bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of lifestyle changes during coronavirus disease 2019 pandemic in Gondar town, Northwest Ethiopia
Authors: Kifle Zemene Demelash , Woldeyohanins Alem Endeshaw , Asmare Biniyam , Atanaw Birhanu , Mesafint Tigist , Adugna Meaza 
Published: March 2022

Background
Coronavirus disease 2019 has had a global effect on people’s lifestyles. Many people have developed irregular eating patterns and become physically inactive, which leads to an aggravation of lifestyle-related diseases and unhealthier lifestyles; these, subsequently raise the severity of coronavirus disease 2019. This study aimed to assess lifestyle changes during coronavirus disease 2019 pandemic in Gondar town, North West, Ethiopia.

Method
Community-based cross-sectional study design was conducted among households at Gondar town from June to August 2021. The study participants were selected by a systematic random sampling technique from proportionally allocated kebeles. Data were collected using face-to-face interview techniques and were entered and analyzed by using a statistical package for the social sciences version 24; P-values < 0.05 were considered as statistically significant.

Result
Overall, 348 study participants were included in the study. Among those respondents, 52.3% (182) were female study participants and the mean age of the respondents was 30.95±14.4. In this study, there was a significant decrement in non-homemade food from 20.4% to 13.4% at (P = <0.001). Concerning water intake, 11.5% (40) of respondents consumed ≥8 cups/day before the coronavirus disease 2019 pandemic, and the percentage increased to 14.7% (51) during the coronavirus disease 2019 pandemic (p = 0.01). Of the participants, 46% participants were reported never engaging in any physical activity before the coronavirus pandemic, and the percentage decreased to 29.9% during the pandemic (P = 0.002). The respondents also exhibited increment tension in large from 4.9% to 22.7% before and during the coronavirus disease 2019 pandemic, respectively. Furthermore, about 6.3% of the study participants slept badly before the coronavirus disease 2019 pandemics and the effects of sleeping badly and restlessly increased to 25.9% during the coronavirus disease 2019 pandemic (P = <0.001).

Conclusion
The current study demonstrates that there is a noticeable alteration in food consumption, food choices, regular mealtime, sleeping habits, mental exhaustion, and practice of physical activity.
Internalizing symptoms and family functioning predict adolescent depressive symptoms during COVID-19: A longitudinal study in a community sample
Authors: Vacaru Stefania V. , Beijers Roseriet , de Weerth Carolina 
Published: March 2022

BackgroundThe COVID-19 pandemic and lockdown pose a threat for adolescents’ mental health, especially for those with an earlier vulnerability. Accordingly, these adolescents may need increased support from family and friends. This study investigated whether family functioning and peer connectedness protects adolescents with earlier internalizing or externalizing symptoms from increased depressive symptoms during the first Dutch COVID-19 lockdown in a low-risk community sample.MethodsThis sample comprised 115 adolescents (Mage= 13.06; 44% girls) and their parents (N= 111) and is part of an ongoing prospective study on child development. Internalizing and externalizing symptoms were self-reported a year before the COVID-19 lockdown. In an online survey during the first Dutch lockdown (April-May 2020), adolescents reported depressive symptoms and perceived peer connectedness, and parents reported family functioning.ResultsTwenty-four percent of adolescents reported clinically relevant symptoms of depression during the first COVID-19 lockdown. Depressive symptoms were significantly predicted by earlier internalizing, but not externalizing symptoms. Furthermore, higher quality of family functioning, but not peer connectedness, predicted fewer adolescent depressive symptoms. Family functioning and peer connectedness did not moderate the link between pre-existing internalizing symptoms and later depressive symptoms.ConclusionsIn a low-risk community sample, one-in-four adolescents reported clinically relevant depressive symptoms at the first COVID-19 lockdown. Higher earlier internalizing symptoms and lower quality of family functioning increased risks. These results indicate that even in low-risk samples, a substantial group of adolescents and their families are vulnerable during times of crisis.
Small business managers and Covid-19—The role of a sense of coherence and general resistance resources in coping with stressors
Authors: Hansson Josefine , Landstad Bodil J. , Vinberg Stig , Hedlund Marianne , Tjulin Åsa 
Published: March 2022

BackgroundThe response of small business managers to an external event such as the pandemic can have a profound effect on the work environment, health and well-being for themselves and their employees. Previous research on small business managers during the pandemic has mainly focused on traditional pathogenic effects, and there is a lack of studies looking at the issue from a salutogenic health promotion perspective. The aim of this study is to explore whether a sense of coherence and general resistance resources were experienced by small business managers in Sweden and Norway during the Covid-19 pandemic.MethodsA qualitative design was applied through exploratory interviews with 16 managers of small businesses in Sweden and Norway. A content analysis of the interviews was conducted using the sense of coherence concept by Aaron Antonovsky, with the three main components of comprehensibility, meaningfulness and manageability acting as a conceptual framework for the analysis process.ResultsWithin the three main sense-of-coherence categories, six general resistance resources were identified as being important for the managers to handle uncertainty during the pandemic. These were understanding rules and regulations, social support, optimism, proactivity, problem-solving and flexibility and cooperation.ConclusionsThe small business managers handled the pandemic in a way that worked well in their contexts, and the pandemic generally did not have a negative effect on their businesses or themselves. A salutogenic approach, through which the managers focused on identifying and using resources, was an important factor for managing stressors and adversity during the pandemic. Hence, the concept of salutogenesis may be used as an intervention to foster better health in small businesses, both at a personal and organisational level in order to handle future challenges effectively.
The cardiac autonomic response to acute psychological stress in type 2 diabetes
Authors: Monzer Nelly Lou , Hartmann Mechthild , Buckert Magdalena , Wolff Kira , Nawroth Peter , Kopf Stefan , Kender Zoltan , Friederich Hans-Christoph , Wild Beate 
Published: March 2022

Background
Impaired cardiac autonomic control is common among people with type 2 diabetes. The autonomic nervous system and its regulatory influence on the cardiovascular system also play a key role in the physiological response to psychosocial stressors. It is unclear whether the disease-related impairment of cardiac autonomic control in people with type 2 diabetes affects the stress response. The aim of this study was therefore to examine the cardiac autonomic and the psychological stress response of people with type 2 diabetes compared to healthy control participants.

Methods
We used the trier social stress test to induce stress in n = 51 participants with type 2 diabetes and n = 47 healthy controls. We assessed heart rate (HR) and heart rate variability (HRV) using six ECG samples before, during and after the stress test. We measured participants’ psychological stress response using visual analogue scales.

Results
Longitudinal multilevel models showed an attenuated HR increase in response to the stress test combined with a slower HR recovery after the stress test, in people with type 2 diabetes. This pattern was accompanied by significantly lower low frequency HRV but no differences in high frequency HRV between the groups. Additionally, people with type 2 diabetes showed an increased level of self-reported psychological tension 45 minutes after the stress test.

Conclusions
The impairment of the autonomic nervous system found in people with type 2 diabetes is reflected in the HR response to stress—but not in the HRV response—and partially mirrored in the psychological stress response. Our results underline the importance of considering the interplay of psychosocial stress and disease-related changes in the physiological stress response system in research and treatment of type 2 diabetes.
The shame spiral of addiction: Negative self-conscious emotion and substance use
Authors: Batchelder Abigail W. , Glynn Tiffany R. , Moskowitz Judith T. , Neilands Torsten B. , Dilworth Samantha , Rodriguez Sara L. , Carrico Adam W. 
Published: March 2022

BackgroundThe bidirectional associations between negative self-conscious emotions such as shame and guilt and substance use are poorly understood. Longitudinal research is needed to examine the causes, consequences, and moderators of negative self-conscious emotions in people who use substances.MethodsUsing parallel process latent growth curve modeling, we assessed bidirectional associations between shame and guilt and substance use (i.e., number of days in the past 30 used stimulants, alcohol to intoxication, other substances, or injected drugs) as well as the moderating role of positive emotion. Emotions were assessed using the Differential Emotions Scale. The sample included 110 sexual minority cisgender men with biologically confirmed recent methamphetamine use, enrolled in a randomized controlled trial in San Francisco, CA. Participants self-reported emotions and recent substance use behaviors over six time points across 15 months.ResultsHigher initial levels of shame were associated with slower decreases in stimulant use over time (b= 0.23,p= .041) and guilt was positively associated with stimulant use over time (β = 0.85,p< .0001). Initial levels of guilt and alcohol use were positively related (b= 0.29,p= .040), but over time, they had a negative relationship (β = -0.99,p< .0001). Additionally, higher initial levels of other drug use were associated with slower decreases in shame over time (b= 0.02,p= .041). All results were independent of depression, highlighting the specific role of self-conscious emotions.ConclusionsShame and guilt are barriers to reducing stimulant use, and expanded efforts are needed to mitigate the deleterious effects of these self-conscious emotions in recovery from a stimulant use disorder.
The effects of exercise training on autonomic and hemodynamic responses to muscle metaboreflex in people living with HIV/AIDS: A randomized clinical trial protocol
Authors: Gama Gabriel , dos Santos Rangel Marcus Vinicius , de Oliveira Coelho Vanessa Cunha , Paz Gabriela Andrade , de Matos Catarina Vieira Branco , Silva Bárbara Pinheiro , Lopes Gabriella de Oliveira , Lopes Karynne Grutter , Farinatti Paulo , Borges Juliana Pereira 
Published: March 2022

BackgroundPeople living with HIV (PLHIV) present impaired muscle metaboreflex, which may lead to exercise intolerance and increased cardiovascular risk. The muscle metaboreflex adaptations to exercise training in these patients are unknown. The present study aims to investigate the effects of a supervised multimodal exercise training on hemodynamic and autonomic responses to muscle metaboreflex activation in PLHIV.Methods and designIn this randomized clinical trial protocol, 42 PLHIV aged 30–50 years will be randomly assigned at a ratio of 1:1 into an intervention or a control group. The intervention group will perform exercise training (3x/week during 12 weeks) and the control group will remain physically inactive. A reference group composed of 21 HIV-uninfected individuals will be included. Primary outcomes will be blood pressure and heart rate variability indices assessed during resting, mental stress, and activation of muscle metaboreflex by a digital sphygmomanometer and a heart rate monitor; respectively. Mental stress will be induced by the Stroop Color-Word test and muscle metaboreflex will be activated through a post-exercise circulatory arrest (PECA) protocol, being the latter performed without and with the application of a capsaicin-based analgesic balm in the exercised limb. Secondary outcomes will be heart rate, peripheral vascular resistance, stroke volume, cardiac output, blood lactate, anthropometric markers and handgrip maximal voluntary contraction. The intervention and control groups of PLHIV will be evaluated at baseline and after the intervention, while the HIV-uninfected reference group only at baseline.DiscussionThe findings of the present study may help to elucidate the muscle metaboreflex adaptations to exercise training in PLHIV.Trial registrationThis study will be performed at University of Rio de Janeiro State following registration at ClinicalTrials.gov asNCT04512456on August 13, 2020.
A Bayesian network meta-analysis of the primary definitive therapies for locoregionally advanced nasopharyngeal carcinoma: IC+CCRT, CCRT+AC, and CCRT alone
Authors: Zhang Zhan-Jie , Shi Liang-Liang , Hong Xiao-Hua , Xiao Bo-Ya , Lin Guo-He , Liu Quentin , Wang Bi-Cheng 
Published: March 2022

Background
The major aim of this Bayesian network analysis was to determine the optimal treatment strategy for locoregionally advanced nasopharyngeal carcinoma (LANPC).

Method
We systematically searched databases and extracted data from randomized clinical trials involving LANPC patients randomly assigned to receive induction chemotherapy followed by concurrent chemoradiotherapy (IC+CCRT), CCRT followed by adjuvant chemotherapy (CCRT+AC), or CCRT.

Results
In the network analysis, IC+CCRT was significantly better than CCRT alone for 5-year FFS (odds ratio [OR]: 1.63, 95% credible interval [CrI] 1.16–2.29), DMFS (OR: 1.56, 95% CrI 1.08–2.22), and LFRS (OR: 1.62, 95% CrI 1.02–2.59), but not OS (OR: 1.35, 95% CrI 0.92–2.00). Rank probabilities showed that IC+CCRT was ranked the best followed by CCRT+AC and CCRT for all 5-year outcomes. Although compared to IC+CCRT and CCRT, CCRT+AC did not significantly improve survival but had the highest 5-year survival rates.

Conclusions
IC+CCRT could be recommended as a front-preferred primary definitive therapy for patients with LANPC.
Why does it take so long for rare disease patients to get an accurate diagnosis?—A qualitative investigation of patient experiences of hereditary angioedema
Authors: Isono Moeko , Kokado Minori , Kato Kazuto 
Published: March 2022

Introduction
Many patients with rare diseases experience a diagnostic delay. Although several quantitative studies have been reported, few studies have used a qualitative approach to directly examine how patients with rare disease obtain a diagnosis and why it takes many years. In this study, we focused on hereditary angioedema (HAE), which has been reported to have long diagnostic delays, despite the knowledge that not having an accurate diagnosis can cause life-threatening problems.

Objective
The objective of this study was to analyze patients’ experiences and elucidate why it takes a long time to reach a diagnosis of HAE. We also aimed to propose possible solutions for the problem.

Methods
A qualitative study using semi-structured interviews was conducted. Nine patients who took over 5 years from the presentation of initial symptoms to an HAE diagnosis participated. The contents of the interviews were subjected to an inductive contents analysis.

Results
By analyzing the patients’ struggles that were experienced during the undiagnosed period, three themes were generated: (1) acceptance and resignation towards their conditions, (2) proactive search for a cause, and (3) independent efforts outside of the hospital. While a few patients continued to seek out a diagnosis during the undiagnosed period, many had become accustomed to their health condition without suspecting a rare disease.

Conclusions
We found that one of the most important factors related to the prolonged undiagnosed period is the lack of suspicion of a rare disease by patients and their medical professionals. While current policies tend to focus on the period from suspecting rare diseases to the time of a clear diagnosis, our results strongly suggest that measures are needed to facilitate patients and clinicians to become aware of rare diseases.
Anti-reflux surgical treatment for Barrett’s oesophagus
Authors: Shevchenko B. F. , Prolom N. V. , Babii O. M. , Tarabarov S. O. , Zeleniuk O. V. 
Published: March 2022

The aim of the study. To improve the effectiveness of surgical treatment for patients with hiatal hernia (HH) and gastro-esophageal reflux disease (GERD) in combination with Barrett’s esophagus by developing a new method for surgical correction of the physiological cardia incompetence.
Materials and methods. The study was conducted in the Department of Digestive Surgery of the State Institution “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine” in 2020–2021 and involved 56 patients with HH and GERD, among them axial HH was detected in 42 patients (75.0 %) – type I; paraesophageal HH – in 6 patients (10.7 %) – type II; mixed HH – in 8 patients (14.3 %) – type III (code ICD-10 – K44). The diagnosis was established using esophagogastroduodenoscopy (by high-resolution NBI mode), X-ray and histological examinations, manometry.
Results. When the diagnosis of HH in combination with Barrett’s esophagus was confirmed, a two-stage treatment was performed. During the first stage, argonoplasmic coagulation of the altered esophageal mucosa was done. Anti-reflux procedures constituted the second stage to remove HH and restore an excessive dilatation of the esophageal orifice of the diaphragm by cruroraphy with correction of anti-reflux function of the cardia by fundoplication, angle of His reconstruction and providing free food passage. 11 (19.6 %) patients underwent surgery according to a new technique that provided reliable recovery of cardia physiological functions and preservation of the anatomical relation between the diaphragm and the esophageal-gastric junction and included cruroraphy and fundoplication.
Conclusions. Thus, the proposed two-stage method of surgical treatment for patients with HH and GERD in combination with Barrett’s esophagus is highly effective. The application of the proposed method provides the elimination of pathological changes which are visible on conventional endoscopy in the esophageal mucosa, reliable restoration of cardia physiology and preservation of the anatomical relation between the diaphragm and the esophageal-gastric junction. In the post-surgical period, the proposed method of surgical treatment reduces the likelihood of recurrent failure of cardia physiological functions, dysphagia and Barrett’s esophagus.
Practical application of the International classification of functioning during medical and social expertise of a child with cerebral palsy
Authors: Nazar O. V. , Hdyria O. V. , Moiseienko R. O. , Martyniuk V. Yu. , Vladymyrov O. A. 
Published: March 2022

The aim of the work is to assess the degree of dysfunction and limitation in daily life activities in a child with cerebral palsy, to provide an expert opinion for medical and social expertise by Medical Supervisory Committee (MSC) in accordance with the principles of the International Classification of Functioning, Disability and Health (ICF).
Materials and methods. A clinical example of measuring the degree of disability of the cerebral palsy child in accordance with the ICF principles using standardized tools for functional status assessment and the ICF Categorical Profile. International standardized scales recommended by the international expert group to be applied for cerebral palsy children were used at the State Institution “Ukrainian Medical Center for Rehabilitation of Children with Organic Nervous System Disorders of Ministry of Health”.
Results. During a comprehensive examination of the child with cerebral palsy, a multidisciplinary team of specialists determined the degree of body dysfunction and limitation in daily life activities as well as environmental effect influence on the level of functioning and social adjustment. Based on these findings, ICF Categorical Profile of the patient was formed capturing all spheres of his activity according to the functional state. Parents of the child received the medical conclusion based on the results of the examination for MSC expertise at the place of residence.
Conclusions. The IСF covers the whole complex of life activity and functioning of CP children and reflects all the changes associated with their growth, development and state of health, as distinct from the classical clinical examination of patients. Standardized tools for the assessment of the degree of dysfunction and life activity limitations in CP children allow to avoid controversies between specialists from different medical institutions during medical and social assessment and when making a rehabilitation diagnosis. Members of multidisciplinary rehabilitation team can timely identify and correct dysfunctions, provide early career guidance based on child functional capacity by using the IСF principles to assess life activity in CP children.
Investigation of the effects of machining parameters on surface integrity in micromachining
Authors: Etyemez Ayhan , Aydin Umut 
Published: March 2022

Abstract
In this study, the effect of cutting conditions on surface integrity was investigated in micromilling of magnesium alloy (AZ91). Microtool diameter, cutting speed, feed rate, and depth of cut parameters are used. These variables were investigated at three different levels with the Taguchi L9 experimental design method. The least-best objective function was used. As a result of the experiments, surface roughness values were obtained. It has been determined that surface roughness values and depth of cut are effective parameters. After evaluating the results obtained, variance and regression analyses were performed. Based on the analysis of variance, 58.73% feed rate was found for the 1.0 mm diameter tool, on the other hand, for the 0.8 mm diameter tool, the depth of cut was found to be an effective parameter with 53.6%.