bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic markers of short and long-term exogenous DL-beta-hydroxybutyrate supplementation in episodic migraine patients: an exploratory analysis of a randomized-controlled-trial
Authors: Putananickal Niveditha , Gross Elena C. , Orsini Anna-Lena , Schmidt Simone , Hafner Patricia , Gocheva Vanya , Nagy Sara , Henzi Bettina C. , Rubino Daniela , Schädelin Sabine , Sandor Peter , Fischer Dirk 
Published: May 2023

Background: Emerging findings propose that the pathophysiology of migraine may be associated with dysfunctional metabolic mechanisms. Recent findings suggest that migraine attacks are a response to the cerebral energy deficit, and ingestion of ketone bodies stabilizes the generation of a migraine attack. Based on these findings, ketone body supplementation is postulated as a prophylactic treatment approach to restore cerebral metabolism deficiency. Metabolic markers are unexplored after exogenous ketone body supplementation in episodic migraineurs. Therefore, the present single-arm uncontrolled explorative analysis evaluated blood ketone body and glucose concentration after short and long-term 6 g exogenous DL-Mg-Ca-beta-hydroxybutyrate (DL-βHB) supplementation.Methods: The presented data are part of the MigraKet randomized-control cross-over clinical trial of 41 episodic migraineurs (Number NCT03132233). Patients were given a single dose of 6 g DL-βHB. Ketone body and glucose blood concentration were assessed before intake, 20, and 40 min after DL-βHB intake. Ketone body, glucose concentration and glycated hemoglobin values were evaluated after 12 weeks of 18 g DL-βHB ingestion (total dose), taken three times daily (6g/dose; 3x/day). Linear models explored the association between the ketone body and glucose levels.Results: Ketone body concentration increased within-group to a mean of 0.46 (0.30) mmol/L after 40 min post- DL-βHB supplementation [estimate = 0.24 mmol/L, CI = (0.20.0.27), p &lt; 0.01]. This within-group increase of ketone body concentration did not change after repeated daily intake of DL-βHB supplementation over 12 weeks [estimate = 0.00 mmol/L, CI = (−0.03.0.04), p = 0.794]. DL-βHB intake significantly reduced blood glucose concentration within-group from a mean baseline of 4.91 (0.42) mmol/L to 4.75 (0.47) mmol/L 40 min post-DL-βHB supplementation [estimate = −0.16 mmol/L, CI = (−0.15, 0.03), p &lt; 0.01]. Repeated DL-βHB supplementation for 12 weeks showed no change within-group in acute ketone bodies concentration [estimate = 0.00 mmol/L, CI = (−0.03.0.04), p = 0.794] and in the HbA1c value [estimate = 0.02, CI = (−0.07.0.11), p = 0.69].Conclusion: A single dose of 6 g DL-βHB significantly elevated blood ketone bodies and decreased blood glucose concentration within-group in episodic migraineurs. Long-term DL-βHB supplementation for 12 weeks showed no effect within-group on acute ketone body concentration and had not impact on HbA1c. The elevation of the ketone body concentration was moderate, indicating that nutritional ketosis was not reached. Therefore, a dose higher than 6 g of DL-βHB is required to reach the nutritional level of ketosis. ClinicalTrials.gov Identifier: NCT03132233.
Longitudinal links between maternal directives, children’s engagement in family conversations, and child linguistic skills
Authors: Tulviste Tiia , Tamm Anni 
Published: May 2023

BackgroundResearch on mother–child verbal interaction is largely inspired by Vygotsky. The results align with his view that children acquire language and culture-specific ways of using language through actively participating in daily conversations with adults. Supporting Vygotsky’s concept of the Zone of Proximal Development, the facilitative features of such conversations have been found to depend on age, the level of the child’s language skills, and the interactional context. Most previous studies in the field have been conducted in English-speaking Western families with a focus on the first years of children’s lives. As Estonian middle-class mothers have been found to put greater emphasis on controlling children than mothers from other cultural contexts, we included the frequency of using directives as one of the features of mothers’ speech that might have an impact on child language development.AimAccordingly, the current study explored the relative impact of various aspects of mother–child interaction (e.g., mothers’ vocabulary diversity, use of attentional and behavioral directives, wh-questions, and the amount of children’s talk) on children’s language skills using data collected from Estonian middle-class families at two timepoints, 1 year apart. As a novel approach to this topic, the study also examined the correlation between mothers’ input features and children’s participation in the parent–child conversation.MethodA total of 87 children aged 3;0 and 4;0 and their mothers participated in the study. We observed the mother–child interactions during a semistructured videotaped game played at home. Mothers reported their children’s language skills via the ECDI-III. Children’s language comprehension and production were measured using the examiner-administered NRDLS.Results and conclusionAlthough the results showed somewhat differential effects of various aspects of mothers’ speech on different measures of child language skills at two timepoints, the diversity of mothers’ speech was positively, and mothers’ frequent use of directives negatively related to children’s language skills. At both ages, the diversity of mothers’ speech predicted the amount of children’s verbal contribution to conversations. The findings will be discussed in light of Vygotskian and his followers’ theoretical views and theories about child language development.
Plasma neurofilament light chain protein is not increased in forensic psychiatric populations: a pilot study
Authors: Fernqvist Anja , Alexiou Eirini , Zetterberg Henrik , Howner Katarina , Nilsson Thomas , Andiné Peter 
Published: May 2023

IntroductionNeurofilament light chain protein (NfL) is a fluid biomarker of neural injury measurable in cerebrospinal fluid and blood. Patients with different neurodegenerative disorders and mild traumatic brain injury display elevated levels of NfL. However, so far, elevated levels of NfL have not been demonstrated in persons with psychiatric disorders. To our knowledge, the occurrence of NfL in the blood has not previously been studied in persons undergoing forensic psychiatric assessment or persons treated in forensic mental health services. Supposedly, these persons suffer from experiences and conditions with a higher risk of neural injury than other psychiatric patients.MethodsIn this pilot study, we investigated plasma levels of NfL in 20 persons undergoing forensic psychiatric assessment and 20 patients at a forensic psychiatric hospital. NfL values were compared with control groups of healthy individuals matched for age and sex.ResultsThe prevalence of increased NfL in both forensic groups was low and did not differ compared with the controls. However, some persons undergoing forensic psychiatric assessment showed slightly elevated values.DiscussionThe slightly elevated values were observed in the group investigated closer in time to the index crime, when elevated NfL levels could be expected to be more prevalent due to acute conditions from the time of the offense. This gives reason to look further into this group.
Treatment cost assessment for COVID-19 inpatients in Shenzhen, China 2020–2021: facts and suggestions
Authors: Yuan Shasha , Li Ting , Chu Cordia , Wang Xiaowan , Liu Lei 
Published: May 2023

BackgroundKnowledge regarding the treatment cost of coronavirus disease 2019 (COVID-19) in the real world is vital for disease burden forecasts and health resources planning. However, it is greatly hindered by obtaining reliable cost data from actual patients. To address this knowledge gap, this study aims to estimate the treatment cost and specific cost components for COVID-19 inpatients in Shenzhen city, China in 2020–2021.MethodsIt is a 2 years' cross-sectional study. The de-identified discharge claims were collected from the hospital information system (HIS) of COVID-19 designated hospital in Shenzhen, China. One thousand three hundred ninety-eight inpatients with a discharge diagnosis for COVID-19 from January 10, 2020 (the first COVID-19 case admitted in the hospital in Shenzhen) to December 31, 2021. A comparison was made of treatment cost and cost components of COVID-19 inpatients among seven COVID-19 clinical classifications (asymptomatic, mild, moderate, severe, critical, convalescent and re-positive cases) and three admission stages (divided by the implementation of different treatment guidelines). The multi-variable linear regression models were used to conduct the analysis.ResultsThe treatment cost for included COVID-19 inpatients was USD 3,328.8. The number of convalescent cases accounted for the largest proportion of all COVID-19 inpatients (42.7%). The severe and critical cases incurred more than 40% of treatment cost on western medicine, while the other five COVID-19 clinical classifications spent the largest proportion (32%−51%) on lab testing. Compared with asymptomatic cases, significant increases of treatment cost were observed in mild cases (by 30.0%), moderate cases (by 49.2%), severe cases (by 228.7%) and critical cases (by 680.7%), while reductions were shown in re-positive cases (by 43.1%) and convalescent cases (by 38.6%). The decreasing trend of treatment cost was observed during the latter two stages by 7.6 and 17.9%, respectively.ConclusionsOur findings identified the difference of inpatient treatment cost across seven COVID-19 clinical classifications and the changes at three admission stages. It is highly suggestive to inform the financial burden experienced by the health insurance fund and the Government, to emphasize the rational use of lab tests and western medicine in the COVID-19 treatment guideline, and to design suitable treatment and control policy for convalescent cases.
Assessment of disaster preparedness and related impact factors among emergency nurses in tertiary hospitals: descriptive cross-sectional study from Henan Province of China
Authors: Zhang Jiange , Yang Lei , Cao Xue , Ren Ying , Han Xu , Zang Shuting , Cai Fangfang , Xu Lijun , Qin Lijie , Zhang Peirong , Cheng Yanwei 
Published: May 2023

BackgroundThe aim of this study was to investigate the current state of disaster preparedness and to determine associated factors among emergency nurses from tertiary hospitals in Henan Province of China.MethodsThis multicenter descriptive cross-sectional study was conducted with emergency nurses from 48 tertiary hospitals in Henan Province of China between September 7, 2022–September 27, 2022. Data were collected through a self-designeds online questionnaire using the mainland China version of the Disaster Preparedness Evaluation Tool (DPET-MC). Descriptive analysis and multiple linear regression analysis were used to evaluate disaster preparedness and to determine factors affecting disaster preparedness, respectively.ResultsA total of 265 emergency nurses in this study displayed a moderate level of disaster preparedness with a mean item score of 4.24 out 6.0 on the DPET-MC questionnaire. Among the five dimensions of the DPET-MC, the mean item score for pre-disaster awareness was highest (5.17 ± 0.77), while that for disaster management (3.68 ± 1.36) was the lowest. Female gender (B = −9.638, p = 0.046) and married status (B = −8.618, p = 0.038) were negatively correlated with the levels of disaster preparedness. Five factors positively correlated with the levels of disaster preparedness included having attended in the theoretical knowledge training of disaster nursing since work (B = 8.937, p = 0.043), having experienced the disaster response (B = 8.280, p = 0.036), having participated in the disaster rescue simulation exercise (B = 8.929, p = 0.039), having participated in the disaster relief training (B = 11.515, p = 0.025), as well as having participated in the training of disaster nursing specialist nurse (B = 16.101, p = 0.002). The explanatory power of these factors was 26.5%.ConclusionEmergency nurses in Henan Province of China need more education in all areas of disaster preparedness, especially disaster management, which needs to be incorporated into nursing education, including formal and ongoing education. Besides, blended learning approach with simulation-based training and disaster nursing specialist nurse training should be considered as novel ways to improve disaster preparedness for emergency nurses in mainland China.
Association between perfluoroalkyl and polyfluoroalkyl internal exposure and serum α-Klotho levels in middle-old aged participants
Authors: Li Min , Ma Yuanlin , Cheng Wenli , Zhang Luyun , Zhou Cheng , Zhang Wenji , Zhang Wenjuan 
Published: May 2023

PurposeExposure to perfluoroalkyl and polyfluoroalkyl substances causes oxidative stress, which is strongly associated with adverse health effects. Klotho protein plays an anti-aging role via antioxidation activity.MethodsWe investigated the levels of serum α-Klotho and PFAS exposure in adults who participated in the National Health and Nutrition Examination Survey from 2013 to 2016. A nationally representative subsample of 1,499 adults aged 40–79 years was analyzed for the associations of serum α-Klotho levels with serum PFAS exposures by correlation analysis and multiple general linear models. Of note, the potential confounding factors including age and gender were adjusted. Quantile-based g-computation models were used to assess the effects of mixed PFAS exposure on serum α-Klotho levels.ResultsThe weighted geometric mean of serum α-Klotho was 791.38 pg/mL for the subjects during 2013–2016. After adjusting for potential confounders, serum Klotho levels showed a statistically significant downward trend with increasing quartiles of PFOA and PFNA. Multivariate adjusted general linear regression analysis showed that increased exposure to PFNA was substantially associated with lower serum levels of α-Klotho, and each 1-unit increase in PFNA concentration was accompanied by a 20.23 pg/mL decrease in α-Klotho level; while no significant association was observed between other PFAS exposures and serum α-Klotho levels. It was negatively correlated between α-Klotho and Q4 for PFNA relative to the lowest quartile (Q1) of exposure (P = 0.025). It was found that the strongest negative correlation between PFNA exposure and serum α-Klotho levels was in the middle-aged (40–59 years) female participants. Furthermore, the mixture of the four PFAS substances showed an overall inverse association with serum α-Klotho concentrations, with PFNA being the major contributor.ConclusionsTaken together, in a representative sample of the U.S. middle-aged and elderly populations, serum concentrations of PFAS, especially PFNA, have been negatively associated with serum levels of α-Klotho, which is strongly associated with cognition and aging. It was important to note that the majority of associations were limited to middle-aged women. It will be meaningful to clarify the causal relationship and the pathogenic mechanisms of PFAS exposure and α-Klotho levels, which is helpful to aging and aging-related diseases.
Factors related to the appearance and development of burnout in nursing students: a systematic review and meta-analysis
Authors: Velando-Soriano Almudena , Suleiman-Martos Nora , Pradas-Hernández Laura , Membrive-Jiménez María José , Ramírez-Baena Lucia , Gómez-Urquiza Jose L. , Cañadas-De La Fuente Guillermo Arturo 
Published: May 2023

IntroductionBurnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are exposed to various stress-producing situations.AimThe aim of this study is to identify and analyse the main risk factors for burnout among nursing students.MethodsA systematic review with meta-analysis was performed. The search equation used was “Burnout AND Nursing students”. Quantitative primary studies on burnout in nursing students, and related risk factors published in English or Spanish and with no restriction by year of publication were included.ResultsA sample of n = 33 studies were included. Three variables are identified can influence burnout in nursing students: academic, interpersonal, environmental and/or social factors. The meta-analyses, with the higher sample of n = 418 nursing students, show that some personality factors, empathy, and resilience are correlated with emotional exhaustion, depersonalization and personal accomplishment.ConclusionThe personality factors that can influence the development of burnout in nursing students, such as resilience and empathy, among others, must be taken into account when preventing the appearance and treating burnout. Professors should teach nursing students to prevent and recognize the most frequent symptoms of burnout syndrome.
Analyses of hospitalization in Alzheimer's disease and Parkinson's disease in a tertiary hospital
Authors: Chen Sihui , Fu Jiajia , Lai Xiaohui , Huang Yan , Bao Ting , Chen Xueping , Shang Huifang 
Published: May 2023

BackgroundTo characterize the pattern of hospitalization in patients with Alzheimer's disease (AD) or Parkinson's disease (PD), and compare the differences to see whether AD patients and PD patients have a different picture of hospitalization.MethodsThe clinical features of all consecutive patients from January 2017 to December 2020 were reviewed. We identified AD patients and PD patients from an electronic database in a tertiary medical center.ResultsThe study group comprised 995 AD patients and 2,298 PD patients who were admitted to the hospital for the first time, and re-hospitalized 231 AD patients and 371 PD patients were also included. AD patients were older than PD patients when they were hospitalized (p &lt; 0.001). AD patients had longer lengths of stay, higher re-hospitalization rates, and higher intrahospital mortality rates than PD patients during hospitalization even after adjusting age and gender. PD patients had higher levels of total cost than AD patients due to the cost of the deep brain stimulation (DBS) insertion. Hospitalizations for AD patients occurred most often in the department of geriatrics, while most PD patients were admitted to the department of neurology. Hospitalization due to the presence of comorbid conditions was much higher in AD patients, but a larger proportion of PD patients were hospitalized due to PD disease itself.ConclusionsThe present study found that AD patients and PD patients have a significantly different picture of hospitalization. It is important to implement different management for hospitalized AD and PD, and different emphasis should be given when establishing primary prevention strategies, informing care needs, and guiding healthcare resource planning.
Balancing sensory inputs: somatosensory reweighting from proprioception to tactile sensation in maintaining postural stability among older adults with sensory deficits
Authors: Liu Ziyin , Wang Qi , Sun Wei , Song Qipeng 
Published: May 2023

BackgroundSensory deficits increase the risk of falls among older adults. The purpose of this study was to investigate the correlations of lower extremity muscle strength, proprioception, and tactile sensation to postural stability among older adults with and without sensory deficits, to understand the contribution of each factor to postural stability, and to explore sensory reweighting among the two populations.MethodsA total of 103 participants were recruited and divided into two older adult groups with (female = 24, male = 26, age = 69.1 ± 3.15 years, height = 162.72 ± 6.94 cm, body mass = 64.05 ± 9.82 kg) and without sensory deficits (female = 26, male = 27, age = 70.02 ± 4.9 years, height = 163.76 ± 7.60 cm, body mass = 65.83 ± 10.31 kg), based on whether a 5.07 Semmes–Weinstein monofilament could be detected at foot soles. Their Berg Balance Scale (BBS), lower extremity muscle strength, proprioception, and tactile sensation were tested and compared between the two groups. Pearson's or Spearman's correlations were used to explore the relationships between the BBS and each variable. Factor analysis and multivariate linear regression were used to verify the degrees of correlation between the generated factors and the postural stability.ResultsLow BBS (p = 0.003, η2 = 0.088) scores and higher proprioception thresholds (knee flexion: p = 0.015, η2 = 0.059; knee extension: p = 0.011, η2 = 0.065; ankle plantarflexion: p = 0.006, η2 = 0.075; ankle dorsiflexion: p = 0.001, η2 = 0.106) were detected among older adults with sensory deficits compared with those without sensory deficits. Lower extremity muscle strength (ankle plantarflexion: r = 0.342, p = 0.002; hip abduction: r = 0.303, p = 0.041) and proprioception (knee flexion: r = −0.419, p = 0.004; knee extension: r = −0.292, p = 0.049; ankle plantarflexion: r = −0.450, p = 0.002; ankle dorsiflexion: r = −0.441, p = 0.002) were correlated with BBS among older adults without sensory deficits, while lower extremity muscle strength (ankle plantarflexion: r = 0.501, p&lt;0.001; hip abduction: r = 0.302, p = 0.041) and tactile sensation (great toe: r = −0.388, p = 0.008; 5th metatarsal: r = −0.301, p = 0.042) were correlated with BBS among older adults with sensory deficits.ConclusionOlder adults with sensory deficits have poorer proprioception and postural stability. Somatosensory reweighting occurs from proprioception to tactile sensation among older adults with sensory deficits in maintaining postural stability.
Psychosocial Attributes of Housing and Their Relationship With Health Among Refugee and Asylum-Seeking Populations in High-Income Countries: Systematic Review
Authors: Brake Tessa-Maria , Dudek Verena , Sauzet Odile , Razum Oliver 
Published: May 2023

Objectives: Housing as a social determinant of health should provide not only shelter, but also a feeling of home. We explored psychosocial pathways creating a sense of home and influencing the relationship between housing and health among asylum seekers and refugees (ASR) in high-income countries.Methods: We performed a systematic review. To be included, studies had to be peer-reviewed, published between 1995 and 2022, and focus on housing and health of ASR in high-income countries. We conducted a narrative synthesis.Results: 32 studies met the inclusion criteria. The psychosocial attributes influencing health most often identified were control, followed by expressing status, satisfaction, and demand. Most attributes overlap with material/physical attributes and have an impact on ASR’s mental health. They are closely interconnected with each other.Conclusion: Psychosocial attributes of housing play an essential role in the health of ASR; they are closely associated with material/physical attributes. Therefore, future research on housing and health of ASR should routinely study psychosocial attributes, but always in association with physical ones. The connections between these attributes are complex and need to be further explored.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42021239495.