bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of Fluid and Cellular Monitoring in Septic Shock using Bioelectrical Impedance Analysis
Authors: Cha Susie , Diaz Jesse , Szerlip Harold
Published: December 2024

Background: Septic shock requires careful fluid management to optimize patient outcomes. However, traditional fluid assessment methods are often invasive and lack accuracy. This study explores the application of bioelectrical impedance analysis (BIA) to monitor fluid status and cellular integrity in septic shock patients during their first week in the intensive care unit (ICU).
Methods: This study enrolled 25 adult septic shock patients requiring vasopressors and mechanical ventilation within 24 hours of ICU admission (11 survivors, 14 non-survivors). Serial BIA assessments were performed on Days 0,3 and 7 and the daily rates of change were calculated between consecutive measures for fluid volume (total body water [TBW], extracellular water [ECW]), fluid distribution (the ECW/TBW ratio), and cellular integrity (reactance). Hierarchical clustering was used to identify similarity patterns among BIA parameters.
Results: During the initial period (Days 0-3), no difference in TBW was observed between survivors and non-survivors. However, survivors maintained a stable ECW/TBW ratio (-0.05%) and reactance (-0.10%), while non-survivors exhibited an increased ECW/TBW ratio (+2.73%, p<0.01) and decreased reactance (-9.42%, p<0.05). As the week progressed (Days 3-7), survivors showed signs of recovery with reduced TBW (-1.77%) and increased reactance (+3.50%). Meanwhile, non-survivors continued to deteriorate, with increased TBW (+1.27%, p<0.01), a further rise in ECW/TBW ratio (+0.25%, p=0.06), and decreased reactance (-4.33%, p<0.05).
Hierarchical clustering analysis distinguished two sets of physiological characteristics measured by BIA: one reflecting fluid status and another reflecting cellular health. The association of the ECW/TBW ratio with these clusters varied by outcome group. The ECW/TBW ratio clustered with cellular health parameters in survivors but with fluid status parameters in non-survivors.
Conclusions: This study shows that using BIA to monitor fluid volume, distribution, and cellular health provides clinicians with a comprehensive tool for monitoring patient progression in septic shock during resuscitation. By analyzing BIA parameters in a collective manner, this study offers new insights into the changes in fluid status and potential underlying factors driving these shifts. This approach not only improves the prognostic accuracy but also allows for more informed decisions on treatment efficacy and patient management through a noninvasive, bedside method. This approach may improve prognostic accuracy and could allow for more informed decisions on treatment efficacy and patient management through a noninvasive, bedside method.
Frequency of exacerbation and risk factors for postoperative adjuvant endocrine therapy- related arthralgia in patients with breast cancer: a prospective cohort study
Authors: Uno Maya , Takahashi Yuko , Hatono Minami , Kawada Kengo , Tsukioki Takahiro , Kochi Mariko , Ikeda Hirokuni , Iwatani Tsuguo , Iwamoto Takayuki , Hara Kyoko , Ogasawara Yutaka , Yoshitomi Seiji , Doihara Hiroyoshi , Shien Tadahiko , Taira Naruto , Toyooka Shinichi
Published: December 2024

Background: Postoperative endocrine therapy is crucial in reducing breast cancer recurrence; however, low completion rates attributable to arthralgia pose challenges. Furthermore, the specific risk factors for endocrine therapy-related arthralgia and the impact of lifestyle factors, such as soy isoflavone intake, as well as equol production capacity, on arthralgia remain elusive. Therefore, this study was undertaken to determine the frequency and risk factors for adjuvant endocrine therapy-related arthralgia in Japan, with a specific focus on the influence of soy isoflavone on this condition.
Methods: A prospective cohort of patients commencing adjuvant endocrine therapy post-breast cancer surgery at three centers in Japan was followed up for one year after treatment initiation. Data on clinicopathological background, social background, and lifestyle status, such as soy isoflavone intake,were collected from electronic medical records and self-administered questionnaires. The presence or absence of equol production capacity was assessed via urinalysis without soy food loading. The incidence of arthralgia was investigated using the Patient-Reported Outcome-Common Terminology Criteria for Adverse Events. Cox proportional hazard tests were used to examine risk factors for endocrine therapy-related arthralgia.
Results: Among the 297 patients included in this study, 138 were started on tamoxifen (TAM) and 159 on aromatase inhibitors (AIs). During the observation period, 64.6% of patients experienced exacerbation or onset of arthralgia, and 14.0% reported interference with daily activities owing to arthralgia. The risk factor for arthralgia was AI use (vs. TAM), and those for arthralgia-related interference encompassed smoking (vs. no smoking history) and major depressive disorder (vs. normal). Moreover, being more than 20 years postmenopausal (vs. premenopausal) was an independent risk-reducing factor.
Conclusions: The risk factors for endocrine therapy-related arthralgia in Japan included AI use, smoking, and depression. However, no significant association was observed between endocrine therapy-related arthralgia and high or low soy isoflavone intake, as well as the presence or absence of equol-producing capacity.
Trial Registration: This study has been registered and published in the University Hospital Medical Information Network-Clinical Trials Registry (Study ID: UMIN000030099) on January 25, 2018.
B lymphocyte subset-based stratification in primary Sjögren's syndrome: implications for lymphoma risk and personalized treatment
Authors: Qi Xuan , Zhao Doudou , Wang Naidi , Han Yipeng , Huang Bo , Feng Ruiling , Jin Yuebo , Wang Ruoyi , He Jing
Published: December 2024

Objective
This study aimed to perform a detailed stratification analysis of B lymphocyte subsets in patients with primary Sjögren's syndrome (pSS) and to investigate their associations with lymphoma risk, clinical phenotypes, and disease activity.
Methods
In this retrospective study, we analyzed data from 137 patients with pSS. We employed machine learning approaches, specifically principal component analysis (PCA) and k-means clustering, to examine B lymphocyte subset distributions from flow cytometry data and immunoglobulin IgG and complement (C3, C4) levels. The optimal cluster number was determined using the Elbow Method in R software. Based on these 10 variables, patients were categorized into distinct subgroups. We then comprehensively compared clinical characteristics, laboratory parameters, and disease activity indices among these identified subgroups.
Results
Four distinct subgroups were identified. Cluster A exhibited a significantly higher lymphoma incidence rate of 20%, compared to 3.39% in Cluster B and 0% in Clusters C and D (p = 0.007). Cluster A also had the highest percentage of double-negative B cells (32.26 ± 17.96%) and plasma cells (2.02 ± 1.92%). ESSDAI scores indicated that disease activity was highest in Cluster A (9.00, 6.00–20.00), followed by Clusters B (7.00, 3.50–14.00), C (6.00, 1.25–17.50), and D (5.00, 1.50–9.00), respectively.
Conclusion
This innovative stratification method revealed the critical role of B cell subset imbalance in the pathogenesis of pSS and provided new evidence for predicting lymphoma risk and guiding personalized treatment.
The impact of sagittal cortical support on stability after internal fixation of intertrochanteric femoral fractures: a finite element analysis
Authors: Miao Jinhu , Dai Jin , Chen Zhihao , Liu Yadong , Shao Guoxi
Published: December 2024

Objective: To explore the optimal sagittal cortical support reduction mode with proximal femoral bionic nails (PFBN) for treating intertrochanteric femoral fractures (ITFFs) with medial wall defects to prevent internal fixation failure.
Methods: A 64-year-old healthy male volunteer with no history of hip or systemic disease was recruited. High-resolution computed tomography images with a slice thickness of 0.602 mm of his right femur were obtained. These images were used to establish three-dimensional (3D) models. The lesser trochanter and medial wall were cut off to create an AO Foundation/Orthopaedic Trauma Association (AO/OTA) type 31-A1.3 pertrochanteric fracture model. PFBN was used to simulate fixation. Under the conditions of coronal anatomical reduction, eighteen different fracture sagittal reduction modes were examined, which included intact or defective medial walls, as well as neutral, negative 5%,10%,15%,20%, and positive 5%,10%,15%,20%, were simulated. A load of 600 N was applied to simulate a 60 kg elderly patient standing on one leg. The models were subjected to finite element analysis (FEA). The displacement and von Mises stress distributions were analyzed.
Results: Under the conditions of an intact or defective medial wall, the 10% positive sagittal cortical support reduction pattern showed minimal stress and displacement. In the case of medial wall defects, with 20% loss of reduction in both negative and positive sagittal mal reduction, the maximum equivalent stresses were 188.52 MPa and 211.21 MPa, respectively, which are 2.66 and 2.98 times greater than the maximum equivalent stress of 70.761 MPa observed when the medial wall was intact. Meanwhile, the 20% negative reduction pattern seemed to have the largest displacement.
Conclusion: Under the conditions of an intact or defective medial wall, the 10% positive sagittal support reduction pattern showed the best mechanical stability for ITFF. The negative support reduction pattern was prone to fixation failure and should be avoided during an operation.
Assessing the acute effects of diagonal mobilization on static and dynamic balance in young football players: A randomized double-blind study
Authors: Studnicki Rafał , Taraszkiewicz Marcin , Hansdorfer-Korzon Rita , Kawczyński Adam
Published: December 2024

This randomized double-blind study aimed to assess the acute effects of manual therapy focusing on diagonal sliding (DM) on the static and dynamic balance of young male and female soccer players. Thirty-two regional-level footballers aged between 14 and 16 were randomly assigned to either receive DM or to a control group exposed to a placebo condition. Participants underwent assessment twice: once before the intervention and again afterward. Tests included the single leg lend and hold test and the single leg standing test, measured using force plates. The following variables were recorded: time to stabilization, peak drop landing force, as well as center of pressure (CP) range in the anterior-posterior and medial-lateral directions, and mean velocity while standing on one leg. Significant interactions time × group were found in CP media-lateral (p = 0.003), CP anterior-posterior (p = 0.006), CP mean velocity (p = 0.044), time to stabilization (p < 0.001), and peak drop landing force (p = 0.347;). Within-experimental group analysis (post-pre) revealed significant differences in CP media-lateral (p = 0.001), CP anterior-posterior (p = 0.012), CP mean velocity (p < 0.001), time to stabilization (p < 0.001) and peak drop landing force (p = 0.425). The time to stabilization and the center of pressure range in the anterior-posterior and medial-lateral directions were significantly influenced by the DM intervention. Therefore, it is recommended that individuals involved in clinical or sports settings consider this approach in future analyses.
Sepsis secondary to co-infection with malaria, dengue and COVID 19 : a case report
Authors: Guibla Ismael , Zabramba Augustin , Traore Salah Idriss Seif , Tankoano Aida Ida , Ilboudo Charles Sombewindé , Ouédraogo R Franks Aymar , Ouédraogo Matharie Donalde , Poda Armel , Traoré Ibrahim Alain
Published: December 2024

The co-infection of malaria, dengue fever and COVID-19 is rarely described in sub-Saharan Africa. We report a case of co-infection of malaria, dengue fever and COVID-19 complicated by sepsis requiring an admission in intensive care unit. The diagnosis of COVID-19 was delayed due to the classical signs of malaria and dengue fever. This trio should be systematically considered in the context of any infectious presentation in sub-Saharan Africa, especially during the winter season, as symptoms and biological parameters are not discriminative.
Cybersecurity Culture Among Healthcare Workers in Indonesia: Knowledge Gaps, Demographic Influences, and Strategic Policy Solutions
Authors: Irwandy Irwandy , Mangilep Adelia U. Ady , Anggraeni Rini , Noor Noer Bahry , Niartiningsih Andi , Latifah Nur
Published: December 2024

Introduction: Digitalization in healthcare has increased cybersecurity risks, especially in regions with limited protective measures. In Indonesia, the cybersecurity culture among healthcare professionals remains underdeveloped, posing potential threats to patient data security.
Objectives: This study assessed cybersecurity culture among healthcare workers in Makassar, Indonesia, focusing on their knowledge, attitudes, and practices, and examined the influence of demographics on these factors.
Methods: A cross-sectional survey was conducted with 574 healthcare workers from three hospitals in Makassar. The survey measured cybersecurity knowledge, attitudes, and practices, and analyzed demographic influences such as age, gender, and profession.
Results: Findings revealed substantial knowledge gaps, with 61.7% of respondents unaware of cybersecurity policies, and 65.5% unable to recognize email fraud. Although attitudes toward security were generally positive, risky behaviors—such as using personal devices for sensitive data (72.1%) and installing unauthorized software (70.2%)—persisted. Younger healthcare workers and nurses exhibited stronger cybersecurity practices, while older staff and physicians had lower compliance.
Conclusion: This study underscores an urgent need for comprehensive cybersecurity training, policy clarity, and leadership support in Indonesian healthcare. Targeted interventions based on demographic factors could enhance adherence to cybersecurity practices, bolstering patient data protection and healthcare system resilience.
Prospective Study of Safety and Biomarkers Using Multimodal Analysis with Swept-Source Oct and Oct-Angiography in Patients with Dry Age Related Macular Degeneration Treated with Photobiomodulation.
Authors: Rezende Marcussi Palata , Faria Fernanda Atoui , Polido Julia , Belfort Rubens , Cabral Thiago
Published: December 2024

Background:
The Photobiomodulation-Valeda device is an innovative approach for treating dry age-related macular degeneration (AMD). The main objective of this study was to conduct a multimodal imaging analysis using swept-source technology in OCT (SS-OCT) and OCT-Angiography (SS-OCTA) in patients with dry AMD treated with Photobiomodulation (PBM), focusing primarily on safety and biomarkers.
Materials and Methods:
A prospective interventional study was conducted involving 19 patients (25 eyes) diagnosed with dry AMD. The treatment consisted of nine sessions of PBM using the Valeda Light Delivery System. Various biomarkers were assessed before and one week after the treatment, including Best Corrected Visual Acuity (BCVA) for logMAR, central macular thickness (CMT), subfoveal choroidal thickness (SCT), capillary density (CD), and avascular areas of the superficial (AASP) and deep plexus (AADP).
Results:
The study included 25 eyes, predominantly in AREDS category II. Significant improvements were observed in BCVA (p = 0.001). No significant changes were observed in CMT, SCT, CD, AASP, and AADP (p > 0,05). The treatment was well tolerated, with few mild side effects, and no patient developed wet AMD.
Conclusion:
PBM-Valeda therapy shows promise as a treatment strategy for dry AMD, resulting in improved visual acuity (as previously demonstrated in Lightsite I, II, and III). It is important to emphasize the safety of the treatment, as none of the biomarkers (CMT, SCT, CD, AASP, and AADP) exhibited harmful changes. Side effects were minimal, there were no signs of retinotoxicity, and no patient developed exudative AMD, after 1 cycle: 9 sessions of PBM treatment.
Contraceptive use after bariatric surgery
Authors: Tanjaturon Kasidech , Uaamnuichai Sutira , Suphapimol Suphachai , Porntawansak Gade , Kachornvitaya Pattharasai , Udomsawaengsup Suthep , Jaisamrarn Unnop , Santibenchakul Somsook
Published: December 2024

Background
Bariatric surgery is an effective intervention for morbid obesity with established short-term efficacy for weight reduction and long-term efficacy in improving health outcomes. Pregnancy is contraindicated in the first year after bariatric surgery and therefore necessitates careful contraceptive planning to reduce pregnancy complications. This study aimed to assess contraceptive use and counseling among women with obesity before and after bariatric surgery at King Chulalongkorn Memorial Hospital.
Methods
This descriptive study, including a retrospective group with data from records and a prospective group followed over time, was conducted from July 31, 2023, to May 26, 2024.The study included 90 reproductive-aged women who underwent bariatric surgery between January 1, 2018, and October 31, 2023. Participants were surveyed on contraceptive use, counseling, and related factors. Data were collected from medical records and through questionnaires.
Results
In this study, 85.7% of sexually active participants used contraception 6–12 months after surgery, with male condoms being the most common method. Only 31.4% of the participants used effective contraception (including male and female sterilization, contraceptive implants, intrauterine devices, and depot medroxyprogesterone acetate). Contraceptive counseling was most frequent before surgery and 3 months after surgery; however, seven participants did not receive adequate information about the appropriate contraception for their condition.
Conclusion
Although the contraceptive prevalence among participants was relatively high, the use of effective contraception was low. The study highlights the need for improved contraceptive counseling and education in patients who have undergone bariatric surgery. Enhanced counseling can help in selecting safe and effective contraceptive methods and reducing the risk of unintended pregnancies during the first year after surgery, a period considered unsafe for pregnancy.
Significance of mineral elements characterization for anaerobic digestion substrates: The case of avocado oil processing by-products
Authors: Rashama Charles , Ijoma Grace N , Matambo Tonderayi S. , Riann Christian
Published: December 2024

Mineral elements effects on anaerobic biogas production (AD) were reviewed and inferences made for avocado oil processing by-products. Mineral elements in these by-products were measured using ICP-OES methods. It was noted that there is no consensus among researchers on absolute mineral requirements for optimal digester performance and only ranges stating lowest and highest mineral requirements could be found from different studies. These ranges vary for each element depending on analytical methods used, substrate type and digester operating conditions. Mineral elements exceeding certain limits in digesters can be toxic to the AD microorganisms, a situation which negatively affect the efficiency and stability of substrate biodegradation to biogas. Other mineral elements, such as arsenic, despite their concentration in the digester, are naturally toxic to microorganisms. These toxic minerals must therefore be removed or detoxified if detected in substrates. Researchers choose to perform substrate mineral elemental analysis depending on their pre-existing knowledge of the substrate, recommendations from standards adopted in the research and objective of their studies. The bioavailability of minerals in substrates require further investigation to accurately correlate mineral elements concentration in avocado oil processing by-products by ICP-EOS methods to the expected AD performance when using these substrates. The current study revealed mineral elements related to avocado oil processing by-products that may need possible attention for optimal biodegradation of these substrates to biogas.
Validation and in-silico function prediction of circTIAL1 as a novel marker of abnormal lung development in nitrofen-induced Congenital Diaphragmatic Hernia (CDH)
Authors: Jank M. , Kraljevic M. , Aptekmann A. O. , Patel D. , Boettcher M. , LeDuc R. , Keijzer Richard
Published: December 2024

PURPOSE
Circular RNAs (circRNAs) are stable, non-coding RNAs with tissue- and developmental-specific expression making them suitable biomarkers for congenital anomalies. Current circRNA discovery pipelines have focused on human and mouse. We aim to bridge this gap by combining bioinformatics resources and used circTIAL1 as a model candidate in the nitrofen rat model of congenital diaphragmatic hernia (CDH).
METHODS
CircTIAL1 backsplice junction sequences from a microarray were used to predict mature circRNA sequences and downstream pathways by miRNA interactions using CRAFT and circAtlas. We validated circTIAL1 expression using conventional PCR, amplicon sequencing, RT-qPCR and Basescope™ in situ hybridization.
RESULTS
Expression of parental gene Tial1 was decreased in nitrofen-induced lungs at embryonic day (E)15 (p = 0.004) and E21 (p = 0.008); while at E18 there was no significant difference (p = 0.65). At E21, circTIAL1 expression did not differ between CDH and control lungs (p = 0.07); however, there was a decreased expression in male pups (p = 0.0167). In situ hybridization confirmed low circTIAL1 expression. CircRNA::miRNA::mRNA interactions revealed pathway enrichment for inflammation/infection and neuron function/development.
CONCLUSION
For the first time, we report circRNA profiling in nitrofen-induced CDH with a sex-specific expression of circTIAL1. Current bioinformatics tools have significant challenges, but can guide hypothesis formation on their biological role.
Machine Learning-Based Prediction of Depression Risk in Patients with Multimorbidity: A Study Using NHANES Data from 2009-2016
Authors: Ye Kangli , Peng Han , Zhang Xuan , Wang Lefeng , Yang Jian , Hu Mengjie
Published: December 2024

OBJECTIVE
Patients with multimorbidity are at a significantly higher risk of developing depression compared to those without multimorbidity, which can severely impair psychosocial functioning and decrease quality of life. However, no effective method currently exists to assess depression risk in these patients. In this study, we leveraged data from the National Health and Nutrition Examination Survey (NHANES) database and applied machine learning (ML) techniques to construct a depression risk prediction model, aiming to predict the likelihood of depression in patients with multimorbidity.
METHODS
Data from the 2009–2016 NHANES cycles were used, incorporating a wide range of demographic and clinical variables in the analysis. Various machine learning algorithms were evaluated for their predictive performance, and the CatBoost classifier, which demonstrated the best performance, was selected to build the prediction model. The model’s predictions were interpreted using SHapley Additive exPlanations (SHAP) values, which ranked the importance of features and visualized the contribution of variables, such as socioeconomic status, biological factors, and lifestyle habits, in predicting depression among multimorbid patients.
RESULTS
The predictive performance of the model was robust for both overall depression and the binary classification of moderate to severe depression. For moderate to severe depression classification, the model achieved an accuracy of 0.9541, an AUC of 0.9903, and an F1 score of 0.954. The accuracy and recall were 0.9475 and 0.9607, respectively, with a kappa value of 0.9081 and an MCC of 0.9083. SHAP plots revealed that age and socioeconomic status were among the most important predictors for both depression and moderate to severe depression classifications.
CONCLUSION
This study developed a machine learning model to predict depression risk in patients with multimorbidity using NHANES data. The model demonstrated excellent predictive performance, and SHAP plots highlighted key predictors such as age and socioeconomic status, which significantly influenced the prediction of depression and its severity.
Comparative effectiveness of combination therapy of adalimumab and glucocorticoid with glucocorticoid monotherapy in Vogt–Koyanagi–Harada disease
Authors: Chen Tingting , Liu Xiaotong , Li Guodong , Zhang Yingying , Mao Qinglan , Zhan Yurui
Published: December 2024

Purpose: To make a preliminary investigation of the clinical efficacy and safety in treating VKH between adalimumab combined with glucocorticoids and adalimumab alone.
Methods: The medical records of 23 patients with VKH diagnosed were retrospectively analyzed, the GM group received glucocorticoid monotherapy, and the ACWG group received a consolidation of adalimumab subcutaneous injection on top of the conventional treatment in the GM group. The BCVA, and the CMT, as well as the oral hormone dose, recurrence,and adverse events were investigated.
Results: 23 patients (46 eyes) with VKH syndrome were included in this study, 11 males and 12 females. After 3,6 and 10 months of the treatment, the ACWG group significantly improved BCVA compared to the GM group (P<0.05). Compared to pre-treatment, CMT decreased at all time points after treatment in both groups (P<0.05). There was a statistically significant difference in CMT improvement between the two groups after 1 month and 3 months of treatment (P＜0.05). The average steroid dose was reduced significantly in the ACWG group(P＜0.05). A higher recurrence rate was found in the GM group(P=0.046).
Conclusion: The therapy of adalimumab combined with a glucocorticoid is effective and safe, and the recurrence and the burden of oral hormones are also reduced.
Predictive Value of Urethral Sphincter Complex Volume for Persistent High Voiding Pressure in Female Urethral Diverticulum Patients Post-Diverticulectomy
Authors: Chen Jen-Chieh , Pan Po-Hsun , Lin Chih-Chieh , Lin Alex T. L. , Huang Eric Yi-Hsiu , Fan Yu-Hua
Published: December 2024

Purpose
This study evaluated the relationship between urethral diverticulum volume (UDv), urethral sphincter complex volume (USCv), clinical and urodynamic characteristics, and surgical outcomes in women with UD.
Methods
A retrospective study was conducted on 53 female patients who underwent diverticulectomy for UD. They were divided into two groups: proximal/middle UD (pmUD, n = 43) and distal UD (dUD, n = 10). Preoperative assessments included videourodynamic study (VUDS) and magnetic resonance imaging, with a follow-up VUDS 1 month post-surgery.
Results
Compared to the dUD group, pmUD patients were less likely to present with a vaginal lump (37.2% vs. 80.0%, p = 0.031) but had significantly larger USCv (9.96 ± 5.91 cm3 vs. 5.23 ± 1.19 cm3, p < 0.001) and UDv (6.27 ± 7.40 cm3 vs. 0.84 ± 0.81 cm3, p < 0.001). The pmUD patients had longer surgeries and higher recurrence rates (32.6% vs. 0%, p = 0.018). In the pmUD group, 24 patients had bladder outlet obstruction (BOO) and 25 exhibited high-pressure voiding (> 20cmH2O). No significant association was found between UDv or USCv and recurrence, unresolved BOO, or high-pressure voiding status. However, a USCv cutoff of ≥ 8.2 cm3 was identified, predicting unresolved high-pressure voiding status post-surgery (p = 0.023). Additionally, 9.3% pmUD patients developed de novo stress urinary incontinence, correlated with larger UDv (11.5 ± 14.3 cm3 vs. 5.9 ± 6.4 cm3, p = 0.02).
Conclusion
A USCv cutoff of ≥ 8.2 cm3 was identified as a predictor for unresolved high-pressure voiding after diverticulectomy.
A cluster-randomized controlled trial of a family-based psychosocial intervention to prevent childhood obesity from preschool ages: the PRESAFALIN study protocol.
Authors: Berruezo Paula , Homs Clara , Estrada Lidia , Lopez-Iglesias Gisela , Lecegui Paula , Valdés-Querol Gina , Carmona-Bach Maria , Mas-Ribera Berta , Orive-Vidal Anna , Araoz Agustina , Según Genís , Torres Silvia , Kim Tina , Díez Julia , Cereijo Luis , Schröder Helmut , Franco Manuel , Gómez Santiago Felipe
Published: December 2024

Background: Childhood obesity is a major global concern, and Spain's high obesity rates highlight the urgent need for effective and innovative interventions in early age. The PRESAFALIN study aims to promote parental competence, self-efficacy, and resilience to improve children's healthy behaviors and reduce the risk of developing obesity.
Methods: This cluster randomized trial will involve 120 child day care centers and public nursery schools across Catalonia and Madrid, Spain, engaging 1,200 families with children aged 0 to 5 years. The study will evaluate children’s zBMI and health-related variables among children, parents/caregivers, and educators through both in-person and self-reported measures. The intervention will unfold in three phases: a 10-month cycle of family group and individual workshops, along with pedagogical and communication materials in the short term. Follow-up and ongoing support will continue up to age 12 in the mid- and long-term phases.
Discussion: The study's strengths include a holistic, flexible approach, long-term follow-up, emphasis on educator training, and socioeconomic equity. Moreover, it will address challenges like self-selection bias and attrition. Overall, the PRESAFALIN study aims to provide valuable insights into how early interventions on parental psychosocial factors determine childhood obesity, guiding scalable public health strategies.
Trial Registration: This study protocol is registered and approved in the ISRCTN registry (ISRCTN 15553317).
Bayesian mixed effect models to account for environmental modulators of acute malnutrition treatment in children
Authors: Sánchez-Martínez Luis Javier , Faes Christel , Charle-Cuéllar Pilar , Samake Salimata , Samake Mahamadou N’tji , Bagayoko Aliou , Bunkembo Magloire , Gado Abdoul Aziz , Sanoussi Atté , Ousmane Nassirou , Lazoumar Ramatoulaye Hamidou , Hernández Candela Lucía , López-Ejeda Noemí
Published: December 2024

Acute child malnutrition is a global public health problem influenced by very diverse factors, including socioeconomic and dietary aspects, but also seasonal and geographic factors. The present study is a secondary analysis that attempts to characterize which variables have influenced the Middle Upper-Arm Circumference (MUAC) upon admission and the Length of Stay (LOS) for treatment recovery. The sample of children analysed was 852. Initially, data cleaning and a reduction of the dimensionality of dietary diversity were carried out. A selection of the importance of the variables using the Watanabe Akaike Information Criteria (WAIC) was carried out prior to the adjustment of Bayesian mixed effects models, with the variables of travel time to health site and week of admission as random factors, on the MUAC and LOS variables. Clear differences were seen between both contexts. Highlighting significant interactions of travel time in Niger while the seasonal effect stood out in Mali. The MUAC models identified a positive effect of age in both contexts, and in Niger, influences of diet diversity, comorbidities, breastfeeding and vaccination appeared. On the other hand, the LOS models highlighted the severity upon admission, and in Niger also factors related to the treatment protocol and the distance to the water source, while in Mali, the quality of water was more decisive. The present study shows the importance of considering acute child malnutrition from a multidimensional and complex approach, where diverse factors (biological, socioeconomic, ecological, etc.) can influence directly or as modulators of the disease and its treatment.
The association between proton pump inhibitor use and risk of osteoarthritis: a cross-sectional study
Authors: Zhang Lisheng , Xiong Ling , Sun Yuanting , Feng Fabo , Lin Yanze
Published: December 2024

Background
Proton pump inhibitors (PPIs) are widely used for managing gastrointestinal conditions, but emerging evidence suggests a potential association with osteoarthritis (OA). This study aims to evaluate the relationship between PPI use and OA, and to investigate whether prolonged PPI use further contributes to OA risk.
Methods
We performed a cross-sectional analysis using National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018. PPIs use information was obtained by using prescription medications in the preceding month, and OA status was identified via standard questionnaire. Multivariable regression models were employed to estimate the association between PPIs use and OA after the adjustment for potential confounders. Subgroup analyses were conducted to explore potential interaction effects based on age, gender, race, and body mass index.
Results
A total of 18,605 participants were included in the analysis, of whom 2,090 had OA. After adjusting for all covariates, multifactorial logistic regression revealed a significant association between PPI use and increased OA risk (OR = 1.855 95%CI = 1.549–2.221, P < 0.001). Notably, a dose-response relationship was identified, with each additional year of PPI use increasing OA risk by 7.6% (OR: 1.076, 95% CI: 1.049–1.103, P < 0.001). Subgroup analyses showed that PPI use was significantly associated with OA risk across all populations, with the exception of young adults, other Hispanic, and other racial groups. Of particular note, in middle-aged and Mexican American subpopulations, prolonged PPI use corresponded with a significant higher OA risk.
Conclusions
This study demonstrates a significant association between PPI use and an increased risk of OA, with a further risk increment observed with prolonged PPI.
Predicting acute rejection in simultaneous pancreas-kidney transplantation using donor- derived cell-free DNA as biomarker
Authors: Liu Luhao , Li Guanghui , Zhang Peng , Chen Rongxin , Ouzaouit Abdelhak , Jiang Tingya , Guo Yuhe , Fang Jiali , Ma Junjie , Chen Zheng
Published: December 2024

Background:
Donor-derived cell-free DNA (dd-cfDNA) has been evaluated as a rejection marker in organ transplantation. Here, we assessed the predictive and diagnostic utility of dd-cfDNA for the detection of acute rejection (AR) in patients who have undergone simultaneous pancreas-kidney transplantation (SPKT).
Material and Methods:
Between June 2019 and January 2022, 60 patients with end-stage renal disease were registered to undergo simultaneous pancreas and kidney transplantation at the Organ transplantation department of the Second Affiliated Hospital of Guangzhou Medical University. Patients diagnosed with biopsy-proven AR (n = 30), and normal graft function (n = 30) were divided into AR group and stable group, respectively.
Results:
The time for diagnosing and confirming a rejection incidence in the AR group was (17 ± 4) days post-operation where plasma dd-cfDNA was found to be 5.4 ± 2.0%. In the stable group however, the plasma dd-cfDNA was 1.70 ± 0.48% at 2 weeks post-operation, showing a statistically significant difference (P < 0.01). The SNP-based dd-cfDNA assay discriminated patients with active rejection from non-rejection when dd-cfDNA cut-off was 1.81%, showing an area under the curve, sensitivity and specificity of 0.86, 95.7% and 57.1% respectively.
Conclusion:
The significant increase in plasma dd-cfDNA in SPKT recipients with acute rejection signify that its use as biomarker could facilitate timely detection of graft rejection for the initiation of prompt management strategies among recipients.
Evaluation of the Analgesic Effect of Laser Therapy at Acupuncture Points in Orthodontic Patients
Authors: Queiroga Raquel Porto , Segundo Aguinaldo Silva Garcez
Published: December 2024

Photobiomodulation and laser acupuncture are pain management treatments, offering safe, non-invasive options for patients seeking alternatives to conventional treatments. Therefore, the aim of this research is to evaluate the effects of low-level laser therapy at acupuncture points on pain mechanisms caused by orthodontic separators. For the study, 162 healthy adult volunteers over the age of 18 were selected. Orthodontic separators were installed to stimulate pain. The volunteers were divided into three groups: Group 1 received diode laser (808 nm, 100 mW) at acupuncture points for 40 seconds (4 J energy), Group 2 received diode laser (808 nm, 100 mW) on molars with orthodontic separators for 40 seconds (4 J energy), and Group 3 received a placebo at acupuncture points. The acupuncture points used were: LI4 (Hegu), EX2 (Yintang), LI6 (Pianli), LI11 (Quchi), and LU7 (Lieque). A modified Visual Analogue Scale (VAS) was used to assess pain levels. To evaluate differences in pain intensity between groups and over time, the Friedman and Kruskal-Wallis tests were used. Statistical analysis confirmed a significant difference in pain intensity between groups over time (p < 0.001). No significant difference in pain perception was observed between genders (p = 0.943). The difference between the groups that received laser therapy at acupuncture points and local points was not statistically significant (p = 0.272). It can be concluded that laser therapy at acupuncture points yields results similar to laser therapy for pain induced by the installation of orthodontic separators, with both being more effective than placebo treatment.
Extraction and Characterization of Starch from Ginger (Zingiber officinate)
Authors: Singh Anurag , yadav Mayur
Published: December 2024

The aim of research was to extract the starch from ginger. It contains gingerol, fat, starch and volatile oil. It is the rhizome of the plant Zingiber Officinate. Ginger is belonging to the family Zingiberaceae is an ancient Indian medicine used in several disorders. It is a popular spice with important nutraceuticals attributes is cultivated extensively in India. after extraction of starch from ginger. The obtained starch had a yield of 13%. The prepared starch was characterized by FTIR and TGA to investigate the chemical composition, thermal properties. From these findings results suggested that the ginger can be used to extract starch. Due to biodegradable and biocompatible in nature. It will be used for biodegradable film and biomedical applications.
Contact force multiscale calculation in the framework of the non-smooth dynamic approach
Authors: Cavalieri Federico José , Sánchez Eliana , Cardona Alberto
Published: December 2024

Smooth contact models derived from the Hertz theory are widely used in structural dynamics analysis to calculate variable-in-time forces, stresses, and deformations. However, these models require very small time steps during the period in which bodies are in contact to integrate the equations of motion, yielding in a highly time-consuming numerical solution. Furthermore, penetration between bodies is unavoidable. On the other hand, non-smooth techniques use an impact law to calculate the impulses. They arrive to a scheme with a constant time step resulting in very efficient calculations. However, these techniques do not provide a straightforward approach to calculate the variable in time contact forces that are needed to verify or design the structural components. In this work, a new methodology of calculation of impact forces that combines the impulse values obtained from non-smooth algorithms together with a local contact force law derived from continuous force models is presented. Thus, the computational time required to calculate the contact forces is reduced significantly. Several numerical examples are presented to show the robustness and performance of the proposed methodology.
Biases toward weight, diet, and exercise expressed by health science students and their professors
Authors: Clark James E. , Wiszniak Martha F. , Bicomong Ricci , Sousa Makayla , Jolivette Dalton , Sirois Emily
Published: December 2024

Background
Bias is a recognized to inhibit a holistic model of healthcare. Yet, little has been investigated into how bias in the educational process influences the development of bias in healthcare professionals.
Methods
344 students and professors (152 M/172 F/ 20 other) completed an electronic survey regrading ideals of diet, exercise, health, body weight, and how one obtains information for developing or modeling healthy behaviors. Responses were analyzed based on group averages,
Results
Social media appears to be the most cited source for information on lifestyle interventions. Even with awareness of social pressures to be thin, “thinnest” body was deemed to be healthiest. A greater confirmation bias was expressed in older respondents regarding advice to overweight individuals, with younger respondents being more conscious of their approach.
Conclusion
For students, biases appear to develop through combination of preconceived ideals reinforced by educators. Recommendations appear to be based on personal beliefs and projection of biases by educators and students based on personal anecdotes or over-reliance on social media for modeling of appropriate healthy behaviors and attitudes.
Understanding One Health and Zoonosis: A Bibliometric Analysis of Turkish Research and Global Perspectives (1974-2023)
Authors: DIOP samba deguene , Inci Abdullah , KIZGIN Alina Denis , DUZLU Onder , YILDIRIM Alparslan
Published: December 2024

Background/aim: This article aims to assess, through a bibliometric analysis, the level of understanding of the concepts of One Health and zoonosis among Turkish researchers and to find existing gaps.
Materials and methods: A bibliometric analysis was used to examine trends in research concerning "One Health," "Zoonosis," and "Zoonoses", focusing on publications originating from Türkiye and globally. Data from Scopus were gathered and analysed using VOSviewer and Rstudio software.
Results: Research interest in One Health and zoonoses has increased in Türkiye since the 2000s. Despite this growing interest, the number of articles on these topics in Türkiye remains lower than in other developed countries. The analysis revealed the interdisciplinary nature of “One Health” and “zoonosis” research, which draws on contributions from diverse academic fields in Türkiye. Academicians from different fields have made significant contributions, and the top ten most prominent authors in these fields were identified. Comparisons between Türkiye and other countries shed light on nuanced disparities. Thus, research on these concepts is distributed by field. Most of the research in Türkiye has been conducted in medical sciences, followed by immunology and veterinary sciences. Our keywords analysis showed significant differences in the concepts "One Health" and "zoonosis". In Türkiye, the “One Health” concept is associated predominantly with animals, especially felines. This term is mostly linked to zoonotic pathogens such as Toxoplasma, Anthrax, Fasciola hepatica, andEchinococcus. It also includes concepts such as epidemiology, infectious diseases, and antibiotic resistance. Beyond Turkish borders, this concept has a wider understanding and is associated with concepts such as environmental health, education, veterinary medicine, and food safety. In Türkiye, the “zoonosis” concept is linked to pathogens such as Anthrax, Fasciola hepatica, Echinoccocus, Brucella, Leishmania, and hantavirus. When the zoonosis term is analysed globally, besides the pathogens associated with Türkiye, it includes pathogens such as Ricketssia, Salmonella, Taenia solium, and Giardia. Zoonosis is also closely related to concepts such as climate change, animal welfare, and vector-borne and food-borne diseases.
Chemoselective Ligation between Acyl Hydrazines and Nitroalkanes as 1,3,4-Thiadiazoles using Elemental Sulfur
Authors: Li Jing , Wang Xiaonan , Yu Xiuwen , Qian Ruixi , Xu Si , Lear Martin , He Wanxiao
Published: December 2024

Substituted 1,3,4-thiadiazoles find extensive use in pharmaceutical, agricultural, and materials chemistry. The incorporation of adaptable heterocyclic pharmacophores results in tunable hybrid molecules with diverse medicinal properties. In this study, the direct coupling of primary nitroalkanes and acyl hydrazines (hydrazides) was achieved simply by the mild action of S8 and Na2S. This method now delivers wide varieties of multi-functionalized 1,3,4-thiadiazoles in excellent yields. The reaction is scalable, shows a broad substrate scope, and tolerates a wide range of functional groups. The power of this method is exemplified with over twenty acyl hydrazines, spanning a diverse range of nitroalkane substrate classes, as well as the concise and scalable synthesis of 1,3,4-thiadiazole derivatives of over ten distinct types of drugs and peptides.
Home-based digital counselling by frontline community workers for anxiety and depression in rural Pakistan: piloting mPareshan - a task-shifting primary mental health care intervention
Authors: Rabbani Fauziah , Nafis Javeria , Akhtar Samina , Siddiqui Amna , Merali Zul
Published: December 2024

Background
There is limited evidence that interventions for improving mental well-being can be integrated sustainably into primary health care in Pakistan. We aimed to pilot ‘mPareshan digital intervention’ locally, adapted from WHO mhGAP and delivered by trained and supervised women lay workers to learn if it was feasible and possibly effective in reducing anxiety and depression prior to proposing implementation on a larger scale.
Method
Using Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), a baseline household survey was conducted by independent data collectors to measure anxiety and depression. We trained 72 government Lady Health Workers (LHWs) and Lady Health Supervisors (LHSs) in District Badin, Sindh for 3 days to screen and counsel adult men and women (> 18 years) with mild and moderate symptoms of anxiety and depression. Supervised by LHSs, these screen positive participants (SPs) received 6 counselling sessions by LHWs through the mPareshan app during their routine household visits. The app had interactive audio/video psychoeducation features. Severe cases of anxiety and depression were referred to nearest available mental health service.
Results
Out of the 366 individuals surveyed at baseline, 98 participants (53 men and 45 women, mean age 43.2 years) screened positive for mild and moderate anxiety and depression and were eligible for the mPareshan digital counselling intervention. 6 SPs were lost to follow up for various reasons. Of the 92 SPs who completed all 6 counselling sessions, their mean PHQ-9 score declined from 7.5 (sd 3.1) before intervention to 2.6 (sd 2.2) after intervention. Mean GAD-7 score fell from 6.6 (sd 3.0) to 2.1 (sd 2.2) after 6 sessions. No significant association between sociodemographic variables (age, gender, education, and income levels) and anxiety and depression scores was noted.
Conclusion
Preliminary evidence of a meaningful improvement in anxiety and depression was found using this locally adapted digital counselling intervention delivered by lay health workers in a rural setting of Sindh, Pakistan. There is a need to test the effectiveness of this task-shifting mental health model in an appropriately powered randomised controlled trial.
Trial Registration
ACTRN12622000989741 at the Australian New Zealand Clinical Trial Registry (https//www.anzctr.org.au/Default.aspx).