bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary Steroid Profile in Elite Female Athletes in Relation to Serum Androgens and in Comparison With Untrained Controls
Authors: Eklund Emma , Andersson Alexander , Ekström Lena , Hirschberg Angelica Lindén 
Published: September 2021

IntroductionIn female athletes, the interpretation of doping tests is complex due to hormonal variations during the menstrual cycle and hormonal contraceptive use, both influencing the urinary steroid profile. Exercise is suggested to affect circulating steroid hormone levels, and in women, the urinary steroid profile differs between in competition testing and out of competition testing. No previous study has investigated the relationship between amount of exercise and the urinary steroid profile in female elite athletes.PurposeTo compare the urinary steroid profile between female Olympic athletes and age- and BMI-matched untrained controls, and to study the urinary steroid profile in relation to serum hormones and amount of exercise.MethodsIn this cross-sectional study conducted at the Women’s Health Research Unit, Karolinska University Hospital, Stockholm, 94 female elite athletes and 86 untrained controls were included. Serum estrogens and testosterone and the urinary steroid profile were analyzed by liquid chromatography–tandem mass spectrometry and gas chromatography-tandem mass spectrometry, respectively. Exercise hours/week were evaluated by questionnaire.ResultsAlthough serum steroid hormones were comparable between groups, the athletes demonstrated approximately 30% lower urinary steroid metabolites of testosterone, epitestosterone, androsterone, etiocholanolone, 5α-androstan-3α, 17β-diol, and 5β-androstan-3α, 17β-diol compared to the controls. The urinary steroid metabolites correlated positively with serum steroid hormones. In the athletes, urinary steroid metabolites: androsterone (rs = −0.28, p = 0.007), epitestosterone (rs = −0.22, p = 0.034), 5αAdiol (rs = −0.31, p = 0.002) and testosterone (rs = −0.24, p = 0.026), were negatively correlated with amount of training (hours per week).ConclusionThe urinary concentrations of steroid metabolites were lower in elite athletes than in sedentary controls, although serum steroids were comparable between groups. Moreover, exercise time was negatively associated with the urinary concentrations. Our findings suggest alternative excretion routes of androgens in the athletes related to training.
Chinese International Students in the United States: The Interplay of Students’ Acculturative Stress, Academic Standing, and Quality of Life
Authors: Su Zhaohui , McDonnell Dean , Shi Feng , Liang Bin , Li Xiaoshan , Wen Jun , Cai Yuyang , Xiang Yu-Tao , Yang Ling 
Published: September 2021

BackgroundAcculturation could cause grave health consequences in international students. However, there is a shortage of research into how acculturative stress might affect international students’ quality of life in light of their academic standing and experience. The lack of research is particularly pronounced among Chinese international students, representing the largest body of international students studying in the United States (U.S.). Thus, to bridge the research gap, this study aims to examine the interplay between international students’ acculturative stress, academic standing, and quality of life among a nationally representative sample of Chinese international students studying in the United States.MethodsAn online survey that gauges Chinese international students’ levels of acculturative stress, academic standing, and quality of life was developed. Over 350 higher education institutions across the United States were approached, including public universities, private universities, and community colleges, among which approximately 220 institutions responded positively and supported survey distribution. A total of 751 students completed the survey. Multiple regression analyses were carried out to examine the associations between students’ acculturative stress, academic standing, and quality of life.ResultsFindings reveal that acculturative stress negatively affects all four domains of Chinese international students’ quality of life, irrespective of their academic standing. Data analyses also show that compared to master’s and doctoral students, undergraduates experience the highest levels of acculturative stress. Furthermore, a significant difference emerged among undergraduate and doctoral international students’ acculturative stress levels, but not among undergraduate and master’s students, or master’s and doctoral students.ConclusionOur study found that, compared to master’s and doctoral students, undergraduates had more significant acculturative stress associated with lower levels of quality of life. This finding highlights the potentially positive role of academic experience – while acculturative stress deteriorates international students’ quality of life, students’ academic standing and experience could be the protective factor in the equation. Future research could further examine how universities and colleges can capitalize on their academic apparatuses and resources to improve international students’ academic performance and students’ acculturation experience and quality of life.
The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders
Authors: Bergmann Niklas , Hahn Eric , Hahne Inge , Zierhut Marco , Ta Thi Minh Tam , Bajbouj Malek , Pijnenborg Geradina Henrika Maria , Böge Kerem 
Published: September 2021

Background: Schizophrenia spectrum disorders (SSD) are frequently accompanied by comorbid depressive and anxiety symptoms, as well as impaired quality of life (QoL). A growing body of evidence has demonstrated the relevance of mindfulness for SSD in recent years. The study examined the association between mindfulness, depression, anxiety, and QoL.Materials and Methods: A total of 83 participants with SSD were recruited at the in- and outpatient psychiatric hospital care. Participants completed the Southampton Mindfulness Questionnaire, Comprehensive Inventory for Mindful Experiences, and Freiburger Mindfulness Inventory, the Depression, Anxiety, Stress Scale to assess depression and anxiety, and the WHO-QoL Questionnaire. Multiple regression analyses examined the relationship between mindfulness and QoL and the mediating role of depression and anxiety.Results: Mindfulness had a significant statistical positive effect on QoL domains physical health, psychological, and environmental QoL in patients with SSD. Depression was identified as a significant mediator of this relationship.Conclusion: This study provides novel insight into mindfulness’ mechanisms and paves the way for a process-oriented approach to treat SSD. The results provide first evidence for the process-based value of mindfulness for SSD; future studies can focus on the role of mindfulness for central therapeutic processes of change by employing longitudinal designs.
Persistence of Neuronal Alterations in Alcohol-Dependent Patients at Conclusion of the Gold Standard Withdrawal Treatment: Evidence From ERPs
Authors: Kuntz André , Missonnier Pascal , Prévot Anne , Favre Grégoire , Herrmann François R. , Debatisse Damien , Merlo Marco C. G. , Gothuey Isabelle 
Published: September 2021

Background: One of the main challenges for clinicians is to ensure that alcohol withdrawal treatment is the most effective possible after discharge. To address this issue, we designed a pilot study to investigate the efficacy of the rehabilitation treatment on the main stages of information processing, using an electroencephalographic method. This topic is of main importance as relapse rates after alcohol withdrawal treatment remain very high, indicating that established treatment methods are not fully effective in all patients in the long run.Method: We examined in alcohol-dependent patients (ADP) the effects of the benzodiazepine-based standard detoxification program on event-related potential components at incoming (D0) and completion (D15) of the treatment, using tasks of increasing difficulty (with and without workload) during an auditory oddball target paradigm. Untreated non-alcohol-dependent-volunteers were used as matching controls.Results: At D0, ADP displayed significantly lower amplitude for all ERP components in both tasks, as compared to controls. At D15, this difference disappeared for the amplitude of the N1 component during the workload-free task, as well as the amplitude of the P3b for both tasks. Meanwhile, the amplitude of the N2 remained lower in both tasks for ADP. At D0, latencies of N2 and P3b in both task conditions were longer in ADP, as compared to controls, whilst the latency of N1 was unchanged. At D15, the N2 latency remained longer for the workload condition only, whereas the P3b latency remained longer for the workload-free task only.Conclusion: The present pilot results provide evidence for a persistence of impaired parameters of ERP components, especially the N2 component. This suggests that neural networks related to attention processing remain dysfunctional. Longitudinal long-term follow-up of these patients is mandatory for further assessment of a link between ERP alterations and a later risk of relapse.
Psychometric Properties of the Korean Version of the Mental Health Professionals Stress Scale
Authors: Lee Eun Sol , Ryu Vin , Lee Ji Hyun , Hong Hyeon , Han Hyeree , Park Subin 
Published: September 2021

Background: Job stress of mental health professionals can have a negative impact on them, particularly their psychological health and mortality, and may also affect organizations' and institutions' ability to provide quality mental health services to patients.Aim: This study aimed to: (1) investigate the validity and reliability of the Korean Mental Health Professionals Stress Scale (K-MHPSS), (2) develop K-MHPSS cut-off points to measure clinical depression and anxiety, and (3) examine whether specific stressors vary by area of expertise.Methodology: Data were collected via an online survey over 3 months, from August to October 2020. An online survey using a survey website was administered to volunteers who accessed the link and consented to participate. Data from 558 participants (200 clinical psychologists, 157 nurses, and 201 social workers) were included in the final analysis. Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the K-MHPSS; concurrent validity of the scale was determined by analyzing correlation; internal consistency was determined by Cronbach's alpha coefficient. In addition, ROC curve analysis and Youden's index were used to estimate optimal cut-off points for K-MHPSS; one-way ANOVA was performed to investigate the difference among the three groups.Results: The seven-factor model of the original scale did not be replicated by Korean mental health professionals. The K-MHPSS had the best fit with the six-factor model, which consists of 34 items. Concurrent validity was confirmed, and overall reliability was found to be good. The K-MHPSS cut-off points for depression and anxiety appeared to slightly different by professional groups. Furthermore, nurses and social workers showed significantly higher total scores compared to clinical psychologists, and there are significant differences in subscale scores among professionals.Conclusion: The Korean version of the MHPSS has appropriate psychometric properties and can be used to assess the occupational stress of mental health professionals. It can also serve as a reference point for screening clinical level of depression and anxiety in mental health professionals.
Time to Evaluate the Clinical Repercussions of Zika Virus Vertical Transmission? A Systematic Review
Authors: Amaral Yasmin Notarbartolo di Villarosa do , Malacarne Jocieli , Brandão Paloma Glauca , Brasil Patrícia , Nielsen-Saines Karin , Moreira Maria Elisabeth Lopes 
Published: September 2021

Background: Vertical transmission of Zika Virus (ZIKV) can be associated with several clinical features in newborn infants. The goal of the present review was to analyze the current state of knowledge regarding clinical repercussions following perinatal exposure to ZIKV in children up to 3 years of age.Methods: A systematic review of published studies was carried out, without the restriction of language or date of publication, identified in the databases PubMed, Virtual Health Library (BVS), Scopus, and Web of Science and the catalog for CAPES theses and dissertations. According to the proposed flowchart, the bibliographic search resulted in 1,563 papers. Of these, according to the eligibility criteria, 70 were selected for systematic review; all were published between 2016 and 2021.Results: Regarding clinical findings, 19 papers evaluated clinical imaging alterations, 21 ophthalmic manifestations, and 39 evaluated the central nervous system; of these, 15 analyzed neuro-psychomotor development. The remainder evaluated audiological (n = 14), nutritional (n = 14), orthopedic (n = 7), cardiorespiratory (n = 5), genitourinary (n = 3) or endocrinological (n = 1) manifestations.Conclusion: It is critical for studies to continue monitoring children with antenatal ZIKV exposure as they grow, given the unknown long-term repercussions of ZIKV and the recognized postnatal complications of this infection during pregnancy. Broader descriptions of observed clinical findings are also important in order to characterize the entire spectrum of disease in children.Systematic Review Registration: PROSPERO REGISTER: CRD42020205947.
Associations Between Maternal Post-traumatic Stress Disorder and Traumatic Events With Child Psychopathology: Results From a Prospective Longitudinal Study
Authors: Glaus Jennifer , Pointet Perizzolo Virginie , Moser Dominik A. , Vital Marylène , Rusconi Serpa Sandra , Urben Sébastien , Plessen Kerstin J. , Schechter Daniel S. 
Published: September 2021

Introduction: Exposure to interpersonal violence (IPV) can lead to post-traumatic stress disorder (PTSD) in mothers, and in turn adversely affect the mother-child relationship during early development, as well as the mental health of their children. Our objectives are to assess: (1) the association of maternal IPV-PTSD to child psychopathology, (2) the association of maternal IPV independently of PTSD to child psychopathology, and (3) the relationship between child exposure to violence to the psychopathology of these children.Methods: We used data from the longitudinal Geneva Early Childhood Stress Project. The sample included 64 children [mean age at Phase 1 = 2.4 (1.0–3.7) years] of mothers with or without IPV-PTSD. Data on mothers was collected during Phase 1, using the Clinical Administered PTSD Scale (CAPS), the Brief Physical and Sexual Abuse Questionnaire (BPSAQ) and the Conflict Tactics Scale (CTS2). Modules of a semi-structured diagnostic interview, and the Violence Exposure Scale were used to collect information on child at Phase 2, when children were older [mean age = 7.02 (4.7–10)].Results: A higher CAPS score in mothers when children were toddler-age was associated with an increased risk of symptoms of attention deficit/hyperactivity disorder (ADHD; β = 0.33, p = 0.014) and PTSD in school-age children. The association between maternal IPV-PTSD and child PTSD (β = 0.48, p &lt; 0.001) symptoms remained significant after adjustment for potential confounders. Among children, exposure to violence was associated with an increased risk of symptoms of generalized anxiety (β = 0.37, p = 0.006), major depressive (β = 0.24, p = 0.039), ADHD (β = 0.27, p = 0.040), PTSD (β = 0.52, p &lt; 0.001), conduct (β = 0.58, p = 0.003) and oppositional defiant (β = 0.34, p = 0.032) disorders.Conclusion: Our longitudinal findings suggest that maternal IPV-PTSD during the period of child development exert an influence on the development of psychopathology in school-aged children. Mothers' IPV was associated with child psychopathology, independently of PTSD. Child lifetime exposure to violence had an additional impact on the development of psychopathology. Careful evaluation of maternal life-events is essential during early childhood to reduce the risk for the development of child psychopathology. Early efforts to curb exposure to violence in children and early intervention are both needed to reduce further risk for intergenerational transmission of trauma, violence, and related psychopathology.
Food Safety Knowledge, Attitudes, and Practices Among Jordan Universities Students During the COVID-19 Pandemic
Authors: Osaili Tareq M. , Al-Nabulsi Anas A. , Taybeh Asma' O. 
Published: September 2021

Objective: This study aimed to evaluate food safety knowledge, attitudes and practices (KAP) amongst university students in Jordan and changes in food-related behaviors during the COVID-19 pandemic. Correlation between food safety KAP scores and general characteristics of university students was also evaluated.Methods: A cross-sectional study was conducted where an Internet-based questionnaire was distributed through social media platforms. The sample consisted of 1,739 respondents from 29 Jordanian universities. The participants completed a 58-item questionnaire covering demographical characteristics and different food safety aspects which were namely “COVID-19 food-related attributes,” “food cooking and storage,” “personal hygiene.” “cross-contamination prevention/disinfection procedures.” and “restaurant hygiene.” Descriptive statistics, Chi square tests and binary logistic analysis were used to assess the data.Results: The sample consisted of 67.2% females with a mean age of 21.3 ± 1.8 years. The average overall score of the tested aspects was 14.1/34.0 which corresponds to 41.3% of the questions being answered correctly. The percentage of correct answers of “COVID-19 food-related attributes,” “food cooking and storage,” “cross-contamination prevention/disinfection procedures,” “personal hygiene” and “restaurant hygiene” was 56.8, 36.6, 28.4, 44.6. and 36.9%, respectively. A significant (P &lt;0.05) association between respondents' food safety KAP scores and gender, marital status, university degree, employment status, self-rating of food safety knowledge, and the source of food safety information.Conclusion: University students in Jordan had insufficient KAP scores which is a concerning trend during the pandemic. Teaching fundamentals of food safety in the form of short courses/ lectures is recommended.
Surgical Approaches to Upper Limb Spasticity in Adult Patients: A Literature Review
Authors: Hashemi Mahdis , Sturbois-Nachef Nadine , Keenan Marry Ann , Winston Paul 
Published: September 2021

Introduction:Spasticity is the main complication of many upper motor neuron disorders. Many studies describe neuro-orthopedic surgeries for the correction of joint and limb deformities due to spasticity, though less in the upper extremity. The bulk of care provided to patients with spasticity is provided by rehabilitation clinicians, however, few of the surgical outcomes have been summarized or appraised in the rehabilitation literature.Objective:To review the literature for neuro-orthopedic surgical techniques in the upper limb and evaluate the level of evidence for their efficacy in adult patients with spasticity.Method:Electronic databases of MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews were searched for English, French as well as Farsi languages human studies from 1980 to July 2, 2020. After removing duplicated articles, 2,855 studies were screened and 80 were found to be included based on the criteria. The studies were then divided into two groups, with 40 in each trial and non-trial. The results of the 40 trial articles were summarized in three groups: shoulder, elbow and forearm, and wrist and finger, and each group was subdivided based on the types of intervention.Results:The level of evidence was evaluated by Sackett's approach. There were no randomized control trial studies found. About, 4 studies for shoulder, 8 studies for elbow and forearm, 26 studies for wrist and finger (including 4 for the thumb in palm deformity), and 2 systematic reviews were found. Around, two out of 40 trial articles were published in the rehabilitation journals, one systematic review in Cochrane, and the remaining 38 were published in the surgical journals.Conclusion:Most surgical procedures are complex, consisting of several techniques based on the problems and goals of the patient. This complexity interferes with the evaluation of every single procedure. Heterogenicity of the participants and the absence of clinical trial studies are other factors of not having a single conclusion. This review reveals that almost all the studies suggested good results after the surgery in carefully selected cases with goals of reducing spasticity and improvement in function, pain, hygiene, and appearance. A more unified approach and criteria are needed to facilitate a collaborative, evidence-based, patient referral, and surgical selection pathway.
Establishment and Verification of a Perioperative Blood Transfusion Model After Posterior Lumbar Interbody Fusion: A Retrospective Study Based on Data From a Local Hospital
Authors: Liu Bo , Pan Junpeng , Zong Hui , Wang Zhijie 
Published: September 2021

Objective: We aimed to analyze the related risk factors for blood transfusion and establish a blood transfusion risk model during the per-ioperative period of posterior lumbar interbody fusion (PLIF). It could provide a reference for clinical prevention and reduction of the risk of blood transfusion during the peri-operative period.Methods: We retrospectively analyzed 4,378 patients who underwent PLIF in our hospital. According to whether they were transfused blood or not, patients were divided into the non-blood transfusion group and the blood transfusion group. We collected variables of each patient, including age, sex, BMI, current medical history, past medical history, surgical indications, surgical information, and preoperative routine blood testing. We randomly divide the whole population into training group and test group according to the ratio of 4:1. We used the multivariate regression analyses get the independent predictors in the training set. The nomogram was established based on these independent predictors. Then, we used the AUC, calibration curve and DCA to evaluate the nomogram. Finally, we verified the performance of the nomogram in the validation set.Results: Three or more lumbar fusion segments, preoperative low hemoglobin, with hypertension, lower BMI, and elder people were risk factors for blood transfusion. For the training and validation sets, the AUCs of the nomogram were 0.881 (95% CI: 0.865–0.903) and 0.890 (95% CI: 0.773–0.905), respectively. The calibration curve shows that the nomogram is highly consistent with the actual observed results. The DCA shows that the nomogram has good clinical application value. The AUC of the nomogram is significantly larger than the AUCs of independent risk factors in the training and validation set.Conclusion: Three or more lumbar fusion segments, preoperative low hemoglobin, with hypertension, lower BMI, and elder people are associated with blood transfusion during the peri-operative period. Based on these factors, we established a blood transfusion nomogram and verified that it can be used to assess the risk of blood transfusion after PLIF. It could help clinicians to make clinical decisions and reduce the incidence of peri-operative blood transfusion.