bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the efficacy and safety of transcranial pulse stimulation on adolescents with attention deficit hyperactivity disorder: Study protocol of a pilot randomized, double-blind, sham-controlled trial
Authors: Cheung Teris , Chau Bolton , Fong Kwan Hin , Lam Joyce Yuen Ting , Lo Herman , Li Man Ho , Li Albert Martin Man Chim , Beisteiner Roland , Lei Sun , Yee Benjamin K. , Cheng Calvin Pak Wing 
Published: March 2023

BackgroundTraditional treatment alone might not effectively control the severity of attention deficit hyperactivity disorder (ADHD) symptoms. Transcranial pulse stimulation (TPS) is a non-invasive brain stimulation (NIBS) technology used on older adults with mild neurocognitive disorders and adults with major depressive disorder. However, there has been no study conducted on young adolescents with ADHD. This will be the first nationwide study evaluating the efficacy and safety of TPS in the treatment of ADHD among young adolescents in Hong Kong.MethodsThis study proposes a double-blinded, randomized, sham-controlled trial including TPS as an intervention group and a sham TPS group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 1-month (T3) and 3-month follow-ups (T4).RecruitmentA total of 30 subjects aged between 12 and 17 years, diagnosed with attention deficit hyperactivity disorder (ADHD), will be recruited in this study. All subjects will be computer randomized into either the intervention group or the sham TPS group on a 1:1 ratio.InterventionAll subjects in each group will have to undertake functional MRI (fMRI) before and after six 30-min TPS sessions, which will be completed in 2 weeks' time.OutcomesBaseline measurements and post-TPS evaluation of the ADHD symptoms and executive functions will also be conducted on all participants. The 1- and 3-month follow-up periods will be used to assess the long-term sustainability of the TPS intervention. For statistical analysis, ANOVA with repeated measures will be used to analyze data. Missing data were managed by multiple imputations. The level of significance will be set to p &lt; 0.05.Significance of the studyResults emerging from this study will generate new knowledge to ascertain whether TPS can be used as a top-on treatment for ADHD.Clinical trial registrationclinicaltrails.gov, identifier: NCT05422274.
Interhemispheric transfer time and concussion in adolescents: A longitudinal study using response time and event-related potential measures
Authors: Christensen Benjamin A. , Clark Bradley , Muir Alexandra M. , Allen Whitney D. , Corbin Erin M. , Jaggi Tyshae , Alder Nathan , Clawson Ann , Farrer Thomas J. , Bigler Erin D. , Larson Michael J. 
Published: March 2023

IntroductionConcussion in children and adolescents is a public health concern with higher concussion incidence than adults and increased susceptibility to axonal injury. The corpus callosum is a vulnerable location of concussion-related white matter damage that can be associated with short- and long-term effects of concussion. Interhemispheric transfer time (IHTT) of visual information across the corpus callosum can be used as a direct measure of corpus callosum functioning that may be impacted by adolescent concussion with slower IHTT relative to matched controls. Longitudinal studies and studies testing physiological measures of IHTT following concussion in adolescents are lacking.MethodsWe used the N1 and P1 components of the scalp-recorded brain event-related potential (ERP) to measure IHTT in 20 adolescents (ages 12–19 years old) with confirmed concussion and 16 neurologically-healthy control participants within 3 weeks of concussion (subacute stage) and approximately 10 months after injury (longitudinal).ResultsSeparate two-group (concussion, control) by two-time (3 weeks, 10 months) repeated measures ANOVAs on difference response times and IHTT latencies of the P1 and N1 components showed no significant differences by group (ps ≥ 0.25) nor by time (ps ≥ 0.64), with no significant interactions (ps ≥ 0.15).DiscussionResults from the current sample suggest that measures of IHTT may not be strongly influenced at 3 weeks or longitudinally following adolescent concussion using the current IHTT paradigm.
Information, ingestion, and impulsivity: The impact of technology-enabled healthy food labels on online grocery shopping in impulsive and non-impulsive consumers
Authors: Ljusic Nikola , Fagerstrøm Asle , Sigurdsson Valdimar , Arntzen Erik 
Published: March 2023

IntroductionUnhealthy food consumption is a problem for society, companies, and consumers. This study aims to contribute to knowledge regarding such issues by investigating how technology-enabled healthy food labels can impact food choice in an online grocery store context. We conceptualized unhealthy and healthy food choice as a matter of impulsivity problems. Three technology-enabled healthy food labels were derived based on variables that might impact self-control, and their influence on food choice was investigated.MethodsThe empirical study consisted of three parts. In the first part, participants’ impulsivity was measured using an adjusting delay task. Part two investigated the effects of self-monitoring, pre-commitment, and social comparison-based technology-enabled healthy food labels on food choice in a hypothetical online grocery shopping setting using a choice-based conjoint experiment. Lastly, in the third part, three where demographical questions were asked.ResultsThe results (n = 405) show that self-monitoring, pre-commitment, and social comparison-based technology-enabled healthy food labels had the most to least impact on food choice in that order. Furthermore, the results indicate that self-monitoring and pre-commitment labels had more impact on the choice for impulsive compared to non-impulsive participants. Similarly, the results indicate that social comparison had more impact on choice for non-impulsive participants. These findings suggest that self-monitoring of previous healthy food choices might be more effective than pre-commitment based on discounts for healthy food products. However, these differences were minor.DiscussionThis finding has managerial implications as grocery stores might increase their revenue by introducing self-monitoring labels in an online grocery shopping setting. Future research should investigate these technology-enabled healthy food labels in natural food purchase settings.
Artificial intelligence annotated clinical-pathologic risk model to predict outcomes of advanced gastric cancer
Authors: Chen Yan , Shou Lin , Xia Ying , Deng Yanju , Li Qianguo , Huang Zhishuang , Li Youlan , Li Yanmei , Cai Wenliang , Wang Yueshan , Cheng Yingying , Chen Hongzhuan , Wan Li 
Published: March 2023

BackgroundGastric cancer with synchronous distant metastases indicates a dismal prognosis. The success in survival improvement mainly relies on our ability to predict the potential benefit of a therapy. Our objective is to develop an artificial intelligence annotated clinical-pathologic risk model to predict its outcomes.MethodsIn participants (n=47553) with gastric cancer of the surveillance, epidemiology, and end results program, we selected patients with distant metastases at first diagnosis, complete clinical-pathologic data and follow-up information. Patients were randomly divided into the training and test cohort at 7:3 ratio. 93 patients with advanced gastric cancer from six other cancer centers were collected as the external validation cohort. Multivariable analysis was used to identify the prognosis-related clinical-pathologic features. Then a survival prediction model was established and validated. Importantly, we provided explanations to the prediction with artificial intelligence SHAP (Shapley additive explanations) method. We also provide novel insights into treatment options.ResultsData from a total 2549 patients were included in model development and internal test (median age, 61 years [range, 53-69 years]; 1725 [67.7%] male). Data from an additional 93 patients were collected as the external validation cohort (median age, 59 years [range, 48-66 years]; 51 [54.8%] male). The clinical-pathologic model achieved a consistently high accuracy for predicting prognosis in the training (C-index: 0.705 [range, 0.690-0.720]), test (C-index: 0.737 [range, 0.717-0.757]), and external validation (C-index: 0.694 [range, 0.562-0.826]) cohorts. Shapley values indicated that undergoing surgery, chemotherapy, young, absence of lung metastases and well differentiated were the top 5 contributors to the high likelihood of survival. A combination of surgery and chemotherapy had the greatest benefit. However, aggressive treatment did not equate to a survival benefit. SHAP dependence plots demonstrated insightful nonlinear interactive associations among predictors in survival benefit prediction. For example, patients who were elderly, or poor differentiated, or presence of lung or bone metastases had a worse prognosis if they undergo surgery or chemotherapy, while patients with metastases to liver alone seemed to gain benefit from surgery and chemotherapy.ConclusionIn this large multicenter cohort study, we developed an artificial intelligence annotated clinical-pathologic risk model to predict outcomes of advanced gastric cancer. It could be used to discuss treatment options.
The diagnosis and treatment of a special rare type of Monteggia equivalent fractures in children
Authors: Su Fei , Li Min , Ma Yishan , Yang Yating , Hao Xue , Jia Haoruo , Dang Youting , Lu Qingda , Liu Chenxin , Yang Shuai , Wang Huan , Wang Bing , Jie Qiang 
Published: March 2023

PurposeTo explore the characteristics, mechanism, treatment, and prognosis of head–neck separation type of Monteggia equivalent fractures in children.MethodsPatients with this injury were reviewed retrospectively. The lesion was characterized by a fracture of the ulnar with radial neck fracture but without dislocation of the radial head. Our classification was based on the direction of displacement and angulation of fractures on radiographs, divided into the extension-valgus type and flexion-varus type. The fractures were treated with reduction and internal fixation, depending on the fracture type. The clinical results were evaluated by using radiology and the Mayo Elbow Performance Score (MEPS).ResultsA total of 12 patients were followed up for an average of 40.5 months. The ulnar fractures were treated with closed reduction (CR) and K-wire fixation in one patient, elastic stable intramedullary nail (ESIN) fixation in four patients, open reduction (OR) and plate fixation in five, with no fixation in two. CR with ESIN fixation was successful in 11 patients with radial neck fractures, but one underwent OR and K-wire fixation. All fractures healed on time, with fewer complications (avascular necrosis in one patient, and bulk formation of metaphysis in another). The therapeutic efficacy was evaluated by using MEPS and was found to be excellent in 10 patients, good in one, and fair in another.ConclusionsThe head–neck separation type of Monteggia equivalent fractures in children is rare. Its characteristics are different from that of Monteggia fracture. The length and anatomic structure of the ulna should be restored and stabilized first, while the radial neck fracture should be treated with CR and ESIN fixation. Satisfactory clinical results can be achieved with fewer complications.
High baseline prevalence of atopic comorbidities and medication use in children treated with allergy immunotherapy in the REAl-world effeCtiveness in allergy immunoTherapy (REACT) study
Authors: Fritszching Benedikt , Porsbjerg Celeste , Buchs Sarah , Larsen Julie Rask , Freemantle Nick , Contoli Marco 
Published: March 2023

BackgroundRespiratory allergy, commonly manifesting as allergic rhinitis (AR) and asthma, is a chronic progressive disease that frequently starts in childhood. Allergy immunotherapy (AIT) is the only causal treatment for respiratory allergy with the potential to modify the underlying cause of allergy and, ultimately, prevent disease progression. This analysis aimed to determine if AIT is received sufficiently early to halt the progression of allergic disease, by characterizing the burden and progression of disease in children prior to AIT initiation in real-life clinical practice.MethodsThe REAl-world effeCtiveness in allergy immunoTherapy (REACT) study was a large retrospective cohort study using German claims data between 2007 and 2017. Characteristics of two pre-defined AIT age cohorts from the REACT study – children (aged &lt;18 years) and adults (aged ≥18 years) – were evaluated during the 1-year period before the first AIT prescription. For comparison, a control group of all subjects with a confirmed diagnosis of AR and without prescriptions for AIT was included. Burden of disease was assessed using diagnostic codes for atopic comorbidities [e.g., atopic dermatitis (AD), asthma, and acute allergic conjunctivitis] and non-atopic comorbidities (e.g., migraine, headache); medication use, recorded as prescriptions for symptom-relieving AR medication and reliever/controller medication for asthma, was also assessed. Data were analyzed descriptively, using summary statistics.ResultsBoth children (n = 11,036) and adults (n = 30,037) showed a higher prevalence of atopic comorbidities and a greater drug burden prior to AIT initiation compared to AR patients not treated with AIT (n = 1,003,332). In the two age-specific AIT cohorts, children consistently showed the highest prevalence of atopic comorbidities compared to adults (AIT children, AIT adults – asthma: 41.4%, 34.5%; AD: 19.9%, 10.2%; acute allergic conjunctivitis: 13.6%, 10.2%). Generally, prescriptions per year for symptom-relieving AR and asthma treatments were also higher for children initiating AIT vs. adults (AIT children, AIT adults – AR prescriptions per subject: 1.72, 0.73; asthma prescriptions per subject: 1.42, 0.79).ConclusionsChildren with AR who are offered AIT in real-life show considerable disease burden prior to initiation. As AIT may alleviate the burden and halt the progression of allergic disease, considering AIT earlier in the disease course may be warranted.
Development and psychometric properties of the Stressors in Breast Cancer Scale
Authors: Cerezo M. Victoria , Soria-Reyes Lorena M. , Pajares Bella , Gómez-Millán Jaime , Blanca María J. 
Published: March 2023

BackgroundA diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient’s daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer.AimsThe aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS).MethodA panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed.ResultsValidity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald’s omega and Cronbach’s alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life.DiscussionThe results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.
Effects of Ramadan fasting on the diurnal variations of physical and cognitive performances at rest and after exercise in professional football players
Authors: Khemila Syrine , Romdhani Mohamed , Farjallah Mohamed Amine , Abid Rihab , Bentouati Emna , Souissi Mohamed Abdelkader , Abedelmalek Salma , Garbarino Sergio , Souissi Nizar 
Published: March 2023

IntroductionRamadan fasting (RF) is characterized by daily abstinence from food and fluid intake from dawn to sunset. The understanding of the Ramadan effects on the diurnal variations of athletic and cognitive performance is crucial for practitioners, coach and researchers to prepare sport events and optimize performance. The aim of the present study was to reveal the effects of RF on the diurnal variation of physical and cognitive performances at rest and after exercise.MethodIn a randomized order, 11 male football players (age: 19.27 ± 0.9; height: 1.79 ± 0.04 cm; body mass: 70.49 ± 3.97 kg; BMI: 21.81 ± 1.59 kg/m2) completed a 30-s Wingate test [i.e., mean (MP) and peak powers (PP)] at 07:00, 17:00, and 21:00 h on five occasions: 1 week before Ramadan (BR); the second (R2); the third (R3); the fourth (R4) week of Ramadan; and 2 weeks after Ramadan (AR), with an in-between recovery period of ≥72 h. Simple (SRT) and choice (CRT) reaction times, mental rotation test (MRT) and selective attention (SA) test were measured before and after Wingate test. Rating of perceived exertion (RPE), body composition, dietary intake, profile of mood states (POMS) and Pittsburgh Sleep Quality Index (PSQI) were assessed over the five periods.ResultsCompared to BR, RF decreased MP at 17:00 h (p &lt; 0.05, d = 1.18; p &lt; 0.001, d = 2.21, respectively) and PP at 17:00 h (p &lt; 0.05, d = 1.14; p &lt; 0.001, d = 1.77, respectively) and 21:00 h (p &lt; 0.01, d = 1.30; p &lt; 0.001, d = 2.05, respectively) at R3 and R4. SRT (p &lt; 0.001,d = 1.15; d = 1.32, respectively), number of correct answers (MRTE; p &lt; 0.05, d = 1.27; d = 1.38, respectively) and SA (p &lt; 0.01, d = 1.32; d = 1.64, respectively) increased during R2 and R3 in the evening before exercise compared to BR. Short term maximal exercise enhanced SRT (p &lt; 0.01, d = 1.15; p &lt; 0.001, d = 1.35, respectively), MRTE (p &lt; 0.001, d = 2.01; d = 2.75 respectively) and SA (p &lt; 0.05, d = 0.68; d = 1.18, respectively) during R2 and R3 in the evening. In comparison to BR, sleep latency and sleep duration increased during R3 (p &lt; 0.001, d = 1.29; d = 1.74, respectively) and R4 (p &lt; 0.001, d = 1.78; d = 2.19, respectively) and sleep quality increased in R2, R3 and R4 (p &lt; 0.01, d = 1.60; p &lt; 0.001, d = 1.93; d = 2.03, respectively).ConclusionDuring RF, anaerobic and cognitive performances were unaffected in the morning but were impaired in the afternoon and evening. Short-term maximal exercise mitigates the negative effects of fasting on cognitive performance. Maximal exercise could thus partially counteract the effect of fasting on cognitive function.
Faith-based health screenings for Marshallese adults living in the Republic of the Marshall Islands: Study design and results
Authors: Andersen Jennifer A. , Rowland Brett , O'Connor Gail , Bing Williamina Ioanna , Riklon Sheldon , Mendoza-Kabua Philmar , McElfish Pearl A. 
Published: March 2023

IntroductionStriking health disparities exist in the Republic of the Marshall Islands (RMI). The RMI has one of the highest age-adjusted type 2 diabetes mellitus (T2DM) rates in the world (23.0%) compared to global (9.3%) and United States (US; 13.3%) rates. We conducted health screenings including clinical indicators of T2DM and hypertension among Marshallese in the RMI.MethodsScreenings were conducted at 20 churches on Majuro Atoll. Participants completed questionnaires and biometric data collection assessing glycated hemoglobin (HbA1c), blood pressure, and body mass index.ResultsScreenings included 528 participants and showed a high prevalence of T2DM, obesity, and hypertension. One-third of participants were referred to the non-communicable disease clinic. The percent of adults in this study with T2DM-indicative HbA1c (48.5%) is higher than observed at the national level (23.0%).DiscussionResults highlight the need for non-communicable disease-related programs in the RMI.
Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia
Authors: Alsulami Salhah , Baig Mukhtiar , Ahmad Tauseef , Althagafi Nouf , Hazzazi Eman , Alsayed Razan , Alghamdi Majd , Almohammadi Thikra 
Published: March 2023

IntroductionThe current study evaluated obesity prevalence, physical activity, and dietary practices among Saudi adults in the Makkah region of the Kingdom of Saudi Arabia (KSA). The current survey was accomplished between November 2021 and March 2022.MethodA validated questionnaire, Arab Teens Lifestyle Study (ATLS), was used to evaluate all participants' physical activities, sedentary behaviors, and nutritional habits in addition to demographic data.ResultA total of 2,115 people [1,238 (58.5%) women and 877 (41.5%) men] participated in this survey. Being overweight was prevalent in 32.8% of the population (41% of men and 28.9% of women), obesity was prevalent in 23% of the population (males 23.1% and females 24.2%). Obese people consumed more soft drinks, and overweight people did not consume enough vegetables (fresh/cooked). Obese people consumed fast food (e.g., burgers, sausage, pizza, or Arabic shawarma) over three times each week. The mean (SD) number of days of practice walking was 2.51 (2.05) vs. 1.3 (1.87) (p &lt; 0.001) for lean and obese individuals, respectively. In addition, individuals with normal BMI had more days of jogging, moderate and high-intensity exercise, dancing, and strength training than those with obesity. The odds of being obese increased with age (OR: 1.07; p &lt; 0.001), in males (OR: 2.16; p &lt; 0.001), in participants earning &lt;5,000 SR/month (1.3 thousand $) and 10–15 thousand SR/month (1.34–2.66 thousand $) (OR: 2.36; P = 0.01). Obesity was inversely associated with moderate-intensity exercise (OR: 0.802; p = 0.009), and regular walking (OR: 0.685; CI: 0.624–0.752; p &lt; 0.001).DiscussionOverweight and obesity were prevalent in 32.8% and 23% of the population, respectively. Sociodemographic factors associated with obesity. Focused intervention strategies are needed to overcome the obesity issue.