bluuebunny/crossref_metadata_2025 huggingface dataset:
Conventional Microlumbar Discectomy versus Minimally Invasive Tubular Discectomy – A Prospective Study
Authors: Malini S. , Thomas Anu C. , Vadakkedam Sajeev S.
Published: December 2024

Background:

Minimally invasive surgical procedures are fast becoming the norm and standard in all aspects of surgery. It is of utmost importance that they be critically analyzed against conventional time-tested standard procedures. Standard microscopic lumbar discectomy is the gold standard for lumbar disc herniations. It is used as a yardstick for comparison of newer procedures such as tubular discectomy (TD).

Objective:

The objective of our study is to compare conventional microlumbar discectomy (MLD) with minimally invasive TD.

Material and Methods:

The study was nonrandomized prospective study of patients who underwent either type of surgery at our institute from 2018 to 2020. Preoperative and postoperative Visual Analog Score and Oswestry Disability Questionnaire score were assessed. Furthermore, duration of surgery, blood loss, length of hospital stay, and rate of complications were compared between the two groups.

Results:

We observed that patients in the TD group had improved VAS and Oswestry Disability Index scores than conventional MLD group during initial postoperative period which were statistically significant. The TD group had significantly lesser blood loss (P = 0.000) and shorter duration of hospital stay (P = 0.000) even though the duration of surgery was longer (P = 0.038). There was no statistically significant difference between the complication rates in both the groups. There were no recurrences in either group.

Conclusions:

In our study, we found that patients who underwent TD showed earlier pain relief and functional recovery as compared to conventional MLD and had lesser blood loss and shorter hospital stay. The overall long-term pain relief was similar in both the groups. However, large sample randomized trials and long-term outcome analysis would be needed to make better judgment regarding choice of one procedure over the other.
Lytic Lesion in Pediatric Femur---a Diagnostic Dillema—LCH (Langerhan’s Cells Histocytosis)-Case Report
Authors: Mohiuddin Mohammed Jalal , Atta Mohammed Ali Abdelatty , Hassan Aser Hassan Mohammed , Farooq Malik Dilaver
Published: December 2024

Lytic lesions affecting the bones are one of the common presentations. Infectious and neoplastic pathologies are the most common differential diagnoses, with marginal differences in blood and radiological parameters between these two groups. Langerhan’s cell histiocytosis is a rare orthopedic condition that contributes <1% of bony lesions. Reported here is one such case in which radiology was suggestive of a neoplastic pathology (Ewing’s sarcoma), and biopsy results were first reported as osteomyelitis; however, later, with immunohistochemistry diagnosis of Langerhan’s cell histiocytosis was confirmed. After the biopsy, the pain subsided. The patient was observed, and Leison healed itself without significant complications. Langerhans cell histiocytosis, though not very common, needs to be considered a possible differential diagnosis in cystic bone lesions. Treatment varies, ranging from observation to local radiation therapy. The course of disease varies from patient to patient, based on the type of treatment offered.
Soft Tissue Analysis of the Chin, Length and Thickness of the Upper Lip in Normodivergent, Hypodivergent and Hyperdivergent Pattern Patients: A Cephalometric Study
Authors: Khan Sohail , Siddiqui Hina , Qamruddin Irfan , Ali Danish , Kumar Sarvaich , Shah Mairah , Fatima Samar , Soomar Sunia , Younus Aqsa , Zehra Qurrat-ul- Ain , Dawar Sarah
Published: December 2024

Objective:

To determine mean soft tissue chin, upper lip length and thickness in patients visiting the orthodontic department and to compare the mean length and thickness of the soft tissue chin and upper lip in patients with different mandibular divergent patterns.

Study design:

Cross-sectional study.

Place and duration:

The study was conducted at Orthodontics OPD of Jinnah Sindh medical university, from January 2021 to March 2021.

Materials and Methods:

Pretreatment lateral cephalometric radiographs of 150 subjects were taken. Subjects were classified into normodivergent, hypodivergent and hyperdivergent on the basis of the mandibular plane angle (SN-GoGn). The measurements of the length and thickness of the upper lip and soft tissue chin were recorded in millimeter using a scale. SPSS version 20 was used for data entry and analysis.

Results:

The study included a total of 150 participants. The median values, along with their interquartile ranges (IQR), for various facial parameters were as follows: the vertical angle was 32.50 (IQR: 27–40), facial angle was 84 (IQR: 80–87), upper lip length was 19 (IQR: 17–21), upper lip thickness was 11 (IQR: 10–13), thickness of the soft tissue chin was 10 (IQR: 9–11), another measure of the soft tissue chin was 9 (IQR: 8–11) and the length of the soft tissue chin was 7 (IQR: 6–8). Three study groups reported no significant differences based on upper lip length (P = 0.187), upper lip thickness (P = 0.196), soft tissue chin thickness (P = 0.216) and soft tissue chin length (P = 0.330). On the Kruskal–Wallis test, vertical angle (P < 0.001), facial angle (P = 0.002) and soft tissue thickness (Gn-Gnʹ) were found to be significantly different among the three groups.

Conclusion:

An insignificant difference was found in the upper lip length in all patterns. In patients exhibiting hypodivergent patterns, the lip thickness value was comparatively greater. The thickness of the soft tissue chin is more in subjects exhibiting the hypodivergent pattern than in patients exhibiting the hyperdivergent pattern.
Management of the Impacted Tooth with Dilacerated Roots – A Surgical Challenge
Authors: Bin Wan Mustafa Wan Mahadzir , Hashim Nadirah , Ishak Muhammad Syamil , Jasni Amy Dalilah , Ven Hong Sue
Published: December 2024

The impacted tooth poses a challenge to dental and oral surgeons due to its unpredictable morphology which leads to increased difficulty during its extraction. A particular type of morphology is the dilacerated root. The root morphology of the third molar, for example, is considered to be the most variable in the human dentition. Careful considerations should be made on impacted teeth with dilacerated roots. In addition to the type of impaction, proximity to the inferior alveolar nerve or the maxillary sinus, number of roots and shape of the roots should be assessed to enable correct decision-making and successful management of these impacted teeth. In this case series, successful surgical management of impacted teeth with dilacerated roots is presented and the definition, prevalence, aetiology, diagnosis, imaging of dilacerations and surgical methods to achieve successful removal of these teeth are described.
Effect of Local Anaesthesia Immediately before Dental Treatment on the Relationship between Dental Anxiety and Salivary Cortisol Levels in Patients with ICDAS-II Score 5 Lesions
Authors: Erdemir Ugur , Erden Kayalıdere Ezgi , Alshawi Ahmed , Günes Ozunal Zeynep , Ozel Yildiz Sevda , Yildiz Esra
Published: December 2024

Background:

Dental anxiety is a psychological and physical state of fear in patients experiencing stress over dental procedures.

Aim:

This cross-sectional study aimed to investigate the effects of local anaesthesia administered immediately before dental treatment on the association between dental anxiety and salivary cortisol levels in patients with International Caries Detection and Assessment System (ICDAS) score 5 lesions.

Materials and Methods:

A total of 95 patients aged between 16 and 45 years who had a caries lesion with an ICDAS-II score of at least 5 were examined at Istanbul University, Faculty of Dentistry, Department of Restorative Dentistry. At the beginning of operative procedures and just before the administration of anaesthesia, the Modified Dental Anxiety Scale was used to measure patients’ dental anxiety, and enzyme-linked immunosorbent assay kits were used to assess patients’ unstimulated salivary cortisol levels. The data were statistically analysed using the Mann–Whitney U test and Spearman correlation analysis P < 0.05.

Results:

The mean values between male and female patients for dental anxiety scores were statistically significant, 9.07 ± 3.07 and 12.42 ± 4.33, respectively (P < 0.05). However, salivary cortisol levels did not exhibit statistical significance; the mean values were 4.49 ± 2.31 and 3.95 ± 2.39, respectively (P > 0.05). There were significant correlations between age and salivary cortisol levels in female patients (P < 0.05), but there were no significant correlations for any of the parameters in male patients (P > 0.05).

Conclusions:

Within the limits of this study, patient gender had an influence on the extent of dental anxiety, and a significant correlation was found between age and salivary cortisol levels in female patients.
Chronological age and performance differences: A comparative analysis of speed, change of direction and explosive power amongst U-15 and U-18 soccer players
Authors: Termizi Muhammad Iftiqar Ahmad , Azidin Raja Mohammed Firhad Raja , Sharir Raihana
Published: December 2024

Background:

Chronological age is calculated from a single time point away from an individual’s date of birth, and changes in physical fitness may vary amongst individuals. Understanding how these variations manifest across different age groups is crucial for optimizing athletic performance in youth sports.

Aim:

This study aims to examine the disparities in speed, change of direction (COD), and explosive power performance between two competitive age groups of youth soccer players.

Methods:

Thirty soccer players (n = 30) were recruited from a secondary school, comprising two age groups: under 15 (n = 15) and under 18 (n = 15) years. The participants underwent three physical tests assessing speed, COD, and explosive power performance.

Results:

The findings revealed significant differences in explosive power performance between the two age groups (P = 0.04). Speed performance exhibited a trend towards significance (P = 0.05), while COD results did not reach statistical significance.

Conclusion:

These outcomes underscore the potential influence of age on sport-related performance, particularly in explosive power. This suggests that training programs may need to be tailored differently for athletes in different age groups to maximize performance outcomes.
A scoping review of the factors associated with mental health among Malaysian adolescents
Authors: Zamri Eva Nabiha , Sha Li , Haizam Tengku Nurul Adiba Binti Tengku Mohd Noor , Isa Siti Nor Ismalina
Published: December 2024

Issues in mental health among adolescents in Malaysia are increasing over the years, and specific interventions targeting its possible contributing factors might be effective. Therefore, this review aims to identify common mental health problems among Malaysian adolescents and their associated factors to support targeted interventions. SCOPUS and PubMed databases were used to search the articles. We conducted literature search on PubMed and SCOPUS using keywords and phrases in line with the PRISMA protocol. The primary outcome focused on identifying mental health problems, while the secondary outcome involved identifying associated factors among Malaysian adolescents. Out of 307 studies, there are only 19 (6.2%) eligible cross-sectional studies included in the review. The common mental health studies are psychological distress (depression, anxiety and stress), followed by suicidal tendency and general mental health. We also have grouped the identified risk factors into six groups, namely socio-demographic, psychological, family structure/relationship, peer relationship, school-related factors and substance misuse/rule-breaking. The variety of factors that contribute to the mental health of Malaysian adolescents in Malaysia requires a concerted effort from various stakeholders such as government and non-governmental agencies, the community, peers and families. Implementing sustainable mental health promotion programmes through educational and behavioural changes is essential for empowering all segments of society with knowledge and enabling proactive measures to support adolescent mental health.
Impact of exercise on the adolescent immune system: A scoping review
Authors: Mohamed Rwayda Abdulkader , Mohamad Siti Mardhiana , Yusof Hazwani Ahmad
Published: December 2024

Physical activity is important for people of all ages as it plays a significant role in maintaining overall health, including enhancing the immune system. This review study aims to investigate how physical exercise can have an impact on the immunological response among adolescents. The study performed a literature search in the Medline through EBSCO, Cochrane Library, Scopus and PUBMED database in December 2023. This review included English-language scientific articles published between 1st January 2010 and 31st January 2024, empirical research exclusively and studies on healthy adolescents. The review was conducted according to the PRISMA principles (PRISMA-ScR) and scoping studies’ methodological framework. The results of the scoping search through the above-selected databases showed that there were 1887 articles. During the full-text review, 134 papers were initially included. Ultimately, only 12 articles were included in the final review, with 122 excluded for not meeting the inclusion criteria. These studies collectively suggested that regular exercise can have significant positive effects on various aspects of the immune system in adolescents, such as reducing inflammation and increasing anti-inflammatory cytokines. Improvements in physical fitness and body composition were also noted, especially with long-term interventions. Some studies showed that exercise can influence immune responses, potentially reducing infection risk. However, exercise intensity and duration played crucial roles in determining the extent of immunological and inflammatory responses. Future studies should integrate consistent aerobic and strength training, while also ensuring that physical activities are pleasurable and varied to foster sustained participation among teenagers.
Body composition, bone health status and isokinetic muscular performance among Malaysian young male badminton players, archers and non-athletes
Authors: Goh Rou Xian , Ooi Foong Kiew , Chen Chee Keong , Irene Tong King Ming , Jusoh Mohd Rahimi Che , Ghafar Rosniwati , Lau Jiun Sien
Published: December 2024

Background:

This study investigated body composition, bone health status and isokinetic muscular performance among Malaysian young male badminton players, archers and non-athletes as controls.

Methods:

Thirty-three participants (mean age: 15.1 [1.4 years]) were divided into three groups, which were non-athlete control (n = 11), archery (n = 11) and badminton (n = 11) groups. Participants’ percentage of body fat (%BF), muscle mass or fat-free mass (FFM) and bone speed of sound (SOS) were measured. In addition, participants’ knee (flexion and extension) and shoulder (extension and flexion) peak torque (PT, an indicator of muscular strength) and average power (AVG.P) were measured using an isokinetic dynamometer.

Results:

Badminton athletes showed a significant higher (P = 0.021) shoulder extension AVG.P at 180°/s compared to the non-athletes. Both badminton and archery athletes showed significantly higher values of isokinetic knee flexion AVG.P at 180°/s and 300°/s, knee extension PT and AVG.P at 180°/s when compared to non-athletes. In badminton players, significant positive correlations were observed between FFM with arm bone SOS (r = 0.727, P = 0.011) and shoulder PT at 60°/s (r= 0.736, P = 0.010), respectively. Arm bone SOS showed significant positive correlations with shoulder PT at 60°/s (r = 0.674, P = 0.023), shoulder flexion AVG.P at 300°/s (r = 0.614, P = 0.023) and shoulder extension AVG.P at 300°/s (r = 0.633, P = 0.049), respectively. Leg bone SOS was also significantly positive correlated with knee flexion AVG.P at 300°/s (r = 0.727, P = 0.011) and knee extension AVG.P at 300°/s (r = 0.639, P = 0.034), respectively, in badminton players.

Conclusions:

Engagement in badminton and archery sports of athletes could enhance muscular strength and power compared to non-athletes.
The effects of exercise timings on cardiovascular responses: A scoping review
Authors: Chen Wei Joo , Ludin Arimi Fitri Mat , Farah Nor M. F.
Published: December 2024

The beneficial effects of exercise on cardiovascular health are well known, but increasing epidemiological evidence suggests that certain physical activity timings during the day may be associated with better health outcomes due to diurnal variations in physiological functions. Whether exercising at a specific time of day will elicit a better cardiovascular response than other timings remain to be established. This scoping review aimed to summarise the effects of exercise timings (i.e. morning, afternoon, evening and night) on cardiovascular parameters (i.e. blood pressure [BP], heart rate [HR] and HR variability) from published evidence and to discuss the research gaps and implication for future studies. A systematic search was conducted in PubMed, Medline, Cochrane and Web of Science up to October 2023. Overall, 49 articles met the selection criteria, involving 914 participants from various age groups and health status. HR was the most frequently studied outcome, followed by BP. Overall, the findings showed no clear evidence for the most favourable exercise timing during the day on cardiovascular parameters. Heterogeneity across studies suggests that the beneficial effects of exercise on cardiovascular parameters may not be significantly altered by time of day for most people.
The influence of body composition on cardiorespiratory performance, energy substrate utilisation and running gait pattern of university rugby players
Authors: Shalan Nor Aijratul Asikin Mohamad , Baki Mohd Hafizuddin , Zahudi Azrena Zaireen Ahmad , Mustafa Mirza Azny , Rahim Norhazira Abdul
Published: December 2024

Aims:

This study explored the differences in body composition, cardiorespiratory performance, substrate oxidation and running gait patterns of university rugby players with normal and high body fat (HBF) percentages. Correlations between: (1) body composition and aerobic fitness, (2) fat mass (FM) and skeletal muscle mass (SMM) with substrate oxidation and running gait pattern.

Methods:

Body composition, cardiorespiratory performance and running gait patterns were collected from 15 university rugby players. Substrate oxidation was calculated using a stoichiometric formula. The association between target variables was determined using Pearson’s correlation coefficient.

Results:

Normal body fat (NBF) participants had lower body weight (P= 0.019), body mass index (BMI) (P = 0.001), body fat percentage (P ≤ 0.001), (FM; P ≤ 0.001), sum of 8 skinfolds (P ≤ 0.001) and waist-to-hip ratio (WHR; P = 0.017), while higher (SMM; P ≤ 0.001) and ventilatory threshold 2 (VT2) (P = 0.011) than HBF participants. Maximal fat oxidation (MFO) for NBF occurs at 60% of VO2max (3.21 ± 0.21 g/min) and at 50% VO2max (3.42 ± 0.21 g/min) for HBF. NBF trunks leaning 3° more (P = 0.03) at midstance than HBF. The selected body composition variables were moderately correlated with VO2max (P < 0.001). Carbohydrate oxidation (CHO) is correlated with FM (R = +0.85, P ≤ 0.001) and SMM (R= +0.79, P ≤ 0.001), and MFO was only correlated with FM (R = +0.85, P = 0.00). The trunk lean angle was correlated with FM (R = −0.53; P = 0.04).

Conclusions:

Rugby players with NBF percentage and high SMM possessed higher VT2 value and delayed fat to CHO switch than HBF players. BMI, FM, SMM, bone mass and WHR are moderately influenced aerobic fitness. While FM and SMM strongly influence substrate oxidation, their association with running gait pattern is moderate to weak.
Effects of stretching versus strengthening exercise on pain level and static and dynamic balance among collegiate athletes with knee injuries
Authors: Azman Muhammad Irfan , Leong Ernie Yen Lee , Abdullah Nurul Fadhilah , Chan Ebby Waqqash Mohamad
Published: December 2024

Background:

This study compared the effects of stretching versus strengthening exercises on pain levels and static and dynamic balance among collegiate athletes with knee injuries.

Methods:

A quasi-experimental pre–post study design was employed involving 20 athletes mean age of 22.65 ± 1.18 years from a university, divided into stretching exercise group (n = 10) and strengthening exercise group (n = 10). Both groups completed 4 weeks of exercises, 3 times per week, with intensity adjusted based on progress. Outcome measures included pain levels and static and dynamic balance assessed using Visual Analog Scale, Stork Stand Test, and Y-Balance Test, respectively.

Results:

Within-group analysis showed that there was improvement for both groups (P < 0.05). Stretching exercise has been found to improve pain (−20.75%), static balance (16.89%) anterior dynamic balance (32.03%), posteromedial (PM) dynamic balance (29.50%), and posterolateral (PL) dynamic balance (17.96%). Conversely, strengthening exercise has been found to improve pain (−26.09%), static balance (11.22%), anterior dynamic balance (18.07%), PM dynamic balance (14.04%), and PL dynamic balance (11.51%). However, the between-group analysis showed no significant differences between both groups (P > 0.05).

Conclusion:

This suggests both exercises are effective in alleviating pain and improving static and dynamic balance. Therefore, incorporating both exercises into rehabilitation programs may benefit athletes with knee injuries.
Potential of Artificial Intelligence in Improving Speed and Efficiency of Clinical Trials
Authors: Prabhakar Vijay R.
Published: December 2024

In recent years, artificial intelligence (AI) has demonstrated its ability to improve many facets of health care. Clinical trials are no exception. There s enormous potential in the use of AI in all stages of clinical trials – planning, conduct, and analysis. However, clinical trials are highly regulated, and the guidance on the use of AI in trials has not yet been developed. Once these challenges are overcome or in the appropriate setting, AI can offer significant speed and cost advantage across all stages of clinical trials. In the planning stage, AI can simulate patient journey to enable patient-centric study design and identify the patient pool and investigational sites based on eligibility criteria. The tools can run multiple scenarios on timeline, cost, and complexity to determine feasibility. Generative AI can be used to create study documents. During study conduct, AI can be deployed to identify risks for data quality and integrity enabling reduction in monitoring visits and potentially reducing carbon footprint. AI can predict event accrual and data cleaning using machine learning. During study closeout, AI can accelerate data query resolution by bots and reduce site burden. The generative AI applied during the creation of study documents can be efficiently used to write study reports and generate tables and figures. In summary, AI has the potential to improve the efficiency of clinical trials, and if development is successful, AI can even potentially reduce the cost of drug to the patient.
Evaluation of preemptive pregabalin efficacy on block characteristics and postoperative analgesia in patients undergoing infra-umbilical surgeries under spinal anesthesia: A prospective randomized double-blind placebo controlled study
Authors: Kumari Indira , Dhania Swati , Sethi Surendra Kumar , Choudhary Santosh , Jain Ipra , Yadav Vidhu
Published: December 2024

Background and Aims:

Spinal anesthesia is the most common technique used for infraumbilical surgeries. Preemptive analgesics have been reported to improve the quality of spinal anesthesia and enhance postoperative analgesia. The present study aimed to evaluate the efficacy of preemptive oral pregabalin on the quality of spinal anesthesia and postoperative analgesia in patients undergoing infraumbilical surgeries.

Materials and Methods:

Seventy patients American Society of Anesthesiologists physical status I and II, posted for infra-umbilical surgeries under spinal anesthesia, were randomly allocated into two groups. Group P (n = 35) received preemptive oral pregabalin 150 mg and Group C (n = 35) received placebo, 1 h before surgery. Duration of sensory block was the primary objective while onset of sensory and motor block, duration of motor block and analgesia, rescue analgesic consumption, and side effects were secondary objectives. Qualitative and quantitative variables were analyzed using Chi-square test and Student’s t-test, respectively. P < 0.05 was considered significant.

Results:

The duration of sensory block was significantly longer in Group P (156.71 ± 5.41 min) than in Group C (135.14 ± 7.22 min) (P = 0.001) (95% CI = 21.57 [18.53–24.61]). The duration of postoperative analgesia was significantly longer in Group P (529.71 ± 6.17 min) than in Group C (219.85 ± 5.21 min) (P = 0.001) (95% CI = 309.86 [307.14–312.58]). The duration of the motor block was also significantly longer in Group P (220.28 ± 4.19 min) than in Group C (195.71 ± 5.95 min) (P = 0.001) (95% CI = 24.57 [22.12–27.03]). Onset of sensory and motor block was comparable between both groups. The rescue analgesic consumption was also significantly lesser in Group P (P < 0.000). Sedation scores were higher in the pregabalin group with stable hemodynamics and minimal side effects.

Conclusion:

Pregabalin can be effectively used as preemptive analgesic as it improves the spinal block characteristics and enhances the duration of postoperative analgesia along with minimal side effects.
Psychometric Properties of the Fear of Monkeypox Scale among Men Who Have Sex with Men
Authors: Lin Chung-Ying , Pakpour Amir H. , Griffiths Mark D. , Lin Chien-Wen , Yen Cheng-Fang
Published: December 2024

Objectives:

An outbreak of monkeypox (Mpox) appeared suddenly and rapidly spread worldwide during 2022. Men who have sex with men (MSM) are at a high risk of contracting Mpox compared to other cohorts. In the present study, we intended to examine the psychometric properties of a newly developed scale among MSM: the Fear of Mpox Scale (FMS) assessing the fear of Mpox.

Methods:

This is an online study. The factor structures of the FMS were first examined using exploratory factor analysis. After determining the factor structure, the FMS was further examined for (a) internal consistency using Cronbach’s α and (b) concurrent validity using correlations with anxiety, depression, and risk perception of contracting Mpox, and the known-group validity by comparing the scores of the FMS across MSM with sexual orientation and education level.

Results:

In total, 389 MSM participated in this study. The results indicated that the FMS had a one-factor structure. The FMS had acceptable internal consistency (α = 0.911) and concurrent validity (associated with anxiety [p < 0.01], depression [p < 0.001], and risk perception [p < 0.001]). No significant difference in the FMS scores was found between the groups with regard to sexual orientation or educational level.

Conclusion:

The results of the present study indicated that the psychometric properties of the FMS were good and that they can be used for assessing the fear of Mpox among MSM.
Contact with Nature: A Construction Study of the GREEN Model
Authors: Li Shih-Ming , Huang I-Feng , Yang Ya-Hui
Published: December 2024

Objective:

Contact with nature (CWN) is a key mental health promoting lifestyle. We developed the GREEN model, which comprises five factors – group, reflection, empowerment, emotion, and nature, to assess the mental health benefits from CWN. In this study, we intended to investigate whether the GREEN model can serve as a framework for CWN.

Methods:

In this study, we included 112 study participants of students aged 19–28 years taking classes between March and May 2023 at one of two Taiwanese universities. Assessments were done using the Analytic Hierarchy Process (AHP) questionnaire and the Inclusion of Nature in Self (INS) scale.

Results:

On the basis of the AHP survey results, we found that the following weights were assigned to the GREEN model factors: group, 0.13; reflection, 0.21; empowerment, 0.22; emotion, 0.31; and nature, 0.14. We also found that in a subset of study participants with a consistency ratio of < 0.1 in the AHP, the weights to the model factors were as follows: group, 0.12; reflection, 0.22; empowerment, 0.20; emotion, 0.34; and nature, 0.12. All five factors had a weight of > 0.1, indicating that they had good CWN. The weights for the GREEN model factors differed between the low- and high-INS groups. Emotional calmness was emerged as the most crucial factor for effective CWN programs.

Conclusion:

The results of this study suggest that the GREEN model is useful for CWN-related interventions.
Classification and identification of risk factors for type 2 diabetes
Authors: Tang Shan-Shan , Zhao Xue-Fei , An Xue-Dong , Sun Wen-Jie , Kang Xiao-Min , Sun Yu-Ting , Jiang Lin-Lin , Gao Qing , Li Ze-Hua , Ji Hang-Yu , Lian Feng-Mei
Published: December 2024

The risk factors for type 2 diabetes mellitus (T2DM) have been increasingly researched, but the lack of systematic identification and categorization makes it difficult for clinicians to quickly and accurately access and understand all the risk factors, which are categorized in this paper into five categories: Social determinants, lifestyle, checkable/testable risk factors, history of illness and medication, and other factors, which are discussed in a narrative review. Meanwhile, this paper points out the problems of the current research, helps to improve the systematic categorisation and practicality of T2DM risk factors, and provides a professional research basis for clinical practice and industry decision-making.
Renal effects and safety of tirzepatide in subjects with and without diabetes: A systematic review and meta-analysis
Authors: Kamrul-Hasan A B M , Patra Shinjan , Dutta Deep , Nagendra Lakshmi , Muntahi-Reza AFM , Borozan Sanja , Pappachan Joseph M
Published: December 2024

BACKGROUND

Type 2 diabetes (T2D), as well as obesity, are risk factors for chronic kidney disease (CKD) and end-stage renal disease. The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefits in preventing CKD often guide clinicians in choosing them appropriately. Only limited data based on randomized controlled trials (RCTs) is currently available on the renal effects and safety profile of tirzepatide.

AIM

To explore the renal benefits and safety of tirzepatide vs controls.

METHODS

RCTs involving patients receiving tirzepatide for any indication in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases. The co-primary outcomes were percent change from baseline (CFB) in urine albumin-to-creatinine ratio (UACR) and absolute CFB in estimated glomerular filtration rate (eGFR; in mL/min/1.73 m2); the secondary outcome was tirzepatide’s renal safety profile. RevMan web was used to conduct meta-analysis using random-effects models. Outcomes were presented as mean differences (MD) or risk ratios with 95% confidence intervals.

RESULTS

Fifteen RCTs (n = 14471) with mostly low risk of bias (RoB) were included. Over 26-72 weeks, tirzepatide 10 mg [MD -26.95% (-40.13, -13.76), P < 0.0001] and 15 mg [MD -18.03% (-28.58, -7.47), P = 0.0008] were superior to placebo in percent reductions of UACR. Tirzepatide, at all doses, outperformed insulin in percent reductions of UACR. Compared to the placebo, the percent UACR reduction was greater in subjects with T2D than those with obesity but without T2D (MD -33.25% vs -7.93%; P = 0.001). The CFB in eGFR with all doses of tirzepatide was comparable [5 mg: MD- 0.36 (-1.41, 2.14); 10 mg: MD- 1.17 (-0.22, 2.56); 15 mg: MD- 1.42 (-0.04, 2.88)]; P < 0.05 for all] vs insulin. Tirzepatide (pooled and separate doses) did not increase the risks of adverse renal events, urinary tract infection, nephrolithiasis, acute kidney injury, and renal cancer compared to the placebo, insulin, and glucagon-like peptide-1 receptor agonists.

CONCLUSION

Short-term data from RCTs with low RoB suggests that tirzepatide positively impacts UACR without detrimental effects on eGFR in subjects with T2D and obesity without T2D, with a reassuring renal safety profile. Larger RCTs are warranted to prove the longer-term renal benefits of tirzepatide, which might also prevent eGFR decline and worsening of CKD.
Insulin autoantibodies, D-dimer and microalbuminuria: A cross-sectional, case-control study of type 2 diabetes
Authors: Zhang Lin-Shan , Yu Peng , Yao Fei , Lu Zhi-Qiang , Li Xiao-Mu , Chen Hong
Published: December 2024

BACKGROUND

Type 2 diabetes mellitus (T2DM) often leads to vascular complications, such as albuminuria. The role of insulin autoantibodies (IAA) and their interaction with D-dimer in this context remains unclear.

AIM

To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.

METHODS

We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin, and 115 age- and sex-matched IAA-negative T2DM patients as controls. Propensity scores were calculated using multivariate logistic regression. Key variables were selected using the least absolute shrinkage and selection operator (LASSO) algorithm. We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.

RESULTS

The IAA-positive group had significantly higher D-dimer levels [0.30 (0.19-0.55) mg/L vs 0.21 (0.19-0.33) mg/L, P = 0.008] and plasma insulin levels [39.1 (12.0-102.7) μU/mL vs 9.8 (5.5-17.6) μU/mL, P < 0.001] compared to the IAA-negative group. Increases in the insulin dose per weight ratio, diabetes duration, and urinary albumin-to-creatinine ratio (UACR) were observed but did not reach statistical significance. The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients. D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group. The odds ratio for D-dimer elevation (> 0.5 g/L) was 2.88 (95% confidence interval: 1.17-7.07) in the IAA-positive group (P interaction < 0.05).

CONCLUSION

D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.
Distinguishing exocrine pancreas disease-associated diabetes from type 2 diabetes based on anthropometric and metabolic parameters
Authors: Juza Anna , Kołodziej-Spirodek Lilianna , Gutkowski Krzysztof , Partyka Mariusz , Dąbrowski Mariusz
Published: December 2024

BACKGROUND

Adult-onset diabetes is most often considered to be type 2 diabetes. However, other types of diabetes can develop in adults, including exocrine pancreas disease-associated diabetes, also called type 3c diabetes. Differential diagnosis between these types of diabetes still remains a diagnostic challenge.

AIM

To define anthropometric and laboratory markers that will allow for early diagnosis of pancreatic disease-associated diabetes.

METHODS

The study group included 44 patients with pancreatogenic diabetes (26 with pancreatic cancer and 18 with chronic pancreatitis), while the control group consisted of 35 patients with type 2 diabetes. We analyzed several parameters, including sex, age, body mass index (BMI), fasting plasma glucose, fasting C-peptide and insulin with homeostasis model assessment of insulin resistance (HOMA-IR) index calculation, adrenomedullin, adiponectin and creatinine levels with epidermal growth factor receptor (eGFR) calculation. We also developed an equation, termed type 3c diabetes index, which utilized BMI, fasting insulin and adrenomedullin levels, and eGFR to better identify patients with type 3c diabetes.

RESULTS

Compared to patients with type 2 diabetes, patients with pancreatogenic diabetes had significantly lower BMI (25.11 ± 4.87 kg/m2 vs 30.83 ± 5.21 kg/m2), fasting C-peptide (0.81 ± 0.42 nmol/L vs 1.71 ± 0.80 nmol/L), insulin (76.81 ± 63.34 pmol/L vs 233.19 ± 164.51 pmol/L) and HOMA-IR index, despite similar fasting plasma glucose levels. Patients with pancreatogenic diabetes also had lower adrenomedullin levels (0.41 ± 0.25 ng/mL vs 0.63 ± 0.38 ng/mL) but higher adiponectin levels (13.08 ± 7.20 μg/mL vs 8.28 ± 4.01 μg/mL) and eGFR levels (100.53 ± 21.60 mL/min/1.73 m2 vs 85.14 ± 19.24 mL/min/1.73 m2). Finally, patients with pancreatogenic diabetes had significantly lower Type 3c diabetes index values.

CONCLUSION

Patients with pancreatogenic diabetes differ from patients with type 2 diabetes in anthropometric and laboratory parameters. The type 3c diabetes index had the highest discriminating value, above any single parameter.
Interdisciplinary perspectives on diabetes and microcirculatory dysfunction: A global bibliometric analysis
Authors: Li Yuan , Wang Bing , Xu Meng-Ting , Wang Ying-Yu , Liu Wei-Qi , Fu Sun-Jing , Li Bing-Wei , Ling Hao , Liu Xue-Ting , Zhang Xiao-Yan , Li Ai-Ling , Zhang Xu , Liu Ming-Ming
Published: December 2024

BACKGROUND

The prevalence of diabetes and its association with microcirculatory dysfunction presents a significant challenge in contemporary global health. Addressing this nexus is crucial for developing targeted therapeutic interventions.

AIM

To trace the progression and delineate the current state of interdisciplinary research concerning diabetes and microcirculation.

METHODS

Employing a bibliometric approach, this study scrutinizes 12886 peer-reviewed publications retrieved from the PubMed and Web of Science databases. The focus is on elucidating the research trajectory and thematic concentrations at the confluence of diabetes and microcirculation.

RESULTS

Research outputs have surged since 2011, with the United States, China, and the United Kingdom leading in the quantity and quality of publications. This analysis revealed that journals such as Diabetes Care and The New England Journal of Medicine, along with top research institutions, have significantly contributed to advancing the understanding of microvascular processes affected by diabetes. The central themes identified include inflammation, oxidative stress, and endothelial dysfunction, which are critical in mediating the microvascular complications of diabetes.

CONCLUSION

This bibliometric evaluation reveals an evolving landscape focusing on diabetes and microcirculatory dysfunction. The complexity of diabetic microvascular issues encouraged multidisciplinary research strategies that are imperative for global health outcomes.
Tacrolimus induces insulin receptor substrate 1 hyperphosphorylation and inhibits mTORc1/S6K1 cascade in HL7702 cells
Authors: Li Hao-Yan , Wang Yi , Ran Min , Gao Fei , Zhu Bo-Yu , Xiao Hai-Ying , Xu Chun
Published: December 2024

BACKGROUND

Tacrolimus (FK506) is a key calcineurin inhibitor used to prevent organ transplant rejection and is effective in improving graft survival. However, it is linked to hyperglycemia and insulin resistance, contributing to new-onset diabetes after transplantation and negatively affecting islet function.

AIM

To study the effects of tacrolimus on the insulin signaling pathway of hepatocytes.

METHODS

HL7702 cells were treated with different concentrations of tacrolimus (0.1 mg/L, 1 mg/L, 5 mg/L) for 24 hours. The proteins involved in insulin signaling were detected by Western blotting.

RESULTS

Compared with the control group, phosphorylation of insulin receptor substrate (IRS) 1 at Ser 307 and Ser 323 were increased significantly when the tacrolimus concentration reached 1 and 5 mg/L. Phosphorylation of IRS1 at Ser 1101 was also increased, although not significantly. However, phosphorylation of Ribosomal protein S6 kinase beta-1 at Thr 389 was decreased significantly. The levels of phosphorylated glycogen synthase kinase 3α Ser 21 and Ser 9 were increased. Surprisingly, phosphorylation of glycogen synthase at Ser 641 was increased. There was no significant change in the activity of glycogen phosphorylase.

CONCLUSION

Tacrolimus has no direct effect on hepatic glucose metabolism, but inhibits IRS1-mediated insulin signaling. This may be one of the underlying mechanisms by which tacrolimus induces insulin resistance.
Efficacy of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists on proteinuria and weight in a diabetes cohort
Authors: Lu Di-Fei , Zheng Rui , Li Ang , Zhang Jun-Qing
Published: December 2024

BACKGROUND

With accumulating evidence showing a benefit in the renal and cardiovascular systems, diabetes guidelines recommend that patients with diabetes and chronic kidney disease (CKD) be treated with sodium-glucose cotransporter-2 inhibitor (SGLT2i) and/or glucagon like peptide-1 receptor agonists (GLP-1RAs) for renal protection. The real-world efficacy of the two medications on the urinary albumin-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) remains to be explored.

AIM

To evaluate the SGLT2i and GLP-1RA application rates and UACR alterations after intervention in a real-world cohort of patients with diabetes.

METHODS

A cohort of 5482 patients with type 2 diabetes were enrolled and followed up at the Integrated Care Clinic for Diabetes of Peking University First Hospital for at least 6 months. Propensity score matching was performed, and patients who were not recommended for GLP-1RA or SGLT2i with comparable sex categories and ages were assigned to the control group at a 1:2 ratio. Blood glucose, body weight, UACR and eGFR were evaluated after 6 months of treatment in real-world clinical practice.

RESULTS

A total of 139 (2.54%) patients started GLP-1RA, and 387 (7.06%) received SGLT2i. After 6 months, the variations in fasting blood glucose, prandial blood glucose, and glycosylated hemoglobin between the GLP-1RA group and the SGLT2i and control groups were not significantly different. UACR showed a tendency toward a greater reduction compared with the control group, although this difference was not statistically significant (GLP-1RA vs control, -2.20 vs 30.16 mg/g, P = 0.812; SGLT2i vs control, -20.61 vs 12.01 mg/g, P = 0.327); eGFR alteration also showed no significant differences. Significant weight loss was observed in the GLP-1RA group compared with the control group (GLP-1RA vs control, -0.90 vs 0.27 kg, P < 0.001), as well as in the SGLT2i group (SGLT2i vs control, -0.59 vs -0.03 kg, P = 0.010).

CONCLUSION

Compared with patients who received other glucose-lowering drugs, patients receiving SGLT2i or GLP-1RAs presented significant weight loss, a decreasing trend in UACR and comparable glucose-lowering effects in real-world settings.
Correlation between diabetic peripheral neuropathy and thyroid hormone sensitivity in elderly patients with type 2 diabetes mellitus
Authors: Fei Si-Jia , Luo Jing-Yi , Wang Wei-Hao , Guo Li-Xin , Pan Qi
Published: December 2024

BACKGROUND

Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM), significantly affecting patients’ quality of life and imposing a substantial economic burden. Recent studies have highlighted the role of thyroid hormones in diabetes complications, particularly in elderly patients with T2DM. However, the relationship between thyroid hormone sensitivity and DPN remains unclear.

AIM

To investigate the correlation between thyroid hormone sensitivity and DPN in elderly patients with T2DM.

METHODS

In a cohort of 256 elderly patients with T2DM, propensity score matching was used to balance age, sex, and diabetes duration. Clinical data were collected to calculate thyroid hormone sensitivity and analyze its correlation with DPN. A random forest model was used to evaluate the diagnostic value of free triiodothyronine/free thyroxine (FT3/FT4) for DPN.

RESULTS

Patients with DPN had a lower FT3/FT4 ratio [ (0.302 ± 0.053) vs (0.316 ± 0.049), P = 0.040]. Quartile stratification showed decreasing DPN prevalence with higher FT3/FT4 ratios. Spearman’s correlation analysis showed that a lower FT3/FT4 ratio was associated with higher glycated hemoglobin, fasting blood glucose, reduced nerve conduction velocity, and electrical skin conductance. Logistic regression indicated a positive relationship between the median FT3/FT4 ratio and bilateral foot electrochemical skin conductance [odds ratio (OR): 1.019; 95%CI: 1.005-1.034; P = 0.007] and sural nerve sensory amplitude (OR: 1.310; 95%CI: 1.008-1.703; P = 0.043). Receiver operating characteristic analysis using a random forest model showed that incorporating FT3/FT4 improved predictive performance for DPN, with an area under the curve of 0.74, sensitivity of 0.79, specificity of 0.64, and accuracy of 0.77.

CONCLUSION

In elderly patients with T2DM with euthyroidism, a lower FT3/FT4 ratio is correlated with increased DPN incidence, affecting both large and small nerve fibers. FT3/FT4 is an effective predictor of DPN.
Nova grščina za klasične filologe
Authors: Kavčič Jerneja
Published: December 2024

Namen pričujoče objave je pokazati, kako uporabiti staro grščino kot osnovo za učenje novogrškega jezika. Temelji na opažanju, da se lahko velik del besedišča, pa tudi slovničnih oblik stare grščine uporabi v novi grščini, ne da bi se pravil slednje posebej učili. Ideja se morda zdi nenavadna, ker se tudi klasični filologi učenja nove grščine ponavadi lotijo s pomočjo enega od številnih učbenikov, namenjenih učenju nove grščine kot tujega jezika. Ti na podobnosti med staro in novo grščino praviloma ne opozarjajo niti jih ne skušajo izkoriščati, vse to pa velja tudi za učbenike, ki v svojem naslovu trdijo, da so nastali za potrebe klasičnih filologov.
Evaluating the impact of replacing synthetic detergents with fatty acids made soap on microbial dynamics and wastewater treatment efficiency
Authors: Chairattanamanokorn Prapaipid , Imai Tsuyoshi , Sudiartha Gede Adi Wiguna , Fujii Akihiko , Migita Yoshiomi , Kitazato Miho , Yoshida Miki , Kanyama Takahide , Kawahara Takayoshi
Published: December 2024

Synthetic detergent contains linear alkyl sulfonate (LAS) that presents a greater environmental risk compared to other contaminants. There has been an interest in replacing synthetic detergent with a more biodegradable detergent made from a mixture of sodium and potassium fatty acid. The present study conducted a field experiment by replacing the usage of detergent with soap (a combination of sodium and potassium fatty acid) in two household areas to evaluate the divergent effect of detergent and soap on the microbiome of the activated sludge process for sewage treatment. Results indicated that the use of soap increased the abundance of fatty acid-consuming bacteria and nitrogen-fixation bacteria. Additionally, soap enables more bacteria strains to be proactive in degrading organic matter, LAS, anionic, and nonionic surfactants. Consequently, replacing detergents with soap in WWTP service areas can positively influence microbial dynamics, improving the overall efficiency of the wastewater treatment process.