bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between gynecological disorders and insomnia and depression trajectories: a longitudinal study of middle-aged women
Authors: Zhong Huiyong , Zeng Fuling 
Published: January 2025

BackgroundInsomnia and depression often receive inadequate attention regarding their association with common menopausal gynecological disorders (GDs), and there is a lack of longitudinal epidemiological evidence. Furthermore, the specific disorders that exhibit the strongest correlation with depression, as well as the potential mediating role of insomnia, remain poorly understood.MethodsUsing data from the Study of Women’s Health Across the Nation (SWAN) spanning 1996 to 2008, this study analyzed a sample of 2217 racially diverse premenopausal women (aged 42 to 53 at baseline). Longitudinal trajectory analysis, employing latent class mixture models (LCMM), was used to identify optimal patterns for insomnia and depression. Logistic regression explored associations between pelvic pain, pelvic prolapse or relaxation, abnormal bleeding, and insomnia/depression trajectories. A causal mediation model investigated whether insomnia mediated the link between gynecological disorders and depression.ResultsThe analysis included 2217 participants for insomnia trajectories and 1767 for depression trajectories. Insomnia and depression showed similar patterns, with a single high and low trajectory and minimal fluctuations. Logistic regression revealed a significant positive correlation between pelvic pain, abnormal bleeding, number of GDs, and an increased risk of high insomnia and depression trajectories. Insomnia trajectories mediated 23.6%, 14.3%, and 11.9% of the association between pelvic pain, abnormal bleeding, and number of GDs, respectively, with depression trajectories.ConclusionsThis study found the significant associations between pelvic pain, abnormal bleeding, and comorbidity with an elevated risk of insomnia and depression during the menopausal transition.
Multimodal machine learning for analysing multifactorial causes of disease—The case of childhood overweight and obesity in Mexico
Authors: Silva Sepulveda Rosario , Boman Magnus 
Published: January 2025

BackgroundMexico has one of the highest global incidences of paediatric overweight and obesity. Public health interventions have shown only moderate success, possibly from relying on knowledge extracted using limited types of statistical data analysis methods.PurposeTo explore if multimodal machine learning can enhance identifying predictive features from obesogenic environments and investigating complex disease or social patterns, using the Mexican National Health and Nutrition Survey.MethodsWe grouped features into five data modalities corresponding to paediatric population exogenous factors, in two multimodal machine learning pipelines, against a unimodal early fusion baseline. The supervised pipeline employed four methods: Linear classifier with Elastic Net regularisation, k-Nearest Neighbour, Decision Tree, and Random Forest. The unsupervised pipeline used traditional methods with k-Means and hierarchical clustering, with the optimal number of clusters calculated to be k = 2.ResultsThe decision tree classifier in the supervised early fusion approach produced the best quantitative results. The top five most important features for classifying child or adolescent health were measures of an adult in the household, selected at random: BMI, obesity diagnosis, being single, seeking care at private healthcare, and having paid TV in the home. Unsupervised learning approaches varied in the optimal number of clusters but agreed on the importance of home environment features when analysing inter-cluster patterns. Main findings from this study differed from previous studies using only traditional statistical methods on the same database. Notably, the BMI of a randomised adult within the household emerged as the most important feature, rather than maternal BMI, as reported in previous literature where unwanted cultural bias went undetected.ConclusionOur general conclusion is that multimodal machine learning is a promising approach for comprehensively analysing obesogenic environments. The modalities allowed for a multimodal approach designed to critically analyse data signal strength and reveal sources of unwanted bias. In particular, it may aid in developing more effective public health policies to address the ongoing paediatric obesity epidemic in Mexico.
Association between workplace violence from patients and the mental health status of healthcare workers in Zhuhai China: a cross-sectional study
Authors: Zheng Ying , Li Xuping , Sun Yajun , Mao Chun , Huang Jiaju , Li Jingya , Zhang Guangchuan , Wei Ning , Wang Xiaohui , Teng Yongyong 
Published: January 2025

ObjectiveWorkplace violence (WPV) poses a serious occupational risk. This study aims to explore the association between WPV from patients and the occurrence of insomnia, depression, and anxiety among healthcare workers.MethodsInformation about the WPV from patients was collected by a self-designed questionnaire. Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) were used for the assessment of mental health. Logistic regression was used to explore the association between WPV from patients and insomnia, depression, and anxiety. Mediation analysis was used to evaluate the mediation effect of depression and anxiety on the relationships between WPV from patients and insomnia.ResultsOf 10,413 included healthcare workers, 40.05% experienced verbal violence, 6.44% experienced physical violence from patients in the past year. There is a significant association between verbal violence and insomnia (OR = 1.780, 95% CI: 1.591–1.990), depression (OR = 1.823, 95% CI: 1.640–2.026), and anxiety (OR = 1.831, 95% CI: 1.606–2.087), as well as physical violence (insomnia: OR = 1.220, 95% CI: 1.002–1.481; depression: OR = 1.274, 95% CI: 1.052–1.540; anxiety: OR = 1.316, 95% CI: 1.058–1.630). Moreover, depression and anxiety mediated the relationship between WPV and insomnia, the mediated proportion was 62.21% in the association between verbal violence and insomnia, and 60.22% in the association between physical violence and insomnia.ConclusionsThe association between WPV from patients and heightened risks of mental health issues emphasizes the necessity of supportive work environments. Recognizing the mediating role of depression and anxiety stresses the significance of tailored mental health training for healthcare staff.
Does social support improve self-management among rural hypertensive patients? An empirical analysis based on generalized propensity score matching
Authors: Li Jiantao , Zhang Jingru , Wang Yuxiao , Zhang Hanwen , Ma Yangyang 
Published: January 2025

BackgroundThis study aimed to examine the causal effect between perceived social support and self-management in rural patients with hypertension and to provide a basis for improving self-management.MethodsA cross-sectional study of 1,091 rural hypertensive patients in Shanxi Province was conducted from March through June 2022 to analyze the factors influencing social support as well as the causal effects of social support and self-management using generalized propensity score matching.ResultsRural hypertensive patients had a low level of social support (social support score = 0.632 ± 0.178). Social support had a significant and inverted U-shaped relationship with self-management; with increasing social support levels, the levels of self-management first rose and then declined, with an inflexion point of 0.774. Social support had significant negative correlations with sex, age, number of child, living status (i.e., living alone or living with others), disease duration, family economic status, and decision-making power, and positive correlations with having a spouse and having medical insurance.ConclusionGreater emphasis should be placed on the older adult, individuals living alone, those without spouses, only children, economically disadvantaged populations, and uninsured individuals to enhance the social support they received and ultimately improve their self-management of hypertension. Furthermore, establishing social support systems that are congruent with rural relational networks is crucial for promoting effective hypertension self-management.
Mental health and psychological resilience amid the spread of the Omicron variant: a comparison between China and Korea
Authors: Qin Chenyuan , Lee Minjung , Deng Jie , Lee Yubin , You Myoungsoon , Liu Jue 
Published: January 2025

ObjectivesBesides physical health risks, large public health events also exert negative impacts on people's mental health. We aimed to explore the prevalence and correlates of mental distress and its association with psychological resilience among countries amid the Omicron wave.MethodsWe conducted cross-sectional surveys simultaneously in China and South Korea from March 15 to 30, 2023. Brief Resilience Scale (BRS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale were used to measured psychological resilience and mental distress.ResultsSelf-reported rates of anxiety and depressive symptoms in 3,000 Chinese participants were 24.5% and 30.5%, while the above-mentioned rates were 17.2%and 34.4% in 1,000 Korean participants. Chinese participants had a marginally higher BRS score. Psychological resilience was inversely associated with the prevalence of anxiety symptoms and depressive symptoms. Similar results can be observed in Korea. Results remained robust in all models.ConclusionChinese and Korean populations reported a high prevalence of mental distress with variations in different characteristics, indicating practical implications for developing tailored mental health policies and services in the context of large public health events.
Perinatal outcomes and predictors of placental abruption: a retrospective study in an Ethiopian tertiary care center
Authors: Tadese Mesfin , Getachew Gebresenbet , Kebede Tirusew Nigussie , Yesuf Toyba Ebrahim , Tessema Saba Desta , Damesa Wogene Asefa , Solomon Gebeyehu Shumet 
Published: January 2025

BackgroundPlacental abruption is a critical obstetric condition characterized by the premature separation of the placenta from the uterus, leading to severe maternal and fetal complications. In Ethiopia, the maternal and perinatal morbidity and mortality rates are alarmingly high, and placental abruption significantly contributes to these adverse outcomes. Despite its severity, there is a lack of comprehensive data on the burden, risk factors, and outcomes associated with placental abruption in the Ethiopian context. Thus, the study aimed to investigate the adverse perinatal outcomes of placental abruption and the factors associated with these outcomes among pregnant women admitted to the University of Gondar Comprehensive Specialized Hospital in Ethiopia.MethodAn institution-based retrospective cross-sectional study was conducted among 367 pregnant women who were admitted and managed for placental abruption from January 1, 2021, to January 1, 2023, at the University of Gondar Comprehensive Specialized Hospital. A simple random sample method was employed to choose the medical records. Data was collected using a checklist prepared with the KOBO collect tool and then exported to SPSS version 25.0. Variables having a p-value of less than 0.05 were deemed significant in the multivariable logistic regression analysis that was done. The adjusted odds ratio with a 95% confidence interval was reported.ResultThe prevalence of adverse perinatal outcome of placental abruption was 39.2, 95% CI: 34.3–44.1. The most common adverse outcomes were prematurity (25.6%), low birth weight (25.6%), and NICU admission (13.9%). Severe placental abruption [AOR (CI) = 8.82 (4.48–17.31)] and abruption at preterm gestation [AOR (CI) = 18.71 (9.59–36.42)] were significant predictors of adverse perinatal outcomes.ConclusionThe adverse perinatal outcomes of pregnancies complicated by placental abruption in this study were higher compared to other studies in Ethiopia. The degree of placental abruption and gestational age at diagnosis were significant associates of adverse perinatal outcomes. The study highlights the critical need for patient-centered counseling on antenatal bleeding to encourage early healthcare-seeking behavior, close follow up for those undergoing expectant management and the early detection and management of placental abruption to improve perinatal outcomes.
Higher triglyceride-glucose index and triglyceride glucose-body mass index protect against sarcopenia in Chinese middle-aged and older non-diabetic women: a cross-sectional study
Authors: Li Min , Liu Ying , Gao Lei , Zheng Yongli , Chen Luyao , Wang Yan , Zhang Wei 
Published: January 2025

PurposeSarcopenia, an age-related complication, constitutes a major public health problem given the aging of the population. However, it is frequently overlooked and undertreated in mainstream practice. The study aimed to investigate the correlations between triglyceride-glucose (TyG) index and TyG-body mass index (BMI) and sarcopenia in non-diabetic middle-aged and older women and whether they would be helpful indicators of sarcopenia.Patients and methodsThis cross-sectional study was conducted in the Department of Endocrinology, Hebei Medical University Third Hospital. This study prospectively enrolled 460 non-diabetic postmenopausal women aged ≥50 years.ResultsAs TyG and TyG-BMI increased, the prevalence of sarcopenia decreased. In multivariate analysis, the TyG index and TyG-BMI index were inversely associated with sarcopenia (OR: 0.492; 95% CI: 0.256–0.944 and OR: 0.948; 95% CI: 0.934–0.962). Women in the fourth TyG-BMI quartiles showed decreased OR of 0.009 (95% CI: 0.001–0.072) for sarcopenia with respect to first quartiles after adjusting confounding factors. The area under the curve (AUC) for TyG index in the diagnosis of sarcopenia was 0.598 (95% CI: 0.529–0.666), while the AUC for TyG-BMI index was 0.858 (95% CI: 0.816–0.899).ConclusionHigher TyG index and TyG-BMI index protected against sarcopenia in non-diabetic middle-aged and older females. Moreover, the TyG-BMI index was a reliable and cost-efficient biomarker to predict sarcopenia.
Factors influencing health-related quality of life in children with asthma: insights from Addis Ababa public hospitals
Authors: Kasse Tsehaynew , Zenebe Selemaye , Agegnehu Yalemzer , Lonsako Arega Abebe 
Published: January 2025

BackgroundBronchial asthma is a global health problem in particular a respiratory condition characterized by broncho spasms that negatively affect the quality of life (QOL) of children. However, there is a paucity of data regarding the health-related quality of life of asthma in children in Ethiopia, and the study area.ObjectiveThe objective of this study was to assess the health-related quality of life among asthmatic children aged 7–17 in selected hospitals in Addis Ababa, Ethiopia.MethodsAn institutional-based analytical cross-sectional study involving 136 asthmatic children aged 7–17 years was conducted in the selected hospital in Addis Ababa, from February to April 2024. Respondents were chosen using a systematic random sampling method. Structured, interviewer-administered, and pretested questionnaires, were used to collect data. The data were coded and entered into Epi-Data 3.1 before being exported to SPSS version 25 for analysis. Logistic regression was employed to identify factors influencing health-related quality of life Statistical significance was set at p &lt; 0.05 with a 95% confidence interval.ResultsThe study found that 46% [95% CI: 37.6–54.4%] of the study participants had a poor quality of life. Factors associated with an increased likelihood of poor quality of life included caregivers’ lack of formal education (Adjusted Odds Ratio [AOR]: 1.39 [1.80–10.69]), a family history of asthma (AOR: 2.51 [1.46–4.299]), longer asthma duration (AOR: 3.47 [1.89–6.39]), uncontrolled asthma (AOR: 3.47 [1.89–6.39]), moderate persistent asthma (AOR: 2.4 [1.40–4.20]), and comorbidities (AOR: 2.4 [1.40–4.20]).ConclusionThe study highlights almost half of asthmatic children had a poor quality of life in Addis Ababa. Factors such as caregivers’ lack of formal education, a family history of asthma, longer duration and increased severity of asthma, uncontrolled asthma, and comorbidities were significantly associated with poor quality of life. Therefore, implementing targeted education programs, encouraging family history assessments, and strengthening comorbidity screening and management for children and their families in Addis Ababa are recommended.
Global burden and trends of norovirus-associated diseases from 1990 to 2021 an observational trend study
Authors: Zhu MengLan , Huang ZiLing , Liu TongTong , Wu ChenNan , Shang ZhiHan , Zhang LuLu 
Published: January 2025

BackgroundNorovirus remains a significant viral cause of waterborne and foodborne gastroenteritis outbreaks and epidemics worldwide. The burden of norovirus extends across different income settings.MethodsLeveraging secondary data from the 2021 Global Burden of Diseases Study, our analysis spanned the period from 1990 to 2021 to assess the burden of norovirus-associated diseases (NADs). We utilized descriptive statistics to examine global mortality rates and disability-adjusted life years (DALYs). For trend analysis, we employed annual percentage change (EAPC) through linear regression and applied Joinpoint analysis to identify significant changes over time. A comprehensive age-period-cohort model evaluated the key mortality risk factors. Furthermore, a Bayesian age-period-cohort analysis was conducted to forecast trends up to 2035, providing valuable insights for policy formulation and resource allocation.ResultsIn 2021, the global age-standardized mortality rate (ASMR) for NADs was 1.62 per 100,000 population (95% UI: 0.35 to 2.91), while the age-standardized DALY rates (ASDR) was 79.02 years per 100,000 population (95% UI: 26.61 to 132.26). A downward trend was observed in most regions and countries, with EAPC of −4.29% (95% UI: −4.53 to −4.05) for ASMR and −4.40% (95% UI: −4.62 to −4.19) for ASDR from 1990 to 2021. Notably, children under 5 years old had considerably higher ASDR: 475.52 years (95% UI: 160.73 to 893.72) per 100,000 for males and 335.44 years (95% UI: 112.29 to 623.48) per 100,000 for females. Mortality risk from NADs escalated with age, with a peak of 69.27 (95% CI: 64.04 to 74.92) per 100,000 for the under-five age group, and 11.38 (95% CI: 10.59 to 12.22) per 100,000 for individuals over 95 years. Bayesian Age-Period Cohort projections indicate a continued decline in ASMR and ASDR through 2035.DiscussionBetween 1990 and 2021, ASMR and ASDR for NADs significantly declined due to public health interventions, vaccination, and improved sanitation. However, norovirus remains highly contagious, especially among children and the older adult. Projections suggest a continued decrease in the burden of such diseases by 2035. To further reduce this burden, preventive measures like vaccination and infection control strategies are essential for high-risk populations, alongside ongoing research into norovirus epidemiology and transmission dynamics.
Health-related physical fitness in children among five Mediterranean countries: a cross-cultural study from the DELICIOUS project
Authors: Aly Mohamed , El-Gyar Noha , Shalaby Amira M. , Abdelkarim Osama 
Published: January 2025

BackgroundHealth-related fitness (HRF) components are essential for supporting healthy growth and reducing long-term health risks in children. This study explored cross-cultural variations in HRF among children from five Mediterranean countries—Egypt, Italy, Lebanon, Portugal, and Spain—within the framework of the DELICIOUS project.MethodsA total of 860 children participated in the study, including 204 from Egypt (n = 204, 11.72 ± 1.46 years), 150 from Italy (9.66 ± 1.10 years), 200 from Lebanon (10.73 ± 1.90 years), 181 from Portugal (11.04 ± 1.83 years), and 125 from Spain (12.33 ± 2.27 years). Participants completed the International Physical Performance Test Profile (IPPTP), which assesses sprint speed (20 m dash), coordination (jumping sideways), upper body strength (push-ups), abdominal strength (sit-ups), lower body power (standing long jump), and cardiovascular endurance (6-min run). Children were categorized into two age groups: 8–10 and 11–14 years. ANCOVA, adjusting for BMI, was performed to analyze differences across countries and age groups.ResultsAnalysis revealed significant differences in HRF across countries and age groups (p &lt; 0.05). Spanish boys and girls consistently demonstrated superior sprint performance (20 m dash) and cardiovascular endurance (6-min run) compared to peers from other countries. Lebanese and Spanish girls exhibited stronger abdominal performance (sit-ups) than Egyptian girls, while Spanish girls also excelled in lower-body power (standing long jump). These findings underscore cross-cultural variations in HRF outcomes among Mediterranean children.ConclusionCross-cultural differences in physical education programs and sports participation appear to influence HRF in children across the Mediterranean region. These findings underscore the need for culturally tailored physical education strategies and public health initiatives to ensure balanced fitness development in diverse cultural populations.
Challenges faced by community health volunteers in offering sexual and reproductive health care services to young women during the COVID-19 pandemic in Khwisero and Nairobi in Kenya
Authors: Yusuf Mariam F. , Onyango-Ouma Washington , Muinde Jacinta Victoria S. , Wangamati Cynthia Khamala 
Published: January 2025

IntroductionCommunity health volunteers (CHVs) are fundamental in many health systems across the globe. In Kenya, CHVs were essential in providing sexual and reproductive health (SRH) services during the COVID-19 pandemic. The study highlights challenges experienced by community health volunteers in Kenya while providing SRH services during the COVID-19 pandemic.MethodThe study utilized a qualitative research design to explore challenges experienced by CHVs in offering SRH services in Dagoretti North and South sub-counties in Nairobi and Khwisero sub-county in western Kenya during the COVID-19 pandemic period. We conducted 17 in-depth interviews, 7 focus group discussions, and 1 group discussion with CHVs. The data was collected in different periods: in Khwisero, November 2022–August 2023, and in Nairobi, February–April 2023.ResultsThe study's findings show that CHVs experienced several challenges while providing SRH services. The challenges included distrust by the community as a result of the interaction between anti-COVID-19 measures and other past and present health interventions such as vaccines for other diseases, insufficient personal protective gear and equipment (PPEs), limited human and financial resources to address community needs, limited and poor training on response to misinformation that led to vaccine hesitancy, and mental strain from stigma and burnout.ConclusionDuring pandemics, governments should provide adequate personal protective gear and financial and human resources for CHVs' work as they deliver SRH services to the community under risky conditions. In addition, CHVs must be trained to address misinformation about relevant medical interventions during epidemics and pandemics and provided with psychosocial support to mitigate the impact of psychological distress.