bluuebunny/crossref_metadata_2025_split huggingface dataset:
3-day intervention program for family members of hikikomori sufferers: A pilot randomized controlled trial
Authors: Kubo Hiroaki , Urata Hiromi , Sakai Motohiro , Nonaka Shunsuke , Kishimoto Junji , Saito Kazuhiko , Tateno Masaru , Kobara Keiji , Fujisawa Daisuke , Hashimoto Naoki , Suzuki Yuriko , Honda Yoko , Nakao Tomohiro , Otsuka Kotaro , Kanba Shigenobu , Kuroki Toshihide , Kato Takahiro A. 
Published: January 2023

BackgroundsHikikomori, pathological social withdrawal, is becoming a crucial mental health issue in Japan and worldwide. We have developed a 3-day family intervention program for hikikomori sufferers based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). This study aims to confirm the effectiveness of the 3-day program by a randomized controlled trial.MethodsThis study was registered on the UMIN Clinical Trials Registry (UMIN000037289). Fifteen parents were assigned to the treat as usual (TAU) group (TAU only; Age Mean, 65.6; SD, 7.8), and 14 to the Program group (program + TAU; Age Mean, 67.9; SD, 8.6). This study was discontinued due to the COVID-19 pandemic; the recruitment rate was 36.3% of our target sample size of 80.ResultsPerceived skills improved temporally and stigma temporally worsened in the TAU group. Confidence decreased and attitude showed no change in both groups. Aggressive behaviors of hikikomori sufferers were significantly worsened in the Program group; however, no serious domestic violence was reported. In the TAU group, Avoidance and irregular life patterns were improved. Activity levels were worsened in both groups. Two participants (16.7%) in the Program group and one participant (7.7%) in the TAU group reported actual behavioral changes (e.g., utilizing support).ConclusionWe could not draw general conclusions on the effectiveness of the program due to the study discontinuation. Nevertheless, this study indicates the necessity for revision of the program to improve family members’ confidence in engaging with hikikomori sufferers, with safer approaching by families.
Prevalence and effects of sleep-disordered breathing on middle-aged patients with sedative-free generalized anxiety disorder: A prospective case-control study
Authors: Chen Tien-Yu , Kung Yen-Ying , Lai Hsiao-Ching , Lee Li-Ang , Jen I-An , Chang Hsin-An , Liu Chia-Yu , Kuo Terry B. J. , Yang Cheryl C. H. 
Published: January 2023

ObjectiveGeneralized anxiety disorder (GAD) and sleep-disordered breathing (SDB) share similar symptoms, such as poor sleep quality, irritability, and poor concentration during daily activities. This study aims to investigate the proportion of undiagnosed SDB and its impacts on anxiety severity and autonomic function in newly diagnosed, sedative-free GAD patients.MethodsThis prospective case-control study included newly diagnosed GAD patients and control participants with matched age, sex, and body mass index (BMI) in Taiwan. All participants completed questionnaires for sleep and mood symptoms and a resting 5-min heart rate variability (HRV) examination during enrollment. The participants also used a home sleep apnea test to detect SDB. An oxygen desaturation index (ODI) ≥ 5 was considered indicative of SDB.ResultsIn total, 56 controls and 47 newly diagnosed GAD participants (mean age 55.31 ± 12.36 years, mean BMI 23.41 ± 3.42 kg/m2) were included. There was no significant difference in the proportion of undiagnosed SDB in the control and sedative-free GAD groups (46.43 vs. 51.06%). Sedative-free GAD patients with SDB scored significantly higher on Beck Anxiety Inventory (23.83 ± 11.54) than those without SDB (16.52 ± 10.61) (p &lt; 0.001). Both control and sedative-free GAD groups with SDB had worse global autonomic function than the control group without SDB, as evidenced by the HRV results (p &lt; 0.05 for all).ConclusionAverage age 55 years and mean BMI 23 kg/m2 patients with GAD and matched controls had an undiagnosed SDB prevalence of approximately 50%. SDB correlated with worsening anxiety severity and reduced cardiac autonomic function. Moreover, age and BMI were considered major risk factors for predicting undiagnosed SDB.
Experiencing COVID-19, home isolation and primary health care: A mixed-methods study
Authors: Parisi Sandra , Lehner Nina , Schrader Hanna , Kierer Leonard , Fleischer Anna , Miljukov Olga , Borgulya Gabor , Rüter Gernot , Viniol Annika , Gágyor Ildikó 
Published: January 2023

ObjectivesAlthough the vast majority of COVID-19 cases are treated in primary care, patients' experiences during home isolation have been little studied. This study aimed to explore the experiences of patients with acute COVID-19 and to identify challenges after the initial adaptation of the German health system to the pandemic (after first infection wave from February to June 2020).MethodsA mixed-method convergent design was used to gain a holistic insight into patients experience. The study consisted of a cross-sectional survey, open survey answers and semi-structured telephone interviews. Descriptive analysis was performed on quantitative survey answers. Between group differences were calculated to explore changes after the first infection wave. Qualitative thematic analysis was conducted on open survey answers and interviews. The results were then compared within a triangulation protocol.ResultsA total of 1100 participants from all German states were recruited by 145 general practitioners from August 2020 to April 2021, 42 additionally took part in qualitative interviews. Disease onset varied from February 2020 to April 2021. After the first infection wave, more participants were tested positive during the acute disease (88.8%; 95.2%; P &lt; 0.001). Waiting times for tests (mean 4.5 days, SD 4.1; 2.7days, SD 2.6, P &lt; 0.001) and test results (mean 2.4 days, SD 1.9; 1.8 days, SD 1.3, P &lt; 0.001) decreased. Qualitative results indicated that the availability of repeated testing and antigen tests reduced insecurities, transmission and related guilt. Although personal consultations at general practices increased (6.8%; 15.5%, P &lt; 0.001), telephone consultation remained the main mode of consultation (78.5%) and video remained insignificant (1.9%). The course of disease, the living situation and social surroundings during isolation, access to health care, personal resilience, spirituality and feelings of guilt and worries emerged as themes influencing the illness experience. Challenges were contact management and adequate provision of care during home isolation. A constant contact person within the health system helped against feelings of care deprivation, uncertainty and fear.ConclusionsOur study highlights that home isolation of individuals with COVID-19 requires a holistic approach that considers all aspects of patient care and effective coordination between different care providers.
Continuous voluntary community care services for older people in China: Evidence from Wuhu
Authors: Xin Ying , An Jianzeng , Xu Jia 
Published: January 2023

IntroductionChina has limited formal care services and weak unpaid informal care support for older people, which has caused a care service shortage for them. Voluntary community care services are thus a type of formal care service that aims to meet older people's unmet care needs. However, the continuity of such voluntary community care services is important for the degree to which these unmet care needs of older people can be satisfied. Therefore, this study examines what motivates volunteers to provide voluntary community care services for older people in China. It argues that providing continuous voluntary community care services can be motivated by the interaction of volunteers' internal and external motivations.MethodsThis study employs the grounded theory approach, including open coding, axial coding, selective coding, and saturation testing, and derives the data from 15 semi-structured interviews with volunteers from September to December 2021 in Wuhu, China.ResultsThe analysis identifies three internal motivations (altruism, social interaction, and self-fulfillment) and three external motivations (social support, standardized management, and relevant benefits) as well as the interaction between them as factors that impact volunteers' willingness to offer continuous voluntary community care services for older people.DiscussionThe study's findings highlight the impact of continuous volunteering on society, which is significant to provide voluntary community care services for older people. It thus contributes to the development of China's care policy and future care supply services as well as serves as a reference for care development models in other welfare states, particularly in places where both formal and informal care are underdeveloped such as China.
Partnerships supporting policies: A social marketing case study of mask supply solutions in South Korea during the COVID-19 pandemic
Authors: Paek Hye-Jin , Hove Thomas 
Published: January 2023

BackgroundSouth Korea was one of the first countries to experience a large outbreak of COVID-19. Early on, public health authorities recommended mask wearing as one of the main preventive measures against the virus. Compared to people in other countries, most South Koreans were willing to follow this recommendation. However, during the early stages of the pandemic, panic buying and vendor hoarding led to a nationwide mask shortage. The problem that needed to be solved was not to change the public's behavior but rather to make masks more available to them.Case descriptionTo stabilize mask supply and demand, the South Korean government implemented a distribution system that limited mask purchases to two per person per week, in a 5-day rotation determined by birth year. The places designated for selling masks included pharmacies, post offices, and marts that had access to data about registered South Korea residents who had and had not bought their allotted masks. Despite this system, supply problems persisted. In different regions of the country, population density and demand varied, and some pharmacies sold out their stocks of masks earlier than others. Recognizing that people needed a more effective system for finding masks, the government made mask inventory data available to companies and the general public. Three weeks later, about 200 mask apps and web services had been launched. Supplies of masks quickly stabilized, and people could more easily find and buy them. In addition, pharmacies were able to sell out their stocks of masks more efficiently.ConclusionThe South Korean case of mask demand and distribution during COVID-19 illustrates how all six of the social marketing components (policy, supplemented by products, price, place, promotion, and partnerships) need to be coordinated for effective mitigation of infectious disease. In particular, this case highlights the importance of public-private partnerships among the government, production companies, retailers, and members of the general public.
Public health risk associated with the co-occurrence of aflatoxin B1 and ochratoxin A in spices, herbs, and nuts in Lebanon
Authors: Daou Rouaa , Hoteit Maha , Bookari Khlood , Joubrane Karine , Khabbaz Lydia Rabbaa , Ismail Ali , Maroun Richard G. , Khoury André el 
Published: January 2023

BackgroundAflatoxin B1 and ochratoxin A are mycotoxins produced by filamentous fungi that attack crops on field and storage. Both mycotoxins present a risk on public health since aflatoxin B1 is a hepatotoxic and hepatocarcinogenic agent while ochratoxin A can be nephrotoxic. Those mycotoxins can be found in several food items including spices, herbs, and nuts.ObjectivesIn Lebanon, few studies address aflatoxin B1 and ochratoxin A contamination in spices, herbs, and nuts. So, the aim of this study is to investigate the concentrations of those two mycotoxins particularly in spices and herbs and the concentration of aflatoxin B1 in nuts, and to determine the dietary exposure of the Lebanese population and their possible attribution to liver cancer and renal damage.MethodsIn this work, a total of 198 samples of spices, herbs, and nuts were collected from different sites. Aflatoxin B1 and ochratoxin A were quantified using immune-affinity columns. A food frequency questionnaire was used to quantify the consumption of spices, herbs, and nuts in Lebanon. Exposure to aflatoxin B1 and ochratoxin A was calculated accordingly and liver and kidney cancer risks were evaluated.ResultsAflatoxin B1 was respectively found in 100, 20.4, and 98.6% of the spices, herbs, and nuts samples, while ochratoxin A was found in 100 and 44.4% of spices and herbs, respectively. Aflatoxin B1 was found at mean concentration of 0.97, 0.27, and 0.40 μg/kg in spices, herbs, and nuts, respectively while ochratoxin A was found at mean concentrations of 38.8 and 1.81 μg/kg in spices and herbs, respectively. Aflatoxin B1 occurrence was shown to be associated in this study with 0.017 additional cancer cases per 100,000 persons per year, and ochratoxin A weekly exposure was shown to be 5.04 ng/kg bw less than the Provisional Tolerable Weekly Intake of 100 ng/kg bw which indicates low risk of renal damage from spices and herbs consumption.ConclusionThe consumption of spices, herbs, and nuts in Lebanon could lead to an increase in health risks associated with aflatoxin B1 and ochratoxin A, specifically spices. The reported occurrence may be directly related to poor storage conditions.
Association between sarcopenia and cognitive function in older Chinese adults: Evidence from the China health and retirement longitudinal study
Authors: Du Hongzhen , Yu Miao , Xue Hongmei , Lu Xuning , Chang Yaping , Li Zengning 
Published: January 2023

BackgroundSarcopenia and cognitive impairment are the most common causes of disability in the aging population. The potential role of sarcopenia in the development of cognitive impairment remains poorly understood. A cross-sectional analysis was performed using nationally representative data to evaluate associations between sarcopenia and cognition in China.MethodsWe included 2,391 participants (35.63% female) who were at least 60 years of age in 2015 from the China Health and Retirement Longitudinal Study (CHARLS). Muscle strength, appendicular skeletal mass (ASM), and physical performance measurements, were measured to diagnose sarcopenia according to the Asian Working Group for Sarcopenia 2019 (AWGS2019). Cognitive function was assessed by 10 items in the Telephone Interview for Cognitive Status (TICS-10), delayed word recall, and graph drawing. Based on cognitive score tertiles, data were divided into three groups. Multiple linear and logistic regression models were used to assess the relationship between sarcopenia and cognition.ResultsThe prevalence of possible sarcopenia was 27.16% for men and 27.46% for women. Cognitive decline was significantly associated with sarcopenia status (β = −0.88, p &lt; 0.001) and negatively associated with components of sarcopenia in male group. The results remained consistent in male after further adjusting for creatinine, uric acid, blood sugar, etc. Low cognitive function in female was only associated with low muscle strength (β = −0.85, p = 0.02). In addition, participants with possible sarcopenia had greater risk of cognitive decline than those without sarcopenia (OR = 1.41; 95% CI: 1.06–1.87). However, the same association was not significant in female group.ConclusionWe suggest that sarcopenia might be associated with cognition function, with possible sarcopenia being significantly associated with higher cognition risk in China population, which providing a further rationale for timely recognition and management of sarcopenia.
Country score tool to assess readiness and guide evidence generation of immunization programs in aging adults in Europe
Authors: Pham Thi Hao , Beck Ekkehard , Postma Maarten J. , Németh Bertalan , Ágh Tamás , de Waure Chiara , Salisbury David M. , Nutma Nynke , van der Schans Jurjen 
Published: January 2023

ObjectivesDelaying of policies for immunization of aging adults, low vaccine uptake, and the lack of supportive evidence at the national level could diminish the value in health and economics of such programs. This study aims to develop a “country score tool” to assess readiness and to facilitate evidence generation for aging adult immunization programs in Europe, and examine the comprehensiveness, relevance, acceptability, and feasibility of the tool.MethodsThe tool was developed in two phases. First, a modified Delphi process was used to construct the tool. The process included a literature review, stakeholder consultations, and a three-round Delphi study. The Delphi panel included researchers, supra-national and national decision-makers of immunization programs recruited from five countries, using snowball sampling method. The consensus was predefined at the agreement rate of 70%. Pilot testing of the tool was conducted in the Netherlands, Germany, Serbia, and Hungary involving researchers in the field of health technology assessment. After assessing the countries' readiness, researchers evaluated four features, namely comprehensiveness, relevance, acceptability, and feasibility of the tool via an online survey that included 5-scale Likert questions. The percentages of affirmative answers including “agree” and “totally agree” choices were presented.ResultsThe review identified 16 tools and frameworks that formed the first version of our tool with 14 items. Eight experts were involved in the Delphi panel. Through three Delphi rounds, four items were added, one was dropped, and all others were amended. The consensus was achieved on the tool with 17 items divided into decision-making and implementation parts. Each item has a guiding question, corresponding to explanations and rationales to inform assessment with readiness scores. Eight researchers completed the pilot testing. The tool was rated as comprehensive (75%), relevant (100%), acceptable (75%), and feasible (88%) by participants.ConclusionThrough a thorough and transparent process, a country score tool was developed helping to identify strengths, weaknesses, and evidential requirements for decision-making and implementation of immunization programs of aging adults. The tool is relevant for different European contexts and shows good comprehensiveness, acceptability, and feasibility.
Prognostic accuracy of the one-legged balance test in predicting falls: 15-years of midlife follow-up in a British birth cohort study
Authors: Blodgett Joanna M. , Hardy Rebecca , Davis Daniel H. J. , Peeters Geeske , Hamer Mark , Kuh Diana , Cooper Rachel 
Published: January 2023

IntroductionThe one-legged balance test is a common screening tool for fall risk. Yet, there is little empirical evidence assessing its prognostic ability. The study aims were to assess the prognostic accuracy of one-legged balance performance in predicting falls and identify optimal cut-points to classify those at greater risk.MethodsData from up to 2,000 participants from a British birth cohort born in 1,946 were used. The times an individual could stand on one leg with their eyes open and closed were recorded (max: 30 s) at ages 53 and 60–64. Number of falls in the past year was self-reported at ages 53, 60–64 and 68; recurrent falls (0–1 vs. 2+) and any fall (0 vs. 1+) were considered binary outcomes. Four longitudinal associations between balance times and subsequent falls were investigated (age 53 → 60–64; age 53 → 68; age 60–64 → 68; age 53 &amp; 60–64 → 68). For each temporal association, areas under the curve (AUC) were calculated and compared for a base sex-only model, a sex and balance model, a sex and fall history model and a combined model of sex, balance and fall history. The Liu method was used to identify optimal cut-points and sensitivity, specificity, and AUC at corresponding cut-points.ResultsMedian eyes open balance time was 30 s at ages 53 and 60–64; median eyes closed balance times were 5 s and 3 s, respectively. The predictive ability of balance tests in predicting either fall outcome was poor (AUC range for sex and balance models: 0.577–0.600). Prognostic accuracy consistently improved by adding fall history to the model (range: 0.604–0.634). Optimal cut-points ranged from 27 s to 29 s for eyes open and 3 s to 5 s for eyes closed; AUC consistently indicated that using “optimal” cut-points to dichotomise balance time provided no discriminatory ability (AUC range:0.42–0.47), poor sensitivity (0.38–0.61) and poor specificity (0.23–0.56).DiscussionDespite previous observational evidence showing associations between better one-legged balance performance and reduced fall risk, the one-legged balance test had limited prognostic accuracy in predicting recurrent falls. This contradicts ongoing translation of this test into clinical screening tools for falls and highlights the need to consider new and existing screening tools that can reliably predict fall risk.
Cassava yield gap—A model-based assessment in Nigeria
Authors: Srivastava Amit Kumar , Ewert Frank , Akinwumiju Akinola Shola , Zeng Wenzhi , Ceglar Andrej , Ezui Kodjovi Senam , Adelodun Adedeji , Adebayo Abass , Sobamowo Jumoke , Singh Manmeet , Rahimi Jaber , Gaiser Thomas 
Published: January 2023

IntroductionCassava production is essential for food security in sub-Saharan Africa and serves as a major calorie-intake source in Nigeria. Estimating the yield gap in Nigeria is essential to indicate the most important limiting factors for production, and identify the yield gap hotspot areas. Secondly, these assessments may help set agendas in policy development and research prioritization where current information is scarce.Materials and methodsHere, Wwe used a crop model, LINTUL5, calibrated for five different cassava varieties based on field experiments embedded into a modeling framework SIMPLACE to estimate potential, water- and nutrient (current) limited cassava yield gaps (YG) as affected by climate factors and contributing a better understanding of yield gaps and its potentials in 30 states of Nigeria.ResultsOur study shows that cumulative radiation and precipitation were the most significant factors associated with cassava yield variability (p &lt; 0.01). The YG averaged across states was estimated as 18.2 Ton7ha-1, with a maximum of 31.2 Ton7ha-1 35 in Kano state. Across the states, nutrient limitation accounts for 55.3% of the total cassava yield gap, while the remaining 44.7% is attributed to water limitation. The highest untapped water-limited yields were estimated in the northern states, such as Bauchi, Gombe, and Sokoto, characterized by the short rainy season.ConclusionOur results showed that most northern states are better equipped to become leading cassava producers in Nigeria under adequate crop management practices involving irrigation and soil fertility enhancement. We reached this conclusion because the northern states usually receive the highest radiation from their characteristic reduced cloud cover, even Therefore, policy and management interventions can be prioritized in these areas. Conclusively, the current cassava yield levels can be increased by a factor of five by emphasizing nutrient and soil health management and irrigation, particularly in areas characterized by a shorter rainy season (Sudan Savanna) in Nigeria.