bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gaps and Opportunities for Strengthening In‐School Support for Youth Living With HIV
Authors: Njuguna Irene , Mugo Cyrus , Mbwayo Anne , Augusto Orvalho , Wamalwa Dalton , Inwani Irene 
Published: November 2023

AbstractObjectivesWith optimized antiretroviral treatment youth living with HIV (YLH) now spend most of their time in schools, making schools an important venue to optimize outcomes. We evaluated school support for YLH.MethodsWe conducted surveys with public secondary/high schools in 3 Kenyan counties (Nairobi, Homa Bay, and Kajiado) to determine policies and training related to HIV. Chi‐squared tests and Poisson regression were used to compare policy availability and staff training by county HIV prevalence and school type.ResultsOf 512 schools in the 3 counties, we surveyed 100. The majority (60%) of schools surveyed had boarding facilities. The median student population was 406 (IQR: 200, 775). Only half (49%) of schools had medication use policies; more in boarding than day schools (65% vs 30%, p = .003). While most schools (82%) had clinic attendance policies; policy availability was higher in higher HIV prevalence counties (Homa Bay [100%], Nairobi [82%], Kajiado [56%], p < .05). Overall, 64% had confidentiality policies with higher policy availability in higher HIV prevalence regions (p < .05). Few schools had staff trained in HIV‐related topics: HIV prevention (37%), HIV treatment (18%), HIV stigma reduction (36%). Few were trained in confidentiality (41%), psychosocial support (40%), or mental health (26%). Compared to day schools, boarding school were more likely to have staff trained in HIV prevention (prevalence ratio: 2.1 [95% confidence interval 1.0, 4.0], p = .037).ConclusionIn this survey of Kenyan schools, there were notable gaps in HIV care policy availability and training, despite high HIV burden. Development and implementation of national school HIV policies and staff training as well as strengthening clinic and family support may improve outcomes for YLH.
Personal factors and baseline function in patients undergoing non-operative management for chronic hip-related groin pain: a cross-sectional study
Authors: DeMargel Rebecca D , Steger-May Karen , Haroutounian Simon , Zorn Patricia , Cheng Abby , Clohisy John C , Harris-Hayes Marcie 
Published: November 2023

AimLittle is known about the relationship between personal factors and perception of hip-related function among patients with chronic hip-related groin pain (HRGP) seeking non-operative management. This analysis was performed to determine if depressive symptoms, central sensitisation, movement evoked pain (MEP), pressure hypersensitivity and activity level were associated with patients’ perception of hip-related function, represented by the International Hip Outcome Tool (iHOT-33).MethodsThis cross-sectional study used baseline data from a pilot randomised clinical trial. Participants had anterior hip symptoms for at least 3 of the past 12 months reproduced on examination. Depressive symptoms, central sensitisation and activity level were quantified with self-report questionnaires. MEP was assessed during step down and squat. Pain pressure threshold (PPT) was used to assess pressure hypersensitivity. Statistical analysis was performed to assess bivariate association between variables and independent association of variables with iHOT-33.ResultsData from 33 participants (aged 18–40 years) with HRGP were analysed. Greater depressive symptoms (rs=−0.48, p=0.005), higher MEP during step down (rs=−0.36, p=0.040) and squat (rs=−0.39, p=0.024), and greater central sensitisation (rs=−0.33, p=0.058) were associated with lower (worse) iHOT-33 scores. Greater depressive symptoms (β=−0.47, 95% CI −0.76 to −0.17; p=0.003) and higher MEP during squat (β=−0.38, 95% CI −0.68 to −0.08; p=0.014) accounted for 37% of variability in iHOT-33. After adjusting for depressive symptoms and MEP, PPT, central sensitisation symptoms and activity level were not associated iHOT-33.ConclusionsIn patients with HRGP seeking non-operative management, greater depressive symptoms and MEP are independently associated with worse self-perceived hip function.Trial registration numberNCT03959319
Self-Care Behavior and Associated Factors of Nursing Students with Dysmenorrhea: A Structural Equation Model
Authors: Chen Jinpei , Duan Yajing , Zhang Yongai , Zhang Xiaona , Chu Miao , Shi Yurun , Zhang Xinmin 
Published: November 2023

Objective. To assess the factors influencing the self-care behavior among nursing students with dysmenorrhea. Background. The practice of self-care behavior for dysmenorrhea has gradually attracted immense attention from society; however, thus far, only a few studies have been conducted to predict this behavior and analyze the associated factors by creating a structural equation model. Methods. A cross-sectional multistage cluster sampling study was conducted among nursing students within six universities in Shaanxi province, China. A model was constructed, and structured questionnaires were adopted to measure model variables, including e-health literacy, negative emotion, self-efficacy, self-care agency, degree of dysmenorrhea, and self-care behavior for dysmenorrhea. Descriptive data analysis was performed using SPSS 23.0 software, and AMOS 23.0 was used to verify and analyze the structural model. Results. In total, 1851 valid questionnaires were collected; the effective recovery rate was 93.15%, and the prevalence of dysmenorrhea was 64.51%. e-Health literacy (B = 0.171,

P

< 0.001), self-efficacy (B = 0.416,

P

< 0.001), self-care agency (B = 1.177,

P

< 0.001), and degree of dysmenorrhea (B = 0.310,

P

< 0.001) significantly influenced self-care behavior for dysmenorrhea. The total, direct, and indirect effects of e-health literacy and self-efficacy on self-care behavior for dysmenorrhea were 0.158 and 0.492, 0.128 and 0.248, and 0.030 and 0.244, respectively. Conclusion. The self-care behavior for dysmenorrhea is affected by several factors and self-efficacy has the greatest effect on it. To promote girls to actively implement self-care behavior for dysmenorrhea, educators should strengthen the training of self-efficacy and self-care agency of the nursing students to alleviate the uncomfortable experience brought by dysmenorrhea and decrease the harm of dysmenorrhea. Implications for Nursing Management. Nursing managers should work with constant efforts to explore and optimize the management model for dysmenorrhea, encouraging young women to actively engage in self-care behavior for dysmenorrhea, to alleviate the discomfort experienced by individuals and improve women’s overall health.
The Origin of Electoral Absenteeism in Early Italy: New Evidence to Explain North–South Diverging Trends
Authors: Brosio Giorgio , Zanola Roberto 
Published: November 2023

Abstract
Low turnout rates with high geographical disparities characterized Italian national elections in the first six decades after the country’s founding in 1861. Historians have largely overlooked these regional voting differences and their potential economic implications. A multiple-group interrupted time series analysis regression model demonstrates distinct electoral trends between the Center-North and the South, coinciding with electoral reforms in 1894 that affected electoral competition, particularly in the South. Furthermore, a random effect panel regression model reveals determinants of regional abstention rates, which indicate that different factors influenced abstention rates in the Center-North than in the South, emphasizing the relevance of political factors in the creation and widening of regional divergences in Italy.
Impact of telemedicine on disease activity assessment: A case-crossover study nested within a cohort of patients with systemic lupus erythematosus
Authors: Almaghlouth Ibrahim , Almalag Haya M. , Alzuhair Hajer , Alsaigh Rafif , Bedaiwi Asma , Hassen Lena M. , Alzomia Sulaiman , Alanazi Boshra , Alabdulkareem Abdulaziz Mohammed , Alahmari Saud , Asfina Kazi Nur , Khalil Najma , Omair Mohammed A. , Bedaiwi Mohamed 
Published: November 2023

Introduction The utilisation of telemedicine has been rapidly growing among patients with rheumatic diseases, especially following the corona virus disease 2019 pandemic. Ease and convenience appear to dominate the reasons for this growth. However, the effects of this approach in patients with systemic lupus erythematosus (SLE) are yet to be revealed. In this study, we examined the effect of telemedicine on disease activity assessment and damage scores in patients with SLE. Methods This case-crossover study was nested within a national prospective cohort of patients with SLE in Saudi Arabia. Patients with SLE were included if they fulfilled the Systemic Lupus International Collaborating Clinics classification criteria between March 2020 and March 2021 and were assessed at three time points with 3 months between assessments, according to the standardised protocol of this cohort. Telemedicine was conducted for the first evaluation, while in-person assessments were used at the second and third visits. The primary outcome was the difference in the SLE disease activity index 2000 (SLEDAI-2K) score. The primary analysis was conducted using the repeated measure model and adjusted for potential confounders, including demographics, medications, and changes in steroid doses. Several sensitivity analyses were conducted to mitigate selection and time-varying confounders. Results A total of 92 participants were included in this study. Most patients were females (88%), with a mean (±standard deviation [SD]) age of 36 (±13) years. The mean (±SD) disease activity scores at baseline were as follows: SLEDAI-2K, 5 (±5); SLE responder index, 3.8 (±3.5); Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index, 1 (±1). The mean difference in SLEDAI-2K score was −1.641 (95% confidence interval −2.773 to −0.510, p = 0.005*) between telemedicine and follow-up visits. The results were consistent in all sensitivity analyses. Conclusion We found that telemedicine assessment was associated with a much higher disease activity score than subsequent assessments, which may suggest an overestimation of disease activity and later assessment accuracy. Cautious adoption has been suggested for SLE patients with active disease.
Oct biomarkers for early prognosis in diabetic macular edema treatment with ranibizumab
Authors: Pessoa Bernardete , Leite João , Ferreira André , Ramalhão João , Poças João , José Diana , Coelho Constança , Figueira João , Meireles Angelina , Beirão João Melo 
Published: November 2023

Background Diabetic macular edema is the main cause of vision loss in patients with diabetic retinopathy. In this work, we aimed to assess the role of Optical Coherence Tomography (OCT) biomarkers in patients treated with ranibizumab. Methods A prospective study enrolling 46 eyes with DME under ranibizumab intravitreal therapy with 12 months of follow-up. The primary endpoint was to assess the association between OCT biomarkers at baseline and the type of treatment response. Results Good responders, compared with partial/non responders, had lower number of inner nuclear layer cysts (INLc) at baseline, (26.5% vs 73.5%, p = 0.035) and presented, at 12 months of follow-up, lower percentage of disorganization of retinal inner layers (12.0% vs 88.0%, p = 0.001), lower disruption of outer plexiform layer (8.7% vs 91.3%, p < 0.001) and lower outer nuclear layer cysts (17.4% vs 82.6%, p = 0.013). At the end of follow-up, it was observed a higher frequency of inner nuclear layer cysts in patients with higher glycated haemoglobin ( p = 0.028). Conclusion This study showed the value and importance of OCT parameters, such as absence of INLc, as a prognostic therapeutic response. A normalization of the macular anatomy with ranibizumab is more likely to happen in early complete responders. The association between INLc and higher glycated haemoglobin levels showed the importance of systemic metabolic control in systemic diabetic manifestations. Clinicaltrials.gov NCT04387604.
Smaller-Incision new-generation implantable miniature telescope: Three-months follow-up study
Authors: Savastano Alfonso , Ferrara Silvia , Sasso Paola , Savastano Maria Cristina , Crincoli Emanuele , Caporossi Tomaso , De Vico Umberto , Vidal Aroca Faustino , Francione Giuseppe , Sammarco Leonardo , Gambini Gloria , Fedeli Chiara , Di Nardo Emiliana , Rizzo Stanislao 
Published: November 2023

Purpose To evaluate three months follow-up of SING IMT implant in patients affected by late-stage AMD Design Prospective cohort study Subjects In a total of 80 eyes of 40 patients who underwent the enrollment tests, 11 patients’ eyes affected by late-stage AMD matched the inclusion criteria and underwent SING IMT implant from February to June 2022. Methods Before surgery, each patient underwent the enrollment examination to verify inclusion and exclusion criteria. Main outcome measures BCVA for distance and for near, IOP, ACD and ECD were evaluated at 1 and 3 months follow up. Also quality of life in doing the activities of daily life was evaluated. Results BCVA for distance and for near improved from baseline to 3 months follow up (23.91 ± 9.418 ETDRS letters and 59.09 ± 11.58 ETDRS letters respectively (p < 0.001). An endothelial cell loss was shown (p < 0.001), with a rate of cell density reduction around 8.3% (baseline vs 3 months). Conclusions SING IMT could be a valid surgical device to improve patients’ sight and quality of life which have been deteriorated by late-stage macular degeneration. Further studies with more patients and longer follow up are needed to confirm our results.
Achromatopsia: Long term visual performance and clinical characteristics
Authors: Eshel Yuval Margherita , Abaev Ora , Yahalom Claudia 
Published: November 2023

Background Achromatopsia is an autosomal recessive cone dysfunction syndrome, characterized by absence of color discrimination, low visual acuity, photophobia, and nystagmus. Achromatopsia constitutes a common cause of visual impairment in children, with a prevalence of 1:30,000 worldwide. Objective To characterize the clinical characteristics of achromatopsia, the main genes causing the disease in our population and the clinical course of the disease, with an emphasis on visual function stability with increasing age. Methods Retrospective study based on medical charts of patients with achromatopsia. Patients were divided into two groups according to their age at last follow-up: older and younger than 10 years. A subset of patients with long term follow-up were analyzed separately, with patients being described in both age groups. Results Seventy-six patients were included in the study. The mean age was 14.28 years. Variants in the CNGA3 gene were the most common (73.6%). Clinical characteristics included photophobia (96.2%), nystagmus (93.6%), hypermetropia (72.3%) and strabismus (51.1%). In the large cohort there was no correlation of age with visual acuity ( p = 0.129). In the separate subset cohort with long follow-up there was a relative improvement in visual acuity with age ( p < 0.001). Conclusions CNGA3 is the main gene associated with achromatopsia in our population (around ∼ 73%), which is in contrast to the distribution worldwide (∼ 25%). Most achromats suffer from photophobia and nystagmus, and the main refractive error is hypermetropia. Achromatopsia's natural course seems to be stationary, and there may even be a slight improvement in visual acuity with time.
Using WhatsApp support groups to promote responsive caregiving, caregiver mental health and child development in the COVID-19 era: A randomised controlled trial of a fully digital parenting intervention
Authors: Skeen Sarah , Marlow Marguerite , du Toit Stefani , Melendez-Torres GJ , Mudekunye Lynette , Mapalala Edwick , Ngoma Kelvin , Ntanda Byamukama Michael , Maketha Moroesi , Grieve Caitlin , Hartmann Laura , Gordon Sarah , Tomlinson Mark 
Published: November 2023

Objective Digital interventions hold important potential for supporting parents when face-to-face interventions are unavailable. We assessed the feasibility and effectiveness of a digital parenting intervention in Zambia and Tanzania. Methods Using a randomised controlled trial, we evaluated the Sharing Stories digital parenting intervention for caregivers of children aged 9–32 months with access to a smartphone in their household. Caregivers were stratified based on child age and randomly assigned to the intervention or waitlist control arm. The intervention was delivered via facilitated WhatsApp groups over 6 weeks to promote caregiver wellbeing and responsive caregiving through shared reading activities. Primary outcomes were caregiver-reported responsive caregiving, child language and socio-emotional development. Secondary outcomes were caregiver mental health and parental stress. Masked assessors conducted assessments at baseline and immediate follow-up. Results Between October 2020 and March 2021, we randomly assigned 494 caregiver–child dyads to the intervention ( n = 248) or waitlist control ( n = 246) arm. Caregivers in the intervention group reported more responsive caregiving (OR = 2.55, 95% CI: 1.15–5.66, p = 0.02), time reading or looking at books (β = 0.45, p = 0.04) and telling stories (β = 0.72, p = 0.002). Intervention caregivers reported significantly lower symptoms of depression (β = −0.64, p = 0.05) and anxiety (β = −0.65, p = 0.02). Child development and parental stress did not differ significantly between groups. Conclusions Digital parenting interventions using WhatsApp can effectively promote responsive caregiving and caregiver mental health in low-resource settings, with great potential for scalability. Trial registration ISRCTN database, ISRCTN77689525.
A Health App for Post-Pandemic Years (HAPPY) for people with physiological and psychosocial distress during the post-pandemic era: Protocol for a randomized controlled trial
Authors: Liu Justina Yat-Wa , Man David Wai-Kwong , Lai Frank Ho-Yin , Cheung Teris Cheuk-Chi , Cheung Amy Ka-Po , Cheung Daphne Sze-Ki , Choi Thomas Kup-Sze , Fong Gabriel Ching-Hang , Kwan Rick Yiu-Cho , Lam Simon Ching , Ng Vincent To-Yee , Wong Heung , Yang Lin , Shum David Ho-Keung 
Published: November 2023

Objective This article describes a protocol for a randomized controlled trial to evaluate the effects of a three-level Health App for Post-Pandemic Years (HAPPY) on alleviating post-pandemic physiological and psychosocial distress. Methods Convenience and snowball sampling methods will be used to recruit 814 people aged 18+ with physiological and/or psychosocial distress. The experimental group will receive a 24-week intervention consisting of an 8-week regular supervision phase and a 16-week self-help phase. Based on their assessment results, they will be assigned to receive interventions on mindfulness, energy conservation techniques, or physical activity training. The waitlist control group will receive the same intervention in Week 25. The primary outcome will be changes in psychosocial distress, measured using the Kessler Psychological Distress Scale (K10). Secondary outcomes will include changes in levels of fatigue (Chinese version of the Brief Fatigue Inventory), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index), pain intensity (Numeric Rating Scale), positive appraisal (Short version of the 18-item Cognitive Emotion Regulation Questionnaire), self-efficacy (Chinese version of the General Self-efficacy Scale), depression and anxiety (Chinese version of the 21-item Depression Anxiety Stress Scale), and event impact (Chinese version of the 22-item Impact of Event Scale–Revised). All measures will be administered at baseline (T0), Week 8 after the supervision phase (T1), and 24 weeks post-intervention (T2). A generalized estimating equations model will be used to examine the group, time, and interaction (Time × Group) effect of the interventions on the outcome assessments (intention-to-treat analysis) across the three time points, and to compute a within-group comparison of objective physiological parameters and adherence to the assigned interventions in the experimental group. Conclusions The innovative, three-level mobile HAPPY app will promote beneficial behavioral strategies to alleviate post-pandemic physiological and psychosocial distress. Trial registration ClinicalTrials.gov, NCT05459896. Registered on 15 July 2022.
Holo-omics analysis reveals the influence of gut microbiota on obesity indicators in Jinhua pigs
Authors: Liu Shuang , Lai Xueshuang , Xie Qinqin , Wang Zhen , Pan Yuchun , Wang Qishan , Zhang Zhe 
Published: November 2023

Abstract
Background
The mechanisms behind obesity are complex and multi-faceted, involving the interplay of both host genomics and gut microbiome. In recent years, research has largely focused on these factors separately, but rarely from the viewpoint of holo-omics, which considers the host and microbiome as an integrated entity. To address this gap in knowledge, the present study aimed to investigate the holo-omics basis of obesity in Jinhua pigs, a Chinese indigenous breed known for its high degree of fat deposition and superior meat quality.

Methods
Six pigs with extreme obesity phenotype were selected from a larger cohort of eighteen Jinhua pigs, and the contents of the jejunum, cecum, and colon regions were collected after slaughter at 240 days of age. The data obtained was processed, denoised, and annotated using QIIME2, with expression differences being analyzed using edgeR software.

Results
The results showed significant differences in jejunal microbial diversity and composition between the two groups, with gut transcriptomics also indicating that differentially expressed genes in the jejunum were enriched in lipid metabolism pathways. These findings provide further evidence of the influence of the gut microbiome and host gene expression on fat deposition in Jinhua pigs.

Conclusions
This study provides valuable insights into the mechanisms of fat deposition in Jinhua pigs from the viewpoint of holo-omics. The integration of host transcriptomics and microbiome data helps shed light on the complex interactions between the host and gut microbiome, and highlights the importance of considering both factors in our understanding of obesity.