Datasets:

---

Yoxas

/

statistical_literacy

like 0

[ "Aim- to study spatial orientation and constructive praxis disorders in normally developed and mentally retarded children aged 8-11.", "The research was performed in the research laboratory of the Faculty of Special and Inclusive Education at the Armenian State Pedagogical University after Kh.", "Abovyan and Armenian state institute of physical culture and sport.", "A total of 131 children aged between 8 and 11 years participated in the study, including 73 healthy schoolchildren and 58 children with mild mental retardation.", "The results of the experimental study of task performance show that interesting data have been obtained which will serve as a basis for the development of necessary means, methods, and conditions for the development of elementary practical orientation in mentally retarded elementary school children.", "The analysis of the results of the study allows us to highlight the following important points: - Mentally retarded younger pupils lag behind their healthy peers in all the studied indicators.", "- 8-9-year-old have less developed practical spatial orientation skills than their older counterparts.", "The results of the conducted experimental research testify to insufficient development of elementary practical orientation and understanding of spatial relations of objects in mentally retarded elementary school children." ]

[ "Aim: based on a retrospective analysis, the relationship between external genital endometriosis and comorbid breast pathology was established and risk factors were identified, their comparison and the formation of a prognostic risk criterion were determined.", "Materials and Methods: to address the objectives of the study, a retrospective analysis of 470 cases of patients treated for external genital endometriosis after surgical treatment and comorbid breast pathology was conducted.", "The control group included 30 healthy non-pregnant women.", "Statistical processing was performed on a personal computer using the statistical software package Statistica 10.", "Results: As a result of the analysis, the age of the patients ranged from 23 to 40 years.", "The average age of patients in the study group was (32.2}1.18) years, and in the control group (31.1}1.35) (p>0.05).", "The groups were homogeneous in terms of age (p>0.05), marital status (p>0.05) and level of education (p>0.05).", "Close relatives in 208 (44.25}2.18) % (OR=8.86; 95 % CI: (0.68-10.53); p<0.002) cases suffered from benign (hormone-dependent) tumours and tumour-like diseases of the uterus and appendages in isolation or in various combinations (fibroids, adenomyosis, endometrial hyperplasia).", "It was also found that 102 (21.70}1.67) % of patients had endometriosis, which may indicate a genetic predisposition to this disease.", "In the closest relatives of EM patients: in 118 (25.10}2.01) % of the examined parents, breast problems were noted, in 66 (14.04}1.12) % - diabetes mellitus, and in 98 (20.85}1.22) % thyroid diseases were detected, which in total amounted to (60.00}2.23) % (OR=9.12; 95 % CI: (0.58-11.54); p<0.002).", "Early menarche almost tripled the risk of EM (OR=2.72; 95% CI: (1.02-5.11); p<0.002), and menstrual irregularities doubled it (OR=2.04; 95% CI: (1.09-3.14); p<0.05), higher education, urban residents - 2.2 times higher (OR= 2.27; 95 % CI: (1.11-3.63); p<0.05), diseases of the gastrointestinal tract and hepatobiliary complex - 5.2 times higher (OR=5.27; 95 % CI: (1.89-12.03); p<0.05), frequently recurrent inflammatory diseases of the appendages - 3 times higher (OR=3.14; 95 % CI: (0.91-5.14); p<0.05), dysmetabolic manifestations (thyroid dysfunction) - 5 times higher (OR=5.11; 95 % CI: (1.61-9.503); p<0.002).", "Conclusions: Thus, in endometriosis and dyshormonal diseases of the mammary glands, menstrual and generative function disorders, along with clinical symptoms of pelvic pain, dysmenorrhoea, autonomic nervous system disorders and sexual dysfunction, are significant components of this problem, initiating comorbidity processes in target organs in the setting of hormonal maladaptation.", "Therefore, these comorbidities become a trigger for the activation of systemic hormonal imbalance and become an urgent interdisciplinary problem that requires further study." ]

[ "Aim: Dynamic comparison of the lower limbs length, depending on the type of sport, followed by the construction of a mathematical model for predicting sports abilities.", "Materials and Methods: The comparison of the lower limbs length in dynamics was carried out on 132 students of higher education institutions of Bukovyna.", "While the primary study was carried out during September-October 2021, next study of these same students was conducted in September-October 2022.", "The main group consists of 92 (69.7%) students, the control group - 40 (30.30%) students aged 16 to 18 years.", "All students underwent an anthropometric study (determination of the length of the lower limbs) according to the method of P.P.", "Shaparenka.", "The comparesment of anthropometric parameters in the main group depending on the type of sport used the Kruskel-Wallis test (non-parametric analysis of variance) in order to identify a reliable difference in the average indicators of the respondents depending on the type of sport (the median of the distribution was considered as a measure of central tendency).", "In order to establish which pairs of age groups had a statistical difference in the medians, the Conover-Iman test was used.", "A paired t-test (t-test of paired samples) was performed to compare the length of the respondents' lower limbs during the first measurement and again one year later.", "Statistical analysis of the obtained data was performed using the licensed RStudio program.", "Results: The distribution of the length of the right lower limb of the respondents of the main group by measurement shows that the average value of the length of the right lower limb has changed: a significant difference in the length of the right lower limb was found between the first (M = 88.812, SD = 5.287) and the second (M = 89.377, SD = 5.347) measurements; t (68) = -5.223, p < 0.001.", "The distribution of the length of the left lower limb shows that the average value of the length of the left lower limb has changed also: a significant difference in the length of the left lower limb was found between the first (M = 88.667, SD = 5.266) and the second (M = 89.435, SD = 5.309) measurements; t (68) = -8.289, p < 0.001.", "Conclusions: In order to dynamically compare the length of the lower limbs for comprehensive control and selection of promising students in football, volleyball, handball and basketball, a mathematical model was derived for predicting the length of the lower limbs, in corresponding sports: right lower limb y = 0.506 x and left y = 0.507x, where y - is the length of the left lower limb, x - is the height.", "The coefficient of determination is 99.8%.", "A significant predictor for the length of both lower limbs is the height." ]

[ "Aim: To describe the epidemiological, clinical and laboratory characteristics and clinical progress of patients hospitalized with heart failure (HF) who started treatment with empagliflozin before discharge.", "Methods: We performed a retrospective observational study of patients aged ≥18 years admitted to the Internal Medicine Department of University Hospital Jaen, Jaen, Spain with acute HF between 1 May 2022 and 31 May 2023.", "Patients had to have a life expectancy of ≥1 year and have started treatment with empagliflozin during admission.", "Results: We included 112 patients (mean age, 85.2 ± 6.5 years; 67.9% women; 35.7 and 31.3% in NYHA functional classes III and IV; 73.2% with HF and preserved ejection fraction).", "Before admission, 80.4% were taking loop diuretics, 70.6% renin-angiotensin-aldosterone system inhibitors, 49.1% betablockers and 25% mineralocorticoid receptor antagonists.", "At admission, 94.6% were taking furosemide (15.2% at high doses, 36.6% at intermediate doses).", "The dose of furosemide was reduced at initiation of empagliflozin.", "At the end of follow-up, 13.4% of patients had died, 93.8% of the survivors continued treatment with empagliflozin and 26.8% had attended the emergency department with signs and symptoms of HF.", "Conclusion: Introduction of empagliflozin before discharge from hospital in patients admitted with HF made it possible to reduce the dose of diuretics during admission.", "The frequency of complications was as expected, and treatment was largely maintained." ]

[ "Aim: To document the clinical patterns of antibiotic prescriptions in government hospitals, where the majority of physicians possess a degree-based training.", "Materials and Methods: A Retrospective cross section study carried out between 1/7/2022 and April 2023 that enrolling 300 patients from governmental hospitals from different provinces of Central and northern Iraq.", "The research form contained 15 fields divided into three sections.", "The first section contains social information such as age, gender, field of work, Residence and education.", "The second part consists of diagnosis and lab.", "Finding.", "The third part related to antibiotic uses: Number of AB prescribed, duration of using, type of use, route of administration, AB interaction, dose administration of AB, indication of Ab, and Class of AB.", "Results: A total of 300 eligible patients, 165 patients (55.0%) were male and 135 (45.0%) were female, patients were <20 years ages were 117 (39.0%), 25 (8.3%) from the 20-29 years age group, 40-49 years ages were 28 (9.3%) and >50 years ages were 105 (35.0%) were which belong to the pediatric population.", "The 198 patients (66.0%) were used cephalosporins and 106 (53.5%) of them used alone.", "A 13-19% percentage of patients had used penicillin, carbapenem, anti-fungal, and aminoglycoside in combination form.", "Conclusions: The implementation of clinical guidelines, the provision of direct instruction, and the regular dissemination of antibiogram data have the potential to encourage a more judicious consumption of antibiotics." ]

[ "Aim: To empirically investigate the relationship between work characteristics and subjective well-being of managers and employees in educational organizations.", "Materials and Methods: Analysis of work characteristics was done using The Work Design Questionnaire (WDQ).", "The modified BBC Subjective Well-being scale (BBC-SWB) was used to analyze educational staff's well-being.", "The research data were processed using mathematical statistics: descriptive statistics (mean, std.", "deviation), Pearson correlation, and independent samples t-test.", "345 respondents from the Central region of Ukraine participated in the survey.", "Results: Although educational staff had a generally positive assessment of work characteristics, there were certain disproportions in their assessments of individual work characteristics: work autonomy characteristics were rated lower than task characteristics, while social characteristics and work context characteristics were rated lower than knowledge characteristics.", "In addition, educational organization managers rated the vast majority of work characteristics higher than employees, which suggests a more favorable organizational environment for managers than employees.", "There were three work characteristics groups in the context of their associations with staff's subjective well-being: 1) work characteristics that had a positive statically significant relationship with both managers and employees' subjective well-being indicators; 2) work characteristics that had positive and negative statistically significant relationships with employees' subjective well-being indicators; 3) work characteristics that had positive and negative statistically significant relationships with managers' subjective well-being indicators.", "Conclusions: The obtained findings may be helpful for managers and employees of educational organizations in promoting staff's subjective well-being and increasing educational organizations' effectiveness." ]

[ "Aim: To research how the future dentists' professional self-determination (reflects the cognitive-reflexive component of higher medical education applicants' readiness to use digital technologies in their professional activities) develops within the formation of information technology competence in the modern realities of Ukraine.", "Materials and Methods: The author's questionnaire consisted of 15 questions.", "The questionnaire surveys covered 98 future dentists who studied 'Medical Informatics' and 'Information Technology in Dentistry' at the Ivano-Frankivsk National Medical University in the September-December 2017-2018 and September- December 2022-2023 academic years.", "The research results were assessed according to the algorithm described.", "The research used such methods as analysis, synthesis, comparison, concretisation, systematisation, and generalisation, as well as methods of mathematical statistics for evaluating data, namely correlation analysis, Kolmogorov-Smirnov test, Cronbach's alpha, Fisher's test (F-test of equality of variances), Student's t-test and ranking.", "Results: The research found positive dynamics of the professional self-determination levels (in 2022 compared to 2017, the low level decreased by 20.5%, the satisfactory level - by 19.0%, the average level increased by 20.6%, the high level - by 18.9%) and their quality, which within the research increased by 39.5%.", "Conclusions: By forming information technology competence, future dentists changing the priorities of professional self-determination in the modern realities of Ukraine and acquiring readiness (within the cognitive-reflexive component) to use digital technologies in professional activities." ]

[ "Aim: To study and investigate the incidence of Coronavirus infection in children, the course of the disease, the risks of complications and their interrelationships.", "Materials and Methods: Study included the analysis and observation of children (n=55, aged 14.36±3.62 years) with confirmed Coronerovirus infection, who were observed in the CNE ≪CMCH≫ in Uzhgorod in outpatient conditions.", "A study of clinical presentations, a clinical and laboratory examination followed by a mathematical analysis of the symptoms data in children with an identified Coronavirus infection and in the dynamics up to week 30 (with survey intervals in 3 weeks) from the diagnosis verification was carried out.", "Results: A dynamic analysis of the clinical manifestation of symptoms in children with an identified Corona virus infection and within 30 weeks (with survey intervals of 3 weeks) from the beginning of the diagnosis verification was carried out.", "Complaints from the respiratory system were prevailed.", "The most long-lasting complaint was observed ≪changes in the sense of taste and smell≫ (from 35(63.6%) to 6(10.9%) up to 18 weeks inclusive.", "Other complaints ≪Cough, Rhinitis, Shortness of breath, Pain in the chest≫ was observed for 6 weeks.", "Sore throat, muscular and joint pain were persisted for 3 weeks.", "Fever was not identified at week 3.", "Illness with other viral respiratory diseases started at week 9 and was observed until week 30 (from 10(18.2%) to 19(34.5%)) with varying levels.", "A decrease in cases of IgM identification was observed within 6 weeks (from 55, 100% to 20, 36, 4%).", "On the 9th week, the presence of IgM was not established.", "There is also an increase in the number of cases of detection of IgG in patients with a level maximum of 6 weeks.", "Conclusions: There is a positive effect of the CRP level on the occurrence of symptoms of cough, rhinitis, shortness of breath, chest pain, change in taste and smell, muscle and joint pain (r=0.33-0.55), with the most significant data for the symptom of pain in chest (p=0.00001).", "Ferritin level interactions mostly had a negative direction (r=-0.35-0.48, p=0.02-0.00001) on the development of symptoms, with the exception of rhinorrhea (r=0.48, p=0.00002) and chest pains (r=0.39, 0.003).", "According to multiple logistic regression analysis the chance of the symptom of a change in taste and smell increases due to an increasing in the level of Procalcitonin in 1.48 times.", "The chance of the symptom of shortness of breath increased due to an increasing in the Ferritin level in 1.025 times." ]

[ "Aimed at building autonomous service robots, reasoning, perception, and action should be properly integrated.", "In this paper, the depth cue has been analysed as an early stage given its importance for robotic tasks.", "So, from neuroscience findings, a hierarchical four-level dorsal architecture has been designed and implemented.", "Mainly, from a stereo image pair, a set of complex Gabor filters is applied for estimating an egocentric quantitative disparity map.", "This map leads to a quantitative depth scene representation that provides the raw input for a qualitative approach.", "So, the reasoning method infers the data required to make the right decision at any time.", "As it will be shown, the experimental results highlight the robust performance of the biologically inspired approach presented in this paper." ]

[ "Aimed to corroborate students' and faculty's experiences with e-learning during the current pandemic.", "A cross-sectional study was conducted from February to June 2020.", "Seven surveys were distributed electronically to all undergraduate students and the faculty (4 to students and 3 to teachers) at the Southern Medical University (China).", "Descriptive statistics and t-tests were used to analyze the data.", "Statistical significance was set at p < .05.", "Most students had some exposure to e-learning prior to the all e-learning regiment, contrasted with close to 90% of teachers having no or very limited experience.", "Students' perceptions of the most helpful e-learning activities did not change significantly overall (Week 3 vs. Week 9).", "Approaching 60% of students (Week 9) did find online discussion/Q&A/forum helpful, an increase from less than 30% (Week 3).", "Among teachers, gaps emerged (Week 9) between e-teaching activities used and their perceived effectiveness.", "Despite pre-recorded lectures being the most frequently used method, the least gap was associated with live-stream lectures-the least used.", "Over time, teacher's perceived effectiveness of e-teaching vs. in-person teaching did not differ significantly overall.", "When the results among students (Week 7) and teachers (Week 9) were corroborated, a slightly higher percentage of teachers viewed online teaching to be less effective than in-person teaching and a slightly higher percentage of teachers viewed online teaching as far less effective.", "For preferred learning modes after the resumption of in-person learning, students' preferences did not differ significantly overall (Week 3 vs. week 9).", "Surveys conducted in Week 9 found that a slightly higher percentage of students (~ 70%) than teachers (~ 60%) preferred some forms of hybrid learning and a lower percentage of students preferred face-to-face learning only.", "Approximately three quarters of teachers responded that at least 50% of course materials could be mastered by students on their own.", "Overall, the perceived effectiveness of e-learning among students and teachers has not changed significantly over time.", "Nor have students' preferences shifted significantly for various learning modes after the in-person learning resumed.", "However, informative directional trends have emerged.", "Our research illustrates empirically the need to corroborate students' and instructors' experiences over time to inform more holistic improvements of e-learning." ]

[ "Aiming at being part of the discussion about the cognitive functioning of patients with arachnoid cysts (AC) and the value of neuropsychological testing in these patients, we present our study in which we investigated the cognitive functioning of 32 children with ACs of the middle cranial fossa.", "We compared the Stanford Binet 5 (SB 5) results obtained by the patients with the population mean values and analysed the relation between the patients' clinical details and the results of SB 5.", "The main conclusions of this research are: (1) In SB 5 tasks, the tested group performed worse than the population mean, which could be related to AC of the middle cranial fossa.", "Deficits concern especially visuospatial reasoning, quantitative reasoning, and knowledge.", "The obtained results indicate the coexistence of cognitive impairment and AC of the middle cranial fossa.", "(2) In patients with AC, neuroimaging information has only limited predictive ability regarding cognitive syndromes.", "(3) The complaints reported in the interview are not necessarily objectively reflected in the clinical assessment.", "Neuropsychological assessment should be part of the management of all patients with AC.", "(4) Cognitive deficits in patients with AC may become more pronounced with age.", "Accordingly, increasing school difficulties in these patients should be expected.", "In light of the above, there is a clear indication of the need for neuropsychological support and support in school functioning for patients with AC.", "(5) Neuropsychological control in patients with AC is crucial not only with regard to treatment decisions but primarily for monitoring school performance and providing these patients with adequate neuropsychological and psychological support." ]

[ "Aiming at the problem that ultra-wide band (UWB) cannot be accurately localized in environments with large noise variations and unknown statistical properties, a combinatorial localization method based on improved cubature (CKF) is proposed.", "First, in order to overcome the problem of inaccurate local approximation or even the inability to converge due to the initial value not being set near the optimal solution in the process of solving the UWB position by the least-squares method, the Levenberg-Marquardt algorithm (L-M) is adopted to optimally solve the UWB position.", "Secondly, because UWB and IMU information are centrally fused, an adaptive factor is introduced to update the measurement noise covariance matrix in real time to update the observation noise, and the fading factor is added to suppress the filtering divergence to achieve an improvement for the traditional CKF algorithm.", "Finally, the performance of the proposed combined localization method is verified by field experiments in line-of-sight (LOS) and non-line-of-sight (NLOS) scenarios, respectively.", "The results show that the proposed method can maintain high localization accuracy in both LOS and NLOS scenarios.", "Compared with the Extended Kalman filter (EKF), unbiased Kalman filter (UKF), and CKF algorithms, the localization accuracies of the proposed method in NLOS scenarios are improved by 25.2%, 18.3%, and 11.3%, respectively." ]

[ "Aiming at the problems of long sharing time, low accuracy, recall, and F1 value in the traditional data sharing method of college dance teaching resource database, a data sharing method of college dance teaching resource database based on PSO algorithm is proposed.", "Multiple regression KNN method is used to eliminate the data noise of college dance teaching resource database, so as to obtain the missing value and complete the filling of incomplete data of college dance teaching resource database.", "Taking the preprocessed data as the basic element of transmission object statistics and analysis, establish the data transmission self-service channel of college dance teaching resource database, calculate the similarity of the data according to the unequal length sequence, and use the partial least square method to complete the feature extraction of the resource database data.", "According to the feature extraction results, particle swarm optimization algorithm is adopted to share the data of college dance teaching resource database.", "The simulation results show that the accuracy, recall, and F1 value of the data sharing method of college dance teaching resource database based on PSO algorithm are high, and the sharing time is short." ]

[ "Aims This study aimed to assess the quality of life (QoL) of older adults in rural Odisha, India, exploring its multidimensional nature across physical, psychological, social, and environmental domains.", "The impact of depression and various sociodemographic factors on QoL was also investigated.", "Methods The research was conducted in the Tangi block of Khordha district, Odisha, encompassing 468 older adults.", "The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire, Geriatric Depression Scale (GDS-15), and sociodemographic questionnaire were used in data collection.", "Sampling employed a multistage approach, with statistical analysis utilizing Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY), including t-tests for normally distributed data and the Mann-Whitney U test for non-normally distributed data.", "Results The QoL of older adults in rural Odisha showed variability, with physical and social domains exhibiting relatively positive scores compared to psychological and environmental domains.", "Depression significantly impacted all QoL dimensions, with the most profound effect observed in global QoL and global health.", "Sociodemographic factors such as employment, substance use, elder abuse, adverse life events, and poverty were identified as significant determinants of global QoL.", "Additionally, recreational activity, elder abuse, education, and employment significantly affected all QoL domains.", "Conclusions This study reveals the complex landscape of QoL of older adults in rural Odisha.", "The findings emphasize the need for comprehensive interventions targeting mental health, social support, and environmental conditions to enhance the overall well-being of this population.", "Policymakers and healthcare professionals should consider these multidimensional factors to develop effective strategies for improving the QoL of older adults in similar contexts." ]

[ "Aims: Pain diagnoses in the 10th version of the International Classification of Diseases (ICD-10) did not adequately support the current management of pain.", "Therefore, we aimed to review the new 11th revision (ICD-11) in order to analyze its usefulness for the management, coding, research and education of chronic pain from a Latin American perspective.", "Methods: The Latin American Federation of Associations for the Study of Pain convened a meeting of pain experts in Lima, Peru.", "Pain specialists from 14 Latin American countries attended the consensus meeting.", "Results: In ICD-11, chronic pain is defined as pain that persists or recurs longer than 3 months and is subdivided into seven categories: chronic primary pain and six types of chronic secondary pain.", "Chronic primary pain is now considered a disease in itself, and not a mere symptom of an underlying disease.", "Conclusion: The novel definition and classification of chronic pain in ICD-11 is helpful for better medical care, research and health statistics.", "ICD-11 will improve chronic pain management in Latin American countries, for both the pain specialist and the primary care physician." ]

[ "Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes.", "Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight.", "Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care.", "Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention.", "Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security.", "One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity.", "The difference in overweight prevalence at follow-up did not reach statistical significance.", "Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale.", "As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale." ]

[ "Aims: To identify, appraise and describe studies of cognitive interventions to improve diagnostic decision making (DDM) amongst medical professionals, assess their effectiveness and identify methodological limitations in existing studies.", "Methods: We systematically searched for studies (publication date 2000-2016) in multiple databases including Cochrane Controlled Trials, EMBASE, ERIC, Medline, PubMed and PsycINFO, and used additional strategies such as hand searching and snowballing.", "Included studies evaluated cognitive interventions to enhance DDM amongst medical professionals, using defined outcomes such as diagnostic accuracy.", "A meta-analysis assessed the impact of \"reflection\".", "Results: Forty-four studies out of 10,114 screened citations, involving 4380 medical professionals, were included.", "Studies evaluated reasoning workshops/curricula, de-biasing workshops, checklists, reflection, feedback, and instructions to induce analytical thinking.", "Guided reflection was demonstrated to improve DDM [effect size 0.38(95%CI 0.23-0.52), p < 0.001].", "Immediate feedback and modeling reflection using contrasting examples also appeared to improve diagnostic accuracy, however underlying methodological issues prevented a quantitative assessment of any strategies other than reflection.", "Conclusions: Educational interventions incorporating practising deliberate reflection on a formulated diagnosis, modeled reflection on contrasting examples and immediate feedback are promising strategies for improving DDM.", "The effectiveness of other strategies is unknown, with more methodological refinements required in future research." ]

[ "Air pollution (AP) is linked up to 20% of cardiovascular deaths.", "The aim of this nationwide study was to investigate subpopulations vulnerable to AP for non-ST- (NSTEMI) and ST-elevation myocardial infarction (STEMI) incidence.", "We analysed short- (lags up to seven days) and mid-term (0-30 days moving average) influence of particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2) and benzo(a)pyrene (BaP) on hospitalizations due NSTEMI and STEMI in 2011-2020.", "Data on AP concentrations were derived using GEM-AQ model.", "Study included residents of five voivodeships in eastern Poland, inhabited by over 8,000,000 individuals.", "Higher NO2 and PM2.5 concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3-5.7%.", "Increased SO2 and PM2.5 concentration triggered STEMI in the short- (SO2, PM2.5) and mid-term (PM2.5) amongst those aged ≥ 65 years.", "In the short- and mid-term, women were more susceptible to PM2.5 and BaP influence resulting in increased STEMI incidence.", "In rural regions, STEMI risk was triggered by SO2, PM2.5 and BaP.", "Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%).", "There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors.", "AP exposure is associated with the threat of a higher risks of NSTEMI and STEMI, especially to younger people, women, residents of rural areas and those with lower income.", "National Science Center and Medical University of Bialystok, Poland." ]

[ "Air pollution contributes to a large disease burden and some populations are disproportionately exposed.", "We aimed to evaluate ethnic and socioeconomic differences in exposure to air pollution in the Netherlands.", "We did a nationwide, cross-sectional analysis of all residents of the Netherlands on Jan 1, 2019.", "Sociodemographic information was centralised by Statistics Netherlands and mainly originated from the National Population Register, the tax register, and education registers.", "Concentrations of NO2, PM2·5, PM10, and elemental carbon, modelled by the National Institute for Public Health and the Environment, were linked to the individual-level demographic data.", "We assessed differences in air pollution exposures across the 40 largest minority ethnic groups.", "Evaluation of how ethnicity intersected with socioeconomic position in relation to exposures was done for the ten largest ethnic groups, plus Chinese and Indian groups, in both urban and rural areas using multivariable linear regression analyses.", "The total study population consisted of 17 251 511 individuals.", "Minority ethnic groups were consistently exposed to higher levels of air pollution than the ethnic Dutch population.", "The magnitude of inequalities varied between the minority ethnic groups, with 3-44% higher exposures to NO2 and 1-9% higher exposures to PM2·5 compared with the ethnic Dutch group.", "Average exposures were highest for the lowest socioeconomic group.", "Ethnic inequalities in exposure remained after adjustment for socioeconomic position and were of similar magnitude in urban and rural areas.", "The variability in air pollution exposure across ethnic and socioeconomic subgroups in the Netherlands indicates environmental injustice at the intersection of social characteristics.", "The health consequences of the observed inequalities and the underlying processes driving them warrant further investigation.", "The Gravitation programme of the Dutch Ministry of Education, Culture, and Science, the Netherlands Organization for Scientific Research, the Netherlands Organisation for Health Research and Development, and Amsterdam University Medical Center." ]

[ "Air pollution is a pervasive global environmental challenge that presents substantial and differential risk across populations.", "Individual-level pollution exposure is a function of varying factors, including but not limited to geographic location, proximity to point sources, ventilation, and behavioral patterns.", "Mounting evidence suggests that informational interventions can play a substantial role in mediating exposures for specific population subgroups and reduce downstream adverse health outcomes.", "The literature has yet to address whether access to air quality information is sociodemographically stratified, and whether such access correlates with increased uptake of exposure reducing behaviors at the population level.", "This study represents a first step in answering these questions by analysing responses from the \"Clean Air Public Insight Tracker\" nationally representative survey (n = 1,993) of the UK population, administered by UK charity Global Action Plan.", "Results from logistic regression and zero-inflated negative binomial models estimate 28% of the population have accessed air pollution information, while the odds of younger individuals (ages 18-36), men, and non-white individuals of accessing digitally available air quality information are greater that those outside these categories.", "Additionally, the odds of behavior uptake is greater if an individual accesses digital information sources like the internet, mobile apps or social media, has a higher education qualification or cares for someone with a health condition.", "These findings contribute to the growing literature surrounding which population groups engage with environmental and health-relevant information channels, and what connects engagement with air quality channels and uptake of exposure reducing behaviors.", "These results reinforce the need for additional research around air pollution informational alerts and exploring causal links between specific exposure reducing behaviours and improved health outcomes.", "It can also help inform the flow of resources and targeting of informational campaigns towards sociodemographic groups that are less likely to engage with air quality information." ]

[ "Air pollution is considered the most prominent public health.", "Economically, air pollution imposes additional costs on governments.", "This study aimed to quantify health effects and associated economic values of reducing PM2.5 air pollution using BenMAP-CE in Qom in 2019.", "The air quality data were acquired from Qom Province Environmental Protection Agency, and the population data were collected from Qom Province Management and Planning Organization website.", "The number of deaths due to Stroke, Chronic Obstructive Pulmonary Disease, Lung Cancer, and Ischemic Heart Disease attributable to PM2.5 were estimated using BenMAP-CE based on two control scenarios, 2.4 and 10 μg/m3, known as scenarios I and II, respectively.", "The associated economic effect of premature deaths was assessed by value of a statistical life (VSL) approach.", "The annual average of PM2.5 concentration was found to be 16.32 μg/m3 (SD: 9.93).", "A total of 4694.5 and 2475.94 premature deaths in scenarios I and II were found to be attributable to PM2.5 in overall, respectively.", "The total associated cost was calculated to be 855.91 and 451.40 million USD in scenarios I and II, respectively.", "The total years of life lost due to PM2.5 exposure in 2019 was 158,657.06 and 78,351.51 in scenarios I and II, respectively.", "The results of both health and economic assessment indicate the importance of solving the air pollution problem in Qom, as well as other big cities in Iran.", "The elimination of limitations, such as insufficient local data, should be regarded in future studies." ]

[ "Airlines' fleet assignment heavily affects the economic and ecological performance of the global air transportation system (ATS).", "Consequently, it is inevitable to include potential changes of the fleet assignment when modeling and assessing future global ATS scenarios.", "Therefore, this article presents a novel explanatory approach to modeling the fleet assignment in the global ATS.", "The presented approach is based on formulating and solving an optimization problem, which describes the fleet assignment in the ATS through a suitable combination of objective function and constraints.", "While the objective function combines both the airline and the passenger perspective on the fleet assignment, the constraints include additional operational and technological aspects.", "In comparison to the available global fleet assignment models in the literature, which rely on statistical approaches, the advantages of the presented approach via an optimization problem lie in the overall scenario capability and the consideration of explicit aircraft types instead of simplifying seat categories.", "To calibrate and validate our model, we use 10 years of historic flight schedule data.", "The results underline the strengths and weaknesses of the presented approach and indicate potential for future improvement." ]

[ "Airport security screening is a visual inspection task comprising search and decision.", "Problem solving is used to support decision making.", "However, it is not well understood.", "This study investigated how airport security screeners employ problem solving during x-ray screening, and how strategies change with experience.", "Thirty-nine professional security screeners were observed performing x-ray screening in the field at an Australian International Airport.", "Video and eye-tracking data were collected and analysed to explore activity phases and problem-solving strategies.", "Less-experienced screeners performed more problem solving and preferred problem-solving strategies that rely on visual examination without decision support or that defer decision making, compared to more-experienced screeners, who performed efficient and independent strategies.", "Findings also show that screeners need more time to develop problem-solving skills than visual scanning skills.", "Screeners would benefit from problem-solving support tools and intensified training and mentorship within the first six months of experience to advance problem-solving competencies." ]

[ "AirRater is a free environmental health smartphone app developed and available in Australia that collects individual health data and disseminates environmental hazard information to populations.", "Following previous evaluations with app users, the aim of this study was to better understand how clinicians, government agency and non-government advocacy group representatives perceive an app designed to reduce the impacts of environmental hazards on individual and public health.", "Nine government agency and non-government advocacy group representatives, along with 11 clinicians based in Australia participated in a semi-structured interview or focus group to explore perspectives on AirRater.", "Interview and focus group data were transcribed and analysed using the qualitative data analysis software NVivo.", "Results indicate that for clinicians, apps like AirRater can add value as an educational, patient self-management and diagnostic tool.", "For government and peak bodies, apps can add value by addressing environmental health literacy and monitoring and forecasting gaps, as well as supporting advocacy efforts and public health surveillance.", "We conclude that environmental health smartphone apps can support a range of stakeholders to achieve shared goals and priorities related to individual and public health outcomes.", "Further research is needed to better understand how apps could be embedded into clinical practice and policy settings." ]

[ "Alarm fatigue among nurses working in the intensive care unit has garnered considerable attention as a national patient safety priority.", "A viable solution for reducing the frequency of alarms and unnecessary noise is intensive care unit alarm monitor customization.", "A 24-bed cardiovascular and thoracic surgery intensive care unit in a large academic medical center identified a high rate of alarms and associated noise as a problem contributing to nurse alarm fatigue.", "An alarm monitor quality improvement project used both alarm frequency and nurse surveys before and after implementation to determine the effectiveness of interventions.", "Multimodal interventions included nurse training sessions, informational flyers, organizational policies, and an alarm monitor training video.", "Unexpected results inspired an extensive investigation and secondary analysis, which included examining the data-capturing capabilities of the alarm monitors and the impact of context factors.", "Alarm frequencies unexpectedly increased after the intervention.", "The software data-capturing features of the alarm monitors for determining frequency did not accurately measure nurse interactions with monitors.", "Measured increases in patient census, nurse staffing, and data input from medical devices from before to after the intervention substantially affected project results.", "Alarm frequencies proved an unreliable measure of nurse skills and practices in alarm customization.", "Documented changes in context factors provided strong anecdotal evidence of changed circumstances that clarified project results and underscored the critical importance of contemporaneous collection of context data.", "Designs and methods used in quality improvement projects must include reliable outcome measures to achieve meaningful results." ]

[ "Albumin continues to be used routinely by cardiac anaesthesiologists perioperatively despite lack of evidence for improved outcomes.", "The Multicenter Perioperative Outcomes Group (MPOG) data ranked our institution as one of the highest intraoperative albumin users during cardiac surgery.", "Therefore, we designed a quality improvement project (QIP) to introduce a bundle of interventions to reduce intraoperative albumin use in cardiac surgical patients.", "Our institutional MPOG data were used to analyse the FLUID-01-C measure that provides the number of adult cardiac surgery cases where albumin was administered intraoperatively by anaesthesiologists from 1 July 2019 to 30 June 2022.", "The QIP involved introduction of the following interventions: (1) education about appropriate albumin use and indications (January 2021), (2) email communications reinforced with OR teaching (March 2021), (3) removal of albumin from the standard pharmacy intraoperative medication trays (April 2021), (4) grand rounds presentation discussing the QIP and highlighting the interventions (May 2021) and (5) quarterly provider feedback (starting July 2021).", "Multivariable segmented regression models were used to assess the changes from preintervention to postintervention time period in albumin utilisation, and its total monthly cost.", "Among the 5767 cardiac surgery cases that met inclusion criteria over the 3-year study period, 16% of patients received albumin intraoperatively.", "The total number of cases that passed the metric (albumin administration was avoided), gradually increased as our interventions went into effect.", "Intraoperative albumin utilisation (beta=-101.1, 95% CI -145 to -56.7) and total monthly cost of albumin (beta=-7678, 95% CI -10712 to -4640) demonstrated significant decrease after starting the interventions.", "At a single academic cardiac surgery programme, implementation of a bundle of simple and low-cost interventions as part of a coordinated QIP were effective in significantly decreasing intraoperative use of albumin, which translated into considerable costs savings." ]

[ "Albumin is the most prevalent plasma protein and is involved in a variety of critical physiological processes.", "Low serum albumin levels have been linked to depression symptoms in people who had recent suicide attempts and those suffering from several mental diseases such as acute episodes of mania, and schizophrenia.", "However, there has been little investigation into the relationship between depression and serum albumin levels in community-dwelling persons.", "This research aimed to examine the relationship between serum albumin and depression in a population-based sample and whether it differs depending on other possible confounders.", "Our data were derived from a national household population study conducted in 2017 with a sample size of 3,521 Jordanians aged > 17 years old.", "The Patient Health Questionnaire (PHQ-9) scale, a self-administered scale, was used to screen for depression.", "Concentrations of serum albumin and other medical biomarkers were measured by blood tests.", "Using descriptive statistics for depression distribution and multivariate logistic regression analysis, the connection between albumin levels and depression was investigated.", "The odds ratios (ORs) for depression were significantly lower in the third and fourth quartiles of serum albumin concentration compared to the first quartile (OR = 0.64 and 0.66, respectively; P values = <0.001 and <0.001, respectively).", "This association was statistically significant even after controlling for variables such as gender, age, marital status, education, and occupation (OR = 0.67 and 0.75, respectively, and P values = 0.001 and 0.02, respectively), as well as after further controlling for other health status variables such as nutrition, comorbidity, body mass index, somking status, and biomedical markers such as serum calcium, phosphate, and magnesium (OR = 0.58 and 0.59, respectively, and P values = <0.001 and 0.001, respectively).", "Moreover, the unadjusted and adjusted odds ratios in the three regression models declined linearly with rising quartiles of serum albumin (P trend = <0.001, 0.009, and 0.001, respectively).", "Our research found an inverse relationship between serum albumin and depression.", "Serum albumin could be a warning measure for depression.", "It is required for appropriate intervention measures to be implemented." ]

[ "Alcohol consumption continues to be prevalent and is on the rise in many countries, posing a grave risk for the health and wellbeing of millions and creating a strain on health services worldwide.", "A hopeful trend has emerged, however, as consumers' growing preference for healthier, sustainable lifestyles has led traditional alcoholic brands to innovate, launching reduced or non-alcoholic (NoLo) options.", "This aligns with the SDGs and is reflected in NoLo spirits representing four of Spain's top ten disruptive innovations of 2022.", "This paper uses a mixed methodology in a qualitative-quantitative sequential approach to gain insight into this phenomenon.", "The study involved 13 in-depth interviews with HoReCa (an acronym for Hotels, Restaurants, and Caterings) professionals and four focus groups among consumers.", "Second, behavioral reasoning theory (BRT) was used in a quantitative study aiming to explore motivations for and against consuming NoLo spirits.", "Data from a survey of 620 participants was conducted and analyzed using SEM-PLS to measure the antecedents of consumer's behavioral intention towards NoLo spirits and to gauge the potential for marketing opportunities.", "The research reveals that the purchase intention of NoLo spirits is strongly related to health consciousness, while enjoying the effects of alcohol for fun and entertainment, and the social pressure to drink hinders its consumption.", "In addition, it was found that \"reasons for\" are more substantial than \"reasons against\" the consumption of those beverages, differing significantly by age group.", "Results offer implications for theory and practice, including recommendations for practitioners and regulators willing to improve sustainability in the industry.", "Further, this paper helps augment the innovation adoption literature by using BRT in the paradoxical context of consumers' increasing alcohol abuse despite their professed attempts to adopt healthier lifestyles." ]

[ "Alcohol consumption significantly impacts disease burden and has been linked to various diseases in observational studies.", "However, comprehensive meta-analyses using Mendelian randomization (MR) to examine drinking patterns are limited.", "We aimed to evaluate the health risks of alcohol use by integrating findings from MR studies.", "A thorough search was conducted for MR studies focused on alcohol exposure.", "We utilized two sets of instrumental variables-alcohol consumption and problematic alcohol use-and summary statistics from the FinnGen consortium R9 release to perform de novo MR analyses.", "Our meta-analysis encompassed 64 published and 151 de novo MR analyses across 76 distinct primary outcomes.", "Results show that a genetic predisposition to alcohol consumption, independent of smoking, significantly correlates with a decreased risk of Parkinson's disease, prostate hyperplasia, and rheumatoid arthritis.", "It was also associated with an increased risk of chronic pancreatitis, colorectal cancer, and head and neck cancers.", "Additionally, a genetic predisposition to problematic alcohol use is strongly associated with increased risks of alcoholic liver disease, cirrhosis, both acute and chronic pancreatitis, and pneumonia.", "Evidence from our MR study supports the notion that alcohol consumption and problematic alcohol use are causally associated with a range of diseases, predominantly by increasing the risk." ]

[ "Alcohol use disorder (AUD) is a leading cause of cirrhosis.", "Insufficient clinician knowledge and comfort managing AUD impacts access to treatment.", "Using Kern's Framework for Curriculum Development, we aimed to (i) develop and evaluate the effect of an \"AUD in cirrhosis\" educational intervention on clinicians' knowledge, attitudes, comfort, preparedness, and intention (practice habits) to integrate AUD management into their practice, and (ii) assess clinicians' motivation using Self Determination Theory.", "Kern's approach was used for curriculum development.", "Pilot session feedback informed a three-part flipped-classroom series conducted by interdisciplinary clinicians in hepatology, psychiatry, primary care, and addiction psychology.", "Participants watched a video followed by a live session focused on (a) withdrawal, (b) screening and brief intervention, and (c) prescribing pharmacotherapy.", "Questionnaires assessing knowledge and practice habits were adapted from the literature.", "Attitudes were evaluated using the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ).", "Self Determination Theory informed motivation questions.", "Paired sample t-tests on pre-post questionnaires (n = 229 clinicians; 95 completed questionnaires) revealed significant improvements in preparedness and comfort screening, providing a brief intervention, prescribing pharmacotherapy, and SAAPPQ domains.", "No significant changes were observed in the intention to prescribe pharmacotherapy.", "Effect size analysis showed medium to large effects across most topic areas.", "The developed sessions improved knowledge, attitudes, and practice habits of clinicians caring for this patient population.", "Given the rise in AUD and significant consequences in cirrhosis, this data offers promise that interactive education may improve practice habits of clinicians interfacing with this patient population." ]

[ "Alcohol use disorders (AUD) associate with structural and functional brain differences, including impairments in neuropsychological function; however, reviews (mostly cross-sectional) are inconsistent with regards to recovery of such functions following abstinence.", "Recovery is important, as these impairments associate with treatment outcomes and quality of life.", "To assess neuropsychological function recovery following abstinence in individuals with a clinical AUD diagnosis.", "The secondary objective was to assess predictors of neuropsychological recovery in AUD.", "Following the preregistered protocol (PROSPERO: CRD42022308686), APA PsycInfo, EBSCO MEDLINE, CINAHL, and Web of Science Core Collection were searched between 1999-2022.", "Study reporting follows the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, study quality was assessed using the JBI Checklist for Cohort Studies.", "Eligible studies were those with a longitudinal design that assessed neuropsychological recovery following abstinence from alcohol in adults with a clinical diagnosis of AUD.", "Studies were excluded if participant group was defined by another or co-morbid condition/injury, or by relapse.", "Recovery was defined as function reaching 'normal' performance.", "Sixteen studies (AUD n = 783, controls n = 390) were selected for narrative synthesis.", "Most functions demonstrated recovery within 6-12 months, including sub-domains within attention, executive function, perception, and memory, though basic processing speed and working memory updating/tracking recovered earlier.", "Additionally, verbal fluency was not impaired at baseline (while verbal function was not assessed compared to normal levels), and concept formation and reasoning recovery was inconsistent.", "These results provide evidence that recovery of most functions is possible.", "While overall robustness of results was good, methodological limitations included lack of control groups, additional methods to self-report to confirm abstinence, description/control for attrition, statistical control of confounds, and of long enough study durations to capture change." ]

[ "Alcohol use is pervasive in the Caribbean; however, the prevalence and correlates of alcohol use and drinking problems in the elderly have not been extensively studied.", "Data were obtained from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study, a cohort study of Caribbean people from Puerto Rico, Barbados, Trinidad, and Tobago, and the U.S. Virgin Islands, collected between 2013 and 2018 (baseline study sample, ages 60+, n = 811).", "Descriptive statistics were used to compare the differences in drinking status (current vs. former vs. never), alcohol problems (Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) scale score ≥2 vs. <2), and binge drinking days (0 days vs. 1-2 days vs. ≥3 days) across sample characteristics.", "Logistic regression analyses estimated the association of these alcohol measures with sociodemographic (e.g., sex), psychological (depression), and cultural (e.g., religion) correlates.", "Thirty-six percent were 70 + years of age, 64 % were female, and 41 % had less than a high school education.", "Alcohol problems (≥2 CAGE score) was 21 %.", "Binge drinking ≥3 days was 30.6 %.", "Never attending religious services (vs. attending once a week or more) was associated with almost three times higher odds of alcohol problems (adjusted Odds Ratio: OR = 2.88, 95 % CI = 1.02, 8.15) four times higher odds of increasing binge drinking days (aOR = 4.04, 95 % CI = 1.11, 14.96).", "College education was protective against both the outcomes.", "We provide current estimates of alcohol problems among elderly Eastern Caribbean people.", "Among the sociodemographic, psychological, and cultural correlates examined, religious attendance was significant.", "Replicate longitudinal studies using DSM-5 alcohol dependence are recommended." ]

[ "Alexithymia is the inability to identify and recognize emotions.", "The present study examined the impact of alexithymia on prolonged exposure (PE) therapy.", "Participants (n = 68) with PTSD underwent 10 PE sessions.", "Alexithymia was assessed via the Toronto Alexithymia Scale (TAS-20) and the emotional clarity and awareness subscales of the Difficulties in Emotion Regulation Scale.", "Treatment outcomes were assessed via the PTSD checklist and Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition at posttreatment and 6-month follow-up.", "Those with high alexithymia were more likely to endorse experiencing a full PTSD diagnosis immediately posttreatment, χ²(1) = 12.53, p = .002, and at 6-month follow-up, χ²(1) = 11.21, p = .004.", "Alexithymia was associated with delayed treatment effects on avoidance, with a significant reduction in symptomology observed from pre- to follow-up, t(51) = 4.52, p < .001, and not from pre- to posttreatment.", "Although both the low and high alexithymia groups showed significant changes in negative changes in thinking and mood, F(2, 14) = 9.18, p = .001, d = 1.57 and F(2, 50) = 13.86, p = .001, d = 1.49, respectively, the high alexithymia group exhibited a marginally lesser magnitude of treatment effect.", "Although those with significantly greater difficulties with emotional clarity were more likely to drop out of PE treatment, emotional clarity and awareness did not moderate treatment response.", "Our results confirm the efficacy of PE but also highlight that those with alexithymia show a delayed treatment response and may be at greater risk of pathology after treatment.", "(PsycInfo Database Record (c) 2024 APA, all rights reserved)." ]

[ "All anatomical educators hope that students apply past training to both similar and new tasks.", "This two-group longitudinal study investigated the development of such transfer of learning in a histology course.", "After 0, 10, and 20 sessions of the 10-week-long course, medical students completed theoretical tasks, examined histological slides trained in the course (retention task), and unfamiliar histological slides (transfer task).", "The results showed that students in the histology group gradually outperformed the control group in all tasks, especially in the second half of the course, η2 = 0.268 (p < 0.001).", "The best predictor of final transfer performance was students' retention performance after 10 sessions, β = 0.32 (p = 0.028), and theoretical knowledge after 20 sessions, β = 0.46 (p = 0.003).", "Results of eye tracking methodology further revealed that the histology group engaged in greater \"visual activity\" when solving transfer tasks, as indicated by an increase in the total fixation count, η2 = 0.103 (p = 0.014).", "This longitudinal study provides evidence that medical students can use what they learn in histology courses to solve unfamiliar problems but cautions that positive transfer effects develop relatively late in the course.", "Thus, course time and the complex relationship between theory, retention, and transfer holds critical implications for anatomical curricula seeking to foster the transfer of learning." ]

[ "All clinicians require statistical interpretation skills to keep up to date with evidence-based recommendations in their field.", "However, statistical illiteracy among clinicians is a highly prevalent problem with far-reaching consequences.", "The few available that report statistical literacy improvements after educational interventions do not measure for how long these benefits last.", "To estimate statistical illiteracy among Latin-American clinicians across multiple levels of training and to evaluate a 10-h course at multiple timepoints.", "Using an online questionnaire, we evaluated; self-perceived statistical proficiency, scientific literature reading habits and statistical literacy (using an adaptation of the Quick Risk Test).", "Separately, we evaluated statistical proficiency after a 10-h statistics course in a group of Internal Medicine residents at a tertiary center in Mexico City across multiple time points between November 2020 and February 2021.", "Data from 392 clinicians from 9 Latin American countries were analyzed.", "Most clinicians (85%) failed our adaptation of the Quick Risk Test (mean score = 2.6/10, IQR:1.4).", "The 10-h course significantly improved the scores of the Internal Medicine Residents (n = 16) from 3.8/10, IQR:1.8 to 8.3/10, IQR:1.4 (p < 0.01).", "However, scores dropped after one and 2 months to 7.7/10, IQR:1.6 and 6.1 / 10, IQR:2.2, respectively.", "Statistical Illiteracy is highly prevalent among Latin American clinicians.", "Short-term educational interventions are effective but, their benefits quickly fade away.", "Medical boards and medical schools need to periodically teach and evaluate statistical proficiency to ameliorate these issues." ]

[ "All Doctor of Physical Therapy (DPT) programs in the United States prepare students to demonstrate entry-level clinical performance upon graduation.", "Clinical residency programs are an option for DPT graduates seeking to specialize in a practice area.", "There is little research published on why DPT graduates decide to pursue residency education (RE) or not.", "This study aimed to determine factors influencing a Physical Therapist's (PT) decision-making process in choosing to pursue a postgraduate residency.", "PTs within 3 years of graduation and third-year DPT program students were surveyed.", "Most respondents were from DPT programs in the northeastern United States.", "A survey was created, piloted, and disseminated to various DPT programs.", "The survey asked participants their perceptions of motivating factors or barriers to pursuing a RE using multiple choice questions and Likert items.", "Descriptive statistics and frequencies were reported.", "One-way analysis of variances, chi-square analysis, and unpaired t tests were used.", "Students who considered residency in their second year are 26.5× more likely to apply for a residency (P < .001).", "Participants strongly agreed with the statements that residency will increase confidence when practicing in their specialty area (1.39 ± 0.48), expand their knowledge as clinicians (1.39 ± 0.051), and expedite proficient practice (1.72 ± 0.057).", "Participants considered student burnout, the cost of residency, student loan debt, and geographical relocation as the top barriers to pursuing residency.", "Men were significantly more confident in their ability to apply to residency (F = 8.219, P = .005).", "Married individuals perceived loans or financial obligations (F = 3.607, P = .029), family obligations (F = 17.170, P < .001), and geographical limitations (F = 3.825, P = .024) as barriers more than single individuals.", "There are many variables DPT students and recent graduates consider when deciding whether to pursue RE.", "RPs and entry-level DPT programs should consider these factors to promote increased participation in postprofessional RE." ]

[ "All healthcare professional education programmes must adopt a systematic approach towards ensuring graduates achieve the competencies required to be an evidence-based practitioner.", "While a list of competencies for evidence-based practice exist, health care educators continue to struggle with effectively integrating the necessary competencies into existing curricula.", "The purpose of this project was to develop an open access cross-discipline, learning outcomes framework to support educators in integrating the teaching, learning and assessment required to ensure all graduates of health care professional programmes can achieve the necessary evidence-based practice competencies.", "An interdisciplinary team of health care professional educators and a librarian completed a review of the health professions literature on the teaching and assessment of evidence-based practice.", "The literature, coupled with the teams' collective experiences in evidence-based education and research, were used to identify relevant teaching, learning and evidence-based competency frameworks to inform the project design.", "The guide and toolkit for experience-based co-design developed by the National Health Service Institute for Innovation and Improvement was adopted for this study ( Institute for Innovation and Improvement: Experience Based Design: Guide & Tools In.", "Leeds: NHS; 2009.).", "A four-step approach involving three online participatory co-design workshops and a national validation workshop was designed.", "Students (n = 33), faculty (n = 12), and clinical educators (n = 15) participated in formulating and mapping learning outcomes to evidence-based competencies.", "Through a rigorous, systematic co-design process the Evidenced-based Education Collaborative (EVIBEC) Learning Outcomes Framework was developed.", "This framework consists of a series of student-centred learning outcomes, aligned to evidence-based practice competencies, classified according to the 5 As of EBP and mapped to the cognitive levels of Bloom's taxonomy.", "Associated learning activities for each step of EBP are suggested.", "A consensus-based, student-centred learning outcomes framework aligned to a contemporary set of EBP core competencies has been developed.", "The freely accessible EVIBEC framework may support entry level health care professional EBP education, by informing EBP curriculum development and offering the potential for interdisciplinary approaches to and sharing of valuable teaching and learning resources.", "Co-design proved an effective method in creating and refining this framework." ]

[ "All individuals and groups have blind spots that can create problems if unaddressed.", "The goal of this study was to examine blind spots in medical education from international perspectives.", "From December 2022 to March 2023, we distributed an electronic survey through international networks of medical students, postgraduate trainees, and medical educators.", "Respondents named blind spots affecting their medical education system and then rated nine blind spot domains from a study of U.S. medical education along five-point Likert-type scales (1 = much less attention needed; 5 = much more attention needed).", "We tested for differences between blind spot ratings by respondent groups.", "We also analyzed the blind spots that respondents identified to determine those not previously described and performed content analysis on open-ended responses about blind spot domains.", "There were 356 respondents from 88 countries, including 127 (44%) educators, 80 (28%) medical students, and 33 (11%) postgraduate trainees.", "At least 80% of respondents rated each blind spot domain as needing 'more' or 'much more' attention; the highest was 88% for 'Patient perspectives and voices that are not heard, valued, or understood.'", "In analyses by gender, role in medical education, World Bank country income level, and region, a mean difference of 0.5 was seen in only five of the possible 279 statistical comparisons.", "Of 885 blind spots documented, new blind spot areas related to issues that crossed national boundaries (e.g.", "international standards) and the sufficiency of resources to support medical education.", "Comments about the nine blind spot domains illustrated that cultural, health system, and governmental elements influenced how blind spots are manifested across different settings.", "There may be general agreement throughout the world about blind spots in medical education that deserve more attention.", "This could establish a basis for coordinated international effort to allocate resources and tailor interventions that advance medical education." ]

[ "All learners have a contribution to make to the development of the Chemical Sciences, be that in novel ways to teach, and their perspectives and contexts, but also in research, both in chemical education and the wider Chemical Sciences.", "Through four case studies, this paper explores interactions with diverse groups and how this has altered perspectives on both teaching and research.", "The case studies include work with visually impaired adults, a project bringing together First Peoples in Australia with academics to explore old ways (traditional science) and new ways (modern approaches), primary (elementary) school perspectives on teaching science, and a project in South Africa to connect university and township communities.", "Not only do these case studies demonstrate the immense value these diverse groups bring to our understanding about how to learn, but they also bring new perspectives on how to view and solve chemical problems." ]

[ "All military surgeons must maintain trauma capabilities for expeditionary care contexts, yet most are not trauma specialists.", "Maintaining clinical readiness for trauma and mass casualty care is a significant challenge for military and civilian surgeons.", "We examined the effect of a prescribed clinical readiness program for expeditionary trauma care on the surgical performance of 12 surgeons during a 60-patient MASCAL event.", "The sample included orthopaedic (4) and general surgeons (8) who cared for MASCAL victims at Hamad Karzai International Airport, Kabul, Afghanistan on 26 August 2021.", "One orthopaedic and two general surgeons had prior deployment experience.", "The prescribed program included three primary measures of clinical readiness: 1. expeditionary knowledge (exam score), 2. procedural skills competencies (performance assessment score), 3. clinical activity (operative practice profile metric).", "Data were attained from program records for each surgeon in the sample.", "Each of the 60 patient cases were reviewed and rated (performance score) by The Joint Trauma System's Performance Improvement Branch; a military-wide performance improvement organization.", "All scores were normalized to facilitate direct comparisons using effect size calculations between each pre-deployment measure and MASCAL surgical care.", "Pre-deployment knowledge and clinical activity measures met program benchmarks.", "Baseline pre-deployment procedural skills competency scores did not meet program benchmarks, however those gaps were closed through re-training, ensuring all surgeons met or exceeded the program benchmarks pre-deployment.", "There were very large effect sizes (Cohen's d) between all program measures and surgical care score, confirming the relationship between the program measures and MASCAL trauma care provided by the 12 surgeons.", "The prescribed program measures ensured all surgeons achieved pre-deployment performance benchmarks and provided high quality trauma care to our nation's servicemembers.", "Prognostic, Level III/IV." ]

[ "All over the world, the level of special air pollutants that have the potential to cause diseases is increasing.", "Although the relationship between exposure to air pollutants and mortality has been proven, the health risk assessment and prediction of these pollutants have a therapeutic role in protecting public health, and need more research.", "The purpose of this research is to evaluate the ill-health caused by PM2.5 pollution using AirQ + software and to evaluate the different effects on PM2.5 with time series linear modeling by R software version 4.1.3 in the cities of Arak, Esfahan, Ahvaz, Tabriz, Shiraz, Karaj and Mashhad during 2019-2020.", "The pollutant hours, meteorology, population and mortality information were calculated by the Environmental Protection Organization, Meteorological Organization, Statistics Organization and Statistics and Information Technology Center of the Ministry of Health, Treatment and Medical Education for 24 h of PM2.5 pollution with Excel software.", "In addition, having 24 h of PM2.5 pollutants and meteorology is used to the effect of variables on PM2.5 concentration.", "The results showed that the highest and lowest number of deaths due to natural deaths, ischemic heart disease (IHD), lung cancer (LC), chronic obstructive pulmonary disease (COPD), acute lower respiratory infection (ALRI) and stroke in The effect of disease with PM2.5 pollutant in Ahvaz and Arak cities was 7.39-12.32%, 14.6-17.29%, 16.48-8.39%, 10.43-18.91%, 12.21-22.79% and 14.6-18.54 % respectively.", "Another result of this research was the high mortality of the disease compared to the mortality of the nose.", "The analysis of the results showed that by reducing the pollutants in the cities of Karaj and Shiraz, there is a significant reduction in mortality and linear modeling provides a suitable method for air management planning." ]

[ "Allergic conjunctivitis (AC) is a prevalent ocular condition with a substantial impact on individuals' quality of life.", "This study aimed to explore the demographic patterns, prevalence, symptoms, awareness, and attitudes associated with AC, while also examining potential associations with gender, age, and region of residence in Saudi Arabia.", "A cross-sectional study was conducted involving 487 participants.", "Data was collected through a self-administered questionnaire that included demographic information about AC prevalence, symptoms, attitudes, and awareness levels.", "Statistical analyses, including chi-square tests, were employed to examine associations between variables.", "The study revealed a prevalence of AC (89, 18.3%) with common symptoms being eye redness (73, 82%) and itching (73, 82%).", "Participants displayed diverse awareness levels, with (376, 77.2%) correctly defining AC.", "The majority demonstrated either a good (230, 47.2%) or insufficient (196, 40.2%) attitude, while 54 (11.1%) had a sufficient attitude, and 7 (1.4%) exhibited an excellent attitude and awareness.", "Significant regional disparities were observed, impacting both prevalence and attitudes.", "While no gender differences were noted, the age group of 31-40 displayed a higher prevalence.", "In this study, among 487 participants, the prevalence of AC was found to be 89 (18.3%).", "Meanwhile, attitude levels varied, with the majority demonstrating either a good or insufficient attitude.", "This provides valuable insights into the prevalence, symptoms, and awareness of AC in our population.", "The regional disparities underscore the need for tailored interventions addressing specific geographical contexts.", "The findings contribute to the broader understanding of AC, emphasizing the importance of targeted education and regional considerations in managing and preventing this condition." ]

[ "Allergic rhinitis (AR) has substantially negative impacts on patients' quality of life.", "Besides conventional medicines, many patients use alternative approaches, which sometimes were misconception.", "This study aims to explore and compare the beliefs about AR and its treatment options between 2 different groups; control and AR patient groups.", "A cross-sectional study of 518 respondents residing in the central region of Thailand has been conducted using a self-reported questionnaire which consists of 3 parts; personal profile, the International Study of Asthma and Allergies in Childhood (ISAAC) questions, and the beliefs.", "ISAAC is applied for identifying respondents as the control or the AR group.", "From a total of 518 respondents, 311 (60.0%) were identified as the AR group.", "The demographic data between the control and the AR group has no statistical difference (p > 0.05).", "Regarding the beliefs about AR characteristics, 56.1% of the AR group believe that low immunity causes AR while the number of the control group reaches 56%.", "Thirty-nine point two percent for the AR group and 38.6% for the control group believe that AR is a fatal disease.", "The belief that AR can be spread by droplet/airborne transmission is 22.8% and 28.5% for the AR and the control group, respectively.", "About AR treatment options, 60.1% of the AR group and 43% of the control group believe that taking vitamin C can relieve AR symptoms, which has a statistical difference (p < 0.05) between the 2 groups.", "The belief that prolonged use of antihistamine drugs can cause drug resistance is 29.9% and 24.6% for AR and control groups, respectively.", "Both groups of respondents mostly share common beliefs about AR characteristics and treatment options in which the AR group has higher percentage in some beliefs.", "Therefore, health literacy should be promoted in order to improve patient's care." ]

[ "Allergies have a significant impact on health and quality of life worldwide, yet there is limited research on the awareness and knowledge of allergies.", "This study aimed to explore the level of awareness and knowledge of allergies among visitors in Syrian hospitals.", "A cross-sectional study was conducted between May and September 2022, and a standardized international questionnaire was administered to 504 visitors in three hospitals in Syria.", "Data analysis was performed using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 23.", "The final sample comprised 504 questionnaires with 61.7% of participants achieving an average score.", "Statistical analysis revealed a significant difference in knowledge of allergy scores between the group with only elementary education (M = 3.76, SD = 1.67, p = 0.011), the group with no education (M = 3.65, SD = 1.65, p = 0.006), and the group with a university education (M = 4.44, SD = 1.25).", "Notably, no significant differences were found between the other educational groups.", "A one-way ANOVA was employed to assess the effect of place of living on knowledge of allergy, but no significant differences were observed between the groups (p = 0.462).", "Lastly, a significant negative correlation was detected between participant age and knowledge of allergy scores (r(502) = - 0.102, p = 0.022).", "Allergies represent a substantial global health concern that demands attention from healthcare providers, policymakers, and the public.", "This study emphasizes the importance of investing in health education and awareness campaigns to enhance knowledge and comprehension of allergies, particularly individuals with lower levels of education levels.", "By equipping individuals with the requisite information to effectively manage their allergies, their overall health and wellbeing can be improved." ]

[ "Allogeneic hematopoietic cell transplant (alloHCT) offers many patients with blood cancers a chance of cure but carries risks.", "We characterized how hematologists discuss the high-risk, high-reward concept of alloHCT.", "Qualitative analysis of video-recorded virtual encounters of hematologists who routinely perform alloHCT with actors portraying an older man recently diagnosed with high-risk myelodysplastic syndrome.", "Hematologists (n = 37) were a median age of 44 years, 65% male, and 68% white.", "They frequently used \"teeter-totter\" language that juxtaposed alloHCT's risks and rewards in a dynamic, quickly alternating fashion and communicated uncertainty in transplant outcomes.", "This dialogue oscillated between encouragement about alloHCT's potential for cure and caution about its risks and occurred within single speech turns and in exchanges between hematologist and patient.", "Fewer hematologists outlined their big-picture stance on transplant's risks and benefits early in the conversation.", "Meanwhile, hematologists varied in how they counseled patients to manage transplant-related uncertainty and consider treatment decision making.", "Hematologists use \"teeter-totter\" language to express hope and concern, confidence and uncertainty, and encouragement and caution about the high-risk, high-reward nature of alloHCT.", "Teeter-totter language may help frame big-picture content about alloHCT's risks and benefits that is essential for patient education and decision making." ]

[ "Allogeneic hematopoietic stem cell transplantation (HSCT) can have a long-term impact on patients' sexual functioning and consequently, their relationship satisfaction.", "This study aimed to examine the feasibility and acceptability of a 5-session psychosexual intervention for HSCT survivors and their partners.", "To be eligible patients were required to be more than 3 months post-allogeneic HSCT.", "The intervention comprised 2 components: (1) A psychosexual education session exploring medical/behavioral treatment options for sexual dysfunction, delivered by a specialist nurse; (2) A 4-session Emotionally-Focused Therapy-based relationship education program for couples delivered by a clinical psychologist.", "Measures assessing relationship quality, sexual functioning, anxiety, and depression were administered pre- and post-intervention.", "Feasibility was measured via participation rate, adherence and compliance with completing main measures.", "Acceptability of the intervention was assessed via patient/partner satisfaction surveys.", "Eight of 85 (9.4%) eligible patients and their partners participated in the study.", "Reasons for declining participation included: feeling uncomfortable due to sensitive nature of intervention; did not have any relationship/sexual function issues; and experiencing ongoing medical issues.", "Six of 8 couples (75%) attended at least 4 intervention sessions and 5 of 8 (62.5%) completed the main study measures post-intervention.", "Four couples reported that sexual satisfaction and relationship satisfaction was somewhat or much better post-intervention; 1 reported no change.", "Feasibility criteria were not met, with low enrolment rate, however the intervention was deemed acceptable.", "Couples who participated adhered to the intervention and considered it beneficial.", "Further strategies to identify and manage sexual concerns are required." ]

[ "Allogeneic hematopoietic stem cell transplantation stands as a vital treatment for leukemia, yet its implementation poses considerable challenges and complications.", "A comprehensive understanding of these challenges is crucial for appreciating the significance of enhanced nursing care.", "To explore and summarise the nursing experience of allogeneic haematopoietic stem cell transplantation for acute lymphoblastic leukaemia.", "The significance of this objective lies in the potential transformative impact that enhanced nursing care can have on overall patient outcomes within the context of allogeneic hematopoietic stem cell transplantation.", "Patients with acute lymphoblastic leukaemia treated with allogeneic haematopoietic stem cell transplantation in our hospital between August 2020 and January 2022 were recruited for this study.", "A total of 50 patients who met the complete inclusion criteria were enrolled and included in this study.", "Patients in the traditional group were given traditional nursing interventions, while patients in the exploration group were offered individualized interventions according to their personalized plans.", "In the traditional group, standard nursing care involved routine health education, vital signs monitoring, and sterile care in a laminar flow ward.", "Post-transplantation changes were observed, and patients were encouraged to engage in suitable exercises.", "The exploration group received enhanced infection control measures, including regular disinfection and cleaning of patient wards.", "Individualized care plans, collaborative chemotherapy consultations, and extensive patient and family education were implemented.", "Clinical data of all patients were collected, and their nursing experience was summarized and analyzed by comparing the incidence of adverse reactions and evaluating nursing satisfaction.", "The analysis group demonstrated a significantly lower incidence of adverse reactions compared to the traditional group.", "Specifically, the total adverse reaction rate in the analysis group was 8.00%, markedly lower than the traditional group's 48.00% (P < .05).", "Moreover, patient satisfaction in the exploration group was significantly higher than that observed in the traditional group (P < .05).", "In detail, the satisfaction level in the exploration group reached 92.67%, while the traditional group reported a satisfaction level of 77.56%.", "For patients with acute lymphoblastic leukaemia who received allogeneic haematopoietic stem cell transplantation, a personalized care intervention plan involving careful primary nursing, full protection and enhanced psychological care can It can effectively improve the adverse effects of sleep, thus increasing their satisfaction with nursing." ]

[ "Almost three quarters of mental illnesses start by the age of 25, yet youth (18-25-year-olds) are often underrepresented in U.K. services.", "This is particularly true for those of ethnic minorities.", "In this study, we aimed to understand how young Pakistani women and their parents make decisions to seek help for severe mental health problems, and the barriers and facilitators to accessing professional help.", "Young Pakistani women with experience of severe mental health problems and their parents were recruited from a community sample.", "Semi-structured interviews were conducted with six young people and two parents.", "Data were analyzed using reflexive thematic analysis.", "Pakistani culture and its interplay with British culture strongly influenced the decisions and ability of young Pakistani women and their parents to help-seek, largely through the role of stigma.", "Low mental health literacy, stigma, and a lack of culturally informed services were identified as the most common barriers to accessing care.", "These barriers fed into the internalized stigma these young women experienced which, through fear of damaged reputation and personal prejudices, posed further barriers to seeking help.", "Participants highlighted recommendations for both individual-level (e.g., increased education and awareness) and service-level (e.g., greater choice over care) change to facilitate accessibility of professional help.", "Young Pakistani women face multiple culturally related challenges to accessing care for severe mental health problems at both the individual- and service-level.", "Novel suggestions to address these challenges, such as including youth peer support workers in services, may facilitate more inclusive and accessible services." ]

[ "Alpha-gal syndrome is an emerging allergy characterized by an immune reaction to the carbohydrate molecule alpha-gal found in red meat.", "This unique food allergy is likely triggered by a tick bite.", "Cases of the allergy are on the rise, but prevalence estimates do not currently exist.", "Furthermore, varying symptoms and limited awareness of the allergy among health care providers contribute to delayed diagnosis, leading individuals to seek out their own information and potentially self-diagnose.", "The study aimed to (1) describe the volume and patterns of information-seeking related to alpha-gal, (2) explore correlations between alpha-gal and lone star ticks, and (3) identify specific areas of interest that individuals are searching for in relation to alpha-gal.", "Google Trends Supercharged-Glimpse, a new extension of Google Trends, provides estimates of the absolute volume of searches and related search queries.", "This extension was used to assess trends in searches for alpha-gal and lone star ticks (lone star tick, alpha gal, and meat allergy, as well as food allergy for comparison) in the United States.", "Time series analyses were used to examine search volume trends over time, and Spearman correlation matrices and choropleth maps were used to explore geographic and temporal correlations between alpha-gal and lone star tick searches.", "Content analysis was performed on related search queries to identify themes and subcategories that are of interest to information seekers.", "Time series analysis revealed a rapidly increasing trend in search volumes for alpha-gal beginning in 2015.", "After adjusting for long-term trends, seasonal trends, and media coverage, from 2015 to 2022, the predicted adjusted average annual percent change in search volume for alpha-gal was 33.78%.", "The estimated overall change in average search volume was 627%.", "In comparison, the average annual percent change was 9.23% for lone star tick, 7.34% for meat allergy, and 2.45% for food allergy during this time.", "Geographic analysis showed strong significant correlations between alpha-gal and lone star tick searches especially in recent years (ρ=0.80; P<.001), with primary overlap and highest search rates found in the southeastern region of the United States.", "Content analysis identified 10 themes of primary interest: diet, diagnosis or testing, treatment, medications or contraindications of medications, symptoms, tick related, specific sources of information and locations, general education information, alternative words for alpha-gal, and unrelated or other.", "The study provides insights into the changing information-seeking patterns for alpha-gal, indicating growing awareness and interest.", "Alpha-gal search volume is increasing at a rapid rate.", "Understanding specific questions and concerns can help health care providers and public health educators to tailor communication strategies.", "The Google Trends Supercharged-Glimpse tool offers enhanced features for analyzing information-seeking behavior and can be valuable for infodemiology research.", "Further research is needed to explore the evolving prevalence and impact of alpha-gal syndrome." ]

[ "Alpha-mannosidosis is an ultra-rare lysosomal disease that is caused by variants of the MAN2B1 gene on chromosome 19p13.", "These variants result in faulty or absent alpha-mannosidase in lysosomes, which leads to intracellular accumulation of mannose-containing oligosaccharides.", "Diagnosis of alpha-mannosidosis is often delayed, in part because of the rarity of the disease, its gradual onset and heterogeneity of presentation, but also because of the similarity of many signs and symptoms of the disease to those of other lysosomal diseases.", "Treatment of alpha-mannosidosis was previously limited to hematopoietic stem cell transplantation, but outcomes are variable and not all patients are eligible or have a suitable donor.", "Recently, an enzyme replacement therapy, recombinant human alpha-mannosidase (velmanase alfa), was approved for the treatment of non-neurological manifestations in adult and pediatric patients with alpha-mannosidosis.", "Treatment with velmanase alfa reduces serum levels of oligosaccharides, increases levels of immunoglobulin G, and improves patients' functional capacity and quality of life, although it is not effective for the neurologic phenotype because it does not cross the blood-brain barrier.", "Since the effects of velmanase alfa are more marked in children than adults, early diagnosis to allow early initiation of treatment has become more important.", "To support this, patient, parent/caregiver, and clinician awareness and education is imperative.", "A number of approaches can be taken to meet this goal, such as the development of disease registries, validated diagnostic algorithms, and screening tools, improved under-/post-graduate clinician education, easily accessible and reliable information for patients/families (such as that made available on the internet), and the formation of patient advocacy groups.", "Such approaches may raise awareness of alpha-mannosidosis, reduce the diagnostic delay and thus improve the lives of those affected." ]

[ "Alteplase (tPA) is the initial treatment for acute ischemic stroke.", "Current tPA guidelines exclude patients who took direct oral anticoagulants (DOAC) within the prior 48 hours.", "In this propensity-matched retrospective study we compared acute ischemic stroke patients treated with tPA who had received DOACs within 48 hours of thrombolysis to those not previously treated with DOACs, regarding three outcomes: mortality; intracranial hemorrhage (ICH); and need for acute blood transfusions (as a marker of significant blood loss).", "Using the United States cohort of 54 healthcare organizations in the TriNetx database, we identified 8,582 stroke patients treated with tPA on DOACs within 48 hours of thrombolysis and 46,703 stroke patients treated with tPA not on DOACs since January 1, 2012.", "We performed propensity score matching on demographic information and seven prior clinical diagnostic groups, resulting in a total of 17,164 acute stroke patients evenly matched between groups.", "We recorded mortality rates, frequency of ICH, and need for blood transfusions for each group over the ensuing 7- and 30-day periods.", "Patients treated with tPA on DOACs had reduced mortality (3.3% vs 7.3%; risk ratio [RR] 0.456; P < 0.001), fewer ICHs (6.8% vs 10.1%; RR 0.678; P < 0.001), and less risk of major bleeding as measured by frequency of blood transfusions (0.5% vs 1.5%; RR 0.317; p < 0.001) at 7 days post thrombolytic, than the tPA patients not on DOACS.", "Findings for 30 days post-thrombolytics were similar/statistically significant with lower mortality rate (7.2% vs 13.1%; RR 0.550; P < 0.001), fewer ICHs (7.6% vs 10.8%; RR 0.705; P < 0.001), and fewer blood transfusions (0.9% vs 2.0%; RR 0.448; P < 0.001).", "Acute ischemic stroke patients treated with tPA who received DOACs within 48 hours of thrombolysis had lower mortality rates, reduced incidence of ICH, and less blood loss than those not on DOACs.", "Our study suggests that prior use of DOACs should not be a contraindication to thrombolysis for ischemic stroke." ]

[ "Alterations in haemostasis have been described in dogs and humans with chronic hepatitis.", "Portal vein thrombosis is a recognised complication of chronic hepatitis in humans; however, its prevalence in dogs with chronic hepatitis has not been reported.", "We aimed to estimate the prevalence of, and describe clinical and laboratory data of dogs with chronic hepatitis and portal vein thrombosis and splanchnic venous thrombosis.", "Retrospective cross-sectional study.", "Medical records of dogs admitted to a veterinary teaching hospital between 2009 and 2019 were reviewed.", "Dogs were included if chronic hepatitis was histopathologically confirmed, and if diagnostic imaging or necropsy indicated the presence of thrombosis.", "Clinical and laboratory data (i.e.", "haematology, biochemistry, coagulation panels) were recorded.", "Descriptive statistics were used to characterise dogs with and without thrombosis.", "Records from 136 dogs with chronic hepatitis were identified.", "Three of these dogs, 2.2% (95% confidence interval: 0.8 to 6.3%) all females, were diagnosed with portal vein thrombosis.", "Five dogs in total, (3.7%; 95% confidence interval: 1.6 to 8.3%), including three with portal vein thrombosis, all females, were diagnosed with splanchnic venous thrombosis.", "Dogs with portal vein and splanchnic venous thrombosis often had hyperbilirubinaemia, increased serum gamma-glutamyl transferase activity, and decreased plasma antithrombin 3 activity.", "They also had relatively high alternative Child-Pugh scores for dogs (median 6 out of 13).", "Portal vein and splanchnic venous thrombosis are potentially serious complications that were identified in a relatively low proportion of dogs with chronic hepatitis." ]

[ "Alterations in intestinal permeability have been implicated in ulcerative colitis (UC).", "Infliximab, a monoclonal anti-tumor necrosis factor alpha (TNFα) antibody, can induce clinical response in UC.", "Gene expression in colonic biopsies taken from responders and nonresponders to infliximab can provide insight into the mechanisms of the altered intestinal permeability at a molecular level.", "Colonic biopsies (n = 18 anti-TNFα naïve UC patients; n = 8 normal controls; n = 80 Active Ulcerative Colitis Trial [ACT] 1 patients) were analyzed for mRNA expression using gene expression microarrays.", "Computational reverse causal reasoning was applied to build causal network models of UC and response and nonresponse of UC to treatment.", "Quantitative reverse-transcription polymerase chain reaction (qPCR) was used to confirm differentially expressed genes.", "Reverse causal reasoning on mRNA expression data from anti-TNFα-naïve UC and normal samples provided a mechanistic disease model of the biology of gene expression observed in UC.", "mRNA expression data from the ACT 1 study enabled construction of a mechanistic model describing the biology of nonresponders to infliximab, including evidence for increased intestinal permeability compared with normal and responder samples.", "Gene expression changes identified as central to intestinal permeability dysregulation were confirmed in normal, UC, and infliximab-treated patients by qPCR analysis.", "Gene expression returned toward normal levels in infliximab responders, but not in nonresponders.", "Gene expression analysis and causal network modeling in combination showed that aberrant mRNA expression of genes involved in intestinal epithelial permeability for infliximab responders was restored toward levels observed in normal samples.", "Infliximab nonresponders showed no equivalent restoration in the expression of these genes." ]

[ "Alterations in pharmacy practice from prescription dispensing to more patient-centered relationship intensifies the necessity of clinical decision-making.", "Pharmacists' knowledge as well as ethical reasoning affects their clinical decision-making.", "Unfortunately in Iran pharmacy ethics did not develop along with medical ethics and special considerations are of major importance.", "The study was designed to evaluate pharmacists' attitude toward some principles of bioethics.", "A cross-sectional survey was performed on a sample of Iranian pharmacists attended in continuous education programs in 2010.", "Based on the pharmacists' attitude toward common ethical problems, 9 Likert-type scale scenarios were designed.", "A thousand pharmacists were surveyed and 505 questionnaires were filled.", "For the whole questionnaire the strongly disagree answer was the most ethical answer.", "On a scale from 1-5 on which 5=strongly disagree, the total score of pharmacists ethical attitude was 17.69 ± 3.57.", "For easier analysis we considered the score of 1 for agree and strongly agree answers, score of 2 for neutral answers and score of 3 for disagree and strongly disagree answers.", "The total score in confidentiality for all participants was 4.15 ± 1.45 out of 9, in autonomy 6.25 ± 1.85 out of 9, in non-maleficence 5.14 ± 1.17 out of 6 and in justice was 2.27 ± 0.89 out of 3, however there was no significant difference between men and women in the total score and the score of each theme.", "The older participants (> 40 years) significantly had lower total score (P< 0.05) as well as the score of each theme (P< 0.05), except for non-maleficence.", "The work experience showed impact on the pharmacists' attitude toward autonomy and the participants with more than 5 years work experience significantly obtained lower score in this theme.", "Compiling ethical guidelines and improving pharmacy ethics curriculum is highly critical to provide the best pharmaceutical care and to make clinical decisions in critical situations.", "Therefore further quantitative and qualitative investigations into finding pitfalls and challenges in this issue are highly recommended." ]

[ "Although a contemporary randomized clinical trial has led to the use of whole-pelvic radiation therapy (WPRT), long-term data evaluating a potential reduction in mortality are lacking and are addressed in the current study.", "From 2005 to 2015, 350 men with localized, unfavorable-risk prostate cancer (PC) were randomly assigned to receive androgen deprivation therapy (ADT) and RT plus docetaxel versus ADT and RT.", "Treatment of the pelvic lymph nodes was at the discretion of the treating physician.", "Multivariable Cox and Fine and Grays regression analyses were performed to assess whether a significant association existed between radiation treatment volume and all-cause mortality (ACM) and PC-specific mortality (PCSM), respectively, adjusting for known PC prognostic factors and comorbidity.", "An interaction term between age (categorized by dichotomization at 65 years to enable clinical interpretation and applicability of the results and which approximates the median (66 years [IQR, 61-70]) and radiation treatment volume was included in the analysis.", "After a median follow-up of 10.20 years (IQR, 7.96-11.41), 89 men died (25.43%); of these, 42 died of PC (47.19%).", "Of the 350 randomly assigned patients, 88 (25.14%) received WPRT.", "In men younger than 65 years, WPRT was associated with a significantly lower ACM risk (adjusted hazard ratio [AHR], 0.33 [95% CI, 0.11 to 0.97]; P = .04) and lower PCSM risk (AHR, 0.17 [95% CI, 0.02 to 1.35]; P = .09) after adjusting for covariates, whereas this was not the case for men 65 years or older.", "WPRT has the potential to reduce mortality in younger men with unfavorable-risk PC." ]

[ "Although all residents routinely teach medical students, not all residents are involved in teaching or trained in teaching during undergraduate medical school, as accreditation bodies do not mandate the promotion of teaching skills to undergraduate medical students.", "With relatively inadequate formal training and residents' intrinsic time constraints, tactically incorporating formal medical education elective experiences in medical school curricula is understandable.", "This study explores if medical education electives at Avalon University School of Medicine (AUSOM) can enhance medical students' interest in teaching and research.", "The medical education elective at AUSOM was developed to give interested medical students an elective experience.", "The course modules include accreditation/regulation, curriculum development, learning theories, assessments, and research methodology.", "Students can choose any one of the modules.", "We offered the medical education elective to twenty-five students in the year 2021.", "All of them gave feedback at the end of the elective.", "The data was analyzed qualitatively through framework analysis, which includes familiarization, generating initial codes, searching for themes, reviewing, and defining and naming themes.", "Different themes emerged, enhancing the interest in academic medicine, understanding research methodologies, supporting learners, and awareness of learning theories.", "Doing medical education electives at AUSOM enhanced students' interest in teaching, and students reported that they could understand research methodologies, especially those related to medical education.", "Medical students should have opportunities for electives in medical education, and more research is required to evaluate the effectiveness of medical education electives across medical schools." ]

[ "Although appropriate life skills are recognized as a fundamental right for adolescents and a critical component of health policy, they are often overlooked and rarely researched in pastoral communities.", "Life skills encompass the ability to adopt positive behaviors, which enable individuals to effectively deal with the demands and challenges of everyday life.", "This study aimed to evaluate the effectiveness of a school-linked life skills intervention program on adolescents' sexual and reproductive health skills in the pastoral community of Guji zone.", "A two-arm cluster randomized control trial with a pretest-posttest experimental design was conducted, involving the intervention group (N = 375) and the control group (N = 384).", "This study assessed the effect of a school-linked adolescent-friendly life skills intervention in comparison to the usual RH curriculum, used as a control arm.", "Pretest-posttest and posttest-posttest scores of the control group and trial groups were compared, and the data were collected using 27 self-administered questions.", "The collected data were analyzed using paired-sample independent t-tests and a generalized linear model to examine the relationship between the dependent and independent variables.", "Data were collected from 759 adolescents in 15 intervention and 15 control clusters.", "The findings have shown that the proportion of mean life skills score was significantly higher in the intervention clusters than controls [(375) 70.49% vs. (384) 62.25%, P < 0.001 95% CI (0.06 and 0.1)].", "Adolescents who were trained in school-linked life skills (β = 1.915, 95% CI: 1.411-2.418), were confident to make safe and informed decisions (β = 1.999, 95% CI: 1.562-2.436), and had life skills to deal with SRH issues (β = 1.66, 95% CI: 1.233-2.087) were significantly correlated with predicting the relevant life skills.", "The proportion of adolescents with SRH life skills increased from 384 (52%) at baseline to 375 (70%) at end line in the intervention group compared to 384 (60.31%) at baseline to 384 (62.31%) in control arms, respectively.", "The implementation of a school-linked life skills intervention program proved to have a significant effect on SRH life skills development.", "Furthermore, individual-level and behavioral-level variables were significant in explaining variability in life skills development within the pastoral community.", "Therefore, we recommend scaling up this intervention in all high schools.", "Trial registration PACTR202107905622610, registered on 16 July 2021." ]

[ "Although cancer is still the second leading cause of death worldwide, basic research has largely elucidated the underlying mechanisms that lead us deep into the laws of animate and inanimate nature.", "This review aims to demonstrate that the cancer process profoundly affects and reprograms fundamental principles and concepts of cellular life by harnessing the natural mechanisms of biological evolution.", "It is shown that mutation and selection - the drivers of cancer formation and progression - are mandatory consequences of Boltzmann's version of the second law of thermodynamics, which stipulates that entropy (or disorder) according to probability never decreases, followed by Darwinian evolution by filtering for the suitable geno- and karyotypes.", "Cancer research has shown that malignant cells can develop gradually or abruptly depending on the prevailing stress conditions.", "Similar principles were then observed in the evolution of species, referred to as micro- and macroevolution.", "Cancer cells can be related to phylogenetically older forms of life, and malignant transformation can be viewed as reverse (atavistic) evolution, accompanied by typical rearrangement of system information and loss of 'social' behavior.", "It becomes obvious that in nature no distinction is made between normal biology and pathobiology.", "Instead, everything follows the rules of natural evolution.", "This illustrates the depth of the cancer problem and may explain the serious difficulties faced in trying to eradicate cancer." ]

[ "Although challenging to integrate within university curricula, evidence suggests that interprofessional education (IPE) positively impacts communication and teamwork skills in the workplace.", "The nature of Team-based learning (TBL) lends itself to interprofessional education, with the capacity to foster a culture of collaboration among health professional students.", "Our study was designed to pilot an interprofessional 'back pain' TBL module for physiotherapy and medical students, and to explore their experience of the TBL process, using the conceptual framework of 'knowledge reconsolidation' to discuss our finding.", "Three hundred and eleven students participated in the TBL session: 222/277 (80%) of Year 1 medical students and 89/89 (100%) of Year 2 physiotherapy students.", "Students completed one interprofessional Musculoskeletal Sciences TBL session on the topic of 'back pain'.", "A questionnaire including closed and open-ended items, was distributed to students immediately following completion of the TBL session.", "Descriptive statistics were used to analyse the quantitative data.", "Thematic analysis was used to code and categorise qualitative data into themes.", "Pre-class quiz scores were compared between the groups using a one-way between groups Analysis of Variance (ANOVA) test with Tukeys Post Hoc test.", "In total, 117/311 (38%) of participants completed the questionnaire.", "Both medicine and physiotherapy students appreciated the opportunity to learn about the curriculum of another healthcare discipline, and their scope of practice; gain multiple perspectives on a patient case from different disciplines; and recognised the importance of multidisciplinary teams in patient care.", "Students felt having an interprofessional team of facilitators who provided immediate feedback helped to consolidate student learning and promoted clinical reasoning.", "An analysis of variance revealed no difference between Physiotherapy and Medical students' pre-class quiz scores.", "Our study demonstrated that the small group and task-focused characteristics of TBL provided a student-centred teaching strategy to support the achievement of interprofessional learning goals.", "Students valued their interactions with other students from a different professional degree, the opportunity to problem solve together, and learn different perspectives on a patient case.", "The pre-class quiz results demonstrate that both groups of students had a comparative level of prior knowledge to be able to work together on the in-class activities." ]

[ "Although children from limited-resource families in rural areas are at great risk for nutrition-related chronic diseases, few hands-on programs have been implemented that simultaneously engage both parents and children and include local produce in a single program.", "This study reports on the development, implementation, and evaluation of Cooking with the Seasons for Health (CwS4H).", "Parent-child pairs participated in six sessions (two weekly sessions during each of three growing seasons), which included food tasting, a spotlight vegetable, interactive mini nutrition lesson, a child-focused cooking lesson, hands-on meal preparation, distribution of materials as family guides, and a take-home bag of fresh produce.", "Pre- and postprogram survey data were collected from 23 parents and 22 children.", "Children reported improvements in nutrition knowledge, vegetable preference, and self-efficacy in food preparation and cooking.", "Parents reported gains in nutrition knowledge, nutritional behaviors, vegetable preference, attitude toward food preparation/cooking, involvement of the child in food preparation/cooking, confidence in preparing vegetables, and the child's vegetable intake.", "Parents commented on the value children placed on food preparation and produce selection and how the program enhanced the parent-child relationship.", "By focusing CwS4H on a variety of fresh vegetables, this intervention helped to impact children's vegetable intake behaviors by engaging children in preparing and choosing the food they eat." ]

[ "Although community health worker (CHW) programs focus on improving access to healthcare, some individuals may not receive the intended quality or quantity of an intervention.", "The objective of this research was to examine if certain populations of pregnant women differentially experience the implementation of a community health worker-led maternal health intervention in Zanzibar.", "We included pregnant women enrolled in the Safer Deliveries (Uzazi Salama) program, which operated in 10 of 11 districts in Zanzibar, Tanzania between January 1, 2017, and June 19, 2019 (N = 33,914).", "The outcomes of interest were receipt of the entire postpartum intervention (three CHW visits) and time to first postpartum CHW visit (days).", "Visits by CHWs were done at the women's home, however, a telehealth option existed for women who were unable to be reached in-person.", "We conducted statistical tests to investigate the bivariate associations between our outcomes and each demographic and health characteristic.", "We used multivariate logistic regression to estimate the relationships between covariates and the outcomes and multivariate linear regression to estimate the association between covariates and the average time until first postpartum visit.", "Higher parity (OR = 0.85; P = 0.014; 95%CI: 0.75-0.97), unknown or unreported HIV status (OR = 0.64; p < 0.001; 95%CI: 0.53-0.78), and receipt of phone consultations (OR = 0.77; p < 0.001; 95%CI: 0.69-0.87) were associated with a lower odds of receiving all postpartum visits.", "Similarly, women with an unknown or unreported HIV status (estimated mean difference of 1.81 days; p < 0.001; 95%CI: 1.03-2.59) and those who received a phone consultation (estimated mean difference of 0.83 days; p < 0.001; 95%CI: 0.43-1.23), on average, experienced delays to first visit.", "In addition, current delivery at a referral hospital was associated with lower odds of receiving a postpartum visit and longer time to first visit compared to delivery at home, cottage hospital, PHCU + , or district hospital.", "Women from all other districts received their first visit earlier than women from Kaskazini B.", "There were no differences in the odds of receiving the entire postpartum intervention by sociodemographic variables, including age, education, and poverty assessment indicators.", "The results indicate no differences in intervention contact across wealth and education levels, suggesting that the program is effectively reaching women regardless of SES.", "However, women with other characteristics (e.g., higher parity, unknown or unreported HIV status) had lower odds of receiving the complete intervention.", "Overall, this work generates knowledge on existing disparities in intervention coverage and enables future programs to develop approaches to achieve equity in health care utilization and outcomes." ]

[ "Although comprehensive lifestyle habits are crucial for healthy aging, their adherence tends to decline as individuals grow older.", "Sustaining a healthy life over time poses a motivational challenge.", "Some digital tools, such as smartphone apps aimed at promoting healthy habits, have been used to counteract this decline.", "However, a more profound investigation is necessary into the diverse experiences of users, particularly when it concerns older adults or those who are unfamiliar with information and communications technologies.", "We aimed to develop a mobile app focused on promoting the health of older adults based on the principles of software engineering and a user-centered design.", "The project respected all ethical guidelines and involved the participation of older adults at various stages of the development of the app.", "This study used a mixed methods approach, combining both quantitative and qualitative methodologies for data collection.", "The study was conducted in Ribeirão Prêto, São Paulo, Brazil, and involved 20 older adults of both genders who were aged ≥60 years and enrolled in the Physical Education Program for the Elderly at the University of São Paulo.", "The research unfolded in multiple phases, encompassing the development and refinement of the app with active engagement from the participants.", "A total of 20 participants used a mobile health app with an average age of 64.8 (SD 2.7) years.", "Most participants had a high school education, middle-class status, and varying health literacy (mean score 73.55, SD 26.70).", "Overall, 90% (18/20) of the participants owned smartphones.", "However, 20% (4/20) of the participants faced installation challenges and 30% (6/20) struggled with web-based searches.", "The focus groups assessed app usability and satisfaction.", "Adjustments increased satisfaction scores significantly (Suitability Assessment of Materials: 34.89% to 70.65%; System Usability Scale: 71.23 to 87.14).", "Participant feedback emphasized font size, navigation, visual feedback, and personalization, and suggestions included health device integration, social interaction, and in-app communication support.", "This study contributes to the development of health care technologies tailored to the older adult population, considering their specific needs.", "It is anticipated that the resulting app will serve as a valuable tool for promoting healthy habits and enhancing the quality of life for older adults." ]

[ "Although corticosteroids and other treatments for idiopathic sudden sensorineural hearing loss (ISSNHL) have been described, understanding its prognosis without intervention provides valuable information for patient management.", "The objective of this study is to provide a comprehensive, quantitative statistical analysis of the natural history of untreated idiopathic sudden sensorineural hearing loss (ISSNHL).", "A systematic review and meta-analyses.", "Two independent searches of PubMed, Scopus, Web of Science, and Cochrane Library databases up to June 30, 2022, were performed.", "Adults with idiopathic sudden sensorineural hearing loss who received placebo or were untreated and had audiometric outcome measures in all study types were reviewed.", "These data indicative of the natural history of ISSNHL were analyzed, as were study characteristics related to risk of bias.", "Heterogeneity as assessed via I2 and random effects analyses were performed.", "Six studies meeting the inclusion criteria yielded 319 untreated patients whose natural history could be assessed.", "Heterogeneity among studies was moderate, with a variety of reported outcomes.", "A hearing improvement of at least 30 dB HL was observed in 36% (95% CI 0.28-0.44) of untreated patients, and of at least 10 dB HL was observed in 70% (95% CI 0.57-0.82) of untreated patients at 3 months.", "The mean hearing gain among untreated patients was 24.0 dB HL (95% CI 2.65-45.37) at 2-3 months.", "The observed natural history of ISSNHL suggests that patients can regain some hearing without active treatment.", "In the absence of future studies collecting prospective natural history data from untreated or placebo-treated ISSNHL patients, the data presented here provide the best available historical control data for reconsideration of results in past ISSNHL studies, as well as a roadmap for design and interpretation of future ISSNHL treatment clinical trials.", "Furthermore, knowing there is a statistically significant mean hearing gain of 24.0 dB HL in the untreated/placebo group provides an ethical basis for future placebo study of ISSNHL.", "The current status on ISSNHL management calls for a multi-institutional, randomized, double-blind placebo-controlled trial with validated outcome measures to provide science-based treatment guidance.", "Laryngoscope, 2024." ]

[ "Although COVID-19 vaccination has been widely considered as an important remedy to confront COVID-19, people remain hesitant to take it.", "The objective of this study was to assess the moderation effects of demographic characteristics on the relationship between forms of misinformation and COVID-19 vaccine uptake hesitancy among frontline workers in Dar es Salaam and Dodoma, Tanzania.", "Using a sample of 200 respondents, it assessed the differences in ratings on misinformation regarding COVID-19 vaccine based on respondents' demographics.", "The study used a Five-point Likert scale questionnaire distributed through snowball sampling to frontline workers from Dar es Salaam and Dodoma regions.", "Data was analyzed using binary logistic regression.", "It was found that the forms of misinformation revealed were manipulated imposters, satire, fabricated contents and false contents with their connection, which they influenced COVID-19 hesitancy significantly.", "With exception of age, that significantly moderated hesitancy, this study uncovers that, sex and education level moderated insignificantly in predicting those who are misinformed; misinformed individuals are not any less educated or not based on one's sex, different than individuals who are informed.", "The study informs policy makers on devising appropriate strategies to promote COVID-19 vaccination uptake among the different contextual demographic variables.", "Promotion of information, media and health literacy to the general public should be considered to deter spreading of vaccine-related misinformation." ]

[ "Although cycling has numerous health benefits, the increased breathing volume and lack of protection from exposure to the environment while cycling poses health risks that cannot be disregarded.", "Previous studies evaluating the exposure of cyclists to air pollution have typically focused on assessing exposure to a single pollutant or exposure concentrations on specific urban routes, and have not performed a comprehensive assessment considering the distribution of cyclists.", "The present study used bicycle-sharing big data to conduct a more comprehensive and refined real-time population weighted exposure risk assessment of pileless bike sharing riders in Beijing.", "We quantified the spatial distribution of high exposure areas at different times and found that the exposure risk during the evening peak period was significantly higher than that during the morning peak and early morning periods, particularly in the city center and its environs.", "By establishing stepwise regression models, we identified the significant impact of various urban points of interest (POIs) on exposure risk, with sports venues, public toilets, educational institutions, scenic spots, and financial entities particularly influential at different time periods.", "Medical institutions and shopping venues have a significant negative impact on the exposure levels of PM2.5 and NO2 among cyclists in most cases.", "These findings emphasize the need for targeted pollution control strategies.", "The aim of this study is to mitigate the impact of air pollution on cyclists and create a healthier cycling environment.", "The research results can provide new ideas for urban health planning and support scientific decision-making for sustainable urban development." ]

[ "Although digital health promises improved healthcare efficiency and equity, access and uptake might be low in disadvantaged populations.", "We measured access to digital health technology, the uptake of digital health, digital health literacy and COVID-19 vaccination intentions in an inner-city Australian population experiencing homelessness.", "An existing Australian survey, including a validated digital health literacy measure (eHealth Literacy Scale [eHEALS]), was modified and distributed in three general practices specifically targeting the homeless population.", "Data analysis used appropriate descriptive statistics and correlation coefficients.", "Eighty-three respondents completed the survey in 2021.", "Digital health uptake was much lower than in the general Australian population in 2019-20, despite good access to working smart phones and connectivity.", "Digital health literacy was positively associated with uptake.", "Internet-sourced information was trusted less than information from a general practitioner.", "Further work is needed to understand the perceived usefulness and sociocultural compatibility of digital health in different subpopulations experiencing homelessness, including susceptibility to misinformation." ]

[ "Although educational attainment is a major social determinant of health, according to Marginalization-related Diminished Returns (MDRs), the effect of education tends to be weaker for marginalized groups compared to the privileged groups.", "While we know more about marginalization due to race and ethnicity, limited information is available on MDRs of educational attainment among US immigrant individuals.", "This study compared immigrant and non-immigrant US adults aged 18 and over for the effects of educational attainment on subjective health (self-rated health; SRH).", "Data came from General Social Survey (GSS) that recruited a nationally representative sample of US adults from 1972 to 2022.", "Overall, GSS has enrolled 45,043 individuals who were either immigrant (4,247; 9.4%) and non-immigrant (40,796; 90.6%).", "The independent variable was educational attainment, the dependent variable was SRH (measured with a single item), confounders were age, gender, race, employment and marital status, and moderator was immigration (nativity) status.", "Higher educational attainment was associated with higher odds of good SRH (odds ratio OR = 2.08 for 12 years of education, OR = 2.81 for 13-15 years of education, OR = 4.38 for college graduation, and OR = 4.83 for graduate studies).", "However, we found significant statistical interaction between immigration status and college graduation on SRH, which was indicative of smaller association between college graduation and SRH for immigrant than non-immigrant US adults.", "In line with MDRs, the association between educational attainment and SRH was weaker for immigrant than non-immigrant.", "It is essential to implement two sets of policies to achieve health inequalities among immigrant populations: policies that increase educational attainment of immigrants and those that increase the health returns of educational attainment for immigrants." ]

[ "Although educational development of youths can profoundly affect their other domains of health and well-being across later life trajectories, little research has investigated the prolonged effects of family and individual contexts of youths in middle-school years, a most critical developmental and formative stage, on their educational achievement in middle-aged adulthood.", "The current study employed data of a nationwide representative sample of middle-school youth students in the Longitudinal Study of American Youth (LSAY) to examine how grade-7 parental support for college education, family SES, and educational expectations of youths contribute to their educational achievement in adulthood of mid-thirties through their development of grade-8 academic commitment and grade-9 educational performance in terms of English, mathematics, science, and social studies grade scores.", "Results based on structural equation modeling of longitudinal relationship found that grade-7 parental support for college education, family SES, and educational expectations of youths had significant and direct effects on youths' higher educational achievement in adulthood, and youths' grade-8 academic commitment and grade-9 educational performance significantly mediated the effects of grade-7 family SES, parental support for college education, and educational expectations of youths on their educational achievement in adulthood respectively and/or concurrently.", "Furthermore, interaction analysis supported the promotive but not buffering effects of grade-7 educational expectations of youths by family SES on their grade-9 educational performance and educational achievement in adulthood.", "Implications related to the important findings of the current study pertaining to educational development of youths are discussed." ]

[ "Although effective therapies exist, treatment rates of anxiety disorders (AD) are low, raising the question why affected individuals do not receive treatment.", "We provide data from the nationally representative German Health Interview and Examination Survey-2011 (DEGS1) on the help-seeking behavior and perceived treatment barriers of 650 subjects with Diagnostic and Statistical Manual of Mental Disorders' (DSM-IV AD).", "Only 26% of all cases with AD in the community reported having had contact with mental health services because of their anxiety problems in their lifetime.", "16% were currently receiving professional help, most frequently by psychotherapists (8%), psychiatrists (5%) and general practitioners (5%).", "40% of all cases never even considered seeking help and 31% reported barriers to treatment, such as self-reliance (18%) or beliefs that treatments were ineffective (9%), unavailable (8%) or too stigmatizing (7%).", "Measures to increase treatment rates should thus target individual as well as public attitudes and health literacy to increase awareness of and access to evidence-based interventions." ]

[ "Although emergency health-care services, particularly clinical and surgical care, are an important part of the provision of high quality health care in Ethiopia, infections related with surgical care are still the most well-known medical services-related diseases.", "This study aimed to assess the bacterial profiles and antimicrobial susceptibility pattern of isolates among patients diagnosed with surgical site infections at Mizan-Tepi university teaching hospital, southwest Ethiopia.", "A prospective observational cohort study was conducted from June to September 2021.", "Patient data were collected using a structured questionnaire.", "Follow-up of patients who had undergone a surgical procedure was conducted for at least 30 days.", "Wound swabs were collected from patients suspected to have surgical site infections (SSIs) and cultured onto appropriate culture media.", "The antimicrobial susceptibility testing was done using the disk diffusion technique.", "Data were analyzed using SPSS software version 25.0.", "Frequencies and cross-tabulation were used to summarize descriptive statistics.", "In this study, the postoperative SSIs rate was 12.6%.", "All patients with SSIs were culture positive, and a total of 41 bacterial isolates were detected.", "Of these, 73.2% were Gram-negative, 26.8% were Gram-positive and 24.2% were a mixture of two bacterial growths.", "Escherichia coli accounted for 29.3%, followed by Staphylococcus aureus (19.5%), Proteus species (14.6%) and Pseudomonas aeruginosa (12.2%).", "With the exceptions of amikacin and meropenem, which exhibited very high sensitivity, ranging from 33.3-100.0% isolates was resistant against all other tested antibiotics.", "The resistance rate to three or more classes of antibiotics was 100.0%.", "In this study, the most isolated bacteria causing SSIs were Gram-negative and multidrug-resistant strains.", "This event highlights that surveillance of the bacterial profile and antibiotic susceptibility pattern coupled with the implementation of the strict protocol for antibiotic use and operative room regulations is important to minimize the burden of SSIs." ]

[ "Although emphasis is placed on women's decision-making power regarding family planning use in Ethiopia, the utilization of contraceptives is low.", "There are studies conducted in different parts of the country on women's decision-making power regarding family planning use; however, there are inconsistent findings.", "Thus, this study aimed to determine the pooled prevalence of women's decision-making power regarding family planning use and associated factors in Ethiopia.", "The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to develop the systematic review and meta-analysis.", "All observational studies were retrieved from online databases, including PubMed, CINAHL, Google Scholar, African Journal Online and gray literature.", "The data search was performed from 1 December to 16 May 2022.", "The quality of the studies was critically assessed using the Joanna Briggs Institute checklist.", "Heterogeneity among studies was examined using the I2 statistic.", "RevMan version 5.3 and STATA version 14 software were used for analysis.", "A total of 852 studies were retrieved, and 8 studies were included in the final meta-analysis.", "The pooled prevalence of women's decision-making power regarding family planning use was 57 (95% confidence interval: 37, 77).", "Good knowledge of family planning methods (odds ratio: 2.46, 95% confidence interval: 1.65, 3.67), a positive attitude toward family planning methods (odds ratio: 2.04, 95% confidence interval: 1.3, 3.2), and having primary or higher education (odds ratio: 9.76, 95% confidence interval: 4.36, 21.99) were associated with increased odds of women's decision-making power regarding family planning use.", "Nearly three in five married women made decisions regarding family planning use in Ethiopia.", "Women with good knowledge of family planning methods, a positive attitude toward family planning methods, and women having primary or higher education were associated with increased odds of women's decision-making power regarding family planning use." ]

[ "Although ethics is an indispensable part of dental education, it has not yet played a relevant role in the dental curriculum in Germany.", "The study aimed at assessing their prior knowledge of ethical aspects, and their expectations of and wishes for ethics course of dental students, preclinical vs. clinical, at the dental school Kiel, Germany by means of a validated questionnaire.", "A descriptive cross-sectional study design was used.", "The study population consisted of dental students, from pre-clinical (n = 105) and clinical semesters (n = 110).", "In January 2019, each student completed a validated questionnaire to identify semester-specific ethical teaching content.", "Besides descriptive analyses, Mann-Whitney U test was used to compare pre-clinical and clinical students.", "A total of 215 dental students, with a mean age of 25.3 (SD 4.1), participated in the study, of which 150 were female (69.8%) and 65 were male students (30.2%).", "The results in the areas of 'previous knowledge of ethical issues' and 'expectations and desires in terms of teaching medical ethics' showed similarities and differences between pre-clinical and clinical students.", "Both groups stated that they need training in ethics.", "Moreover, especially clinical students recognize that more ethical competence is needed if the first patient contact will start.", "The study indicates that there is a clear need for ethics education.", "Student awareness of the relevance of ethical competences and the perception of ethical problems increased progressively during the course of their studies.", "Overall, the study provides good support for the development of specific ethics courses." ]

[ "Although extensive research exists about students' clinical learning, there is a lack of translation and integration of this knowledge into clinical educational practice.", "As a result, improvements may not be implemented and thus contribute to students' learning.", "The present study aimed to explore the nature of clinical faculty members' learning related to how they apply research about student autonomy.", "A course, \"Designing learning for students' development of autonomy in clinical practice\" was conducted for faculty responsible for students' clinical education.", "Within the frame of the course the participants designed a project and planned how they would implement it in their clinical context.", "Fourteen clinical faculty members participated in the study.", "The participants' interpretation of the educational intervention, which combines complex theory with the equally complex clinical practice, was explored by studying how the participants' approaches and understanding of the facilitation of autonomy were manifested in their projects.", "The projects in the form of reports and oral presentations were analyzed using qualitative content analysis together with an abductive approach.", "One identified domain was \"Characteristics of the design and content of the projects\".", "This domain was signified by two themes with different foci: Preparing the soil for facilitating student autonomy; and Cultivating opportunities for students to actively strive for autonomy.", "A second identified domain, \"Embracing the meaning of facilitating autonomy\" was connected to participants understanding of theories underlying how to support the development of autonomy.", "This domain contained two themes: Connection between activities and autonomy is self-evident and Certain factors can explain and facilitate development of autonomy.", "Education directed to strategic clinical faculty members to develop evidence-based approaches to student learning can be productive.", "To succeed there is a need to emphasize faculty members individual understanding of actual research as well as learning theories in general.", "Faculty trying to reinforce changes are dependent on their own mandate, the structure in the clinic, and recognition of their work in the clinical context.", "To achieve a potential continuity and sustainability of implemented changes the implementation processes must be anchored throughout the actual organization." ]

[ "Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting.", "To address this need, we developed a serious computer game called the IEMTtraining game.", "In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options.", "The design of this study is a retrospective comparative analysis.", "The research was conducted with 209 nurses in a hospital.", "The data collection process of this study was conducted at the 2019-2020 academic year.", "A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT.", "Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed.", "There was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010).", "The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group.", "The IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs.", "The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies.", "It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load." ]

[ "Although golf is a low-impact sport without physical contact, its movements are carried out over a large range of motion, and their repetition can predispose athletes to the development of injuries.", "This study aimed to investigate the epidemiology of musculoskeletal injuries in golf athletes who participated in championships in southern Portugal, determining the types, locations and mechanisms of injury and their associated risk factors.", "The sample consisted of 140 athletes aged between 18 and 72 years, 133 (95%) being male.", "The measuring instrument was a questionnaire about sociodemographics, modality and injuries' characteristics.", "Throughout golf practice, 70 (50%) athletes reported injuries, totaling 133 injuries.", "In the 12-month period, 43 (30.7%) athletes suffered injuries, totaling 65 injuries.", "The injury proportion was of 0.31, and the injury rate was of 0.33 injuries per 1000 h of golf training.", "The most common injury type was muscle sprain or rupture (19; 30.9%), located in the lumbar spine (17; 27%), in which the repetitive movements were the main injury mechanism (42; 66.7%).", "The athletes who trained 4 times or more per week were 3.5 more likely (CI: 0.97-12.36; p = 0.056) to develop an injury while playing golf.", "Moderate injury presence was observed, with the high training frequency being an associated risk factor." ]

[ "Although hepatitis B is vaccine-preventable, it remains a significant health problem.", "To the best of our knowledge, this is the first hepatitis B outbreak report from Türkiye.", "To investigate the cause of hepatitis B outbreak in a nursing home for the disabled and make recommendations for prevention.", "An outbreak of acute hepatitis B was declared in a nursing home for the disabled following the admission of 3 patients from the home in a hospital.", "Collaborative response was initiated with the Provincial Health Directorate through the Public Health Infectious Diseases Department.", "We began tracking the infection and monitoring active cases.", "Audits and controls were carried out to determine the source, establish protection and control measures, and prevent further transmission.", "Six of the 65 nursing home residents were diagnosed with acute hepatitis B.", "Four of them had diabetes and their blood glucose levels were monitored for at least 12 months.", "Two of the patients had received dental treatment in the last 6 months.", "The frequency of both variables, which may be an indication of the transmission route, was statistically significantly greater in the acute hepatitis B group.", "All the patients who could be sequenced were identified as genotype D. While 3 patients recovered fully, 2 were diagnosed with chronic hepatitis B and one died due to fulminant hepatitis.", "Standard routine immunization should be implemented as a preventive measure for acute hepatitis B.", "Frequent supervision and training on hygiene practices and safety precautions should be conducted for care staff working in collective residential facilities." ]

[ "Although Hispanic population is growing rapidly, Latino students earn fewer STEM degrees than their peers.", "Therefore, it is mandatory to implement strategies that improve STEM retention and graduation rates for Hispanic students.", "There is little research about the ways in which multicampus collaborative CUREs combined with additional academic support, affect low-income, Hispanic students and none that focus solely on Puerto Rican students in STEM.", "Puerto Rico (PR) has a 99% Hispanic population; thus, it is imperative to include PR in education research literature.", "This study sought to examine the impacts of the Research for Improved Student Experiences (RISE) in STEM program at two campuses of the Inter American University of Puerto Rico.", "The program included multicampus collaborative CUREs, academic advising, and peer mentoring using quasi-experimental design.", "Impact assessment included psychosocial metrics such as self-efficacy, science identity and sense of belonging in a pre/posttest design.", "These findings were triangulated with the differences between treatment and control for retention, pass rate, and course grades.", "The findings revealed statistically significant improvements on all metrics.", "This study's findings support multicampus collaborative CUREs, academic advising, and peer mentoring as useful and effective strategies for improving outcomes for low-income Hispanic students in Puerto Rico." ]

[ "Although HIV testing is helpful for early detection and treatment of HIV, its utilization rate is low among college students in China.", "Understanding the acceptance and associated factors of HIV testing is the key to improve the detection rate.", "The purpose of the systematic review was to examine the acceptance and associated factors of HIV testing (including HIV self-testing and HIV counseling and testing services) among college students in China.", "This systematic review was reported following PRISMA guidelines 2020.", "Electronic sources such as PubMed, Embase, Web of Science, CNKI, CBM, Wanfang Database and VIP Database were searched for relevant studies published before September 2022.", "The tool by Agency for Healthcare Research and Quality (AHRQ) was used to assess quality for cross-sectional studies.", "The random-effects and fixed-effect model were employed to estimate the pooled proportions and associated factor of HIV testing acceptance.", "The Cochrane's Q statistic and I2 test were used to examine heterogeneity.", "All the quantitative meta analyses were conducted using STATA version 12 software.", "A total of 21 eligible studies with 100, 821 participants were included in the systematic review.", "The pooled acceptance rate of HIV testing was 68% (95% CI = 60, 76), and varies between regions in China.", "Male, heterosexual and urban college students had higher HIV testing acceptance.", "Gender, medical specialty, sexual education, sexual behavior, HIV/AIDS knowledge, perception HIV risk, and previous HIV testing were the factors associated with HIV testing acceptance.", "The review revealed that most of the college students intend to accept HIV detection, and the proportion of acceptance influenced by different factors.", "Therefore, the government and universities should implement targeted measures, improve HIV testing services, and promote HIV testing behavior.", "PROSPERO CRD42022367976." ]

[ "Although identified as a key competency domain and a needed area of professional development, interpersonal communication in breast cancer care patient navigation is understudied.", "Moreover, the patient-navigator relationship may be influenced by the interpersonal communication skills and behaviors of the patient navigator.", "This paper reports on the interpretation step of a concept mapping study, where key stakeholders shared their perspectives on six identified interpersonal communication components of breast cancer care patient navigation.", "This study utilized concept mapping, a community-engaged mixed method approach.", "After conducting brainstorming, sorting, and concept mapping analysis, a six-cluster concept map of interpersonal communication in breast cancer care patient navigation was identified.", "Interpretation sessions with each participant group (patients, patient navigators, administrators) allowed both naming and more in-depth exploration of the six clusters.", "The sessions were led by a facilitator, the PI, and were audio recorded and transcribed.", "Six 2-h interpretation sessions were conducted with 21 participants, including patients with breast cancer, breast cancer patient navigators (lay or medically trained), and patient navigation administrators from Western Pennsylvania.", "Through a group consensus process, the six clusters were named.", "Participants identified that all six identified components were essential to patient navigation, but the ability to build patient-centered trust and relationships and maintain professional communication were the most impactful components of the patient-navigator relationship.", "These findings validate the importance of interpersonal skills and behaviors of patient navigators in breast cancer care.", "These findings can inform the patient navigation role description, competencies, and the development of curriculum for training and metrics for evaluation." ]

[ "Although implementation of patient navigation programs in clinical practice is widespread, heterogeneity exists in the design and delivery of these services.", "Greater clarity is required on competencies of personnel, delineation of their roles in multidisciplinary cancer care teams, navigation service components that positively impact patient outcomes, and associated metrics.", "A national, double-blind, online survey was implemented between January 24, 2019, and April 25, 2019, to investigate care coordination for advanced (stage III/IV) non-small cell lung cancer (NSCLC).", "Respondents included multidisciplinary team (MDT) members, such as oncologists, pathologists, oncology nurses, advanced practice nurses, and patient navigators, from US cancer programs.", "Customized questions covered NSCLC screening, diagnosis, treatment, and care coordination, with a focus on oncology nurses, advanced practice nurses, and patient navigation.", "Descriptive statistics were computed.", "Subanalyses examined relationships between care delivery and outcomes such as shared decision-making (SDM) through statistical testing.", "Across programs, there was a lack of patient (nurse or lay) navigators (22.3%, 101/452) to assist patients with NSCLC.", "Most respondents (90.1%, 100/111) worked in programs with no formal health literacy assessments.", "Significantly higher mean SDM scores (p < .05) were observed in programs with patient navigators compared with programs without these specialists.", "Patient navigation is pivotal to enhancing the patient experience along the lung cancer care continuum and should be strategically integrated within lung cancer MDTs.", "These findings, along with survey inputs from other MDT disciplines, can help support process improvement plans for patient-centered advanced NSCLC care delivery." ]

[ "Although intercultural competence is a crucial factor for university students' academic achievement and inter-ethnic conflict resolution, psychometrically sound intercultural competence scale is not available in the Ethiopian context.", "The aim of the present study was to translate the original English version of intercultural competence into Amharic language and validate the scale in the Ethiopian context.", "In the processes of retaining culturally equivalent translated measure symmetrical approach was used.", "Data were collected from 476 (Male = 244 and Female = 232) arbitrarily selected university students with an age mean of 22.35 enrolled in undergraduate degree programs at Ambo University.", "The total sample was randomly split into two equal-sized group to execute exploratory factor analysis (EFA, N = 238) and confirmatory factor analysis (CFA, N = 238).", "The result of the study showed that both EFA and CFA supported a significantly correlated four-factor model of intercultural competence (Attitude, Awareness, Knowledge, and Skills).", "Moreover, the Amharic version of the intercultural competence scale showed good psychometric properties in terms of content validity, construct validity, internal consistency, and good fit indices to the data.", "This generally justifies the use of the Amharic version intercultural competence scale in the Ethiopian context.", "To satisfy the needs of the labor market, universities in Ethiopia should promote intercultural dialogues that improve the intercultural competence of university students." ]

[ "Although many challenges of the 21st century need solutions which are directly connected with the development of new technologies, the preferences of prospective students in Germany are often far from mathematics, physics and chemistry.", "Moreover, the acceptance and recognition of new achievements in these disciplines are quite low in society, even if these achievements are the basis for the development of new technologies that positively affect daily life.", "As a part of a campaign intended to increase the number of students in the fields of materials science and materials technology (and related fields), the authors created an escape room focused on materials science and crystallography, which illustrates the approaches used by materials scientists and the beauty of crystallography.", "The fundamental features of the escape room, which are presented in this contribution, are its variability and the ability to inspire participants who have different backgrounds in physics, chemistry and/or materials science.", "By varying the level of difficulty and the game play duration, the escape room structure makes it possible to appeal to a broad audience, offer an authentic escape room experience and impart lasting knowledge through reflection after completion.", "The authors' experiences with the escape room and the feedback from the attendees are summarized at the end of the contribution." ]

[ "Although many studies have been carried out to address burn patients' pain and suffering, pain relief still remains an immense unsolved challenge with individual, social, and cultural aspects.", "This study was conducted aiming to investigate and explain nursing care in burn patients.", "This was a semifocused ethnographic research conducted in burns units in a referral teaching hospital (Mazandaran, Iran).", "The data were collected through descriptive, focused, and selective participant observations and ethnographic interviews with burns unit nurses selected via a purposeful sampling method.", "The collected data were analyzed on the basis of James Spradley's approach.", "Three main categories and nine subcategories were obtained from data analysis that are as follows: 1) Bending over backward (tenacity, altruism, dedication, and conscience and constancy), 2) Prevention is worth a pound of cure (unique clinical methods, enhanced frustration tolerance through self-motivation and self-efficacy, raise patient's hope in despair), and 3) undisputed dominance of nursing art (reduced unsettling experiences, burnt and ripped body rehabilitation, patient stress management, and avoidance of false hope).", "Although burn nurses are under huge physical and mental pressure, they enhance patients' pain tolerance through their art of nursing, which is a collection of empirical knowledge, huge work conscience, unique clinical skills, and various therapeutic communication techniques." ]

[ "Although many studies on early childhood have been conducted, there is still a need for further research on numeracy and vocabulary skills, particularly in Indonesia.", "This research aims to confirm the correlation between numeracy and vocabulary skills in preschool children and to disentangle the effects of environmental factors on both numeracy and vocabulary skills.", "This research was conducted at Early Childhood Education and Care (ECEC) in the Jatinangor district and followed the principle of simple random sampling.", "Children were given numeracy and vocabulary tests, parents were asked to fill out a questionnaire about sociodemographic aspects and the learning environment in their homes, and teachers were asked to fill out a questionnaire about preschool activities concerning numeracy and vocabulary.", "Data were analyzed using a structural equation model with numeracy and vocabulary as outcome variables.", "Covariates such as age, gender and social status were also included in the model.", "The results of this study show that numeracy is closely linked to vocabulary skills and that only a specific preschool activity can explain the variance of numeracy.", "On the other hand, both home numeracy activities and a specific preschool literacy activity are significant predictors of vocabulary skills." ]

[ "Although many surveys have been conducted on patients accessing their own health records in recent years, there is a limited amount of nationwide cross-country data available on patients' views and preferences.", "To address this gap, an international survey of patient users was conducted in the Nordic eHealth project, NORDeHEALTH.", "We aimed to investigate the sociodemographic characteristics and experiences of patients who accessed their electronic health records (EHRs) through national patient portals in Norway, Sweden, Finland, and Estonia.", "A cross-sectional web-based survey was distributed using the national online health portals.", "The target participants were patients who accessed the national patient portals at the start of 2022 and who were aged ≥15 years.", "The survey included a mixture of close-ended and free-text questions about participant sociodemographics, usability experience, experiences with health care and the EHR, reasons for reading health records online, experience with errors, omissions and offense, opinions about security and privacy, and the usefulness of portal functions.", "In this paper, we summarized the data on participant demographics, past experience with health care, and the patient portal through descriptive statistics.", "In total, 29,334 users completed the survey, of which 9503 (32.40%) were from Norway, 13,008 (44.35%) from Sweden, 4713 (16.07%) from Finland, and 2104 (7.17%) from Estonia.", "National samples were comparable according to reported gender, with about two-thirds identifying as women (19,904/29,302, 67.93%).", "Age distributions were similar across the countries, but Finland had older users while Estonia had younger users.", "The highest attained education and presence of health care education varied among the national samples.", "In all 4 countries, patients most commonly rated their health as \"fair\" (11,279/29,302, 38.48%).", "In Estonia, participants were more often inclined to rate their health positively, whereas Norway and Sweden had the highest proportion of negative health ratings.", "Across the whole sample, most patients received some care in the last 2 years (25,318/29,254, 86.55%).", "Mental health care was more common (6214/29,254, 21.24%) than oncological care (3664/29,254, 12.52%).", "Overall, most patients had accessed their health record \"2 to 9 times\" (11,546/29,306, 39.4%), with the most frequent users residing in Sweden, where about one-third of patients accessed it \"more than 20 times\" (4571/13,008, 35.14%).", "This is the first large-scale international survey to compare patient users' sociodemographics and experiences with accessing their EHRs.", "Although the countries are in close geographic proximity and demonstrate similar advancements in giving their residents online records access, patient users in this survey differed.", "We will continue to investigate patients' experiences and opinions about national patient-accessible EHRs through focused analyses of the national and combined data sets from the NORDeHEALTH 2022 Patient Survey." ]

[ "Although maternal hemoglobin levels during pregnancy are commonly associated with perinatal outcomes, their link to childhood neurodevelopment remains uncertain.", "This study aimed to examine the associations between maternal hemoglobin in early and late pregnancy and the educational attainment of offspring mid-childhood in a high-resource obstetric setting.", "Pregnancy data from a prospective birth cohort (Pregnancy Outcome Prediction Study, Cambridge, United Kingdom, 2008-2012, N=3285) were linked to mid-childhood educational outcomes (Department for Education, United Kingdom).", "Regression models adjusted for maternal, child, and socioeconomic factors were used to determine associations between maternal hemoglobin, pregnancy complications, and offspring educational outcomes (aged 5-7 years).", "No association was observed between maternal hemoglobin at 12 weeks and the likelihood of either adverse pregnancy outcomes or children meeting expected educational standards between ages 5-7 years.", "Higher maternal hemoglobin at 28 weeks was associated with an increased risk of small-for-gestational-age infants (adjusted odds ratio, 1.26 [95% confidence interval, 1.11-1.59]; P=.002) and preterm birth (adjusted odds ratio, 1.38 [95% confidence interval, 1.11-1.81]; P=.005).", "There were no adverse birth outcomes associated with anemia.", "However, children of mothers who were anemic at 28 weeks had ∼40% increased risk of not attaining expected educational standards at age 5 (adjusted odds ratio, 1.42 [95% confidence interval, 1.03-1.95]; P=.03).", "There was no association between maternal anemia at 28 weeks and educational performance at ages 6-7.", "No associations were found between high maternal hemoglobin concentrations (top decile) or change in hemoglobin concentrations between 12 and 28 weeks and childhood educational attainment.", "Maternal anemia at 28 weeks of pregnancy is associated with reduced educational attainment at 5 years old but not at older ages (6-7 years old).", "A proactive approach to increasing maternal hemoglobin in high-resource settings is unlikely to impact long-term childhood educational attainment." ]

[ "Although medical professionals possess a positive attitude toward SDM, they lack of a complete understanding of conceptual shared decision making (SDM).", "Therefore, a related knowledge base must be constructed to enhance service education.", "We aimed to examine the effectiveness of an educational program with situational simulation video on nurses' SDM attitude.", "A randomized controlled trial with single-blind study design was conducted, and permuted block randomization was employed.", "Participants were randomly assigned to an experimental group (n = 50) or control group (n = 50).", "Only the experimental group received education programs within 2 weeks, with the first covering the basic concept of SDM and the second comprising situation simulation teaching.", "In both groups, data were collected prior to intervention as baseline, immediately after intervention to evaluate its immediate effects, and 2 months after intervention to test the delay effect.", "A generalized estimating equation, subgroup analysis and descriptive statistics were used to analyse data.", "A significant main effect over time was discovered.", "Nevertheless, no significant group-time interaction was noted between the two groups after a 2-month interval.", "Subgroup analysis reveals that the SDM attitude scores in both the experimental and control groups increase for within group.", "The improvement of SDM attitude score in the experiment group was better than control group at follow test.", "The findings of this study might provide a reference for health care providers when designing service education courses to improve the execution strategies of SDM and thus the quality of care provided." ]

[ "Although medical schools across the United States have updated their curricula to incorporate active learning techniques, there has been little discussion on the nature of the content presented to students.", "Here, we share detailed examples of our experience in using original experiments to lay the groundwork for foundational concepts in renal physiology and pathophysiology.", "We believe that this approach offers distinct advantages over standard case-based teaching by (1) starting with simple concepts, (2) analyzing memorable visuals, (3) increasing graphical literacy, (4) translating observations to \"rules,\" (5) encouraging critical thinking, and (6) providing historical perspective to the study of medicine.", "Although we developed this content for medical students, we have found that many of these lessons are also appropriate as foundational concepts for residents and fellows and serve as an excellent springboard for increasingly complex discussions of clinical applications of physiology.", "The use of original experiments for teaching and learning in renal physiology harnesses skills in critical thinking and provides a solid foundation that will help learners with subsequent case-based learning in the preclerkship curriculum and in the clinical arena." ]

[ "Although MitraClip has been studied in numerous trials, its evidence in the long term is based on a few original studies.", "We used an original technique of evidence synthesis to review long-term comparative trials evaluating MitraClip.", "We searched the PubMed database to select long-term comparative trials of MitraClip.", "The endpoint was all-cause mortality (minimum follow-up, one year).", "Included trials were analyzed using the IPDfromKM (reconstruct Individual Patient Data from published Kaplan-Meier survival curves) method to reconstruct individual patient data from Kaplan-Meier curves.", "Standard survival statistics were used to interpret these long-term efficacy data.", "The survival benefit per patient was estimated from the restricted mean survival time (RMST).", "Six comparative studies of MitraClip were included; 973 patients were treated with MitraClip (six arms), 717 with medical therapy (five arms), and 80 with surgical repair or replacement (one arm).", "In our main analysis, the outcomes observed in patients treated with MitraClip were significantly better than those of medical therapy (hazard ratio for all-cause mortality, 0.5276; 95% confidence interval, 0.4412 to 0.6309; p < 0.001); the number of patients treated with surgery was too small to make reliable comparisons.", "Median survival was 30.4 months for medical therapy versus not reached for the other two groups.", "RMST was 43.931 and 33.756 months for MitraClip and controls, respectively, yielding a gain per patient of 10.17 months (95% confidence interval, 7.47 to 12.88).", "In our simplified cost-effectiveness evaluation, a gain of approximately 10 months per patient compared favorably with the device cost.", "Our analysis provided an original interpretation of the long-term evidence available on MitraClip." ]

[ "Although multiple specialties perform neonatal circumcision (NC), overall NC proceduralist availability is limited.", "The approach to training new practitioners varies.", "This study aims to describe NC training experiences, current practices, and make suggestions for future improvements.", "Perinatal physicians across 11 hospitals in a large Midwestern United States city who perform NC or who conduct newborn examinations and provide circumcision counseling were recruited for semistructured interviews about NC care.", "Interviews were transcribed; training-related comments underwent inductive and deductive qualitative coding.", "Themes related to circumcision training and recommendations for improving the experience of future circumcision learners were summarized.", "Twenty-three physicians (10 family medicine, 8 pediatrics, and 5 obstetrics; 78% currently perform circumcision) participated.", "All participants conducted newborn examinations and provided circumcision counseling, but only 21/23 were trained to perform circumcision.", "Several themes related to training emerged: (1) personal training experience, (2) training others to perform circumcision, and (3) current training needs and barriers.", "Most reported learning in residency by a \"see one, do one, teach one\" approach with minimal formal didactic or structured training.", "Compared with their personal experience, participants noted a shift toward more direct supervision and preprocedure preparation for current trainees.", "However, most reported that circumcision learning continues to be \"hands-on.\"", "Participants desired a more structured approach for future trainees.", "Perinatal physicians noted a shift in the current NC training to a more hands-on approach than they experienced personally.", "Development of a structured NC curriculum was recommended to improve training." ]

[ "Although neuromyelitis optica spectrum disorder (NMOSD) has high recurrence and disability rates, cases of relapses can be recognized, and timely intervention can be provided if the risk of relapse is properly perceived.", "However, there have been no studies to explore patients' perceptions of recurrence risk and coping strategies.", "This study aimed to explore the characteristics of relapse risk perception and coping strategies of patients with NMOSD.", "We adopted the phenomenological method of qualitative research.", "Face-to-face, semi-structured in-depth interviews were conducted with 15 patients with NMOSD.", "The interview data were then analyzed using the Colaizzi seven-step analysis.", "The analysis revealed five major themes.", "The first theme was the 'perception of possibility of relapse', which included subjectively underestimating the likelihood of relapse and shifted from underestimation to overestimation; the second theme was 'relapse warning signs perception'; the third theme was 'perception of relapse triggers', which included understanding relapse triggers, potential misconceptions about relapse triggers, and no identifiable cause of recurrence; the fourth theme was 'perception of the relapse consequences', encompassing severe impairment of body structure and function, prominent psychological problems, limited family roles and social functions, and heavy financial burden; and the final theme was 'relapse risk coping strategies', which included actively yearning for and seeking information support, recurrence risk prevention/management, limitations of coping strategies.", "This study's findings revealed that newly diagnosed patients as well as those who relapsed subjectively underestimated the likelihood of relapse before they had experienced multiple (two or more) relapses.", "In contrast, patients who had experienced multiple relapses had transitioned from initial underestimation to subsequent overestimation.", "Additionally, patients' compliance with medication was identified as a relapse-risk behaviors that was very manageable.", "The occurrence of relapse is associated with significant and extensive adverse effects on patients.", "Consequently, patients are eager to communicate with their healthcare providers regarding treatment planning and relapse management." ]

[ "Although nutritional support is beneficial to the visual rehabilitation of patients with age-related macular degeneration (AMD), a large gap continues to exist between the relevant guidelines and the actual practices of AMD patients; this gap can be attributed to a lack of nutritional literacy.", "Therefore, this study explored the factors affecting nutritional literacy among AMD patients.", "A qualitative study was carried out based on individual in-person interviews with 15 AMD patients; a semistructured interview guide was used for data collection.", "The socioecological model (SEM) was employed for data analysis.", "The Southwest Hospital in Chongqing Province, China.", "A purposive sample of 15 AMD patients was recruited between May and June 2023.", "The social ecosystem of patients with AMD has not been positive.", "At the intrapersonal level, the factors affecting the nutritional literacy of such patients are lack of knowledge, nutrition self-efficacy, economic burdens, dietary preferences and health status.", "At the interpersonal level, the factors that can influence patients' nutritional literacy are social support and social roles.", "At the institutional level, the relevant factors are doctor-patient trust and interdisciplinary-team consistency.", "Finally, at the policy level, a powerful factor is the large gap between policy and implementation.", "Nutritional literacy focuses on the changes in an individual's knowledge and behaviour concerning nutrition.", "To inform the development of nutritional-literacy interventions for people with AMD, medical staff should consider multiple perspectives that can remove the barriers to the SEM at all levels." ]

[ "Although observational studies have found both a positive and negative association between depression and hypercholesterolemia, the findings are mixed and contradictory.", "To our knowledge, this is the first study that employs the bidirectional Mendelian randomization (MR) and multivariable MR analysis with extensive genome-wide association studies (GWAS) data to examine the causal effect between depression and hypercholesterolemia.", "Using summary statistics obtained from GWAS of individuals with European ancestry, we utilize a bidirectional 2-sample MR approach to explore the potential causal association between hypercholesterolemia and depressive symptoms.", "Multivariable Mendelian randomization analysis was used to examine whether the direct causal effect of depression on the risk of hypercholesterolemia can be affected by traits associated with the increased risk of hypercholesterolemia.", "This MR analysis utilized inverse variance weighted (IVW), MR-Egger regression, weighted mode, and weighted median methods.", "Data on the summary level of depression were acquired from a GWAS that involved 500,199 participants.", "We used summary GWAS datasets for hypercholesterolemia including 206,067 participants.", "We also used another GWAS databases of hypercholesterolemiat (n = 463,010) to validate our results.", "By utilizing IVW, it was discovered that there is a possibility of a 31% rise in the risk of hypercholesterolemia due to depression (OR = 1.31, 95% CI = 1.10-1.57, P = .002).", "We found a consistent causal effect of depression on hypercholesterolemia from the IVW analyses using different hypercholesterolemia datasets.", "After adjustment of smoking, physical activity, and obesity, there remains significant causal relationship between depression and hypercholesterolemia (OR = 1.25, 95% CI = 1.01-1.54, P = .040).", "However, we did not find any evidence indicating that hypercholesterolemia leads to depression in the opposite direction.", "Directional pleiotropy was not observed in the MR-Egger regression analysis.", "Additionally, the MR-PRESSO analysis validated these discoveries.", "Neither the leave-one-out sensitivity test nor the funnel plots revealed any outliers.", "In both the unadjusted and adjusted estimates, depression has a consistent direct causal effect on hypercholesterolemia.", "Our study has led to an improved comprehension of the causal connections between hypercholesterolemia and depression, which could aid in the prevention and treatment of hypercholesterolemia." ]

[ "Although oncology clinical practice guidelines recognize the need and benefits of exercise, the implementation of these services into cancer care delivery remains limited.", "We developed and evaluated the impact of a clinically integrated 8-week exercise and education program (CaRE@ELLICSR).", "We conducted a mixed methods, prospective cohort study to examine the effects of the program.", "Each week, participants attended a 1-h exercise class, followed by a 1.5-h education session.", "Questionnaires, 6-min walk tests (6MWT), and grip strength were completed at baseline (T0), 8 weeks (T1), and 20 weeks (T2).", "Semi-structured interviews were conducted with a sub-sample of participants about their experience with the program.", "Between September 2017 and February 2020, 277 patients enrolled in the program and 210 consented to participate in the research study.", "The mean age of participants was 55 years.", "Participants were mostly female (78%), white/Caucasian (55%) and half had breast cancer (50%).", "Participants experienced statistical and clinically meaninful improvements from T0 to T1 in disability, 6MWT, grip strength, physical activity, and several cancer-related symptoms.", "These outcomes were maintained 3 months after program completion (T2).", "Qualitative interviews supported these findings and three themes emerged from the interviews: (1) empowerment and control, (2) supervision and internal program support, and (3) external program support.", "This study demonstrates the impact of overcoming common organizational barriers to deliver exercise and rehabilitation as part of routine care.", "CaRE@ELLICSR demonstrated clinically meaningful improvements in patient-reported and functional outcomes and was considered beneficial and important by participants for their recovery and wellbeing." ]

[ "Although oxidative stress is a recognized factor of inflammation, the correlation between oxidative balance score (OBS), a biomarker indicating the balance of oxidation and antioxidant, and rheumatoid arthritis (RA), an immune system disease that tends to occur in women, remains unexplored.", "Hence, the aim of this study was to investigate the potential association between OBS and RA in women.", "Observational surveys were performed by employing information extracted from the National Health and Nutrition Examination Survey (NHANES) for the period 2007-2018.", "Various statistical techniques were employed to investigate the association between OBS and RA, encompassing multivariable logistic regression analysis, subgroup analyses, smooth curve fitting, and threshold effect analysis.", "The study included 8219 female participants, including 597 patients with RA.", "The results showed that higher Total OBS (TOBS) significantly correlated with lower RA prevalence in the entirely modified model [odd ratio (OR) = 0.968; 95% confidence interval (CI) = 0.952 to 0.984; P = 0.0001].", "Dietary OBS (DOBS) and lifestyle OBS (LOBS) also negatively correlated with RA.", "This association was remarkably consistent across TOBS subgroups by age, race, education level, family poverty-to-income ratio (PIR), hypertension and diabetes.", "Smooth curve fitting and threshold effect analysis also revealed the linear relationship between OBS and RA.", "Overall, OBS was negatively associated with RA in female.", "This study suggested that an antioxidant diet and lifestyle may be promising measures to prevent RA in female." ]

[ "Although patient safety culture is gaining attention globally, more studies are needed to investigate its relevance to the nursing care of mental health (MH) patients.", "This study aimed to illustrate the perceptions and experiences of nurses who work in inpatient mental health care (IMHC) concerning the patient safety practices that are employed to avert safety hazards encountered during the provision of care in IMHC settings.", "Eighteen postgraduate students working as MH nurses in nonprofit hospitals comprised the study sample.", "The participants had a minimum of 2 years' nursing experience in IMHC settings.", "Each participant was interviewed individually using a guided interview technique.", "The inductive data underwent thematic analysis.", "Patient protection and a safety perspective were the overarching themes that emerged from the data.", "Three principal themes and 9 subthemes were illuminated: (a) patient care safety knowledge and background, (b) improving MH care, and (c) development of MH nursing care.", "The findings of this investigation may assist in providing guidance for the further research into and development of a patient safety culture appropriate for IMHC nursing practice, including increased structured educational experiences, judicious risk assessment, assignment of staff to include a mixture of skills and experience levels during assignments, use of standardized handoff procedures, engagement with multidisciplinary care providers, blame-free reflective information sharing and mentoring, and attention to the built environment with consideration of patient and staff safety needs." ]

[ "Although PBL is widely used in several countries, especially in medicine courses, its application in teaching other higher education courses, which involve fundamentals applied to radiology, is still little explored.", "Therefore, we aim to evaluate the implementation of Problem-Based Learning (PBL) in a higher education institution's radiology and biomedicine technologist course, focusing on specific radiology-related disciplines.", "An interventional study was developed with 78 students.", "An active methodology model was created and implemented for one of the groups of participants.", "At the beginning of each semester, students of both groups were evaluated with pre-tests.", "At the end of the semesters, the students performed a post-test and a validated evaluation of the discipline methodology.", "Repeated measures generalized linear regressive models with robust error estimators were used to evaluate test outcomes.", "A significant interaction among the methodologies was found (p=0.020), with better results from students exposed to the active methodology (initial and final grades were 7.18 and 7.57 in the active methodology, respectively, and 7.45 and 6.89 in the traditional methodology, respectively).", "In addition, students' evaluation regarding the quality of the methodology was favorable to the active methodology with statistical significance (p<0.05) in 16 of the 22 items evaluated.", "The students' positive response and performance were attributed to the interaction and innovation of the methodology compared to conventional methods, highlighting the effectiveness of PBL in higher education in radiology and its potential for more participatory and contextualized learning." ]

[ "Although pediatric obstructive sleep apnea (OSA) is estimated to affect 2-3% of the general population, its prevalence in sickle cell disease (SCD) is much higher, with research suggesting a prevalence rate of upwards of 40%.", "Despite the similar underlying pathophysiological mechanisms of neurocognitive effects in pediatric OSA and SCD, there is a scarcity of information on how these two conditions interact.", "The aim of this study was to better understand the contribution of sleep apnea to neurocognitive deficits in children diagnosed with SCD.", "This study assessed cognitive function in 26 children with comorbid SCD and OSA, 39 matched comparisons with SCD only, and 59 matched comparisons in children without a chronic health condition.", "There were significant differences on measures of processing speed and reading decoding, with children without a chronic health condition scoring better than both chronic health condition groups.", "Additionally, the no chronic health condition group performed better on a test of quantitative knowledge and reasoning and a test of visual-spatial construction than the SCD-only group.", "Contrary to our hypotheses, there were no between-group differences suggesting an additive impact of OSA on cognition.", "Exploratory analyses revealed associations within the group that had OSA showing that more severe OSA correlated with lower performance on measures of processing speed and quantitative knowledge/reasoning.", "Children with comorbid OSA and SCD do not present with greater deficits in cognitive functioning than children with SCD alone.", "However, severe OSA may confer additional risk for neurocognitive impairments." ]

[ "Although physical education teachers generally act as the physical activity champion and promote adherence to whole-school physical activity programs, classroom teachers manage the majority of students' access to movement throughout the school day.", "Purpose: To support the adoption of a whole-school physical activity program, this study developed an instrument that identifies barriers perceived by classroom teachers related to adopting this type of program in their school.", "Method: A four-step process provided the conceptual framework for this instrument development (literature review, expert review, quantitative evaluation, and validation).", "The final validation phase (N = 520 teachers) included two individual analyses to separately evaluate respondents from elementary (K-5) and secondary levels (6-12).", "Each group was randomly split to run exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the models.", "Results: CFA results support models with adequate fit to the data for barriers for elementary, e.g., (SRMR = 0.0726; Bentler CFI = 0.92.79) and secondary (SRMR = 0.0813; Bentler CFI = 0.9374) teachers for whole-school programming.", "Conclusion: This instrument can be used by school personnel and researchers to understand perceived barriers for classroom teachers to implement a whole-school physical activity program in their context and then follow up to remove or reduce the barriers." ]

[ "Although physician-pharmacist collaborative clinics for diabetes management have been shown to be effective and cost-effective worldwide, there is limited understanding of the factors that influence their sustainable implementation.", "This study aims to identify the associated factors and provide sustainability strategy to better implement physician-pharmacist collaborative clinics for diabetes management in primary healthcare centers in China.", "A sample of 43 participants were participated in face-to-face, in-depth, semi-structured interviews.", "Consolidated Framework for Implementation Research was used to identify facilitators and barriers to implementing physician-pharmacist collaborative clinics for diabetes management in primary healthcare centers, and to explore discriminating factors between low and high implementation units.", "A sustainable strategy repository based on dynamic sustainability framework was established to inform further implementation.", "This study demonstrated that clear recognition of intervention benefits, urgent needs of patients, adaptive and tailored plan, highly collaborative teamwork and leadership support were the major facilitators, while the major barriers included process complexity, large number and poor health literacy of patients in primary areas, inappropriate staffing arrangements, weak financial incentives and inadequate staff competencies.", "Six constructs were identified to distinguish between high and low implementation units.", "Sixteen strategies were developed to foster the implementation of physician-pharmacist collaborative clinics, targeting Intervention, Practice setting, and Ecological system.", "This qualitative study demonstrated facilitators and barriers to implementing physician-pharmacist collaborative clinics for diabetes management in primary healthcare centers and developed theory-based strategies for further promotion, which has the potential to improve the management of diabetes and other chronic diseases in under-resourced areas." ]