bluuebunny/crossref_metadata_2025_split huggingface dataset:
The older, the less potential benefit for type 2 diabetes from weight control
Authors: Zhou Qi , Sun Jie , Wu Zhu , Wu Wenbin , Zhang Xianbo , Pan Qi , Qi Haimei , Yuan Huiping , Shi Hong , Cao Suyan , Yang Ze , Wang Xiaoxia , Sun Liang 
Published: April 2022

Abstract
Background
Although moderate weight loss improves outcomes of type 2 diabetes mellitus (T2DM) in young and middle-aged adults, there is a lack of high-quality evidence to support the strong relationship between obesity and T2DM in older people. This study aims to investigate whether the association of obesity with T2DM changes with aging.

Methods
In this cross-sectional study, we recruited 63,180 Chinses and US subjects from 3 datasets. Subjects were divided into young & middle-aged (≤59 years), young-old (60–75 years), and old-old (≥75 years). Logistic regression was used to determine the odds ratio (OR) and 95% confidence intervals (95% CI) for the association between obesity and T2DM, stratified by common confounders. A sliding-window based algorithm and restricted cubic splines were used to smoothly estimate the changes with aging.

Results
The OR (95% CI) for the associations between general obesity and T2DM were decreased from the young & middle-aged group (OR, 5.91; 95% CI, 5.33–6.56) to the young-old group (OR, 3.98; 95% CI, 3.56–4.45) and then to the old-old group (OR, 3.06; 95% CI, 2.57–3.66). The trend for this reduced association with aging persisted after stratification by obesity type, region, gender, recruiting time, hypertension, and hyperlipidemia in both Chinese and Americans. We also identified a weakened gender disparity for this association between the young & middle-aged subjects (P for disparity < 0.001) and the old-old group (P for disparity = ~ 0.36).

Conclusions
The obesity-T2DM association is clearly reduced with aging, which indicates that the elderly may gain fewer potential benefits in weight lose than the younger patients. Considering this attenuated association, as well as the increased incidence of geriatric syndrome in the elderly, clinicians should comprehensively balance the benefits and side effects of weight loss in geriatric T2DM interventions.
Risk factors on healthcare-associated infections among tuberculosis hospitalized patients in China from 2001 to 2020: a systematic review and meta-analysis
Authors: Liu Xinliang , Ren Nili , Ma Zheng Feei , Zhong Meiling , Li Hao 
Published: April 2022

Abstract
Background
China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals.

Methods
Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the $$\widehat{{\uptau }}$$

τ
^

2 and I2 statistics to select the meta-analysis model. Review Manager 5.3 was employed and P < 0.05 was considered as statistical significance.

Results
851 records were filtered from the databases, of which 11 studies were included in the quantitative meta-analysis. A total of 11,922 TB patients were included in the systematic review and meta-analysis, of which 1133 were diagnosed as having HAIs. Age older than 60 years (OR: 2.89 [2.01–4.15]), complications (OR: 3.28 [2.10–5.13]), diabetes mellitus (OR: 1.63 [1.22–2.19]), invasive procedure (OR: 3.80 [2.25–6.42]), longer than 15 hospitalization days (OR: 2.09 [1.64–2.64]), secondary tuberculosis (OR: 2.25 [1.48–3.42]), smoking (OR: 1.40[1.02–1.93]), underlying disease (OR: 2.66 [1.53–4.62]), and use of antibiotics (OR: 2.77 [2.35–3.27]) were the main risk factors associated with HAIs among TB hospitalized patients with a statistical significance (P < 0.05).

Conclusions
Age older than 60 years, presence of complications, presence of diabetes mellitus, invasive procedure, longer than 15 hospitalization days, secondary tuberculosis, smoking, presence of underlying disease, and use of antibiotics were the main risk factors which had a negative impact on HAIs among TB hospitalized patients in Chinese hospitals. These findings provided evidence for policy makers and hospital managers to make effective infection prevention and control measures to constrain the rising HAIs. It is also required that more cost-effective infection prevention and control measures should be widely applied in routinely medical treatment and clinical management to reduce the occurrence of HAIs among TB hospitalized patients.
Development and evaluation of a website with patients experiences of multiple sclerosis: a mixed methods study
Authors: Sippel Anna , Scheiderbauer Jutta , Eklund Désirée , Arnade Sigrid , Schmidt Stephan , Kleiter Ingo , Morrison Rebecca , Kofahl Christopher , Heesen Christoph 
Published: April 2022

Abstract
Background
A variety of management options (e.g., disease-modifying therapy, lifestyle interventions, rehabilitation) are available for persons with relapsing-remitting multiple sclerosis (MS). Besides coping with the diagnosis, persons with MS have to make complex decisions, e.g., regarding disease-modifying therapies. In addition to factual information, reports of patient experiences may support other patients in their decision-making. Therefore, we developed a website presenting patient experiences illustrated by video, audio and text files. This study aimed to test the acceptability and usability of a website with patient experiences with MS.

Methods
A mixed-methods approach was applied. A total of 69 participants visited the German “Patient Experiences with MS (PExMS)” website and among them, 50 persons with MS and 6 experts completed an online survey. In total, 18 participants took part in telephone interviews or focus groups. Data from the survey were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis.

Results
Both quantitative and qualitative responses suggest that the PExMS website was viewed positively by patients and experts. 94% of persons with MS agreed that the information was comprehensible and reliable. 54% felt encouraged to share their health problems with others after having studied the website. 74% claimed to use the website if they had to make a decision regarding their health. Qualitative responses deduced from the website fell into 5 key themes: (1) web design, appearance, and functionality, (2) content, (3) usability, (4) satisfaction, and (5) loyalty. The search for persons of similar age and with comparable experiences was a major driving force to navigate the website. The material on the website was perceived as diverse, covering both positive and negative experiences in daily living with MS. All participants greatly appreciated having access to other people’s experiences online and judged the material on the website as particularly helpful in decision-making for disease-modifying therapies.

Conclusions
The findings suggest that the PExMS website might have the potential to be a useful source of audio-visual information for persons with MS. Given the lack of websites available to patients with experiential information, health care professionals may be encouraged to routinely inform patients about this website at regular appointments.
Deep learning algorithm to evaluate cervical spondylotic myelopathy using lateral cervical spine radiograph
Authors: Lee Gun Woo , Shin Hyunkwang , Chang Min Cheol 
Published: April 2022

Abstract
Background
Deep learning (DL) is an advanced machine learning approach used in different areas such as image analysis, bioinformatics, and natural language processing. A convolutional neural network (CNN) is a representative DL model that is highly advantageous for imaging recognition and classification This study aimed to develop a CNN using lateral cervical spine radiograph to detect cervical spondylotic myelopathy (CSM).

Methods
We retrospectively recruited 207 patients who visited the spine center of a university hospital. Of them, 96 had CSM (CSM patients) while 111 did not have CSM (non-CSM patients). CNN algorithm was used to detect cervical spondylotic myelopathy. Of the included patients, 70% (145 images) were assigned randomly to the training set, while the remaining 30% (62 images) to the test set to measure the model performance.

Results
The accuracy of detecting CSM was 87.1%, and the area under the curve was 0.864 (95% CI, 0.780-0.949).

Conclusion
The CNN model using the lateral cervical spine radiographs of each patient could be helpful in the diagnosis of CSM.
Identification of a pyroptosis-related prognostic signature in breast cancer
Authors: Chen Hanghang , Luo Haihua , Wang Jieyan , Li Jinming , Jiang Yong 
Published: April 2022

Abstract
Background
The relationship between pyroptosis and cancer is complex. It is controversial that whether pyroptosis represses or promotes tumor development. This study aimed to explore prognostic molecular characteristics to predict the prognosis of breast cancer (BRCA) based on a comprehensive analysis of pyroptosis-related gene expression data.

Methods
RNA-sequcing data of BRCA were collected from The Cancer Genome Atlas (TCGA) and Gene Expression Ominibus (GEO) datasets. First, pyroptosis-related differentially expressed genes (DEGs) between normal and tumor tissues were identified from the TCGA database. Based on the DEGs, 1053 BRCA patients were divided into two clusters. Second, DEGs between the two clusters were used to construct a signature by a least absolute shrinkage and selection operator (LASSO) Cox regression model, and the GEO cohort was used to validate the signature. Various statistical methods were applied to assess this gene signature. Finally, Single-sample gene set enrichment analysis (ssGSEA) was employed to compare the enrichment scores of 16 types of immune cells and 13 immune-related pathways between the low- and high-risk groups. We calculated the tumor mutational burden (TMB) of TCGA cohort and evaluated the correlations between the TMB and riskscores of the TCGA cohort. We also compared the TMB between the low- and high-risk groups.

Results
A total of 39 pyroptosis-related DEGs were identified from the TCGA-breast cancer dataset. A prognostic signature comprising 16 genes in the two clusters of DEGs was developed to divide patients into high-risk and low-risk groups, and its prognostic performance was excellent in two independent patient cohorts. The high-risk group generally had lower levels of immune cell infiltration and lower activity of immune pathway activity than did the low-risk group, and different risk groups revealed different proportions of immune subtypes. The TMB is higher in high-risk group compared with low-risk group. OS of low-TMB group is better than that of high-TMB group.

Conclusion
A 16-gene signature comprising pyroptosis-related genes was constructed to assess the prognosis of breast cancer patients and its prognostic performance was excellent in two independent patient cohorts. The signature was found closely associated with the tumor immune microenvironment and the potential correlation could provide some clues for further studies. The signature was also correlated with TMB and the mechanisms are still warranted.
Role of procalcitonin in diagnosis of community acquired pneumonia in Children
Authors: Ratageri Vinod H. , Panigatti Puspha , Mukherjee Aparna , Das Rashmi R. , Goyal Jagdish Prasad , Bhat Javeed Iqbal , Vyas Bhadresh , Lodha Rakesh , Singhal Deepak , Kumar Prawin , Singh Kuldeep , Mahapatro Samarendra , Charoo Bashir Ahmad , Kabra S. K. , Jat K. R. 
Published: April 2022

Abstract
Background
The role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial.

Objectives
The objective of this study was to investigate the utility of serum procalcitonin in differentiating bacterial community-acquired lower respiratory tract infection from non-bacterial respiratory infection in children; radiologically confirmed pneumonia was used as the reference. In addition, we assessed the utility of adding the PCT assay to the clinical criteria for diagnosis of pneumonia.

Study design
Subanalysis of a larger prospective,multicentriccohort study.

Participants
Children, 2 months to 59 months of age, attending paediatric OPD of 5 urban tertiary care hospitals, suffering from acute respiratory infection (ARI).

Intervention
Detailed clinical history and examination findings of enrolled children were recorded on predesigned case record form. Samples for PCT were obtained at admission and were measured centrally at the end of the study except for one site using VIDAS® B.R.A.H.M.S PCT kit (Biomerieux SA, France).

Outcomes
Sensitivity and specificity of procalcitonin for diagnosis of radiologically confirmed pneumonia.

Results
Serum Procalcitonin was measured in 370 patients; median (IQR) age of these children being 12 (7, 22) months, 235 (63.5%) were boys. The median (IQR) serum procalcitonin concentration was 0.1(0.05, 0.4) ng/mL.Sensitivity and specificity of raised PCT (> 0.5 ng/mL) for pneumonia as per any CXR abnormalities were 29.7% and87.5%,(P < 0.001) respectively. Raised PCT was also significantly associated with consolidation (34.5%,79.2%,P < 0.02)and pleural effusion(54.6%,79%,P < 001). Adding PCT to the existing clinical criteria of WHO did not improve the sensitivity for diagnosis of pneumonia. PCT was significantly higher in children with severe pneumonia.

Conclusion
Positive PCT (> 0.5 ng/mL) is significantly associated with radiographic pneumonia but not with pneumonia based on WHO criteria.However, it can act as a surrogate marker for severe pneumonia.
The “common” experience of voice-hearing and its relationship with shame and guilt: a systematic review
Authors: Volpato E. , Cavalera C. , Castelnuovo G. , Molinari E. , Pagnini F. 
Published: April 2022

Abstract
Background
Despite Auditory Verbal Hallucinations (AVHs) having been long associated with mental illness, they represent a common experience also in the non-clinical population, yet do not exhibit distress or need for care. Shame and guilt are emotions related to one's perception of oneself and one's responsibility. As such, they direct our attention to aspects of AVHs that are under-researched and elusive, particularly about the status of voices as others, their social implications and the constitution and conceptualisation of the self.

Objectives
This paper aims to provide a systematic review of studies that investigated the relationship between auditory hallucinations, shame, and guilt in people without relevant signs of psychiatric issues.

Methods
We searched studies reporting information about voices characteristics, the relationship between voices and hearers, hearer's reactions, and beliefs, paying peculiar attention to shame and guilt issues. Included papers were evaluated for risk of bias.

Results
Eleven studies that explored the relationship between AVHs, shame and guilt, were extracted. Phenomenological, pragmatic, as well as neuropsychological features of hearing voices in non-clinical populations, allowed us to note a dynamic relationship and the constellation of subjective experiences that can occur. The role of guilt was characterized by few studies and mixed results, while shame was mainly common.

Conclusions
Due to the high heterogeneity detected and the scarce sources available, further studies should focus on both the aetiology and the bidirectional relationship between hearing voices, shame, and guilt in non-clinical people. This can be helpful in therapies for non-clinical populations who are distressed by their voices (e.g., psychotherapy), and for whom shame, and guilt may contribute to negative consequences such as isolation, anxiety or future depression. Moreover, it might favour the development and implication of different treatments considering emotion regulation, distress tolerance and interpersonal sensitivity on the clinical populations.
The psychometric properties of the Bangla Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): preliminary reports from a large-scale validation study
Authors: Islam Md. Saiful , Ferdous Most. Zannatul , Sujan Md. Safaet Hossain , Tasnim Rafia , Masud Jakir Hossain Bhuiyan , Kundu Sourav , Mosaddek Abu Syed Md. , Choudhuri M. Shahabuddin K. , Kira Ibrahim A. , Gozal David 
Published: April 2022

Abstract
Background
The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5.

Methods
A cross-sectional survey was carried out among 10,605 individuals (61.0% male; mean age: 23.6 ± 5.5 [13–71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included the Bangla PCL-5 and the PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model.

Results
The Bangla PCL-5 displayed adequate internal consistency (Cronbach’s alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale, confirming strong convergent validity. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Overall, the seven-factor hybrid model exhibited the best fit to the data.

Conclusions
The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.
Association among calf circumference, physical performance, and depression in the elderly Chinese population: a cross-sectional study
Authors: Tan Jian-Yu , Zeng Qing-Lian , Ni Meng , Zhang Ying-Xiao , Qiu Tian 
Published: April 2022

Abstract
Background
Depression and sarcopenia are common diseases in the elderly population. However, the association between them is controversial. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database, a cross-sectional study was conducted to explore the relationship of calf circumference and physical performance with depression.

Methods
From the 8th wave of CLHLS conducted in 2018, data on calf circumference, physical performance, depressive symptoms, and demographic, socioeconomic, and health-related characteristics were collected. Multiple logistic regression was conducted to explore the impact of calf circumference, physical performance and their combination on depressive symptoms.

Results
We enrolled a total of 12,227 participants aged 83.4 ± 11.0 years, including 5689 (46.5%) men and 6538 (53.5%) women. Patients with depression were more likely to have low calf circumference (2274 [68.2%] vs. 5406 [60.8%], p<0.001) and poor physical performance (3[0, 6] vs. 1[0, 4], p<0.001). A significant multiplicative interaction was found between calf circumference and physical performance in their effect on depression. After adjusting for confounding factors, multiple logistic regression showed that a significant inverse correlation persisted between physical performance and depressive symptoms in normal (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.15–1.26, p<0.001) and low (OR = 1.14, 95% CI: 1.11–1.18, p<0.001) calf circumference group, while the association between calf circumference and depression disappeared. Participants with low calf circumference and poor physical performance were 2.21 times more likely to have depression than those with normal calf circumference and physical performance. All results were found to be robust in sensitivity analyses.

Conclusions
Physical performance was significantly associated with depression in the elderly Chinese population. Attention should be paid to assess depressive symptoms in patients with poor physical performance.
Zambia Assessment of Tuberculosis (TB) and HIV in the Mines (ZATHIM): implications for programs and policies
Authors: Podewils Laura Jean , Long Elizabeth F. , Fuller Tyler J. , Mwakazanga David , Kapungu Kelvin , Tembo Mathias , Mwanza Sydney , Curran Kathryn G. , Smith Jonathan P. , Tobias James L. , Kasongo Webster 
Published: April 2022

Abstract
Background
Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among working populations in the world (The World Bank, Benefits and costs associated with reducing tuberculosis among Southern Africa’s mineworkers, 2014), making mineworkers a key population for TB program efforts. The current evaluation aimed to characterize mineworkers and former (ex-) mineworkers, and assess knowledge, attitudes and practices related to TB and HIV care among mineworkers and healthcare workers (HCWs) in Zambia.

Methods
A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB.

Results
Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%).

Conclusion
Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.