bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomised-crossover clinical trial on the substantivity of a single application of a gel containing chlorhexidine and o-cymen-5-ol on the oral biofilm and saliva
Authors: Suárez-Rodríguez B. , Regueira-Iglesias A. , Blanco-Pintos T. , Sánchez-Barco A. , Vila-Blanco N. , Balsa-Castro C. , Carreira M. J. , Tomás I.
Published: October 2024

Background

No clinical trials have evaluated the antimicrobial activity and substantivity of gel formulations containing chlorhexidine (CHX) and cymenol.

Objective

To compare the in situ antimicrobial effect and substantivity of a new 0.20% CHX + cymenol gel (test) with the current 0.20% CHX gel formulation (control) on salivary flora and dental plaque biofilm up to seven hours after a single application.

Methods

A randomised-crossover clinical trial was conducted with 29 orally healthy volunteers participating in the development of Experiments 1 (saliva) and 2 (dental plaque biofilm). All subjects participated in both experiments and were randomly assigned to receive either the test or control gels. Samples were collected at baseline and five minutes and one, three, five, and seven hours after a single application of the products. The specimens were processed using confocal laser scanning microscopy after staining with the LIVE/DEAD® BacLight™ solution. Bacterial viability (BV) was quantified in the saliva and biofilm samples. The BV was calculated using the DenTiUS Biofilm software.

Results

In Experiment 1, the mean baseline BV was significantly reduced five minutes after application in the test group (87.00% vs. 26.50%; p < 0.01). This effect was maintained throughout all sampling times and continued up to seven hours (40.40%, p < 0.01). The CHX control followed the same pattern. In Experiment 2, the mean baseline BV was also significantly lower five minutes after applying the test gel for: (1) the total thickness of biofilm (91.00% vs. 5.80%; p < 0.01); (2) the upper layer (91.29% vs. 3.94%; p < 0.01); and (3) the lower layer (86.29% vs. 3.83%; p < 0.01). The reduction of BV from baseline was observed for the full-thickness and by layers at all sampling moments and continued seven hours after application (21.30%, 24.13%, and 22.06%, respectively; p < 0.01). Again, the control group showed similar results. No significant differences between test and control gels were observed in either saliva or dental plaque biofilm at any sampling time.

Conclusions

A 0.20% CHX + cymenol gel application demonstrates potent and immediate antimicrobial activity on salivary flora and de novo biofilm. This effect is maintained seven hours after application. Similar effects are obtained with a 0.20% CHX-only gel.
Regulation of health professions education and the growth of schools in Somalia
Authors: Hassan Mulki Mukhtar , Ali Amal Naleye , Ali Ifrah , Mohamed Zeinab Omar , Abdullahi Hamza Mohamed , Ahmed Mohamed Mustaf , Mohamud Abdirahman Khalif , Adebisi Yusuff Adebayo , Okesanya Olalekan John , Lucero-Prisno III Don Eliseo
Published: October 2024

Background

Health professions education, encompassing training programs for medicine and surgery, nursing, midwifery, medical laboratory sciences,, and public health, along with their regulations, are pivotal to achieving universal health coverage and Sustainable Development Goals, contributing significantly to health outcomes and public trust in the healthcare workforce. However, low- and middle-income countries, especially in sub-Saharan Africa, face challenges, such as inadequate resources, outdated curricula, and weak governance. Somalia in particular grapples with a fragmented health system and a critical shortage of skilled health professionals, exacerbated by decades of civil war and political instability.

Methods

This study employed a mixed-method approach that incorporated both qualitative and quantitative data collection and analysis. A comprehensive literature review was conducted along with semi-structured interviews with 44 key informants, including representatives from professional health schools and officials from the Ministry of Health. Additionally, five focus group discussions were held with young professionals and an online survey was administered to students enrolled in professional health courses. The data analysis employed descriptive for quantitative data, and thematic analysis for qualitative data, guided by the human resources for health (HRH) maturity model framework.

Results

This study identified 112 health professions schools across Somalia, with a significant concentration in urban areas, particularly in Benadir. The health workforce analysis revealed a pronounced urban-rural disparity and a density of health professionals below the WHO’s recommended threshold. The focus group discussions and surveys highlighted the employment challenges faced by young physicians and students’ perceptions of their training and future employment opportunities.

Conclusion

The proliferation of health professions schools without adequate quality control, the critical shortage and maldistribution of skilled health professionals, and the absence of a comprehensive regulatory framework are significant challenges facing Somalia’s healthcare system. The establishment of the National Health Professionals’ Council (NHPC) Act in 2020 marks a step towards addressing these issues. This study emphasizes the need for accreditation of health professions schools, capacity building of HRH teams, and collaboration among stakeholders to improve healthcare workforce development and regulation. Addressing urban-rural disparities and combating professional misconduct are also crucial for achieving universal health coverage and improving health outcomes in Somalia.
Promoting motivation and reducing stress in medical students by utilizing self-determination theory – a randomized controlled trial in practical psychiatry courses
Authors: Triebner Nina , Sonnauer Franziska , Rauch Miriam , Kersten Gian-Marco , Rauch Christoph , Mestermann Stefan , Bailer Maximillian , Kornhuber Johannes , Utz Janine , Spitzer Philipp
Published: October 2024

Background

Medical students experience high levels of stress and related mental health problems. Students’ autonomous and controlled motivation and their mental well-being are interconnected. This study aimed to investigate whether an innovative teaching concept based on self-determination theory (SDT) could improve students’ motivation and thereby reduce their stress levels, ultimately providing a healthier framework for learning.

Methods

In a week-long practical psychiatry course for medical students, a new didactic concept was implemented in half the groups (n = 73) and compared with the preexisting concept (n = 75) as a randomized controlled trial (RCT). To promote the SDT-target factors of perceived autonomy, competence, and relatedness, the methods used included team building, exclusively positive feedback, group discussions, and choice in task distribution. Significant group differences in motivation, stress, performance, and their relationships were analyzed through t-tests, multiple linear regression analyses, mediation analyses, and hierarchical linear modeling (HLM) using questionnaires collected before (t0) and after (t1) the course, and students’ exam results (t2).

Results

In the innovation group (n = 53), intrinsic motivation/interest (d = 0.41; p = .019) and perceived choice/autonomy (d = 0.33; p = .048) were greater than in the control group (n = 52). While autonomous regulation remained stable, the innovation group showed reduced controlled regulation (d = -0.36; p = .033) and reported significantly lower stress (d = -0.55; p = .003). The observed changes in motivation collectively mediated the stress reduction. However, students in the innovation group achieved lower exam scores, which seemed to result from the absence of critical feedback, but not from the observed differences in motivation or stress.

Conclusions

This study demonstrated that enhancing intrinsic motivation through SDT-based teaching can effectively reduce stress in medical students. Exclusively strengths-based positive feedback may have hindered exam performance, but optimizing educational concepts to promote motivation and reduce stress will be a valuable step toward improving medical students’ mental well-being.
“Between formulas and freestyle” – a qualitative analysis of peer tutor preparation and its impact on peer relations
Authors: Herinek Doreen , Woodward-Kron Robyn , Ewers Michael
Published: October 2024

Background

Peer tutorials are widely used in medical and health professions education. Some evidence suggests that peer tutorials can have positive effects for student peer tutors and tutees alike. To promote these positive effects, peer tutors are often prepared for their tasks. However, detailed information about this preparation is missing in the literature. The present study thus examines from the tutors’ perspective how peer tutor preparation is conducted, both in interprofessional and uniprofessional contexts, and how this preparation affects peer relations.

Methods

A qualitative design was used for the study. For data gathering, three online focus group discussions were conducted with student peer tutors from uniprofessional and interprofessional settings who had a background in health professions. Data were analysed inductively via thematic analysis.

Results

A total of 19 individuals participated in three focus group discussions (n = 6/n = 6/n = 7). From the participants’ perspective, preparation measures were heterogenous. Of a wide range of different measures, some were perceived as more helpful, others as less helpful. In analysing the data, three relevant themes came up which were dereived from the peer tutors’ perspective: roles, eye level, and (self-)trust. All three themes were found to be closely related and appeared to have a direct influence on peer relations. This influence on the learning/teaching process was either positive or negative depending on the respondents’ experiences.

Conclusion

From the peer tutors’ perspective, the preparation they received affected their relationships with their peers in a variety of ways, influenced by the context and the peer tutors’ needs. This finding should be taken into account when planning and implementing future preparatory activities. In addition, further pedagogical considerations and discussions about preparatory activities for peer tutors and their potential impact on social and cognitive congruence are needed.
Assessment of ICU nurses’ competency towards delirium among critically ill patients
Authors: Hebeshy Mona Ibrahim , Gaballah Samia Hussieny , Ibrahim Noha Mohammed
Published: October 2024

Background

ICU nurses play a critical role in managing delirium in critically ill patients, yet their competency in this area remains under-explored.

Aim

To assess ICU nurses’ competency including their knowledge, practice, and attitudes toward delirium among critically ill patients.

Methods

A correlational descriptive study was conducted with 67 nurses in the medical intensive care unit at Suez Canal University Hospitals. Data was collected using an online survey and analyzed using descriptive statistics, ANOVA, and Pearson’s correlation.

Results

Nurses showed a moderate knowledge level (M = 8.55), a low practice level (M = 6.62), and positive attitudes (M = 21.65) toward ICU delirium. ANOVA results indicated significant differences in practice scores based on educational level, F (2, 64) = 3.361, p = .041, and in knowledge scores based on ICU experience, F(3, 63) = 6.455, p < .001. Nurses with Master of Science in Nursing (MSN) degrees had higher practice scores than those with diplomas or Bachelor of Science in Nursing (BSN) degrees. There were no significant differences in knowledge and attitude scores based on educational level or age. Gender differences were minimal, with male nurses slightly outperforming female nurses. Correlation analysis showed positive relationships between age, education, ICU experience, and ICU nurses’ levels of knowledge and practice.

Conclusion

ICU nurses demonstrate a knowledge-practice gap in delirium management. Targeted educational interventions, mentorship programs, and a focus on practical skills are essential to enhance delirium care.

Relevance to clinical practice

These findings highlight the urgent need for comprehensive delirium education and training programs for ICU nurses. By improving nurses’ knowledge and practice, healthcare organizations can significantly enhance the early detection, prevention, and management of delirium, ultimately leading to improved patient outcomes and reduced length of stay in the ICU.
Health knowledge after stroke in Switzerland: a survey among health professionals on current practice and suggestions for the implementation of a technology-based educational program for stroke survivors
Authors: Devittori Giada , Peduzzi Mosè , Dinacci Daria , Rossi Paolo , Petrillo Claudio , Gassert Roger , Lambercy Olivier
Published: October 2024

Background

It is estimated that 1 in 4 stroke survivors will experience a second stroke. Educating patients about risk factors for stroke and a generally healthier lifestyle may help prevent recurrent strokes, which are a burden on society and the healthcare system. The goals of this paper were to investigate the estimated level of knowledge of stroke patients regarding their disease, the methods of information commonly used in clinical practice, the topics that should be included in an educational program aimed at improving health knowledge among stroke survivors, and how such a program could be delivered with the help of technology-based education (i.e., information delivered by digital platforms such as smartphones or rehabilitation technologies).

Methods

We performed a survey among health professionals working with stroke patients in Switzerland.

Results

161 health professionals of different backgrounds took part in the survey, and 94 completed it. According to the results, only 33% of healthcare professionals thought that patients were well informed about stroke one month after stroke onset. These findings suggest that there is room for improvement in how stroke patients are educated about stroke, risk factors, and prevention. Additionally, it was highlighted that technology is not commonly used in clinical practice to support patients’ education, although this is an acceptable method for healthcare professionals. The results also helped to identify key topics to be included in an educational program and recommendations for implementing such a program in rehabilitation technologies.

Conclusions

This work allowed gaining more insight into healthcare professionals’ opinions on the potential of technology-based education and key aspects to consider when implementing it to support health and prevention knowledge after stroke.
Can switching from cigarettes to heated tobacco products reduce consequences of pulmonary infection?
Authors: Bhat Tariq A. , Kalathil Suresh G. , Leigh Noel J. , Goniewicz Maciej L. , Thanavala Yasmin M.
Published: October 2024

Rationale

While tobacco industry data suggests that switching from combustible cigarettes to heated tobacco products (HTPs), like IQOS, may reduce the users’ exposure to respiratory toxicants, it is not known if using HTPs impacts the outcomes of acute respiratory infections.

Objectives

Does switching from cigarettes to HTPs improve responses to pulmonary infection.

Methods

We conducted experiments in which 3 groups of mice were pre-exposed to cigarette smoke for 8 weeks, followed by 8-week exposure to (1) HTPs (tobacco product switching), (2) air (smoking cessation), or (3) continued exposure to cigarette smoke. Pulmonary bacterial clearance and surrogate markers of lung damage were assessed as study outcomes.

Main results

Significantly compromised clearance of bacteria from the lungs post-acute challenge occurred in both the switching group and in mice continuously exposed to cigarette smoke. Bacterial clearance, inflammatory T-cell infiltration into the lungs, and albumin leak improved at 12 h post-acute challenge in the switching group compared to mice continuously exposed to cigarette smoke. Bacterial clearance, total lung immune-cell infiltration, inflammatory T-cell infiltration into the lungs, the content of total proteins in the BAL, and albumin leak measured post-acute challenge were compromised in the switching group compared to mice in the cessation group. Switching from cigarettes to HTPs did not improve lung myeloperoxidase and neutrophil elastase levels (markers for lung inflammation and damage), which, however, were significantly reduced in the cessation group.

Conclusions

This study reveals only a modest improvement in respiratory infection outcomes after switching exposure from cigarettes to HTPs and significantly compromised outcomes compared to a complete cessation of exposure to all tobacco products.
Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes
Authors: Bertrand Ambre , Lewis Andrew , Camps Julia , Grau Vicente , Rodriguez Blanca
Published: October 2024

Background

Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of cardiac deterioration in T2DM patients is critical for prevention. Our goal is to quantify T2DM-driven abnormalities in ECG and cardiac imaging biomarkers leading to cardiovascular disease.

Methods

We quantified ECG and cardiac magnetic resonance imaging biomarkers in two matched cohorts of 1781 UK Biobank participants, with and without T2DM, and no diagnosed cardiovascular disease at the time of assessment. We performed a pair-matched cross-sectional study to compare cardiac biomarkers in both cohorts, and examined the association between T2DM and these biomarkers. We built multivariate multiple linear regression models sequentially adjusted for socio-demographic, lifestyle, and clinical covariates.

Results

Participants with T2DM had a higher resting heart rate (66 vs. 61 beats per minute, p < 0.001), longer QTc interval (424 vs. 420ms, p < 0.001), reduced T wave amplitude (0.33 vs. 0.37mV, p < 0.001), lower stroke volume (72 vs. 78ml, p < 0.001) and thicker left ventricular wall (6.1 vs. 5.9mm, p < 0.001) despite a decreased Sokolow-Lyon index (19.1 vs. 20.2mm, p < 0.001). T2DM was independently associated with higher heart rate (beta = 3.11, 95% CI = [2.11,4.10], p < 0.001), lower stroke volume (beta = −4.11, 95% CI = [−6.03, −2.19], p < 0.001) and higher left ventricular wall thickness (beta = 0.133, 95% CI = [0.081,0.186], p < 0.001). Trends were consistent in subgroups of different sex, age and body mass index. Fewer significant differences were observed in participants of non-white ethnic background. QRS duration and Sokolow-Lyon index showed a positive association with the development of cardiovascular disease in cohorts with and without T2DM, respectively. A higher left ventricular mass and wall thickness were associated with cardiovascular outcomes in both groups.

Conclusion

T2DM prior to cardiovascular disease was linked with a higher heart rate, QTc prolongation, T wave amplitude reduction, as well as lower stroke volume and increased left ventricular wall thickness. Increased QRS duration and left ventricular wall thickness and mass were most strongly associated with future cardiovascular disease. Although subclinical, these changes may indicate the presence of autonomic dysfunction and diabetic cardiomyopathy.

Graphical Abstract
Stem cell treatment for regeneration of the rotator cuff: study protocol for a prospective single-center randomized controlled trial (Lipo-cuff)
Authors: Cartuliares Mariana Bichuette , Hejbøl Eva Kildall , Schrøder Henrik Daa , Pedersen Andreas Kristian , Frich Lars Henrik
Published: October 2024

Background

Rotator cuff tears (RCT) are a common musculoskeletal condition, especially in the aging population. The prevalence of rotator cuff tears varies based on factors like age, occupation, and activity level. In the general population, the prevalence of rotator cuff tears is estimated to be around 20 to 25%. Rotator cuff tears (RCT) have an impact in patients’ pain level, shoulder function, sleep disturbance, and quality of life. Primary tendon surgery is in mostly cases necessary. This study aimed to examine if treatment of rotator cuff lesions with implantation of micro-fragmented adipose tissue can improve patients’ reported pain and function compared to conventional surgery.

Methods

The study is a prospective superiority parallel-group single-center randomized controlled trial including 30 patients between 40 and 69 years of age in Denmark. Patients will be allocated 1:1 ratio to reconstruction of the supraspinatus tendon with an injection of micro-fragmented adipose tissue into the related muscle (stem cell treatment) or the standard of care (SOC), which is conventional surgery. Patients, project assistants, physicians, and outcome adjudicators are not blinded to randomization due to practical constraints. The radiologist and the statistician performing the analysis will be blinded. The primary outcome will be the Oxford shoulder score at 12 months post-surgery.

Discussion

This study will assess whether adding micro-fragmented adipose tissue therapy to conventional rotator cuff tear treatment can enhance recovery, accelerate return to daily activities, and improve functional outcomes. The research will also determine if this minimally invasive procedure could be standardized for routine patient care.

Trial registration

ClinicalTrials.gov NCT06505135. Registered on July 10, 2024.
Multiple bloodmeals enhance dissemination of arboviruses in three medically relevant mosquito genera
Authors: Ferdous Zannatul , Dieme Constentin , Sproch Hannah , Kramer Laura D. , Ciota Alexander T. , Brackney Doug E. , Armstrong Philip M.
Published: October 2024

Background

Mosquitoes in nature may acquire multiple bloodmeals (BMs) over the course of their lifetime; however, incorporation of frequent feeding behavior in laboratory vector competence studies is rarely done. We have previously shown that acquisition of a second non-infectious BM can enhance early dissemination of Zika virus (ZIKV), dengue virus, and chikungunya virus in Aedes aegypti and ZIKV in Aedes albopictus mosquitoes, yet it is unknown if other taxonomically-diverse virus-vector pairings show a similar trend under a sequential feeding regimen.

Methods

To test this, we evaluated the impact of a second noninfectious BM on the vector competence of Aedes aegypti and Anopheles quadrimaculatus for Mayaro virus, Culex quinquefasciatus for West Nile virus, Aedes triseriatus for La Crosse virus, and Aedes aegypti for Oropouche virus (OROV). Female mosquitoes were fed BMs containing these viruses and half of them were given a second noninfectious BM at 3 or 4-days post infection. Mosquitoes were harvested at various time points and assayed for virus infection in bodies and disseminated infection in legs by performing reverse transcription-quantitative polymerase chain reaction (RT-qPCR) assays.

Results

We found that a second noninfectious BM had no impact on midgut infection rates but increased virus dissemination for all but one of the virus-vector pairings- Ae. aegypti and OROV. Unlike the other arboviruses under consideration, which are strictly mosquito-borne, biting midges (Culicoides spp.) serve as the main vector of OROV and this virus rarely disseminated to the mosquito leg tissue in our study.

Conclusions

Taken together, our findings show that sequential blood feeding enhances virus dissemination across diverse arbovirus-vector pairings, representing three mosquito genera and virus families, but a second BM was insufficient to overcome a strong midgut virus escape barrier in a nonnatural virus–vector pairing.

Graphical Abstract
Accelerating de novo SINE annotation in plant and animal genomes
Authors: Liao Herui , Sun Yanni , Ou Shujun
Published: October 2024

Genome annotation is an important but challenging task. Accurate identification of short interspersed nuclear elements (SINEs) is particularly difficult due to their lack of highly conserved sequences. AnnoSINE is state-of-the-art software for annotating SINEs in plant genomes, but it is computationally inefficient for large genomes. Moreover, its applicability to animals is limited due to the absence of animal pHMMs in its HMM library. Therefore, we propose AnnoSINE_v2, which extends accurate SINE annotation for animal genomes with greatly optimized computational efficiency. Our results show that AnnoSINE_v2’s annotation of SINEs has over 20% higher F1-score compared to the existing tools on animal genomes and enables the processing of complicated genomes, like human and zebrafish, which were beyond the capabilities of AnnoSINE_v1. AnnoSINE_v2 is freely available on Conda and GitHub: https://github.com/liaoherui/AnnoSINE_v2.
Association of hyperactivated transposon expression with exacerbated immune activation in systemic lupus erythematosus
Authors: Wang Frank Qingyun , Dang Xiao , Su Huidong , Lei Yao , She Chun Hing , Zhang Caicai , Chen Xinxin , Yang Xingtian , Yang Jing , Feng Hong , Yang Wanling
Published: October 2024

Background

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disorder, and transposable elements (TEs) have been hypothesized to play a significant role in its development. However, limited research has explored this connection. Our study aimed to examine the relationship between TE expression and SLE pathogenesis.

Methods

We analyzed whole blood RNA-seq datasets from 198 SLE patients and 84 healthy controls. The REdiscoverTE pipeline was employed to quantify TE and other gene expressions, identifying differentially expressed TEs. A TE score was calculated to measure overall TE expression for each sample. Gene ontology and gene set enrichment analyses were conducted to explore the functional implications of TE upregulation. Independent datasets were utilized to replicate the results and investigate cell type-specific TE expression.

Results

Our analysis identified two distinct patient groups: one with high TE expression and another with TE expression comparable to controls. Patients with high TE expression exhibited upregulation of pathways involving nucleic acid sensors, and TE expression was strongly correlated with interferon (IFN) signatures. Furthermore, these patients displayed deregulated cell composition, including increased neutrophils and decreased regulatory T cells. Neutrophils were suggested as the primary source of TE expression, contributing to IFN production.

Conclusions

Our findings suggest that TE expression may serve as a crucial mediator in maintaining the activation of interferon pathways, acting as an endogenous source of nucleic acid stimulators in SLE patients.
Maternal weight status at conception predicts offspring body fat at age 11 years: population data from the Japan Kids Body Composition Study using dual-energy X-ray absorptiometry
Authors: Kouda Katsuyasu , Ohara Kumiko , Nakamura Harunobu , Fujita Yuki , Iki Masayuki
Published: October 2024

Background

Maternal preconception overweight status has been reported to be associated with an increased risk of overweight offspring. However, there are no published population-based studies on the association between maternal preconception weight and offspring body fat measured by dual-energy X-ray absorptiometry (DXA). The present population-based retrospective cohort study aimed to examine the association between maternal weight at conception and offspring body fat measured by DXA.

Methods

The source population consisted of 5th-grade students (1244 students aged 11 years) registered at 8 municipal elementary schools in Kitakata, Fukuroi, Hamamatsu, and Himeji in Japan. The present analyses included 964 participants who provided complete information. Maternal body mass index (BMI) at conception was calculated using records in the Mother and Child Health Handbook (MCHH). Offspring body fat at age 11 years was measured with the same QDR-4500A DXA instrument in a mobile test room that was brought to each school. With regard to the prediction of excess fat in offspring, the area under the curve (AUC) calculated with receiver operating characteristic curve analysis was used to quantify the diagnostic accuracy of maternal BMI at conception.

Results

Adjusted odds ratios for excess body fat in offspring of the overweight mother group (odds ratios, 4.93 to 15.32) were significantly higher than those in the non-overweight mother group. For the prediction of excess offspring fat, AUCs and 95% confidence intervals for maternal BMI at conception were greater than 0.5.

Conclusion

Maternal overweight status at conception might be a risk factor for excess body fat in offspring. Maternal BMI values calculated using MCHH data have the potential to distinguish between the presence and absence of excess fat in the next generation.
Impacts of the COVID-19 pandemic on the experiences of incarcerated pregnant people
Authors: Marsh L. Noël , Kramer Camille , Shlafer Rebecca J. , Sufrin Carolyn B.
Published: October 2024

Background

The COVID-19 pandemic disproportionately impacted incarcerated populations, yet few studies have investigated the specific effects on incarcerated pregnant people. This study compares pregnant people’s experiences of pregnancy and parenting in prison before and during the pandemic in order to explore the impacts of COVID-19 on this population.

Methods

We conducted semi-structured interviews with pregnant people at a state prison as part of a larger study on pregnant people’s experiences during incarceration. Interviews explored participants’ experiences and decision-making related to pregnancy and parenting while incarcerated. This secondary analysis compared interviews conducted between June 2019 and March 2020 (pre-COVID-19) to interviews conducted between June and November 2020 (during COVID-19). Interviews conducted during the pandemic included questions about the impact of COVID-19 on participants’ experiences. Brief three and six-month follow-up interviews were conducted when possible.

Results

COVID-19 introduced new stressors and exacerbated preexisting stressors around participants’ reproductive and parenting experiences. Three major themes emerged: 1) incarceration causes mental, emotional, and physical distress during pregnancy and parenting; 2) COVID-19 worsened conditions of incarceration, contributing to participants’ distress; and 3) the introduction of quarantine protocols during the pandemic felt uniquely punitive for pregnant and postpartum people.

Conclusions

The COVID-19 pandemic was characterized as a major crisis and primary threat to public health, particularly for incarcerated individuals. Yet just as COVID-19 exacerbated preexisting disparities for marginalized, non-incarcerated communities, incarcerated pregnant people similarly described a “worsening” of already-intolerable conditions. The indiscriminate application of quarantine protocols for pregnant people reflects broader carceral logics of control that do not account for the wellbeing of pregnant and postpartum people and their infants, as evidenced by current practices of infant separation, a lack of support, and physically taxing living conditions.
Adolescent boys’ experiences of stress – a focus group study
Authors: Schmidt Manuela , Hansson Erika
Published: October 2024

Background

The number of adolescents reporting that they are stressed has more than doubled among both boys and girls. Most focus is given to girls because they typically not only report higher levels of stress but also feel stressed more frequently than boys do. However, studies have confirmed that boys’ experience of stressors is the same, implying that genders are equally prone to experiencing stress. Although male and female adolescents appear to experience stress in a similar way, how they cope with these stressors might differ. This study focused on boys’ experiences of stress and how they cope with it.

Method

Eight focus groups were conducted with 39 adolescent boys aged 12–19 years enrolled in four schools in southern Sweden. The data was analysed inductively with conventional content analysis.

Results

The analysis resulted in three categories: Stress perception – time as a key factor, Identifying stressors and levels of stress, and Silent struggles and distractions. The boys had experienced considerable stress in their lives, despite their limited understanding of the concept. Their coping skills focused on engaging in sports or distracting themselves from stressors while relying less on social support from peers, school staff, or family.

Conclusions

Adolescent boys might need assistance in identifying stress and clearly voicing their specific concerns. They should also be provided with spaces that are free from stigmatization and judgement. Parents, teachers, and school nurses should be equipped with the appropriate tools and education on how to discuss stress and mental health in general with adolescent boys to prevent possible negative long-term consequences for both their physical and mental health.
Dynamics of persistence, withdrawal, and dropout intentions in the initial phase of nursing training: a qualitative longitudinal study
Authors: Arianta Katrin , Goller Michael
Published: October 2024

Taking the perspective of career choice as a lifelong, iterative, constructive, and agentic process, the present study focuses on the development of vocational aspirations of nursing trainees; that is, thoughts about a long-term perspective in nursing (i.e., persistence), ideas of finishing the training but changing into another profession after some time (i.e., withdrawal), and decisions to terminate the training before completing the programme through a final examination (i.e., dropout). In order to generate detailed insights about the dynamics behind the development of such aspirations during the initial training phase, a qualitative, longitudinal, within-subject study design based on grounded theory was employed. The results mainly show that social interactions with more experienced nurses, practical work experiences, encounters with environments that are either conducive to learning or not, the satisfaction of different needs (e.g., autonomy, competence, belonging, sense of meaningfulness), as well as the associated feelings of well-being affect how vocational aspirations develop over the first year of training. In addition, the study identifies four different patterns of how trainees typically oscillate between thoughts of staying in nursing and leaving the profession in the short or long run: (a) arriving and wanting to stay, (b) staying as a transitional passage, (c) seeking to stay, and (d) exiting as a knee-jerk reaction. The patterns present evidence of a variety of approaches regarding how trainees deal with certain experiences during their training and how the combination of experiences might affect young professionals’ subsequent career choices.
Cardiorespiratory Fitness and Sleep, but not Physical Activity, are Associated with Functional Connectivity in Older Adults
Authors: Wing David , Roelands Bart , Wetherell Julie Loebach , Nichols Jeanne F. , Meeusen Romain , Godino Job G. , Shimony Joshua S. , Snyder Abraham Z. , Nishino Tomoyuki , Nicol Ginger E. , Nagels Guy , Eyler Lisa T. , Lenze Eric J.
Published: October 2024

Background

Aging results in changes in resting state functional connectivity within key networks associated with cognition. Cardiovascular function, physical activity, sleep, and body composition may influence these age-related changes in the brain. Better understanding these associations may help clarify mechanisms related to brain aging and guide interventional strategies to reduce these changes.

Methods

In a large (n = 398) sample of healthy community dwelling older adults that were part of a larger interventional trial, we conducted cross sectional analyses of baseline data to examine the relationships between several modifiable behaviors and resting state functional connectivity within networks associated with cognition and emotional regulation. Additionally, maximal aerobic capacity, physical activity, quality of sleep, and body composition were assessed. Associations were explored both through correlation and best vs. worst group comparisons.

Results

Greater cardiovascular fitness, but not larger quantity of daily physical activity, was associated with greater functional connectivity within the Default Mode (p = 0.008 r = 0.142) and Salience Networks (p = 0.005, r = 0.152). Better sleep (greater efficiency and fewer nighttime awakenings) was also associated with greater functional connectivity within multiple networks including the Default Mode, Executive Control, and Salience Networks. When the population was split into quartiles, the highest body fat group displayed higher functional connectivity in the Dorsal Attentional Network compared to the lowest body fat percentage (p = 0.011; 95% CI − 0.0172 to − 0.0023).

Conclusion

These findings confirm and expand on previous work indicating that, in older adults, higher levels of cardiovascular fitness and better sleep quality, but not greater quantity of physical activity, total sleep time, or lower body fat percentage are associated with increased functional connectivity within key resting state networks.
Case-control study on associations of hemorrhagic bowel syndrome in swine with feed characteristics and intestinal pathogens
Authors: Holenweger Fabienne , Spring Peter , Khayatzadeh Negar , Hofer Andreas , Schüpbach-Regula Gertraud , Grahofer Alexander
Published: October 2024

Haemorrhagic bowel syndrome (HBS) is one of the most common causes of death in fattening pigs worldwide. The objective of this descriptive study was to systematically assess predictors or causal components for the appearance of HBS using case farms (mortality rate caused by HBS ≥ 1.5%) in comparison with control farms (mortality rate caused by HBS ≤ 0.25%), focusing on feed ingredients, feed quality and size, and gastrointestinal pathogens. The inclusion of sugar beet as a feed component in liquid feeding systems was found to be associated (p = 0.03) with farms identified as HBS cases. Another predictive or causal factor found for liquid feeding systems, but only for those using meal, was particle size. A higher percentage of small particles (< 2 mm) in the meal was associated with a higher risk of being an HBS case farm (p = 0.02), while no relevant association was detected for the use of pellets. Sugar beet in the diet was also associated with the incidence of HBS.

The microbial quality of the feed in dry feeding systems, specifically the number of total aerobes at the first and last outlet tubes, was associated with a higher incidence of HBS (p = 0.03). Faecal sample analysis showed a difference (p < 0.05) in the prevalence of B. pilosicoli in the herd category (case vs. control herd). In this descriptive study, five predictive or causal factors were identified for an HBS farm with a mortality rate due to HBS ≥ 1.5%. These included the number of aerobes in dry matter samples from the first and last feeders, the particle diameter of the meal used in liquid feeding systems and sugar beet as a component of liquid feeding rations, and the presence of B. pilosicoli as an infectious agent at animal level. Relevant associations reinforce the findings of the previously published Swiss study that HBS is a multifactorial syndrome involving different aspects of pig production and cannot be attributed to a single cause. Further studies are needed to develop evidenced based causal models for HBS in swine.
Anti-arthritic activity of Trayodashang guggulu, a classical Ayurvedic formulation against complete Freund’s adjuvant-induced rheumatoid arthritis in rats
Authors: Bora Manajit , Sinha Barnali M. , Dixit Amit Kumar , Jamadagni Shrirang , Gaidhani Sudesh N. , Gautam Manish Kumar , Upadhyay Sachidanand , Hazra Jayram , Srikanth Narayanam
Published: October 2024

Background

Rheumatoid arthritis is a chronic autoimmune disease affecting millions of people across the world. Trayodashang guggulu (TG) is a classical Ayurvedic formulation used for the treating joint diseases since decades in the Indian system of traditional medicine. The aim of the study was to evaluate anti-arthritic activity of TG against complete Freund’s adjuvant-induced arthritis in Wistar rats.

Methods

Arthritis was induced by single injection of 0.1 ml complete Freund’s adjuvant into the intraplanter surface of left hind paw of Wistar rats. TG was administered orally at the doses of 100, 200, 400 and 800 mg/kg body weight for 14 days. In the preventive dose group, TG was administered at the dose of 100 mg/kg body weight, orally for 28 days. Paw swelling, joint circumference, serum rheumatoid factor, C-reactive protein, serum IL-1β, TNF-α and histopathological parameters were assessed for the evaluation of arthritis. Effects of TG were compared with standard allopathic drug ibuprofen.

Results

TG reversed complete Freund’s adjuvant-induced arthritis in rats when used for 14 and 28 days. Serum rheumatoid factor, C-reactive protein, IL-1β and TNF-α were decreased in rats treated with both standard drug ibuprofen and TG.

Conclusion

Oral administration of TG reduced experimentally induced rheumatoid arthritis in rats by reversing elevated level of serum biochemical markers as well as reducing joint destruction similar to ibuprofen. Results obtained from the study paved the way in exploring more specific mechanisms of action of TG involving in vitro and in silico models.
Aortic root parameter analysis for transcatheter aortic valve implantation in the Pakistani population: a retrospective study
Authors: Suleman Muhammad , Masoud Maryam , Khan Muhammad Ishaq , Ullah Ihsan , Ullah Abid , Jan Rafi Ullah , Zeb Shah , Ashfaq Umar , Raza Ali , Waleed Mohammad
Published: October 2024

Background

Transcatheter aortic valve implantation (TAVI) is a growing treatment for aortic stenosis, but anatomical variations exist across populations. Asians tend to have smaller aortic annuli and higher bicuspid valve morphology compared to Westerners, potentially impacting TAVI valve selection and outcomes. This study analyzes aortic root parameters in Pakistani patients undergoing TAVI.

Results

We conducted a retrospective analysis of 78 patients who underwent TAVI at the Peshawar Institute of Cardiology from January 2021 to March 2024. Pre-procedural CT scans were analyzed for aortic annulus diameters, area, and other relevant parameters. The mean age was 72.41 years (SD ± 11.99), and 61.5% were male. Aortic annulus diameters (minimum, mean, maximum) were 21.18 mm (SD ± 3.99), 24.21 mm (SD ± 3.93), and 27.49 mm (SD ± 4.43), respectively. Bicuspid aortic valves were present in 34.61% of patients.

Conclusions

Our findings suggest that Pakistani patients undergoing TAVI may have aortic root dimensions comparable to Western populations, with a substantial prevalence of bicuspid valves. However, coronary heights were similar to those reported in Asian populations with smaller annuli. Further studies are needed to assess TAVI outcomes in Pakistani patients and determine if tailored valve sizing strategies are required.
Safety and efficacy of sofosbuvir/ledipasvir combination in treatment of chronic hepatitis C infection in adolescents aged 12–17 years old
Authors: Farhat Manar Sayed , Hassan Essam Ali , Gomaa Ahmed Ali , Algameel Alkassem Ahmed , Mohamed Fatma Abdel Hamid
Published: October 2024

Background

Chronic hepatitis C virus (CHC) infection represents a crucial health problem, especially among children and adolescents. The ledipasvir (LDV)/sofosbuvir (SOF) regimen has been approved to treat adolescents (aged 12 to 17 years old) infected with hepatitis C virus (HCV) genotypes 1, 4, 5, and 6 and then extended to include children above or equal to 3 years old. The current study aims to evaluate the safety and efficacy of SOF/LDV combination in treating CHC-infected 12- to 17-year-old adolescents.

Patients and methods

This retrospective cohort study was performed on 147 Egyptian adolescents with CHC. The patients were treated with SOF 400 mg/LDV 90 mg combination once daily for 12 weeks. Possible side effects and laboratory data including HCV ribonucleic acid polymerase chain reaction (RNA PCR), complete blood count (CBC), and liver tests were recorded at baseline and week 12 after the end of treatment (EOT).

Results

Sustained virological response 12 weeks (SVR12) after end of treatment (EOT) was observed in 146 out of 147 patients (99.3%). The treatment regimen was efficiently tolerated with no reported cases of discontinuation caused by intolerability. Moreover, the side effects were minimal; 71.4% of the patients did not report any side effects related to the treatment. However, the rest mentioned fatigue, headache, or both of them. Fatigue was the main side effect reported in 16.3% of the patients. Furthermore, ALT and AST levels were normalized after treatment. FIB-4 and APRI scores were statistically significantly decreased 2 years post-SVR, in comparison to their levels before treatment, from 0.34 and 0.36 to 0.25 and 0.17, respectively.

Conclusion

The LDV/SOF regimen is one of the safe regimens used to treat adolescent patients with CHC infection.
Proton pump inhibitor use and risk of stroke: A systematic review and meta-analysis
Authors: Zhong Ying , Feng Yaoyao
Published: October 2024

Objective: To explore a link between the use of proton pump inhibitor (PPI) and the risk of stroke.
Methods: Comprehensive literature search in PubMed, EMBASE, and Cochrane CENTRAL Library databases was carried out for observational studies establishing the link between PPI and a risk of stroke. Data extraction and quality assessment were performed by two reviewers. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) using random-effects models were plotted. Subgroup analyses were conducted based on age, gender, PPI type, duration of follow-up, and propensity score matching (PSM).
Results: The analysis included 12 studies, with considerable heterogeneity (I2 = 95%). PPI use did not affect the incidence of ischemic stroke (HR: 1.11, 95% CI: 0.98-1.26). Subgroup analyses revealed that PPI use correlated with the risk of ischemic stroke, in particular in patients<65 years old (HR: 1.25, 95% CI: 1.07-1.45), both males (HR: 1.12, 95% CI: 1.02-1.24) and females (HR: 1.21, 95% CI: 1.10-1.33). The correlation varied depending on the PPI type, with pantoprazole showing elevated risk (HR: 1.66, 95% CI: 1.43-1.93). Duration of follow-up or propensity score matching (PSM) did not impact the association.
Conclusion: PPI use may be linked with ischemic stroke, particularly in individuals <65 years old and of all genders. The specific PPI type may also influence the risk. However, the cumulative analysis did not find any statistically significant association, and heterogeneity among studies was substantial.
PROSPERO Registration Number: CRD42023422247.
doi: https://doi.org/10.12669/pjms.40.10.10409
How to cite this: Feng Y, Zhong Y. Proton pump inhibitor use and risk of stroke: A systematic review and meta-analysis. Pak J Med Sci. 2024;40(10):2432-2440. doi: https://doi.org/10.12669/pjms.40.10.10409
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