from 11 states of India. From the sampled facilities, a total of 327 specialties were included, with 48, 79 and 200 specialties covered in tertiary, private and district hospitals respectively. A mixed methodology consisting of both bottom-up and top-down costing was used for data collection. Unit costs per service output were calculated at the cost centre level (outpatient, inpatient, operating theatre, and ICU) and compared across provider type and geographical location.The unadjusted cost per admission was highest for tertiary facilities (₹ 5690, 75 USD) followed by private facilities (₹ 4839, 64 USD) and district hospitals (₹ 3447, 45 USD). Differences in unit costs were found across types of providers, resulting from both variations in capacity utilisation, length of stay and the scale of activity. In addition, significant differences in costs were found associated with geographical location (city classification).The reliance on cost information from single sites or small samples ignores the issue of heterogeneity driven by both demand and supply-side factors. The CHSI cost data set provides a unique insight into cost variability across different types of providers in India. The present analysis shows that both geographical location and the scale of activity are important determinants for deriving the cost of a health service and should be accounted for in healthcare decision making from budgeting to economic evaluation and price-setting.
Single melatonin injection enhances the testicular artery hemodynamic, reproductive hormones, and semen parameters in German shepherd dogs
Authors: Salama Ali , Abdelnaby Elshymaa A. , Emam Ibrahim A. , Fathi Mohamed 
Published: November 2022

AbstractThis study aimed to determine the effects of melatonin administration on testicular vascular perfusion in relation to steroid hormones and semen characteristics in dogs. The study included 12 normospermic German shepherd dogs (weighed 35 ± 0.5 kg and aged 4 ± 0.5 years). Males received a single melatonin administration (melatonin dimethyl sulfoxide + corn oil via subcutaneous route; MEL;n = 6), while the rest of the animals served as controls (dimethyl sulfoxide + corn oil; Control;n = 6). Males were subjected to routine examination on days -15, 0, 15, 30, 45, and 60. All examined dogs were subjected to Doppler screening, semen collection, and blood sampling. The MEL group showed a significant (P < 0.05) elevation in semen volume, concentration, percentage of sperm motility, and total sperm × 106/ ejaculate compared to other control males. Doppler indices as resistance (RI) and pulsatility (PI) indices declined (P < 0.05) from D 30 (1.02 ± 0.01) until day 60 (0.87 ± 0.02) of treatment. In MEL males, the peak systolic point of velocity (PSV; cm/sec) of the testicular artery elevated (P < 0.05) on day 60 (20.15 ± 0.99) compared to its value on day 0 (17.39 ± 1.84). On D 60, the levels of testosterone (T), estradiol 17-ß (E2), and nitric oxide (NO) elevated (P < 0.05). A negative correlation was detected between testicular volume, scrotal circumference (SC), T levels, Doppler indices, and velocities. In conclusion, single melatonin administration could improve testicular vascularization via increasing Doppler velocities and intratesticular colored areas. In addition, it could improve semen picture and steroids (T and E2) and nitric oxide.
The perceptions of Lithuanian hunters towards African swine fever using a participatory approach
Authors: Stončiūtė Evelina , Malakauskas Alvydas , Conraths Franz J. , Masiulis Marius , Sauter-Louis Carola , Schulz Katja 
Published: November 2022

Abstract
Background
African swine fever (ASF) has been present in Lithuania since 2014. The disease affects mainly the wild boar population. Thus, hunters play a key role in the performance of disease surveillance and control measures. We used participatory methods to gain insight into the knowledge of hunters and to include their perceptions in the design and the implementation of surveillance and control measures to increase their effectiveness.

Results
The willingness and the interest of hunters to participate was high, but only eight focus group meetings with 33 hunters could be held due to the COVID-19 pandemic. The overall knowledge of Lithuanian hunters regarding ASF, investigated by semi-structured interviews, was sufficient to understand their part in ASF control and surveillance. However, their knowledge did not necessarily lead to an increased acceptance of some ASF control measures, like the targeted hunting of female wild boar. Participating hunters showed a good understanding of the processes of the surveillance system. Their trust in the performance within this system was highest towards the hunters themselves, thus emphasizing the importance of acknowledging their role in the system. Hunters refused measures including the reduction of hunting activities. They feared a complete elimination of the wild boar population, which in turn demonstrates the necessity to increase professional information exchange.

Conclusions
The perceptions of Lithuanian hunters regarding ASF surveillance and control in wild boar resembled those obtained in neighboring countries. It is imperative to communicate the results with decision-makers, to consider the views of hunters, when designing or adapting measures to control ASF in wild boar and to communicate with hunters on these measures and their justification.
Does the LHPP gene share a common biological function in pancancer progression?
Authors: Guo Kai , Tian Wei , Wang Hongtao , Chang Dongmin , Dou Yawei , Yuan Jinyan , Chen Yaohua , Hou Bin 
Published: November 2022

AbstractAlthough emerging evidence has revealed that LHPP, a histidine phosphatase protein, suppresses the progression of different cancers, a pan-cancer analysis still remains unavailable. Therefore, we first utilized different bioinformatics tools to explore the tumor inhibitory role of LHPP protein across 33 tumor types based on the TCGA project. Additionally, HGC-27 gastric cancer cells were used to evaluate the biological functions of LHPP after stable transfection with lentiviruses. Consequently, LHPP mRNA and protein expression were down-regulated in the most cancer tissues corresponding to normal tissues. The data showed that patients with higher LHPP performance had a better prognosis of overall survival (OS) and disease-free survival (DFS) in brain glioma and renal carcinoma. In addition, we found that enhancement of LHPP expression attenuated the proliferation, migration and invasion of gastric cancer cells. The expression levels of cell-cycle-related and EMT-related molecules, such as CDK4, CyclinD1, Vimentin and Snail, were clearly reduced. Moreover, a genetic alteration analysis showed that the most frequent mutation types in LHPP protein was amplification. The patients without LHPP mutation showed a better tendency of prognosis in UCEC, STAD and COAD. Cancer-associated fibroblast infiltration was also observed in head and neck squamous cell carcinoma, stomach adenocarcinoma and testicular germ cell tumors. In summary, our pancancer analysis among various tumor types could provide a comprehensive understanding of LHPP biological function in the progression of malignant diseases and promote the development of novel therapeutic targets.