bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of information and preparation for improvement of pediatric perioperative care
Authors: Lööf Gunilla , Lönnqvist Per‐Arne 
Published: February 2022

AbstractThe perioperative period is a significant and stressful experience that may cause negative consequences in children, both in a short‐term and long‐term perspective. Despite a wide base of evidence stating the importance of adequate preparation to reduce anxiety, improve coping, cooperation and enhance recovery, many children continue to report that they feel unprepared for their perioperative experience. To secure children's right to request and need for preparation, the content, format, and availability of existing programs need to be scrutinized. Preparation programs in perioperative care must change from simply providing information to embracing the importance of children's need to process the information provided in order to learn and understand. Interactive web‐based technology can function as a significant resource for preparation of children for perioperative procedures. By changing perspective from children's need for information to their need for learning and by developing preparation programs including adequate educational principles, web‐based technology can be used to its fullest advantage as a healthcare learning and preparation resource.
Large number placements on a bounded number line: The importance of explanations
Authors: Harkness Shelly Sheats , Brass Amy 
Published: February 2022

AbstractUnderstanding large number data is essential for making sense of real‐world problems. For the research reported here, our intent was to find connections between quantitative cognitive science studies and our prior qualitative study about participants' understanding of the relative size of large numbers. While all 23 cognitive science research studies that we reviewed focused only on participants' placements of large numbers on number lines, our study focused on preservice teachers' (PSTs; n = 128) strategies – placements and explanations for their placements – of one billion on a number line bounded by zero and one trillion. Our intent was to answer the following question: What are the connections between three plausible placements substantiated by cognitive scientists – linear; log‐linear; and segmented linear – of large numbers on number line tasks and the nine strategies identified in our qualitative study? We highlight exemplars from the nine PSTs' strategies to show connections between the three plausible placements. In doing so, we illustrate that asking participants to place large numbers on number lines only gives a partial picture of their understanding. Their explanations expand the placements by revealing inconsistencies among the placements and explanations. Implications for future research are also discussed.
Empoderamiento femenino, emprendimiento y pobreza. El caso colombiano
Authors: Finke Jennifer , Osorio-Tinoco Fabian , Pereira Laverde Fernando 
Published: February 2022

Este artículo explora diferentes dimensiones del empoderamiento de las mujeres, que pueden desarrollarse durante el proceso emprendedor. Se evidencian cambios en las dimensiones conforme las mujeres avanzan en el desarrollo de sus emprendimientos, diferenciando características según el contexto (urbano o rural). Adicionalmente, muestra cuáles factores de empoderamiento son claves para la reducción de la pobreza. Se desarrolla un análisis de correspondencia múltiples y un modelo probit ordenado, con datos del Monitor Global de Emprendimiento (GEM por sus siglas en inglés) para Colombia. Los resultados permiten identificar las necesidades y los recursos disponibles para fortalecer el empoderamiento de las mujeres por medio del emprendimiento, mientras que la relación encontrada entre factores de empoderamiento económicos y los ingresos familiares aporta evidencia sobre la importancia del empoderamiento para la reducción de la pobreza.
Arthrogenic Muscle Inhibition Following Anterior Cruciate Ligament Injury
Authors: Pietrosimone Brian , Lepley Adam S. , Kuenze Christopher , Harkey Matthew S. , Hart Joseph M. , Blackburn J. Troy , Norte Grant 
Published: February 2022

Arthrogenic muscle inhibition (AMI) is a common impairment in individuals who sustain an anterior cruciate ligament (ACL) injury. The AMI causes decreased muscle activation, which impairs muscle strength, leading to aberrant movement biomechanics. The AMI is often resistant to traditional rehabilitation techniques, which leads to persistent neuromuscular deficits following ACL reconstruction. To better treat AMI following ACL injury and ACL reconstruction, it is important to understand the specific neural pathways involved in AMI pathogenesis, as well as the changes in muscle function that may impact movement biomechanics and long-term structural alterations to joint tissue. Overall, AMI is a critical factor that limits optimal rehabilitation outcomes following ACL injury and ACL reconstruction. This review discusses the current understanding of the: (1) neural pathways involved in the AMI pathogenesis following ACL injury; (2) consequence of AMI on muscle function, joint biomechanics, and patient function; and (3) development of posttraumatic osteoarthritis. Finally, the authors review the evidence for interventions specifically used to target AMI following ACL injury.
Gender equality and the gender gap in life expectancy in the European Union
Authors: Pinho-Gomes Ana-Catarina , Vassallo Amy , Carcel Cheryl , Peters Sanne , Woodward Mark 
Published: February 2022

IntroductionLife expectancy (LE) depends on the wider determinants of health, which have different impact in women and men. Therefore, this study aimed to investigate whether gender equality was correlated with LE in women and men.MethodsGender equality in the 27 European Union (EU) member states between 2010 and 2019 was estimated using a modified Gender Equality Index (mGEI), based on the index developed by the European Institute for Gender Equality. The correlation between this mGEI and LE and the gender gap in LE was calculated using the Spearman correlation coefficient.ResultsBetween 2010 and 2019, LE increased more for men than women, which resulted in a narrowing of the gender gap in LE in the EU. During the same period, there was an increase in gender equality, as measured by the mGEI, although with substantial heterogeneity between countries. There was a strong correlation between the mGEI and the gender gap in LE (−0.880), which was explained by a stronger correlation between the mGEI and longer LE in men than in women (0.655 vs 0.629, respectively). The domains of the mGEI most strongly associated with a narrowing of the gender gap in LE were health, money and knowledge, while power was the domain with the weakest association.ConclusionsGender equality appears to be at least as beneficial to men as women with regard to LE, thus reinforcing the key role gender equality plays in improving population health and longevity.
Knowledge, attitude and practice of community-dwelling adults regarding advance care planning in Malaysia: a cross-sectional study
Authors: Lim Mun Kit , Lai Pauline Siew Mei , Lim Pei Shan , Wong Pei Se , Othman Sajaratulnisah , Mydin Fadzilah Hanum Mohd 
Published: February 2022

ObjectivesThis study aimed to assess the knowledge, attitude and practice (KAP) among community-dwelling adults in Malaysia regarding advance care planning (ACP), and its associated factors.DesignThis cross-sectional study was conducted from July–September 2018.SettingThis study was conducted at the University Malaya Medical Centre, Kuala Lumpur, Malaysia.ParticipantsWe recruited community-dwelling adults (ambulatory care patients or their accompanying persons) who were ≥21 years old and able to understand English or Malay. A 1:10 systematic sampling procedure was used. Excluded were community-dwelling adults with intellectual disabilities or non-Malaysian accompanying persons. A trained researcher administered the validated English or Malay Advance Care Planning Questionnaire at baseline and 2 weeks later.Primary and secondary outcome measuresThe primary outcome was the KAP regarding ACP. The secondary outcomes were factors associated with KAP.ResultsA total of 385/393 community-dwelling adults agreed to participate (response rate 98%). Only 3.1% of the community-dwelling adults have heard about ACP and 85.7% of them felt that discussion on ACP was necessary after explanation of the term. The desire to maintain their decision-making ability when seriously ill (94.9%) and reducing family burden (91.6%) were the main motivating factors for ACP. In contrast, resorting to fate (86.5%) and perceived healthy condition (77.0%) were the main reasons against ACP. Overall, 84.4% would consider discussing ACP in the future. Community-dwelling adults who were employed were less likely to know about ACP (OR=0.167, 95% CI 0.050 to 0.559, p=0.004) whereas those with comorbidities were more likely to favour ACP (OR=2.460, 95% CI 1.161 to 5.213, p=0.019). No factor was found to be associated with the practice of ACP.ConclusionsDespite the lack of awareness regarding ACP, majority of community-dwelling adults in Malaysia had a positive attitude towards ACP and were willing to engage in a discussion regarding ACP after the term ‘ACP’ has been explained to them.
Impact of governmental support to the IVF clinical pregnancy rates: differences between public and private clinical settings in Kazakhstan—a prospective cohort study
Authors: Issanov Alpamys , Aimagambetova Gulzhanat , Terzic Sanja , Bapayeva Gauri , Ukybassova Talshyn , Baikoshkarova Saltanat , Utepova Gulnara , Daribay Zhanibek , Bekbossinova Gulnara , Balykov Askhat , Aldiyarova Aidana , Terzic Milan 
Published: February 2022

ObjectivesInfertility rates have been increasing in low-income and middle-income countries, including Kazakhstan. The need for accessible and affordable assisted reproductive technologies has become essential for many subfertile women. We aimed to explore whether the public funding and clinical settings are independently associated with in vitro fertilisation (IVF) clinical pregnancy and to determine whether the relationship between IVF clinical pregnancy and clinical settings is modified by payment type.DesignA prospective cohort study.SettingThree private and two public IVF clinics located in major cities.ParticipantsWomen aged ≥18 seeking first or repeated IVF treatment and agreed to complete a survey were included in the study. Demographical and previous medical history data were collected from a survey, while clinical data from medical records. The total response rate was 14%.Primary and secondary outcome measuresClinical pregnancy was defined as a live intrauterine pregnancy identified by ultrasound scan at 8 gestational weeks. The outcome data were missing for 22% of women.ResultsOut of 446 women in the study, 68.2% attended private clinics. Two-thirds of women attending public clinics and 13% of women attending private clinics were publicly funded. Private clinics retrieved, on average, a higher number of oocytes (11.5±8.4 vs 8.1±7.2, p<0.001) and transferred more embryos (2.2±2.5 vs 1.4±1.1, p<0.001) and had a statistically significantly higher pregnancy rate compared with public clinics (79.0% vs 29.7%, p<0.001). Publicly funded women had on average a higher number of oocytes retrieved and a statistically significantly higher probability of clinical pregnancy (RR=1.23, 95% CI 1.02 to 1.47) than self-paid women, after adjusting for covariates. There was no statistically significant interaction between clinical setting and payment type.ConclusionsPrivate clinics and public funding were independently associated with higher IVF clinical pregnancy rates. There is also a need to further investigate whether the increase in public funding will influence clinical pregnancy rates.
Relationship between exposure to ozone and exacerbation requiring hospital admission among patients with asthma: a case-control study in central Taiwan
Authors: Lin Ching-Heng , Wong Li-Ting , Hsu Jeng-Yuan , Chao Wen-Cheng 
Published: February 2022

ObjectiveThe convergence of asthma and air pollutants in ageing populations is currently a growing health issue worldwide, and hence there is an essential need to investigate the association between exposure to air pollution, particularly ozone (O3), and exacerbation requiring admission in patients with asthma.SettingA case-control study at a tertiary referral hospital in central Taiwan.ParticipantsWe used an asthma cohort, which included 11 400 patients with asthma, for the period 2006–2018 at Taichung Veterans General Hospital.Primary and secondary outcome measuresWe identified patients who had admitted for exacerbation as cases and selected patients with asthma without exacerbation, matching (1:4) the cases for age, gender and season of exacerbation, as controls. Data on hourly level of air pollutants were obtained from the Taiwan Environmental Protection Administration. We used conditional logistic regression and calculated adjusted ORs (adjORs) with 95% CIs.ResultsWe enrolled 11 400 participants with asthma, and 4.4% (501) of them had been admitted for exacerbation. Participants with asthma with exacerbation requiring hospitalisation were exposed to a higher level of O3 8-hour daily maximum (adjOR 1.009, 95% CI 1.001 to 1.016) and were more likely to have high Charlson Comorbidity Index (CCI ≥3; adjOR 2.198, 95% CI 1.729 to 2.794) and asthma-chronic obstructive pulmonary disease overlap (adjOR 4.542, 95% CI 3.376 to 6.611) compared with those without exacerbation. The aforementioned associations between exacerbation of asthma requiring hospitalisation and exposure to O3 were similar when defined by either O3 1-hour daily maximum or O3 24-hour average. Moreover, the O3 relevant exacerbation of asthma mainly existed in those aged older than 65 years and patients with medical comorbidities, including gastrointestinal diseases, cardiovascular diseases, neurological diseases, diabetes and renal disease.ConclusionsOur findings highlight the need for vigilance of exposure to O3 among elderly with asthma, particularly those with medical comorbidities. Further studies are warranted to investigate the underlying mechanisms.
Association between pharmaceutical modulation of oestrogen in postmenopausal women in Sweden and death due to COVID-19: a cohort study
Authors: Sund Malin , Fonseca-Rodríguez Osvaldo , Josefsson Andreas , Welen Karin , Fors Connolly Anne-Marie 
Published: February 2022

ObjectiveDetermine whether augmentation of oestrogen in postmenopausal women decreases the risk of death following COVID-19.DesignNationwide registry-based study in Sweden based on registries from the Swedish Public Health Agency (all individuals who tested positive for SARS-CoV-2); Statistics Sweden (socioeconomical variables) and the National Board of Health and Welfare (causes of death).ParticipantsPostmenopausal women between 50 and 80 years of age with verified COVID-19.InterventionsPharmaceutical modulation of oestrogen as defined by (1) women with previously diagnosed breast cancer and receiving endocrine therapy (decreased systemic oestrogen levels); (2) women receiving hormone replacement therapy (increased systemic oestrogen levels) and (3) a control group not fulfilling requirements for group 1 or 2 (postmenopausal oestrogen levels). Adjustments were made for potential confounders such as age, annual disposable income (richest group as the reference category), highest level of education (primary, secondary and tertiary (reference)) and the weighted Charlson Comorbidity Index (wCCI).Primary outcome measureDeath following COVID-19.ResultsFrom a nationwide cohort consisting of 49 853 women diagnosed with COVID-19 between 4 February and 14 September 2020 in Sweden, 16 693 were between 50 and 80 years of age. We included 14 685 women in the study with 11 923 (81%) in the control group, 227 (2%) women in group 1 and 2535 (17%) women in group 2. The unadjusted ORs for death following COVID-19 were 2.35 (95% CI 1.51 to 3.65) for group 1 and 0.45 (0.34 to 0.6) for group 2. Only the adjusted OR for death remained significant for group 2 with OR 0.47 (0.34 to 0.63). Absolute risk of death was 4.6% for the control group vs 10.1% and 2.1%, for the decreased and increased oestrogen groups, respectively. The risk of death due to COVID-19 was significantly associated with: age, OR 1.15 (1.14 to 1.17); annual income, poorest 2.79 (1.96 to 3.97), poor 2.43 (91.71 to 3.46) and middle 1.64 (1.11 to 2.41); and education (primary 1.4 (1.07 to 1.81)) and wCCI 1.13 (1.1 to 1.16).ConclusionsOestrogen supplementation in postmenopausal women is associated with a decreased risk of dying from COVID-19 in this nationwide cohort study. These findings are limited by the retrospective and non-randomised design. Further randomised intervention trials are warranted.
KETOgenic diet therapy in patients with HEPatocellular adenoma: study protocol of a matched interventional cohort study
Authors: Oudmaijer Christiaan Albert Johan , Berk Kirsten Anna , van der Louw Elisabeth Johanna Theresia Maria , de Man Rob , van der Lelij Aart-Jan , Hoeijmakers Jan Hendrik Jozef , IJzermans Jan 
Published: February 2022

IntroductionHepatocellular adenoma (HCA) is an uncommon, solid and benign liver lesion, mainly occurring in women using oral contraceptives. Patients are advised to stop using oral contraceptives (OC) and, as overweight is frequently observed, dietary restrictions. Metabolic changes are assumed to play a role and it has been suggested that diet may help to reduce tumour size. A low-calorie ketogenic diet (LCKD) has been shown to induce weight loss and multiple metabolic changes, including the reduction of portal insulin concentrations, which downregulates hepatic growth hormone receptors. Weight reduction and an LCKD can potentially reduce the size of HCAs.Methods and analysisWe designed a matched, interventional cohort study to determine the effect of an LCKD on the regression of HCA. The study population consists of female subjects with an HCA, 18–50 years of age, body mass index>25 kg/m2, who are entering a surveillance period including cessation of OC. A historical control group will be matched. The intervention consists of an LCKD (approximately 35 g carbohydrate/1500 kcal/day) for 3 months, followed by a less strict LCKD for 3 months (approximately 60 g carbohydrate/1500 kcal/day). Main study endpoint is the diameter of the HCA after 6 months, as compared with the historic control group. Secondary endpoints include adherence, quality of life, change in physical activity, liver fat content, body weight, body composition and resting energy expenditure.Ethics and disseminationThe medical ethical committee has approved the study protocol, patient information files and consent procedure and other study-related documents and procedures.Trial registration numberNL75014.078.20; Pre-results. https://www.trialregister.nl/trial/9092
Prospective study of preoperative autologous blood donation for patients with high risk of allogeneic blood transfusion in lumbar fusion surgery: a study protocol of a randomised controlled trial
Authors: Xu Nanfang , Zhang Youyu , Tian Yun , Li Baohua , Qiao Haiqin , Zhang Xiaoqing , Yang Nan , Li Wei , Zhang Chao , Li Weishi , Fu Wei 
Published: February 2022

IntroductionPreoperative autologous blood donation (PABD) can be used to reduce the exposure of allogeneic blood transfusion in patients undergoing elective surgery. Better blood management to avoid anaemia and reduce allogeneic blood transfusion after spine surgery become increasingly important with development of enhanced recovery after surgery. We present here the design of a randomised controlled trial with three groups to verify the clinical effectiveness of PABD in patients at high risk of transfusion for lumbar fusion surgery and explore the optimal timing of autologous blood donation.Method and analysisPatients (age 18–70 years) who will receive lumbar fusion surgery for degenerative disease with haemoglobin over 110 g/L and ‘high risk’ of allogeneic blood transfusion are eligible, unless they refuse participation or are diagnosed with malignant metastases, infection, cardiovascular and cerebrovascular diseases, haematological disorders or relevant drug history and critical illnesses. A total of 1200 patients will be recruited and randomised into three groups. Patients in group A will not receive PABD and be regarded as control group. PABD will be performed for patients in groups B and C. Blood donation will be finished at 1 week (±3 day) before surgery in group B and 2 weeks (±3 day) before surgery in group C. Primary outcome measures will include haemoglobin decline, incidence and amount of allogeneic blood transfusion. Secondary outcome measures will include days of hospitalisation after surgery, haematocrit level and incidence of complications. This study is a single-centre and open-label randomised controlled trial. The sample size is calculated with reference to the retrospective data and previous studies.Ethics and disseminationThis trial has been approved by the Peking University Third Hospital Medical Science Research Ethic Committee (no: 2020-262-02). Results of the trial will be submitted for publication in a peer-reviewed journal and as conference presentations.Trial registration numberChiCTR2000039824, preresults.
Investigating the effect of macro-scale estimators on worldwide COVID-19 occurrence and mortality through regression analysis using online country-based data sources
Authors: Erdem Sabri , Ipek Fulya , Bars Aybars , Genç Volkan , Erpek Esra , Mohammadi Shabnam , Altınata Anıl , Akar Servet 
Published: February 2022

ObjectiveTo investigate macro-scale estimators of the variations in COVID-19 cases and deaths among countries.DesignEpidemiological study.SettingCountry-based data from publicly available online databases of international organisations.ParticipantsThe study involved 170 countries/territories, each of which had complete COVID-19 and tuberculosis data, as well as specific health-related estimators (obesity, hypertension, diabetes and hypercholesterolaemia).Primary and secondary outcome measuresThe worldwide heterogeneity of the total number of COVID-19 cases and deaths per million on 31 December 2020 was analysed by 17 macro-scale estimators around the health-related, socioeconomic, climatic and political factors. In 139 of 170 nations, the best subsets regression was used to investigate all potential models of COVID-19 variations among countries. A multiple linear regression analysis was conducted to explore the predictive capacity of these variables. The same analysis was applied to the number of deaths per hundred thousand due to tuberculosis, a quite different infectious disease, to validate and control the differences with the proposed models for COVID-19.ResultsIn the model for the COVID-19 cases (R2=0.45), obesity (β=0.460), hypertension (β=0.214), sunshine (β=−0.157) and transparency (β=0.147); whereas in the model for COVID-19 deaths (R2=0.41), obesity (β=0.279), hypertension (β=0.285), alcohol consumption (β=0.173) and urbanisation (β=0.204) were significant factors (p<0.05). Unlike COVID-19, the tuberculosis model contained significant indicators like obesity, undernourishment, air pollution, age, schooling, democracy and Gini Inequality Index.ConclusionsThis study recommends the new predictors explaining the global variability of COVID-19. Thus, it might assist policymakers in developing health policies and social strategies to deal with COVID-19.Trial registration numberClinicalTrials.gov Registry (NCT04486508).