bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of surgical treatment of gout—A retrospective study on 28 cases with tophi
Authors: Zhang Ting , Yang Bin , Xu Xiaohong , Zhang Zengfang , Pan Zhenglun 
Published: January 2025

Introduction
The efficacy, safety, optimal timing, and urate-lowering effects of surgical interventions in gout management remain poorly understood. This study aims to fill this gap by evaluating the role of surgery in treating gout patients with tophi.

Method
A retrospective analysis was conducted on 28 gout patients presenting with tophi. Data were comprehensively retrieved from electronic medical records, including medical history, laboratory findings, surgical procedures, hospitalization duration, postoperative monitoring, and relevant variables.

Results
Postoperative improvements were observed in joint symptoms and functionality. Surgical intervention effectively reduced the frequency of gout flares, demonstrating short-term urate-lowering effects (STULE) and potential long-term urate-lowering effects (LTULE) when combined with urate-lowering treatments (ULT). Primary healing occurred in 65 out of 67 surgical sites (97.01%), with only 2 sites (2.99%) experiencing delayed healing, and minimal complications reported. Prolonged hospital stays were associated with elevated leukocyte counts, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) levels, as well as a higher number of surgical sites, rather than serum uric acid (SUA) levels.

Conclusions
Surgical intervention is a promising and safe therapeutic option for managing gout, particularly in cases with joint deterioration, functional impairment, or nerve involvement. Surgery not only reduces the frequency of gout flares but also provides STULE and potential LTULE when complemented with ULT. Patients with lower inflammatory indices and fewer incisions exhibit faster postoperative recoveries. Optimal timing of surgery, ideally during periods of disease remission, is crucial for minimizing complications and reducing hospitalization durations.
The effects of the SARS-CoV-2 pandemic on self-reported interoception and mental health
Authors: Biotti Federica , Barker Melissa , Carr Lara , Pickard Hannah , Brewer Rebecca , Murphy Jennifer 
Published: January 2025

Background
Atypical interoception has been observed across multiple mental health conditions, including anxiety disorders and depression. Evidence suggests that not only pathological anxiety, but also heightened levels of state anxiety and stress are associated with interoceptive functioning. This study aimed to investigate the effects of the recent Coronavirus SARS-CoV-2 pandemic on self-reported interoception and mental health, and their relationship.

Methods
Self-report measures of interoceptive attention and accuracy, anxiety, stress and depression taken during the pandemic (at three time points) were compared to the same measures taken from comparable samples prior to the pandemic. In the sample collected during the pandemic, the relationship between interoceptive and mental health measures and focus on COVID-19-related news and information, propensity to take objective measures of COVID-19 symptoms, and subjective beliefs concerning COVID-19 symptoms was assessed. Finally, a cross-lagged panel model (CLPM) was used to test directional relationships between self-reported interoceptive and mental health measures across three time points.

Results
Higher self-reported anxiety was associated with a) increased self-reported attention to bodily signals, b) increased focus on COVID-19-related news and information, c) propensity to take objective measures of COVID-19 symptoms, and d) reduced self-reported interoceptive accuracy for bodily signals participants believed were associated with COVID-19. The CLPM revealed a mutual and comparable directional effect from T1 to T2 between interoceptive attention and measures of mental health.

Conclusions
Implications of these findings are discussed in the light of existing models and newly proposed accounts of the relationship between interoception and mental health.
Abuse and its associated factors among elderly population of Kamalamai Municipality of Sindhuli District, Nepal
Authors: Subedi Jwala , Yadav Deepak Kumar , Pokharel Paras Kumar , Uprety Samyog , Yadav Birendra Kumar , K. C. Anisha , Bhandari Sheetal , Baral Samiksha 
Published: January 2025

Background
The global rise in the elderly population brings attention to the pressing issue of elder abuse, categorized into physical, psychological, neglect, financial and sexual abuse. According to the World Health Organization (2022), one in six individuals aged 60 and older has experienced some form of abuse in community setting necessitating increase in awareness and support for older people. This study aimed to assess abuse and its associated factors among elderly population of Kamalamai Municipality of Sindhuli District, Nepal.

Methodology
We conducted a community-based cross-sectional study utilizing both qualitative and quantitative methods. We collected data from June 15 to September 15, 2023. The study involved 398 elderly participants (≥60 years). Stratified sampling techniques was used to select participants. For the qualitative study we utilized purposive sampling technique which included two key informant interviews, one in-depth interview and two focus group discussions. We analyzed quantitative data using IBM SPSS version 20 applying bivariate and multivariable logistic regression analysis at a 95% confidence interval. For qualitative data, thematic analysis was done.

Results
The mean ± SD age of the elderly participants was (70.8± 8.08) years. Among the total of 398 study participants, (64.1%) participants reported experiencing different forms of abuse. The study found that neglect (46.0%), psychological abuse (42.5%), and financial abuse (24.4%) were the most common while physical abuse (4.8%) and sexual abuse (2.8%) were less common. Living in a nuclear family (AOR: 2.74, 95% CI: 1.67–4.51) and lower socio-economic status (AOR: 5.42, 95% CI: 2.28–12.92) were significantly associated with increase risk of elder abuse. Qualitative findings revealed mistreatment, vulnerability, negligence, economic factors, family dynamics, loneliness, financial exploitation, food withholding, physical abuse, and emotional attachment as key aspects of elder abuse.

Conclusion
This study highlights neglect and psychological abuse were the most common forms of elder abuse. These findings emphasize the urgency of implementing programs at the municipal level such as financial support system for elderly individuals from lower socioeconomic backgrounds and education programs for both elderly individuals and their families and caregivers. These initiatives aim to control and reduce the incidence of elder abuse and ensure comprehensive well-being of elderly population.
Measurement properties of instruments to assess insight in psychosis: A systematic review protocol
Authors: Hazan Hadar , Funaro Melissa C. , Srihari Vinod H. 
Published: January 2025

Introduction
Insight in psychosis, defined as a patient’s awareness and judgment of their mental illness, is a complex and evolving concept. Historically, the absence of insight was considered a defining characteristic of psychosis, but recent decades have seen the development of structured tools for its assessment. This systematic review aims to critically appraise the measurement properties of instruments used to assess insight in individuals with schizophrenia spectrum, bridging the gap between theoretical conceptualization and clinical practice.

Methods
This protocol is reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Eligible studies will evaluate instruments measuring insight in psychosis, including self-report, observer ratings, behavioral measurements, and semi-structured interviews. The psychometric properties assessed will encompass reliability, validity, responsiveness, interpretability, and clinical utility. We will include primary quantitative studies published in peer-reviewed journals and available in English.

Results
Two reviewers will conduct data extraction and quality assessment independently, with discrepancies resolved through consensus or a third reviewer. The COSMIN Risk of Bias checklist and the GRADE approach will be used to evaluate each measure’s methodological quality and overall strength of evidence.

Discussion
This systematic review will synthesize current evidence on insight measurement in psychosis, providing a comprehensive overview of the strengths and limitations of existing instruments. The findings will inform future research and clinical practice, facilitating the selection of the most appropriate tools for assessing insight and ultimately contributing to improved care for individuals with psychosis. The findings will provide clinicians and researchers with robust tools for assessing insight, ultimately enhancing treatment outcomes for individuals with psychosis.
Prediction of stunting and its socioeconomic determinants among adolescent girls in Ethiopia using machine learning algorithms
Authors: Zemariam Alemu Birara , Abate Biruk Beletew , Alamaw Addis Wondmagegn , Lake Eyob shitie , Yilak Gizachew , Ayele Mulat , Tilahun Befkad Derese , Ngusie Habtamu Setegn 
Published: January 2025

Background
Stunting is a vital indicator of chronic undernutrition that reveals a failure to reach linear growth. Investigating growth and nutrition status during adolescence, in addition to infancy and childhood is very crucial. However, the available studies in Ethiopia have been usually focused in early childhood and they used the traditional stastical methods. Therefore, this study aimed to employ multiple machine learning algorithms to identify the most effective model for the prediction of stunting among adolescent girls in Ethiopia.

Methods
A total of 3156 weighted samples of adolescent girls aged 15–19 years were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 80% and 20% of the observations were used for training, and testing the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. The performance of the predictive model was evaluated using evaluation metrics value through Python software. The synthetic minority oversampling technique was used for data balancing and Boruta algorithm was used to identify best features. Association rule mining using an Apriori algorithm was employed to generate the best rule for the association between the independent feature and the targeted feature using R software.

Results
The random forest classifier (sensitivity = 81%, accuracy = 77%, precision = 75%, f1-score = 78%, AUC = 85%) outperformed in predicting stunting compared to other ML algorithms considered in this study. Region, poor wealth index, no formal education, unimproved toilet facility, rural residence, not used contraceptive method, religion, age, no media exposure, occupation, and having one or more children were the top attributes to predict stunting. Association rule mining was identified the top seven best rules that most frequently associated with stunting among adolescent girls in Ethiopia.

Conclusion
The random forest classifier outperformed in predicting and identifying the relevant predictors of stunting. Results have shown that machine learning algorithms can accurately predict stunting, making them potentially valuable as decision-support tools for the relevant stakeholders and giving emphasis for the identified predictors could be an important intervention to halt stunting among adolescent girls.
Assessing cardiovascular disease risk and social determinants of health: A comparative analysis of five risk estimation instruments using data from the Eastern Caribbean Health Outcomes Research Network
Authors: Schwartz Jeremy I. , Howitt Christina , Raman Sumitha , Nair Sanya , Hassan Saria , Oladele Carol , Hambleton Ian R. , Sarpong Daniel F. , Adams Oswald P. , Maharaj Rohan G. , Nazario Cruz M. , Nunez Maxine , Nunez-Smith Marcella 
Published: January 2025

Background
Accurate assessment of cardiovascular disease (CVD) risk is crucial for effective prevention and resource allocation. However, few CVD risk estimation tools consider social determinants of health (SDoH), despite their known impact on CVD risk. We aimed to estimate 10-year CVD risk in the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) across multiple risk estimation instruments and assess the association between SDoH and CVD risk.

Methods
Five widely used CVD risk estimation tools (Framingham and WHO laboratory, both laboratory and non-laboratory-based, and ASCVD) were applied using data from ECS participants aged 40–74 without a history of CVD. SDoH variables included educational attainment, occupational status, household food security, and perceived social status. Multivariable logistic regression models were used to compare differences in the association between selected SDoH and high CVD risk according to the five instruments.

Findings
Among 1,777 adult participants, estimated 10-year CVD risk varied substantially across tools. Framingham non-lab and ASCVD demonstrated strong agreement in categorizing participants as high risk. Framingham non-lab categorized the greatest percentage as high risk, followed by Framingham lab, ASCVD, WHO lab, and WHO non-lab. Fifteen times more people were classified as high risk by Framingham non-lab compared with WHO non-lab (31% vs 2%). Mean estimated 10-year risk in the sample was over 2.5 times higher using Framingham non-lab vs WHO non-lab (17.3% vs 6.6%). We found associations between food insecurity, those with the lowest level compared to the highest level of education, and non-professional occupation and increased estimated CVD risk.

Interpretation
Our findings highlight significant discrepancies in CVD risk estimation across tools and underscore the potential impact of incorporating SDoH into risk assessment. Further research is needed to validate and refine existing risk tools, particularly in ethnically diverse populations and resource-constrained settings, and to develop race- and ethnicity-free risk estimation models that consider SDoH.
Occupational burnout during war: The role of stress, disruptions in routine, sleep, work-family conflict, and organizational support as a moderator
Authors: Kalfon Hakhmigari Maor , Diamant Irene 
Published: January 2025

Background
Occupational burnout, resulting from long-term exposure to work-related stressors, is a significant risk factor for both physical and mental health of employees. Most research on burnout focuses on routine situations, with less attention given to its causes and manifestations during prolonged national crises such as war. According to the Conservation of Resources theory, wartime conditions are associated with a loss of resources, leading to accelerated burnout. This study aimed to examine burnout among employees during the war in Israel that broke out in October 2023, placing the population nationwide in a state of existential threat and functional crisis. The researchers hypothesized that Stress, work-to-family conflict, family-to-work conflict, sleep disruption, and routine disruption (H1-H5) would be positively associated with occupational burnout. In addition, the study examined whether organizational strategies, such as flexibility and volunteering, would be negatively associated with burnout (H6) and whether they would moderate the relationship between work-family conflict and burnout during wartime (H7).

Methods
The study involved 374 employees recruited through social networks via a snowball sampling method during the war. Participants completed a questionnaire assessing demographic details, burnout, stress, routine disruptions, work family conflict (work-to-family and family-to-work conflict), sleep disturbances, and organizational support measures. Hierarchical linear regression and Pearson correlation were utilized to model the outcome variable of occupational burnout and Process Model 1 was utilized for the moderation hypothesis.

Results
Findings revealed a notable level of burnout during wartime (M = 3.95, SD = 1.15). Routine disruptions, work-to-family conflict, and sleep disturbances significantly contributed to burnout beyond stress levels, thus hypotheses H1 to H5 were partly supported. Additionally, the organizational resource variable of offering volunteering opportunities was associated with lower burnout levels and moderated the relationship between work-to-family conflict and burnout, thus partially supporting hypotheses H6 and H7.

Conclusion
The findings enhance the understanding of burnout during prolonged crises like war, highlighting the importance of maintaining routine as a key resource for order and control. They also emphasize the role of organizational volunteering in preventing burnout. The theoretical and practical implications are discussed.
Undergraduates’ lifestyle and Suboptimal Health Status (SHS): A cross-sectional study in the Ha’il region of Saudi Arabia
Authors: Alsaif Bandar , Asweto Collins Otieno , Hassan Sehar-un-Nisa , Alzain Mohamed Ali , Saeed Mohammed Elshiekh , Kassar Ahmed , Ali Kamal Elbssir Mohammed , Ghorbel Mouna , Zrieq Rafat , Wang Wei 
Published: January 2025

Background
University students in Saudi Arabia are embracing some of the negative traits of the fast-paced modern lifestyle, typified by unhealthy eating, low physical activity, and poor sleep habits that may increase their risk for poor health. Health and holistic well-being at the population level are among the priorities of the 2030 vision of a vibrant society in the Kingdom of Saudi Arabia. The current study thus aims at determining the prevalence and predictive factors of Suboptimal Health Status (SHS) among university students.

Methods
A cross-sectional study was conducted among 9,026 undergraduate students between 31st May and 15th June 2023. The data was collected through an online questionnaire using the Arabic translation of the SHS (ASHSQ-25) and the Simple Lifestyle Indicator Questionnaire (SLIQ). The chi-square test, Canonical Correlation Analysis (CCA), hierarchical multiple regression, and Receiver Operating Characteristic (ROC) were performed to analyze the data using IBM SPSS software (version 25.0) at a significance level of p<0.05.

Results
The findings showed that 33.7% (3038) of the students were classified as having SHS. The prevalence of SHS was statistically higher among younger and those studying social science discipline, overweight, had poor diets, engaged in low physical activity, and slept <6 hours (p<0.001). Canonical loadings of these factors were significant in predicting the five SHS dimensions range (0.52–0.97). Furthermore, the extracted significant variables from the multiple regression analysis indicated the final model (Model 3) was statistically significant, R2 = 0.646, F (6,9019), p <0.0001, suggesting that 64.6% of the variance in the SHS can be explained by the predictor variables in the model. These variables included age, college, academic level, diet, BMI, and sleeping duration.

Conclusion
Findings show that modifiable predictors such as poor sleep quality, higher BMI scores, and poor dietary habits increase SHS risk among university students in Saudi Arabia. Therefore, the findings of this study emphasize the necessity of early interventions that promote healthy lifestyles.
Mucosal leishmaniasis is associated with the Leishmania RNA virus and inappropriate cutaneous leishmaniasis treatment
Authors: Pazmiño Fredy A. , Parra-Muñoz Marcela , Saavedra Carlos H. , Muvdi-Arenas Sandra , Ovalle-Bracho Clemencia , Echeverry María C. 
Published: January 2025

Background
Mucosal leishmaniasis (ML) is a severe clinical form of leishmaniasis that is characterized by the destruction of the nasal and/or the oral mucosae and appears as a late complication in 5% to 10% of cutaneous leishmaniasis (CL) cases produced by species belonging to Leishmania (Viannia) subgenus. Some strains of Leishmania spp. carry an RNA virus known as Leishmania RNA virus (LRV) that may contribute to the appearance of ML.

Methods
To examine the role of LRV type 1 (LRV1) as a risk factor associated with ML, a retrospective case-control study involving 103 patients was conducted. Cases were defined as patients with ML (n = 33), and controls corresponded to patients with CL and without mucosal lesions (n = 70). Clinical data were recorded from the patient’s medical records. Cryopreserved biopsies were used to detect LRV1 and identify Leishmania species.

Results
The frequency of LRV1 in the 103 patients was 16.5% (95% CI,10.4–25.12) being higher in samples from cases [33.33% (95% CI,18.89–51.76) than from controls [8.57% (95% CI, 3.82–18.10)]. L. (V.) braziliensis was identified in 63.6% of cases and 55.7% of the controls. Multivariate logistic regression indicated that infection with Leishmania spp. carrying LRV1 (OR = 6.30; 95% CI,1.52–26.10, p = 0.011) acts as risk factors for ML occurrence, while the completed treatment for the cutaneous event decreases the risk of ML (OR = 0.039; 95% CI, 0.01–0.12, p < 0.0001).

Conclusions
Our data support the association between LRV1 and ML occurrence and emphasize the effect of completed treatment for CL in preventing ML.
A systematic review on malaria and Tuberculosis (TB) vaccine challenges in sub-Saharan African clinical trials
Authors: Hamisi Maonezi Abas , Asri Nur Ain Mohd , Yassim Aini Syahida Mat , Suppian Rapeah 
Published: January 2025

Objective
For more than a century, developing novel and effective vaccines against malaria and Tuberculosis (TB) infections has been a challenge. This review sought to investigate the reasons for the slow progress of malaria and TB vaccine candidates in sub-Saharan African clinical trials.

Methods
The systematic review protocol was registered on PROSPERO on July 26, 2023 (CRD42023445166). The research articles related to the immunogenicity, efficacy, or safety of malaria or TB vaccines that were published between January 1, 2012, and August 31, 2023, were searched on three databases: Web of Science (WoS), PubMed, and ClinicalTrials.gov.

Results
A total of 2342 articles were obtained, 50 of which met the inclusion criteria. 28 (56%) articles reported on malaria vaccine attributes, while 22 (44%) articles reported on TB vaccines. In both cases, the major challenges in sub-Saharan African clinical trials were immunogenicity and efficacy, rather than safety.

Conclusion
Factors such as population characteristics, pathogen genetic diversity, vaccine nature, strategy, and formulation were associated with slow progress of the malaria and TB vaccine candidates in sub-Saharan African clinical trials.