bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries
Authors: Taheri Morteza , Saad Helmi Ben , Washif Jad Adrian , Reynoso-Sánchez Luis Felipe , Mirmoezzi Masoud , Youzbashi Leila , Trabelsi Khaled , Moshtagh Mozhgan , Muñoz-Helú Hussein , Mataruna-Dos-Santos Leonardo Jose , Seghatoleslami Ali , Torabi Farnaz , Soylu Yusuf , Kurt Cem , Vancini Rodrigo Luiz , Delkash Shabnam , Rezaei Marjan Sadat , Ashouri Mahdi , Tahira Shazia , Sayyah Mansour , Chtourou Hamdi , Dergaa Ismail , Strahler Jana , Guimarães-Mataruna Andressa Fontes , Lebaron Tyler W. , Ezdini Ebrahim Shaabani , Alizade Ardeshir , Zouhal Hassane , Tarnava Alexander T. , Clark Cain , Bigdeli Nooshin , Ammar Achraf , Eken Özgür , Ayed Karim Ben , Bragazzi Nicola Luigi , Nobari Hadi , Thuany Mabliny , Weiss Katja , Knechtle Beat , Irandoust Khadijeh 
Published: November 2023

Abstract
Background
Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale—21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.

Results
The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).

Conclusion
In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.
Dengue-induced Guillain–Barre syndrome: a case series
Authors: Imtiaz Hina , Khan Ayisha Farooq , Khan Sara 
Published: November 2023

Abstract
Background
Dengue virus is an RNA virus that is associated with a myriad of neurological manifestations. Less than 5% of patients develop neuromuscular complications. Guillain–Barre syndrome (GBS) is an uncommon neurological sequelae of dengue fever. Studies have shown acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) to be the most common variants associated with dengue fever in Asian countries. Very few cases have been reported from Pakistan to date.

Case presentation
We present four adult patients with dengue-associated GBS. The time interval between onset of symptoms of dengue fever and development of lower limb weakness in all patients was between 6 and 20 days. Dengue was diagnosed based on either serology or dengue NS1 antigen testing. Acute inflammatory demyelinating polyneuropathy (AIDP) (n = 1), AMAN (n = 1), and AMSAN (n = 2) variants were identified. One patient had a coexisting myopathy which has not been previously reported. All patients showed good recovery after treatment with plasmapheresis or intravenous immunoglobulins.

Conclusions
Our case series is valuable in contributing to the limited pool of reported cases of dengue fever complicated by GBS. Early detection of new onset symmetrical limb weakness during or after a dengue infection is imperative for early treatment and to limit disability.
Longitudinal metagenomic study reveals the dynamics of fecal antibiotic resistome in pigs throughout the lifetime
Authors: Ma Lingyan , Song Yuanyuan , Lyu Wentao , Chen Qu , Xiao Xingning , Jin Yuanxiang , Yang Hua , Wang Wen , Xiao Yingping 
Published: November 2023

Abstract
Background
The dissemination of antibiotic resistance genes (ARGs) poses a substantial threat to environmental safety and human health. Herein, we present a longitudinal paired study across the swine lifetime from birth to market, coupled with metagenomic sequencing to explore the dynamics of ARGs and their health risk in the swine fecal microbiome.

Results
We systematically characterized the composition and distribution of ARGs among the different growth stages. In total, 829 ARG subtypes belonging to 21 different ARG types were detected, in which tetracycline, aminoglycoside, and MLS were the most abundant types. Indeed, 134 core ARG subtypes were shared in all stages and displayed a growth stage-associated pattern. Furthermore, the correlation between ARGs, gut microbiota and mobile genetic elements (MGEs) revealed Escherichia coli represented the main carrier of ARGs. We also found that in most cases, the dominant ARGs could be transmitted to progeny piglets, suggesting the potential ARGs generation transmission. Finally, the evaluation of the antibiotic resistance threats provides us some early warning of those high health risk ARGs.

Conclusions
Collectively, this relatively more comprehensive study provides a primary overview of ARG profile in swine microbiome across the lifetime and highlights the health risk and the intergenerational spread of ARGs in pig farm.

Graphical Abstract
Comparable performance of machine learning algorithms in predicting readmission and complications following total joint arthroplasty with external validation
Authors: Shaikh Hashim J. F. , Botros Mina , Ramirez Gabriel , Thirukumaran Caroline P. , Ricciardi Benjamin , Myers Thomas G. 
Published: November 2023

Abstract
Background
The purpose of the study was to use Machine Learning (ML) to construct a risk calculator for patients who undergo Total Joint Arthroplasty (TJA) on the basis of New York State Statewide Planning and Research Cooperative System (SPARCS) data and externally validate the calculator on a single TJA center.

Methods
Seven ML algorithms, i.e., logistic regression, adaptive boosting, gradient boosting (Xg Boost), random forest (RF) classifier, support vector machine, and single and a five-layered neural network were trained on the derivation cohort. Models were trained on 68% of data, validated on 15%, tested on 15%, and externally validated on 2% of the data from a single arthroplasty center.

Results
Validation of the models showed that the RF classifier performed best in terms of 30-d mortality AUROC (Area Under the Receiver Operating Characteristic) 0.78, 30-d readmission (AUROC 0.61) and 90-d composite complications (AUROC 0.73) amongst the test set. Additionally, Xg Boost was found to be the best predicting model for 90-d readmission and 90-d composite complications (AUC 0.73). External validation demonstrated that models achieved similar AUROCs to the test set although variation occurred in top model performance for 90-d composite complications and readmissions between our test and external validation set.

Conclusion
This was the first study to investigate the use of ML to create a predictive risk calculator from state-wide data and then externally validate it with data from a single arthroplasty center. Discrimination between best performing ML models and between the test set and the external validation set are comparable.

Level of Evidence
III.
Do financing institutions consider operating performance in estimating cost of debt?
Authors: Miah Muhammad Shahin , Islam Mohammad Ariful , Amir Md. Khaled Bin 
Published: November 2023

AbstractThis paper examines the relationship between firm performance and cost of debt. More specifically this paper empirically shows that fund providers charge lower cost on debt for highly performing companies compared to lower performing companies. We argue that the profitable companies are more resilient, and they have more survivable capacity which impacts on the pricing of the cost of debt. In contrast, lower performing companies are more prone to financial distress or may have higher chances of non-repayment of loans thereby fund providers charge higher interest to compensate the risks. Consistently, analyzing 547 firm year observations for the period of 2015–2019 we find that the cost of debt is significantly lower for the highly performing companies compared to the lower performing companies. The negative relation between the cost of debt and firm performance is highly pronounced in smaller companies compared to bigger companies. It suggests that fund providers create opportunities for smaller companies thereby results in balanced growth in the economy. Our results are robust to a set of alternative measures of firm performance. This study has several policy implications and contributions to the literature of the cost of debt in developing economies.
Corticosteroid and antibiotic use in hospitalized patients in Lebanon with acute exacerbation of chronic obstructive pulmonary disease
Authors: Basma S. , Al-Hajje A. , Salameh P. , Nader I. , Henaine AM. 
Published: November 2023

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is currently one of the leading causes of death worldwide, with 90% of these deaths reported in low- and middle-income countries. In Lebanon, the prevalence of COPD is 9.7%. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends the use of antibiotics and corticosteroids in inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The studies examining the level of conformity with the GOLD recommendations are rare, which increases the need for the current study.

Methods
A 3-month cross-sectional study was done. Patients included were those diagnosed with acute exacerbations of COPD and admitted to one of the selected hospitals in Beirut, of various nationalities and sexes, aged 18 to 89. Data were selected from patient files admitted between January 2020 and June 2022 using a data collection sheet. The SPSS version 24 statistics software was used to conduct statistical analysis.

Results
A total of 260 patients were recruited, with 86.7% receiving systemic corticosteroids, 24.3% respecting dose, and 81.8% respecting the appropriate duration of corticosteroid intake. 80% exhibited pulmonary indications for receiving antibiotics, and 56.53% had the necessary cardinal symptoms. Around 74.5% of patients use antibiotics for the recommended time of 5 to 7 days. Age (p value = 0.006), gender (p value = 0.049), alcohol consumption (p value = 0.018), and use of psychiatric medications (p value = 0.049) are correlated with the conformity index of corticosteroid administration. A correlation was observed between the duration of use of antibiotics with cardinal symptoms (p value = 0.003), CRP-value (p value = 0.007), and type of hospital (p value = 0.00).

Conclusion
This investigation revealed a need for correction in a deviation from the guidelines, shed light on existing clinical procedures, and emphasized the growing concern about the uncontrollable rate of antibiotic use and inadequate corticosteroid dosing.
Hearing profile of recovered severe acute respiratory syndrome Coronavirus-2 (SARS-COV2) patients
Authors: Abdulghffar Abdulrahman Nabil Fathi , EL Fouly Hedayat El Sayed , EL Minawi Mohamed Sherif , Medhat Mariam Magdy 
Published: November 2023

AbstractBackgroundCoronaviruses are large, encapsulated RNA viruses that can infect both humans and animals and cause minor respiratory illnesses. In December 2019, numerous cases of pneumonia of unknown origin were reported in Wuhan, China. Coronavirus Disease 2019 (COVID-19), the cause of these cases, was discovered on January 6, 2020. The new coronavirus was declared an epidemic by the WHO on March, 2020. Several studies on COVID-19 have found that auditory complaints and hearing impairment can be detected using various tests.ObjectivesPure tone audiometry (PTA) and transient evoked otoacoustic emissions (TEOAEs) were used to assess hearing in recovered SARS-CoV-2 patients. Also, to compare the presence of patient's auditory complaints with the test findings.MethodsA case- control study was conducted, with each case and control group consisting of 58 people who were age and sex matched and ranged in age from 18 to 50 years. PTA, Extended PTA and, TEOAEs were used to evaluate hearing in both groups.ResultsPTA revealed a statistically significant difference in right ear thresholds at 250 Hz, 500 Hz, 4 kHz, and 8 kHz and left ear thresholds at 250 Hz, 4 kHz, 8 kHz, and 12.5 kHz between patients and controls. Additionally, a statistically significant difference in TEOAEs' overall reproducibility and amplitude between patients and controls was discovered. Affection for PTA and TEOAEs were related to the patient's complaints of hearing loss and tinnitus, respectively.ConclusionsWhether a patient is symptomatic or not, COVID-19 may have a negative impact on their hearing.
Treatment of cerebral ventriculitis with a new self-irrigating catheter system: narrative review and case series
Authors: Stati Gloria , Migliorino Ernesto , Moneti Manuel , Castioni Carlo Alberto , Scibilia Antonino , Palandri Giorgio , Virgili Giulio , Aspide Raffaele 
Published: November 2023

AbstractCerebral ventriculitis is a life-threatening condition that requires prompt and effective pharmacological intervention. The continuous irrigation of the cerebral ventricles with fluid and its drainage is a system to remove toxic substances and infectious residues in the ventricles; this system is called IRRAflow®. We used this kind of ventricular irrigation/drainage system to treat two patients with post-surgical cerebral ventriculitis and a patient with bacterial meningitis complicated with ventriculitis. In this case series, we discuss the management of these three cases of cerebral ventriculitis: we monitored cytochemical parameters and cultures of the cerebrospinal fluid of patients during their ICU stay and we observed a marked improvement after irrigation and drainage with IRRAflow® system. Irrigation/drainage catheter stay, mode settings, and antibiotic therapies were different among these three patients, and neurological outcomes were variable, according to their underlying pathologies. IRRAflow® system can be applied also in other types of brain injury, such as intraventricular hemorrhage, intracranial abscess, subdural hematomas, and intracerebral hemorrhage, with the aim to remove the hematic residues and enhance the functional recovery of the patients. IRRAflow® seems a promising and useful tool to treat infectious and hemorrhagic diseases in neuro-intensive care unit.
Application of two-dimensional chaotic system and implementation of DSP
Authors: Wang Ying-Ying , Luo Hai-Jun 
Published: November 2023

Abstract
Given that the limited complexity of most current 2D maps undermines chaos-based practical applications, this paper proposes a 2D Logical Cosine Coupled Map (2D-LSCCM) and compares the bifurcation maps, Lyapunov exponent spectrum, and spectral entropy complexity of the classical 2D chaos model. Based on this model, this paper proposes an image encryption scheme using ascending alignment permutation and XOR pixel diffusion algorithm. After a series of tests, such as chi-square test, anti-attack test, key sensitivity test, and correlation test, the simulation findings show that the chaotic system proposed in this paper has excellent security performance compared with other systems. Moreover, a hardware platform based on DSP (Digital Signal Processing) and NIST test have been developed to analyze and test chaotic sequences.
Papillary Thyroid Carcinoma in a Pediatric Patient With β-Thalassemia
Authors: Choleva Lauryn , Wilkes Meredith 
Published: November 2023

Abstract
β-Thalassemia is characterized by the abnormal synthesis of β-hemoglobin chains resulting in hemolytic anemia. Treatment involves frequent blood transfusions, which leads to deposition of iron in many organs, including endocrine glands. To date, several cases of papillary thyroid cancer (PTC) in patients with β-thalassemia have been reported in the adult literature, but there have been none in pediatrics. Here we report on an female adolescent with β-thalassemia who initially presented for evaluation of secondary amenorrhea. On examination, her thyroid gland was asymmetric, firm in consistency, with palpable lymph nodes along the right anterior cervical chain. A thyroid ultrasound revealed an enlarged right lobe containing 3 focal hypoechoic masses with calcific foci. Biopsy was consistent with PTC. She underwent total thyroidectomy and histological examination confirmed the diagnosis. Her postoperative course was uncomplicated and she was started on replacement therapy with levothyroxine. This is the first reported case of PTC in a pediatric patient with β-thalassemia. The incidence of thyroid cancer in patients with β-thalassemia is currently unknown; however, there may be utility in routine surveillance of this patient population.
Designing and evaluation of ebastine–benzamide cocrystals
Authors: Salih Zainab M. , Al-Khedairy Eman B. H. 
Published: November 2023

Background: Ebastine (EB) is a selective nonsedating H1 antihistamine belonging to Class II(BCS); it has inadequate oral bioavailability due to its poor water solubility. Cocrystal is one of the most recent methods that has been utilized to improve some physicochemical characteristics of a drug, such as solubility and dissolution rate. This research's main objective was to design and evaluate EB cocrystal as a trial to enhance its solubility. Methods: Various techniques were employed to formulate cocrystals, such as solvent evaporation, slurry, and drop asset grinding using benzamide (BENZ) as a co-former in different molar ratios. The prepared formulas were characterized by percentage yield, drug content, saturation solubility, in vitro dissolution studies, infrared spectroscopy (FTIR), Raman spectroscopy, powder X-ray diffraction (PXRD), and differential scanning calorimetry (DSC), Results: Solubility enhanced by 347 fold in distilled water with enhanced dissolution profile. Conclusions: Co-crystallization is a potential solid formation method due to its ability to enhance physicochemical and mechanical characteristics. Co-crystals have been successfully formed from a variety of medicines and co-former, using distinct hydrogen bond synthon motifs.
Associations between item characteristics and statistical performance for paediatric medical student multiple choice assessments
Authors: Bosi Isabelle , O'Mara Deborah , Clark Tyler , Patabendige Nounu Sarukkali , Kennedy Sean E. , Gunasekera Hasantha 
Published: November 2023

Background: Multiple choice questions (MCQs) are commonly used in medical student assessments but often prepared by clinicians without formal education qualifications. This study aimed to inform the question writing process by investigating the association between MCQ characteristics and commonly used statistical measures of individual item quality for a paediatric medical term. Methods: Item characteristics and statistics for five consecutive annual barrier paediatric medical student assessments (each n=60 items) were examined retrospectively. Items were characterised according to format (single best answer vs. extended matching); stem and option length; vignette presence and whether required to answer the question, inclusion of images/tables; clinical skill assessed; paediatric speciality; clinical relevance/applicability; Bloom’s taxonomy domain and item flaws. For each item, we recorded the facility (proportion of students answering correctly) and point biserial (discrimination). Results: Item characteristics significantly positively correlated (p<0.05) with facility were relevant vignette, diagnosis or application items, longer stem length and higher clinical relevance. Recall items (e.g., epidemiology items) were associated with lower facility. Characteristics significantly correlated with higher discrimination were extended matching question (EMQ) format, longer options, diagnostic and subspeciality items. Variation in item characteristics did not predict variation in the facility or point biserial (less than 10% variation explained). Conclusions: Our research supports the use of longer items, relevant vignettes, clinically-relevant content, EMQs and diagnostic items for optimising paediatric MCQ assessment quality. Variation in item characteristics explains a small amount of the observed variation in statistical measures of MCQ quality, highlighting the importance of clinical expertise in writing high quality assessments.
TECNOLOGIA RECREATIVA EM UNIDADE PEDIÁTRICA E CIRÚRGICA: REVISÃO INTEGRATIVA
Authors: Valentim da Silva Moreira Italo , Da Silva Sabino Aderlaine , Andrade da cunha Marques Anne Grace , Véras Fontes Esteves Arinete 
Published: November 2023

Introdução: toda e qualquer criança, onde ela estiver, tem o direito de brincar. No entanto, quando a criança está doente, ela pode ser submetida a tratamento com internações e ações hospitalares que afetam sua rotina, afastando-a dos seus pares e podendo privá-la de brincar. Tal situação implica em pouco contato social com outras crianças, dificuldades emocionais e baixo nível de atividade física, o que pode acarretar prejuízos à criança. Objetivo: analisar nas evidências científicas a importância e benefício das tecnologias recreativas utilizadas em unidade cirúrgica pediátrica. Materiais e Método: estudo de revisão integrativa, com questão de pesquisa elaborada pela estratégia PICO, selecionando-se os descritores "Tecnologia Biomédica", "Recreação", "Centro Cirúrgico", "Sala de Cirurgia", "Bloco Cirúrgico", "Cirurgia", "Sala de Operações", “Enfermagem Pediátrica”, “Equipe de Enfermagem”, “Profissionais de Enfermagem”, “Enfermeiras”, “Saúde da Criança”, em português e inglês, e utilizou-se o operador booleano AND ou OR. Realizou-se a busca em quatro fontes de literatura científica, no período de setembro de 2020 a fevereiro de 2021. Aplicaram-se os critérios de inclusão e exclusão, bem como os dados extraídos por formulário próprio. Resultados: a amostra final quantificou doze estudos e seus resultados foram agrupados em duas categorias: Atividades lúdicas e seus benefícios para a criança hospitalizada; Percepção dos profissionais e de familiares na recreação do paciente. Conclusão: o estudo contribuirá para que profissionais da área da saúde tenham um olhar diferenciado no cuidado do paciente hospitalizado, levando em consideração que o brincar oferta subsídios primordiais na amenização da aflição.
Projectes interdisciplinaris centrats en l'alimentació sostenible mitjançant maletes didàctiques: Canvis perceptius de l'estudiantat
Authors: Sabido-Codina Judit , Solé-Coromina Laia , Amat Arnau 
Published: November 2023

La nova conjuntura contextual fa imprescindible desenvolupar en els futurs ciutadans una consciència crítica amb el seu entorn, tal i com recull la nova llei educativa LOMLOE. Aquest article vol descriure i analitzar l’ús i la viabilitat de projectes interdisciplinaris centrats en l’agroecologia en la formació inicial de professorat en el context del tercer curs del grau de Mestre d’Educació Primària. Per assolir l’anàlisi sobre l’ús i viabilitat es va passar un qüestionari perceptiu de caràcter qualitatiu a un total de 36 estudiants. Els resultats presentats mostren com a través de la realització del projecte, els i les estudiants no només han canviat la seva concepció respecte la interdisciplinarietat, els PSR i les maletes didàctiques, sinó que també tenen la percepció que aquests canvis tindran afectació en la seva pràctica com a futurs docents.