bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric injury attendances in different population groups in Israel before, during, and after COVID-19 lockdowns: a descriptive study, 2018–2022
Authors: Bernstine Tomer , Edelstein Michael , Krupik Danna 
Published: November 2023

Abstract
Background
Lockdowns and quarantines during the COVID-19 pandemic influenced healthcare services’ usage patterns such as emergency department (ED) attendance. During the pandemic, Israel issued three lockdowns (March–May 2020, September–October 2020, and December 2020–February 2021) to mitigate the spread of COVID-19. Little is known about the impact of these lockdowns on ED attendance for injuries in the diverse population of Northern Israel.

Methods
We described patterns of ED attendance before, during, and after COVID-19 lockdowns. We extracted data from medical records of all northern Israeli children aged 0–17 years old who attended Ziv Medical Center (ZMC) emergency department (ED) due to injury, between 01/01/2018 and 10/02/2022. We compared the volume and characteristics of ED attendance during lockdown periods to the same time periods in the 2 years before the pandemic and 1 year after the lockdowns, using chi-square tests.

Results
Seven thousand six hundred nineteen northern children attended ZMC ED during the time periods of the study for injuries and were analyzed. Mean attendance numbers during lockdowns decreased compared to previous years, with an increase in injuries proportion (67.8% (1502/2216) vs. 52.7% (2038/3868) p < 0.001). The proportion of 0–4-year-olds attending for injuries during the lockdown increased compared to pre-pandemic (39.68% vs. 30.7%, p < 0.0001). Minority population attendance decreased (27.47% vs. 30.71% p = 0.02). Hospitalization rates increased (13.21% vs. 10.65% p = 0.01). Post-lockdown periods saw a return to the pre-pandemic age and ethnicity distribution.

Conclusions
Compared to previous years, the volume of injuries was lower during lockdowns for all ages, with a relative increase in the proportion of injuries among younger children attending the ED. A lower proportion of attendance from minority groups suggests different health-seeking behavior patterns during emergencies compared to the general population. Understanding these differences will help better plan for future emergencies.
Sensitive and rapid detection of tet(X2) ~ tet(X5) by loop-mediated isothermal amplification based on visual OTG dye
Authors: Chen Guiling , Chen Lulin , Lin Sisi , Yang Congzhu , Liang Huanlin , Huang Kuang , Guo Zhusheng , Lv Fei 
Published: November 2023

AbstractThe emergence of tigecycline-resistant tet(X2/X3/X4/X5) genes poses a new threat to the efficacy of anti-infective therapy and the safety of our food and environment. To control the transfer of such genes, a sensitive and rapid molecular method is warranted to detect tet(X2/X3/X4/X5) genes in clinical isolates. Herein, we established a loop-mediated isothermal amplification (LAMP) assay to rapidly detect tet(X2/X3/X4/X5) genes, and the results were assessed by chromogenic visualization. The specificity and sensitivity of the primers during the LAMP assay for the simultaneous detection of tet(X2/X3/X4/X5) genes were determined in this study. All 48 clinical strains without tet(X2/X3/X4/X5) genes yielded negative results during the LAMP assay, substantiating the high specificity of the LAMP primers. The detection thresholds of this assay were 1.5 × 102 CFU/ml and 0.2 fg/uL corresponding to a 10 to 100-fold and 100-fold increase in sensitivity compared to polymerase chain reaction (PCR) assays. Out of 52 bacterial strains tested, using PCR as a reference, our research revealed that the LAMP assay demonstrated a sensitivity and specificity of 100%. To sum up, our novel approach has huge prospects for application in the simultaneous detection of tet(X2/X3/X4/X5) genes and can be applied to detect other drug-resistance genes.
Assessment of the relationship between plasma fibrinogen-to-albumin ratio and slow coronary flow phenomenon in patients without obstructive coronary artery disease
Authors: Yang Shao-bing , Cui Ying , Hou Jian-jun , Zhang Hui , Pei Xiao-yang , Wang Yong 
Published: November 2023

Abstract
Background
Prior studies have suggested that the chronic inflammatory response has an important role in the pathophysiology of slow coronary flow phenomenon (SCFP). However, data are scarce regarding the role of plasma fibrinogen-to-albumin ratio (PFAR) in patients having SCFP without obstructive coronary artery disease (CAD). In this study, we investigated the relationship between PFAR and the presence of SCFP in patients without obstructive CAD.

Methods
From January 2021 to January 2023, we consecutively recruited 1085 patients without obstructive CAD according to the diagnostic and exclusion criteria. In total, SCFP was diagnosed in 70 patients. A 1:2 age-matched case–control study was then conducted using comparators without SCFP. Ultimately, this study enrolled 70 patients with angiographically normal coronary arteries and SCFP, along with 140 comparators with angiographically normal coronary arteries and normal coronary flow. Plasma fibrinogen and albumin levels were measured, and the PFAR was then calculated for each patient.

Results
PFARs were significantly greater in the SCFP group than in the comparators with normal coronary flow (82.8 ± 15.4 vs 73.1 ± 19.5, p < 0.001). PFAR increased with increasing numbers of vessels affected by SCFP. Multivariate logistic regression analysis showed that PFAR was an independent predictor of SCFP (odds ratio: 1.818, p = 0.015). Receiver operating characteristic (ROC) curve analysis indicated that PFAR showed a better predictive value of SCFP than fibrinogen or albumin, although not significantly (p > 0.05).

Conclusion
PFAR is an independent predictor of SCFP in patients without obstructive CAD. PAFR could improve the predictive value of SFCP than albumin or fibrinogen alone, but not significantly.
Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study
Authors: Jiba Darlinda F. , Lakoh Sulaiman , Wang Shuchao , Sun Wei , Barrie Umu , Kamara Matilda N. , Jalloh Abdulai Tejan , Tamba Francis K. , Yendewa George A. , Song Jin-Wen , Yang Guang 
Published: November 2023

Abstract
Background
Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV).

Methods
A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P < 0.05.

Results
Of the 3082 PLHIV individuals in our study, 2294 (74.4%) were female and 2867 (93.0%) were receiving ART. With a median age of 36 years, 211 (6.8%, 95% CI 6.0–7.7) were positive for syphilis. The prevalence of syphilis was highest in people aged 60 years and over (21.1%, 95%CI 14.7–29.2), followed by people aged 50–60 years (15.5%, 95%CI 11.9–19.9) and in the widowed population (11.9%, 95%CI 8.9–15.8). There were no differences in syphilis seropositivity between gender, ART status, ART regimen, duration of ART, HIV viral load and hospital level of care. Older age (50–60 years: adjusted OR 3.49, 95%CI 2.09–5.85 P < 0.001; 60–100 years: adjusted OR 4.28, 95%CI 2.21–8.17, P < 0.001) was an independent predictor of seropositive syphilis.

Conclusions
We observed a high prevalence of syphilis among PLHIV. Older people and widowed population have higher syphilis seropositivity. Older age was an independent predictor of syphilis positivity. Therefore, we call for the integration of syphilis screening, treatment and prevention in HIV services.
Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma
Authors: Go Se-Il , Choi Bong-Hoi , Park Mi Jung , Park Sungwoo , Kang Myoung Hee , Kim Hoon-Gu , Kang Jung Hun , Jeong Eun Jeong , Lee Gyeong-Won 
Published: November 2023

Abstract
Background
Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed.

Methods
In this study, 305 DLBCL patients were reviewed. They were categorized into normal/mild (n = 219) and moderate/severe (n = 86) CONUT groups. Sarcopenia was assessed using the L3-skeletal muscle index measured by baseline computed tomography imaging. Based on CONUT score and sarcopenia, patients were grouped: A (normal/mild CONUT and no sarcopenia), B (either moderate/severe CONUT or sarcopenia, but not both), and C (both moderate/severe CONUT and sarcopenia).

Results
The moderate/severe CONUT group showed higher rates of ≥ grade 3 febrile neutropenia, thrombocytopenia, non-hematologic toxicities, and early treatment discontinuation not related to disease progression, compared to the normal/mild CONUT group. The moderate/severe CONUT group had a lower complete response rate (58.1% vs. 80.8%) and shorter median overall survival (18.5 vs. 162.6 months) than the normal/mild group. Group C had the poorest prognosis with a median survival of 8.6 months, while groups A and B showed better outcomes (not reached and 60.1 months, respectively). Combining CONUT score and sarcopenia improved the predictive accuracy of the Cox regression model (C-index: 0.763), compared to the performance of using either CONUT score (C-index: 0.754) or sarcopenia alone (C-index: 0.755).

Conclusions
In conclusion, the moderate/severe CONUT group exhibited treatment intolerance, lower response, and poor prognosis. Additionally, combining CONUT score and sarcopenia enhanced predictive accuracy for survival outcomes compared to individual variables.
The predicting role of serum tumor-specific growth factor for prognosis of esophageal squamous cell carcinoma
Authors: Xu Xiaoqin , Wang Weigang , Tian Baoguo , Zhang Xiaofang , Ji Yanfen , Jing Jiexian 
Published: November 2023

Abstract
Objective
Tumor-specific growth factor (TSGF) is an immune-related factor that offers good performance in the clinical management of human cancers. However, the role of serum TSGF in esophageal squamous cell carcinoma (ESCC) has not been fully clarified.

Methods
A total of 562 ESCC cases were collected in our study, with available information on preoperative serum levels of TSGF at diagnosis. Preoperative serum TSGF was detected using the rate method. We retrospectively analyzed its correlation with clinicopathological features of ESCC and survival.

Results
The cut-off value of serum TSGF was determined to be 60.5 U/mL by receiver operating characteristic (ROC) analysis. Serum TSGF was associated with gender (P < 0.001), tumor location (P = 0.022), tobacco use (P < 0.001), alcohol consumption (P < 0.001), lymph node involvement (P = 0.007), and TNM staging (P = 0.004). The survival analysis revealed that ESCC patients with high levels of serum TSGF had poorer prognosis than those with high TSGF (P = 0.006), especially for male ESCC cases (P = 0.001), under 60 year (P = 0.036), male middle location (P = 0.023), tobacco consumption (P = 0.004), G1 + G2 (P = 0.031), advanced T staging (P = 0.033), lymph node involvement (P = 0.003), TNM staging (P = 0.003). Univariate Cox regression analysis indicated that exposure to smoking and drinking, tumor grade, T staging, lymph node metastasis, TNM staging, and serum TSGF level were the prognosis-related factors of ESCC. Multivariate regression analysis revealed that smoking history, higher serum TSGF levels, and advanced T stage enhanced the risk of ESCC-related death.

Conclusion
In brief, serum TSGF levels had in relation to malignant features of ESCC. It was positively correlated with survival but was identified as an independent risk factor for ESCC.
Development and validation of the ADHD Symptom and Side Effect Tracking - Baseline Scale (ASSET-BS): a novel short screening measure for ADHD in clinical populations
Authors: Young Joel L. , Powell Richard N. , Zabel Celeste , Saal Jaime , Welling Lisa L. M. , Fortain Jillian , Ceresnie Ashley 
Published: November 2023

Abstract
Objective
The aim was to develop and test a novel screen of adult ADHD, with a specific focus on clinical use. We designed a series of three studies to accomplish this aim.

Method
Study One (n = 155) and Study Two (n = 591) collected data via surveys to conduct exploratory and confirmatory factor analyses, respectively. Study Three analyzed the scale’s psychometrics in a clinical sample (n = 151).

Results
Study One and Study Two identified a 10-item scale with a two-factor structure. Study Three found good discriminant validity, sensitivity = 80.0%, specificity = 80.2%, and convergent validity with both the Brown Executive Function/Attention Scales, r (131) = .76, p < .001, and the Conner’s Adult ADHD Rating Scales r (131) = .71, p < .001.

Conclusion
The scale demonstrated effectiveness in screening for ADHD in a psychiatric outpatient population. Its results may be used to identify patients that may benefit from thorough ADHD diagnostic procedures.
Dynamics of usage of menstrual hygiene and unhygienic methods among young women in India: a spatial analysis
Authors: Meher Trupti , Sahoo Harihar 
Published: November 2023

Abstract
Background
Menstruation, especially the menstrual cycle, is a vital sign for female adolescent health and maintaining menstrual hygiene is of utmost importance for menstruating girls and women. However, menstrual hygiene and management are issues that have not received adequate attention. Therefore, the present study aimed to explore spatial patterns of menstrual hygiene practices in India and to identify their socioeconomic and demographic determinants among women aged 15–24 years.

Methods
The study utilized data from the fifth round of the National Family Health Survey (NFHS-5) conducted during 2019–21 in India. The analysis was limited to 241,180 women aged 15–24 years. The statistical methods range from multinomial logistic regression, spatial autocorrelation in terms of Moran’s I statistics, to spatial regression in order to understand the spatial dependence and clustering in different methods of menstrual practices across the districts of India.

Results
Almost half of the respondents (49.8 percent) reported using hygienic methods of bloodstain protection, while 22.7 percent still relied on unhygienic methods and 27.5 percent reported using both hygienic and unhygienic methods during their menstruation. Factors like age, place of residence, caste, religion, education, wealth index and toilet facility were found to be significantly associated with the use of unhygienic and both methods. It was also observed that the percentage of women practicing hygienic methods was predominantly higher in the Southern region. On the other hand, states like Madhya Pradesh and Bihar appeared to be hotspots for unhygienic menstrual practices. The univariate Moran’s I value for unhygienic and both methods were 0.722 and 0.596, respectively, depicting high spatial autocorrelation across districts in India. In spatial regression, rural residence, illiteracy, poverty, and no toilet facility were found to be statistically significant predictors of the use of unhygienic method and both methods.

Conclusion
Young women should be educated about the importance of menstrual hygiene practices and the physiological consequences of unhygienic practices. Furthermore, interventions should target socio-economically disadvantaged women to increase the use of sanitary napkins.
Assessment of a venous thromboembolism prophylaxis shared decision-making intervention (DASH-TOP) using the decisional conflict scale: a mixed-method study
Authors: León‑García Montserrat , Humphries Brittany , Morales Pablo Roca , Gravholt Derek , Eckman Mark H. , Bates Shannon M. , Suárez Nataly R. Espinoza , Xie Feng , Perestelo‑Pérez Lilisbeth , Alonso‑Coello Pablo 
Published: November 2023

Abstract
Background
Venous thromboembolism (VTE) in pregnancy is a major cause of maternal morbidity and death. The use of low-molecular-weight heparin (LMWH), despite being the standard of care to prevent VTE, comes with some challenges. Shared decision-making (SDM) interventions are recommended to support patients and clinicians in making preference-sensitive decisions. The quality of the SDM process has been widely assessed with the decisional conflict scale (DCS). Our aim is to report participants’ perspectives of each of the components of an SDM intervention (DASH-TOP) in relation to the different subscales of the DCS.

Methods
Design: A convergent, parallel, mixed-methods design.
Participants: The sample consisted of 22 health care professionals, students of an Applied Clinical Research in Health Sciences (ICACS) master program.
Intervention: We randomly divided the participants in three groups: Group 1 received one component (evidence -based information), Group 2 received two components (first component and value elicitation exercises), and Group 3 received all three components (the first two and a decision analysis recommendation) of the SDM intervention.
Analysis: For the quantitative strand, we used a non-parametric test to analyze the differences in the DCS subscales between the three groups. For the qualitative strand, we conducted a content analysis using the decisional conflict domains to deductively categorize the responses.

Results
Groups that received more intervention components experienced less conflict and better decision-making quality, although the differences between groups were not statistically significant. The decision analysis recommendation improved the efficacy with the decision-making process, however there are some challenges when implementing it in clinical practice. The uncertainty subscale showed a high decisional conflict for all three groups; contributing factors included low certainty of the evidence-based information provided and a perceived small effect of the drug to reduce the risk of a VTE event.

Conclusions
The DASH-TOP intervention reduced decisional conflict in the decision -making process, with decision analysis being the most effective component to improve the quality of the decision. There is a need for more implementation research to improve the delivery of SDM interventions in the clinical encounter.
The effects of COVID-19 event strength on job burnout among primary medical staff
Authors: Li Xinru , Song Yiwen , Hu Bingqin , Chen Yitong , Cui Peiyao , Liang Yifang , He Xin , Yang Guofeng , Li Jinghua 
Published: November 2023

Abstract
Background
As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic’s harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship.

Methods
Multilevel stratified convenience sampling method was used to recruit 1148 primary medical staff from 48 PHC institutions in Jilin Province, China. All participants completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analyzed using SPSS PROCESS 3.5 Macro Model 6.

Results
COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the “job stress → work engagement” chain.

Conclusions
This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.
Taste receptor type 1 member 3 enables western diet-induced anxiety in mice
Authors: Song Jae Won , Lee Keon-Hee , Seong Hobin , Shin Dong-Mi , Shon Woo-Jeong 
Published: November 2023

Abstract
Background
Accumulating evidence supports that the Western diet (WD), a diet high in saturated fat and sugary drinks, contributes to the pathogenesis of anxiety disorders, which are the most prevalent mental disorders worldwide. However, the underlying mechanisms by which WD causes anxiety remain unclear. Abundant expression of taste receptor type 1 member 3 (TAS1R3) has been identified in the hypothalamus, a key brain area involved in sensing peripheral nutritional signals and regulating anxiety. Thus, we investigated the influence of excessive WD intake on anxiety and mechanisms by which WD intake affects anxiety development using wild-type (WT) and Tas1r3 deficient (Tas1r3−/−) mice fed a normal diet (ND) or WD for 12 weeks.

Results
WD increased anxiety in male WT mice, whereas male Tas1r3−/− mice were protected from WD-induced anxiety, as assessed by open field (OF), elevated plus maze (EPM), light–dark box (LDB), and novelty-suppressed feeding (NSF) tests. Analyzing the hypothalamic transcriptome of WD-fed WT and Tas1r3−/− mice, we found 1,432 genes significantly up- or down-regulated as a result of Tas1r3 deficiency. Furthermore, bioinformatic analysis revealed that the CREB/BDNF signaling-mediated maintenance of neuronal regeneration, which can prevent anxiety development, was enhanced in WD-fed Tas1r3−/− mice compared with WD-fed WT mice. Additionally, in vitro studies further confirmed that Tas1r3 knockdown prevents the suppression of Creb1 and of CREB-mediated BDNF expression caused by high levels of glucose, fructose, and palmitic acid in hypothalamic neuronal cells.

Conclusions
Our results imply that TAS1R3 may play a key role in WD-induced alterations in hypothalamic functions, and that inhibition of TAS1R3 overactivation in the hypothalamus could offer therapeutic targets to alleviate the effects of WD on anxiety.