bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review articles (Meta-Analyses) effects of walking on cognitive function in individuals with mild cognitive impairment: a systematic review and meta-analysis
Authors: Lin Jia-Chi , Chen I-Hsuan , Cheng Fang-Yu 
Published: August 2023

Abstract
Background
Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Previous studies have shown that regular exercise can improve cognition and physical performance in older adults. Walking is a low-technology and low-cost exercise that has been proven to improve cognition and mobility in healthy elderly individuals. However, no systematic review or meta-analysis has explored whether walking can improve cognitive function in older adults with MCI. This study aimed to explore the effects of walking interventions on cognitive functions in individuals with MCI.

Methods
In accordance with the PRISMA guidelines, MEDLINE, PubMed, SPORTDiscus, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan were searched from inception to July 2023. Independent reviewers selected randomized clinical trials (RCT) that compared the effects of walking with no intervention or other exercises in individuals with MCI. The primary outcomes were cognitive functions, and the secondary outcome was walking endurance. Three reviewers independently conducted data extraction. The risk of bias was assessed using the Revised Cochrane Risk of Bias assessment tool.

Results
Fourteen RCTs were included in this review. The quality of evidence in these studies was rated as good to excellent. The results of the meta-analysis showed that the individuals with MCI had no significant improvement in cognitive function but had significant improvement in the 6-min walk test (Mean Difference=23.70, p=0.008) after walking interventions compared to no intervention or other exercises.

Conclusion
Walking intervention has no significant improvement on cognitive functions in older adults with MCI. However, walking induces beneficial effects on aerobic capacity.

Trial registration
This systematic review has the registration number CRD42021283753 on PROSPERO.
Evaluation and optimization of the syndromic management of female genital tract infections in Nairobi, Kenya
Authors: Omosa-Manyonyi Gloria S. , de Kam Marloes , Tostmann Alma , Masido Mwasi A. , Nyagah Nyawira , Obimbo Moses M. , van der Ven Andre J.A.M. , Oever Jaap ten 
Published: August 2023

Abstract
Background
Genital tract infections pose a public health concern. In many low-middle-income countries, symptom-based algorithms guide treatment decisions. Advantages notwithstanding, this strategy has important limitations. We aimed to determine the infections causing lower genital tract symptoms in women, evaluated the Kenyan syndromic treatment algorithm for vaginal discharge, and proposed an improved algorithm.

Methods
This cross-sectional study included symptomatic non-pregnant adult women presenting with lower genital tract symptoms at seven outpatient health facilities in Nairobi. Clinical, socio-demographic information and vaginal swabs microbiological tests were obtained. Multivariate logistic regression analyses were performed to find predictive factors for the genital infections and used to develop an alternative vaginal discharge treatment algorithm (using 60% of the dataset). The other 40% of data was used to assess the performance of each algorithm compared to laboratory diagnosis.

Results
Of 813 women, 66% had an infection (vulvovaginal candidiasis 40%, bacterial vaginosis 17%, Neisseria gonorrhoea 14%, multiple infections 23%); 56% of women reported ≥ 3 lower genital tract symptoms episodes in the preceding 12 months. Vulvovaginal itch predicted vulvovaginal candidiasis (odds ratio (OR) 2.20, 95% CI 1.40–3.46); foul-smelling vaginal discharge predicted bacterial vaginosis (OR 3.63, 95% CI 2.17–6.07), and sexually transmitted infection (Neisseria gonorrhoea, Trichomonas vaginalis, Chlamydia trachomatis, Mycoplasma genitalium) (OR 1.64, 95% CI 1.06–2.55). Additionally, lower abdominal pain (OR 1.73, 95% CI 1.07–2.79) predicted sexually transmitted infection. Inappropriate treatment was 117% and 75% by the current and alternative algorithms respectively. Treatment specificity for bacterial vaginosis/Trichomonas vaginalis was 27% and 82% by the current and alternative algorithms, respectively. Performance by other parameters was poor to moderate and comparable between the two algorithms.

Conclusion
Single and multiple genital infections are common among women presenting with lower genital tract symptoms at outpatient clinics in Nairobi. The conventional vaginal discharge treatment algorithm performed poorly, while the alternative algorithm achieved only modest improvement. For optimal care of vaginal discharge syndrome, we recommend the inclusion of point-of-care diagnostics in the flowcharts.
Rural-urban disparities in nutritional status among women in Ethiopia based on HIV serostatus: a cross-sectional study using demographic and health survey data
Authors: Abebe Hirut , Agardh Anette , Arunda Malachi Ochieng 
Published: August 2023

Abstract
Background
Ethiopia is one of the sub-Saharan African countries most affected by the human immunodeficiency virus (HIV) epidemic and also by severe undernutrition, which is particularly prevalent among women. HIV infection, reproductive biology, and their role in society increase the vulnerability of women to malnutrition. Various factors including urbanization could cause differences in the nutritional status of rural and urban residents. In this study, we aimed to assess rural-urban disparities in nutritional status among women of reproductive age based on HIV serostatus in Ethiopia.

Method
Data from the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 were used. Among 15,683 women included in the survey, 8822 non-pregnant women aged 15–49 years, including those who gave birth two months before the DHS survey were included in this study. Multinomial logistic regression was used to determine the relative risk ratios (RRR) for the associations between study variables.

Results
Generally, the prevalence of underweight among women of reproductive age was higher in rural residents (28.9%) than in urban residents (12.3%) in Ethiopia. Being overweight was more prevalent among urban women than rural women, (35.1% vs. 4.8%). About 32% of HIV-positive women were underweight in both rural and urban areas. About 29% of HIV-positive urban women were overweight compared to 3.4% of HIV-positive rural women. Among urban residents, HIV-positive women were about 4 times more likely to be underweight than their HIV-negative counterparts, RRR 3.8 (95% CI: 1.58, 9.26). However, there was no significant difference in nutritional status between HIV-positive and HIV-negative women living in rural areas. Anemic women were more likely to be underweight while, wealthy women were less likely to be underweight in both rural and urban areas. Women aged 25–49 years were generally more likely to be overweight/obese and less likely to be underweight compared to younger women aged $$\le 24$$years.

Conclusion
Malnutrition was more prevalent among HIV-positive women living in urban Ethiopia. Targeted nutritional interventions for HIV-positive women of reproductive age living in urban areas could be considered. Furthermore, efforts should be made to improve the nutritional status of women of reproductive age across the country.
Perinatal outcomes among Indian-born mothers in Australia
Authors: Barthasarathy Kanmani , Lam Louisa 
Published: August 2023

Abstract
Objective
To examine the incidence of adverse perinatal outcomes and the risk of adverse perinatal outcomes for Indian-born mothers compared to other mothers living and giving birth in Australia.

Design, setting and participants
This retrospective cohort study was designed to investigate all births in Australia in 2012 and those in the Monash Health Birthing Outcomes System (BOS) 2014 to Indian-born mothers in Australia. Data sets were analysed involving descriptive statistics using Statistical Package for Social Sciences (SPSS vs. 23).

Results
Indian-born mothers in Australia are at increased risk of induced labour, emergency caesarean section, very preterm birth (20–27 weeks), babies with low to very low birth weight, and low Apgar score (0–2) at 5 min, gestational diabetes, hypothyroidism, iron deficiency anaemia and vitamin B12 deficiencies compared to other mothers giving birth in Australia. This is despite a range of protective factors (25–34 years, married, nonsmokers, and a BMI < 30) that would normally be expected to reduce the risk of adverse perinatal outcomes for mothers giving birth in a developed country.

Conclusion
In the absence of many of the recognized maternal risk factors, Indian-born mothers continue to face increased risk of adverse perinatal outcomes, despite access to high quality maternity care in Australia. Recommendations arising from this study include the need for an intervention study to identify maternal risk factors for Indian-born mothers in mid to late pregnancy that contribute to the risk for very preterm birth and low birth weight.
Retroperitoneal ectopic pregnancy: successful expectant management in condition of early pregnancy failure
Authors: Le Diep Ngoc , Nguyen Phuc Nhon , Huynh Phuong Hai 
Published: August 2023

Abstract
Background
Retroperitoneal ectopic pregnancy (REP) refers to abnormal implantation of the fertilized egg in the retroperitoneal cavity. REP can be divided into pelvic and abdominal positions. Extremely rare, the incidence of REP is less than 1% of ectopic pregnancy (EP). Herein, we report the first case of paraaortic-located REP in association with successful expectant management, thus raising awareness among healthcare providers, particularly in low-resource settings.

Case presentation
A reproductive-age woman presented at our tertiary referral hospital because of amenorrhea and a positive pregnancy test. Based on serial serum β-hCG levels and imaging modalities including transabdominal ultrasound, transvaginal sonography, and magnetic resonance imaging (MRI), a REP of 7–9 weeks of gestational age adherent to abdominal paraaortic region was detected. Since the pregnancy was spontaneously arrested without clinical symptoms, expectant management was first indicated following careful evaluation. After a 1-month follow-up, the ectopic mass naturally degenerated without complications and her β-hCG concentration returned to a negative value. Therefore, the patient recovered completely and avoided unnecessary surgery as well as toxicity of medical treatment when using systemic methotrexate.

Conclusions
In addition to transvaginal and transabdominal ultrasound, MRI is necessary for the diagnosis of nonviable REP. Alongside the great vessels in the abdominal cavity should be taken into consideration in all suspected cases relating to this rare entity. Expectant management may be carefully indicated in conditions of nonviable REP and unruptured REP, where applicable.
The influence of media use degree on public depressive symptoms: mediating role of big five personality
Authors: Gong Fangmin , Jia Yuhan , Sun Xinying , Min Hewei , Jia Xiaocen , Wang Fei , Huang Xincheng , Lin Xin , Li Zheming , Wu Yibo 
Published: August 2023

Abstract
Background
Mixed results have been found regarding the relationship between media use degree and depressive symptoms. The purpose of this study is to explore the relationship between media use degree, big five personality and depressive symptoms with a mediation model.

Method
This was a cross-sectional study. With 9-item Patient Health Questionnaire (PHQ-9), 10-item Big Five Inventory (BFI-10) and self-designed media usage scale, 11,031 participants aged 12 and above in 120 cities in China were collected. Pearson correlation analysis and regression analysis were performed on the data. The Process plug-in was used to construct the mediation model and explore the relationship among media use degree, big five personality and depressive symptoms. The nonparametric percentile Bootstrap method was used to test the mediating effect of personality traits.

Results
The degree of media use was positively correlated with depressive symptoms (r = 0.20, P < 0.001), and big five personality played a mediating role between the degree of media use and depressive symptoms. Among five traits, extroversion (r=-0.12, P < 0.001), conscientiousness (r=-0.23, P < 0.001), openness (r=-0.03, P < 0.01) and agreeableness (r=-0.22, P < 0.001) were negatively correlated with depressive symptoms, and neuroticism (r = 0.25, P < 0.001) were positively correlated with depressive symptoms. In addition, extraversion (-0.004, -0.001), conscientiousness (-0.015, -0.008), agreeableness (-0.008, -0.001) and neuroticism (-0.015, -0.007) in big five personality played a mediating role between media use and depressive symptoms.

Conclusion
The degree of media use positively predicted depressive symptoms, and excessive media use may bring risks to mental health. People with high neuroticism, low agreeableness, low conscientiousness and low extroversion are more likely to suffer from depressive symptoms.
Correlation between negative life events and suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture
Authors: Song Xiaozhen , Zou Shoukang , Li Yangling , Chen Liyu , Feng Ping , Xu Peiwei , Zhang Hang , Deng Fang , Xu Hanmei , Tao Yuanmei , Jin Meijiang , Ran Maojia , Zhang Hong , Ma Fanghua , Wang Ying , Yin Li 
Published: August 2023

Abstract
Objective
To investigate the incidence of suicide attempts among adolescents with HIV/AIDS in Liangshan Prefecture, Sichuan Province, as well as the correlation between negative life events, sleep, exercise, drug therapy and suicide attempts.

Methods
A total of 180 Yi adolescents aged 11–19 years with HIV/AIDS in a county of Liangshan Prefecture, Sichuan Province, China, were investigated by census. The main outcome indicators included the incidence of suicide attempts and whether negative life events, sleep, exercise, drug therapy and other factors were related to suicide attempts.

Results
We found that the incidence rate of suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture was 13.9%. Negative life events were a risk factor for suicide attempts (OR = 1.047, p < 0.001, 95% CI 1.027–1.067). In the factors of negative life events, adaptation was a risk factor for suicide attempts (OR = 1.203, p = 0.026, 95% CI 1.022–1.416), and academic pressure showed a tendency to be a risk factor for suicide attempts (OR = 1.149, p = 0.077, 95% CI 0.985–1.339). However, the punishment factor, interpersonal stress factor and loss factor had no significant correlation with suicide attempts. There was no significant correlation between sleep, exercise, drug therapy and suicide attempts.

Conclusion
The proportion of suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture is high and should be considered. Negative life events are independent risk factors for suicide attempts, and it is necessary to strengthen the screening and early intervention for suicide attempts in HIV/AIDS adolescents with definite negative life events.
Physical activity and TV viewing parenting practices for toddlers among South Asian and white families in the UK: born in Bradford 1000 study
Authors: Kwon Soyang , Kandula Namratha R. , Tandon Pooja S. , Shah Nilay S. 
Published: August 2023

Abstract
Background
Children of South Asian (SA) origin in the UK have lower levels of physical activity (PA), compared to their White counterparts. Parents play an important role in establishing PA habits among young children. The aim of this study was to compare PA and television (TV) viewing parenting practices for young children between SA British (SAB) and White British (WB) parents living in the UK.

Methods
We conducted a secondary analysis of the Born in Bradford (BiB) 1000 study, using survey data at child ages 24 and 36 months. The study sample included three groups of mothers (n = 1,149): foreign-born SAB (n = 458), UK-born SAB (n = 276), and WB (n = 455). Mothers completed a survey about parenting practices (i.e., PA supports, PA restrictions, TV viewing restrictions) at child age 24 months and child PA and TV viewing behaviors at child ages 24 and 36 months. Parenting practices were compared among the three groups. Multivariable linear regression analyses compared children’s weekly walking frequency and daily TV viewing hours by parenting practices in the three groups.

Results
The foreign-born SAB group showed the lowest frequencies of PA-supportive parenting practices (verbal encouragement: 3.7 ± 3.1 times/week; logistic support: 1.5 ± 1.8 times/week) and the highest frequencies of PA-restrictive parenting practices (7.8 ± 7.7 times/week) among the three groups (p < 0.01). Children of Foreign-born SAB mothers had the most frequent TV watching during a mealtime (4.0 ± 3.1 times/week) among the three groups (p < 0.01). Less frequent PA-supportive parenting practices and SA ethnicity were associated with lower walking frequency at 24 and 36 months of age among children (p < 0.01). More frequent exposure to TV at mealtimes and SA ethnicity were associated with higher TV viewing time at 24 and 36 months of age among children (p < 0.01).

Conclusions
This study demonstrated that SAB parents, particularly those who are foreign-born, apply parenting practices for their young children that are less supportive of PA and more supportive of TV viewing, and their children have lower PA and higher TV viewing time, compared with their WB counterparts.
Facilitating pain assessment and communication in people with deafness: a systematic review
Authors: Mansutti Irene , Tomé-Pires Catarina , Chiappinotto Stefania , Palese Alvisa 
Published: August 2023

Abstract
Background
Pain is a common reason for seeking out healthcare professionals and support services. However, certain populations, such as people with deafness, may encounter difficulties in effectively communicating their pain; on the other side, health care professionals may also encounter challenges to assess pain in this specific population.

Aims
To describe (a) the state of the research in the field of pain assessment in individuals with deafness; (b) instruments validated; and (b) strategies facilitating the pain communication or assessment in this population.

Methods
A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were performed, searching Medline, CINAHL, Scopus, Embase and PsycInfo databases, from their initiation to July 2023. Primary and secondary studies, involving adults with deafness and investigating pain assessment and communication difficulties, facilitators, or barriers, were eligible. The included studies were assessed in their methodological quality with the Quality Assessment for Diverse Studies tool; data extraction and the narrative synthesis was provided by two researchers.

Results
Five studies were included. Two were validation studies, while the remaining were a case report, a case study and a qualitative study. The interRAI Community Health Assessment and the Deafblind Supplement scale have been validated among people with deafness by reporting few psychometric properties; in contrast, instruments well established in the general population (e.g. Visual Analogue Scale) have been assessed in their usability and understandability among individuals with deafness, suggesting their limitations. Some strategies have been documented as facilitating pain communication and assessment: (a) ensuring inclusiveness (the presence of family members as mediators); (b) ensuring the preparedness of healthcare professionals (e.g. in sign language); and (c) making the environment friendly to this population (e.g. removing masks).

Conclusions
The research regarding pain in this population is in its infancy, resulting in limited evidence. In recommending more research capable of establishing the best pain assessment instrument, some strategies emerged for assessing pain in which the minimum standards of care required to offer to this vulnerable population should be considered.
Open versus percutaneous tracheostomy in patients with COVID-19: retrospective cohort analysis
Authors: González-Muñoz Alejandro , Ramírez-Giraldo Camilo , Peña Suárez Jorge David , Lozano-Herrera Jaime , Vargas Mendoza Isabella , Rodriguez Lima David Rene 
Published: August 2023

Abstract
Background
During the COVID-19 pandemic, a great number of patients required Mechanical Ventilation (MV). Tracheostomy is the preferred procedure when difficult weaning is presented. Surgical techniques available for performing tracheostomy are open and percutaneous, with contradictory reports on the right choice. This paper aims to describe the clinical results after performing a tracheostomy in patients with COVID-19, regarding both surgical techniques.

Methods
An observational, analytical study of a retrospective cohort was designed. All patients admitted to the Hospital Universitario Mayor Méderi, between March 2020 and April 2021 who presented COVID-19 requiring MV and who underwent tracheostomy were reviewed. Open versus percutaneous tracheostomy groups were compared and the primary outcome evaluated was in-hospital mortality.

Results
A total of 113 patients were included in the final analysis. The median age was 66.0 (IQR: 57.2 – 72.0) years old and 77 (68.14%) were male. Open tracheostomy was performed in 64.6% (n = 73) of the patients and percutaneous tracheostomy in 35.4% (n = 40) with an in-hospital mortality of 65.7% (n = 48) and 25% (n = 10), respectively (p < 0.001). In a multivariate analysis, open tracheostomy technique [OR 9.45 (95% CI 3.20–27.92)], older age [OR 1.05 (95% CI 1.01–1.09)] and APACHE II score [OR 1.10 (95% CI 1.02–1.19)] were identified as independent risk factors for in-hospital mortality. Late tracheostomy (after 14 days) [OR 0.31 (95% CI 0.09–1.02)] and tracheostomy day PaO2/FiO2 [OR 1.10 (95% CI 1.02–1.19)] were not associated to in-hospital mortality.

Conclusions
Percutaneous tracheostomy was independently associated with lower in-hospital mortality and should be considered the first option to perform this type of surgery in patients with COVID-19 in extended MV or difficulty weaning.
Liposuction and port site nipple sparing mastectomy: an alternative method for the operative treatment of gynecomastia at Alexandria main university hospital
Authors: Asal Mohamed , Ewedah Moataz , Bassiony Mahmoud , Abdelatif Ahmed 
Published: August 2023

Abstract
Background
Gynecomastia is characterized by unusually large masses that radiate concentrically from the base of the nipple and is caused by abnormal growth of the glandular tissue of the male breast. An alternative strategy for the surgical treatment of gynecomastia was used in this experimental study, which aims to use liposuction and port site nipple sparing mastectomy.

Methods
The study was conducted in the surgical oncology unit at Alexandria Main University Hospital included 103 patients with a mean age of 27 and no medical history. 100 patients had bilateral gynecomastia, and three patients had unilateral gynecomastia,with two having it on the right side and one on the left.

Results
Among the 103 participants, 83 had grade II gynecomastia and 20 had grade I. Only one of the three patients who participated in the study had an expanding hematoma on one side that needed to be surgically evacuated in the operating room. None of our patients experienced an infection or seroma following surgery. Furthermore, only three of our patients experienced nipple areolar complicated superficial epidermolysis, which need regular dressings until recovery. Of the 103 patients, 97 (94.17%) were pleased with the outcomes.

Conclusion
Liposuction and port site nipple sparing mastectomy are viable options for treating grade I to II gynecomastia, particularly if the patient prefers a more aesthetically pleasing chest contour; no scars equals better patient satisfaction.

Trial registration
retrospectively registered.