bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal melatonin levels and temporal dietary intake: results from MY-CARE cohort study
Authors: Teoh Ai Ni , Kaur Satvinder , Shafie Siti Raihanah , Shukri Nurul Husna Mohd , Bustami Normina Ahmad , Takahashi Masaki , Shibata Shigenobu 
Published: July 2023

AbstractChrononutrition emerges as a novel approach to promote circadian alignment and metabolic health by means of time-of-the-day dietary intake. However, the relationship between maternal circadian rhythm and temporal dietary intake during pregnancy remains understudied. This study aimed to determine the change in melatonin levels in pregnant women across gestation and its association with temporal energy and macronutrient intake. This was a prospective cohort involving 70 healthy primigravidas. During the second and third trimesters, pregnant women provided salivary samples collected at 9:00, 15:00, 21:00, and 3:00 h over a 24 h day for melatonin assay. Data on chrononutrition characteristics were collected using a 3-day food record. Parameters derived from melatonin measurements including mean, amplitude, maximal level, area under the curve with respect to increase (AUCI), and area under the curve with respect to ground (AUCG) were computed. A rhythmic melatonin secretion over the day that remained stable across trimesters was observed among the pregnant women. There was no significant elevation in salivary melatonin levels as pregnancy advanced. In the second trimester, higher energy intake during 12:00–15:59 h and 19:00–06:59 h predicted a steeper melatonin AUCI (β=-0.32, p = 0.034) and higher AUCG (β = 0.26, p = 0.042), respectively. Macronutrient intake within 12:00–15:59 h was negatively associated with mean melatonin (Fat: β=-0.28, p = 0.041) and AUCG (Carbohydrate: β=-0.37, p = 0.003; Protein: β=-0.27, p = 0.036; Fat: β=-0.32, p = 0.014). As pregnant women progressed from the second to the third trimester, a flatter AUCI was associated with a reduced carbohydrate intake during 12:00–15:59 h (β=-0.40, p = 0.026). No significant association was detected during the third trimester. Our findings show that higher energy and macronutrient intakes particularly during 12:00–15:59 h and 19:00–06:59 h are associated with the disparities in maternal melatonin levels. Findings suggest the potential of time-based dietary approaches to entrain circadian rhythm in pregnant women.
Family resilience and its influencing factors among advanced cancer patients and their family caregivers: a multilevel modeling analysis
Authors: Cui Panpan , Shi Jiaoxia , Li Shifeng , Getu Mikiyas Amare , Wang Ruibo , Chen Changying 
Published: July 2023

Abstract
Background
Cancer is highly prevalent worldwide. Family resilience is a positive variable that helps families burdened by advanced cancer to cope effectively. This study aimed to describe the family resilience of advanced cancer patients and caregivers in dyads and identify its influencing factors at the individual and dyadic levels.

Methods
This multisite cross-sectional study was conducted in oncology units in five tertiary hospitals in China. A total of 270 advanced cancer patient-caregiver dyads were recruited between June 2020 and March 2021. Patients’ and caregivers’ family resilience was measured by the Family Resilience Assessment Scale. Data on potential influencing factors, including demographic and disease-related characteristics as well as family sense of coherence, psychological resilience, perceived social support, symptom burden, and caregiver burden, were collected. Multilevel modeling analysis was adopted to control for the interdependence of the dyads.

Results
A total of 241 dyads were included in the data analysis. The mean ages of patients and caregivers were 53.96 (SD 15.37) and 45.18 (SD 13.79) years, respectively. Most caregivers were spouses and adult children (45.6% and 39.0%, respectively). Patients reported a higher mean family resilience score than caregivers (152.56 vs. 149.87, respectively). Undergoing fewer than two types of treatment and a lower symptom burden of patients predicted higher patient (B = -9.702, -0.134, respectively) and caregiver (B = -5.462, -0.096, respectively) family resilience. Patients also reported higher family resilience under the following conditions: 1) were on a medical insurance plan other than the new rural cooperative medical system (B = 6.089), 2) had a better family sense of coherence (B = 0.415), 3) whose caregivers were unmarried (B = 8.618), perceived lower social support (B = -0.145) and higher psychological resilience (B = 0.313). Caregivers who were ≤ 44 years old (B = -3.221), had similar previous caregiving experience (B = 7.706), and had a stronger family sense of coherence (B = 0.391) reported higher family resilience.

Conclusions
Our findings highlight the importance of adopting a dyadic approach when caring for advanced cancer patients and their caregivers. Dyadic longitudinal research is suggested to discover more modifiable factors of family resilience and tailored interventions are needed to obtain optimal dyadic outcomes.
Familial and lifestyle factors related to physical activity in elementary school students: a cross-sectional study based on a nationally representative survey in Japan
Authors: Motoki Noriko , Morota Haruka , Shibazaki Takumi , Nakamura Chizuko , Nakazawa Yozo 
Published: July 2023

Abstract
Purpose
The decrease in physical activity (PA) among children has become a global concern. Since the analysis of sociodemographic factors as determinants of exercise habits has been inconclusive, this study investigated the factors related to participation in organized sports and moderate-to-vigorous PA (MVPA) levels.

Methods
Cross-sectional data from the Sports-Life Survey conducted in 2019 by the Sasagawa Sports Foundation were used. Data on the gender, age, grade, annual household income, family members, and lifestyle habits of elementary school children as well as information on participation in organized sports and MVPA were collected by written questionnaires. Multiple logistic regression models were applied to calculate the adjusted odds ratio and 95% confidence interval for the association of each variable with participation in organized sports and frequent MVPA (≥ 60 min/day for ≥ 5 days/week).

Results
A total of 1,197 participants were included in the analysis. Whereas 1,053 (88.2%) students expressed a like for PA, only 725 students (60.8%) actually took part in organized sports. Organized sports participation was significantly associated with gender, grade, population density, household income, daily breakfast, lower screen time, and frequent exercise with parents (all P < 0.05). We observed that 12.3% of participants met the frequent MVPA level, which was significantly related to lower screen time and exercise habits with parents (both P < 0.05).

Conclusions
Social and family factors may be strong determinants of engagement in PA among Japanese elementary school-aged children. Parental involvement appears particularly important for promoting PA among youths.
Validation of the Chinese version stage of recovery instrument-30 (STORI-30) for adults with severe mental illness
Authors: Lau Sharon Wing-Yung , Law Colin Kwok-Man , Ng Siu-Man 
Published: July 2023

Abstract
Background
Stage of Recovery Instrument-30 (STORI-30) is grounded in a five-stage model of psychological recovery, and serves as measuring recovery stage of people with mental illness.

Aims
To develop and validate the Chinese version STORI-30 on adults with severe mental illness.

Methods
STORI-30 was translated to traditional Chinese through forward-backward method. An expert panel and potential users evaluated face validity and content validity. The Chinese version STORI-30 plus other convergent and divergent scales were then administered to 113 participants for field test.

Results
Face and content validity were confirmed with acceptable Content Validity Index and high inter-rater agreement. Exploratory factor analysis revealed a three-factor structure. An ordinal sequence was presented among the five subscales, similar to the original version. Construct validity was supported by positive correlations with recovery and mental well-being scales, and negative correlation with self-stigma scale. Good internal consistency (Cronbach’s α = 0.78–0.86) and high level of test-retest reliability (Intraclass correlation coefficient = 0.96) were obtained.

Conclusions
Chinese STORI-30 presents satisfactory psychometric properties in internal consistency, construct convergent and divergent validity, and test-retest reliability. The three-factor structure revealed does not echo the original five-stage recovery model. Further studies exploring the underlying structure are warranted.
Cytoreductive surgery offers prognostic benefits in metastatic gastrointestinal stromal tumors with generalized progression following imatinib therapy: a single institute retrospective study
Authors: Liu Dao-Ning , Jia Wei-Wei , Wang Hai-Yue , Wu Jian-Hui , Li Cheng-Peng , Hao Chun-Yi 
Published: July 2023

Abstract
Background
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Distant metastasis has been detected in approximately 50% of GIST patients at the first diagnosis. The surgical strategy for metastatic GIST with generalized progression (GP) after imatinib therapy remains unclear.

Methods
We recruited 15 patients with imatinib-resistant metastatic GIST. They received cytoreductive surgery (CRS) for tumor rupture, intestinal obstruction and gastrointestinal bleeding. We collected clinical, pathological and prognostic data for analyses.

Results
OS and PFS after R0/1 CRS were 56.88 ± 3.47 and 26.7 ± 4.12 months, respectively, when compared with 26 ± 5.35 and 5 ± 2.78 months after R2 CRS (P = 0.002 and P < 0.001, respectively). The OS of patients from the initiation of imatinib in the R0/1 group was 133.90 ± 15.40 months when compared with 59.80 ± 10.98 months in the R2 CRS group. There were two significant grade III complications after 15 operations (13.3%). No patient underwent reoperation. In addition, no perioperative death occurred.

Conclusions
R0/1 CRS is highly probable to provide prognostic benefits for patients with metastatic GIST who experience GP following imatinib treatment. An aggressive surgical strategy for achieving R0/1 CRS can be deemed safe. If applicable, R0/1 CRS should be carefully considered in imatinib-treated patients with GP metastatic GIST.
Prevalence, correlates and treatment needs of dental caries in patients attending a diabetic clinic in rural southwestern Uganda: a cross-sectional study
Authors: Arubaku Wilfred , Tusubira Deusdedit , Ssedyabane Frank , Chamut Steffany , Seymour Brittany Anne , Siedner Mark J. , Niyonzima Vallence , Nabbanja Juliet , Kakongi Nathan , Kwizera Godfrey , Maling Samuel 
Published: July 2023

Abstract
Background
Diabetes mellitus is a complex heterogeneous metabolic disorder known to lead to several pathogenic disorders, and has a bidirectional relationship with oral health conditions. This study aimed at estimating the prevalence, treatment needs and correlates of dental caries among adult patients attending a diabetic clinic in Uganda.

Methods
This was a cross-sectional study that used questionnaires to collect data on socio-demographic factors, diabetes history, oral health status, dental health care, dietary factors, lifestyle factors, and dental examination guided by the modified World Health Organization oral health questionnaire for adults.

Results
We enrolled 239 participants, prevalence of dental caries was 71.6%, treatment need was nearly 100%, and mean DMFT was 3.82 (SD = 5.46). Dental caries experience was associated with being widowed.

Conclusion
We found a high prevalence of dental caries experience and large treatment need among our participants. We recommend integration of oral health care into routine diabetic services in rural sub Saharan Africa.
Prevalence and risk of developing sexual dysfunction in women with multiple sclerosis (MS): a systematic review and meta-analysis
Authors: Yazdani Amid , Ebrahimi Narges , Mirmosayyeb Omid , Ghajarzadeh Mahsa 
Published: July 2023

AbstractObjectiveTo estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS).MethodsWe systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar and also gray literature up to October 2021.The search strategy includes:(“Multiple Sclerosis” OR “MS” OR “Disseminated Sclerosis” OR (Disseminated AND Sclerosis) OR (Sclerosis AND Multiple)) AND (“Sexual Dysfunction” OR (Sexual AND Dysfunction) OR (Sexual AND Dysfunctions) OR (Sexual AND Disorders) OR (Sexual AND Disorder) OR “Sexual Dysfunctions” OR “Sexual Disorders” OR “Sexual Disorder” OR “Psychosexual Dysfunctions” OR (Dysfunction AND Psychosexual) OR (Dysfunctions AND Psychosexual) OR “Psychosexual Dysfunction” OR “Psychosexual Disorders” OR (Disorder AND Psychosexual) OR (Disorders AND Psychosexual) OR “Psychosexual Disorder” OR “Hypoactive Sexual Desire Disorder” OR “Sexual Aversion Disorder” OR (Aversion Disorders AND Sexual) OR (Disorders AND Sexual Aversion) OR “Sexual Aversion Disorders” OR “Orgasmic Disorder” OR (Disorders AND Orgasmic) OR “Orgasmic Disorders” OR “Sexual Arousal Disorder” OR (Arousal Disorders AND Sexual) OR (Disorders AND Sexual Arousal) OR “Sexual Arousal Disorders” OR “Frigidity”).ResultsWe found 2150 articles by literature search, after deleting duplicates 1760 remained. Fifty-six articles remained for meta-analysis. The pooled prevalence of SD in MS patients estimated as 61% (95%CI:56–67%) (I2:95.7%,P < 0.001). The pooled prevalence of Anorgasmia in MS patients estimated as 29% (95%CI:20–39%) (I2:85.3%,P < 0.001). The pooled odds of developing SD in MS women estimated as 3.05(95%CI: 1.74–5.35) (I2:78.3%,P < 0.001). The pooled prevalence of decreased vaginal lubrication in MS patients estimated as 32%(95%CI:27–37%) (I2 = 94.2%,P < 0.001). The pooled prevalence of reduced libido was 48%(95%CI:36–61%) (I2:92.6%,P < 0.001). The pooled prevalence of arousal problems was 40%(95%CI: 26–54%) (I2:97.4%,P < 0.001). The pooled prevalence of intercourse satisfaction was 27% (95%CI: 8–46%) (I2:99%,P < 0.001).ConclusionThe result of this systematic review and meta-analysis show that the pooled prevalence of SD in women with MS is 61% and the odds of developing SD in comparison with controls is 3.05.
Mental health experiences of HIV/TB healthcare workers during the COVID-19 pandemic – lessons for provider well-being and support from a qualitative study in seven South African provinces
Authors: Yang Blia , Egg Rafaela , Brahmbhatt Heena , Matjeng Mahlodi , Doro Thanduxolo , Mthembu Zandile , Muzah Batanayi , Foster Brendon , Theunissen Johanna , Frost Ashley , Peetz April , Reichert Katie , Hoddinott Graeme 
Published: July 2023

Abstract
Background
COVID-19 has substantially reshaped health service delivery. Healthcare workers have had to serve more clients, work longer shifts, and operate in conditions of uncertainty. They have experienced multiple stressors related to the additional ‘labour of care’, including managing the frustration of inadequate therapeutic or symptom relief options, witnessing clients dying, and having to give this news to clients’ family members. Ongoing psychological distress among healthcare workers can severely undermine performance, decision-making and well-being. We sought to understand the impact of the COVID-19 pandemic on the mental health experiences of healthcare workers delivering HIV and TB services in South Africa.

Methods
We used a pragmatic and exploratory design to understand HCWs’ mental health experiences with in-depth qualitative data. We implemented the study in ten high HIV/TB burden districts across seven of South Africa’s nine provinces among healthcare workers employed by USAID-funded implementing partners. We conducted in-depth interviews (virtual) with 92 healthcare workers across 10 cadres.

Results
Healthcare workers reported experiencing a range of extreme and rapidly fluctuating emotions because of COVID-19 that negatively impacted on their well-being. Among these, many healthcare workers report experienced a great deal of guilt at their inability to continue to provide quality care to their clients. In addition, a constant and pervasive fear of contracting COVID-19. Healthcare workers’ stress coping mechanisms were limited to begin with, and often further interrupted by COVID-19 and non-pharmaceutical response measures e.g., ‘lockdowns’. Healthcare workers reported a need for greater support for managing the everyday burden of work – not only when experiencing a mental well-being ‘episode’. Further, that whenever they were exposed to stressor events, e.g., supporting a child living with HIV who reports sexual abuse to the healthcare worker, that this this would trigger additional support interventions and not rely on the healthcare worker seeking this out. Further, that supervisors spend more effort demonstrating appreciation toward staff.

Conclusions
The COVID-19 epidemic has added significant mental health burden for healthcare workers in South Africa. Addressing this requires broad and cross-cutting strengthening of everyday support for healthcare workers and centring staff’s mental well-being as core to delivering quality health services.
Reduced intestinal lipid absorption improves glucose metabolism in aged G2-Terc knockout mice
Authors: Liu Xue , Khalil Ahmed Elagamy Mohamed Mahmoud , Muthukumarasamy Uthayakumar , Onogi Yasuhiro , Yan Xiaocheng , Singh Inderjeet , Lopez-Gonzales Elena , Israel Andreas , Serrano Alberto Cebrian , Strowig Till , Ussar Siegfried 
Published: July 2023

Abstract
Background
Biological aging is an important factor leading to the development of pathologies associated with metabolic dysregulation, including type 2 diabetes, cancer, cardiovascular and neurodegenerative diseases. Telomere length, a central feature of aging, has additionally been identified as inversely associated with glucose tolerance and the development of type 2 diabetes. However, the effects of shortened telomeres on body weight and metabolism remain incompletely understood. Here, we studied the metabolic consequences of moderate telomere shortening using second generation loss of telomerase activity in mice.

Results
Aged male and female G2 Terc-/- mice and controls were characterized with respect to body weight and composition, glucose homeostasis, insulin sensitivity and metabolic activity. This was complemented with molecular and histological analysis of adipose tissue, liver and the intestine as well as microbiota analysis. We show that moderate telomere shortening leads to improved insulin sensitivity and glucose tolerance in aged male and female G2 Terc-/- mice. This is accompanied by reduced fat and lean mass in both sexes. Mechanistically, the metabolic improvement results from reduced dietary lipid uptake in the intestine, characterized by reduced gene expression of fatty acid transporters in enterocytes of the small intestine. Furthermore, G2-Terc-/- mice showed significant alterations in the composition of gut microbiota, potentially contributing to the improved glucose metabolism.

Conclusions
Our study shows that moderate telomere shortening reduces intestinal lipid absorption, resulting in reduced adiposity and improved glucose metabolism in aged mice. These findings will guide future murine and human aging studies and provide important insights into the age associated development of type 2 diabetes and metabolic syndrome.
Providing multimedia information to children and young people increases recruitment to trials: pre-planned meta-analysis of SWATs
Authors: Knapp Peter , Moe-Byrne Thirimon , Martin-Kerry Jacqueline , Sheridan Rebecca , Roche Jenny , Coleman Elizabeth , Bower Peter , Higgins Steven , Stones Catherine , Graffy Jonathan , Preston Jenny , Gamble Carrol , Young Bridget , Perry Daniel , Dahlmann-Noor Annegret , Abbas Mohamed , Khandelwal Payal , Ludden Siobhan , Azuara-Blanco Augusto , McConnell Emma , Mandall Nicky , Lawson Anna , Rogers Chris A. , Smartt Helena J. M. , Heys Rachael , Stones Simon R. , Taylor Danielle Horton , Ainsworth Sophie , Ainsworth Jenny 
Published: July 2023

AbstractBackgroundRandomised controlled trials are often beset by problems with poor recruitment and retention. Information to support decisions on trial participation is usually provided as printed participant information sheets (PIS), which are often long, technical, and unappealing. Multimedia information (MMI), including animations and videos, may be a valuable alternative or complement to a PIS. The Trials Engagement in Children and Adolescents (TRECA) study compared MMI to PIS to investigate the effects on participant recruitment, retention, and quality of decision-making.MethodsWe undertook six SWATs (Study Within A Trial) within a series of host trials recruiting children and young people. Potential participants in the host trials were randomly allocated to receive MMI-only, PIS-only, or combined MMI + PIS. We recorded the rates of recruitment and retention (varying between 6 and 26 weeks post-randomisation) in each host trial. Potential participants approached about each host trial were asked to complete a nine-item Decision-Making Questionnaire (DMQ) to indicate their evaluation of the information and their reasons for participation/non-participation. Odds ratios were calculated and combined in a meta-analysis.ResultsData from 3/6 SWATs for which it was possible were combined in a meta-analysis (n = 1758). Potential participants allocated to MMI-only were more likely to be recruited to the host trial than those allocated to PIS-only (OR 1.54; 95% CI 1.05, 2.28;p = 0.03). Those allocated to combined MMI + PIS compared to PIS-only were no more likely to be recruited to the host trial (OR = 0.89; 95% CI 0.53, 1.50;p = 0.67). Providing MMI rather than PIS did not impact on DMQ scores. Once children and young people had been recruited to host trials, their trial retention rates did not differ according to intervention allocation.ConclusionsProviding MMI-only increased the trial recruitment rate compared to PIS-only but did not affect DMQ scores. Combined MMI + PIS instead of PIS had no effect on recruitment or retention. MMIs are a useful tool for trial recruitment in children and young people, and they could reduce trial recruitment periods.