bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gut microbiota alterations in children and their relationship with primary immune thrombocytopenia
Authors: Li Xiangyu , Zhang Minna , He Le , Zhou Jingfang , Shen Peng , Dai Weijie , Yang Xiaozhong , Yuan Yufang , Zhu Haiyan , Wang Honggang 
Published: June 2023

IntroductionGut microbiota reportedly play a critical role in some autoimmune diseases by maintaining immune homeostasis. Only a few studies have examined the correlation between gut microbiota and the onset of primary immune thrombocytopenia (ITP), especially in children. The purpose of this study was to investigate changes in the composition and diversity of the fecal microbiota of children with ITP, as well as the correlation between such microbiota and the onset of ITP.MethodsTwenty-five children newly diagnosed with ITP and 16 healthy volunteers (controls) were selected for the study. Fresh stool samples were collected to identify changes in the composition and diversity of gut microbiota as well as for potential correlation analysis.ResultsIn ITP patients, the phyla that were most frequently encountered were Firmicutes (54.3%), followed by Actinobacteria (19.79%), Bacteriodetes (16.06%), and Proteobacteria (8.75%). The phyla that were predominantly found in the controls were, Firmicutes (45.84%), Actinobacteria (40.15%), Bacteriodetes (3.42%), and Proteobacteria (10.23%). Compared with those of the controls, the proportions of Firmicutes and Bacteriodetes in the gut microbiota of ITP patients were increased while the proportions of Actinobacteria and Proteobacteria were decreased. Furthermore, gut microbiota in ITP patients varied by age group, showed specific changes in diversity, and were correlated with antiplatelet antibodies. IgG levels were significantly positively correlated with Bacteroides (P&lt;0.01).ConclusionsThe gut microbiota of children with ITP are imbalanced, as shown by the increase in Bacteroidetes, which was positively correlated with IgG. Thus gut microbiota may contribute to ITP pathogenesis via IgG.Clinical Trial RegistrationThe clinical trial were registered and approved by the Institutional Review Committee of The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University. Ethics number KY-2023-106-01.
Grafts vs. flaps: a comparative study of Bracka repair and staged transverse preputial island flap urethroplasty for proximal hypospadias with severe ventral curvature
Authors: Zhang Youtian , Wang Xin , Wu Yong , Li Shengbin , Zhang Dongzheng , Ma Xiong , Wang Cong , Zhang Zhenhua , Ma Yukun , Wei Baolong , Guan Yong 
Published: June 2023

IntroductionBracka repair and staged transverse preputial island flap urethroplasty are both significant methods in treating proximal hypospadias. They utilize the flap and graft techniques, respectively, to achieve a satisfactory success rate. This study aimed to compare the outcomes of these 2 methods in the treatment of proximal hypospadias with severe ventral curvature.MethodsWe retrospectively analyzed 117 cases of proximal hypospadias with severe ventral curvature who had undergone either Bracka repair (n = 62) or staged transverse preputial island flap urethroplasty (n = 55). All operations were performed by a single surgeon, and the choice of method was determined by the surgeon's preference based on his experience. Cosmetic outcome was evaluated with Pediatric Penile Perception Score (PPPS). Patients' characteristics including age, penis length, glans diameter, length of the urethral defect and ventral curvature degree, cosmetic outcomes, and complication rates were all compared.ResultsThere was no significant difference in age, penis length, glans diameter, length of the urethral defect, or ventral curvature degree. In the Bracka group, there were 5 patients with fistula, 1 patient with stricture, and 1 case of dehiscence. In the staged transverse preputial island flap urethroplasty group, there were 4 patients with fistula, 1 with stricture, and 2 with diverticulum. The scores of shaft skin and general appearance were consistently higher in the Bracka group than in the staged transverse preputial island flap urethroplasty group. The differences in complication rate and cosmetic outcome were not statistically different (P &gt; 0.05).ConclusionsBracka repair and staged transverse preputial island flap urethroplasty are both satisfactory staged surgical options for proximal hypospadias with severe ventral curvature and have similar complication rates. Bracka repair may create a better appearance, but more studies are needed to confirm this finding. Pediatric surgeons should consider additional factors, such as the patient's specific condition, parents' inclination, and personal experience, rather than safety, to make the best choice between the 2 methods.
Effect of the personality traits of healthy Japanese workers on depressive symptoms and social adaptation, and on the achievement rate of exercise therapy to prevent major depression
Authors: Ikenouchi Atsuko , Okamoto Naomichi , Matsumoto Tomomi , Yoshimura Reiji 
Published: June 2023

BackgroundThis study determined the effects of personality traits on depressive symptoms and social adaptation in healthy workers, and the effects of depressive symptoms or social adaptation before and after exercise therapy, and personality traits before exercise therapy on the achievement rates of exercise therapy aimed at preventing major depression.MethodsTwo hundred fifty healthy Japanese workers were given an eight-week walking program as exercise therapy. After excluding 35 participants who had dropped or provided incomplete information, 215 were included in the analysis. The Japanese version of the NEO five-factor inventory was used to assess participants’ personality traits before the exercise therapy. Depressive symptoms were evaluated using the Japanese version of the Zung self-rating depression scale (SDS-J) and social adaptation was evaluated using the Japanese version of the social adaptation self-evaluation scale (SASS-J) before and after the exercise therapy.ResultsThe SDS-J scores correlated with neuroticism and negatively correlated with extraversion, agreeableness, and conscientiousness before the exercise therapy. The SDS-J was also negatively correlated with openness in women, but not in men, while the SASS-J was associated with extraversion, openness, agreeableness, and conscientiousness, and negatively correlated with neuroticism. There was no significant change in levels of depression before and after exercise therapy; however, social adaptation increased significantly in men. No association was found between SDS-J and SASS-J scores before the exercise therapy and the achievement rate. The achievement rates of exercise therapy were negatively correlated with SDS-J or SASS-J after exercise therapy in women. The SDS-J after exercise therapy was correlated with neuroticism in men and negatively correlated with extraversion in women. The SASS-J after exercise therapy was negatively correlated with neuroticism and correlated with extraversion and openness in men. In contrast, the SASS-J after exercise therapy correlated with openness and agreeableness in women. Conscientiousness was correlated with the achievement rate of exercise therapy in men, but not with the various personality traits in women.ConclusionDepressive symptoms and social adaptation were differently associated with personality traits and achievement rates before and after exercise therapy. Conscientiousness before exercise therapy predicted a higher achievement rate for exercise therapy in men.
Economic evaluations of interventions focusing on child abuse and neglect in high-income countries: a systematic review
Authors: Kugener Tom , Wiethoff Isabell , van Mastrigt Ghislaine , van den Berg Bram , Evers Silvia M. A. A. 
Published: June 2023

IntroductionChild abuse and neglect are together considered to be an important public health problem with a high individual and societal burden. Different interventions have been developed to prevent, diagnose, or treat maltreatment. While their effectiveness has been synthesized in prior reviews, the analysis of their cost-effectiveness is less common. The aim of this study is to synthesize and analyse economic evaluations of interventions focusing on child abuse and neglect in high-income countries.MethodsA systematic literature review was performed using MEDLINE, EMBASE, EconLit, PsycInfo and NHS EED. This study follows the PRISMA guidelines and double scoring was performed. The review includes trial- and model-based economic evaluations of preventive, diagnostic, and treatment related interventions in children up to 18 years or their caregivers. Risk of bias was assessed using the CHEC-extended checklist. The results are presented in a cost-effectiveness plane.ResultsOf 5,865 search results, the full texts of 81 were analyzed, resulting in the inclusion of 11 economic evaluations. Eight of the included studies focus on prevention of child abuse and neglect, one study on diagnosis, and two on treatment. The heterogeneity between studies did not allow for the quantitative pooling of results. Most interventions were cost-effective, with the exception of one preventive and one diagnostic intervention.ConclusionThis study was subject to some limitations, as no gray literature was included, and the selection of studies may have been arbitrary due to varying terminologies and methodologies in the field. However, the quality of studies was high, and several interventions showed promising results.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021248485, identifier: CRD42021248485.
Fast and accurate assessment of depression based on voice acoustic features: a cross-sectional and longitudinal study
Authors: Wang Yang , Liang Lijuan , Zhang Zhongguo , Xu Xiao , Liu Rongxun , Fang Hanzheng , Zhang Ran , Wei Yange , Liu Zhongchun , Zhu Rongxin , Zhang Xizhe , Wang Fei 
Published: June 2023

BackgroundDepression is a widespread mental disorder that affects a significant portion of the population. However, the assessment of depression is often subjective, relying on standard questions or interviews. Acoustic features have been suggested as a reliable and objective alternative for depression assessment. Therefore, in this study, we aim to identify and explore voice acoustic features that can effectively and rapidly predict the severity of depression, as well as investigate the potential correlation between specific treatment options and voice acoustic features.MethodsWe utilized voice acoustic features correlated with depression scores to train a prediction model based on artificial neural network. Leave-one-out cross-validation was performed to evaluate the performance of the model. We also conducted a longitudinal study to analyze the correlation between the improvement of depression and changes in voice acoustic features after an Internet-based cognitive-behavioral therapy (ICBT) program consisting of 12 sessions.ResultsOur study showed that the neural network model trained based on the 30 voice acoustic features significantly correlated with HAMD scores can accurately predict the severity of depression with an absolute mean error of 3.137 and a correlation coefficient of 0.684. Furthermore, four out of the 30 features significantly decreased after ICBT, indicating their potential correlation with specific treatment options and significant improvement in depression (p &lt; 0.05).ConclusionVoice acoustic features can effectively and rapidly predict the severity of depression, providing a low-cost and efficient method for screening patients with depression on a large scale. Our study also identified potential acoustic features that may be significantly related to specific treatment options for depression.
The role of only-child status in the effect of childhood trauma and parental rearing style on depressive symptoms in Shanghai adolescents
Authors: Zhong Yingyan , Huang Xinxin , Chen Jianhua , Li Yuting , Li Yan , Chen Rumeng , Cong Enzhao , Xu Yifeng 
Published: June 2023

IntroductionAfter decades of the one-child policy, China changed its rules to allow two children in 2016, which altered family dynamics. Few studies have examined the emotional problems and the family environment of multi-child adolescents. This study aims to explore the role of only-child status in the impact of childhood trauma and parental rearing style on depressive symptoms of adolescents in Shanghai, China.MethodsA cross-sectional study was conducted on 4,576 adolescents (M = 13.42 years, SD = 1.21) from seven middle schools in Shanghai, China. Childhood Trauma Questionnaire-Short Form, the Short Egna Minnen Beträffande Uppfostran, and Children’s Depression Inventory were used to evaluate childhood trauma, perceived parental rearing style, and depressive symptoms of adolescents, respectively.ResultsResults showed that girls and non-only children reported more depressive symptoms, while boys and non-only children perceived more childhood trauma and negative rearing styles. Emotional abuse, emotional neglect, and father’s emotional warmth significantly predicted depressive symptoms in both only children and non-only children. Father’s rejection and mother’s overprotection were related to adolescents’ depressive symptoms in only-child families, but not non-only child families.DiscussionTherefore, depressive symptoms, childhood trauma, and perceived negative rearing styles were more prevalent among adolescents in non-only child families, while negative rearing styles were especially associated with depressive symptoms in only children. These findings suggest that parents pay attention to their impacts on only children and give more emotional care to non-only children.
Relating movement markers of schizophrenia to self-experience—a mixed-methods study
Authors: Martin Lily A. L. , Melchert David , Knack Monika , Fuchs Thomas 
Published: June 2023

IntroductionBasic self-disorders on the one hand and motor symptoms on the other hand are discussed as endophenotypes of schizophrenia psychopathology. However, the systematic interaction between motor symptoms and the self-experience of patients is rarely studied.MethodsIn a previous study we defined motor markers of schizophrenia via a data-driven analysis of patients' gait patterns. In this study, we related the movement markers to measures of basic self-disorder obtained with EASE interviews. We substantiated the correlations with a qualitative content analysis of the interviews of a subset of four patients. We related qualitative and quantitative data on an intra- and interpersonal level.ResultsOur results suggest an association between the previously defined, theory-independent movement markers and basic self-disorders, specifically in the domain of cognition, self-experience and bodily experiences. While movement marker manifestation was not precisely reflected in the individuals' descriptions of anomalous self- and body experience, we found clear trends of more and more intense descriptions with increasing movement marker scores, when looking at specific experiences, such as hyper reflexivity.DiscussionThese results foster an integrated view of the patient and could stimulate therapeutic approaches aiming at an improvement of self- and body-experience of patients with schizophrenia.
Myopia in elementary school students in Eastern China during the COVID-19 pandemic
Authors: Huang Shuaishuai , Shen Fanhan , Zhou Fujun , Gong Qinghai , Liu Kui , Feng Wei , Cen Dong 
Published: June 2023

BackgroundMyopia is an increasingly serious public concern, particularly among primary school students. The prevalence of myopia and its influencing factors in primary school pupils in Eastern China during the COVID-19 pandemic had not been explored.MethodsA randomly clustered sampling method was performed, and selected pupils from grade 1 to grade 3 in 15 primary schools in the Fenghua District of Zhejiang Province were included and given myopia screening and uniform questionnaire survey 1 year later.ResultsA total of 4,213 students completed the myopia screening and questionnaire survey. Myopia was diagnosed in 1,356 pupils, with a myopia incidence of 32.19%. The spherical equivalent (SE) refraction of the included pupils decreased on average by 0.50 ± 2.15 D 1 year later. The myopia rate was positively correlated with the increase of grade, in which the myopia rate among grade 3 students was the highest at 39.69%. The myopia rate among female students was higher than that among male students. Students residing in urban areas had a higher myopia rate than in rural areas. Maintaining an near work distance ≥33 cm was a significant protective factor (OR = 0.84, 95% CI: 0.74–0.96). Students with two myopic parents had a higher risk of myopia (OR = 1.61, 95% CI: 1.34–1.92).ConclusionDuring the COVID-19 pandemic, the myopia rate among early primary school students in Eastern China was high. More attention and implementation of interventions from health and education departments, such as training the development of good eye behavior, should be considered to strengthen the intervention of myopia in primary school students.
The effects of height-for-age and HIV on cognitive development of school-aged children in Nairobi, Kenya: a structural equation modelling analysis
Authors: Maina Rachel , He Jia , Abubakar Amina , Perez-Garcia Miguel , Kumar Manasi , Wicherts Jelte M. 
Published: June 2023

BackgroundEmpirical evidence indicates that both HIV infection and stunting impede cognitive functions of school-going children. However, there is less evidence on how these two risk factors amplify each other’s negative effects. This study aimed to examine the direct effects of stunting on cognitive outcomes and the extent to which stunting (partially) mediates the effects of HIV, age, and gender on cognitive outcomes.MethodologyWe applied structural equation modelling to cross-sectional data from 328 children living with HIV and 260 children living without HIV aged 6–14 years from Nairobi, Kenya to test the mediating effect of stunting and predictive effects of HIV, age, and gender on cognitive latent variables flexibility, fluency, reasoning, and verbal memory.ResultsThe model predicting the cognitive outcomes fitted well (RMSEA = 0.041, CFI = 0.966, χ2 = 154.29, DF = 77, p &lt; 0.001). Height-for-age (a continuous indicator of stunting) predicted fluency (β = 0.14) and reasoning (β = 0.16). HIV predicted height-for-age (β = −0.24) and showed direct effects on reasoning (β = −0.66), fluency (β = −0.34), flexibility (β = 0.26), and verbal memory (β = −0.22), highlighting that the effect of HIV on cognitive variables was partly mediated by height-for-age.ConclusionIn this study, we found evidence that stunting partly explains the effects of HIV on cognitive outcomes. The model suggests there is urgency to develop targeted preventative and rehabilitative nutritional interventions for school children with HIV as part of a comprehensive set of interventions to improve cognitive functioning in this high-risk group of children. Being infected or having been born to a mother who is HIV positive poses a risk to normal child development.
Impact of digital health literacy on health-related quality of life in Chinese community-dwelling older adults: the mediating effect of health-promoting lifestyle
Authors: Liu Siqi , Lu Ya , Wang Dan , He Xiaochong , Ren Wei , Kong Dehui , Luo Yu 
Published: June 2023

BackgroundIn the context of aging and digitalization, the development and application of digital health can help meet the growing health needs of older adults. Improving digital health literacy of older adults may be an effective way to alleviate the shortage of public health resources and improve their health-related quality of life (HRQoL). However, the impact of digital health literacy on HRQoL in older adults and the underlying mechanism remain unclear. This study intends to explore whether digital health literacy has an effect on HRQoL in community-dwelling older adults, and whether health-promoting lifestyle plays a mediating role between digital health literacy and HRQoL, while providing a theoretical basis for the scientific construction of HRQoL intervention programs for older adults.MethodsThe cross-sectional study was conducted in Chongqing, China from September 2020 to April 2021. 572 community-dwelling older adults were surveyed by stratified sampling. Data on sociodemographic characteristics, digital health literacy, health-promoting lifestyle and HRQoL were collected. Univariate analysis was used to compare the differences in HRQoL among community-dwelling older adults with different sociodemographic characteristics. Pearson correlation analysis was used to explore the correlation between digital health literacy, health-promoting lifestyle and HRQoL. SPSS PROCESS macro was used to examine the mediating effect of health-promoting lifestyle between digital health literacy and HRQoL.ResultsThe mean score of HRQoL was 97.97 (SD 11.45). Univariate analysis showed that there were statistically significant differences in HRQoL among community-dwelling older adults with different gender, age, educational level, marital status, and monthly household income per capita (p &lt; 0.05). There were positive correlations between digital health literacy, health-promoting lifestyle and HRQoL, with correlation coefficients ranging from 0.416 to 0.706 (p &lt; 0.001). Digital health literacy was positively associated with HRQoL (β = 0.210, p &lt; 0.001), and health-promoting lifestyle mediated the relationship between digital health literacy and HRQoL, with an indirect effect of 0.175 (95% Bootstrap CI 0.135–0.214).ConclusionDigital health literacy can affect HRQoL through the mediating effect of health-promoting lifestyle. It is suggested that relevant management institutions, communities and families should strengthen the cultivation of the digital health literacy of older adults, promote their development of health-promoting lifestyle, and ultimately improve HRQoL.
Exploring the Significance of Legal Status on Refugees’ and Asylum Seekers’ Access to Health Care in Germany—A Mixed-Method Study
Authors: Nowak Anna Christina , Razum Oliver , Hornberg Claudia 
Published: June 2023

Objectives: The study aims to investigate the significance of legal status for well-being and access to and use of needs-based health care by asylum seekers and refugees in Germany.Methods: Using a mixed-method-design, we first conducted a cross-sectional study to explore access to health care and unmet needs of refugees and asylum seekers and legal status. Data were analysed using descriptive statistics. For the qualitative study a heterogeneous sample was recruited from the quantitative data. Interviews were analysed using a deductive-inductive approach.Results: Quantitative results showed that health care utilisation was associated with an unsecure legal status but not with unmet care needs. The in-depth qualitative study revealed that the legal status determines experiences of structural violence that can negatively affect well-being and associated access to health care.Conclusion: An insecure legal status can affect access to health care for refugees and asylum seekers. In order to improve health, changes in living conditions and the removal of access barriers are necessary.