bluuebunny/crossref_metadata_2025_split huggingface dataset:
Television-viewing time and bodily pain in Australian adults with and without type 2 diabetes: 12-year prospective relationships
Authors: Dzakpasu Francis Q. S. , Owen Neville , Carver Alison , Sethi Parneet , Brakenridge Christian J. , Salim Agus , Urquhart Donna M. , Cicuttini Flavia , Dunstan David W. 
Published: November 2022

Abstract
Background
Bodily pain is a common presentation in several chronic diseases, yet the influence of sedentary behaviour, common in ageing adults, is unclear. Television-viewing (TV) time is a ubiquitous leisure-time sedentary behaviour, with a potential contribution to the development of bodily pain. We examined bodily pain trajectories and the longitudinal relationships of TV time with the bodily pain severity; and further, the potential moderation of the relationships by type 2 diabetes (T2D) status.

Method
Data were from 4099 participants (aged 35 to 65 years at baseline) in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), who took part in the follow-ups at 5 years, 12 years, or both. Bodily pain (from SF36 questionnaire: a 0 to 100 scale, where lower scores indicate more-severe pain), TV time, and T2D status [normal glucose metabolism (NGM), prediabetes, and T2D] were assessed at all three time points. Multilevel growth curve modelling used age (centred at 50 years) as the time metric, adjusting for potential confounders, including physical activity and waist circumference.

Results
Mean TV time increased, and bodily pain worsened (i.e., mean bodily pain score decreased) across the three time points. Those with T2D had higher TV time and more-severe bodily pain than those without T2D at all time points. In a fully adjusted model, the mean bodily pain score for those aged 50 years at baseline was 76.9(SE: 2.2) and worsened (i.e., bodily pain score decreased) significantly by 0.3(SE: 0.03) units every additional year (p <0.001). Those with initially more-severe pain had a higher rate of increase in pain severity. At any given time point, a one-hour increase in daily TV time was significantly associated with an increase in pain severity [bodily pain score decreased by 0.69 (SE: 0.17) units each additional hour; p <0.001], accounting for the growth factor (age) and confounders’ effects. The association was more-pronounced in those with T2D than in those without (prediabetes or NGM), with the effect of T2D on bodily pain severity becoming more apparent as TV time increases, significantly so when TV time increased above 2.5 hours per day.

Conclusion
Bodily pain severity increased with age in middle-aged and older Australian adults over a 12-year period, and increments in TV time predicted increased bodily pain severity at any given period, which was more pronounced in those with T2D. While increasing physical activity is a mainstay of the prevention and management of chronic health problems, these new findings highlight the potential of reducing sedentary behaviours in this context.
Cardiovascular (Framingham) and type II diabetes (Finnish Diabetes) risk scores: a qualitative study of local knowledge of diet, physical activity and body measurements in rural Rakai, Uganda
Authors: Ssekubugu Robert , Makumbi Fredrick , Enriquez Rocio , Lagerström Susanne R. , Yeh Ping Teresa , Kennedy Caitlin E. , Gray Ronald H. , Negesa Lilian , Serwadda David M. , Kigozi Godfrey , Ekström Anna Mia , Nordenstedt Helena 
Published: November 2022

Abstract
Background
Non-communicable diseases such as cardiovascular conditions and diabetes are rising in sub-Saharan Africa. Prevention strategies to mitigate non-communicable diseases include improving diet, physical activity, early diagnosis, and long-term management. Early identification of individuals at risk based on risk-score models – such as the Framingham Risk Score (FRS) for 10-year risk of cardiovascular disease and the Finnish type 2 Diabetes risk score (FINDRISC) for type 2 diabetes which are used in high-income settings – have not been well assessed in sub-Saharan Africa. The purpose of this study was to qualitatively assess local knowledge of components of these risk scores in a rural Ugandan setting.

Methods
Semi-structured qualitative in-depth interviews were conducted with a purposively selected sample of 15 participants who had responded to the FRS and FINDRISC questionnaires and procedures embedded in the Rakai Community Cohort Study. Data were summarized and categorized using content analysis, with support of Atlas.ti.

Results
Participants described local terms for hypertension (“pulessa”) and type 2 diabetes (“sukaali”). Most participants understood physical activity as leisure physical activity, but when probed would also include physical activity linked to routine farm work. Vegetables were typically described as "plants", “leafy greens”, and “side dish”. Vegetable and fruit consumption was described as varying seasonally, with peak availability in December after the rainy season. Participants perceived themselves to have good knowledge about their family members’ history of type 2 diabetes and hypertension.

Conclusions
While most items of the FRS and FINDRISC were generally well understood, physical activity needs further clarification. It is important to consider the seasonality of fruits and vegetables, especially in rural resource-poor settings. Current risk scores will need to be locally adapted to estimate the 10-year risk of cardiovascular diseases and type 2 diabetes in this setting.
Barriers to vulnerable adolescent girls’ access to sexual and reproductive health
Authors: Janighorban Mojgan , Boroumandfar Zahra , Pourkazemi Razieh , Mostafavi Firoozeh 
Published: November 2022

Abstract
Background
Vulnerable adolescents are exposed to sexual and reproductive health harms. Ignoring the sexual and reproductive health of this group can have irreparable consequences. The present qualitative study aimed to explore the barriers to the access of vulnerable adolescent girls to sexual and reproductive health.

Methods
In this study, sixteen 14-19-year-old adolescent girls and twenty-two key informants were selected using purposive sampling method. Through in-depth semi-structured interviews, they expressed their experiences of barriers to sexual and reproductive health in vulnerable adolescent girls. The data were encoded using the conventional qualitative content analysis.

Results
Based on the results of the study, neglecting the reproductive and sexual health of vulnerable adolescent girls at different levels leads to serious challenges and obstacles in providing and maintaining it. Lack of a responsible family, the repulsive behaviors of the family and following risky behaviors of peers led to ignoring the sexual and reproductive health of adolescent girls. Unanswered sexual questions, defective life skills, unwanted pregnancy during adolescence, lack of awareness of unsafe sex, violating cultural norms and wounded psyche in vulnerable adolescent girls threaten their sexual and reproductive health. Ineffectiveness of key organizations in providing sexual and reproductive health services alongside lack of legal, political and social support in this area indicate that the sexual and reproductive health of these girls is not a priority for the society.

Conclusion
Numerous personal, family, social, legal and political barriers challenge the sexual and reproductive health of vulnerable adolescent girls. Developing a comprehensive and practical program beside legal and political support for this issue can provide the basis for the sexual and reproductive health of this group of adolescents in societies.
Disseminated nontuberculous mycobacterial infection with cryptic immunodeficiency mimicking malignancy: a case report
Authors: Sun Xiaochuan , Zhang Ting , Sun Hongli , Sun Xuefeng 
Published: November 2022

Abstract
Background
Nontuberculous mycobacteria (NTM) usually invades vulnerable hosts. Disseminated NTM (dNTM) infection can affect nearly all organs and be easily misdiagnosed as metastatic carcinoma or other systemic diseases, especially in seemingly immunocompetent hosts. Identification of underlying immunodeficiency is critical for the diagnosis and treatment of dNTM. Adult-onset immunodeficiency (AOID) with anti-IFN-γ autoantibodies has recently been recognized as a crucial but frequently neglected risk factor for dNTM infection. Frequent relapses of infection are common in AOID patients despite appropriate anti-infective treatment and B-cell-depleting therapy has shown some promising results. Herein, we report a case of dNTM infection mimicking malignancy in an AOID patient who was successfully treated with rituximab.

Case presentation
A middle-aged male presented with fever, productive cough, multifocal skin abscesses and multiple osteolytic lesions with pathological fractures. Chest CT revealed consolidation of the lingula while bronchoscopy showed a mass completely blocking the airway opening of the inferior lingual segment. Metagenomic next-generation sequencing and mycobacterial culture of skin pus and bronchoalveolar lavage fluid reported Mycobacterium Colombiense, confirming the diagnosis of dNTM infection. However, anti-NTM antibiotics alone failed to prevent disease relapse and progression. Further evaluation indicated undetectable serum IFN-γ concentration and high-titer autoantibodies against IFN-γ, suggesting that AOID was the underlying reason for dNTM. Rituximab was added to treatment and successfully controlled the infection without relapse at one-year follow-up.

Conclusion
We reported a rare case of disseminated Mycobacterium Colombiense infection manifested with pulmonary mass, pathological fracture and dermapostasis in a host with AOID. Our case demonstrated that AOID should be screened when patients get the episode of disseminated NTM infection particularly when other risk factors are excluded. Besides prolonged anti-NTM therapy, AOID-associated NTM infection should be treated with B-cell-depleting therapy to prevent recurrence.
The shoulder abductor strength is a novel predictor of tracheostomy in patients with traumatic cervical spinal cord injury
Authors: Jian Yunbo , Mu Zhiping , Sun Dawei , Zhang Dan , Luo Chunmei , Zhang Zhengfeng 
Published: November 2022

Abstract
Background
Early prediction of tracheostomy in traumatic cervical spinal cord injury (TCSCI) patients is often difficult. This study aims to clarify the association between shoulder abductor strength (SAS) and tracheostomy in patients with TCSCI.

Methods
We retrospectively analyzed 513 TCSCI patients who were treated in our hospital. All patients were divided into a tracheostomy group and a non-tracheostomy group. The SAS was assessed using the Medical Research Council (MRC) Scale for Muscle Strength grading. Potential predictors were assessed for their association with tracheostomy in patients. A nomogram was developed based on multivariable logistic regression analysis (MLRA) to visualize the predictive ability of the SAS. Validation of the nomogram was performed to judge whether the nomogram was reliable for visual analysis of the SAS. Receiver operating characteristics curve, specificity, and sensitivity were also performed to assess the predictive ability of the SAS.

Results
The proportion of patients with the SAS grade 0–2 was significantly higher in the tracheostomy group than in the non-tracheostomy group (88.1% vs. 54.8%, p = 0.001). The SAS grade 0–2 was identified as a significant predictor of the tracheostomy (OR: 4.505; 95% CI: 2.080–9.758; p = 0.001). Points corresponding to both the SAS grade 0–2 and the neurological level of injury at C2-C4 were between 60 and 70 in the nomogram. The area under the curve for the SAS grade 0–2 was 0.692. The sensitivity of SAS grade 0–2 was 0.239. The specificity of SAS grade 0–2 was 0.951.

Conclusions
SAS is a novel predictor of tracheostomy in patients after TCSCI. The SAS grade 0–2 had a good predictive ability of tracheostomy.
General self-efficacy and social support in men and women with pain – irregular sex patterns of cross-sectional and longitudinal associations in a general population sample
Authors: Samulowitz Anke , Hensing Gunnel , Haukenes Inger , Bergman Stefan , Grimby-Ekman Anna 
Published: November 2022

Abstract
Background
The study of sex and gender patterns in psychosocial resources is a growing field of interest in pain research with importance for pain rehabilitation and prevention. The aims of this study were first, to estimate cross-sectional differences in psychosocial resources (general self-efficacy and social support) across men and women in a population with frequent musculoskeletal pain (pain in the back or neck/shoulder nearly every day or now and again during the week for the last 12 months) and to compare these differences with a population with no frequent pain. Second, to examine if psychosocial resources at baseline were associated with pain at follow-up among men and women in the frequent pain population.

Methods
This study was based on survey data from the Swedish Health Assets Project, including The General Self-Efficacy Scale and social support questions. Participants (n = 4010, 55% women) were divided into no frequent pain (n = 2855) and frequent pain (n = 1155). General self-efficacy and social support were analyzed (cross-sectional and longitudinal data) with linear and logistic regressions.

Results
Men, with and without frequent pain, had higher general self-efficacy than the corresponding groups in women. Women, with and without frequent pain, had stronger emotional social support than the corresponding groups in men. Men with no frequent pain had weaker instrumental social support than women with no frequent pain (OR = 0.64 (95% CI 0.47–0.87)), men with frequent pain did not (OR = 1.32 (95% CI 0.86–2.01)). In the frequent pain population, the interaction between sex and strong (compared to weak) emotional social support was statistically significant (p = 0.040) for no frequent pain at follow-up, with women having OR = 1.81 and men OR = 0.62. Among women, strong emotional social support was associated with no frequent pain at follow-up. Among men, strong emotional social support was associated with frequent pain at follow-up.

Conclusion
Some of the associations between general self-efficacy, social support and musculosceletal pain showed unexpected sex patterns. Gendered expectations might have relevance for some of the results.
Finite element comparative analysis of three different internal fixation methods in the treatment of Pauwels type III femoral neck fractures
Authors: Ma Ji , Zhao Ziying , Zhi Xiaodong , Wang Hao , Wang Wei 
Published: November 2022

Abstract
Background
Comparison of 4 cannulated lag screws (3 inverted triangular cannulated screws + anti-rotating screws;4 CLS), dynamic hip screws + derotational screws (DHS + DS), and femoral neck fixation system (FNS) in the treatment of Biomechanical properties of middle-aged Pauwels type III femoral neck fractures.

Methods
The femur CT data of a healthy young volunteer was selected and imported into Mimics software to construct a three-dimensional model of a normal femur. Pauwels type III femoral neck fractures were simulated according to the 70° fracture line. Use Geomagic and SolidWorks software to optimize and build CLS, DHS + DS, and FNS fracture internal fixation models. Finally, Ansys software was used to analyze the stress distribution, peak value, and maximum displacement of the proximal fracture fragment and internal fixation; the displacement distribution, and peak value of the fracture surface at the fracture end.

Results
① The stress peaks of the proximal fracture fragments in the three groups were concentrated near the femoral calcar. The peak stress of the FNS group was the largest, and the DHS + DS group was the smallest. ②The displacement of the fracture fragments was all located at the top of the femur. The peak displacement of the FNS group was the largest, and the DHS + DS group was the smallest. ③ The internal fixation stress of the three groups is concentrated in the middle part of the device. The stress distribution of the first two groups of models is more uniform than that of FNS. The peak stress of FNS is the largest and the CLS is the smallest. ④ The internal fixed displacements are all located at the top of the model. The peak displacement of the CLS is the largest, and the DHS + DS is the smallest. ⑤ The displacement of the fracture surface is in the upper part of the fractured end. The peak displacement of the FNS group was the largest, and the DHS + DS group was the smallest.

Conclusion
Compared with the other two internal fixation methods, dynamic hip screw + derotational screw (DHS + DS) showed good biomechanical stability. When Pauwels type III femoral neck fracture occurs in young adults, DHS + DS can be given priority as the preferred treatment for this type of fracture.
Towards cataloguing and characterising advance care planning and end-of-life care resources
Authors: Ramirez-Valdez Edric Aram , Leong Clare , Wu Frances , Ball Sarah , Maistrello Giulia , Martin Graham , Fritz Zoë 
Published: November 2022

AbstractBackgroundResources for healthcare professionals, patients and those important to them relating to planning and coordinating treatment and care at the end of life are abundant, and can be difficult to navigate. However, they have not been systematically collated or catalogued in terms of their purpose, scope or intended audience.AimTo collate, categorise and characterise advance care planning and end-of-life treatment and care (EoLT + C) resources directed towards healthcare professionals, patients and their families.MethodsRapid review and thematic synthesis of resources available in the United Kingdom. Google searches and reviews of websites belonging to selected organisations that develop and publish materials relating to EoLT + C, and advance care planning were used. Materials were included if they were intended for those over 18 living in the UK and pertained to five domains of EoLT + C: identifying those approaching end of life; accessing EoLT + C services; conducting important conversations about EoLT + C and preferences; advance care planning, including recording of preferences and plans; and ensuring that plans and preferences are accessed and used by health and social care services.Results246 resources directed at healthcare professionals, patients and their families were identified, collated, catalogued and made internationally available for clinicians, researchers, patients and the public. 61 were classified as interactive, providing decision support in EoLT + C that went beyond simply providing information. Of these, there was notable content overlap among tools for identifying patients in their last year of life. There was variation in the development of tools across all domains of end-of-life care by geography and patient group. Few interactive resources integrated seamlessly with a digital interface or healthcare provider workflows. Incentives for the adoption of best-practice appeared rare.ConclusionsWe present a repeatable and scalable approach to the cataloguing and characterisation of palliative care resources. The identified resources will be of benefit not only to those in the UK but to those in other countries, developing or evaluating their own resources for aiding professionals and patients to plan and deliver excellent treatment and care at the end of life.
The use of a technology-assisted and teacher-supervised online discussion platform to promote academic progress in blended embryology courses
Authors: Gong Linlin , Song Yang , Xu Yingsong , Wang Mingqi , Ma Haiying , Liu Weiwei , Zhu Liang , Li Jian , Luan Man , Chu Wanjiang , Wang Xiuli , Zhou Xin , Wei Wei , Hao Lihong 
Published: November 2022

AbstractBackgroundStudents’ engagement with learning materials and discussions with teachers and peers before and after lectures are among the keys to the successful implementation of blended programs. Mixed results have been reported by previous studies on blended learning. This study evaluated the effectiveness of embedding a teacher-supervised online discussion platform in a blended embryology course in terms of its impact on students’ capabilities to handle difficult and cognitively challenging tasks.MethodsTwo forms of blended learning were investigated and compared in this study. Students in the control group (n = 85) learned online materials before each class, followed by classroom instruction and activities in which face-to-face discussion and communication between students were encouraged. Students in the experimental group (n = 83) followed a similar procedure with an additional teacher-supervised online discussion platform to guide, supervise and evaluate their learning progress. All participants were first-year medical students in clinical medicine at Dalian Medical University who had enrolled in 2017. All participants took the final exam to test their learning outcomes.ResultsThe embryology grades of students in the experimental group were significantly higher than those of students in the control group (p = 0.001). Additionally, the scores of students in the experimental group on questions with a high difficulty level (p = 0.003) and questions assessing high-order cognitive skills (p = 0.003) were higher than those of students in the control group; the effect size was moderate (η2 > 0.05).ConclusionsIn blended embryology courses, compared with learner-led and face-to-face discussion, the teacher-supervised online discussion platform has great potential to enable students to achieve higher grades and solve difficult and cognitively challenging tasks.
Key tips to providing a psychologically safe learning environment in the clinical setting
Authors: Hardie Philip , O’Donovan Roisin , Jarvis Suzi , Redmond Catherine 
Published: November 2022

AbstractHaving psychological safety embedded in preceptorship relationships facilitates positive interpersonal and educational experiences for students. Psychological safety refers to a student’s belief as to whether or not it is safe for them to take interpersonal risks, such as asking questions, sharing an idea for improvement or speaking up to maintain patient safety. Having psychological safety leads to collaboration, positive student learning experiences and effective patient care. This article presents key guidelines for preceptors to provide a psychologically safe learning environment for their students. Guidelines fall under four categories 1) before meeting students, 2) first meeting students, 3) continued relationship with students, and 4) general rules. These guidelines are informed by current literature on psychological safety and preceptorship and the author's clinical expertise in nursing preceptorship. We conceptualise psychological safety in a nursing preceptorship for preceptors to denote the experience of inclusivity, empowerment, and well-being of students within the social, cultural and physical clinical learning environment. A crucial attribute to cultivating a psychologically safe environment involves being an accessible and approachable preceptor.