bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anxiety, depression and post-traumatic stress disorder in patients on hemodialysis in the setting of the pandemic, inflation, and the Beirut blast: a cross-sectional study
Authors: Khoury Rita , Ghantous Ziad , Ibrahim Roy , Ghossoub Elias , Madaghjian Patille , Karam Elie , Karam Georges , Fares Najat , Karam Sabine 
Published: April 2023

Abstract
Background
In 2020, Lebanon has witnessed its worst economic crisis, exacerbated by the COVID-19 pandemic and a massive explosion of its capital. Amidst these stressors, this study aims at assessing the prevalence of depression, anxiety, suicidality, post-traumatic stress disorder (PTSD) and cognitive impairment in patients undergoing hemodialysis in an academic hospital destroyed by the explosion.

Methods
This cross-sectional study conducted 6 months after the blast included adults on hemodialysis, with no previous diagnoses of dementia or intellectual disability. It explores prevalence rates of psychiatric disorders, in addition to other medical and psychosocial variables such as frailty, malnutrition, sarcopenia, quality of life and religiosity.

Results
Forty two patients (mean age 66.1; SD: 11.2 years) undergoing hemodialysis for 6.12 years (SD:7.22 years) were included. Anxiety and depression rates reached 54.8% and 57.1% using cut-offs of 6 and 7 respectively on the Hospital Anxiety and Depression rating Scale. 9.5% of the patients reported being in the hospital at the time of the blast and 7.1% reported being injured. 33.3% screened positively for PTSD using a cut-off of 23 on the PCL-5. 26.2% had passive death wishes and 7.1% had suicide plans, however no one had attempted it. 23.8% were found cognitively impaired as shown by the Mini-Cog (<3). Around two-third of participants were moderately to severely malnourished per the GLIM criteria. One third suffered from frailty, according to the FRAIL screening tool. Around 60% suffered from sarcopenia, based on handgrip strength measures. These findings contrast with “acceptable to good” quality of life subjectively reported by participants on the Short Form 36 (SF-36) Health Survey. While one-third of participants participated in organizational religious activities, 88% reported significant subjective meaning of religion in their heart.

Conclusions
Rates of depression, anxiety, PTSD, suicidality, and cognitive impairment were found to be alarming in the setting of an urban dialysis unit following a major explosion. Psychiatric disorders were found to be compounded with increased prevalence of malnutrition, frailty, and sarcopenia. These findings urge healthcare providers to implement early diagnostic and intervention strategies to improve both mental and physical wellbeing of this vulnerable population, in similar settings.
Development of a 24-hour movement behaviors questionnaire (24HMBQ) for Chinese college students: validity and reliability testing
Authors: Zheng Jiaxin , Tan Teck Cheng , Zheng Kefeng , Huang Tao 
Published: April 2023

Abstract
Background
Physical activity (PA), sedentary behaviors (SB), and sleep are interrelated behavior components of a 24-hour day. Research interests continue to increase in examining the inter-relationship of three behaviors and their combined effects on health. The purpose of this study was to develop a comprehensive instrument to measure 24-hour movement behaviors for Chinese college students.

Methods
The 24-hour movement behaviors questionnaire (24HMBQ) was developed based on a literature review and expert review. The target population (Chinese college students) and an expert panel assessed the face and content validity. After the final revision of the questionnaire, the participants (n = 229) were asked to complete the 24HMBQ twice to examine test-retest reliability. Convergent validity was evaluated using Spearman’s rho, by comparing the 24HMBQ estimates of sleep, SB, and PA with results derived from the Pittsburgh Sleep Quality Index (PSQI), the Adult Sedentary Behaviors Questionnaire in China (ASBQC), and the International Physical Activity Questionnaire - Short Form (IPAQ-SF).

Results
The 24HMBQ exhibited good face validity and high acceptability to respondents. Regarding content validity, the S-CVI/UA and S-CVI/Ave were 0.88 and 0.97, respectively. As indicated by ICC, the test-retest reliability was considered moderate to excellent, ranging from 0.68 to 0.97 (P < 0.01). Regarding the convergent validity, correlations were 0.32 for the duration of sleep per day, 0.33 for total time of physical activity per day, and 0.43 for the duration of sedentary behaviors per day.

Conclusion
The 24HMBQ is a feasible questionnaire with suitable validity and moderate to excellent test-retest reliability of all items. It is a promising tool to investigate 24-hour movement behaviors of Chinese college students. The 24HMBQ can be administrated in epidemiological studies.
Promotion of health-enhancing physical activity in the sport sector: a study among representatives of 536 sports organisations from 36 European countries
Authors: Matolić Tena , Jurakić Danijel , Podnar Hrvoje , Radman Ivan , Pedišić Željko 
Published: April 2023

AbstractBackgroundIt is a common belief that most sports clubs and organisations are primarily focused on elite sports while placing less emphasis on the promotion of health-enhancing physical activity (HEPA). However, there is a lack of evidence on this topic in the scientific literature. Therefore, the aim of this study was to determine the level and correlates of the commitment of sports organisations in Europe to HEPA promotion.MethodsRepresentatives of 536 sports organisations from 36 European countries responded to our survey. A multiple regression analysis was conducted with the commitment of sports organisation to HEPA promotion (0 [“not at all”] – 10 [“most highly”]) as the outcome variable and organisation type (“national sport association” reference group [ref], “European sports federation”, “national umbrella sports organisation”, “national Olympic committee”, “national sport-for-all organisation”), headquarters in a European Union member state (“no” [ref], “yes”), region of Europe (“Western” [ref], “Central and Eastern”, “Northern”, “Southern”), commitment to elite sports (“low” [ref], “medium”, “high”), and awareness of Sports Club for Health (SCforH) guidelines (“no” [ref], “yes”) as explanatory variables.ResultsApproximately 75.2% (95% confidence interval [CI]: 71.5, 78.8) of sports organisations were highly committed to elite sports. Only 28.2% (95% CI: 24.4, 32.0) of sports organisations reported a high commitment to HEPA promotion. A higher commitment to HEPA promotion was associated with the national Olympic committees (β = 1.48 [95% CI: 0.41, 2.55],p = 0.007), national sport-for-all organisations (β = 1.68 [95% CI: 0.74, 2.62],p < 0.001), location in Central and Eastern Europe (β = 0.56 [95% CI: 0.01, 1.12],p = 0.047), and awareness of SCforH guidelines (β = 0.86 [95% CI: 0.35, 1.37],p < 0.001).ConclusionFrom our findings, it seems that most sports organisations are primarily focused on elite sports. Coordinated actions at the European Union and national levels are needed to improve the promotion of HEPA through sports organisations. In this endeavour, it may be useful to consider national Olympic committees, national sport-for-all organisations, and relevant sports organisations in Central and Eastern Europe as role models and to raise the awareness of SCforH guidelines.
The impact of income-support interventions on life course risk factors and health outcomes during childhood: a systematic review in high income countries
Authors: Boccia Delia , Maritano Silvia , Pizzi Costanza , Richiardi Matteo G. , Lioret Sandrine , Richiardi Lorenzo 
Published: April 2023

Abstract
Background
In high income countries one in five children still lives in poverty, which is known to adversely shape the life course health trajectory of these children. However, much less is understood on whether social and fiscal policies have the capacity to reverse this damage, which intervention is likely to be most effective and when these interventions should be delivered to maximise their impact. This systematic review attempts to address these questions by looking at the impact of income-support interventions, delivered during the first 1,000 days of life, on cardiovascular, metabolic, respiratory and mental health outcomes.

Methods
The review was restricted to experimental or quasi experimental studies conducted in high income countries. Studies were retrieved from multidisciplinary databases as well as health, economic, social sciences-specific literature browsers. All papers retrieved through the search strategy were double screened at title, abstract and full text stage. Relevant data of the selected studies were extracted and collected in tables, then summarised via narrative synthesis approach. Robustness of findings was assessed by tabulating impact by health outcome, type of intervention and study design.

Results
Overall, 16 relevant papers were identified, including 15 quasi-experimental studies and one randomized control trial (RCT). Income-support interventions included were unconditional/conditional cash transfers, income tax credit and minimum wage salary policies. Most studies were conducted in United States and Canada. Overall, the evidence suggested limited effect on mental health indicators but a positive, albeit small, effect of most policies on birth weight outcomes. Despite this, according to few studies that tried to extrapolate the results into public health terms, the potential number of negative outcomes averted might be consistent.

Conclusions
Income-support interventions can positively affect some of the health outcomes of interest in this review, including birth weight and mental health. Given the large number of people targeted by these programs, one could infer that – despite small – the observed effect may be still relevant at population level. Nonetheless, the limited generalisability of the evidence gathered hampers firm conclusions. For the future, the breadth and scope of this literature need to be broadened to fully exploit the potential of these interventions and understand how their public health impact can be maximised.
Age-specific transmission dynamics under suppression control measures during SARS-CoV-2 Omicron BA.2 epidemic
Authors: Zhu Wenlong , Wen Zexuan , Chen Yue , Gong Xiaohuan , Zheng Bo , Liang Xueyao , Xu Ao , Yao Ye , Wang Weibing 
Published: April 2023

Abstract
Background
From March to June 2022, an Omicron BA.2 epidemic occurred in Shanghai. We aimed to better understand the transmission dynamics and identify age-specific transmission characteristics for the epidemic.

Methods
Data on COVID-19 cases were collected from the Shanghai Municipal Health Commission during the period from 20th February to 1st June. The effective reproductive number (Rt) and transmission distance between cases were calculated. An age-structured SEIR model with social contact patterns was developed to reconstruct the transmission dynamics and evaluate age-specific transmission characteristics. Least square method was used to calibrate the model. Basic reproduction number (R0) was estimated with next generation matrix.

Results
R0 of Omicron variant was 7.9 (95% CI: 7.4 to 8.4). With strict interventions, Rt had dropped quickly from 3.6 (95% CI: 2.7 to 4.7) on 4th March to below 1 on 18th April. The mean transmission distance of the Omicron epidemic in Shanghai was 13.4 km (95% CI: 11.1 to 15.8 km), which was threefold longer compared with that of epidemic caused by the wild-type virus in Wuhan, China. The model estimated that there would have been a total 870,845 (95% CI: 815,400 to 926,289) cases for the epidemic from 20th February to 15th June, and 27.7% (95% CI: 24.4% to 30.9%) cases would have been unascertained. People aged 50–59 years had the highest transmission risk 0.216 (95% CI: 0.210 to 0.222), and the highest secondary attack rate (47.62%, 95% CI: 38.71% to 56.53%).

Conclusions
The Omicron variant spread more quickly and widely than other variants and resulted in about one third cases unascertained for the recent outbreak in Shanghai. Prioritizing isolation and screening of people aged 40–59 might suppress the epidemic more effectively. Routine surveillance among people aged 40–59 years could also provide insight into the stage of the epidemic and the timely detection of new variants.

Trial registration
We did not involve clinical trial.
Associations of free sugars from solid and liquid sources with cardiovascular disease: a retrospective cohort analysis
Authors: Dasgupta Kaberi , Mussa Joseph , Brazeau Anne-Sophie , Dahhou Mourad , Sanmartin Claudia , Ross Nancy A. , Rahme Elham 
Published: April 2023

Abstract
Background
The World Health Organization recommends a 10% total energy (TE%) limit for free sugars (i.e., added sugars and naturally occurring sugars in fruit juice, honey, and syrups) based on evidence linking higher intakes with overweight and dental caries. Evidence for cardiovascular disease (CVD) is limited. Impacts may differ by sex, age group, and solid vs. liquid sources; liquids may stimulate more adverse CVD profiles (due to their rapid absorption in the body along along with triggering less satiety). We examined associations of consuming total free sugars ≥ 10 TE% with CVD within four sex and age-defined groups. Given roughly equal free sugar intakes from solid and liquid sources, we also evaluated source-specific associations of free sugars ≥ 5 TE% thresholds.

Methods
In this retrospective cohort study, we estimated free sugars from 24-h dietary recall (Canadian Community Health Survey, 2004–2005) in relationship to nonfatal and fatal CVD (Discharge Abstract and Canadian Mortality Databases, 2004–2017; International Disease Classification-10 codes for ischemic heart disease and stroke) through multivariable Cox proportional hazards models adjusted for overweight/obesity, health behaviours, dietary factors, and food insecurity. We conducted analyses in separate models for men 55 to 75 years, women 55 to 75 years, men 35 to 55 years, and women 35 to 55 years. We dichotomized total free sugars at 10 TE% and source-specific free sugars at 5 TE%.

Results
Men 55 to 75 years of age had 34% higher CVD hazards with intakes of free sugars from solid sources ≥ 5 TE% vs. below (adjusted HR 1.34, 95% CI 1.05- 1.70). The other three age and sex-specific groups did not demonstrate conclusive associations with CVD.

Conclusions
Our findings suggest that from a CVD prevention standpoint in men 55 to 75 years of age, there may be benefits from consuming less than 5 TE% as free sugars from solid sources.
Co-infection with Mycobacterium tuberculosis and Nocardia farcinica in a COPD patient: a case report
Authors: Chen Yingzhu , Hu Wei 
Published: April 2023

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by persistent airflow limitation. Infection with either Mycobacterium tuberculosis or Nocardia in COPD patients has been reported. However, co-infection with Mycobacterium tuberculosis and Nocardia is rare. Herein, we described such a patient with COPD in a primary hospital, and the diagnosis process.

Case presentation
A 79-year-old female farmer with COPD was consecutively admitted to two hospitals with chief complaints of worsening cough, sputum and gasping since January10, 2022. Microbiological examination was not performed at the first hospital due to unknown reasons, and empirical antibiotic treatment was not effective. The patient was subsequently referred to our hospital. After screening the source of infection and the pathogen, she was diagnosed with tuberculosis. However, the patient did not benefit from antituberculosis treatment, with no remission of respiratory tract symptoms. Cerebrospinal fluid and bronchoalveolar lavage fluid specimens were subsequently sent for microbiological examination. The results indicated Mycobacterium tuberculosis and Nocardia.spp. After four days of bacterial culture, Nocardia.spp grew on medium, and Nocardia.farcinica was identified by the MALDI-TOF MS system and 16 s RNA. The patient was prescribed trimethoprim sulfamethoxazole (TMP/SMX) in combination with anti-tuberculosis drugs to treat the co-infection. She showed gradual improvement and was discharged from the hospital on February 19, 2022. However, the follow-up results were unclear.

Conclusions
Co-infection with Nocardia and Mycobacterium tuberculosis should be considered in COPD patients. Repeated microbiological and microscopy examinations are essential in primary hospitals.
Surgical interventions for symptomatic knee osteoarthritis: a network meta-analysis of randomized control trials
Authors: Bin Geng , Jinmin Liu , Cong Tian , Yuchen Tang , Xiaohui Zhang , Yayi Xia 
Published: April 2023

Abstract
Background
Multiple surgical interventions exist for the treatment of symptomatic knee osteoarthritis, but the surgeon and patient may often have difficulty deciding which interventions are the best option.

Methods
We conducted a systematic review to identify randomized clinical trials (RCTs) that compared complications, revisions, reoperations, and functional outcomes among TKA (total knee arthroplasty), UKA (unicompartmental knee arthroplasty), HTO (high tibial osteotomy), BCA (bicompartmental knee arthroplasty), BIU (bi-unicompartmental knee arthroplasty), and KJD (knee joint distraction). The PubMed, Embase, and Cochrane databases were reviewed for all studies comparing two or more surgical interventions. Direct-comparison meta-analysis and network meta-analysis (NMA) were performed to combine direct and indirect evidence. The risk of bias was assessed using the revised Cochrane risk of bias tool for RCTs.

Results
This NMA and systematic review included 21 studies (17 RCTs), with a total of 1749 patients. The overall risk-of-bias assessment of the RCTs revealed that 7 studies had low risk, 5 had some concerns, and 9 had high risk. SUCRA (the surface under the cumulative ranking curve) rankings revealed that KJD had the greatest risk of appearing postoperative complications, revisions, and reoperations, and UKA or TKA had the lowest risk. The majority of comparisons among various treatments showed no difference for functional outcomes.

Conclusion
Each surgical intervention is noninferior to other treatments in functional outcomes, but UKA and TKA are better options to treat OA according to SUCRA rankings by comparing complications, revisions, and reoperations. KJD is an imperfect option for treating OA. Other treatments should be carefully considered for each patient in accordance with their actual conditions. However, this conclusion is limited by the selection of reviewed publications and individual variation of surgical indications for patients.

Trial registration
This study was registered with Research Registry (reviewregistry1395).
Relationship between trabecular bone score, bone mineral density and vertebral fractures in patients with axial spondyloarthritis
Authors: Valls-Pascual Elia , Orenes-Vera Ana Victoria , Sendra-García Ana , Martínez-Ferrer Àngels , Montolío-Chiva Lydia , Vázquez-Gómez Ignacio , Flores-Fernández Eduardo , Ybáñez-García Desamparados , Vega-Martínez María , García-Ferrer Luis , Graells-Ferrer Magdalena , Alegre-Sancho Juan José 
Published: April 2023

Abstract
Background
In patients with axial spondyloarthritis, vertebral fracture risk is elevated and not always correlated with bone mineral density (BMD). Trabecular bone score (TBS) may offer some advantages in the assessment of vertebral fracture risk in these patients. The primary objective of this study was to compare TBS and BMD between axial spondyloarthritis patients depending on their vertebral fracture status. Secondary objectives were to estimate the prevalence of morphometric vertebral fractures, and to explore factors associated with fracture, as well as the interference of syndesmophytes on BMD and TBS.

Methods
A cross-sectional study was conducted. Data were collected on demographic and clinical characteristics, lab results, imaging findings and treatment. Statistical analysis was performed using SPSS v.13 statistical software.

Results
Eighty-four patients (60 men and 24 women; mean age of 59 years) were included. Nearly half (47.6%) of them had lumbar syndesmophytes. The rate of morphometric fracture was 11.9%. TBS showed a higher area under the curve (0.89) than total hip, femoral neck and lumbar BMD (0.80, 0.78, and 0.70 respectively) for classifying patients regarding their fracture status. Nonetheless, the differences did not reach statistical significance.
Syndesmophytes affected lumbar spine BMD (p < 0.001), but not hip BMD or TBS. Fractures were associated with TBS, total hip BMD, erythrocyte sedimentation rate and C-reactive protein levels.

Conclusions
We identified decreased TBS and total hip BMD, as well as increased erythrocyte sedimentation rate and C-reactive protein levels as factors associated with morphometric vertebral fractures. Unlike lumbar spine BMD, TBS is not affected by the presence of syndesmophytes.
Extracurricular activities in medical education: an integrative literature review
Authors: Kim Sejin , Jeong Hyeyoon , Cho Hyena , Yu Jihye 
Published: April 2023

Abstract
Background
The importance of extracurricular activities (EAs) has been emphasized in medical education. These activities could enhance medical students’ emotional and physical health and afford them developmental opportunities. Despite the growing amount of research related to this theme, few studies review and synthesize the existing literature. This study aims to provide an understanding of the educational implications of EAs in medical colleges and constructs an integrated conceptual framework concerning their types and learning outcomes by literature review.

Methods
An integrative literature review was conducted following Torraco’s method, with the aim to generate a new framework for the given topic. The authors utilized Scopus and PubMed as databases, using search terms “extracurricular,” “medical,” and “students.” Initially, titles and abstracts were screened to include relevant studies, and the researchers verified the eligibility of the articles by following the inclusion and exclusion criteria. Of the 263 articles identified, 64 empirical studies were selected for further review.

Results
EAs in undergraduate medical education can be classified into direct extracurricular activities and indirect extracurricular activities, the latter of which is sorted into nine sub-categories. We identified seven main categories regarding the learning outcomes of EAs. In addition to general activities (e.g., pro-social activities, team sports), some distinctive activities such as research have been largely addressed in previous studies. The results of EAs were discussed in relation to academic growth, career development, and psychological experiences.

Conclusions
This review identified the types and learning outcomes of EAs in the context of medical education, thereby suggesting ways to improve the quality of EAs and maximize their educational effects.