bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-intensity exercise increases breast milk adiponectin concentrations: a randomised cross-over study
Authors: Holmen Mads , Giskeødegård Guro F. , Moholdt Trine 
Published: December 2023

IntroductionAdiponectin plays a role in glucose and fat metabolism and is present in human breast milk. It has been postulated that higher breast milk adiponectin concentrations may prevent rapid weight gain in infancy. Prior research indicates that circulating adiponectin increases acutely after endurance exercise, but no prior research has investigated the effect of exercise on breast milk adiponectin concentrations. The purpose of this randomised, cross-over study was to determine the acute effects of endurance exercise on adiponectin concentrations in human breast milk.MethodsParticipants who were exclusively breastfeeding a 6–12 week-old term infant (N = 20) completed three conditions in the laboratory: (1) Moderate-intensity continuous training (MICT), (2) High-intensity interval training (HIIT), and (3) No activity (REST). At each condition, we collected breast milk at 07:00 h (before exercise/rest), 11:00 h (immediately after exercise/rest), 12:00 h (1 h after exercise/rest), and 15:00 h (4 h after exercise/rest) and determined adiponectin concentrations using enzyme-linked immunosorbent assay. We compared changes in adiponectin concentrations after MICT and HIIT, adjusted for the morning concentration on each test day, with those after REST, using paired t-tests.ResultsAdiponectin concentrations increased 1 h after HIIT, from 4.6 (± 2.2) μg/L in the 07:00 h sample to 5.6 (± 2.6) μg/L. This change was 0.9 μg/L (95% confidence interval 0.3 to 1.5) greater than the change between these two timepoints in the REST condition (p = 0.025). There were no other statistically significant changes in adiponectin concentrations.ConclusionHIIT may increase adiponectin concentrations in breast milk acutely after exercise. Further studies should determine the impact of exercise-induced elevations in breast milk adiponectin concentrations on growth and metabolism in infancy.
The roles of serum vitamin D and tobacco smoke exposure in insomnia: a cross-sectional study of adults in the United States
Authors: Gao Tianci , Hou Mengxing , Wang Qianfei , Liu Dong , Chen Fenqiao , Xing Yueyi , Mei Jianqiang 
Published: December 2023

AimTobacco smoke exposure and vitamin D (VD) status were both associated with insomnia. However, the combined effect of smoking and VD on insomnia has not been discussed. This study aimed to explore the role of VD in the association between tobacco smoke exposure and insomnia.MethodsData on adults were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2005–2008 for this cross-sectional study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between serum cotinine, serum VD, and insomnia. A surface diagram was drawn to reflect the effect of VD on the association between serum cotinine and insomnia. In addition, the potential regulating effect of VD in subgroups of smoking status was also performed. The evaluation index was odds ratios (ORs) with 95% confidence intervals (CIs).ResultsAmong the eligible participants, 1,766 had insomnia. After adjusting for covariates, we found that elevated serum cotinine levels were associated with higher odds of insomnia [OR = 1.55, 95% CI: (1.22, 1.97)]. However, the relationship between serum VD level and insomnia was not significant (P = 0.553). Higher serum cotinine levels were also associated with higher odds of insomnia [OR = 1.52, 95% CI: (1.17, 1.98)] when serum VD level was &lt;75 nmol/L; however, this relationship became non-significant when serum VD concentration was elevated (P = 0.088). Additionally, the potential regulating effect of VD was also found in adults who were not smoking.ConclusionVD may play a potential regulative role in the association between tobacco smoke exposure and insomnia. Further studies are needed to clarify the causal relationships between VD, tobacco smoke exposure, and insomnia.
Influence of parotid lymph node metastasis on distant metastasis in parotid gland cancer
Authors: Meng Fan , Yuan Junhui , Zhang Xu , Liu Jun , Li Hailiang 
Published: December 2023

BackgroundThe aim of this study was to analyze the impact of the number and extranodal extension (ENE) of positive parotid lymph nodes (LNs) on distant metastasis in parotid cancer.MethodsPatients with surgically treated parotid cancer were retrospectively enrolled. The hazard ratios (HRs) of the number and ENE of positive parotid LNs on distant metastasis-free survival (DMFS) were evaluated.ResultsIn the Cox model, the groups with zero and one positive LN had comparable 10-year DMFS, but those with two positive LNs had an HR of 2.11 (95% CI: 1.36–5.29), and those with three or more positive LNs had an HR of 3.31 (95% CI: 2.05–8.43). The presence of ENE in parotid LNs did not impact the DMFS (p = 0.462; HR: 2.17; 95% CI: 0.84–6.17).ConclusionParotid LN metastasis was associated with decreased DMFS; this effect was mainly driven by the number of positive LNs rather than ENE.
Aggressive approach for spontaneous pneumothorax treatment in children with Marfan syndrome?
Authors: Zarfati Angelo , Frediani Simone , Pardi Valerio , Aloi Ivan Pietro , Madafferi Silvia , Accinni Antonella , Bertocchini Arianna , Inserra Alessandro 
Published: December 2023

Background and objectivesMarfan syndrome (MS) is a systemic disease of connective tissues consisting of a variable combination of anomalies. These patients have an increased risk of spontaneous pneumothorax (SP). However, there is a scarcity of pediatric literature on management, and no specific guidelines exist. Our aim was to analyze the management of spontaneous pneumothorax in children and adolescents with Marfan syndrome, comparing syndromic and non-syndromic patients.MethodsRetrospective analysis of pediatric patients (18 years) with SP diagnosed at our tertiary pediatric hospital (January 10–June 22), with special emphasis on diagnosis, treatment, and follow-up (FU).ResultsSixty-six patients with SP were identified, with nine (13%) having MS. In terms of baseline, there were no significant differences between the groups (age, sex, asthma, symptoms, and side, first-line treatment and hospitalization length). Overall, Marfan patients had significantly more first-line treatment failures requiring additional surgery, as well as more contralateral occurrences and the need for surgery/chest drain during the follow-up. Instead, conservative management resulted in significantly more ipsilateral recurrences and the need for surgery/chest drain in Marfan patients than controls during the follow-up.ConclusionsTreatment failure, contralateral occurrence, ipsilateral recurrence, and the need for surgery/chest drain during follow-up make management of patients with Marfan syndrome and spontaneous pneumothorax more difficult. In patients with a diagnosed MS a more aggressive first-line management should be considered, bearing in mind the higher risks of this population.
Plasma phospholipids profiling changes were associated with the therapeutic response to Roxadustat in peritoneal dialysis patients
Authors: Yang Ya-Hui , Saimaiti Yishakejiang , Zhao Yang , Tang Wen 
Published: December 2023

Background: Elevated Phospholipids (PLs) and sphingolipid (SM) metabolism relates to with poor clinical status and adverse outcome of end-stage kidney disease patients undergoing peritoneal dialysis (PD). Studies have suggested that the use of hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) (Roxadustat) is associated with altered lipid metabolism. Observing on how PLs and SMs changes after the HIF-PHI treatment in PD patients may help understand the possible effect of HIF-PHI on PD patients besides correcting of anemia.Materials and methods: Stable peritoneal dialysis (PD) patients treated with Roxadustat for over 3 months were included. Phospholipid and sphingolipid metabolism were measured before and after treatment.Results: 25 PD patients were included. Overall, phospholipid and sphingolipid metabolism showed a decreasing trend after HIF-PHI treatment. Levels of LysoPC (20:0), 1,2-dilinoleoyl-sn-glycero-3-phosphocholine [CisPC (DLPC) (18:2)], lysophosphatidylethanolamine (LysoPE) (14:0), and sphingomyelin (d18:1/17:0) (17:0) were significantly decreased (all p &lt; 0.05). Further regression analyses confirmed the significant relationship between the increased of hemoglobin levels and the decrease in egg lyso PC: phosphatidylethanolamines (PE) (16:0–18:1), PE (16:0–18:2), PE (16:0–22:6), PE (18:0–20:4), PE (18:0–18:2), LysoPE (18:0), LysoPE (18:1), and phosphatidylcholine (PC) (18:1–18:0).Conclusion: This study demonstrated that phospholipid and sphingolipid metabolism decreased after administration of HIF-PHI and was associated with improvement of anemia.
Psychiatric trainees as second victims after exposure to patient suicide: a French qualitative study
Authors: Durif-Bruckert Christine , Cuvillier Bruno , Vieux Maxime , Chalancon Benoit , Villeval Philippe , Leaune Edouard 
Published: December 2023

BackgroundThe exposure to patient suicide (PS) has been identified as one of the most frequent and troubling professional experience for psychiatric trainees. Further studies are needed to better understand how residents cope with these experiences and the association between perceived support and the impacts of PS.MethodIn this qualitative study, we aimed to assess the impact of exposure to PS during psychiatric residency on trainees’ professional career and practical experience. A total of 19 French psychiatric residents participated in 4 focus-groups performed between November 2017 and May 2019.ResultsA total of 4 thematic clusters were identified through a five-step content analysis, namely: (a) reactions to the exposure; (b) coping strategies; (c) professional impact; and (d) prevention and postvention proposals. All participants described the critical impact of the support provided after PS, especially by their senior staff. Those who felt supported by their superior reported less negative impact, both in emotional and professional dimensions. Participants also shared proposals to improve the prevention and postvention issues related to the exposure to PS.ConclusionWe performed the first qualitative study based on focus groups on the impact of PS on psychiatric residents, which allowed for an in-depth understanding of the participants’ lived experiences of the exposure to PS. The narratives inform the need and means to implement prevention and postvention strategies designed to buffer the negative impact of the exposure to PS in psychiatric trainees.
Detection of COVID-19 epidemic outbreak using machine learning
Authors: Cho Giphil , Park Jeong Rye , Choi Yongin , Ahn Hyeonjeong , Lee Hyojung 
Published: December 2023

BackgroundThe coronavirus disease (COVID-19) pandemic has spread rapidly across the world, creating an urgent need for predictive models that can help healthcare providers prepare and respond to outbreaks more quickly and effectively, and ultimately improve patient care. Early detection and warning systems are crucial for preventing and controlling epidemic spread.ObjectiveIn this study, we aimed to propose a machine learning-based method to predict the transmission trend of COVID-19 and a new approach to detect the start time of new outbreaks by analyzing epidemiological data.MethodsWe developed a risk index to measure the change in the transmission trend. We applied machine learning (ML) techniques to predict COVID-19 transmission trends, categorized into three labels: decrease (L0), maintain (L1), and increase (L2). We used Support Vector Machine (SVM), Random Forest (RF), and XGBoost (XGB) as ML models. We employed grid search methods to determine the optimal hyperparameters for these three models. We proposed a new method to detect the start time of new outbreaks based on label 2, which was sustained for at least 14 days (i.e., the duration of maintenance). We compared the performance of different ML models to identify the most accurate approach for outbreak detection. We conducted sensitivity analysis for the duration of maintenance between 7 days and 28 days.ResultsML methods demonstrated high accuracy (over 94%) in estimating the classification of the transmission trends. Our proposed method successfully predicted the start time of new outbreaks, enabling us to detect a total of seven estimated outbreaks, while there were five reported outbreaks between March 2020 and October 2022 in Korea. It means that our method could detect minor outbreaks. Among the ML models, the RF and XGB classifiers exhibited the highest accuracy in outbreak detection.ConclusionThe study highlights the strength of our method in accurately predicting the timing of an outbreak using an interpretable and explainable approach. It could provide a standard for predicting the start time of new outbreaks and detecting future transmission trends. This method can contribute to the development of targeted prevention and control measures and enhance resource management during the pandemic.
The comparison between effects of Taichi and conventional exercise on functional mobility and balance in healthy older adults: a systematic literature review and meta-analysis
Authors: Li Yiting , Liu Meng , Zhou Kaixiang , Dong Gengxin , Manor Brad , Bao Dapeng , Zhou Junhong 
Published: December 2023

BackgroundTaichi is beneficial for functional mobility and balance in older adults. However, such benefits of Taichi when comparing to conventional exercise (CE) are not well understood due to large variance in study protocols and observations.MethodsWe reviewed publications in five databases. Eligible studies that examined the effects of Taichi on the outcomes of functional mobility and balance in healthy older adults as compared to CE were included. Subgroup analyses compared the effects of different types of CE (e.g., single and multiple-type exercise) and different intervention designs (e.g., Taichi types) on those outcomes (Registration number: CRD42022331956).ResultsTwelve studies consisting of 2,901 participants were included. Generally, compared to CE, Taichi induced greater improvements in the performance of Timed-Up-and-Go (SMD = −0.18, [−0.33 to −0.03], p = 0.040, I2 = 59.57%), 50-foot walking (MD = −1.84 s, [−2.62 to −1.07], p &lt; 0.001, I2 = 0%), one-leg stance with eyes open (MD = 6.00s, [2.97 to 9.02], p &lt; 0.001, I2 = 83.19%), one-leg stance with eyes closed (MD = 1.65 s, [1.35 to 1.96], p &lt; 0.001, I2 = 36.2%), and functional reach (SMD = 0.7, [0.32 to 1.08], p &lt; 0.001, I2 = 86.79%) tests. Subgroup analyses revealed that Taichi with relatively short duration (&lt;20 weeks), low total time (≤24 h), and/or using Yang-style, can induce significantly greater benefits for functional mobility and balance as compared to CE. Uniquely, Taichi only induced significantly greater improvements in Timed-Up-and-Go compared to single- (SMD = −0.40, [−0.55 to −0.24], p &lt; 0.001, I2 = 6.14%), but not multiple-type exercise. A significant difference between the effects of Taichi was observed on the performance of one-leg stance with eyes open when compared to CE without balance (MD = 3.63 s, [1.02 to 6.24], p = 0.006, I2 = 74.93%) and CE with balance (MD = 13.90s, [10.32 to 17.48], p &lt; 0.001, I2 = 6.1%). No other significant difference was shown between the influences of different CE types on the observations.ConclusionTaichi can induce greater improvement in functional mobility and balance in older adults compared to CE in a more efficient fashion, especially compared to single-type CE. Future studies with more rigorous design are needed to confirm the observations here.
Public first aid education model design study based on user experience
Authors: Luo Jing , Zheng Kaiqiao , Hong Wudi 
Published: December 2023

BackgroundPresently, China’s first aid penetration rate remains relatively low, leaving ample room for improvement in the existing first aid education model. Given its role as a service for the general public, public first aid education must thoroughly consider the learning needs and experiences of the public when designing the teaching mode.MethodsSemi-structured interviews were employed to gather detailed insights into participants’ experiences in the first aid learning process. Subsequently, NVivo was utilized to analyze the interviews and identify specific design strategies. Additionally, a 7-point scale questionnaire was employed to assess the intervention effects of music familiarity and the simulation of teaching aids on users’ willingness and confidence in learning. Building upon the design strategy, a “feedback device + app” approach was proposed. Finally, user satisfaction was evaluated through a scale questionnaire.ResultsThe use of familiar music had a significant positive effect on participants’ willingness and confidence to learn, while users’ fear of teaching aids had no effect on willingness and confidence. The user experience-based first aid education model can better meet the public’s learning needs for first aid knowledge and skills.ConclusionThis study proposes a first aid education model based on user experience design methodology, which optimizes the public’s self-learning experience by evoking positive emotions while circumventing negative emotions. The educational model was recognized by users in terms of design concepts and is expected to help increase first aid prevalence in the future.
Turnover intention of nurses in public hospitals and its association with quality of working life: a cross-sectional survey in six provinces in China
Authors: Tang Changmin , Zhou Sitong , Liu Chaojie , Min Rui , Cai Ruipeng , Lin Taoyu 
Published: December 2023

ObjectivesHigh turnover intention can exacerbate the workforce shortage of nurses. This study aimed to determine the level of turnover intention of public hospital nurses in China and its associated factors.MethodsA cross-sectional questionnaire survey of 2,863 nurses was conducted in 48 public hospitals across six provinces in mainland China, measuring the sociodemographic (gender, age, marital status, and monthly basic salary) and work characteristics (professional title, workload, night sleep deprivation, and workplace violence) of respondents, their quality of working life (QWL), and turnover intention. Multivariate logistic regression models were established to determine the association between QWL and turnover intention after adjustment for variations of the sociodemographic and work characteristics.ResultsOverall, 42.8% of respondents reported turnover intention. Higher QWL scores (AOR = 0.824 for job and career satisfaction, p &lt; 0.001; AOR = 0.894 for professional pride, p &lt; 0.001; AOR = 0.911 for balance between work and family, p &lt; 0.05) were associated with lower turnover intention. Workplace violence was the strongest predictor of higher turnover intention (AOR = 3.003–4.767) amongst the sociodemographic and work characteristics, followed by an age between 30 and 40 years (AOR = 1.457 relative to &lt;30 years), and night sleep deprivation (AOR = 1.391–1.808). Senior professional title had a protective effect (AOR = 0.417 relative to no title) on turnover intention.ConclusionHigh levels of turnover intention are evident across China in nurses employed by public hospitals, in particular in those aged between 30 and 40 years. Low QWL and poor work environment are significant predictors of turnover intention.
A reflection on COVID-19 and oral mucosal lesion: a systematic review
Authors: Kot Wai Ying , Li Jing Wen , Chan Alice Kit Ying , Zheng Li Wu 
Published: December 2023

IntroductionThe aim of this systematic review is to provide a clinical update of the current knowledge on COVID-19 and oral mucosal lesions, to analyze the types and prevalence of oral mucosal lesions in patients with COVID-19, and to clarify the potential association between COVID-19 and oral mucosal lesions.MethodsThe literature search was conducted using PubMed, Web of Science, Scopus and the Cochrane Library, as well as literatures via manual searches of the reference lists of included studies. Studies published in English that mentioned oral mucosal lesions in patients with COVID-19 were included, resulting in a total of 31 studies.ResultsMost of the included studies were considered to have a moderate to high risk of bias according to the Joanna Briggs Institute bias assessment tools. Based on COVID-19 severity, the characteristics and patterns of oral mucosal lesions in COVID-19 patients were described, analyzed and synthesized. Overall, ulcers without specific diagnosis had the highest prevalence in COVID-19 patients, followed by traumatic ulcers, candidiasis, petechiae and aphthous-like lesions. Homogeneity of data cannot be achieved in statical analysis, indicating randomness of outcome (ulcers without specific diagnosis, 95% CI: 28%–96%, I2 = 98.7%).DiscussionGiven the limited evidence from currently available studies, the association between COVID-19 and oral mucosal lesions remains difficult to clarify. Healthcare professionals should be aware of the possible association between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.
Effect of sorbitan ester structure on the separation between tetrahydrofuran and water
Authors: Bartokova Bibiana , Marangoni Alejandro G. , Laredo Thamara , Pensini Erica 
Published: December 2023

This study separates tetrahydrofuran (THF)-water mixtures containing varying THF percentages, using sorbitan esters (Spans) with different tail characteristics. We probe the separation mechanisms using attenuated total reflectance-Fourier transform infrared spectroscopy and small angle X ray scattering (SAXS). THF and water are miscible and interact through hydrogen bonds. Water splits the COC absorbance band of THF into a peak at ≈1,070 cm−1 (crystalline THF) and a dominant peak at ≈1,050 cm−1 (glassy THF), indicating disorder. Depending on the Span, separation occurs for mixtures containing up to 70% THF (v/v, relative to water). Spans with unsaturated tails separate the lowest THF percentages. Tail length and number of Span tails enhances ordering of THF, and the crystalline THF peak at ≈1,070 cm−1 dominates. Spans interact with THF through hydrogen bonds, as reflected in the splitting of the COC band of THF. Furthermore, C-H…O hydrogen bonds cause a blueshift in the νas(CH2) band of Spans with increasing THF. This effect is most significant in Span 40 and 60, indicating that they interact with THF more strongly than Span 20, Span 80 and Span 85. In contrast, they interact with water less strongly than Span 20, Span 80 and Span 85, as indicated by their flocculation at low THF percentages. Therefore, we propose that separation between THF and water occurs primarily through two mechanisms: 1) Span 20, Span 80 and Span 85 compete against THF for interactions with water through their hydrophilic head, and 2) Span 40 and Span 60 preferentially interact with THF through their tails. Nonetheless, water also interacts with the heads of Span 40 and Span 60, as indicated by SAXS. SAXS shows that in THF Spans self-assemble into micelles, which aggregate into either surface fractals or mass fractals. There are two persistence lengths because of the limited order in THF. Water orders self-assembled structures, likely by favoring the formation of micelles which host water in their interior. Therefore, we identify a single persistence length (≈25 Å), representative of the distance between the micelle centers.