bluuebunny/crossref_metadata_2025_split huggingface dataset:
#junkfluenced: the marketing of unhealthy food and beverages by social media influencers popular with Canadian children on YouTube, Instagram and TikTok
Authors: Potvin Kent Monique , Bagnato Mariangela , Amson Ashley , Remedios Lauren , Pritchard Meghan , Sabir Soulene , Gillis Grace , Pauzé Elise , Vanderlee Lana , White Christine , Hammond David 
Published: April 2024

Abstract
Background
Marketing of unhealthy foods to children on digital media significantly impacts their dietary preferences and contributes to diet-related noncommunicable diseases. Canadian children spend a significant amount of time on digital devices and are frequently exposed to unhealthy food marketing on social media, including by influencers with celebrity status who endorse products. This study aimed to examine the frequency, healthfulness, and power of unhealthy food marketing in posts by influencers popular with Canadian children on YouTube, Instagram and TikTok.

Methods
The top 9 influencers popular amongst Canadian children aged 10–12 years were identified from the 2021 International Food Policy Study Youth Survey. A total of 2,232 Instagram, YouTube and TikTok posts made by these influencers between June 1st 2021 and May 31st 2022 were examined for instances of food marketing. Food products/brands were identified and frequencies were calculated for the number of posts promoting food products/brands, posts promoting products/brands classified as less healthy according to Health Canada’s Nutrient Profile Model (2018) and marketing techniques utilized.

Results
YouTube had the highest average rate of food marketing instances per post, at a rate of 1 food marketing instance every 0.7 posts, while TikTok and Instagram had instances every 10.2 posts and 19.3 posts, respectively. Overall, fast food restaurants was the most promoted food category (21%), followed by regular soft drinks (13%), snacks (11%), candy and chocolate (11%) and water (8%). The most frequently used marketing techniques were appeals to fun/cool (37%), the use of songs or music (28%) and the product being consumed (25%). In terms of healthfulness, 83% of the products/brands (87% of brands and 82% of products) promoted were classified as less healthy.

Conclusions
Social media influencers play a substantial role in promoting unhealthy food products to children, primarily fast food items. Given the significant impact of such marketing on children, there is a need for ongoing government-led monitoring, and it is crucial to include social media and influencer marketing in marketing restrictions targeting children in Canada to safeguard this vulnerable demographic.
Paratesticular cellular angiofibroma: a case report
Authors: Murashima Takaya , Kida Kazutaka , Gi Toshihiro , Hida Takuya , Fujii Masato , Nagai Takahiro , Takamori Hiroki , Mukai Shoichiro , Sato Yuichiro , Kamoto Toshiyuki 
Published: April 2024

Abstract
Introduction
Paratesticular cellular angiofibroma is a rare benign mesenchymal tumor. The optimal management is surgical resection due to the difficulty of preoperative accurate diagnosis.

Case presentation
A 51-year-old Japanese male visited our hospital complaining of asymptomatic left scrotal swelling. Physical examination revealed a nontender elastic paratesticular mass (5.5 cm in diameter). Although testicular germ cell tumor was ruled out clinically, the possibility of malignant potential remained for the tumor. Since the patient consented to complete resection, a transinguinal radical orchiectomy was performed. The pathological diagnosis revealed cellular angiofibroma. The patient recovered without perioperative complications, and no apparent recurrence was observed at 5 years after surgery.

Conclusion
The pathological findings were compatible for cellular angiofibroma. The tumor was successfully resected, and no apparent recurrence was observed at 5 years after surgery.
Comparing cardiorespiratory fitness, body composition, and muscular endurance of patients with schizophrenia and schizoaffective disorders with a population-based sample
Authors: Kheradmand Ali , Aliabbar Shiva , Danaee Hamid , Hassabi Mohammad , Hamdieh Mostafa , Abedi-Yekta Amir Hosein 
Published: April 2024

Abstract
Background
There is an entrenched reverse link between cardiorespiratory fitness (CRF) and earlier deaths. The purpose of our study was to provide a report of CRF elements in a sample of hospitalized patients with schizophrenia and to compare them with a population-based sample.

Methods
This study was performed on 60 subjects (30 in the schizophrenic and schizoaffective group and 30 in the control group). CRF factors such as body mass index (BMI), and body fat, push-up test, curl-up test, VO2 peak, and sit-and-reach test, were compared across two groups. The Positive and Negative Syndrome Scale (PANSS) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) were assessed in the case group.

Results
The body fat percentage, abdominal circumference, and BMI are more in schizophrenic patients. Also, flexibility, muscle endurance, and maximum aerobic capacity are significantly lower in schizophrenic and schizoaffective patients comparing healthy subjects (P < .001). Moreover, we found that with the increasing severity of the disease, the CRF of the patients became worse (P <.001).

Conclusion
Patients with schizophrenia and schizoaffective disorders should be evaluated for cardiorespiratory and other factors of CRF. Exercise prescription treatment can be helpful to improve social functioning and decrease the impact of cardiovascular disease in patients with schizophrenia.
Clustering of lifestyle risk factors in relation to suicidal thoughts and behaviors in young adolescents: a cross-national study of 45 low- and middle-income countries
Authors: Zhan Yongle , Wang Pei , Zhan Yongan , Lu Zhiming , Guo Yidan , Ahmad Noor Ani , Owusu Andrew , Chher Tepirou , Hinneh Johnson T. , Aryal Krishna Kumar , Darwish Noorali , Senanayake Sameera J. , Mufadhal Bushra abdulrahman Ahmed , Rady Alissar , Bassier-Paltoo Marcia , Batbaatar Suvd 
Published: April 2024

Abstract
Background
Prior research has reaffirmed lifestyle risk behaviors to cluster among adolescents. However, the lifestyle cluster effect on suicidal thoughts and behaviors (STBs) was unclear among adolescents in low- and middle-income countries (LMICs). No comparison of such associations was conducted across nations.

Methods
Data from 45 LMICs were obtained from the Global School-based Student Health Survey (GSHS) between 2009 and 2019. Lifestyle behavior factors were collected through a structured questionnaire. Suicidal ideation, plan, and attempt were ascertained by three single-item questions. Lifestyle risk scores were calculated via a sufficient dimension reduction technique, and lifestyle risk clusters were constructed using a latent class analysis. Generalized linear mixed models with odds ratio (OR) and 95% confidence interval (CI) were used to estimate the lifestyle-STB associations.

Results
A total of 229,041 adolescents were included in the final analysis. The weighted prevalence of suicidal ideation, plan, and attempt was 7.37%, 5.81%, and 4.59%, respectively. Compared with the favorable lifestyle group, the unfavorable group had 1.48-, 1.53-, and 3.11-fold greater odds of suicidal ideation (OR = 1.48, 95%CI: 1.30–1.69), plan (OR = 1.53, 95%CI 1.34–1.75), and attempt (OR = 3.11, 95%CI 2.64–3.65). Four clusters of lifestyle risk behaviors were identified, namely healthy lifestyles (H–L), insufficient intake of vegetables and fruit (V-F), frequent consumption of soft drinks and fast food (D-F), and tobacco smoking and alcohol drinking (S-A) clusters. Compared with H–L cluster, V-F cluster was associated with 43% and 42% higher odds of suicidal ideation and plan, followed by S-A cluster (26% for ideation and 20% for plan), but not significant in D-F cluster (P > 0.05). D-F cluster was associated with 2.85-fold increased odds of suicidal attempt, followed by V-F cluster (2.43-fold) and S-A cluster (1.18-fold).

Conclusions
Clustering of lifestyle risk behaviors is informative for risk stratification of STBs in resource-poor settings. Lifestyle-oriented suicide prevention efforts should be initiated among school-attending adolescents in LMICs.
Real-World Challenges of Managing Diffuse Large B-Cell Lymphoma in a Developing Country
Authors: Iftikhar Raheel , Ahmad Usman , Haider Ghulam , Mahmood Humera , Khan Maryam , Masood Misbah , Anwar Nida , Javed Qamar , Sajid Nadia , Tariq Rija , Mehmod Sana , Haider Javeria , Abro Nargis Aalam , Shahbaz Shanzah , Khokhar Abbas , Khan Zeeshan Ahmed , Pervez Hassan , Moosajee Munira , Aziz Zeba 
Published: April 2024

PURPOSE To highlight challenges and cancer care disparities in patients of diffuse large B-cell lymphoma management in resource-constrained settings. MATERIALS AND METHODS This multicenter retrospective study included 738 patients from 12 public and private sector hematology-oncology centers across Pakistan. Patients were divided into limited-resource and enhanced-resource settings as per national diffuse large B-cell lymphoma (DLBCL) guidelines. RESULTS The median age at diagnosis was 47 years (range, 14-89). Male:female ratio was 2.5:1. Majority of the patients (69.3%) were treated in limited-resource settings. Computed tomography was used as a staging modality in 442 (60%) patients. Limited-stage DLBCL was present in 13.5% of patients, while 86.3% had advanced-stage disease at diagnosis. First-line regimens included rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in 56% and cyclophosphamide, doxorubicin, vincristine, prednisone in 34% of patients, while 10% of patients received palliative regimens upfront. Of evaluable data, complete remission was documented in 299 (74.4%) patients, 39 (9.8%) had partial response and 63 (13.5%) had progressive disease. Disease-free survival (DFS) and overall survival (OS) status were not available for 345 (46.8%) patients at the time of data collection. Overall study cohort had a median follow-up of 2.2 years with a median OS of 3.6 years (95% CI, 3.1 to 4.1), median DFS of 3.1 years (95% CI, 2.6 to 3.6), and a 5-year OS of 40% and DFS of 36%. CONCLUSION Patients from low- and middle-income countries present at an earlier age and have more advanced disease. Patients were frequently lost to follow-up, and record keeping was inadequate more so in patients treated in limited-resource settings. There is a need to establish a national lymphoma registry, improve record keeping, and standardize treatments to ensure improvement in treatment outcomes.
Real-World Evidence of Ribociclib Plus Aromatase Inhibitors as First-Line Treatment in Advanced Breast Cancer: The BrasiLEEira Study
Authors: Suzuki Daniele Assad , Morelle Alessandra Menezes , de Brito Mayana Lopes , Paes Flavia Rocha , Mattar André , Leal Jorge H. Santos , Simon Sérgio D. , Lima Ellias Magalhães Abreu , Werutsky Gustavo , Piotto Gustavo H. Munhoz , Bines José , Damiani Lucas Petri , Macedo Ariane , Campos Lígia , Buehler Anna Maria 
Published: April 2024

PURPOSE Cyclin inhibitors plus endocrine therapy represent the reference standard for hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2–) locally advanced or metastatic breast cancer (ABC). Efficacy results on hard end points such as overall survival come from well-designed randomized clinical trials (RCTs). However, a limitation of RCTs is the low external results validity, and their extrapolation to a broader population may not be appropriate. Real-world studies can overcome these limitations, also increasing the reliability of RCTs. MATERIALS AND METHODS The BrasiLEEira was an observational, longitudinal, retrospective, multicenter study to evaluate the effectiveness and safety of ribociclib plus nonsteroidal aromatase inhibitors in Brazilian women age 18 years or older with HR+/HER2– ABC. The study was approved by the institutional review boards of all 11 hospitals. Data were collected anonymously from medical records using an electronic case report form designed by an independent academic research organization, which conducted the study considering all recommendations of international guidelines. The primary end point was 1-year progression-free survival (PFS) rate. Secondary end points included mortality, dose reduction, and safety. RESULTS The mean age of 76 patients was 57 years, and 28.9% were Black/Brown. The most prevalent comorbidity was arterial hypertension (34.7%). About 26.0% had endocrine-resistant disease, and 54.1% had more than three metastatic sites. The PFS rate was 77.6%. Three patients died (3.9%). Dose reductions occurred in 37.7% of patients. The most common adverse event was neutropenia (68.4%). CONCLUSION The high-quality evidence from the BrasiLEEira study corroborates the RCTs' findings, expanding its validity to a broader spectrum and underrepresented population who may benefit from ribociclib treatment.
Κατασκευές της αιτιογένεσης και της (ανα)παραγωγής της αστυνομικής βίας στο πλαίσιο συνεντεύξεων με νέους ενηλίκους
Authors: Μπουτζή Άννα Μαρία , Σταματάρος Λουκάς , Φίγγου Λία 
Published: April 2024

Η παρούσα μελέτη είχε ως στόχο την ανάδειξη των τρόπων με τους οποίους κατασκευάζεται η αστυνομική βία στο λόγο νέων ενηλίκων στο ελληνικό πλαίσιο. Η εστίαση της έρευνας ήταν κυρίως στις κατασκευές της αιτιογένεσης του φαινομένου, και στην ανάδειξη των ρητορικών και μακροκοινωνικών (ιδεολογικών) συνεπειών αυτών των κατασκευών. Τα δεδομένα προήλθαν από δεκαεπτά (17) ατομικές συνεντεύξεις με νέους, οι οποίες πραγματοποιήθηκαν διαδικτυακά λόγω των περιορισμών που επιβλήθηκαν στο πλαίσιο της διαχείρισης της πανδημίας του COVID-19. Η ανάλυση βασίστηκε στις αρχές της κριτικής λογοψυχολογίας και ανέδειξε τέσσερις κύριες επιχειρηματολογικές γραμμές τις οποίες κινητοποίησαν οι συμμετέχουσες/-οντες για να ερμηνεύσουν την αστυνομική βία: Η πρώτη επιχειρηματολογική γραμμή αφορούσε την προσωπικότητα και τις ατομικές διαφορές μεταξύ αστυνομικών, η δεύτερη εστίαζε στην αστυνομική κουλτούρα και τις διαδικασίες εκπαίδευσης, η τρίτη επικεντρωνόταν στο ρόλο της αστυνομίας ως κρατικού/συστημικού θεσμού και η τέταρτη εξέταζε το φαινόμενο ως αποτέλεσμα διομαδικής σύγκρουσης. Τα ευρήματα συζητιούνται αναφορικά με την ευθύνη της δράσης που κατασκευάζουν κάθε φορά και τη δυνητική συνεισφορά τους στην καταδίκη ή τη νομιμοποίηση και την κανονικοποίηση της αστυνομικής βίας.
The use of artificial intelligence in the diagnosis and detection of complications of diabetes
Authors: Ziajor Seweryn , Tomasik Justyna , Sajdak Piotr , Turski Mikołaj , Bednarski Artur , Stodolak Marcel , Szydłowski Łukasz , Żurowska Klaudia , Krużel Aleksandra , Kłos Kamil , Dębik Marika 
Published: April 2024

Introduction: Diabetes poses a significant global health challenge, impacting patient well-being and longevity. Despite advances in diagnosis and treatment, the prevalence of diabetes continues to rise, with projections indicating a substantial increase in affected individuals in the coming years. The complications of diabetes, including cardiovascular disease, retinopathy, nephropathy, and neuropathy, underscore the importance of early detection and management. In this context, artificial intelligence (AI) offers promising opportunities to revolutionize diabetes care, enabling faster diagnostics, more effective treatment strategies.
Description of the State of Knowledge: Artificial intelligence (AI) has emerged as a transformative force in healthcare, leveraging machine learning and deep learning algorithms to analyze vast amounts of medical data. These algorithms enable more accurate diagnosis, prediction of disease onset, and early detection of complications associated with diabetes. Machine learning models, including support vector machines and neural networks, have shown promise in identifying diabetes risk factors and predicting disease progression. Deep learning techniques, with their ability to analyze complex data patterns, offer further insights into diabetes diagnosis. Additionally, fuzzy cognitive maps provide a framework for decision-making based on patient data, enhancing early detection efforts.
Summary: Artificial intelligence holds immense potential to transform diabetes care, offering solutions for early detection, personalized treatment, and improved patient outcomes. By harnessing the power of AI algorithms, healthcare providers can enhance diagnostic accuracy, predict disease progression, and implement targeted interventions.
Poland’s Breast Self-Exams: Empowering Awareness
Authors: Krużel Aleksandra , Kłos Kamil , Sajdak Piotr , Tomasik Justyna , Dębik Marika , Stodolak Marcel , Szydłowski Łukasz , Żurowska Klaudia , Ziajor Seweryn , Bednarski Artur 
Published: April 2024

Introduction and purpose: Breast cancer poses a significant global health challenge, especially in Poland, where it is the most prevalent cancer among women. Despite advancements in medical technology, individual awareness and proactive health practices, such as Breast Self-Examination (BSE), are crucial for early detection. This study focuses on BSE practices in the Tarnów district of Poland, a small city facing unique healthcare challenges, to understand the prevalence, knowledge, and attitudes toward BSE. The aim of study was to comprehensively investigate BSE practices among women in the Tarnów district, considering socio-demographic factors.
Material and Methods: Anonymous questionnaires assessed socio-demographic characteristics, attitudes toward BSE, frequency of BSE performance, knowledge on BSE, and sources of information. The survey involved 100 Polish women in gynecologist and general practitioner offices in Tarnów County. Results were analyzed in relation to age, education, and place of residence.
Results: While 90% of women were familiar with BSE, 10% had never heard of it. While 29% performed BSE monthly, 18% never conducted the examination. Knowledge gaps were identified, particularly regarding optimal BSE practices. Information sources included the Internet (44%) and gynecologists (28%). Notably, 65% expressed a willingness to participate in BSE training.
Conclusions: In conclusion, the study provides valuable insights into BSE practices among women in the Tarnów district, emphasizing the need for targeted interventions to encourage regular BSE. Knowledge gaps and the willingness of women to participate in training present opportunities for healthcare initiatives. The study also highlights the need for broader health education campaigns to dispel myths and enhance awareness, particularly regarding breast cancer affecting both genders. Limitations include a small sample size and geographic specificity to Tarnów district.
Psychometric properties of a modified health belief model for cervical cancer and visual inspection with acetic acid among healthcare professionals in Ethiopia
Authors: Lemlem Semarya Berhe , Gary Rebecca A. , Yeager Katherine A. , Sisay Mitike Molla , Higgins Melinda K. 
Published: April 2024

Purpose
Evidence supports that the Health Belief Model (HBM) can explain and predicts certain health behaviors, including participation in cervical cancer (CC) screening. The purpose of this study was to evaluate the psychometric properties of a modified HBM for CC and visual inspection with acetic acid (VIA) in female healthcare professionals in Addis Ababa, Ethiopia, 2020.

Methods
Psychometric properties related to CC and VIA were tested using 42-item modified HBM self-administered questionnaire and a cross-sectional study design with simple random sampling. Kaiser-Meyer-Olkin and Bartlett’s sphericity test indicated that data sampling adequacy for exploratory factor analysis was 0.792 (χ2 = 3189.95, df = 351, p < .001). Items with cross-loading and factor loadings ≥ 0.5 were retained. Confirmatory factor analysis (CFA) was conducted to determine model fit.

Results
The final analysis included 194 women, (mean age 30±4.34). Twelve items with ≤ 0.5 were removed and 30 retained items loaded into 6 factors; (benefits of VIA, perceived seriousness of CC, barrier (fear of negative outcome), self-efficacy, susceptibility to CC, and barriers (health system delivery)) explained 65% of the total variance. Cronbach’s alpha for the total instrument was 0.8 and reliability for the 6 subscales was 0.76–0.92. Composite reliability and average variance extracted indicated good internal consistency and convergent validity. CFA identified 6 additional items to be removed with high residual covariance. The final 24 items of the modified HBM had an acceptable model fit (goodness-of-fit index (GFI) = 0.861, adjusted GFI = 0.823, comparative fit index = 0.937, root mean square error of approximation = 0.059).

Conclusion
The modified HBM for CC and VIA with 24 items had adequate psychometric properties and may be used by Ethiopian healthcare professionals for research or clinical purposes. To support external validity the updated 24 items tool is suggested for application in further study in different populations in Ethiopia.
Detecting epinephrine auto-injector shortages in Finland 2016–2022: Log-data analysis of online information seeking
Authors: Mukka Milla , Pesälä Samuli , Mustonen Pekka , Kaila Minna , Helve Otto 
Published: April 2024

Introduction
Medicine shortages prevail as a worldwide problem causing life-threatening situations for adults and children. Epinephrine auto-injectors are used for serious allergic reactions called anaphylaxis, and alternative auto-injectors are not always available in pharmacies. Healthcare professionals in Finland use the dedicated internet source, Physician’s Database (PD), when seeking medical information in practice, while Health Library (HL) provides health information for citizens (S1 Data). The objectives were to assess whether (1) professionals’ searches for epinephrine auto-injectors and (2) citizens’ anaphylaxis article openings relate to epinephrine shortages in Finland.

Methods
Monthly log data on epinephrine auto-injectors (EpiPen®, Jext®, Emerade®) from PD and on openings of anaphylaxis articles from HL were collected during 2016–2022. Professionals’ searches of seven auto-injectors and citizens’ openings of four anaphylaxis articles were compared to information on epinephrine shortages reported by Finnish Medicines Agency. Professionals’ auto-injector prescriptions provided by Social Insurance Institution were also assessed.

Results
Total searches in EpiPen® (N = 111,740), Jext® (N = 25,631), and Emerade® (N = 18,329) could be analyzed during 2016–2022. EpiPen® only could visually show seasonal patterns during summertime, peaking vigorously in the summer of 2018 when the major EpiPen® shortage appeared worldwide. Anaphylaxis articles equaled 2,030,855 openings altogether. Openings of one anaphylaxis article (“Bites and Stings”) peaked during summertime, while another article (“Anaphylactic Reaction”) peaked only once (three-fold increase) at the end of 2020 when COVID-19 vaccinations started, and auto-injector prescriptions were lowest. Fifty EpiPen®, one Jext®, and twelve Emerade® shortages were reported. Almost a two-fold increase in peaks of auto-injector prescriptions was found during summertime.

Conclusion
This study shows that (1) epinephrine shortages related to professionals’ searching for auto-injectors, and (2) citizens’ information seeking on anaphylaxis related to summertime and shortages with lesser prescriptions. Therefore, the dedicated internet databases aimed at professionals and citizens could be used as additional information sources to detect anaphylactic reactions and auto-injector shortages.