bluuebunny/crossref_metadata_2025 huggingface dataset:
The Qatar 2022 World Cup warm-up: Football goal-scoring evolution in the last 14 FIFA World Cups (1966–2018)
Authors: Mićović Branimir , Leontijević Bojan , Dopsaj Milivoj , Janković Aleksandar , Milanović Zoran , Garcia Ramos Amador
Published: January 2023

The aim of this study was to elucidate pattern of attacking actions leading up to goal scoring during the 14 FIFA World Cups from 1966 to 2018. The study analysed 1881 goals scored during a total of 732 matches. We employed observational methodology design. Before goal analysis began, it was developed the observing protocol in which data related to selected variables, by system of notation, was entered after reviewing each individual goal scoring action. The analysis of all video material was carried out independently by four experienced examiners (three of them are Ph.D in sports science and one is Ph.D. candidate in sports science with at least 7 years of coaching and experience as analyst in football). The inter-and intra-observer reliability presented good level of agreement. The kappa values ranged from 0.82 (goal scoring through open play) to 1.00 (action leading up to goal), showing a very high agreement for all performance variables. Interclass correlation was very high (ICC = 0.966, 95% upper and lower confidence intervals were between 0.933 and 1.00). A statistically significant trend (p < 0.05) from 1966 to 2018 was identified towards a higher relative frequency of goals scored from set play and collective actions from open play. The Chi-square did not reveal significant differences in the frequency of goal scoring patterns and goal-scoring zones. The results also revealed that the majority of goals were scored between the 76th and 90th minutes of a match (22.7%), from open play (70.5%), inside the penalty area (54.7%), one touch finishing (62.5%), and collective attacks in open play (55.8%). These findings may provide a possible strategic direction for improving goal-scoring performance in football, as well as practical implementation in World Cup tournament preparation.
How do appraisal as threat or challenge, efficacy, and environmental quality affect wellbeing in the COVID-19 pandemic?
Authors: Wallis Hannah , Holzen Veronique , Sieverding Theresa , Matthies Ellen , Schmidt Karolin
Published: January 2023

Background

In crises, it is of great relevance to identify mechanisms that help people to maintain a certain level of wellbeing. This paper investigates whether appraising the COVID-19 pandemic as a threat vs. as a challenge has different effects on subjective wellbeing during the pandemic. Furthermore, we study the role of the perceived local environmental quality for individuals' subjective wellbeing.

Methods

Via online survey study with two times of measurement (N = 758), we investigated (a) the prediction of participants' wellbeing in June 2020 and June 2021 through five variables and (b) how these five variables moderated within-participant differences in subjective wellbeing over time.

Results

Results showed that a stronger perception of the pandemic as a threat (feeling worried) and a lower education in June 2020 predicted a lower subjective wellbeing in 2020 and 2021. A stronger challenge appraisal (feeling confident), higher efficacy expectations, and positive perceptions of the local environmental quality in June 2020 predicted a higher wellbeing in 2020 and 2021. There was no substantial change in participants' aggregated wellbeing over time. However, those who perceived the pandemic more as a threat in June 2020 struggled more with negative changes in their wellbeing, whereas those who perceived the pandemic more as a challenge reported a higher wellbeing.

Conclusion

It seems key to support people in activating positive feelings to successfully cope with crises.
Suicide attempt and its determinants among youth in central, north, and west Gondar zones, northwest Ethiopia: Findings from the youth health project
Authors: Geremew Alehegn Bishaw , Gelagay Abebaw Addis , Yeshitila Hedija Yenus , Azale Telake , Habitu Yohannes Aynaw , Abebe Solomon Mekonnen , Birru Eshetie Melese , Fentie Elsa Awoke
Published: January 2023

Introduction

Suicide is a deliberate attempt to take one's own life. Suicidal behavior among adolescents and young people, a significant global public health issue, is under-researched, particularly in developing nations like Ethiopia. Therefore, this study aimed to assess the prevalence of suicide attempts and their determinants among school-aged and out-of-school youth in the central, north, and west Gondar zones of Ethiopia.

Methods

A community-based cross-sectional study was conducted from 15 March to 15 April 2019, among youth in the central, north, and west Gondar zones. The data for this study were extracted from information collected for the assessment of common health problems and risky behaviors among youth. A multistage cluster sampling technique was used to collect the data using face-to-face interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were done to identify the independent determinants of suicide attempts. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify the presence and direction of the association between the dependent and independent variables.

Results

A total of 1,597 youth participated in this study, and the mean age of the participants was 19.1 ± 2.8 standard deviations (SDs). The lifetime prevalence of suicide attempts in the study participants was 5.5% (95% CI: 4.4, 6.8%). Risky sexual practices (AOR = 1.89, 95%CI: 1.19–2.99), the presence of common mental health problems (AOR = 6.31, 95% CI: 3.78–10.88), having a personal income (AOR = 1.68, 95% CI: 1.05–2.71), and a history of violence (AOR = 2.81, 95% CI 1.76–4.49) were significantly associated with a suicide attempt.

Conclusion

In this study, the prevalence of lifetime suicide attempts among youth is high. The presence of common mental health problems, having a personal income, risky sexual practices, and a history of violence increase the likelihood of suicide attempts. Working on the reduction of risky sexual practices, ensuring the integration of psychological treatment into medical treatment programs for victims of violence, psychosocial support for young people, and integrating youth-friendly health services to promote mental health would help to reduce suicide attempts among youth.
The top 100 most cited papers in insomnia: A bibliometric analysis
Authors: Wan Qingyun , Liu Kai , Wang Xiaoqiu , Luo Shuting , Yuan Xiya , Wang Chi , Jiang Jing , Wu Wenzhong
Published: January 2023

Objective

The number of citations to a paper represents the weight of that work in a particular area of interest. Several highly cited papers are listed in the bibliometric analysis. This study aimed to identify and analyze the 100 most cited papers in insomnia research that might appeal to researchers and clinicians.

Methods

We reviewed the Web of Science (WOS) Core Collection database to identify articles from 1985 to 24 March 2022. The R bibliometric package was used to further analyze citation counts, authors, year of publication, source journal, geographical origin, subject, article type, and level of evidence. Word co-occurrence in 100 articles was visualized using VOS viewer software.

Results

A total of 44,654 manuscripts were searched on the Web of Science. Between 2001 and 2021, the top 100 influential manuscripts were published, with a total citation frequency of 38,463. The top countries and institutions contributing to the field were the U.S. and Duke University. Morin C.M. was the most productive author, ranking first in citations. Sleep had the highest number of manuscripts published in the top 100 (n = 31), followed by Sleep Medicine Reviews (n = 9). The most cited manuscript (Bastien et al., Sleep Medicine, 2001; 3,384 citations) reported clinical validation of the Insomnia Severity Index (ISI) as a brief screening indicator for insomnia and as an outcome indicator for treatment studies. Co-occurrence analyses suggest that psychiatric disorders combined with insomnia and cognitive behavioral therapy remain future research trends.

Conclusion

This study provides a detailed list of the most cited articles on insomnia. The analysis provides researchers and clinicians with a detailed overview of the most cited papers on insomnia over the past two decades. Notably, COVID-19, anxiety, depression, CBT, and sleep microstructure are potential areas of focus for future research.
Facilitating and hindering factors of personal recovery in the context of Soteria—A qualitative study among people with (early episode) psychosis
Authors: Leendertse Pien , Hirzalla Fadi , van den Berg David , Castelein Stynke , Mulder Cornelis Lambert
Published: January 2023

Objective

The objective of this study was to gain insight into patients' experiences of how personal recovery (PR) is facilitated or hindered in the context of an early episode psychosis setting (Soteria). We thereby aimed to contribute to the understanding of how care settings may promote or hinder the process of PR in people with (acute) psychosis.

Method

This study used a qualitative method, consisting of semi-structured in-depth interviews with people who had been admitted to a Soteria house in the Netherlands. Interview transcripts were analyzed following the Grounded Theory approach.

Results

Five themes emerged from the data illustrating how Soteria facilitated or impeded PR. The experience of togetherness in contact with staff and peers, feeling at home, and being active facilitated PR, while the emphasis put on medication by staff was experienced as hindering, and attention to spirituality was missed.

Conclusion

In addition to the literature that identified factors associated with PR in psychosis, the current study gives a sense of how this can be put into practice. By offering treatment within a normalizing, holding environment, with emphasis on equality, close contact, optimism, active structured days, open-mindedness toward spirituality, and the role of medication, PR can be facilitated without detracting from guideline-based treatment aimed at symptomatic recovery. Similarities with existing concepts are discussed.
Physical activity pattern in Iran: Findings from STEPS 2021
Authors: Nejadghaderi Seyed Aria , Ahmadi Naser , Rashidi Mohammad-Mahdi , Ghanbari Ali , Noori Maryam , Abbasi-Kangevari Mohsen , Nasserinejad Maryam , Rezaei Negar , Yoosefi Moein , Fattahi Nima , Ghasemi Erfan , Farzi Yosef , Abdolhamidi Elham , Darman Mahbobeh , Djalalinia Shirin , Farzadfar Farshad
Published: January 2023

Background

Insufficient physical activity (IPA) is a significant risk factor for various non-communicable diseases. The Iran action plan is a 20% reduction in IPA. Therefore, we aimed to describe the age and sex pattern of physical activity domains, IPA, the intensity of physical activity, sedentary behavior, and their associates at Iran's national and provincial levels in 2021.

Methods

This study used the data of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) 2021 in Iran. The STEPS study used the Global Physical Activity Questionnaire (GPAQ) version two developed by WHO for the assessment of physical activity, which included work, transport, and recreational activities domains. We showed and compared demographic and clinical characteristics of participants between males and females, usingt-test and Chi-square test. A logistic regression model adjusted for residential areas, years of schooling, wealth index, age, marital status, and occupation has also been implemented. The results were presented as percentages and 95% confidence intervals (CI).

Results

We included 27,874 participants with a mean (SD) age of 45.69 (15.91), among whom 12,479 (44.77%) were male. The mean prevalence of IPA for the whole population for all ages was 51.3% (50.62–51.98%). By sex, 41.93% (40.88–42.98%) and 57.87% (56.99–58.75%) of men and women had IPA, respectively. According to the physical activity domains, the age-standardized prevalence of no recreational activity was 79.40% (78.80–79.99%), no activity at work was 66.66% (65.99–67.32%), and no activity at transport was 49.40% (48.68–50.11%) for both sexes combined. Also, the overall age-standardized prevalence of sedentary behaviors was 50.82% (50.11–51.53%). Yazd province represented the highest prevalence of IPA (63.45%), while West Azerbaijan province represented the lowest prevalence (39.53%). Among both sexes, living in the urban area vs. rural area [adjusted OR: 1.44; (1.31–1.58)], married vs. single status [adjusted OR: 1.33; (1.16–1.53)], and wealth index of class 3 vs. class 1 [adjusted OR: 1.15; (1.01–1.30)] were significantly associated with a higher rate of IPA.

Conclusion

The prevalence of IPA was considerably high in Iran. To achieve the predefined goal of reducing IPA, the health system should prioritize increasing physical activity, especially in urban areas and among females.
Sleep disturbance and psychotic-like experiences among urban adolescents with and without parental migration
Authors: Wang Dongfang , Ma Zijuan , Zhai Shuyi , Sun Meng , Fan Fang
Published: January 2023

Aim

Sleep disturbance was closely associated with an increased risk of psychotic-like experiences (PLEs). This study aims to explore the association between sleep disturbance and PLEs among urban adolescents with and without parental migration.

Methods

A total of 67, 532 urban Chinese adolescents were recruited in a large web-based survey during April 21st to May 12th, 2021. In our study, sleep disturbance, PLEs, family function, school climate, and a series of socio-demographic were assessed. And hierarchical logistic regression analyses were performed to examine influential factors associated with PLEs.

Results

Urban left-behind children (LBC) had a higher prevalence of sleep disturbance and PLEs than non-LBC. After controlling for confounders, parental migration was associated to PLEs with weak significance (OR = 1.19). Meanwhile, sleep disturbance was found to be a robust risk factor for PLEs (OR = 3.84 and 4.09), with or without the effect of parental migration. In addition, better family function and school climate has significant association with decreased risk of PLEs.

Conclusion

Adolescents with sleep disturbance are more likely to report PLEs. Adolescents' PLEs preventive strategies could focus on reducing sleep disturbance related symptoms as well as improving family function and school climate.
Prevalence of physical activity levels and perceived benefits of and barriers to physical activity among Jordanian patients with coronary heart disease: A cross-sectional study
Authors: Alsaleh Eman , Baniyasin Faris
Published: January 2023

Background

Many studies published in other countries have identified certain perceived benefits of and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease.

Objective

This study aimed to describe the prevalence of levels of physical activity, the benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity.

Methods

A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits of and barriers to physical activity and asked to what extent they disagreed or agreed with each.

Results

Jordanian patients with coronary heart disease perceived various benefits of and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = 0.7). The most substantial barriers to physical activity as perceived by the patients were “feeling anxiety,” “not enough time,” “lack of interest,” “bad weather,” and “feeling of being uncomfortable.” Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behavior.

Conclusion

This study demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity and have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.
Association between aspartate aminotransferase to alanine aminotransferase ratio and the risk of diabetes in Chinese prediabetic population: A retrospective cohort study
Authors: Wang Xiaoqing , Li He , Ji Lin , Cang Jing , Zhao Hang
Published: January 2023

Background

Accumulating evidence has revealed that the aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio is a promising novel biomarker for insulin resistance (IR) and metabolic diseases. However, research on the association between the AST/ALT ratio and the incidence of diabetes progressing from prediabetes remains lacking. Herein, this study aimed to evaluate the relationship between the baseline AST/ALT ratio and risks of diabetes in patients with prediabetes.

Methods

This was a retrospective cohort study involving a total of 82,683 participants across 32 regions and 11 cities in China from 2010 to 2016. Data was obtained based on the DATADRYAD database from the health check screening program. Participants were stratified according to the interquartile range of the AST/ALT ratio (groups Q1 to Q4). The Cox proportional hazard model and smooth curve fitting were used to explore the relationship between the baseline AST/ALT ratio and the risk of diabetes in prediabetic patients. In addition, subgroup analysis was used to further validate the stability of the results.

Results

The mean age of the selected participants was 49.9 ± 14.0 years, with 66.8% of them being male. During the follow-up period 1,273 participants (11.3%) developed diabetes progressing from prediabetes during the follow-up period. Participants who developed diabetes were older and were more likely to be male. The fully-adjusted Cox proportional hazard model revealed that the AST/ALT ratio was negatively associated with the risk of diabetes in prediabetic patients (HR = 0.40, 95% CI: 0.33 to 0.48, P < 0.001). Higher AST/ALT ratio groups (Q4) also presented with a lower risk of progressing into diabetes (HR = 0.35, 95% CI: 0.29 to 0.43, P < 0.001, respectively) compared with the lowest quintile group (Q1). Through subgroup analysis and interaction tests, it was found that the association stably existed in all subgroup variables, and there were a stronger interactive effects in people with age < 45 years, and TG ≤ 1.7 mmol/L in the association between AST/ALT ratio and diabetes incidences in patients with prediabetes (P for interaction < 0.05).

Conclusion

According to our study, a higher AST/ALT ratio is associated with a lower risk of progressing into diabetes from prediabetes. Regular monitoring of AST/ALT ratio dynamics and corresponding interventions can help prevent or slow prediabetes progression for diabetes.
Factors influencing cataract awareness and treatment attitudes among the middle-aged and older in western China's rural areas
Authors: Guan Hongyu , Xue Jing , Ding Yuxiu , Zhang Yunyun , Du Kang , Yang Jie
Published: January 2023

Purpose

This study was conducted to determine the level of knowledge about cataracts and the associated factors among adults aged 50 and above in rural areas of Qingcheng county in Gansu Province of Western China, 2020.

Methods

A large community-based cross-sectional study was conducted among the randomly selected 1,503 adults aged 50 and above from October to December 2020. Data were collected by conducting eye examinations and face-to-face interviews. Multivariate binary logistic regression and multivariate linear regression were used to identify associated factors of knowledge about cataracts. Odds Ratio (OR), Coefficient (C), and 95% Confidence Interval (CI) were reported to declare the statistical associations between knowledge about cataracts and the independent variables.

Results

Of the 1,503 study participants, 1,078 (71.7%) had good knowledge about cataracts. The primary school completed [OR = 1.43 (95% CI 1.08–1.90), P = 0.012], Secondary school & above [OR = 2.69 (95% CI 1.86–3.89), P <0.001], Examine for cataract [OR = 1.82 (95%CI 1.27–2.62), P = 0.001] were positively significantly associated with knowledge about cataracts. Whereas eye examinations [OR = 0.73(95% CI 0.55–0.96), P = 0.022] were negatively associated with knowledge about cataracts. Multivariate linear regression analyses showed a significant negative correlation between age and knowledge of cataract treatment options. Living with at least one child was positively correlated with knowledge of the therapeutic effects of cataracts. And monthly household income was significantly positively correlated with knowledge of the therapeutic effects of cataracts, treatment options, and the surgical reimbursement ratio for cataracts.

Conclusions

More than one-third of the participants still had poor knowledge about cataracts. The respondents with at least primary education and above, with previous examinations, and with examination for cataracts had significant associations with good knowledge about cataracts. So, it is recommended that stakeholders in different hierarchies organize health education by considering the education level of the community, focusing on cataract treatment knowledge and the surgical reimbursement ratio to improve cataract surgery rates.
Development and evaluation of an intervention to improve food and nutrition literacy among Iranian Kurdish primary school children: An application of intervention mapping approach
Authors: Ahmadpour Mohammad , Omidvar Nasrin , Shakibazadeh Elham , Doustmohammadian Azam , Rahimiforoushani Abbas
Published: January 2023

Background

Food and nutrition literacy (FNLIT) is a relatively new term that is used to define the knowledge, skills, and behaviors necessary to achieve a healthy diet. Improving food and nutritional literacy in children is a necessary solution to eliminate nutritional disorders in this age group. The purpose of this study was to design, implement and evaluate an intervention to improve food and nutrition literacy in children aged 10–12 years old based on an intervention mapping (IM) approach.

Methods

This experimental study was performed in three phases. Through the first phase, an intervention was developed using the (IM) approach. In the second phase, the intervention was implemented for 6 months, and in the third phase, the intervention outcomes were evaluated and compared with the control group through a randomized controlled trial among 300 participants (each control and intervention group = 150).

Results

Before the intervention, there was no significant difference between the control and intervention groups in all subscales of FNLIT. After the intervention, there was a significant difference between the control and intervention groups in all subscales of FNLIT (P< 0/001). There were no differences between the two groups in terms of the FNLIT scores at baseline (P> 0.05). However, after 6 months of intervention, a significant difference was observed between the two groups (intra-group differences) (P< 0.001). Such a difference was not identified in the control group after 6 months also the results show the impact of socioeconomic factors and parental literacy on the average score of students' FNLIT and after the intervention, a significant difference was observed between the scores of control and intervention groups in all subscales of the FNLIT (P< 0.001).

Conclusions

The school-based intervention developed and evaluated in this study provides a basis for future programs targeting the improvement of FNLIT in children, especially in poor and deprived areas such as Kurdistan province.

Clinical trial registration

Iranian Clinical Trials Registry (IRCT) Code: 32094.
Loneliness as a mediation from social support leading to a decrease of health-related quality of life among PLWHIV
Authors: Qian Zhe , Li Bing , Liao Leyi , Liao Guichan , Chen Hongjie , Han Juanqing , Yu Tao , Xu Xuwen , Peng Jie , Cai Shaohang
Published: January 2023

This study focused on the mental health of people living with HIV(PLWHIV) and explored their relationship between loneliness and perceived social support, health related quality of life (HRQoL) with a method of structural equation model. We collected clinical and psychological data from consecutively enrolled PLWHIV. A total of 201 PLWHIVs were enrolled and measured with self-reporting survey instruments of UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Social Support Ratio Scale and Short Form Health Survey-36. The levels of loneliness, depression, anxiety, perceived social support and HRQoL were assessed. PLWHIV enrolled were divided into two groups of loneliness and non-loneliness based on their UCLA Loneliness Scale scores. Multivariable analysis indicated that being married is a protective factor associated with loneliness (OR = 0.226; P = 0.032). We further found the loneliness group had a higher level of depression (P < 0.001) and anxiety (P < 0.001), but lower level of HRQoL (P < 0.001) than the non-loneliness group. We found there was a positive linear correlation between social support and HRQoL among the enrolled PLWHIVs (r2 = 0.0592; P = 0.0005). A structural equation model (SEM) was established to evaluate whether the loneliness played as a mediation role between social support and HRQoL. The model showed loneliness as a mediation from social support leading to a decrease of HRQoL. Our findings showed a potential psychological pathway from social support to HRQoL, suggesting the need for interventions focusing on social support may improve poor HRQoL lead by loneliness.
TikTok and adolescent vision health: Content and information quality assessment of the top short videos related to myopia
Authors: Ming Shuai , Han Jie , Li Meng , Liu Yan , Xie Kunpeng , Lei Bo
Published: January 2023

Background

Despite the increasing recognition of the public health value of social media platforms, TikTok short videos focusing on adolescent vision health have not received much attention. We aimed to evaluate the content, sources, and information quality of myopia-related videos on TikTok.

Methods

The top 200 most-liked myopia-related videos on the Chinese version of TikTok were queried and screened on March 12, 2022. The descriptive characteristics, contents, and sources of the selected 168 videos were obtained, and their overall quality, reliability, understandability, and actionability were assessed using the validated scoring instruments DISCERN and PEMAT-A/V.

Results

Medical professionals were the main source (45.8%, 77/168) of videos. Misinformation (10.1%, 17/168) was mainly attributable to for-profit organizations (20%, 3/15) and individual non-medical users (31.3%, 10/32). However, their videos enjoyed the highest numbers of “likes,” “comments,” and “shares” (P < 0.05). The mean reliability and overall quality regarding treatment choice were (2.5 ± 0.5) and (3.1 ± 0.9), respectively. Videos on TikTok showed relatively high understandability (84.7%) and moderate actionability (74.9%). Video producers tended to partly or fully provide information regarding management (81.5%, 137/168) and outcome (82.1%, 138/168), and to ignore or only slightly mention content related to definition (86.9%, 146/169) and signs (82.1%, 138/168). The five video sources showed significant differences in the prevalence of misleading information (P < 0.001), publication reliability (P < 0.001), overall quality (P = 0.039), content score (P = 0.019), and understandability (P = 0.024).

Conclusion

Considering the moderate-to-poor reliability and variable quality across video sources, the substantial myopia-related content on TikTok should be treated with caution. Nevertheless, TikTok videos may serve as a surrogate or supplement for information dissemination if providers can ensure more comprehensive and accurate content.
Clinical characteristics and risk factors analysis of viral shedding time in mildly symptomatic and asymptomatic patients with SARS-CoV-2 Omicron variant infection in Shanghai
Authors: Li Ran , Jin Chen , Zhang Liya , Kong Dehong , Hu Kerong , Xuan Miao , Liu Qi , Li Shaohui , Zhang Keqin , Xue Ying
Published: January 2023

Objective

To analyze the clinical characteristics and risk factors of viral shedding time in mildly symptomatic and asymptomatic patients with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant (BA.2 and BA2.2) infection in Shanghai, and the effect of traditional Chinese medicine (TCM) treatment, so as to provide a reference basis for epidemic prevention, control and clinical treatment.

Methods

A total of 6,134 asymptomatic or mildly symptomatic Omicron-infected patients admitted to Tianhua Road fangcang shelter hospital in Jinshan, Shanghai, between April 2022 and May 2022 were included. Demographic characteristics and clinical histories were collected and compared in subgroups according to the different durations of viral shedding. Spearman's correlation analysis was performed to explore the association between virus shedding time and clinical variables. Multiple linear regression was used to evaluate the risk factors for viral shedding time.

Result

Most patients with asymptomatic and mildly symptomatic Omicron infection were male, and more than half of patients had a viral shedding time of 8–15 days. The patients were divided into three groups according to the time of viral shedding: short-duration (≤ 7 days), intermediate-duration (8–15 days) and long-duration group (≥16 days). The proportion of patients aged ≤ 29 years was the highest in the short-duration group (30.2%), whereas the proportion of patients aged 50–64 yeas was the highest in the long-duration group (37.9%). The proportion of patients with the chronic non-communicable diseases among the short-, intermediate- and long-duration groups was 6.2, 9.4, and 14.9%, respectively. Among them, hypertension was the most found (4.9, 7.8, and 11.7%, respectively). By multivariate analyses, we identified that viral shedding time of Omicron variants was independently negatively correlated with male patients, TCM treatment, and manual laborers, while it was independently positively associated with age and hypertension. Additionally, TCM treatment could significantly shorten the length of viral shedding time, especially for men, age ≥30 years, comorbid chronic non-communicable diseases, unemployed people and manual worker.

Conclusions

Our results suggested that age and hypertension were independent risk factors for the duration of viral shedding in asymptomatic and mildly symptomatic omicron infected patients. TCM can effectively shorten viral shedding time.
Communicating PNPLA3 genetic risk status for NAFLD among Mexican-origin men
Authors: Villavicencio Edgar A. , Maldonado Adriana , Crocker Rebecca M. , Guan Yue , Stallman Chris , Garcia David O.
Published: January 2023

Introduction

The burden of non-alcoholic fatty liver disease (NAFLD) continues to disproportionately impact under-resourced communities in the U.S., particularly Mexican-origin populations. Genetic polymorphisms such as the rs738409 C/G variant in patatin-like phospholipase domain-containing 3 (PNPLA3) have been associated with higher prevalence of and progression along the NAFLD spectrum. This qualitative study conducted in the U.S. Southwest aimed to assess Mexican-origin men's experience receiving genetic testing for PNPLA3 risk carrier status.

Methods

Semi-structured interviews were conducted with 17 Mexican-origin men whose NAFLD status and genetic predisposition were determined as part of a previous cross-sectional study. The interview guide included questions exploring participants' insights on how genetic risk status was delivered, how the information influenced their motivation for lifestyle modification to reduce NAFLD risk, and any knowledge sharing that occurred with family members after learning of their PNPLA3 risk status. Interviews were conducted and audio recorded in English (n = 6) and Spanish (n = 11) and uploaded into NVivo software for data analysis and interpretation. Guided by the Health Belief Model, a thematic analysis approach was used to identify primary themes.

Results

Results highlighted men's preference for receiving this type of genetic risk information through a letter sent to their homes. General comprehension of PNPLA3 risk status was deemed high and most men stated sharing their genetic predisposition to NAFLD with their immediate family members. Participants also indicated that family and awareness of this genetic risk acted as primary motivators for implementing behavior changes (e.g., diet, physical activity) toward the prevention of more severe liver conditions.

Discussion

Findings from this qualitative study suggest the feasibility of communicating genetic risk for NAFLD among Mexican-origin men. Future strategies for the dissemination of genetic risk results among Mexican-origin individuals should consider familial and cultural appropriate strategies.
Taking on the Commercial Determinants of Health at the level of actors, practices and systems
Authors: Lacy-Nichols Jennifer , Jones Alexandra , Buse Kent
Published: January 2023

Tackling the Commercial Determinants of Health (CDoH) is necessary for progress on health equity and will determine whether or not the health-related targets of the SDGs are met. We present a simple visual heuristic of three core aspects of CDoH: commercial actors, commercial practices, and system-level dynamics (which commercial actors influence and perpetuate). We use this heuristic to highlight key research gaps, in particular the need for more voices and evidence on CDoH from the Global South, particularly on what works to curb harmful impacts. We also propose an agenda to address CDoH and actions for different stakeholders. While efforts to curb specific commercial practices are important, far more attention and effort are needed at the systems level, as they can fundamentally shift the way power is distributed in society to improve health equity.
Barriers to gender equity for female healthcare academicians and researchers in Pakistan: Is it still an issue?
Authors: Malik Madeeha , Hussain Azhar , Hashmi Ayisha , Saeed Hamza , Azhar Hafsa , Abbasi Aqsa Sajjid
Published: January 2023

Introduction

Gender inequity in healthcare academia is rising. Female healthcare professionals are struggling to balance their work and family leading to reduced productivity and disparity in three main areas of academic evaluation including teaching, service and research.

Objective

The objective of the current study was to explore perceptions of healthcare academicians regarding gender equity and its associated barriers in healthcare academia in Pakistan.

Methodology

A qualitative study design was used. Study site for this research included medical colleges, pharmacy schools and healthcare educational institutes. Study respondents included healthcare professionals including doctors and pharmacists working as faculty members. Snow ball sampling was used and interviews were conducted till saturation point was achieved. All interviews recorded were transcribed verbatim. Transcribed interviews were then subject to thematic analysis and were analyzed for relevant content.

Results

Thematic analysis of the study yielded many themes and sub themes. The main themes include: Gender equity an issue for healthcare academicians; Barriers toward promoting gender equity among healthcare academicians; Perceived teaching effectiveness among female healthcare academicians; Professional relationship of female healthcare academicians; Representation of female healthcare academicians at leadership positions; Research opportunities for female healthcare academicians; impact of academia as profession on married life and Strategies for improving gender equity disparities in academia of healthcare profession. The results showed that almost all the females as well as male healthcare academicians were of the view that female academicians are competent, hardworking and committed with their jobs. Mixed responses were observed regarding teaching effectiveness of female academicians. Half of the females as well male healthcare academicians thought that female were more effective teachers while other half was of the view that teaching effectiveness is based on individual trait irrespective of gender.

Conclusion

The results of the present study concluded that majority of the male as well as female healthcare professionals perceived gender equity as an issue in academia in Pakistan, especially in underprivileged areas. Non-conducive work environment, harassment at workplace and cultural issues were the main barriers identified toward gender equity in healthcare academia in Pakistan.
Inclusive LGBTQIA+ healthcare: An interprofessional case-based experience for cultural competency awareness
Authors: Prasad Samiksha , O'Malley Chasity B. , DeLeon Rolando , Levy Arkene S. , Griffin Daniel P.
Published: January 2023

Introduction

Lesbian, Gay, Bi-sexual, Transgender, Questioning, Intersex, and Asexual (LGBTQIA+) patients report experiences of discrimination within healthcare settings due to a lack of provider knowledge and biases of healthcare workers. There is an identified need among all health professions to provide more culturally competent healthcare for this community. Early interventions during healthcare profession training programs may be effective to address this need. The overall goal of this study was to assess the educational impact of an active learning session that was specifically designed to enhance LGBTQIA+ cultural competency awareness using an interprofessional setting.

Methods

This 2-year study involved students from 16 healthcare professional programs joining virtually to form interprofessional teams. A small group case-based learning approach was used and included pre/post-activity surveys to measure the change in student attitude and confidence, as well as the change in perception of the importance of the activity.

Results

Results indicate an increase in perception of importance (p < 0.005) and in overall level of confidence (p < 0.001) with respect to LGBTQIA+ issues post-session. Key themes established through the session represent an overall recognition of the importance of interprofessional education and awareness of LGBTQIA+ healthcare needs.

Discussion

The results demonstrate the effectiveness of a case-based approach for enhancing cultural competency awareness across different healthcare professions programs. This session also provided an interprofessional learning environment to allow multiple healthcare professions program students to interact and share perspectives. The positive impact of this intervention in a highly collaborative virtual learning environment also highlights that this immersive active learning approach that can be adopted across different programs and institutions.
Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis
Authors: Zhang Fangkai , Jiang Jianjun , Yang Min , Zou Kun , Chen Dandi
Published: January 2023

Objective

To evaluate the incidence and trend of catastrophic health expenditures (CHE) in China over the past 20 years and explore the socioeconomic factors affecting China's CHE rate.

Methods

The systematic review was conducted according to the Cochrane Handbook and reported according to PRISMA. We searched English and Chinese literature databases, including PubMed, EMbase, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang, China Science and Technology Journal Database (CQVIP), and CBM (Sino Med), for empirical studies on the CHE rate in China and its associated socioeconomic factors from January 2000 to June 2020. Two reviewers conducted the study selection, data extraction, and quality appraisal. The secular trend of the CHE rate was examined, and factors associated with CHE were explored using subgroup analysis and meta-regression.

Results

A total of 118 eligible studies with 1,771,726 participants were included. From 2000 to 2020, the overall CHE rate was 25.2% (95% CI: 23.4%−26.9%) in China. The CHE rate continued to rise from 13.0% in 2000 to 32.2% in 2020 in the general population. The CHE rate was higher in urban areas than in rural areas, higher in the western than the northeast, eastern, and central region, in the elderly than non-elderly, in low-income groups than non-low-income groups, in people with cancer, chronic infectious disease, and cardio-cerebrovascular diseases (CCVD) than those with non-chronic disease group, and in people with NCMS than those with URBMI and UEBMI. Multiple meta-regression analyses found that low-income, cancer, CCVD, unspecified medical insurance type, definition 1 and definition 2 were correlated with the CHE rate, while other factors were all non-significantly correlated.

Conclusion

In the past two decades, the CHE rate in China has been rising. The continuous rise of health expenditures may be an important reason for the increasing CHE rate. Age, income level, and health status affect the CHE rate. Therefore, it is necessary to find ways to meet the medical needs of residents and, at the same time, control the unreasonable rapid increase in health expenditures in China.
Predicting Escherichia coli levels in manure using machine learning in weeping wall and mechanical liquid solid separation systems
Authors: Shetty B. Dharmaveer , Amaly Noha , Weimer Bart C. , Pandey Pramod
Published: January 2023

An increased understanding of the interaction between manure management and public and environmental health has led to the development of Alternative Dairy Effluent Management Strategies (ADEMS). The efficiency of such ADEMS can be increased using mechanical solid-liquid-separator (SLS) or gravitational Weeping-Wall (WW) solid separation systems. In this research, using pilot study data from 96 samples, the chemical, physical, biological, seasonal, and structural parameters between SLS and WW of ADEM systems were compared. Parameters including sodium, potassium, total salts, volatile solids, pH, and E. coli levels were significantly different between the SLS and WW of ADEMS. The separated solid fraction of the dairy effluents had the lowest E. coli levels, which could have beneficial downstream implications in terms of microbial pollution control. To predict effluent quality and microbial pollution risk, we used Escherichia coli as the indicator organism, and a versatile machine learning, ensemble, stacked, super-learner model called E-C-MAN (Escherichia coli–Manure) was developed. Using pilot data, the E-C-MAN model was trained, and the trained model was validated with the test dataset. These results demonstrate that the heuristic E-C-MAN ensemble model can provide a pilot framework toward predicting Escherichia coli levels in manure treated by SLS or WW systems.
Working memory training in children with developmental language disorder: Effects on complex syntax in narratives
Authors: Delage Hélène , Stanford Emily , Baratti Clara , Durrleman Stéphanie
Published: January 2023

This study assesses the impact of a working memory training program on the syntactic complexity of the spontaneous speech of French-speaking children with Developmental Language Disorder (DLD). Thirty-nine 6- to 12-year-old children with DLD were allocated to a WM training (DLDMM,N = 20) or an active control group (DLDSQULA,N = 19). The computerized training sessions took place three times a week, yielding 12 training hours per participant. Syntactic complexity was assessed in storytelling, measuring mean length of utterances, use of embedded clauses and rate of errors in complex utterances. The performance of participants with DLD was first compared to previous spontaneous data of 40 typically-developing (TD) children of the same age. Then, intragroup (pre- vs. post-test) and intergroup (DLDMMvs. DLDSQULA) comparisons were made to assess the impact of the working memory training on the language measures. Global results confirmed syntactic impairment in children with DLD, as opposed to TD children, with large differences for the use of embedded clauses. Findings also suggested gains in the mastery of embedded clauses in children who participated in the WM training, whereas no gains were observed in the DLD control group. These findings confirm deficits in complex syntax in children with DLD, in particular in embedded clauses, and may encourage the clinical use of language sample analysis, which provides an ecological account of children's language performance. While our results should be replicated on a larger scale, they also suggest positive transfer effects of working memory training on the capacity of participants with DLD to produce embedded clauses, in line with previous studies showing a positive effect of WM training on tasks of expressive syntax. It thus seems that working memory training can yield benefits for language, which leaves open the door to new therapeutic approaches for children with DLD.
Extraction of high-quality grade cellulose and cellulose nanocrystals from different lignocellulosic agri-food wastes
Authors: Rovera Cesare , Carullo Daniele , Bellesia Tommaso , Büyüktaş Duygu , Ghaani Masoud , Caneva Enrico , Farris Stefano
Published: January 2023

Introduction

Prompted by the increasing need for an intensified valorization of agri-food waste, in this work a three-step chemical procedure was used to extract high-purity cellulose from garlic stalk, corncob, and giant cane cut-up by a sequential removal of hemicellulose, lignin, ash, and organic compounds. Cellulose nanocrystals of potential interest for nanocomposite applications were then obtained through acid hydrolysis.

Methods

The purity of the cellulose was determined employing Nuclear Magnetic Resonance and infrared spectroscopy, whereas dynamic light scattering, optical, atomic force microscopy, and transmission electron microscopy were used for morphological characterization. The high purity and crystallinity of cellulose was confirmed by comparison with the ultra-pure bacterial cellulose originating from K. sucrofermentans, irrespective of the waste used.

Results and discussion

At the end of the extraction procedure, cellulose yields of 35.73, 37.15, and 39.10%, for garlic stalk, corncob, and giant cane cut-up, respectively, were achieved. Dynamic light scattering and atomic force microscopy analyses showed that the length of the whisker-like nanocrystals depended on the raw material (from ~100 nm up to > 2μm), while the final yield was ~40–50% for all three wastes. The versatility and effectiveness of the method here proposed can be profitably used for a wide range of agro-waste feedstocks.