bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calculated globulin can be used as a screening test for antibody deficiency in children and adolescents
Authors: Frias Sartorelli de Toledo Piza Cristina , Aranda Carolina Sanchez , Solé Dirceu , Jolles Stephen , Condino-Neto Antonio 
Published: October 2024

PurposeCalculated globulin (CG, total protein minus albumin levels) correlate well with IgG levels and has been proposed as a suitable screening method for individuals with primary antibody deficiencies (PADs). We aimed to show the correlation of CG with IgG levels in children and adolescents, utilizing a common method for albumin measurement, bromocresol green.MethodsIndividuals from two Allergy and Immunology clinics were invited to participate. Inclusion criteria were age &lt; 18, stable conditions, and signed informed consent. We included 1084 individuals. Immunoglobulin G values were determined by immunoturbidimetry; the colorimetric bromocresol green method and the Architect Biuret method were utilized for the albumin and total protein (TP) measurements, respectively.ResultsA total of 1084 individuals were included in the analysis and divided into 4 age groups (0 to &lt;1 year, 1 to &lt;4 years, 4 to &lt;10 years, and 10 to &lt;18 years). For all patients, the mean age was 6.1 (± 5) years old, the mean IgG was 9.4 (± 4.7) g/L, and CG was 23.7 (± 5.9) g/L. The most frequent diagnosis were respiratory allergies, followed by inborn errors of immunity. IgG and CG varied according to age group. Cutoff values for hypogammaglobulinemia varied from 13.8 g/L in children &lt; 1 year to 23.1 g/L in children and adolescents aged 10 to &lt;18 years. CG sensitivity varied from 70.9% in children aged 1 to &lt;4 years old to 95.8% in children 4 to &lt;10. Specificity ranged from 87.5% in children 4 to &lt;10 years old to 100% in children and adolescents aged 10 to &lt;18 years.ConclusionCG is a suitable screening test for hypogammaglobulinemia in children less than 18 years of age.
Epidemiological profile of patients hospitalized with Crohn’s disease due to severe acute respiratory infection during the COVID-19 pandemic: a 2-year report from Brazil
Authors: Nascimento Laís Silva , Marson Fernando Augusto Lima , dos Santos Raquel de Cássia 
Published: October 2024

Background and aimsThe novel coronavirus-induced severe acute respiratory syndrome (COVID-19) led to one of the most significant global pandemics of the 21st century, causing substantial challenges for healthcare systems worldwide, including those in Brazil. This study aimed to investigate the demographic and clinical profiles of hospitalized patients in Brazil who had both COVID-19 and Crohn’s disease (CD) over a 2-year period.MethodsAn epidemiological analysis was conducted using data from Open-Data-SUS. The study focused on describing the demographic characteristics, clinical manifestations, comorbidities, and hospitalization details of patients afflicted with severe acute respiratory syndrome due to COVID-19 and CD, with the aim of predicting mortality risk.ResultsThe states of São Paulo, Paraná, and Minas Gerais accounted for 50% of the reported COVID-19 cases. The most affected racial group consisted of individuals who self-declared as mixed race. Common comorbidities included heart disease, diabetes mellitus, and obesity. The age group most affected was 25 to 60 years old, particularly among hospitalized patients with both CD and COVID-19 who ultimately succumbed to the illness. A multivariable analysis was conducted to identify the following significant risk factors for death: (a) the presence of neurological disorder (OR = 6.716; 95% CI = 1.954–23.078), (b) the need for intensive care (OR = 3.348; 95% CI = 1.770–6.335), and (c) the need for invasive mechanical ventilation (OR = 59.017; 95% CI = 19.796–175.944).ConclusionThere was no discernible gender-based prevalence among hospitalized patients with CD and COVID-19; however, individuals of mixed race were disproportionately affected. The 25 to 60 age group emerged as the most vulnerable demographic group, with high risks of hospitalization and mortality. Moreover, the study highlights the potential for COVID-19 to induce systemic pathologies that may result in long-term degenerative effects and sequelae.
Effects of a 6-month aerobic exercise intervention on brain morphology in women with breast cancer receiving aromatase inhibitor therapy: a sub-study of the EPICC trial
Authors: Molina-Hidalgo Cristina , Wan Lu , Velazquez-Diaz Daniel , Huang Haiqing , Grove George , Bender Catherine M. , Gentry Amanda L. , Sereika Susan M. , Kang Chaeryon , Crisafio Mary E. , Erickson Kirk I. 
Published: October 2024

ObjectivePhysical exercise may increase brain volume and cortical thickness in late adulthood. However, few studies have examined the possibility for exercise to influence brain morphology in women treated for breast cancer. We conducted a nested sub-study within a randomized clinical trial to examine whether 6 months of moderate-intensity aerobic exercise in postmenopausal women with early-stage breast cancer influences brain morphology.MethodsWe included twenty-eight postmenopausal women newly diagnosed with Stage 0-IIIa breast cancer (M age = 62.96 ± 5.40) who were randomized to either 45–60 min of supervised aerobic exercise 3 days/week (n = 16) or usual care (n = 12). Before beginning aromatase inhibitor aromatase inhibitor therapy, and the exercise intervention, and again at 6-month follow-up, volumetric and cortical thickness measures were derived from magnetic resonance imaging scans.ResultsThere were no significant intervention effects on brain volume and cortical thickness. However, greater average exercise intensity (%) during the intervention was associated with greater post-intervention cortical volume, mean cortical thickness, precentral gyrus thickness, and superior parietal thickness (all p &lt; 0.05). Finally, total supervised exercise time was associated with higher precentral gyrus thickness after the intervention (p = 0.042, R2 = 0.263).ConclusionThe exercise intervention did not significantly affect brain volumes and cortical thickness compared to the control group. However, positive associations were found between exercise intensity and brain morphology changes after the 6-month intervention, indicating that exercise may reduce the vulnerability of the brain to the deleterious effects of breast cancer and its treatment.
Independent and joint influence of depression and advanced lung cancer inflammation index on mortality among individuals with chronic kidney disease
Authors: Zhou Jie , Liu Wenjun , Liu Xiaoxin , Wu Jijun , Chen Ying 
Published: October 2024

BackgroundThe combined effect of depression and nutritional-inflammatory status on mortality in the chronic kidney disease (CKD) population is unclear.MethodsWe prospectively analyzed 3,934 (weighted population: 22,611,423) CKD participants from the National Health and Nutrition Examination Survey (2007–2018). Depression and nutritional-inflammatory status were assessed with Patient Health Questionnaire 9 (PHQ-9) and Advanced Lung Cancer Inflammation Index (ALI), respectively. Weighted multivariate COX regression models, restricted cubic splines (RCS) models, and stratified analyses were used to investigate the association of PHQ-9 scores and ALI with all-cause mortality.ResultsDuring a median follow-up of 5.8 years (interquartile range 3.4–8.6 years), a total of 985 patients died (25.0%). Each point increase in a patient’s PHQ-9 score increased the risk of all-cause mortality by 4% (HR, 1.04; 95% CI, 1.02–1.06; p &lt; 0.001), in the full adjusted model. However, an increase in ALI levels was associated with a decreased risk. HRs (95% CI) of 0.76 (0.65–0.90), 0.70 (0.57–0.86), and 0.51 (0.41–0.64) in the Q2, Q3, and Q4 of ALI compared with the Q1 of ALI, respectively. In addition, the joint analysis showed that CKD patients without depression and with higher ALI were associated with a reduced risk of all-cause mortality. Namely, patients in the highest ALI group (Q4) without depression had the lowest risk (HR, 0.32; 95% CI, 0.21–0.48). Furthermore, this combined effect was consistent across all subgroups, and no significant interaction was found (p &gt; 0.05 for interaction).ConclusionIn a nationally representative sample of US patients with CKD, coexisting depression and poorer nutrition-inflammation were associated with a significantly increased risk of all-cause mortality.
Association of triglyceride-glucose index and its combination with obesity indicators in predicting the risk of aortic aneurysm and dissection
Authors: Yu Wangqin , Wang Xiaoling , Du Zhongyan , Cheng Wenke 
Published: October 2024

BackgroundThe association between the triglyceride-glucose (TyG) index and its combination with obesity indictors in aortic aneurysm and dissection (AAD) remains unclear. We aimed to investigate the association between TyG and TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist height ratio (TyG-WHtR) and AAD risk.MethodsThis study included 387,483 baseline participants from the UK Biobank with complete data on TyG, TyG-BMI, TyG-WC and TyG-WHtR. Cox proportional hazard models evaluated the relationship between these four indicators and the risk of AAD occurrence. Restricted cubic spline (RCS) examined the non-linear relationship between these indicators and AAD risk, while receiver operating characteristic (ROC) curves assessed the predictive value of these four indicators for AAD risk.ResultsOver a median follow-up of 13.7 years, 3,041 AAD events were recorded. Multivariate Cox regression analysis indicated that for each standard deviation increase, the risk of AAD occurrence increased by 33% (HR: 1.33, 95%CI: 1.29–1.38), 25% (HR: 1.25, 95%CI: 1.21–1.29), 61% (HR: 1.61, 95%CI: 1.56–1.66) and 44% (HR: 1.44, 95%CI: 1.39–1.49) for TyG, TyG-BMI, TyG-WC and TyG-WHtR, respectively. RCS demonstrated a linear relationship between these indicators and AAD risk, with TyG-WC demonstrating the best performance in predicting AAD occurrence based on ROC curves.ConclusionThe present study, based on a large prospective cohort design, showed that higher TyG index and its combination with obesity indices were significantly associated with the risk of AAD. Moreover, AFT models further showed that elevation of these indicators significantly advanced the onset of AAD. In addition, RCS analyses demonstrated a linear association between these indicators and the risk of AAD, and the TyG-WC showed higher predictive ability for AAD. These findings emphasize the potential application of the TyG index and its combination with obesity indicators in the early identification of AAD.
Perceptions of physicians caring for pediatric patients with cancer in Europe: insights into the use of palliative care, its timing, and barriers to early integration
Authors: Lacerda Ana , Bravo-Carretero Isabel M. , Ehrlich Bella S. , Job Godwin , Avilés Martínez María , Leiss Ulrike , Kokkinou Georgia , Scheinemann Katrin , Craig Finella , Krottendorfer Kerstin , Devidas Meenakshi , Baker Justin N. , Agulnik Asya , McNeil Michael J. 
Published: October 2024

BackgroundIntegrating pediatric palliative care (PPC) into pediatric oncology standard care is essential. Therefore, it is important to assess physicians’ knowledge and perceptions of PPC to optimize its practice.ObjectiveTo evaluate the knowledge, comfort levels, and perspectives of physicians regarding the timing and perceived barriers to integrating PPC into pediatric cancer care across Europe.DesignThe Assessing Doctors’ Attitudes on Palliative Treatment (ADAPT) survey, originally developed for other global regions, was culturally and contextually adapted for Europe.Setting/SubjectsThe survey was distributed via the European Society of Paediatric Oncology (SIOPE) membership listserv. Any physicians caring for children with cancer across Eastern, Southern, Central, and Northern Europe were invited to complete the survey.ResultsA total of 198 physicians from 29 European countries completed the ADAPT survey. Physicians demonstrated relative agreement with the World Health Organization’s guidance; median alignment was 83.4% (range 59.9%-94.1%). Although most respondents felt comfortable addressing physical (84.4%) and emotional (63.4%) needs, they felt less comfortable addressing spiritual needs (41.9%) and providing grief and bereavement support (48.5%). There were significant regional differences, such as physicians in Eastern and Southern Europe reporting a lack of PPC specialists, opioids, and home-based care, while those in Northern and Central Europe did not.ConclusionPhysicians caring for children with cancer throughout Europe have a good understanding of PPC. However, misconceptions about PPC persist, requiring educational and capacity-building efforts. Additionally, the regional differences in perceived barriers must be addressed to ensure equitable access to PPC for all European children with cancer.
Comparison of different concentrations atropine in controlling children and adolescent myopia: an umbrella review of systematic reviews and meta-analyses
Authors: Chen Baizhou , Ni Yao , Chen Jinghan , Xing Shuwen , Zhang Zhaotian 
Published: October 2024

PurposeTo evaluate the myopia control effect of different concentrations atropine in children and adolescent.MethodsMeta-analyses and systematic reviews available in the Pubmed, Embase, and Cochrane Library databases from the databases’ inception to August 2023 were searched to evaluate the efficacy and tolerability of different concentrations’ atropine in controlling myopia progression. Overall effects were performed using random-effects model. AMSTAR 2 tool was used to assess the quality of included studies. Prespecified outcomes were weight mean difference (WMD) with 95% credible interval (95% CI) of annual spherical equivalent refraction (SER) changes and annual axial length (AL) changes.Results19 systematic reviews/meta-analyses of different atropine concentrations were included in the analysis. 14 studies reported SER changes, and 17 reported AL changes. In terms of the studies’ overall methodological quality level (measured using AMSTAR 2), 1 study was rated high, 7 moderate, 7 low, and 4 critically low. The 0.01% atropine was found to have statistically significance (annual SER change WMD 0.27 [95% CI 0.21 - 0.34] D/year; annual AL change WMD -0.09 [95% CI -0.1 to -0.07]) mm/year), 0.05% atropine was preferred considering efficacy and tolerability (annual SER change WMD 0.54 [95% CI 0.49 - 0.58] D/year; annual AL change WMD -0.21 [95% CI -0.12 to -0.02]) mm/year).ConclusionsDifferent atropine concentrations alleviated children and adolescent myopia progression. However, higher-quality evidence and further investigation are needed to clarify the dose–response relationship, and practical guidelines must be developed to determine myopia control efficacy.
Exploring the lived experience of performance-related health and wellbeing among flautists
Authors: Wang Jiayi , Welch Graham F. 
Published: October 2024

IntroductionThe study has investigated the lived experience of flautists, focusing on their experiences and perceptions of performance-related physical discomfort, injury and related mental health challenges that they might have encountered in practice and performance. The aims of the research have been to provide flautists with an opportunity to reflect on any physical or psychological performance issues in their own words, and to understand the subjective meaning of these experiences.MethodsA basic qualitative approach was used for gathering data. All the fieldwork was undertaken during or immediately after the Covid-19 pandemic. Consequently, the participating flautists were deliberately selected using professional networks on the basis of their answers to a pre-interview initial questionnaire related to the characteristics of their personal backgrounds and their experiences, as well as being able to participate remotely. There have been two data collection phases. Phase 1 was a specially designed pre-interview questionnaire drawing on themes from appropriate literature. Phase 2 built on the pre-interview questionnaire responses and was designed as semi-structured interviews, undertaken on Zoom, and included a ‘River of Flute-playing Experience’ activity during the interview. The ‘River of Experience’ method is an autobiographical research tool in which participants were asked to annotate key biographical experiences and challenges at various points along their drawing of a meandering river. The combined data analyses drew on thematic analysis.ResultsThe eight participants reported a personal history of performance-related health and wellbeing challenges that they had faced at some point in their lives. The findings reveal that flautists encounter health-related challenges associated with their practice and performances, and the data suggest that they each require an understanding of likely performance-related health challenges and supportive resources to assist them in managing these challenges.DiscussionThe participants’ diverse experiences highlight the importance of managing health and the value of supportive social connections. They cope with health challenges by integrating passion, resilience, and adaptability into their lives, finding ways to grow and continue to thrive in their flute-playing journey. The study underscores the need for comprehensive health education and support resources for flautists, emphasising the significance of resilience and adaptability in fostering health, wellbeing, and success.
In their narratives: academic socialization in the experience of sensory processing sensitivity among university students
Authors: Saglietti Marzia , Marini Mara , Livi Stefano 
Published: October 2024

IntroductionWhile much of the worldwide contemporary research on sensory processing sensitivity (SPS) and environmental sensitivity (ES) has relied on the participation of university students, there remains a significant gap in understanding the academic social experiences of those scoring high in SPS (i.e., highly sensitive individuals).MethodsTo address this gap, this exploratory study aimed to investigate in detail students’ academic socialization through their narratives. We conducted nine interviews with Italian university students who self-identified as highly sensitive.ResultsThrough thematic reflexive analysis, we identified and analyzed 6 themes (with subthemes and versions of subthemes) concerning their self-definitions, their university experience (in classroom, before, during, and after exams), and socialization with peers and teachers.DiscussionAfter 20 years of research on SPS, this study integrates the relevant literature into the field of social psychology and academic socialization, emphasizing the importance of understanding SPS within real-life educational contexts and considering highly sensitive students’ perspectives on their resources and challenges in attending university. By contributing to the emerging qualitative literature on SPS and ES, this study provides practical implications for educators and policymakers seeking to foster inclusive learning environments for all students.
Achievement motivation and mental health among medical postgraduates: the chain mediating effect of self-esteem and perceived stress
Authors: Ma Mu-yun , Li Yao , Guo Li , Yang Guan-e 
Published: October 2024

IntroductionMedical postgraduates generally experience high levels of depression and anxiety. Previous studies have investigated the impact of various achievement motivations on depression/anxiety among medical students.MethodsThis study focused on self-esteem and perceived stress, examining the internal mechanisms through which achievement motivation affects depression/anxiety. 530 medical postgraduate students (66.04% female and 33.96% male) were administered the Achievement Goal Orientation Scale, Self-Esteem Scale, Perceived Stress Scale, and Depression-Anxiety-Stress Scale.ResultsResults indicated that: (1) mastery-approach goals were negatively correlated with depression/anxiety; mastery-avoidance goals were positively correlated with depression/anxiety; performance-avoidance goals positively predicted depression/anxiety; (2) self-esteem mediated the relationship between achievement motivation and depression/anxiety; (3) perceived stress played a mediating role in the relationship between achievement motivation and depression/anxiety; (4) self-esteem and perceived stress played a chain mediating role in the relationship between achievement motivation and depression/anxiety; (5) there was no significant linear correlation between mastery-approach goals and depression/anxiety.DiscussionAlthough this study employed a cross-sectional design and self-report scales, both of which have certain limitations, the findings still hold significant theoretical and practical implications. The research reveals a mediating pathway between achievement goals and mental health, offering new insights into mental health education for medical graduate students.
Unique and cumulative effects of different subtypes of sleep problems on burnout among Chinese nurses
Authors: Lin Ping-Zhen , Lin Yong-Sen , Wang Xu , Chen Lan-Lan , Lin Yan-Yan , Wu Bi-Yu 
Published: October 2024

ObjectiveTo investigate the unique and cumulative associations of different sleep problem subtypes with burnout among Chinese nurses.MethodsA survey was conducted in Quanzhou, China, and a total of 744 nurses were included. Burnout was measured by Maslach Burnout Inventory-Human Services Survey across three dimensions: emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PA). Pittsburgh Sleep Quality Index was used to measure 15 types of sleep problems. Binary logistic regression was employed to explore the association between sleep problems and burnout.ResultsPrevalence of sleep problems, high EE, high DP and low PA were 43.3, 6.9, 23.4, and 63.2%, respectively. Experience of sleep problems significantly increased risk for EE (OR = 1.31, 95%CI: 1.185–1.436), DP (OR = 1.08, 95%CI: 1.023–1.142) and PA (OR = 1.09, 95%CI: 1.036–1.146). Of the 15 sleep problem subtypes, “feel too cold” and “have pain” were significant predictors of high EE (OR = 3.89, 95%CI: 1.629–9.302; OR = 3.00, 95%CI: 1.314–6.827, respectively), and “daytime dysfunction” significantly predicted low PA (OR = 1.68, 95%CI: 1.135–2.491). Around 40.9% of nurses had reported more than three subtypes of sleep problems. Experiencing more than three subtypes of sleep problems were significantly associated with an increased risk of DP and PA (ORs range from 2.07 to 2.71).ConclusionThese findings suggested that sleep problems was associated with an increased risk of burnout in nurses, with both unique and cumulative risks. Interventions should focus on the prevention and management of the effects of sleep problems among nurses.