bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular disease risk and all-cause mortality associated with accelerometer-measured physical activity and sedentary time ‒ a prospective population-based study in older adults
Authors: Länsitie Miia , Kangas Maarit , Jokelainen Jari , Venojärvi Mika , Timonen Markku , Keinänen-Kiukaanniemi Sirkka , Korpelainen Raija 
Published: September 2022

Abstract
Background
Low levels of physical activity (PA) and high sedentary time (ST) are common in older adults and lack of PA is a risk factor for cardiovascular disease (CVD). Knowledge about associations with accelerometer-measured PA, ST and CVD risk in older adults is insufficient. This study examines the associations of accelerometer-measured PA and ST with cardiovascular risk measured using the Framingham risk score (FRS) and all-cause mortality in older adults.

Methods
A population-based sample of 660 (277 men, 383 women) older people (mean age 68.9) participated in the Oulu45 cohort study from 2013‒2015. PA and ST were measured with wrist-worn accelerometers at baseline for two weeks. Ten-year CVD risk (%) was estimated with FRS. The data for all-cause mortality were identified from the Digital and Population Data Services Agency, Finland after an average of 6.2 years follow-up. The associations between moderate to vigorous physical activity (MVPA), light physical activity (LPA), ST and FRS were analyzed using the multivariable linear regression analysis. Associations between LPA, ST and mortality were analyzed using the Cox proportional-hazard regression models.

Results
Each 10 min increase in MVPA (β = -0.779, 95% CI -1.186 to -0.371, p < 0.001) and LPA (β = -0.293, 95% CI -0.448 to -0.138, p < 0.001) was negatively associated with FRS while a 10 min increase in ST (β = 0.290, 95% CI 0.158 to 0.421, p < 0.001) was positively associated with FRS. After adjustment for waist circumference, only ST was significantly associated with FRS. Each 10 min increase in LPA was associated with 6.5% lower all-cause mortality risk (HR = 0.935, 95% CI 0.884 to 0.990, p = 0.020) and each 10 min increase in ST with 5.6% increased mortality risk (HR = 1.056, 95% CI 1.007 to 1.108, p = 0.025).

Conclusion
A higher amount of daily physical activity, at any intensity level, and avoidance of sedentary time are associated with reduced cardiovascular disease risk in older people. Higher time spent in light physical activity and lower sedentary time are associated with lower all-cause mortality.
How formal caregiver’s BPSD knowledge influences positive aspects of caregiving: the mediating role of attitude and the moderating role of self-efficacy
Authors: Hu Rui , Lai Bingbing , Ma Wenhao , Zhang Yuan , Deng Yujiao , Liu Lianqi , Lv Zeping , Chan Chetwyn , Zhang Fan , Tao Qian 
Published: September 2022

Abstract
Background
The current study investigated the relationship between behavioural and psychological symptoms of dementia (BPSD) knowledge and positive aspects of caregiving (PAC), in addition, how caregiving attitude and self-efficacy mediate or moderate this relationship.

Methods
Two hundred twenty-nine formal caregivers (51males and 178females) who has worked in nursing homes for more than a month were recruited.With a cross-sectional, face-to-face survey, structural questionnaires were implemented to evaluate formal caregiver’s BPSD knowledge, attitude, self-efficacy and PAC.A 13-item self-developed questionnaire was used to assess caregiver’s BPSD knowledge about disease characteristics, care and risks, and treatment needs. Dementia attitude, self-efficacy and positive aspects of caregiving were measured by dementia attitude scale, the General self-efficacy scale, and Chinese version of positive aspects of caregiving respectively. Model 5 in the PROCESS micro was employed in order to verify the mediating effect of attitude and the moderating effect of self-efficacy on the relationship between BPSD knowledge and PAC.

Results
The results showed that greater BPSD knowledge was associated with increased PAC, and this relationship was fully mediated by increased friendly attitude toward people with dementia. Moreover, direct effect was moderated by self-efficacy, and that only among those with high self-efficacy, the direct effect of BPSD knowledge was found on promoting PAC.

Conclusions
By elucidating the knowledge-attitude-practice pathway in handling patient’s BPSD, the current study extends existing literature and provides insights for developing psychoeducation programs among formal caregivers.
Systemic immune-inflammation index predicts postoperative delirium in elderly patients after surgery: a retrospective cohort study
Authors: Song Yuxiang , Luo Yungen , Zhang Faqiang , Ma Yulong , Lou Jingsheng , Li Hao , Liu Yanhong , Mi Weidong , Cao Jiangbei 
Published: September 2022

Abstract
Background
Postoperative delirium (POD) is a common complication among elderly patients after surgery. It is unclear whether the systemic immune-inflammation index (SII) can be a predictor of POD. We explored the prognostic value of the SII in predicting POD in elderly patients undergoing non-neurosurgery and non-cardiac surgery in a large retrospective cohort.

Methods
We enrolled elderly patients undergoing non-neurosurgery and non-cardiac surgery between January 2014 and August 2019. Univariate and multivariate logistic regression analyses were performed to explore the correlation between POD and the SII value as both a continuous and categorical variable. Then, propensity score matching (PSM) analysis was applied to eliminate the confounding effect of covariates and prove our results. Subgroup analyses were then performed to discover the association between the SII and POD in different subgroups.

Results
A total of 29,608 patients with a median age of 70 years (IQR: 67–74) were enrolled in the retrospective cohort. The cut-off value of the SII was 650, which was determined by the receiver operating characteristic (ROC) curve. The ORs of an SII value > 650 was 2.709 (95% CI:2.373–3.092, P < 0.001), 1.615 (95% CI:1.384–1.882, P < 0.001), 1.855 (95% CI:1.602–2.146, P < 0.001), and 1.302 (95% CI:1.106–1.531, P = 0.001) for prediction of POD in univariate model and three multivariate regression models. After PSM, the OR of an SII value > 650 was 1.301 (95% CI: 1.062–1.598, P = 0.011). The subgroup analysis indicated that the SII indicates a significantly increased risk of POD in patients with Hb < 130 g/L, 4*109/L < WBC ≤ 10*109/L, albumin < 39 g/L, or duration of MAP < 60 mmHg ≥ 5 min. The SII was found to be a useful prognostic predictor of POD for patients of different ages, sexes, and ASA classifications.

Conclusions
The SII had a predictive value for POD in patients undergoing non-neurosurgery and non-cardiac surgery. As an index generated from routine blood tests, the SII has advantages regarding cost and time. After further validation, the SII may provide a new option for POD prediction.
“There is no joy in the family anymore”: a mixed-methods study on the experience and impact of maternal mortality on families in Ghana
Authors: Lawrence Emma R. , Appiah-Kubi Adu , Lawrence Hannah R. , Lui Maxine Y. , Owusu-Antwi Ruth , Konney Thomas , Moyer Cheryl A. 
Published: September 2022

AbstractBackgroundMaternal mortality has a multifaceted impact on families, especially in low- and middle-income countries, where rates of maternal mortality are high and resources can be lacking. The objective of this study was to explore the ways that maternal mortality influences the physical and emotional wellbeing, financial stability, and caregiving structure of families, and identifies sources of and gaps in support.MethodsOur study used a mixed-methods design. All maternal mortalities in an 18-month period at a tertiary hospital in Ghana were identified using death certificates. Participants were 51 family members (either husbands or other heads of households) in families affected by maternal mortality. A questionnaire assessed demographic characteristics and changes in family health, income, and family structure. Two validated scales assessing psychological wellbeing were administered: the Patient Health Questionnaire-9 and the Inventory of Complicated Grief. Semi-structured interviews were conducted to assess impact on family wellbeing.ResultsQuantitative and qualitative results converged to highlight large, negative impacts of maternal mortality on four areas of family wellbeing: 1) mental health and emotional wellbeing; 2) physical health; 3) family structure; 4) financial stability and security. On the Patient Health Questionnaire-9, 54% (27/50) of participants reported elevated depressive symptoms, with 14% (7/50) of scores falling in the moderately severe or severe ranges. On the Inventory of Complicated Grief, 38% (19/50) exceeded the cutoff for significant impairment in functioning. Worsened family health was associated with greater complicated grief (b = 21.41,p = .004); there were no other significant predictors of depressive symptom severity or complicated grief. Effects on family health centered on concerns about the nutritional status and health of the surviving infant. Family structure was primarily affected by fracturing of the central family unit by sending children to live with relatives. Immense economic strain resulted from hospital bills, funeral expenses, and loss of income. The majority of participants received helpful support from their family (41/51, 80.4%), the community (32/51, 62.7%), and their religious institution (43/51, 84.3%); however, support often stopped soon after the death.ConclusionsMaternal mortality has profound negative impacts on families in Ghana. Impacts are experienced by husbands and heads of households, as well as surviving children. Both immediate and sustained support is needed for families following a maternal death, especially mental health and financial support.
Experiences, concerns, and needs of pregnant and postpartum women during the Covid-19 pandemic in Cyprus: a cross-sectional study
Authors: Hadjigeorgiou Eleni , Vogazianos Paris , Christofi Maria-Dolores , Motrico Emma , Domínguez-Salas Sara , Mesquita Ana R. , Christoforou Andri 
Published: September 2022

Abstract
Background
The current COVID-19 pandemic is a unique stressor with potentially challenging and negative consequences on the experiences of pregnant and postpartum women. International literature highlights the pandemic’s negative impact on women’s perinatal experiences. This is the first study in the scientific literature reporting on the impact of the COVID-19 pandemic, on the perinatal experiences of a large sample of women living in Cyprus.

Aim
To examine the impact of the COVID-19 pandemic on the experiences, concerns and needs of pregnant and postpartum women in Cyprus.

Method
The cross-sectional study was conducted from July 2020 to January 2021. A total of 695 women, 355 pregnant and 340 postpartum women (with infants up to 6 months of age), residing in Cyprus were surveyed.

Results
The great majority of the participants (80.9%) perceived the impact of the COVID-19 pandemic on their life as negative. The greatest sources of stress were identified and quantified for their impact on the participants. Our findings indicate that 74.1% of the pregnant women were concerned about changes due to COVID-19 measures impacting the presence of their family at the time of delivery, 57.2% about their newborn’s health, and 43.1% about changes related to perinatal care. Postpartum women’s concerns were mainly related to the welfare and health of their child (70.3%), whilst half of them (49.1%) expressed concerns about how they were going to care for their baby because of pandemic-related changes. Qualitative data revealed emerging themes as the basis of the pregnant and postpartum women’s concerns and needs.

Conclusions
The COVID-19 pandemic and the associated imposed measures and restrictions had adverse effects on pregnant and postpartum women’s perinatal experiences in Cyprus. The women’s concerns emphasized the need for the development of specialized, evidenced-based support systems which are essential particularly in pandemic-like situations, when pregnant and postpartum women are more vulnerable to isolation.
Potential values of circulating tumor cell for detection of recurrence in patients of thyroid cancer: a diagnostic meta-analysis
Authors: Liang Ming-Xing , Fei Yin-Jiao , Yang Kai , Tang Wen-Juan , Cao Xin-Hui , Tang Jin-Hai 
Published: September 2022

Abstract
Background
Several studies have reported that circulating tumor cells (CTCs) are a promising marker for the diagnosis of thyroid cancer (TC) with recurrence or distant metastasis (DMs). However, some studies emerged with conflicting results. Therefore, we provide a meta-analysis to evaluate the diagnostic performance of CTC for detection of recurrence in patients of TC.

Methods
We searched PubMed, Web of Science, Cochrane library with the keywords “thyroid cancer” and “circulating tumor cells”. Data extraction and risk of bias assessment were performed independently by two reviewers. The summary receiver operating characteristic curve (SROC) and other parameters were adopted to summarize the overall test performance. The sensitivity of CTCs in the detection of recurrent TC was reviewed. All analyses were performed by STATA 12.0 and Meta-disc software.

Results
For CTCs expressing epithelial cell adhesion molecule (EpCAM), seven studies were included in our meta-analysis. Pooled sensitivity, specificity, and diagnostic odds ratio were 0.71 (95% CI: 0.63–0.78), 0.89 (95% CI: 0.84–0.94), and 26.75 (95% CI: 9.11–78.53); 0.78 (95% CI: 0.65–0.89), 0.88 (95% CI: 0.76–0.96), and 40.01 (95% CI: 10.49–152.63) for CTCs expressing thyroid stimulating hormone receptor (TSHR). The area under the SROC for EpCAM and TSHR were both 0.91.

Conclusion
CTC was a reliable marker for the diagnosis of TC patients with recurrence and DMs, and the sensitivity of CTCs expressing TSHR was higher than that of EpCAM. Additional research is warranted in order to establish uniformity in international guidelines, make up the drawbacks of conventional diagnostic methods and to prevent futile surgery.
The effects of chitosan supplementation on anthropometric indicators of obesity, lipid and glycemic profiles, and appetite-regulated hormones in adolescents with overweight or obesity: a randomized, double-blind clinical trial
Authors: Fatahi Somaye , Sayyari Ali Akbar , Salehi Masoud , Safa Majid , Sohouli Mohammadhassan , Shidfar Farzad , Santos Heitor O. 
Published: September 2022

Abstract
Background
Chitosan is one of dietary fiber that has received great attention in improving obesity-related markers, but little is known on its effects on adolescents.

Objectives
To analyze the effects of chitosan supplementation on obesity-related cardiometabolic markers and appetite-related hormones in adolescents with overweight or obesity.

Methods and analysis
A randomized clinical trial was performed on 64 adolescents with overweight and obesity, who were randomly allocated to receive chitosan supplementation (n = 32) or placebo as control (n = 32) for 12 weeks. Anthropometric measures, lipid and glycemic profiles, and appetite-related hormones were examined.

Results
Sixty-one participants completed study (chitosan = 31, placebo = 30). Chitosan supplementation significantly improved anthropometric indicators of obesity (body weight: − 3.58 ± 2.17 kg, waist circumference: − 5.00 ± 3.11 cm, and body mass index: − 1.61 ± 0.99 kg/m2 and − 0.28 ± 0.19 Z-score), lipid (triglycerides: − 5.67 ± 9.24, total cholesterol: − 14.12 ± 13.34, LDL-C: − 7.18 ± 10.16, and HDL-C: 1.83 ± 4.64 mg/dL) and glycemic markers (insulin: − 5.51 ± 7.52 μIU/mL, fasting blood glucose: − 5.77 ± 6.93 mg/dL, and homeostasis model assessment of insulin resistance: − 0.24 ± 0.44), and appetite-related hormones (adiponectin: 1.69 ± 2.13 ng/dL, leptin − 19.40 ± 16.89, and neuropeptide Y: − 41.96 ± 79.34 ng/dL). When compared with the placebo group, chitosan supplementation had greater improvement in body weight, body mass index (kg/m2 and Z-score), waist circumference, as well as insulin, adiponectin, and leptin levels. Differences were significant according to P-value < 0.05.

Conclusion
Chitosan supplementation can improve cardiometabolic parameters (anthropometric indicators of obesity and lipid and glycemic markers) and appetite-related hormones (adiponectin, leptin, and NPY) in adolescents with overweight or obesity.
Current state of the evidence on community treatments for people with complex emotional needs: a scoping review
Authors: Ledden Sarah , Rains Luke Sheridan , Schlief Merle , Barnett Phoebe , Ching Brian Chi Fung , Hallam Brendan , Günak Mia Maria , Steare Thomas , Parker Jennie , Labovitch Sarah , Oram Sian , Pilling Steve , Johnson Sonia ,   the C. E. N. Mental Health Policy Research Unit Group, Papamichail Alexandra , Mason Ava , Thayaparan Avithaa , Wang Baihan , Locke Christian Dalton , Harju-Seppänen Jasmine , Mo Jiping , Tomaskova Magdalena , Lyons Natasha , Spyridonidis Spyros , James Tiffeny , Dedat Zainab , Haime Zoë 
Published: September 2022

Abstract
Background
Improving the quality of care in community settings for people with ‘Complex Emotional Needs’ (CEN—our preferred working term for services for people with a “personality disorder” diagnosis or comparable needs) is recognised internationally as a priority. Plans to improve care should be rooted as far as possible in evidence. We aimed to take stock of the current state of such evidence, and identify significant gaps through a scoping review of published investigations of outcomes of community-based psychosocial interventions designed for CEN.

Methods
We conducted a scoping review with systematic searches. We searched six bibliographic databases, including forward and backward citation searching, and reference searching of relevant systematic reviews. We included studies using quantitative methods to test for effects on any clinical, social, and functioning outcomes from community-based interventions for people with CEN. The final search was conducted in November 2020.

Results
We included 226 papers in all (210 studies). Little relevant literature was published before 2000. Since then, publications per year and sample sizes have gradually increased, but most studies are relatively small, including many pilot or uncontrolled studies. Most studies focus on symptom and self-harm outcomes of various forms of specialist psychotherapy: most result in outcomes better than from inactive controls and similar to other specialist psychotherapies. We found large evidence gaps. Adaptation and testing of therapies for significant groups (e.g. people with comorbid psychosis, bipolar disorder, post-traumatic stress disorder, or substance misuse; older and younger groups; parents) have for the most part only reached a feasibility testing stage. We found little evidence regarding interventions to improve social aspects of people’s lives, peer support, or ways of designing effective services.

Conclusions
Compared with other longer term mental health problems that significantly impair functioning, the evidence base on how to provide high quality care for people with CEN is very limited. There is good evidence that people with CEN can be helped when specialist therapies are available and when they are able to engage with them. However, a much more methodologically robust and substantial literature addressing a much wider range of research questions is urgently needed to optimise treatment and support across this group.
Effects of parenting mode on student adaptability: the mediating effect of irrational beliefs
Authors: Hua Kong , Hongwang Xu , Yujian Deng , Xuefeng Wang , Wei Zhang 
Published: September 2022

Abstract
Backgrounds
In the face of the new environment, different individuals have different reactions. Those who have good adaptability constantly establish individual self-efficacy through making friends and completing their studies, thus forming a good dependency with the university environment. However, individuals with poor ability to adapt to the new environment will have some bad phenomena, such as truancy, weariness and self denial. As a result, the students’ adaptations of to the growth environment where in universities are the important topics in recent years.

Methods
Present study introduces irrational beliefs to investigate the effects of parenting mode on maladaptation of university students. The questionnaires based on simplified parenting mode (Chinese), irrational belief and adaptability were administered in a survey of 510 university students in Zhanjiang on October, 2021, the list of students of Guangdong Ocean University is taken as the sampling frame and determined by random sampling. Parenting mode was used as the independent variable, while the emotionally warm, overprotective and rejecting types were used as the indices. Further, the irrational beliefs including summary comments, awful beliefs and low tolerance to setbacks as well as maladaptation were included in the mediation model for analysis.

Results
The results showed that the rejection parenting mode was negatively related with absolute requirements (r = − 0.143), and learning motivation (r = − 0.157), interpersonal adaptation (r = − 0.283) and physical and psychological adjustment (r = − 0.083). Overprotection was negatively correlated with absolute requirements (r = − 0.042) and interpersonal adaptation (r = − 0.042). The mediating effect of irrational beliefs (low tolerance to setbacks, awful beliefs and absolute requirements), the lower and upper limits of Bootstrap confidence interval were 0.135 and 0.461, respectively, excluding 0, which indicated that the mediating effect is true.

Conclusion
Through the analysis of the data, this study believes that irrational beliefs such as low tolerance to setbacks, awful beliefs and absolute requirements mediate the effects on school adjustment. Negative parenting modes such as overprotection and rejection inculcate irrational beliefs, resulting in maladaptation of university students.
Comparison of LPS and MS-induced depressive mouse model: behavior, inflammation and biochemical changes
Authors: Yu Xiaojin , Yao Hui , Zhang Xiaohui , Liu Lulu , Liu Shuangmei , Dong Youjing 
Published: September 2022

AbstractDepression is a mental disease involving complex pathophysiological mechanisms, and there are many ways to establish depressive mouse models. The purpose of this study is to comprehensively compare the behavioral changes and its mechanism induced by two different models. This study established two depressive mouse models by maternal separation (MS) or lipopolysaccharide (LPS) administration, and added fluoxetine treatment group respectively for comparison. MS induced more apparent anxiety-like behavior while LPS induced more apparent depressive-like behavior. LPS increased peripheral inflammatory factors more apparent, which were mitigated by fluoxetine. MS inhibited the 5-HT system more obviously and was relieved by fluoxetine. LPS triggered stronger immune response in the hippocampus and prefrontal cortex (PFC). MS significantly reduced the expression of neurotrophic proteins and was alleviated by fluoxetine. Overall, LPS induced stronger system inflammation, while MS impaired the function of HPA axis and 5-HT system. Our results will contribute to a deeper understanding of the pathophysiology of different stress-induced depression and will also help researchers select appropriate models of depression for their own needs.