bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of interesting respiratory rehabilitation training for the treatment of refractory Mycoplasma pneumoniae pneumonia in children
Authors: Li Wenqing , Liu Ting , Yao Min , Yu Ru , Shu Meiyan , Zhang Maorong , Huang Jing 
Published: August 2023

Abstract
Backgrounds
Refractory Mycoplasma pneumoniae pneumonia (RMPP) cause damage of pulmonary function and physical therapy assisting medical treatment is needed.

Objective
The aim of this study was to investigate the effect of interesting respiratory rehabilitation training on pulmonary function in children with RMPP.

Methods
A total of 76 children with diagnoses of RMPP in our hospital from January 2020 to February 2021 were enrolled in this prospective study. According to the random number table method, they were divided into the control group and the study group, with 38 cases in each group. The control group were given conventional treatment, and the study group received interesting respiratory rehabilitation training in the basis of conventional treatment. The antipyretic time, disappearance time of pulmonary shadow and cough, length of hospital stay, pulmonary function (first second of expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC) at 1 day before and after intervention, serum interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor (TNF-α), and quality of life (Pediatric Quality of Life Inventory, PedsQL 4.0 scale) were observed in the two groups.

Results
The antipyretic time, disappearance time of pulmonary shadow and cough, length of hospital stay in the study group were shorter than those in the control group (P < 0.05). One day before intervention, there was no significant difference in FVC, FEV1, FEV1/FVC IL-6, CRP, and TNF-α between the two groups (P > 0.05). One day after intervention, FVC, FEV1 and FEV1/FVC in the study group were better than those in the control group (P < 0.05), and the levels of IL-6, CRP, and TNF-α in the study group were lower than those in the control group with significant difference (P < 0.05). One day before intervention, there were no significant differences in physiological function, emotional function, social function, and school function between the two groups (P > 0.05). After intervention, physiological function, emotional function, social function, and school function of the study group were better than those of the control group (P < 0.05).

Conclusion
The interesting respiratory rehabilitation training can effectively improve the pulmonary function of children with RMPP, with strong flexibility, which is worthy of clinical application.
Low mindfulness is related to poor sleep quality from middle adolescents to emerging adults: a process model involving resilience and emotional dysfunction
Authors: Zhou Huaiyuan , Zhu Ziqing , Feng Xiangang , Zhang Ruibin 
Published: August 2023

Abstract
Objectives
Transitions from middle adolescence into merging adulthood, a life stage between age 15–25, has a high prevalence of sleep problems. Mindfulness is a trait defined as being attentive to the present moment which positively relates to sleep quality. In this study, we aimed to investigate how resilience and emotional dysfunction may influence the relationship between trait mindfulness and sleep quality.

Methods
The Five Facet Mindfulness Questionnaire, Connor-Davidson Resilience Scale, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Scales were used to measure the key variables through an online survey of 497 participants between middle adolescence and emerging adults (317 females, mean age 18.27 ± 0.76 years). A process model was built to investigate the mediating roles of resilience and emotional dysfunction in the impact of trait mindfulness on sleep quality, together with the relationships between their specific components.

Results
We found a positive association between mindfulness and sleep quality through resilience and through emotional dysfunction, and through the sequential pathway from resilience to emotional dysfunction. Of note, acting with awareness (mindfulness facet) showed significant indirect effects on sleep quality, mediated by resilience and emotional dysfunction.

Conclusions
Our findings may unveil the underlying mechanisms of how low mindfulness induces poor sleep quality. The findings indicate that conceiving mindfulness as a multifaceted construct facilitates comprehension of its components, relationships with other variables, and underscores its potential clinical significance given its critical implications for mental health.
Posttraumatic stress disorder in a war-affected area of Northeast Ethiopia: a cross-sectional study
Authors: Birhan Zelalem , Deressa Yonas , Shegaw Maregu , Asnakew Sintayehu , Mekonen Tesfa 
Published: August 2023

Abstract
Background
Post-Traumatic Stress Disorder (PTSD) is a chronic condition that affects a significant proportion of war survivors following war and conflict. If PTSD is not managed, it can lead to decreased quality of life and impairments in daily functioning and lead to death. This study aimed to assess the prevalence of post-traumatic stress disorder and its associated factors among residents in a war-affected area, Dessie Town, Northeast Ethiopia.

Methods
A community-based cross-sectional study was conducted among adult residents in the war-affected area, Dessie Town. A total of 615 individuals were selected by a systematic random sampling method. PTSD was assessed using the Post-Traumatic Stress Disorder Checklist, Civilian Version. Multivariable logistic regressions were used to measure the associated factors. Associations between variables were described using odds ratios, 95% confidence intervals, and a p-value less than 0.05.

Results
The prevalence of PTSD was 34.5% (95% CI: 31–38). Female sex (AOR: 1.82; CI: 1.18–2.82), divorced or widowed (AOR: 2.12, CI: 1.23–3.66), having only primary schooling (AOR: 2.17; CI: 1.25–3.78), depression (AOR: 2.03; CI: 1.34–3.08), experienced ill health without medical care during the wartime (AOR: 2.97; CI: 1.43–6.16), forced separation from family (AOR: 1.90; CI: 1.16–3.12), and experienced stressful life events (AOR: 1.60; CI: 1.06–2.42) were significantly associated with PTSD.

Conclusion
A significant rate of PTSD was found among residents of the war-affected area, Dessie Town. One in three people was experiencing PTSD. As a result, post-war mental health early screening and intervention is a priority, particularly for females, those who are separated or divorced, and those who have experienced stressful life events due to the war.
Dementia prediction in the general population using clinically accessible variables: a proof-of-concept study using machine learning. The AGES-Reykjavik study
Authors: Twait Emma L. , Andaur Navarro Constanza L. , Gudnason Vilmunur , Hu Yi-Han , Launer Lenore J. , Geerlings Mirjam I. 
Published: August 2023

Abstract
Background
Early identification of dementia is crucial for prompt intervention for high-risk individuals in the general population. External validation studies on prognostic models for dementia have highlighted the need for updated models. The use of machine learning in dementia prediction is in its infancy and may improve predictive performance. The current study aimed to explore the difference in performance of machine learning algorithms compared to traditional statistical techniques, such as logistic and Cox regression, for prediction of all-cause dementia. Our secondary aim was to assess the feasibility of only using clinically accessible predictors rather than MRI predictors.

Methods
Data are from 4,793 participants in the population-based AGES-Reykjavik Study without dementia or mild cognitive impairment at baseline (mean age: 76 years, % female: 59%). Cognitive, biometric, and MRI assessments (total: 59 variables) were collected at baseline, with follow-up of incident dementia diagnoses for a maximum of 12 years. Machine learning algorithms included elastic net regression, random forest, support vector machine, and elastic net Cox regression. Traditional statistical methods for comparison were logistic and Cox regression. Model 1 was fit using all variables and model 2 was after feature selection using the Boruta package. A third model explored performance when leaving out neuroimaging markers (clinically accessible model). Ten-fold cross-validation, repeated ten times, was implemented during training. Upsampling was used to account for imbalanced data. Tuning parameters were optimized for recalibration automatically using the caret package in R.

Results
19% of participants developed all-cause dementia. Machine learning algorithms were comparable in performance to logistic regression in all three models. However, a slight added performance was observed in the elastic net Cox regression in the third model (c = 0.78, 95% CI: 0.78–0.78) compared to the traditional Cox regression (c = 0.75, 95% CI: 0.74–0.77).

Conclusions
Supervised machine learning only showed added benefit when using survival techniques. Removing MRI markers did not significantly worsen our model’s performance. Further, we presented the use of a nomogram using machine learning methods, showing transportability for the use of machine learning models in clinical practice. External validation is needed to assess the use of this model in other populations. Identifying high-risk individuals will amplify prevention efforts and selection for clinical trials.
Assessment of satisfaction with antiretroviral drugs and the need for long-acting injectable medicines among people living with HIV in Japan and its associated factors: a prospective multicenter cross-sectional observational study
Authors: Ishihara Masashi , Hikasa Shinichi , Tsukiji Mariko , Kunimoto Yusuke , Nobori Kazuko , Kimura Takeshi , Onishi Kenta , Yamamoto Yuki , Haruta Kyohei , Kashiwabara Yohei , Fujii Kenji , Shimabukuro Shota , Watanabe Daichi , Tsurumi Hisashi , Suzuki Akio 
Published: August 2023

Abstract
Background
Long-acting injectable formulations for HIV infection have been approved and are now available in Japan. Although not currently recommended as first-line drugs in Japanese or overseas guidelines, use of such formulations may increase, in accordance with patient conditions and preference. We determine the level of satisfaction with current anti-HIV drugs and analyzed the preferences of patients who favor long-acting injectable drugs based on their satisfaction level with the present anti-HIV drugs.

Methods
People living with HIV (PLWH) who had received antiretroviral therapy (ART) for at least one month and consented to the study between 1 April and 31 December 2021 were included in a survey conducted using a self-administered questionnaire. The content of the survey included satisfaction with seven items (tablet size, ease and feeling when taking the medicine, color, taste, portability, daily oral therapy, and co-payment) related to the anti-HIV drugs they were taking and their need for future drugs (dosage form, frequency of dosing, long-acting injectable, etc.). In addition, factors related to the need for long-acting injectable medications were analyzed with regard to the relationship with satisfaction with anti-HIV drugs.

Results
Overall, 667 patients available for analysis were included in this study. Satisfaction with anti-HIV drugs was highest with regard to “co-payment” and lowest with “daily oral therapy”. Regarding the need for long-acting injectable medications, logistic regression analysis indicated that tablet size and daily oral therapy were significant predictors of patient preference for a once-every-eight-weeks intramuscular formulation in terms of their requirement for long-acting injectable medications (tablet size, OR = 2.14, 95%CI 1.030–4.430, p = 0.042; and daily oral therapy, OR = 1.75, 95%CI 1.010–3.030, p = 0.044).

Conclusions
Patients currently receiving anti-HIV drugs who express dissatisfaction with tablet size and daily oral therapy may prefer a long-acting injectable formulation, taking into consideration patient age, employment status, ART history, frequency of daily dosage and concomitant medications other than ART.
Development and efficacy assessment of hand sanitizers and polylactic acid films incorporating caffeic acid and vanillin for enhanced antiviral properties against HCoV-229E
Authors: Hyun Seok-Woo , Han Sangha , Son Jeong Won , Song Min Su , Kim Dan Ah , Ha Sang-Do 
Published: August 2023

Abstract
Background
Although three years after the outbreak of SARS-CoV-2, the virus is still having a significant impact on human health and the global economy. Infection through respiratory droplets is the main transmission route, but the transmission of the virus by surface contact cannot be ignored. Hand sanitizers and antiviral films can be applied to control SARS-CoV-2, but sanitizers and films show drawbacks such as resistance of the virus against ethanol and environmental problems including the overuse of plastics. Therefore, this study suggested applying natural substrates to hand sanitizers and antiviral films made of biodegradable plastic (PLA). This approach is expected to provide advantages for the easy control of SARS-CoV-2 through the application of natural substances.

Methods
Antiviral disinfectants and films were manufactured by adding caffeic acid and vanillin to ethanol, isopropyl alcohol, benzalkonium chloride, and PLA. Antiviral efficacies were evaluated with slightly modified international standard testing methods EN 14,476 and ISO 21,702.

Results
In suspension, all the hand sanitizers evaluated in this study showed a reduction of more than 4 log within 2 min against HCoV-229E. After natural substances were added to the hand sanitizers, the time needed to reach the detection limit of the viral titer was shortened both in suspension and porcine skin. However, no difference in the time needed to reach the detection limit of the viral titer was observed in benzalkonium chloride. In the case of antiviral films, those made using both PLA and natural substances showed a 1 log reduction of HCoV-229E compared to the neat PLA film for all treatment groups. Furthermore, the influence of the organic load was evaluated according to the number of contacts of the antiviral products with porcine skin. Ten rubs on the skin resulted in slightly higher antiviral activity than 50 rubs.

Conclusion
This study revealed that caffeic acid and vanillin can be effectively used to control HCoV-229E for hand sanitizers and antiviral films. In addition, it is recommended to remove organic matter from the skin for maintaining the antiviral activity of hand sanitizer and antiviral film as the antiviral activity decreased as the organic load increased in this study.
Strategies to strengthen a climate-resilient health system: a scoping review
Authors: Mosadeghrad Ali Mohammad , Isfahani Parvaneh , Eslambolchi Leila , Zahmatkesh Maryam , Afshari Mahnaz 
Published: August 2023

Abstract
Background
Climate change is a major global threat to human health and puts tremendous pressure on health systems. Therefore, a resilient health system is crucial to enhance, maintain, and restore the population’s health. This study aimed to identify interventions and actions to strengthen a climate-resilient health system to deal with the adverse health effects of climate change.

Method
This study was a scoping review. Five databases and Google Scholar search engine were searched using relevant keywords. Initially, 4945 documents were identified, and 105 were included in the review. Content thematic analysis method was applied using MAXQDA 10 software.

Results
Overall, 87 actions were identified for building a climate-resilient health system and were classified into six themes (i.e., governance and leadership; financing; health workforce; essential medical products and technologies; health information systems; and service delivery). The most commonly reported actions were formulating a national health and climate change adaptation plan, developing plans for essential services (electricity, heating, cooling, ventilation, and water supply), assessing the vulnerabilities and capacities of the health system, and enhancing surveillance systems targeting climate-sensitive diseases and their risk sources.

Conclusions
A holistic and systemic approach is needed to build a climate-resilient health system owing to its complex adaptive nature. Strong governance and leadership, raising public awareness, strategic resource allocation, climate change mitigation, emergency preparedness, robust health services delivery, and supporting research, are essential to building a climate-resilient health system.
Cement-augmented pedicle screw for thoracolumbar degenerative diseases with osteoporosis: a systematic review and meta-analysis
Authors: Song Zhoufeng , Zhou Qiujun , Jin Xiaoliang , Zhang Jinjie 
Published: August 2023

Abstract
Background
Cement-augmentation pedicle screws have been widely used in spinal internal fixation surgery combined with osteoporosis in recent years, which can significantly improve the fixation strength, but compared with conventional methods, whether it has more advantages is still inconclusive of evidencebased medicine. To systematically evaluate the efficacy and safety of cement-augmented pedicle screw in the treatment of thoracolumbar degenerative diseases with osteoporosis.

Methods
We searched PubMed, Embase, and Cochrane Library for studies published from the establishment of the database up until June 2023. We included studies that concerning the cement-augmented pedicle screw and the traditional pedicle screw placement for thoracolumbar degenerative diseases with osteoporosis. We excluded repeated publication, researches without full text, incomplete information or inability to conduct data extraction and animal experiments, case report, reviews and systematic reviews. STATA 15.1 software was used to analyze the data.

Results
A total of 12 studies were included in this meta-analysis. The sample size of patients were totally 881, of which, 492 patients in cement-augmented screw group and 389 patients in conventional screw group. Meta-analysis results showed that Japanese Orthopaedic Association (JOA) score (WMD = 1.69, 95% CI 1.15 to 2.22), intervertebral space height (WMD = 1.66, 95% CI 1.03 to 2.29) and post-operation fusion rate (OR = 2.80, 95% CI 1.49 to 5.25) were higher in the cement-augmented screw group than those in the conventional screw group. Operation time was longer in the cement-augmented screw group than that in the conventional screw group (WMD = 15.47, 95% CI 1.25 to 29.70). Screw loosening rate was lower in the cement-augmented screw group than those in the conventional screw group (OR = 0.13, 95% CI 0.07 to 0.22). However, hospitalization time, intraoperative blood loss and Visual analog scale (VAS) score were not significantly different between the two groups (P > 0.05).

Conclusion
Compared with conventional pedicle screw placement, cement-augmented pedicle screw is more effective in the treatment of osteoporotic thoracolumbar degenerative disease by improving fusion rate and interbody height, reducing the incidence of screw loosening, and elevating long-term efficacy.
Evidence on risk factors for knee osteoarthritis in middle-older aged: a systematic review and meta analysis
Authors: Dong Yawei , Yan Yan , Zhou Jun , Zhou Qiujun , Wei Hongyu 
Published: August 2023

Abstract
Purpose
This review was made to identify the risk factors for knee osteoarthritis (KOA) in middle-older aged (≥ 40 years), and to provide the newest evidence for the prevention of KOA.

Method
Cohort study and case–control study of the risk factors of KOA was included from Pubmed, Web of Science, Ovid Technologies, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, SinoMed from their inceptions to July 2023. Two authors independently screened the literature and extracted data. Assessment of quality was implemented according to Agency for Healthcare Research and Quality (AHRQ) and Newcastle–Ottawa Quality Assessment Scale. Meta-analysis was performed using RevMan 5.3 software.

Results
3597 papers were identified from the seven databases and 29 papers containing 60,354 participants were included in this review. Meta-analysis was performed for 14 risk factors, and 7 of these were statistical significance (P < 0.05). The risk factors which were analyzed in this review included trauma history in knee (1.37 [95% CI 1.03–1.82], P = 0.030), body mass index (BMI) ≥ 24 kg/m2 (1.30 [95% CI 1.09–1.56], P = 0.004), gender (female) (1.04 [95% CI 1.00–1.09], P = 0.030), age ≥ 40 (1.02 [95% CI 1.01–1.03], P = 0.007), more exercise (0.75 [95% CI 0.62–0.91], P = 0.003), a high school education background (0.49 [95% CI 0.30–0.79], P = 0.003) and an university education background (0.22 [95% CI 0.06–0.86], P = 0.030).

Conclusion
The risk factors analyzed in this review included trauma history in knee, overweight or obesity, gender (female), age ≥ 40 and the protective factors included more exercise and a high school or an university education background.
A biomechanical investigation of a novel intramedullary nail used to salvage failed internal fixations in intertrochanteric fractures
Authors: Chen Ping , Fan Zhirong , Xu Nengneng , Wang Haizhou 
Published: August 2023

Abstract
Purpose
The ideal approach for revision surgery following femoral head salvage treatments for an intertrochanteric fracture is still up for debate. A novel variety of proximal femoral bionic intramedullary nail (PFBN) has been created in clinical practice. We aimed to compare the biomechanical results of the novel implant to conventional intramedullary and extramedullary fixation in the treatment of intertrochanteric fracture following primary internal fixation failure.

Methods
Using finite element analysis, we created a three-dimensional model of the intertrochanteric fracture's helical blade cut-out for this investigation. The PFBN 1 group, the PFBN 2 group, the PFNA group, and the DHS group were our four test groups. For each fracture group, the von Mises stress and displacements of the femur and internal fixation components were measured under 2100 N axial loads.

Results
The values for the femoral displacement in the PFBN1 group, PFBN2 group, PFNA group, and DHS group were 6.802 mm, 6.716 mm, 8.080 mm, and 8.679 mm, respectively. The internal implant displacement values were 6.201 mm, 6.138 mm, 7.396 mm, and 8.075 mm in the PFBN1 group, PFBN2 group, PFNA group, and DHS group, respectively. The maximum von Mises Stress in the femoral was 187.2 MPa, 85.18 MPa, 106.6 MPa, and 386.2 MPa in the PFBN1 groups, PFBN2 groups, PFNA groups, and DHS groups, respectively. In the PFBN1 groups, PFBN2 groups, PFNA groups, and DHS groups, the maximum von Mises Stress in internal fixation was 586.7 MPa, 559.8 MPa, 370.7 MPa, and 928.4.8 MPa, respectively.

Conclusion
Our biomechanical research demonstrates that intramedullary fixation is more stable than extramedullary fixation when salvaging failed internal fixations in intertrochanteric fracture. Compared with PFNA and DHS, PFBN showed better biomechanical stability in the treatment of patients with revised intertrochanteric fractures. In light of this, we advocate PFBN fixation as the method of choice for intertrochanteric fracture revision. This result still has to be confirmed in more clinical research.