bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-advocate-led global coalition adapting fit-for-purpose outcomes measures to assure meaningful inclusion of DEEs in clinical trials
Authors: Hecker JayEtta , Conecker Gabrielle , Chapman Chere , Hommer Rebecca , Ludwig Natasha N. , Sevinc Gunes , Te Sara , Wojnaroski Mary , Downs Jenny , Berg Anne T.
Published: June 2024

Existing clinical tools that measure non-seizure outcomes lack the range and granularity needed to capture skills in developmental and epileptic encephalopathy (DEE)-affected individuals who also fall in the severe to profound range of intellectual disability. This effectively excludes those with severe impairments from clinical trials, impeding the ability of sponsors to evaluate disease-modifying therapies (DMTs). The Inchstone Project, an international, patient advocate-led collaboration, brings together leading researchers, clinicians, pharmaceutical companies, and advocates to develop an adapted, validated assessment battery within 5 years. The goal is to support trials of DMTs for the DEEs by providing sufficiently sensitive measurement tools to demonstrate therapeutic efficacy. An initial pilot study administered 7 established assessments to 10 individuals affected by SCN2A-DEE, identifying specific limitations of existing measures and areas for improvement. It was clear that most tools do not account for challenges throughout the DEE population, including vision impairments, significant motor impairments and profound intellectual disability, which need to be accounted for in creating a ‘fit-for-purpose’ battery for the DEE population. Several novel assessments, including two measures of responsivity developed for use in monitoring recovery after acquired brain injury as well as individualized Goal Attainment Scaling, showed promise in this group. The team also completed a DEE-wide survey with over 270 caregivers documenting their children’s abilities and priorities for their improvement from new treatments. The Inchstone team is using this information to evaluate how existing tools might be updated to better capture what is most important to families and measure their child’s small but important improvements over time. These efforts are building a coherent picture across multiple DEEs of what domains, or concepts of interest, have the greatest impact on most patients and families. The Inchstone team is on course to adapt non-seizure outcome measures that are (1) sufficiently sensitive to measure small increments of meaningful change (‘Inchstones’) and (2) applicable to multiple DEE conditions.
Study Protocol for Pain Self-Management and Patient-Oriented Buprenorphine Dosing for Pain and Retention in Office-Based Opioid Treatment: A Hybrid Type 1, 2 × 2 Factorial Randomized Controlled Trial
Authors: Salay Melessa , Edwards Karlyn A. , Winstanley Erin L. , Bachrach Rachel L. , Bulls Hailey W. , Hanmer Janel , Liebschutz Jane M. , Robbins Jonathan , Wilson J. Deanna , Yu Lan , Merlin Jessica S. , Murray-Krezan Cristina
Published: June 2024

Chronic pain is a significant factor for patients with opioid use disorder (OUD) contributing to suboptimal retention in buprenorphine treatment, which is a crucial predictor of long-term health outcomes. This study aims to address the critical need for effective interventions targeting chronic pain management within office-based opioid treatment (OBOT) programs. We are conducting a multisite, hybrid type 1, 2 × 2 factorial randomized clinical trial to determine the effectiveness of 2 novel interventions, pain self-management (PSM) and patient-oriented buprenorphine dosing (POD), to decrease pain interference and improve retention in buprenorphine treatment. PSM, a manualized and customizable approach delivered through individual and peer-led group sessions, aims to decrease pain-related symptoms and quality of life. POD involves split dosing of buprenorphine to extend the duration of analgesia to better match its duration of efficacy at managing OUD symptoms, leading to improved retention in buprenorphine treatment. Eligible participants will be randomized into 1 of 4 groups: (1) PSM + POD, (2) PSM + Standard Buprenorphine Dosing, (3) Usual Care + POD, or (4) Usual Care + Standard Buprenorphine Dosing. Usual Care refers to usual care for chronic pain and Standard Buprenorphine Dosing refers to the participant’s current dosing regimen. Secondary objectives encompass overall pain reduction, decreased opioid use, improved pain symptom management, and exploration of implementation strategies. The supplemental approved protocol provides comprehensive insights into the procedures and variables being investigated. As part of the HEAL Initiative®-funded Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR) network, this study aims to fill gaps in behavioral and medication treatments for individuals with co-occurring chronic pain and OUDs, improving pain management and retention in care. Successful outcomes from this trial may inform future larger trials, offering essential evidence for implementation considerations and reimbursement decisions.
Impact of mechanical cues on key cell functions and cell-nanoparticle interactions
Authors: Elblová Petra , Lunova Mariia , Dejneka Alexandr , Jirsa Milan , Lunov Oleg
Published: June 2024

In recent years, it has been recognized that mechanical forces play an important regulative role in living organisms and possess a direct impact on crucial cell functions, ranging from cell growth to maintenance of tissue homeostasis. Advancements in mechanobiology have revealed the profound impact of mechanical signals on diverse cellular responses that are cell type specific. Notably, numerous studies have elucidated the pivotal role of different mechanical cues as regulatory factors influencing various cellular processes, including cell spreading, locomotion, differentiation, and proliferation. Given these insights, it is unsurprising that the responses of cells regulated by physical forces are intricately linked to the modulation of nanoparticle uptake kinetics and processing. This complex interplay underscores the significance of understanding the mechanical microenvironment in shaping cellular behaviors and, consequently, influencing how cells interact with and process nanoparticles. Nevertheless, our knowledge on how localized physical forces affect the internalization and processing of nanoparticles by cells remains rather limited. A significant gap exists in the literature concerning a systematic analysis of how mechanical cues might bias the interactions between nanoparticles and cells. Hence, our aim in this review is to provide a comprehensive and critical analysis of the existing knowledge regarding the influence of mechanical cues on the complicated dynamics of cell-nanoparticle interactions. By addressing this gap, we would like to contribute to a detailed understanding of the role that mechanical forces play in shaping the complex interplay between cells and nanoparticles.
The serine-rich repeat glycoprotein Srr2 mediates Streptococcus agalactiae interaction with host fibronectin
Authors: Pellegrini Angelica , Motta Chiara , Bellan Menegussi Elisa , Pierangelini Andrea , Viglio Simona , Coppolino Francesco , Beninati Concetta , De Filippis Vincenzo , Barbieri Giulia , Pietrocola Giampiero
Published: June 2024

Background

Group B Streptococcus (GBS) is a commensal of healthy adults and an important pathogen in newborns, the elderly and immunocompromised individuals. GBS displays several virulence factors that promote colonisation and host infection, including the ST-17 strain-specific adhesin Srr2, previously characterised for its binding to fibrinogen. Another common target for bacterial adhesins and for host colonization is fibronectin, a multi-domain glycoprotein found ubiquitously in body fluids, in the extracellular matrix and on the surface of cells.

Results

In this study, fibronectin was identified as a novel ligand for the Srr2 adhesin of GBS. A derivative of the ST-17 strain BM110 overexpressing the srr2 gene showed an increased ability to bind fibrinogen and fibronectin, compared to the isogenic wild-type strain. Conversely, the deletion of srr2 impaired bacterial adhesion to both ligands. ELISA assays and surface plasmon resonance studies using the recombinant binding region (BR) form of Srr2 confirmed a direct interaction with fibronectin with an estimated Kd of 92 nM. Srr2-BR variants defective in fibrinogen binding also exhibited no interaction with fibronectin, suggesting that Srr2 binds this ligand through the dock-lock-latch mechanism, previously described for fibrinogen binding. The fibronectin site responsible for recombinant Srr2-BR binding was identified and localised in the central cell-binding domain of the protein. Finally, in the presence of fibronectin, the ability of a Δsrr2 mutant to adhere to human cervico-vaginal epithelial cells was significantly lower than that of the wild-type strain.

Conclusion

By combining genetic and biochemical approaches, we demonstrate a new role for Srr2, namely interacting with fibronectin. We characterised the molecular mechanism of this interaction and demonstrated that it plays a role in promoting the adhesion of GBS to human cervico-vaginal epithelial cells, further substantiating the role of Srr2 as a factor responsible for the hypervirulence of GBS ST-17 strains. The discovery of the previously undescribed interaction between Srr2 and fibronectin establishes this adhesin as a key factor for GBS colonisation of host tissues.
Mitigation of drought-induced stress in sunflower (Helianthus annuus L.) via foliar application of Jasmonic acid through the augmentation of growth, physiological, and biochemical attributes
Authors: Ashraf Farkhanda , Siddiqi Ejaz Hussain
Published: June 2024

Drought stress poses a significant threat to agricultural productivity, especially in areas susceptible to water scarcity. Sunflower (Helianthus annuus L.) is a widely cultivated oilseed crop with considerable potential globally. Jasmonic acid, a plant growth regulator, plays a crucial role in alleviating the adverse impacts of drought stress on the morphological, biochemical, and physiological characteristics of crops. Experimental detail includes sunflower varieties (Armani Gold, KQS-HSF-1, Parsun, and ESFH-3391), four drought stress levels (0, 25%, 50%, and 75% drought stress), and three levels (0, 40ppm, 80ppm) of jasmonic acid. The 0% drought stress and 0ppm jasmonic acid were considered as control treatments. The experimental design was a completely randomized design with three replicates. Drought stress significantly reduced the growth in all varieties. However, the exogenous application of jasmonic acid at concentrations of 40ppm and 80ppm enhanced growth parameters, shoot and root length (1.93%, 19%), shoot and root fresh weight (18.5%, 25%), chlorophyll content (36%), photosynthetic rate (22%), transpiration rate (40%), WUE (20%), MDA (6.5%), Phenolics (19%), hydrogen peroxide (7%) proline (28%) and glycine betaine (15–30%) under water-stressed conditions, which was closely linked to the increase in stomatal activity stimulated by jasmonic acid. Furthermore, JA 80 ppm was found to be the most appropriate dose to reduce the effect of water stress in all sunflower varieties. It was concluded that the foliar application of JA has the potential to enhance drought tolerance by improving the morphological, biochemical, and physiological of sunflower.
Black-white differences in chronic stress exposures to predict preterm birth: interpretable, race/ethnicity-specific machine learning model
Authors: Kim Sangmi , Brennan Patricia A. , Slavich George M. , Hertzberg Vicki , Kelly Ursula , Dunlop Anne L.
Published: June 2024

Background

Differential exposure to chronic stressors by race/ethnicity may help explain Black-White inequalities in rates of preterm birth. However, researchers have not investigated the cumulative, interactive, and population-specific nature of chronic stressor exposures and their possible nonlinear associations with preterm birth. Models capable of computing such high-dimensional associations that could differ by race/ethnicity are needed. We developed machine learning models of chronic stressors to both predict preterm birth more accurately and identify chronic stressors and other risk factors driving preterm birth risk among non-Hispanic Black and non-Hispanic White pregnant women.

Methods

Multivariate Adaptive Regression Splines (MARS) models were developed for preterm birth prediction for non-Hispanic Black, non-Hispanic White, and combined study samples derived from the CDC’s Pregnancy Risk Assessment Monitoring System data (2012–2017). For each sample population, MARS models were trained and tested using 5-fold cross-validation. For each population, the Area Under the ROC Curve (AUC) was used to evaluate model performance, and variable importance for preterm birth prediction was computed.

Results

Among 81,892 non-Hispanic Black and 277,963 non-Hispanic White live births (weighted sample), the best-performing MARS models showed high accuracy (AUC: 0.754–0.765) and similar-or-better performance for race/ethnicity-specific models compared to the combined model. The number of prenatal care visits, premature rupture of membrane, and medical conditions were more important than other variables in predicting preterm birth across the populations. Chronic stressors (e.g., low maternal education and intimate partner violence) and their correlates predicted preterm birth only for non-Hispanic Black women.

Conclusions

Our study findings reinforce that such mid or upstream determinants of health as chronic stressors should be targeted to reduce excess preterm birth risk among non-Hispanic Black women and ultimately narrow the persistent Black-White gap in preterm birth in the U.S.
Educational outcomes among children with congenital heart disease compared to peers: a Scotland-wide record-linkage study of 715,850 schoolchildren
Authors: Fleming Michael , Athanasopoulos Paul , Mackay Daniel F , Pell Jill P
Published: June 2024

Background

Nine in every thousand children born in the United Kingdom have congenital heart disease, and 250,000 adults are living with the condition. This study aims to investigate the associations between congenital heart disease and educational outcomes among school-aged children in Scotland.

Methods

Routine health and education databases were linked to produce a cohort of all singleton children born in Scotland and attending a local authority run primary, secondary, or special school in Scotland at some point between 2009 and 2013. Children with congenital heart disease within this cohort were compared with children unaffected by congenital conditions. Outcomes investigated were special educational need (SEN), absenteeism, exclusion, academic attainment, and unemployment. All analyses were adjusted for sociodemographic and maternity confounders. Absenteeism was investigated as a mediating factor in the associations with attainment and unemployment.

Results

Of the 715,850 children, 6,295 (0.9%) had congenital heart disease and 4,412 (6.1%) had isolated congenital heart disease. Congenital heart disease and isolated congenital heart disease were both significantly associated with subsequent special educational need (OR 3.45, 95% CI 3.26–3.65, p < 0.001 and OR 1.98, 95% CI 1.84–2.13, p < 0.001 respectively), absenteeism (IRR 1.13, 95% CI 1.10–1.16, p < 0.001 and IRR 1.10, 95% CI 1.06–1.13, p < 0.001 respectively), and low academic attainment (OR 1.69, 95% CI 1.39–2.07, p < 0.001 and OR 1.35, 95% CI 1.07–1.69, p = 0.011 respectively). Neither congenital heart disease nor isolated congenital heart disease were associated with school exclusion. Only congenital heart disease (OR 1.21, 95% CI 1.03–1.42, p = 0.022) but not isolated congenital heart disease was associated with unemployment. When days absent were included in the analyses investigating attainment and unemployment, the conclusions were not altered.

Conclusion

Children with congenital heart disease have greater special educational need, lower school attendance, attain lower examination grades and have greater unemployment compared to peers. In addition to healthcare support, affected children need educational support to avoid additional impact on their long-term wellbeing.
Time to treatment-seeking by caretakers of children under-five with diarrhea and associated factors in Uganda: a multilevel proportional hazards analysis
Authors: Tumusiime Sula , Asimwe John Bosco , Atuhaire Leonard , Wasswa Ronald , Nsimbe Dick , Kayera Brian
Published: June 2024

Background

Diarrhea is considered to be one of the major public health concerns in developing countries. It has a detrimental impact, reflecting one of the highest child mortality rates globally, especially in Sub-Saharan Africa, where 2 out of every 10 children in Uganda under the age of five die. The objective of this study was to investigate the factors associated with time to treatment seeking by caretakers of children under-five with Diarrhea in Uganda.

Method

DOVE dataset of 745 caretakers in a prospective and retrospective incidence-based study using multi-stage sampling design was used in the assessment. The analysis was done using a time-to-event approach using life tables, Kaplan Meier survival analysis and multilevel proportional hazards model.

Results

Kaplan-Meier survival analysis indicated the median time to seeking treatment among 745 caretakers of children under-Five after onset of diarrhea was 2 days. The multi-level proportional hazards model of a Weibull distribution showed that the estimated frailty variance was 0.13, indicating heterogeneity of treatment seeking time by caretakers of under-five children with diarrhea across regions in Uganda. Significant factors found to influence time to treatment-seeking by caretakers of children under-five with diarrhea were, male children (HR = 0.82; 95% CI = 0.71–0.95, p = 0.010), belonging to richest wealth quintile (HR = 1.37; 95% CI = 1.05–1.78, p = 0.022), and residing more than 5 km away from a health facility (HR = 0.68; 95% CI = 0.56–0.84, p = 0.000).

Conclusions

There are delays in seeking diarrhea treatment in Uganda because two days are enough to claim a life after dehydration.The policymakers should pay attention to formulate effective intervention to sensitize caregivers on the importance of early treatment-seeking behavior to avoid severe malnutrition caused by diarrhea. Community awareness program should also be encouraged particularly in areas of more than 5 km from the health facility to make people aware of the necessity to take prompt action to seek care in the early stage.
Results from the ENJOY MAP for HEALTH: a quasi experiment evaluating the impact of age-friendly outdoor exercise equipment to increase older people’s park visitations and physical activity
Authors: Levinger Pazit , Dreher Bronwyn L. , Soh Sze-Ee , Dow Briony , Batchelor Frances , Hill Keith D.
Published: June 2024

Background

Recreational parks can play a significant role in older people’s health, with emerging evidence suggesting that changes in the physical environment, such as refurbishments of local parks, can increase park visitations and physical activity engagement. The ENJOY MAP for HEALTH aimed to evaluate the impact of Seniors Exercise Park installations and associated capacity building activities on older people’s park visitation, and park-based physical activity.

Method

The ENJOY MAP for HEALTH was a quasi-experiment study design that involved the installation of specialised Seniors Exercise Park equipment as part of park refurbishment, supported by promotion and community capacity building activities in six municipalities in Victoria, Australia. Direct observations of park users took place prior to park upgrades, one-month post upgrade and 12-months from baseline. The overall number and characteristics of park visitors, and the type and level of physical activity undertaken, were summarised descriptively. Generalised linear models were used to examine the impact of park refurbishment (equipment installation and site activation) on the total number of older people observed in the park, and their engagement in physical activity, accounting for site and seasonal effects.

Results

Overall number of visits increased following park upgrades, with the largest number of visitors observed one-month post upgrade (n = 12,501). The proportion of older people observed at the parks remained relatively low prior to and one-month post upgrade compared to other age groups. However, after adjusting for site and seasonal effects, the number of older people observed in the parks increased significantly post upgrade and site activation compared to prior to the refurbishment (incidence rate ratios (IRR) 3.55; 95% CI 2.68, 4.70). The number of older people observed to be exercising at the Seniors Exercise Park also increased by 100% at 12-months post-installation relative to one-month post upgrade (IRR 2.00; 95% CI 1.26, 3.17).

Conclusion

Installation of the Seniors Exercise Parks and the supportive programs and activities following six park upgrades resulted in an increase in older people’s park visitation and engagement in physical activity. Community engagement and training of volunteers with the support of local governments are likely to contribute to the increased park usage by older people.

Trial registration

This trial was registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12621000965808. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380745&isReview=true.
Factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia
Authors: Elfaki Noor S. , Abdelgyoum Hafeia A. , Elhelali Ala
Published: June 2024

Background

Health-seeking behavior (HSB) involves any action or inaction taken by individuals who perceive themselves to have a health problem or illness aimed at finding appropriate medical treatments. Studies suggest a positive relationship between the availability and quality of health services and their utilization. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia, to improve healthcare access and health outcomes.

Method

A cross-sectional study was conducted targeting Sudanese residents of the Kingdom of Saudi Arabia (KSA). Participants were recruited using convenient sampling. A self-administered questionnaire was distributed electronically. A total of 494 participants were recruited for the study.

Results

This study showed that the majority of the participants (66.6%) visited a primary healthcare center when faced with a medical problem. However, the prevalence of self-medication in the past three months was 45.7%. Significant factors influencing health-seeking behavior included age (OR [95% CI]: 1.032 [1.000-1.066]) and lack of health insurance (OR = 1.01, 95% CI [1.00-1.02], p = 0.019).

Conclusions

This study emphasizes the importance of understanding healthcare-seeking behavior among immigrant groups, particularly Sudanese immigrants in Saudi Arabia. It highlights the significance of insurance as a determinant of healthcare-seeking behavior and calls for reforming current policies to reduce disparities in accessing healthcare services.
A qualitative exploration of experts’ views about multi-dimensional aspects of hookah smoking control in Iran
Authors: Dadipoor Sara , Alavi Azin , Eshaghi Sani Kakhaki Hadi , Shahabi Nahid , Kader Zainab
Published: June 2024

Background

The related literature has primarily addressed cigarette smoking control. It seems that researchers have failed to explore the determinants of hookah smoking (HS) control. In an attempt to fill this gap, the present study explores experts’ views about aspects of HS control in Bandar Abbas, a city in the south of Iran.

Methods

The present qualitative study, conducted in 2022 and 2023, used a content analysis. To this aim, 30 experts in tobacco prevention and control were invited to participate in the research. Twenty seven accepted the invitation. In-depth, semi-structured, and face-to-face interviews were held with the experts. A purposive sampling was used and the data collection continued until data saturation. The interviews lasted between 18 and 65 min. MAXQDA 10.0 was used for data management and analysis.

Results

The expert interviewees had a mean age of 44.77 ± 6.57 years and a mean work experience of 18.6 ± 6.8 years. A total number of six main categories were extracted from the data, including usin influential figures to control HS, controlling HS by alternative activities, changing beliefs and attitudes toward HS, taking administrative and regulatory measures, and facilitating HS cessation.

Conclusion

This qualitative study explored the multifaceted ways people adopt to quit HS. Using influential figures to control hookah smoking, promoting alternative activities as a means of control, changing beliefs and attitudes, enforcing administrative regulations, and facilitating quit attempts all play an important role in tackling the prevalence of hookah smoking. These findings emphasize the importance of a comprehensive and multifaceted approach to integrate various interventions to effectively address hookah smoking behavior.
The transition of eldercare responsibility and traditional filial piety concepts and its urban-rural differences in China: an age-period-cohort analysis from 2006 to 2017
Authors: Liu Xiangxiang , Yu Hong-jie , Zhang Min-zhe , Yang Hong-guang , Chen Rui , Zhao Litao , He Qi-qiang
Published: June 2024

Background

With rapid urbanization, massive migration, and non-family–based eldercare involvement, Chinese concepts of eldercare responsibility and filial piety are shifting. We performed age-period-cohort (APC) analyses to assess the transition of old-age pension coverage, eldercare responsibility, and filial piety concepts and its urban-rural differences among Chinese adults using data from the China General Social Survey (2006–2017).

Methods

Old-age pension coverage (yes/no) and primary eldercare responsibility (government/offspring/self/sharing) were investigated in 2010, 2012, 2013, 2015, and 2017. Filial piety was evaluated using customized questionnaires in 2006 and 2017. The APC effects were estimated using mixed effects and generalized additive models.

Results

Among 66,182 eligible participants (mean age: 48.8 years, females: 51.7%) in the six waves, APC analyses indicated that old-age pension coverage increased with aging and over time. Across cohort groups, it grew as the cohort was younger in urban residents but decreased in rural residents. The concept of offspring-based (> 50%) and government/self/offspring-shared eldercare (> 30%) predominated. APC analyses revealed that the offspring-based concept declined with aging (OR = 0.81, 95% CI: 0.79–0.84), whereas the government-based (OR = 1.37, 95% CI: 1.33–1.41) and self-based (OR = 1.55, 95% CI: 1.47–1.63) concepts increased with aging. People born around the 1940s have a comparatively higher possibility to perceive that the primary eldercare responsibility should be undertaken by the government and elder parents. In contrast, people born in the younger cohort were more likely to perceive that adult children are responsible for their parents’ primary eldercare. Filial piety score slightly increased with aging (β = 0.18, SD: 0.05) but decreased as the birth cohort was younger. In addition, rural participants were more likely to perceive offspring-based eldercare and maintain filial piety, and the related urban-rural difference was intensified by aging.

Conclusions

The traditional concept that eldercare solely relies on offspring has changed to relying on multiple entities, including the government and self-reliance. Diluted filial piety in people born in the young cohort requires reinforcement. Moreover, future healthy aging policies need to focus more on urban-rural disparities to promote equity in social well-being.
Association of demographics, lumbar active range of motion and disability in chronic low back: a baseline data analysis of a randomized controlled trial from Pakistan
Authors: Baig Aftab Ahmed Mirza , Ansari Basit , Ahmed Syed Imran , Ishaque Farhan , Farooqui Waqas Ahmed
Published: June 2024

Background

The disability and significant economic costs accredited to Low back pain (LBP) are likely to rise which is an essential problem in low and middle-income countries like Pakistan. The associated factors of LBP are age, sex, and race including physical activity, high spinal load, lifting, bending, and twisting occupations. The literature highlighted there is substantial differences in associated factors of LBP within available studies in developing countries. The objective is to investigate the association of demographic factors and lumbar range of motion with disability in patients with chronic low back.

Methods

A baseline data analysis was performed as an analytical cross-sectional study among 150 patients with chronic low back in a randomized controlled trial with a duration from March 2020 and January 2021. After recording demographics, Modified-Modified Schober’s test was used to measure lumbar flexion and extension and Oswestry disability index for disability. After the descriptive analysis the continuous variables, age and pain were analyzed with Spearman’s correlation. Variables that were significant in bivariate analysis were then fitted in a multivariable linear regression. The Kruskal–Wallis test was used to analyze variations of disability in gender, marital status, work status, education level, and duration of pain. The p-value of 0.05 was significant.

Results

The results showed a significant correlation between age and pain in sitting (rh=-0.189, p = 0.021 and rh = 0.788, p < 0.001) with the disability but no significant effects of age and pain in sitting (B=-0.124, p = 0.212 and B = 1.128, p = 0.082) on disability were found. The decrease in lumbar flexion and extension was found to increase disability (B=-6.018 and − 4.032 respectively with p < 0.001). Female gender (x2(1) = 15.477, p = < 0.001) and unmarried marital status (x2(1) = 4.539, p = 0.033) had more disability than male gender and married marital status, respectively. There was a significance between groups of the duration of pain regarding disability (x2 (2) = 70.905, p < 0.001). Age, education level, and work status showed no significance (p > 0.05).

Conclusions

The female gender and unmarried marital status are associated with functional disability. Decreased lumbar range of motion accompanies more disability, while age, education level, and work status do not effect on disability.
Correlation between the incidence of inguinal hernia and risk factors after radical prostatic cancer surgery: a case control study
Authors: Xiang An-Ping , Shen Yue-Fan , Shen Xu-Feng , Shao Si-Hai
Published: June 2024

Objective

The incidence of recurrent hernia after radical resection of prostate cancer is high, so this article discusses the incidence and risk factors of inguinal hernia after radical resection of prostate cancer.

Methods

This case control study was conducted in The First People’s Hospital of Huzhou clinical data of 251 cases underwent radical resection of prostate cancer in this hospital from March 2019 to May 2021 were retrospectively analyzed. According to the occurrence of inguinal hernia, the subjects were divided into study group and control group, and the clinical data of each group were statistically analyzed, Multivariate Logistic analysis was performed to find independent influencing factors for predicting the occurrence of inguinal hernia. The Kaplan-Meier survival curve was drawn according to the occurrence and time of inguinal hernia.

Results

The overall incidence of inguinal hernia after prostate cancer surgery was 14.7% (37/251), and the mean time was 8.58 ± 4.12 months. The average time of inguinal hernia in patients who received lymph node dissection was 7.61 ± 4.05 (month), and that in patients who did not receive lymph node dissection was 9.16 ± 4.15 (month), and there was no significant difference between them (P > 0.05). There were no statistically significant differences in the incidence of inguinal hernia with age, BMI, hypertension, diabetes, PSA, previous abdominal operations and operative approach (P > 0.05), but there were statistically significant differences with surgical method and pelvic lymph node dissection (P < 0.05). The incidence of pelvic lymph node dissection in the inguinal hernia group was 24.3% (14/57), which was significantly higher than that in the control group 11.8% (23/194). Logistic regression analysis showed that pelvic lymph node dissection was a risk factor for inguinal hernia after prostate cancer surgery (OR = 0.413, 95%Cl: 0.196–0.869, P = 0.02). Kaplan-Meier survival curve showed that the rate of inguinal hernia in the group receiving pelvic lymph node dissection was significantly higher than that in the control group (P < 0.05).

Conclusion

Pelvic lymph node dissection is a risk factor for inguinal hernia after radical resection of prostate cancer.
Oral management for a patient with trismus accompanied by Isaacs’ syndrome: a case report
Authors: Tani Asuka , Mizutani Shinsuke , Watanabe Mitsuru , Irie Takashi , Masaki Katsuhisa , Isobe Noriko , Kashiwazaki Haruhiko
Published: June 2024

Background

Isaacs’ syndrome, also known as neuromyotonia or peripheral nerve hyperexcitability, is a rare disorder that affects the peripheral nervous system. Clinical findings include cramps, fasciculations, and myokymia; however, there are few reports of dental treatment for trismus.

Case presentation

A patient with trismus due to Isaacs’ syndrome experienced swelling and pain in the gingiva surrounding his right lower first molar. He was diagnosed with chronic apical periodontitis by a dentist near his home. However, the patient was informed that dental treatment and medication could not be administered because of the presence of Isaacs’ syndrome, and he visited the Geriatric Dentistry and Perioperative Oral Care Center at Kyushu University Hospital 2 weeks later. The patient’s painless mouth-opening distance (between incisors) was 20 mm at that time, and medication, including amoxicillin capsules and acetaminophen, was administered because the dental extraction forceps or endodontic instruments were difficult to insert into the oral cavity for treatment. Two months after his initial visit, the patient visited us complaining of pain in the same area. However, he had recently undergone plasmapheresis treatment in neurology to alleviate limited mouth opening and systemic myalgia, resulting in a pain-free mouth-opening distance of approximately 35 mm. During this temporary period in which he had no restriction in mouth opening, we performed tooth extraction and bridge restoration on the mandibular right first molar and created an oral appliance for sleep bruxism.

Conclusions

Plasmapheresis therapy transiently reduced trismus, rendering dental interventions feasible, albeit temporarily. This case report underscores the importance of close collaboration between neurologists and dentists who encounter similar cases while furnishing valuable insights to inform dental treatment planning.
A proof of principle investigation of a novel enzyme formulation on dental calculus deposition: a 4-week randomized human clinical trial
Authors: Milleman Kimberly R. , Deener Greg , Milleman Jeffery L. , Mish Barbara , Schuller Reinhard , Mynarcik Dennis
Published: June 2024

Background

The dissolution of dental calculus, safely and at home, is among the more challenging issues facing the over-the-counter healthcare industry. Pontis Biologics, Inc. has developed novel model of calculus development and structure and has formulated a dentifrice (Tartarase™) using digestive enzymes as active ingredients that is shown to dissolve dental calculus in this Proof of Principle clinical trial.

Methods

This investigation was designed to evaluate the safety and efficacy of a novel enzyme formulation to remove existing calculus deposits in 4 weeks, measured using the Volpe-Manhold Index (V-MI) on lingual surfaces of 6 lower anterior teeth. The test formulation was compared to Crest Cavity Protection, as a control dentifrice. A total of 40 randomized test subjects began the study with 20 assigned to the control dentifrice and 20 assigned to the Tartarase groups (ten each, one brushing with Tartarase twice daily and one brushed with Tartarase and wore a dental tray filled with Tartarase for 30 min then brushed again with Tartarase, once daily).

Results

The Crest group experienced a 12% increase in calculus, in contrast to the results of both Tartarase groups that experienced a 40% reduction in calculus in 4 weeks of unsupervised at home use of the Tartarase toothpaste formulation.

Conclusions

This proof of principle study demonstrates that a dentifrice, formulated along the lines of the Tartarase material, is capable of combating calculus accumulation using the same oral hygiene habits that are common worldwide.

Trial registration

This trial was registered retrospectively at clinicaltrials.gov and has the Unique Identification Number: NCT06139835, 14/11/2023.
Prevalence of intimate partner violence among Indian women and their determinants: a cross-sectional study from national family health survey – 5
Authors: Manna Sayantani , Singh Damini , Barik Manish , Rehman Tanveer , Ghosal Shishirendu , Kanungo Srikanta , Pati Sanghamitra
Published: June 2024

Introduction

Intimate partner violence (IPV) can be described as a violation of human rights that results from gender inequality. It has arisen as a contemporary issue in societies from both developing and industrialized countries and an impediment to long-term development. This study evaluates the prevalence of IPV and its variants among the empowerment status of women and identify the associated sociodemographic parameters, linked to IPV.

Methods

This study is based on data from the National Family Health Survey (NFHS) of India, 2019-21 a nationwide survey that provides scientific data on health and family welfare. Prevalence of IPV were estimated among variouss social and demographic strata. Pearson chi-square test was used to estimate the strength of association between each possible covariate and IPV. Significantly associated covariates (from univariate logistic regression) were further analyzed through separate bivariate logistic models for each of the components of IPV, viz-a-viz sexual, emotional, physical and severe violence of the partners.

Results

The prevalence of IPV among empowered women was found to be 26.21%. Among those who had experienced IPV, two-thirds (60%) were faced the physical violence. When compared to highly empowered women, less empowered women were 74% more likely to face emotional abuse. Alcohol consumption by a partner was established to be attributing immensely for any kind of violence, including sexual violence [AOR: 3.28 (2.83–3.81)].

Conclusions

Our research found that less empowered women experience all forms of IPV compared to more empowered women. More efforts should to taken by government and other stakeholders to promote women empowerment by improving education, autonomy and decision-making ability.
Toxicity assessment of Cucurbita pepo cv Dayangua and its effects on gut microbiota in mice
Authors: Zhang Huan , Zhou Yazhou , Pan Zhiyuan , Wang Bikun , Yang Lei , Zhang Nan , Chen Baiyi , Wang Xiaona , Jian Zhiguang , Wang Likun , Ling Hui , Qin Xiaoming , Zhang Zhelin , Liu Teng , Zheng Aiping , Tan Yafang , Bi Yujing , Yang Ruifu
Published: June 2024

Background

Cucurbita pepo cv Dayangua (CPD) is an edible plant with diverse pharmacological properties. The current research on CPD has primarily focused on initial investigations of its chemical composition and pharmacological effects, and no comprehensive toxicity assessment has been conducted to date.

Methods

In the present study, the toxicity of CPD was evaluated through both acute and sub-chronic oral toxicity tests in mice. 16S rDNA sequencing was used to analyze the composition of the gut microbiota of mice at different time points to observe the effect of CPD on these microbial communities.

Results

In the acute toxicity test, CPD exhibited low toxicity, with a median lethal dose (LD50) > 2000 mg/kg. The sub-chronic toxicity test indicated that CPD administration at doses of 200, 400, and 600 mg/kg did not cause mortality or significant organ damage in mice. Furthermore, analysis of the gut microbiota after gavage administration of CPD at 400 and 600 mg/kg revealed an improved abundance of some beneficial gut bacteria.

Conclusions

In summary, no acute or sub-chronic toxic effects were observed in mice following the oral administration of CPD. CPD did not affect the structure and diversity of the gut microbiota and may contribute to an increase in the number of beneficial gut bacteria.
Public perceptions of artificial intelligence in healthcare: ethical concerns and opportunities for patient-centered care
Authors: Witkowski Kaila , Okhai Ratna , Neely Stephen R.
Published: June 2024

Background

In an effort to improve the quality of medical care, the philosophy of patient-centered care has become integrated into almost every aspect of the medical community. Despite its widespread acceptance, among patients and practitioners, there are concerns that rapid advancements in artificial intelligence may threaten elements of patient-centered care, such as personal relationships with care providers and patient-driven choices. This study explores the extent to which patients are confident in and comfortable with the use of these technologies when it comes to their own individual care and identifies areas that may align with or threaten elements of patient-centered care.

Methods

An exploratory, mixed-method approach was used to analyze survey data from 600 US-based adults in the State of Florida. The survey was administered through a leading market research provider (August 10–21, 2023), and responses were collected to be representative of the state’s population based on age, gender, race/ethnicity, and political affiliation.

Results

Respondents were more comfortable with the use of AI in health-related tasks that were not associated with doctor-patient relationships, such as scheduling patient appointments or follow-ups (84.2%). Fear of losing the ‘human touch’ associated with doctors was a common theme within qualitative coding, suggesting a potential conflict between the implementation of AI and patient-centered care. In addition, decision self-efficacy was associated with higher levels of comfort with AI, but there were also concerns about losing decision-making control, workforce changes, and cost concerns. A small majority of participants mentioned that AI could be useful for doctors and lead to more equitable care but only when used within limits.

Conclusion

The application of AI in medical care is rapidly advancing, but oversight, regulation, and guidance addressing critical aspects of patient-centered care are lacking. While there is no evidence that AI will undermine patient-physician relationships at this time, there is concern on the part of patients regarding the application of AI within medical care and specifically as it relates to their interaction with physicians. Medical guidance on incorporating AI while adhering to the principles of patient-centered care is needed to clarify how AI will augment medical care.
Divergent strains of EHV-1 in Swedish outbreaks during 2012 to 2021
Authors: Öhrmalm Johan , Cholleti Harindranath , Theelke Anna-Karin , Berg Mikael , Gröndahl Gittan
Published: June 2024

Equid alphaherpesvirus 1 (EHV-1) is a ubiquitous and significant viral pathogen in horses worldwide, causing a range of conditions, including fever, respiratory disease, abortion in pregnant mares and the severe neurological disease called equine herpes myeloencephalopathy (EHM). Despite that EHV-1 is a notifiable animal disease in Sweden, there is limited knowledge about the circulating strains. This study aimed to analyze the genetic diversity of EHV-1 strains in equine samples from different Swedish outbreaks by partial genome sequencing. Genotyping based on three selected open reading frames ORF11, ORF30, and ORF34 in the viral genome was conducted for 55 outbreaks of EHV-1 spanning from the years 2012 to 2021. The analysis revealed 14 different genovariants, with one prominent genovariant identified in 49% of the outbreaks. Additionally, the study identified seven mutations not previously described. Three new mutations were demonstrated in ORF11, all synonymous, and four new mutations in ORF34, two synonymous, and two non-synonymous. Notably, different EHV-1 genovariants were found in five out of six studied EHM outbreaks, but clonal spreading was shown within the outbreaks. Moreover, the study demonstrated that healthy (recovered) horses that returned from an EHM outbreak at an international meeting in Valencia, Spain (2021), were positive for the virus clone responsible for the severe disease outbreak despite several weeks of quarantine. These findings shed light on the genetic diversity and transmission dynamics of the virus and significantly contribute to better understanding of the epidemiology of EHV-1 in Sweden and globally.
Right-sided ureteral hemangiosarcoma in a paraplegic dog
Authors: Maia Suellen Rodrigues , Manochio Mayara , Soares Lara Vilela , Andrade Yury Carantino Costa , Alvarenga Alef Winter Oliveira , Crivellenti Leandro Zuccolotto
Published: June 2024

Background

This study aims to describe a rare case of primary ureteral hemangiosarcoma, in which surgical intervention preserved the kidney and ureter after tumor removal.

Case presentation

A 13-year-old, neutered male dog, weighing 14 kg, mixed-breed, presented with apathy, anorexia, acute-onset vomiting, and abdominal discomfort during the physical examination. Ultrasonography and pyelography revealed a right-sided dilation of the renal pelvis and ureter due to complete obstruction in the middle third of the ureter. A mass obstructing the lumen of the right ureter was completely resected, and ureteral suturing was performed, preserving the integrity of the involved structures. Histopathology confirmed primary ureteral hemangiosarcoma. Due to the local and non-invasive nature of the mass, chemotherapy was not initiated. The patient’s survival was approximately two years, and normal renal function was preserved throughout this period.

Conclusions

Considering this type of tumor in the differential diagnosis of upper urinary tract obstructive disorders. Furthermore, the preservation of the ureter and kidney is a suitable therapeutic option after surgical resection of non-invasive tumors.