bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of school-based high-intensity interval training on body composition, cardiorespiratory fitness and cardiometabolic markers in adolescent boys with obesity: a randomized controlled trial
Authors: Meng Cao , Yucheng Tang , Shu Li , Yu Zou 
Published: March 2022

Abstract
Background
With accumulating evidence suggesting that CVD has its origins in childhood obesity. The purpose of this study was to determine the effect of a real-world school-based high-intensity interval training intervention on body composition, cardiorespiratory fitness and cardiometabolic markers in obese boys aged 10 to 13 years.

Methods
Forty-five adolescent boys with obesity (age = 11.2 ± 0.7 years, BMI = 24.2 ± 1.0 kg/m2), were randomized to high-intensity interval training group (HIIT, n = 15), moderate-intensity continuous training group (MICT, n = 15), or a control group (CON, n = 15). The intervention groups performed three weekly exercise sessions over 12 weeks. HIIT group performed two sets of eight bouts of 15 s run at high-intensity [90 ~ 100% maximal aerobic speed (MAS)] separated by eight bouts of 15 s recovery run at low-intensity (50% MAS), MICT group performed 30 min run at moderate intensity (60 ~ 70% MAS) and CON group were instructed to continue their normal behaviors. All participants had indices of body composition, cardiorespiratory fitness (CRF) and cardiometabolic markers measured at baseline and post-intervention. Statistical differences between and within groups were determined by use of two-way analysis of variance (ANOVA) with repeated measures.

Results
Following the school-based training program, BMI and body fat mass decreased (BMI: − 1.8 kg/m2 vs. – 1.2 kg/m2, P < 0.01; FM: − 1.6 kg, P < 0.05 vs. -3.7 kg, P < 0.01) in HIIT and MICT group, but there was no significant difference between the two interventions; $$\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}}$$

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both increased significantly in two intervention groups, and the increment of HIIT group was significantly greater than that of MICT (6.1 mL/kg/min vs. 3.8 mL/kg/min, P < 0.01), Visceral adipose tissue was significant decrease in HIIT group (− 53 g vs. -17 g, P < 0.01) whilst the MICT group experienced a significant decrease in body fat percentage (− 3.1 ± 1.0 kg, P < 0.01), but there were no significant difference between the two interventions. Low-density lipoprotein cholesterol decreased only in HIIT group (− 17.2%, P < 0.05). Significant decrease in the usual index of insulin resistance (HOMA-IR) occurred in HIIT and MICT groups (− 27.3 and − 28.6%, respectively; P < 0.05).

Conclusions
Our results demonstrated that high-intensity interval training based on running can be used to improve the physical health of obese adolescents in school. Further investigations involving a larger cohort of participants, taken from different schools, is recommended.

Trial registration
title Effect of High Intensity Interval Training on Obese Children and Adolescents, time 16/12/2017, IDChiCTR-IOR-17013992, websitehttp://www.chictr.org.cn
Coping strategies and depression during the COVID-19 pandemic in pregnant women: a cross sectional study
Authors: Firouzbakht Mojgan , Rahmani Narges , Sharif Nia Hamid , Omidvar Shabnam 
Published: March 2022

Abstract
Background
Pregnant women are vulnerable to psychological problems depending on the adaptive capacities of their personality and coping strategies. This study aimed to investigate the association between coping strategies of pregnant women during the COVID-19 pandemic and depression.

Methods
This web-based cross-sectional study was conducted in 2021 on 318 pregnant women in Amol, Iran. Data collection was performed via questionnaires (Brief cope, Edinburgh Postnatal Depression Scale, CDA, and Demographic questionnaire). The questionnaires were completed through the WhatsApp and Telegram applications. Data were analyzed using the hierarchical regression analysis and SPSS software (v. 21) at the significance level of 0.05.

Results
About 40% of participants had depression. The most prevalent coping strategy used by pregnant women was the avoidance strategy. Hierarchical regression revealed that the coping strategy of avoidance was a significant predictor of depression (β = 0.226, p = 0.046) after controlling background characteristics.

Conclusions
The findings of this study suggest that avoidance style associated with depression in pregnant women. Therefore, obtaining further knowledge about impacts of coping strategies on pregnant women seems to be essential.
Incremental burden of relapse in patients with major depressive disorder: a real-world, retrospective cohort study using claims data
Authors: Touya Maëlys , Lawrence Debra F. , Kangethe Anne , Chrones Lambros , Evangelatos Themmi , Polson Michael 
Published: March 2022

Abstract
Background
Relapse is common in major depressive disorder (MDD). In this study, we evaluated the incremental health care burden of relapse in patients with MDD.

Methods
This real-world retrospective cohort study used administrative medical and pharmacy claims data to identify commercially insured adult patients in the United States diagnosed with MDD who initiated a new antidepressant between January 1, 2012, and September 30, 2017. All-cause health care resource utilization, total costs, and medication adherence were evaluated in two cohorts: patients with and patients without relapse. Relapse was defined as suicide attempts, psychiatric hospitalization, mental health–related emergency department (ED) visit, use of electroconvulsive therapy, or reinitiation of treatment after a gap ≥6 months.

Results
The study population included 14,186 patients (7093 baseline-matched patients per cohort). The mean follow-up period was 27.5 and 26.0 months for patients with and patients without relapse, respectively. Patients with relapse had significantly higher rates of hospitalization (16.6% vs 8.5%; p < .0001) and ED visits (54.8% vs 34.7%; p < .0001) than patients without relapse. The total costs for patients with relapse were significantly higher ($12,594 vs $10,445; p < .0001). Patients with relapse were also less adherent to antidepressants (mean proportion of days covered, 0.43 vs 0.49; p < .0001).

Conclusions
Relapse of MDD was associated with increased total costs and health care utilization and lower adherence to antidepressants. Reducing the risk of relapse may result in a reduction of the associated health care burden; however, findings may only be generalizable to patients with commercial insurance.
Contextual and psychological factors influencing open defecation free status: an exploratory qualitative study in rural South Western Uganda
Authors: Ntaro Moses , Owokuhaisa Judith , Isunju John Bosco , Mulogo Edgar , Ssempebwa John C. 
Published: March 2022

Abstract
Introduction
Achieving the Open defecation free (ODF) status remains a major challenge in Uganda, yet it contributes significantly to child health improvement. Literature on social, cultural and behavioral aspects that influence the ODF status in rural Uganda is limited. The study therefore, explored perceived factors influencing the ODF status in rural South Western Uganda.

Methods
An exploratory study employing qualitative techniques and based on deductive analysis between month December 2020 and January 2021 was conducted. Seven Focus Group Discussions (FGDs and three Key Informant Interviews (KIs) were conducted in Kabale District, southwestern Uganda. Focus Group Discussion participants were mothers and fathers having children of 2 years and below while KIIs included local community leaders and health extension workers. Data was analyzed using a categorization matrix derived from the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) model which is comprised of contextual and psychological factors. Text was further categorized into high and low statements for attainment of ODF status.

Results
The contextual factors influencing the Open Defecation Free status behavior included; farming activities far from home, financial constraints, rainy seasons, collapsible soft soils, and alcohol use. Psychological factors influencing ODF status included; perceived health risk for typhoid disease, low perceived severity for lack of ODF components, negative attitude of less value attached to ODF components, and a feeling of time wastage practicing ODF status behavior. The perception that the community has the ability to attain the ODF status was high. Although, the capability to maintain ODF was low when it comes to replacement of ODF component if stolen or destroyed.

Conclusion
Open Defecation Free status is influenced by contextual and psychological factors. Therefore, it’s crucial for sanitation promotors to always identify such context specific factors in order to design sanitation and hygiene promotion interventions to address the ODF free status related challenges.
Interobserver reliability of scapula fracture classifications in intra- and extra-articular injury patterns
Authors: Huflage Henner , Fieber Tabea , Färber Christian , Knarr Jonas , Veldhoen Simon , Jordan Martin C. , Gilbert Fabian , Bley Thorsten Alexander , Meffert Rainer H. , Grunz Jan-Peter , Schmalzl Jonas 
Published: March 2022

Abstract
Background
Morphology and glenoid involvement determine the necessity of surgical management in scapula fractures. While being present in only a small share of patients with shoulder trauma, numerous classification systems have been in use over the years for categorization of scapula fractures. The purpose of this study was to evaluate the established AO/OTA classification in comparison to the classification system of Euler and Rüedi (ER) with regard to interobserver reliability and confidence in clinical practice.

Methods
Based on CT imaging, 149 patients with scapula fractures were retrospectively categorized by two trauma surgeons and two radiologists using the classification systems of ER and AO/OTA. To measure the interrater reliability, Fleiss kappa (κ) was calculated independently for both fracture classifications. Rater confidence was stated subjectively on a five-point scale and compared with Wilcoxon signed rank tests. Additionally, we computed the intraclass correlation coefficient (ICC) based on absolute agreement in a two-way random effects model to assess the diagnostic confidence agreement between observers.

Results
In scapula fractures involving the glenoid fossa, interrater reliability was substantial (κ = 0.722; 95% confidence interval [CI] 0.676–0.769) for the AO/OTA classification in contrast to moderate agreement (κ = 0.579; 95% CI 0.525–0.634) for the ER classification system. Diagnostic confidence for intra-articular fracture patterns was superior using the AO/OTA classification compared to ER (p < 0.001) with higher confidence agreement (ICC: 0.882 versus 0.831). For extra-articular fractures, ER (κ = 0.817; 95% CI 0.771–0.863) provided better interrater reliability compared to AO/OTA (κ = 0.734; 95% CI 0.692–0.776) with higher diagnostic confidence (p < 0.001) and superior agreement between confidence ratings (ICC: 0.881 versus 0.912).

Conclusions
The AO/OTA classification is most suitable to categorize intra-articular scapula fractures with glenoid involvement, whereas the classification system of Euler and Rüedi appears to be superior in extra-articular injury patterns with fractures involving only the scapula body, spine, acromion and coracoid process.
Healthcare professionals’ perspective on delivering personalised and holistic care: using the Theoretical Domains Framework
Authors: Wong Eunice , Mavondo Felix , Horvat Lidia , McKinlay Louise , Fisher Jane 
Published: March 2022

Abstract
Background
Interventions to improve personalised and holistic care delivery by healthcare professionals are more likely to be effective if they target the factors influencing specific behaviours. This study reports on the development and testing of a questionnaire to identify perspectives of healthcare professionals’ personalised and holistic care behaviours based on the Theoretical Domains Framework.

Methods
The study was conducted in public health services in Victoria, Australia. The questionnaire was developed and pilot-tested with behaviour change researchers and healthcare professionals. Doctors, nurses and midwives were recruited via notices and email invitations from Safer Care Victoria's website and mailing lists of healthcare professionals and invited to completed the questionnaire online (hosted on Qualtrics). Health services administrators and allied health professionals were excluded from the study. Confirmatory factor analysis was undertaken to generate the model of best fit and group differences were tested using univariate tests.

Results
One hundred and four healthcare professionals from public health services in Victoria, Australia, completed the 39-item questionnaire focusing on specific personalised and holistic care behaviours. The final model consisted of 13 factors and 39 items, and CFA produced an acceptable fit, as well as adequate levels of discriminant validity and internal consistency (α = 0.60 to 0.84). Seven domains, “social influence”, “motivation & goals”, “environmental context and resources’, “skills”, ‘beliefs about consequences”, “behaviour regulation” and “nature of behaviour” were identified. Significant differences in the factors influencing these behaviours were found in groups with different years of experience and role seniority. These findings suggest that future interventions need to be targeted to specific groups.

Conclusion
This study identified the specific behaviours and the factors associated with performance of personalised and holistic care among healthcare professionals. The findings suggest several interventions and policy functions may be taken to improve personalised and holistic care.
DNA methylation reveals distinct cells of origin for pancreatic neuroendocrine carcinomas and pancreatic neuroendocrine tumors
Authors: Simon Tincy , Riemer Pamela , Jarosch Armin , Detjen Katharina , Di Domenico Annunziata , Bormann Felix , Menne Andrea , Khouja Slim , Monjé Nanna , Childs Liam H. , Lenze Dido , Leser Ulf , Rossner Florian , Morkel Markus , Blüthgen Nils , Pavel Marianne , Horst David , Capper David , Marinoni Ilaria , Perren Aurel , Mamlouk Soulafa , Sers Christine 
Published: March 2022

AbstractBackgroundPancreatic neuroendocrine neoplasms (PanNENs) fall into two subclasses: the well-differentiated, low- to high-grade pancreatic neuroendocrine tumors (PanNETs), and the poorly-differentiated, high-grade pancreatic neuroendocrine carcinomas (PanNECs). While recent studies suggest an endocrine descent of PanNETs, the origin of PanNECs remains unknown.MethodsWe performed DNA methylation analysis for 57 PanNEN samples and found that distinct methylation profiles separated PanNENs into two major groups, clearly distinguishing high-grade PanNECs from other PanNETs including high-grade NETG3. DNA alterations and immunohistochemistry of cell-type markers PDX1, ARX, and SOX9 were utilized to further characterize PanNECs and their cell of origin in the pancreas.ResultsPhylo-epigenetic and cell-type signature features derived from alpha, beta, acinar, and ductal adult cells suggest an exocrine cell of origin for PanNECs, thus separating them in cell lineage from other PanNENs of endocrine origin.ConclusionsOur study provides a robust and clinically applicable method to clearly distinguish PanNECs from G3 PanNETs, improving patient stratification.
Determinants of livestock species ownership at household level: Evidence from rural OR Tambo District Municipality, South Africa
Authors: Taruvinga A. , Kambanje A. , Mushunje A. , Mukarumbwa P. 
Published: March 2022

AbstractAn understanding of factors influencing smallholder farmers’ livestock ownership at the household level is vital in formulating pro-poor livestock production policies and technologies. Hence, this study examined factors that influence livestock ownership of smallholder farmers. The data was collected randomly from three purposively selected study areas in the OR Tambo District (King Sabata Dalindyebo, Port St Johns and Ingquza Hill local municipalities) in the Eastern Cape Province of South Africa using a cross-sectional survey of 650 households. A multivariate probit model (MPM) was used to estimate correlates of livestock species ownership at the household level. Results indicated that education, age, household income, marital status, religion, rainfall, gender, household size and employment status influence livestock species ownership at the household level. Therefore, efforts to promote livestock ownership and production should be guided by these significant explanatory variables in the study area. Interdependence among species was also noted (cattle and sheep; goats and pigs; sheep and pigs; cattle and goats; goats and sheep), suggesting complementarity among the different types of livestock species. This complementarity among the species can possibly be explained by functional diversity generic with multi-species livestock farming which is worth supporting to enhance biodiversity conservation, climate change mitigation, rural resource use efficiency and socio-economic sustainability at the household level.
RETRACTED ARTICLE: Research on Construction Risks and Countermeasures of Concrete Dam
Authors: Song Hang , Wang Dai , Liu Wei-Jia 
Published: March 2022

AbstractThe harsh environment will reduce the interlayer bonding quality of mass concrete and cause plastic cracking. These defects will seriously affect the safety and durability of the structure. This study tested the layer state (water content and penetration resistance), interlayer mechanical properties, and early-age crack resistance of concrete to evaluate the impact of extreme weather on concrete interlayer properties and crack resistance. Furthermore, the interlayer splitting tensile strength of concrete under different treatment measures (covering insulation quilts and artificial grooves) was analyzed to find a method to reduce the construction risk of mass concrete. At the same time, the early-age crack resistance of concrete under different treatment measures (covering insulation quilts and adding PVA fibers) was evaluated. The results showed that the interlayer splitting tensile strength of concrete decreased by 50%, 40%, 29%, and 70%, respectively, compared with bulk concrete under extreme weather conditions (high temperature, strong winds, steep descent in temperature, and short-time heavy rainfall). Covering insulation quilts can reduce the construction risk of concrete under extreme weather conditions such as high temperature, strong winds and steep descent in temperature. This is mainly due to the fact that insulation quilt reduces the impact of the external environment on the concrete and effectively prevents the evaporation of moisture inside the concrete. In addition, covering insulation quilts can reduce the total cracking area of concrete under extreme weather conditions (strong winds and dry-heat, strong winds and cold waves, and short-time heavy rainfall) by 85–100%. At the same time, adding PVA fibers can inhibit the generation and expansion of micro-cracks on the concrete surface. This is due to the bridging and cracking resistance of PVA fibers.
Sleep disturbances in the context of neurohormonal dysregulation in patients with bipolar disorder
Authors: Roloff Tom , Haussleiter Ida , Meister Klara , Juckel Georg 
Published: March 2022

Abstract
Background
Sleep dysfunction is a core symptom in bipolar disorder (BD), especially during major mood episodes. This study investigated the possible link between subjective and objective sleep disturbances in inter-episode BD, changes in melatonin and cortisol levels, and circadian melatonin alignment. The study included 21 euthymic BD patients and 24 healthy controls. Participants had to wear an actigraphy device, keep a weekly sleep diary and take salivary samples: five samples on the last evening to determine the dim light melatonin onset (DLMO) and one the following morning to measure rising cortisol. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and Regensburg Insomnia Scale (RIS), and circadian alignment by the phase angle difference (PAD).

Results
In comparison to healthy controls, BD patients had: (1) higher PSQI (5.52 ± 3.14 vs. 3.63 ± 2.18; p = 0.022) (significant after controlling for age and gender), and higher RIS scores (8.91 ± 5.43 vs. 5.83 ± 3.76; p = 0.031); (2) subjective a longer mean TST (p = 0.024) and TIB (p = 0.002) (both significant after controlling for age and gender), longer WASO (p = 0.019), and worse SE (p = 0.036) (significant after controlling for gender); (3) actigraphically validated earlier sleep onset (p = 0.002), less variation in sleep onset time (p = 0.005) and no longer TST (p = 0.176); (4) no differing melatonin levels (4.06 ± 2.77 vs. 3.35 ± 2.23 p = 0.352), an 1.65 h earlier DLMO (20.17 ± 1.63 vs. 21.82 ± 1.50; p = 0. 001) (significant after controlling for gender), and a phase advance of melatonin (6.35 ± 1.40 vs. 7.48 ± 1.53; p = 0.017) (significant after controlling for gender); and (5) no differing cortisol awakening response (16.97 ± 10.22 vs 17.06 ± 5.37 p = 0.969).

Conclusions
Patients with BD, even in euthymic phase, have a significantly worse perception of their sleep. Advanced sleep phases in BD might be worth further investigation and could help to explain the therapeutic effects of mood stabilizers such as lithium and valproate.
Health supply chain system in Uganda: current issues, structure, performance, and implications for systems strengthening
Authors: Lugada Eric , Komakech Henry , Ochola Irene , Mwebaze Shiela , Olowo Oteba Martin , Okidi Ladwar Denis 
Published: March 2022

Abstract
Background
The health supply chain system is essential for the optimum performance of the healthcare system. Despite increased investments in the health supply chain system, access to quality Essential Medicines and Health Supplies remain a big challenge in Uganda. This article discusses the structure, performance, and challenges of the health supply chain system in Uganda. It provides reflections and implications for ongoing interventions for system strengthening.

Discussions
The findings highlight several issues and challenges affecting the health supply chain system from functioning optimally across all levels of the health system. The challenges identified include an ineffective structure to support planning, coordination and management, inadequate funding, shortage of skilled staff, weak regulatory and governance structures at national and sub-national levels, and slow adoption and use of Electronic Logistics Information Systems to support supply chain processes and functions. Overcoming these challenges will require greater investments to improve policy development and implementation, infrastructure, equipment and support systems, knowledge and skills of supply chain personnel, increased funding and improving governance and accountability.