bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating Stress Sensitization and Steeling for Early-Life Adversity and Recent Stressful Life Experiences: Health and Illness in Older Adulthood
Authors: Thoma Myriam V. , Balsiger Simona-Viktoria , Höltge Jan , Rohner Shauna L.
Published: July 2024

Early-life adversity (ELA) and recent stress experiences are relevant explanatory factors in the understanding of health differences across the life span. However, their particular role in explaining the vast health heterogeneity in older adulthood has yet to be defined. To address this gap, this study examined (a) the health of older individuals with differing levels of ELA and recent stressful experiences; and (b) the type (i.e., linear, curvilinear) of the expected stress-health relationships. Longitudinal quantitative data were collected on health, ELA, and stressful life experiences of the previous 21 months in N = 216 participants ( Mage = 69.8 years, 45.8% female). Findings support linear (rather than curvilinear) stress-health relationships for ELA and recent stress with physical and mental health. Furthermore, ELA significantly moderated the relationship between recent stress and physical illnesses. As the detrimental health impact of ELA can still be detected in older adulthood, ELA may be critical for understanding later life health heterogeneity.
Novel insights into causal effects of serum lipids, lipid metabolites, and lipid-modifying targets on the risk of intracerebral aneurysm
Authors: Qiu Youjia , Song Bingyi , Yin Ziqian , Wang Menghan , Tao Yuchen , Xie Minjia , Duan Aojie , Chen Zhouqing , Si Ke , Wang Zhong
Published: July 2024

Introduction:

Different serum lipid and lipid-lowering agents are reported to be related to the occurrence of intracerebral aneurysm (IA). However, the causal relationship between them requires further investigation.

Patients and methods:

Mendelian randomization (MR) analysis was performed on IA and its subtypes by using instrumental variants associated with six serum lipids, 249 lipid metabolic traits, and 10 lipid-lowering agents that were extracted from the largest genome-wide association study. Phenome-wide MR analyses were conducted to identify potential phenotypes associated with significant lipid-lowering agents.

Results:

After multiple comparison adjustments ( p < 0.0083), genetically proxied triglyceride (TG) (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.07–1.47, p = 0.005) and high-density lipoprotein cholesterol (HDL-C) levels (OR 0.93, 95% CI 0.89–0.98, p = 0.008) showed causal relationships with the risk of IA. Four lipid metabolic traits showed a causal relationship with the risk of IA ( p < 0.0002). As confirmed by drug target MR, the causal relationship between the HMGCR target and IA, HMGCR target and subarachnoid hemorrhage (SAH), ANGPTL3 target and SAH, CETP target, and SAH remained statistically significant after multiple adjustments ( p < 0.005). Additionally, phenome-wide MR did not identify other diseases linked to the significant lipid-lowering agent ( p < 6.39 × 10−5).

Discussion and conclusion:

This study not only supports that serum lipids (TG and HDL-C) are associated with IA but also confirms the positive effect and absence of safety concerns of intervening HMGCR, ANGPTL3, and CETP targets in IA and its subtypes, opening new avenues for IA treatment.
Politicising Space, (In)visibilising Grief: Pandemic commemoration and the UK’s “National COVID Memorial Wall”
Authors: Purnell Kandida
Published: July 2024

This article contributes to knowledge on the politics of national commemoration in the context of the COVID-19 pandemic by exploring the case of the United Kingdom (UK) and the ‘National COVID Memorial Wall’ in its material and digital manifestations. Questioning how the Wall functions socially and politically as a site of ‘national’ COVID-19 commemoration and using a combination of participatory in person and digital ethnographies, this article demonstrates how the Wall at once politicises public space while simultaneously serving to reinforce existing inequalities and patterns of (in)visibility while inadvertently overing the pandemic through its timing. While appraising the politics and space of the Wall in London and its digital version, this article highlights how inequalities exacerbated through the pandemic have (mis)informed and are reflected in the physical and virtual construction of the self-proclaimed ‘national’ COVID-19 memorial. Within a context defined by competitive victimhood and commemorative crowding which come to define ‘post’-pandemic society and make for fraught commemorative processes that ought to be approached by Governments’ with specific sensitivity, this article argues that the Wall politicises and opens up space within which previously contained grief becomes visible and felt while being limited in its capacity to make particular victims of the pandemic visible and thus to amplify marginalised and contained voices and grief.
Medication Engagement, Determinants of Health, and A1C Levels Among Adults With Type 2 Diabetes within a Tribal Health System
Authors: Nelson Tarah , Wilkie Diana J. , Yao Yingwei , Segal Richard , DeVaughan-Circles Ashley , Donahoo William T. , Goins R. Turner , Manson Spero M. , Legaspi Anatolia B. , Scarton Lisa
Published: July 2024

Purpose

The purpose of this study was to examine the association between determinants of health, medication engagement, and A1C levels in adults with type 2 diabetes (T2DM) receiving Tribal health and pharmacy services.

Methods

A retrospective analysis of 2020-2021 electronic health record data was conducted and included adult patients with T2DM using Choctaw Nation Health Services Authority prescribed ≥1 noninsulin glucose-lowering medication in 2020, had ≥1 A1C value in 2020 and 2021, and had a valid zip code in 2021. Patients receiving both insulin and other noninsulin glucose-lowering medication were included. The proportion of days covered (PDC) was used to calculate medication engagement. Statistical analyses included bivariate analysis and linear regression.

Results

There were 3787 patients included in the analyses; 62.5% were considered engaged (PDC ≥ 0.8). The mean 2020 A1C level was 8.0 (64 mmol/mol) ± 1.8; 33% had an A1C of <7%, 42% had an A1C of 7% to 9%, and 25% had an A1C >9%. The mean A1C in 2021 was 7.9 (63 mmol/mol) ± 1.7; 34% had an A1C of <7%, 44% had an A1C of 7% to 9%, and 22% had an A1C >9%. Older age was weakly correlated with higher engagement; higher engagement was associated with lower A1C levels while adjusting for covariates.

Conclusions

Medication engagement was associated with lower A1C levels, and older age was weakly associated with higher engagement to noninsulin glucose-lowering medications, consistent with previous literature. No determinants of health were significantly associated with A1C levels while adjusting for covariates.
Development of an IMU based 2-segment foot model for an applicable medical gait analysis
Authors: Bauer Leandra , Hamberger Maximilian Anselm , Böcker Wolfgang , Polzer Hans , Baumbach Sebastian Felix
Published: July 2024

Background

The two most commonly instrumented gait analysis tools used are Optical Motion Capture systems (OMC) and Inertial Measurement Units (IMU). To date, OMC based gait analysis is considered the gold-standard. Still, it is space-, cost-, and time-intense. On the other hand IMU systems are more cost- and time effective but simulate the whole foot as a single segment. To get a more detailed model of the foot and ankle, a new 2-segment foot model using IMU was developed, comparable to the multi-segment foot models assessed by OMC.

Research question

Can an IMU based 2-segment foot model be developed to provide a more detailed representation of the foot and ankle kinematics?

Methods

To establish a 2-segment foot model, in addition to the previous 1-segment foot model an IMU sensor was added to the calcaneus. This allowed the differentiation between the hindfoot and forefoot kinematics. 30 healthy individuals (mean age 27 ± 7 years) were recruited to create a norm data set of a healthy cohort. Moreover, the kinematic data of the 2-segment foot model were compared to those of the traditional 1-segment foot model using statistical parametric mapping.

Results

The 2-segment foot model proved to be applicable. Furthermore, it allowed for a more detailed representation of the foot and ankle joints, similar to other multi-segment foot model. The healthy cohort’s norm data set showed a homogeneous motion pattern for gait.

Conclusion

The 2-segment foot model allows for an extension of IMU-based gait analysis. Futures studies must prove the reliability and validity of the 2-segment foot model in healthy and pathologic situations.

Level of evidence

Level II.
Examining the knowledge level of nurses regarding aseptic non touch technique in nurses: a cross-sectional study
Authors: Chen Yilin , Cao Xiuzhu , Liu Chang , Sheng Wanting , Wang Jie , Zhao Linfang
Published: July 2024

Background

Healthcare-associated infections (HAIs) are important indicators of healthcare quality. The aseptic non touch technique (ANTT), a standardised aseptic technique, is a crucial preventative measure against HAIs. However, there is insufficient evidence currently available regarding ANTT awareness and proficiency among nurses. This study aimed to investigate the status of ANTT proficiency in a cohort of nurses and analyse the associated risk factors, with the ultimate goal of providing a reference for promoting the application of ANTT in clinical practice.

Methods

The study population was sampled from nurses working in a tertiary hospital in Zhejiang Province, China, in January 2024. A cross-sectional survey was conducted using a self-designed questionnaire to assess ANTT knowledge. Multivariate linear regression analysis was used to analyse the risk factors influencing ANTT knowledge in nurses.

Results

A total of 458 nurses were included in this study. The cohort had an overall score of 49.7% correct responses on the ANTT knowledge questionnaire, with a mean score of 12.4 ± 2.4 out of 25, and 30.1% of the nurses felt that they did not need training related to ANTT. Multivariate linear regression analysis indicated that professional title, educational level, and the need for ANTT training were independently associated with ANTT knowledge in nurses. Nurses with Master’s degrees and associated chief nurses were observed to have higher levels of ANTT knowledge compared to the rest.

Conclusions

ANTT knowledge is insufficient among nurses in China, and its importance is not widely recognised. Continuous efforts are required to strengthen this knowledge. Constructing sustained, multiform, and stratified training programmes may represent an effective method to strengthen ANTT knowledge among nurses and promote its clinical use.
Readiness to provide comprehensive emergency obstetric and neonatal care: a cross-sectional study in 30 health facilities in Tanzania
Authors: Juma Damas , Stordal Ketil , Kamala Benjamin , Bishanga Dunstan R. , Kalolo Albino , Moshiro Robert , Kvaløy Jan Terje , Manongi Rachel
Published: July 2024

Background

Despite the global progress in bringing health services closer to the population, mothers and their newborns still receive substandard care leading to morbidity and mortality. Health facilities’ capacity to deliver the service is a prerequisite for quality health care. This study aimed to assess health facilities’ readiness to provide comprehensive emergency obstetric and newborn care (CEmONC), comprising of blood transfusion, caesarean section and basic services, and hence to inform improvement in the quality of care interventions in Tanzania.

Methods

A cross-sectional assessment of 30 CEmONC health facilities implementing the Safer Births Bundle of Care package in five regions of Tanzania was carried out between December 2020 and January 2021. We adapted the World Health Organization’s Service Availability and Readiness Assessment tool to assess amenities, equipment, trained staff, guidelines, medicines, and diagnostic facilities. Composite readiness scores were calculated for each category and results were compared at the health facility level. For categorical variables, we tested for differences by Fisher’s exact test; for readiness scores, differences were tested by a linear mixed model analysis, taking into account dependencies within the regions. We used p < 0.05 as our level of significance.

Results

The overall readiness to provide CEmONC was 69.0% and significantly higher for regional hospitals followed by district hospitals. Average readiness was 78.9% for basic amenities, 76.7% for medical equipment, 76.0% for diagnosis and treatment commodities, 63.6% for staffing and 50.0% for guidelines. There was a variation in the availability of items at the individual health facility level and across levels of facilities. We found a significant difference in the availability of basic amenities, equipment, staffing, and guidelines between regional, and district hospitals and health centres (p = 0.05). Regional hospitals had significantly higher scores of medical equipment than district hospitals and health centers (p = 0.02). There was no significant difference in the availability of commodities for diagnosis and treatment between different facility levels.

Conclusion

Facilities’ readiness was inadequate and varied across different levels of the facility. There is room to improve the facilities’ readiness to deliver quality maternal and newborn care. The responsible authorities should take immediate actions to address the observed deficiencies while carefully choosing the most effective and feasible interventions and monitoring progress in readiness.
Postoperative monitoring of ovariohysterectomy carried out with two types of surgical sutures in shelter cats and differences in selected blood parameters between shelter and pet cats
Authors: Cymbryłowicz Jacek , Jawor Paulina , Wierzbicki Heliodor , Trębacz Piotr , Stefaniak Tadeusz
Published: July 2024

Background

Reduction of inflammation and early detection of complications after surgical procedures are important objectives for proper veterinary practice. This study aimed to evaluate the differences between shelter and pet female cats in selected acute-phase parameters scheduled to ovariohysterectomy. Postoperative monitoring after ovariohysterectomy with the same laboratory parameters was performed in shelter cats, in which two different types of surgical sutures were used for the entire procedure. The experimental group comprised 40 female cats from animal shelters (‘shelter cats,’ n = 40). These cats were divided into two subgroups: group A (n = 20) operated on with absorbable sutures and group NA (n = 20) operated on with non-absorbable sutures. In addition, the same parameters were evaluated in pet female cats (n = 19). Blood was collected from shelter cats immediately before surgery (term 0), at 24 and 72 h (terms 1 and 3, respectively), and at 7 and 14 days (terms 7 and 14, respectively) after ovariohysterectomy. Blood samples from the pet cat group were collected only once.

Result

The mean haptoglobin concentration before ovariohysterectomy in pet cats was significantly lower than that in shelter cats. Fibrinogen concentration was significantly lower in pet cats than in cats from group A. Serum albumin, beta-1, beta-2, and gamma-globulin concentrations were significantly higher in the shelter cats than in the pet cats. Subcutaneous tissue thickening at the site of the postoperative wound was observed in five patients cats (25%) in group A, and two (10%) cats in the NA group.

Conclusion

These results indicate that ovariohysterectomy leads to local and general inflammatory responses. The majority of cats from animal shelters suffered from subclinical inflammation.
Understanding the process of adolescent assent for voluntary male medical circumcision in Zimbabwe: findings from a cross-sectional study
Authors: West Rebecca L. , Sharma Sunny , Hurst Nisa , Bench Will , Nhando Nehemiah , Maponga Brian , Bullock Lucy , Egualeonan Darius , Reast Jemma , Xaba Sinokuthemba , Hatzold Karin , Gumede-Moyo Sehlulekile
Published: July 2024

Background

Voluntary medical male circumcision (VMMC) is a method for combination HIV prevention for adolescents > 15 years in settings with generalized epidemics. In Zimbabwe, policy currently allows VMMC in adolescents > 15 years old, but there is consideration to lower the threshold to 13 years old. There is a need to understand current practices in assent/consent, and parents’ requirements for assent/consent to inform policy recommendations for the VMMC programme in lowering its age threshold.

Methods

Cross-sectional surveys were conducted in September 2022 using convenience sampling among three respondent groups: uncircumcised adolescents/young men (AYM) aged 13–16 years (n = 881), circumcised AYM aged 13–20 years (n = 247), and parents of uncircumcised adolescents aged 13–16 years (n = 443). Surveys asked about VMMC knowledge, experiences with mobilisers, circumcised AYM’s assent/consent experiences, and parents’ preferences for assent/consent processes.

Results

Knowledge of VMMC was significantly lower among younger adolescents aged 13–14 than their 15–16 year-old peers. 57% (142/247) of circumcised AYM had a one-to-one discussion with their provider before having the procedure, 32% (80/247) said they were not fully informed about VMMC prior to the procedure, and 54% (134/247) wanted more information about procedure-related pain. Over half (56%, 42/75) of circumcised AYM whose parents had not provided consent in-person for them to receive the procedure reported that their parents had never been contacted to verify consent.

Conclusions

There are gaps in the current assent/consent process for VMMC in Zimbabwe. Providers should be trained to give balanced information on risks and benefits of the procedure, including potential for pain. One-on-one discussions between providers and adolescents prior to the procedure, age-appropriate counselling, and tools for providers to ascertain adolescents’ understanding and ability to provide assent are essential processes, especially if the age threshold is lowered to include younger adolescents. it is also imperative to improve communication with parents, particularly to verify consent for their children has been given, per national guidelines.
A comprehensive review of recent advances in research on COVID in communication studies
Authors: Cyrek Barbara , Peltonen Jenna
Published: July 2024

Background

The COVID-19 pandemic initiated a great global crisis, during which media influenced society and social interactions affected media use. Researchers from various research fields have studied the pandemic both globally and locally. This study aims to summarize the research on COVID-19 pandemic within communication studies, taking into account 358 articles published in SJR best ranked journals in 2020–2022.

Methods

The study uses both qualitative and quantitative methods. Using manual coding and qualitative content analysis, we investigate articles’ distribution according to journals, time, accessibility (either open, free or restricted) and methodological approaches. We also provide a qualitative summary of trending research themes. Using quantitative social network analysis (SNA) we present the distribution of institutions and countries in articles’ affiliations, and the collaboration network at institutional and country level.

Results

Results show an in-time increase of COVID-related publications. Articles were affiliated with 490 institutions from 68 countries, with the USA having the greatest representation. There was an underrepresentation of African and South American countries, which reflects the core-periphery challenge in knowledge production. The network analysis revealed that very few of possible connections were actually achieved. There is an observable trend of using quantitative methods. A growth on the gap between qualitative and quantitative studies was observed each year. More than a half of articles using qualitative methods were published in restricted access. Our qualitative summary of the addressed topics and main findings in articles related to COVID-19, media and society revealed a wide research interest in pandemics impacts on news consumption, media use and journalism, as well as infodemic, conspiracy narratives, science mistrust and discrimination and inequalities increased by the pandemic.

Conclusion

To provide a wider perspective on the worldwide impact of pandemic, more studies from underrepresented countries are needed. The collaboration between institutions and countries requires strengthening. Qualitative studies were conducted considerably less than quantitative studies and they were usually published in restricted access, which leads to a methodological gap.
Use of multiple pharmacies by people living with HIV
Authors: Sahloff Eric G. , Sturgill Kuan , Vaidya Varun , Duggan Joan M.
Published: July 2024

Using multiple pharmacies has been linked to negative outcomes including increased inappropriate drug use, toxicity, and mortality, yet up to half of all patients in the US use multiple pharmacies. A pilot survey was administered to measure pharmacy use in people living with HIV (PWH) and examine the associated attitudes and outcomes. In a midwestern HIV clinic, a convenience sample was surveyed based on using single (SPU) versus multiple pharmacies (MPU). One hundred forty-two subjects participated (69 SPU; 73 MPU): 75% male, 59% white, and > 70% being ≥ 40 years old. There was a trend towards increased recall of self-reported CD4 and viral load status for SPUs vs MPUs [OR 2.26 (95%, 0.91–5.64)]. SPU participants indicated acquiring all meds in one place [Likert Scale weighted average (LS WA) = 4.45], proximity (LS WA = 3.64), the identification of adverse effects (LS WA = 4.17), and concerns about missing potential drug-drug interactions (LS WA = 4.06) as reasons for preferring a single pharmacy. The desire to keep HIV status private (LS WA = 3.65) was noted as a significant reason for using a separate pharmacy specifically for acquiring antiretrovirals in MPU participants. Results indicate patients often have justifiable reasons for using single versus multiple pharmacies.
Validation of IMU against optical reference and development of open-source pipeline: proof of concept case report in a participant with transfemoral amputation fitted with a Percutaneous Osseointegrated Implant
Authors: Ahmed Kirstin , Taheri Shayan , Weygers Ive , Ortiz-Catalan Max
Published: July 2024

Background

Systems that capture motion under laboratory conditions limit validity in real-world environments. Mobile motion capture solutions such as Inertial Measurement Units (IMUs) can progress our understanding of "real" human movement. IMU data must be validated in each application to interpret with clinical applicability; this is particularly true for diverse populations. Our IMU analysis method builds on the OpenSim IMU Inverse Kinematics toolkit integrating the Versatile Quaternion-based Filter and incorporates realistic constraints to the underlying biomechanical model. We validate our processing method against the reference standard optical motion capture in a case report with participants with transfemoral amputation fitted with a Percutaneous Osseointegrated Implant (POI) and without amputation walking over level ground. We hypothesis that by using this novel pipeline, we can validate IMU motion capture data, to a clinically acceptable degree.

Results

Average RMSE (across all joints) between the two systems from the participant with a unilateral transfemoral amputation (TFA) on the amputated and the intact sides were 2.35° (IQR = 1.45°) and 3.59° (IQR = 2.00°) respectively. Equivalent results in the non-amputated participant were 2.26° (IQR = 1.08°). Joint level average RMSE between the two systems from the TFA ranged from 1.66° to 3.82° and from 1.21° to 5.46° in the non-amputated participant. In plane average RMSE between the two systems from the TFA ranged from 2.17° (coronal) to 3.91° (sagittal) and from 1.96° (transverse) to 2.32° (sagittal) in the non-amputated participant. Coefficients of Multiple Correlation (CMC) results between the two systems in the TFA ranged from 0.74 to > 0.99 and from 0.72 to > 0.99 in the non-amputated participant and resulted in ‘excellent’ similarity in each data set average, in every plane and at all joint levels. Normalized RMSE between the two systems from the TFA ranged from 3.40% (knee level) to 54.54% (pelvis level) and from 2.18% to 36.01% in the non-amputated participant.

Conclusions

We offer a modular processing pipeline that enables the addition of extra layers, facilitates changes to the underlying biomechanical model, and can accept raw IMU data from any vendor. We successfully validate the pipeline using data, for the first time, from a TFA participant using a POI and have proved our hypothesis.
Maximizing tree carbon in croplands and grazing lands while sustaining yields
Authors: Sprenkle-Hyppolite Starry , Griscom Bronson , Griffey Vivian , Munshi Erika , Chapman Melissa
Published: July 2024

Background

Integrating trees into agricultural landscapes can provide climate mitigation and improves soil fertility, biodiversity habitat, water quality, water flow, and human health, but these benefits must be achieved without reducing agriculture yields. Prior estimates of carbon dioxide (CO2) removal potential from increasing tree cover in agriculture assumed a moderate level of woody biomass can be integrated without reducing agricultural production. Instead, we used a Delphi expert elicitation to estimate maximum tree covers for 53 regional cropping and grazing system categories while safeguarding agricultural yields. Comparing these values to baselines and applying spatially explicit tree carbon accumulation rates, we develop global maps of the additional CO2 removal potential of Tree Cover in Agriculture. We present here the first global spatially explicit datasets calibrated to regional grazing and croplands, estimating opportunities to increase tree cover without reducing yields, therefore avoiding a major cost barrier to restoration: the opportunity cost of CO2 removal at the expense of agriculture yields.

Results

The global estimated maximum technical CO2 removal potential is split between croplands (1.86 PgCO2 yr− 1) and grazing lands (1.45 PgCO2 yr− 1), with large variances. Tropical/subtropical biomes account for 54% of cropland (2.82 MgCO2 ha− 1 yr− 1, SD = 0.45) and 73% of grazing land potential (1.54 MgCO2 ha− 1 yr− 1, SD = 0.47). Potentials seem to be driven by two characteristics: the opportunity for increase in tree cover and bioclimatic factors affecting CO2 removal rates.

Conclusions

We find that increasing tree cover in 2.6 billion hectares of agricultural landscapes may remove up to 3.3 billion tons of CO2 per year – more than the global annual emissions from cars. These Natural Climate Solutions could achieve the Bonn Challenge and add 793 million trees to agricultural landscapes. This is significant for global climate mitigation efforts because it represents a large, relatively inexpensive, additional CO2 removal opportunity that works within agricultural landscapes and has low economic and social barriers to rapid global scaling. There is an urgent need for policy and incentive systems to encourage the adoption of these practices.
The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose–response meta-analysis
Authors: Gheysari Rezvan , Nikbaf-Shandiz Mahlagha , Hosseini Amir Mehdi , Rasaei Niloufar , Hosseini Shabnam , Bahari Hossein , Asbaghi Omid , Rastgoo Samira , Goudarzi Kian , Shiraseb Farideh , Behmadi Reza
Published: July 2024

Aims

L-carnitine plays a role related to cardiometabolic factors, but its effectiveness and safety in CVD are still unknown. We aim to assess the effect of L-carnitine supplementation on CVD risk factors.

Methods

A systematic literature search was conducted in PubMed, Web of Science, and Scopus until October 2022. The main outcomes were lipid profiles, anthropometric parameters, insulin resistance, serum glucose levels, leptin, blood pressure, and inflammatory markers. The pooled weighted mean difference (WMD) was calculated using a random-effects model.

Results

We included the 21 RCTs (n = 2900) with 21 effect sizes in this study. L-carnitine supplementation had a significant effect on TG (WMD = − 13.50 mg/dl, p = 0.039), LDL (WMD = − 12.66 mg/dl, p < 0.001), FBG (WMD = − 6.24 mg/dl, p = 0.001), HbA1c (WMD = -0.37%, p = 0.013) HOMA-IR (WMD = -0.72, p = 0.038 (, CRP (WMD = − 0.07 mg/dl, P = 0.037), TNF-α (WMD = − 1.39 pg/ml, p = 0.033), weight (WMD = − 1.58 kg, p = 0.001 (, BMI (WMD = − 0.28 kg/m2, p = 0.017(, BFP (WMD = − 1.83, p < 0.001) and leptin (WMD = − 2.21 ng/ml, p = 0.003 (in intervention, compared to the placebo group, in the pooled analysis.

Conclusions

This meta-analysis demonstrated that administration of L-carnitine in diabetic and glucose intolerance patients can significantly reduce TG, LDL-C, FBG, HbA1c, HOMA-IR, CRP, TNF-α, weight, BMI, BFP, and leptin levels.

PROSPERO registration code: CRD42022366992.
Assessing blood-brain barrier dysfunction and its association with Alzheimer’s pathology, cognitive impairment and neuroinflammation
Authors: Preis Lukas , Villringer Kersten , Brosseron Frederic , Düzel Emrah , Jessen Frank , Petzold Gabor C. , Ramirez Alfredo , Spottke Annika , Fiebach Jochen B. , Peters Oliver
Published: July 2024

Background

Blood-brain barrier (BBB) alterations may contribute to AD pathology through various mechanisms, including impaired amyloid-β (Aβ) clearance and neuroinflammation. Soluble platelet-derived growth factor receptor beta (sPDGFRβ) has emerged as a potential biomarker for BBB integrity. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers a direct assessment of BBB permeability. However, the relationship between BBB dysfunction, cognitive impairment, and AD pathology remains unclear, with inconsistent findings in the literature.

Methods

We conducted a cross-sectional study using data from the DELCODE and DESCRIBE cohorts to investigate BBB dysfunction in participants with normal cognition (NC), mild cognitive impairment (MCI), and AD dementia. BBB function was assessed using DCE-MRI and sPDGFRβ levels in cerebrospinal fluid and AD biomarkers Aβ and tau were measured. In a subset of patients, the CSF/plasma-ratio of albumin (QAlb) as a standard marker of BBB integrity and markers of neuroinflammation were analyzed.

Results

91 participants (NC: 44, MCI: 21, AD: 26) were included in the analysis. The average age was 74.4 years, 42% were female. Increased hippocampal BBB disruption was observed in the AD-group (Ktrans: 0.55 × 10− 3 min− 1 ± 0.74 × 10− 3 min− 1) but not the MCI-group (Ktrans: 0.177 × 10− 3 min− 1 ± 0.22 × 10− 3 min− 1), compared to the NC group (Ktrans: 0.19 × 10− 3 min− 1 ± 0.37 × 10− 3 min− 1, p < .01). sPDGFRβ was not significantly different between the cognitive groups. However, sPDGFRβ levels were significantly associated with age (r = .33, p < .01), independent of vascular risk factors. Further, sPDGFRβ showed significant positive associations with soluble Aβ levels (Aβ40: r = .57, p < .01; Aβ42: r = .39, p < .01) and YKL-40 (r = .53, p < .01), a marker of neuroinflammation. sPDGFRβ/DCE-MRI was not associated with overall AD biomarker positivity or APOE-status.

Conclusion

In dementia, but not MCI, hippocampal BBB disruption was observed. sPDGFRβ increased with age and was associated with neuroinflammation independent of cognitive impairment. The association between Aβ and sPDGFRβ may indicate a bidirectional relationship reflecting pericytes’ clearance of soluble Aβ and/or vasculotoxic properties of Aβ.
Maximum length binary sequences and spectral power distribution of periodic signals
Authors: Orth Sebastian , Klingbeil Harald
Published: July 2024

The maximum length binary sequence (MLBS) is widely used as a broadband pseudo-random noise excitation signal, for example, for system identification. Although its properties have been known for decades, misleading or inaccurate statements can be found in many references. For example, it is sometimes stated that the spectrum of the MLBS is white, whereas in other references a sinc behavior is stated. In this paper, we therefore analyze the MLBS properties based on precise definitions for the given context (time-discrete vs. time-continuous, periodic vs. non-periodic, etc.), especially with respect to Fourier analysis. Another difficulty arises from the fact that in the literature the mathematical definitions are often simplified by means of normalizations which makes the physical interpretation difficult. Therefore, special emphasis is put on scaling factors which allow such a physical interpretation.
In-depth analysis of the medical supply for indigenous people in North-Eastern Colombia: a dominance of infectious diseases and only insufficient therapeutic options
Authors: Bauer Hannah , Frickmann Hagen , Concha Gustavo , Kreienbrock Lothar , Hartmann Maria , Warnke Philipp , Hagen Ralf Matthias , Molitor Ernst , Hoerauf Achim , Kann Simone
Published: July 2024

Background

Colombian indigenous Wiwas are exposed to a variety of partly complex medical conditions with a predominance of infectious diseases. The study provided here aims at verifying of falsifying previous suspicions on therapeutic shortcomings and neglect of disease categories.

Material and methods

Local diagnoses within various subpopulations of indigenous Wiwas obtained by a study physician and local health brigades and health points between 2017 and 2018 were coded following the ICD 10 classification from 2019. Proportions of diagnoses per ICD-10 sub-chapter were evaluated to find diseases and to rank the occurrence of diagnoses in the population of indigenous people. Thereafter, the available medication provided by the indigenous health care provider Dusakawi for the treatment of the indigenous patients was analyzed in regard of its sufficiency to cover the recorded diseases.

Results

The majority of the diseases found in the communities cannot at all (32%) or only partially (56%) be treated according to available guidelines. Only few (12%), predominantly infectious diseases, were covered completely by the provided medication. Notably, there are some ICD chapters with diseases that do only rarely appear at all in the gained datasets, e.g., complications during birth, mental disorders or cancer.

Conclusions

An expansion and revision of the medical supply for the indigenous population of the Sierra Nevada de Santa Marta is needed. An emergency kit for medical brigades and health points should be provided and in place. Awareness for neglected diseases needs to be created.
Feasibility of Regional Lymphadenectomy for Stomach-Preserving Surgery in Early Gastric Cancer Omitting Sentinel Node Navigation: A Post Hoc Analysis of the SENORITA Trial
Authors: Park Sin Hye , Kim Young-Woo , Min Jae-Seok , Yoon Hong Man , An Ji Yeong , Eom Bang Wool , Hur Hoon , Lee Young Joon , Cho Gyu Seok , Park Young-Kyu , Jung Mi Ran , Park Ji-Ho , Hyung Woo Jin , Jeong Sang-Ho , Kook Myeong-Cherl , Han Mira , Nam Byung-Ho , Ryu Keun Won
Published: July 2024

Background

Sentinel node navigation (SNN) has been known as the effective treatment for stomach-preserving surgery in early gastric cancer; however, SNN presents several technical difficulties in real practice.

Objective

This study aimed to evaluate the feasibility of regional lymphadenectomy omitting SNN, using the post hoc analysis of a randomized controlled trial.

Methods

Using data from the SENORITA trial that compared laparoscopic standard gastrectomy with lymphadenectomy and laparoscopic SNN, 237 patients who underwent SNN were included in this study. Tumor location was divided into longitudinal and circumferential directions. According to the location of the tumor, the presence or absence of lymph node (LN) metastases between sentinel and non-sentinel basins were analyzed. Proposed regional LN stations were defined as the closest area to the primary tumor. Sensitivities, specificities, positive predictive values, and negative predictive values (NPV) of SNN and regional lymphadenectomy were compared.

Results

Metastasis to non-sentinel basins with tumor-free in sentinel basins was observed in one patient (0.4%). The rate of LN metastasis to non-regional LN stations without regional LN metastasis was 2.5% (6/237). The sensitivity and NPV of SNN were found to be significantly higher than those of regional lymphadenectomy (96.8% vs. 80.6% [p = 0.016] and 99.5% vs. 97.2% [p = 0.021], respectively).

Conclusions

This study showed that regional lymphadenectomy for stomach-preserving surgery, omitting SNN, was insufficient; therefore, SNN is required in stomach-preserving surgery.
Did the Paycheck Protection Program Help Small Businesses? Evidence from Commercial Mortgage-Backed Securities
Authors: Agarwal Sumit , Ambrose Brent W. , Lopez Luis A. , Xiao Xue
Published: July 2024

In this study, we examine the broader economic effects of the US federal government’s Paycheck Protection Program by focusing on the performance of securitized commercial mortgages. We provide novel evidence for spillover effects of government interventions in the face of economic crises. We find that the PPP reduced mortgage delinquencies by approximately $36 billion in 2020. The strongest effects occur when PPP funds targeted businesses in areas most affected by COVID-19, where banks overperformed in providing PPP loans, and among mortgages on properties in retail and lodging. Thus, PPP relief to small businesses eased economic distress beyond the labor market. (JEL G21, G28, I12, I18, L25, R33)
Intergenerational and Sibling Spillovers in High School Majors
Authors: Dahl Gordon B. , Rooth Dan-Olof , Stenberg Anders
Published: July 2024

This paper estimates family spillovers in high school major choice in Sweden, where admission to oversubscribed majors is determined based on GPA. Using a regression discontinuity design, we find large sibling and intergenerational spillovers that depend on the sex mix of a dyad. Same-sex siblings copy one another, while younger brothers recoil from an older sister’s choices. Fathers and mothers influence sons but not their daughters, except when a mother majors in the male-dominated program of engineering. Back-of-the-envelope calculations reveal that these within-family spillovers have sizable implications for the sex composition of majors. (JEL I21, J12, J13, J16)
Effects of concurrent training on glycemic and vascular parameters among patients with T2DM-associated Peripheral Artery Disease
Authors: Amin Uroosa , Adnan Qurat-ul-Ain , Ahmad Tauseef
Published: July 2024

Objective: To evaluate the effects of CT to improve HbA1C and ABI among the T2DM-associated PAD population.
Methods: A randomized, single-blinded, two-arm trial was conducted at the Department of Rehabilitation Sciences of Dr. Ziauddin Hospital in Karachi between July to September 2023. A total of 80 T2DM-associated PAD patients were included and randomly divided into Experimental Group (n=40) and Control Group (n=40), using the sealed envelope method. Experimental group patients received Concurrent Training (CT), whereas Control Group patients underwent Aerobic Training (AT) for 12 weeks. Both groups received thirty-minute sessions three times a week that was progressed to 60 minutes over 12 weeks. HbA1C and ABI were measured at baseline and after 12 weeks.
Results: Analysis revealed an average age of 46.75±3.59 and the duration of T2DM for developing PAD is 14.82±2.23 on average. Findings revealed that both training groups were significantly effective (p<0.000) at 95% CI in improving glycemic and vascular parameters after 12 weeks. Subsequently, findings showed that the CT group showed more significant improvement than AT group in improving HbA1C for glycemic control (p=0.002, CT: pre: 9.53±1.406, post: 7.81±0.81, AT: pre: 8.74±0.908, post: 8.15±0.83) and ABI for systemic blood flow (p=0.0001, CT: pre: 0.84±0.03, post: 0.94±0.03, AT: pre: 0.82±0.02, post: 0.86±0.02).
Conclusion: CT showed a two-fold improvement in glycemic control and arterial blood flow than AT group, which represents that CT is an effective therapeutic approach for T2DM-associated Fontain’s stage IIa PAD rehabilitation.
doi: https://doi.org/10.12669/pjms.40.8.9045
How to cite this: Amin U, Adnan QA, Ahmad T. Effects of concurrent training on glycemic and vascular parameters among patients with T2DM-associated Peripheral Artery Disease. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.9045
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Φαρμακευτική και διατροφική φροντίδα σε ογκολογικούς ασθενείς μέσω συστημάτων υποστήριξης κλινικών αποφάσεων
Authors: Νιμέε Φραντζέσκα
Published: July 2024

Η σύγχρονη θεώρηση της Φαρμακευτικής και Διατροφικής Φροντίδας τοποθετεί στο επίκεντρο του Συστήματος Υγείας τους ασθενείς και την ποιότητα της υγειονομικής περίθαλψης που τους παρέχεται. Tα συστήματα υποστήριξης κλινικών αποφάσεων κατέχουν ένα συμβουλευτικό ρόλο στην διαδικασία λήψης αποφάσεων εκ μέρους του κλινικού, με το μεγαλύτερο πλεονέκτημα τους να αποτελεί η βελτίωση της ποιότητας φροντίδας του ασθενή. Ο καρκίνος συνιστά µείζον πρόβληµα δηµόσιας υγείας, δεδομένου ότι εξαπλώνεται µε ρυθμούς επιδημίας παρά την πρόοδο της ιατρικής επιστήμης. Στις µέρες µας αποτελεί τη δεύτερη αιτία θανάτου παγκοσμίως. Η ανακάλυψη ολοένα και περισσότερων αντικαρκινικών φαρμάκων αποτέλεσε σταθμό στην ανάγκη για ανάπτυξη της Φαρμακευτικής Φροντίδας σε ογκολογικούς ασθενείς, ενώ αντίστοιχα η ανάγκη για περαιτέρω έρευνα στην Διατροφική Φροντίδα ογκολογικών ασθενών προκύπτει από την ετερογένεια των διατροφικών συστάσεων, αλλά και από την πολυπλοκότητα της διατροφής και του τρόπου ζωής ως σύνολο. Αντικείμενο της παρούσας Διδακτορικής Διατριβής είναι η εισαγωγή ενός Συστήματος Υποστήριξης Κλινικών Αποφάσεων (ΣΥΚΑ) στην κλινική πρακτική για την εφαρμογή της φαρμακευτικής και διατροφικής συμβουλευτικής των ογκολογικών ασθενών που χρήζουν φαρμακευτική και διατροφική φροντίδα. Μεθοδολογικά, το ΣΥΚΑ μας εξασφάλισε ένα μεγάλο πλεονέκτημα, την ομοιογένεια στο σχεδιασμό και την εκτέλεση της έρευνας μας. Πραγματοποιήσαμε την πρώτη Ανασκόπηση Φαρμακευτικής Αγωγής στον Ελλαδικό χώρο, όπου προέκυψαν τα εξής αποτελέσματα: ο μέσος αριθμός Προβλημάτων που Σχετίζονται με τα Φάρμακα (DRPs) ανά ασθενή ήταν 1,89 και πιο ειδικά ανά ογκολογικό ασθενή 1,67. Το μέσο κόστος φαρμακευτικής αγωγής για τον ασθενή ήταν 38,64 €, ενώ για τον ογκολογικό ασθενή 36,78 €. Επιπροσθέτως, στο περιβάλλον του Νοσοκομείου με τη αρωγή του ΣΥΚΑ υλοποιήθηκε μία τυχαιοποιημένη, διπλά τυφλή, ελεγχόμενη με εικονικό φάρμακο μελέτη της επίδρασης της μελατονίνης στη Κόπωση που Σχετίζεται με τον Καρκίνο (CRF), όπου φάνηκε ότι μόνο στην ομάδα παρέμβασης βελτιώθηκε η CRF(p = 0.003). Μελλοντικές μελέτες χρειάζονται τόσο στο κομμάτι της Ανασκόπησης Φαρμακευτικής Αγωγής και των DRPs, όσο και στην αντιμετώπιση της CRF.
Application of the Valsalva maneuver in medicine and sport
Authors: Karkos Patrycja , Kuśmierczyk Katarzyna , Jurga Marta , Gastoł Bartłomiej , Mikołap Karolina , Kras Marta , Staroń Arkadiusz , Sztemberg Elena , Plizga Jakub , Głuszczyk Agnieszka
Published: July 2024

The Valsalva maneuver, named after Antonio Maria Valsalva, is one of the vagal maneuvers.  It is defined as a forced expiration against a closed glottis, leading to an increase in intrathoracic and intra-abdominal pressure. Over the years it has become a subject of interest to many clinical researchers who have comprehensively studied its physiology and clinical significance. As a result, the application of the Valsalva maneuver has expanded to become a versatile technique applied across a wide range of medical specialties as a diagnostic and therapeutic tool. Additionally, it has found its use in sport among athletes. The aim of this article is to present the current state of knowledge about the clinical significance of the Valsalva maneuver and show that this simple physiological technique described in the 18th century remains a valuable tool in modern clinical practice and has found its use in sport. The review was based on chosen literature obtained from the PubMed electronic database, Google Scholar electronic database, and other scientific articles. Search terms included keywords listed below.
Keywords: Valsalva maneuver; vagal maneuver; respiratory maneuver; autonomic system
ESG Risk and Firm Value: The Role of Materiality in Sustainability Reporting
Authors: Eriandani Rizky , Winarno Wahyu Agus
Published: July 2024

Purpose: This research aims to investigate the impact of environmental, social, and governance (ESG) risk on firm value and analyse the disclosure of materiality as a moderation variable.
Methodology/Approach: We select research data through purposive sampling. We obtain ESG risk scores from Sustainalytics. Content analysis measures the materiality of sustainability disclosures. We processed 204 company data sets in Indonesia using moderated regression analysis techniques between 2020 and 2022.
Findings: Empirical results show that greater environmental, social, and governance risks will lower firm value. Furthermore, the disclosure of materiality in the sustainability report can moderate the negative impact of ESG risk on the firm's value.
Research Limitation/Implication: This research's implications are essential for standard-makers and governments to increase corporate attention to environmental, social, and governance risk aspects. The company's operations pose ESG risk, which negatively impacts market value as investors rely on this information for their decision-making. Furthermore, this research also implies that management understands the importance of materiality in sustainability reports.
Originality/Value of paper: This research enriches existing literature on corporate risk, focusing on environmental, social, and governance risks. This paper also adds references to materiality disclosure in sustainability reports.
Dynamic Robust Parameter Design Using Response Surface Methodology based on Generalized Linear Model
Authors: Oyama Kosuke , Masato Ohkubo , Nagata Yasushi
Published: July 2024

Purpose: When designing an input-output system susceptible to noise, engineers assume a functional relation between the input and the output. The Taguchi method, which uses a dynamic, robust parameter design (RPD) to evaluate the robustness of the input-output relation against noise, is employed. This study aims to address extending the scope of use of a dynamic RPD.
Methodology/Approach: A target system in a typical dynamic RPD can be interpreted as one in which the relation between the input and the output is a linear model, and the output error follows a normal distribution. However, an actual system often does not conform to this premise. Therefore, we propose a new analysis approach that can realize a more flexible system design by applying a response surface methodology (RSM) based on a generalized linear model (GLM) to dynamic RPD.
Findings: The results demonstrate that 1) a robust solution can be obtained using the proposed method even for a typical dynamic RPD system or an actual system, and 2) the target function can be evaluated using an adjustment parameter.
Research Limitation/implication: Further analysis is required to determine which factor(s) in the estimated process model largely contribute(s) to changes in the adjustment parameter.
Originality/Value of paper: The applicability of typical dynamic RPD is limited. Hence, this study’s analytical process provides engineers with greater design flexibility and deeper insights into dynamic systems across various contexts.
Category: Research paper
Keywords: robust parameter design; dynamic system; generalized linear model; response surface methodology; Taguchi method