bluuebunny/crossref_metadata_2025 huggingface dataset:
An Investigation of Factors Influencing Attitudes Towards Online and Offline Games with the Moderator Effects of Gender in Iran
Authors: Monfared Davoud , Joorabchi Toktam Namayandeh
Published: March 2024

Due to the escalating popularity of video games, the industry’s annual income rose to $197 billion in 2022. To promote video games, it is imperative to possess adequate insights into the attitudes and emotions of adolescent gamers. This study aims to investigate the factors influencing video game engagement in Iran by utilising quantitative data obtained from 205 students participating in video gaming activities in Mashhad. The results proved that playing online and offline games at home, hand in hand with the participants’ interest in play, has a positive impact on the gamers’ attitudes towards playing games. Moreover, no relationship was found between prior game experience, playing games (team/individual—online/offline) patterns and attitudes towards playing games.
MicroRNA-190b Targets RFWD3 in Estrogen Receptor–Positive Breast Cancer
Authors: Frick Elisabet Alexandra , Kristjansdottir Karen , Ragnarsdottir Snaedís , Vilhjalmsson Arnar Ingi , Bustos Maria Rose , Vidarsdottir Linda , Gudjonsson Thorkell , Sigurdsson Stefan
Published: March 2024

Background:

In the year 2020, breast cancer was the most common form of cancer worldwide. Roughly 70% of breast cancers are estrogen receptor–positive (ER+). MicroRNA-190b (miR-190b) has previously been reported to be upregulated in ER+ breast cancers. Previously, we have demonstrated that miR-190b is hypomethylated in ER+ breast cancers, potentially leading to its upregulation.

Objectives:

To further study the role of miR-190b in ER+ breast cancer and to identify its clinically relevant targets in breast cancer.

Design:

Patient cohort and cell line–based RNA-sequencing analysis.

Methods:

The Cancer Genome Atlas was used to obtain gene expression data and clinical information on patients with breast cancer. To identify messenger RNA (mRNA) targets for miR-190b, the ER+ breast cancer cell line T-47D was used to immunoprecipitate biotin-labeled miR-190b followed by RNA sequencing. Western blot was used to confirm miR-190b target. Patient survival based on miR-190b and selected target was studied using the Cancer Genome Atlas.

Results:

In this study, we confirm that miR-190b is overexpressed in breast cancer via differential expression analysis and show that high expression of miR-190b results in more favorable outcomes in Luminal A patients, hazard ratio (HR) = 0.29, 95% confidence interval [CI] = 0.12-0.71, P = .0063. MicroRNA-190b target analysis identified RING finger and WD repeat domain 3 (RFWD3) as one of miR-190b regulatory targets in ER+ breast cancer. Survival analysis of RFWD3 showed that elevated levels result in poorer overall survival in patients with Luminal A breast cancer (HR = 2.22, 95% CI = 1.33-3.71, P = .002). Gene ontology analysis of our sequencing results indicates that miR-190b may have a role in breast cancer development and/or tumorigenesis and that it may be a suitable tool in characterization between the ER+ subtypes, Luminal A, and Luminal B.

Conclusions:

We show that miR-190b targets RFWD3 in ER+ breast cancers leading to lower RFWD3 protein expression. Low levels of RFWD3 are associated with better outcomes in patients with Luminal A breast cancer but not in patients with Luminal B breast cancer. These findings provide novel insights into miR-190b role in breast cancer and that its clinical relevance is subtype specific.
Caregiver-centred empowerment for families raising autistic children: A qualitative case study from Argentina
Authors: Szlamka Zsófia , Sebastián Cukier , Hanlon Charlotte , Hoekstra Rosa A
Published: March 2024

Autistic children and their caregivers in Argentina often lack access to information, resources and evidence-based interventions. Caregiver empowerment may help support families to uphold their child’s rights and access suitable education and support. This study aimed to examine the perceptions on empowerment of caregivers of autistic children in Argentina. This was a phenomenological, qualitative study. We conducted 32 semi-structured individual interviews remotely. Participants included caregivers, health service providers, non-governmental organisation representatives, special education teachers and policy representatives. Data were analysed thematically. We developed three main themes: Caregiver agency: from intuitive coping strategies to entrepreneurship; ‘I had to cut down on therapy’: Economic instability and inequality affecting service access; and Equipping caregivers to be empowered. Both caregivers and professionals talked about the contribution of socio-economic inequalities to caregivers’ sense of disempowerment. Caregivers identified coping strategies and discussed their experiences with advocacy. They expressed that in-person and online support groups have an empowering effect. Based on participant views, strategies supporting caregiver empowerment may involve: interventions are co-designed by professionals and caregivers; focusing on caregiver mental health; and addressing the profound impact of poverty on the quality of life of families.

Lay abstract

Caregivers of children with developmental disabilities, including autism, often struggle to access services, information and resources in Argentina. Little is known about how caregivers can be empowered to support their children as they wish to in the Argentinian setting. We spoke with 32 people online to understand existing and potential practices of supporting caregivers. The people we spoke with included caregivers, health service providers, non-governmental organisations’ representatives providing services or technical support, special education teachers and policy representatives. Participants said that poverty, and inequalities in accessing support, impact how caregivers can support their children. They mentioned examples that help caregivers feel empowered, such as peer support groups and caregiver training. Many caregivers spoke about how they became advocates for their children and how they developed initiatives such as advocacy campaigns and well-being support groups. Caregivers in Argentina may be empowered in various ways, and the following strategies can improve empowerment: strengthening collaboration between professionals and caregivers; focusing on caregiver mental health; and addressing the profound impact of poverty on the quality of life of families.
Bright-siding stigma: Older adults’ experiences at a higher weight in Atlantic Canada
Authors: Bombak Andrea E , Chinho Norma , Thomson Lisa , Burk Courtney , Akhter Sumaiya , O’Keefe Kathleen , Turner Lee
Published: March 2024

The lived experiences of higher-weight people vary; homogenous samples may fail to capture this diversity. This study develops an in-depth understanding of the lived experiences of higher-weight (Body Mass Index ⩾ 30) older adults (⩾60 years of age) in a Canadian Atlantic province. Participants ( n = 11) were interviewed face-to-face using a semi-structured interview guide twice at 2-to-3-month intervals regarding their perceived treatment in social and health situations; how positive and negative healthcare experiences affected their health, lifestyles and healthcare seeking-behaviour; and recommendations in terms of patient experiences, access and inclusion. Participants infrequently reported negative experiences; however, participants’ experiences were informed by uptake of moralistic, neoliberal discourses. Thematic content analysis identified two major themes: active citizenship (participants demonstrated internalisation of the imperative for weight loss, healthy lifestyles and active ageing) and bright-siding (participants expressed that a positive attitude could prevent/help cope with stigma). Results suggest that individualistic, rather than collective, political solutions to health and stigma have been taken up by higher-weight older adults in a Canadian Atlantic province, which may hinder attempts at structural reforms addressing stigma.
Experimental and numerical study of the three-dimensional temperature field in the arch ribs of the reinforced concrete ribbed arch bridge during construction
Authors: Tian Zhongchu , Zhang Zujun , Wu Zhengqian , Peng Wenping , Xu Binlin
Published: March 2024

The unique structural design of an arch ring featuring varying inclination angles for individual segments causes variations in the longitudinal distribution of the temperature field d along the arch axis. This study aims to enhance the understanding of temperature fields in reinforced concrete (RC) arch bridges with diverse arch ring structural configurations during their construction phases. A comprehensive investigation into the three-dimensional distribution pattern of solar-induced temperature fields within arch ribs during the construction of RC ribbed arch bridges was conducted. A field test specifically measuring the temperature distribution across arch rib cross-sections was conducted on-site, involving an RC arch bridge constructed using the cable-stayed cantilever cast in situ method. Analyzing the monitored on-site temperature data revealed the distribution characteristics of temperature fields at the arch foot cross-section under solar radiation. By comparing these findings with international standards, a vertical temperature gradient fitting model for arch rib cross-sections under solar radiation was formulated. Drawing upon meteorological records and solar radiation principles, an adaptive numerical simulation finite element model was developed to depict the temperature field within an arch rib section. This model was rigorously verified. Subsequently, a comprehensive analysis of the three-dimensional temperature field of the arch rib under solar radiation was performed. Additionally, a three-dimensional temperature gradient fitting model was proposed, accounting for the longitudinal inclination of the bridge.
Institutional entrepreneurship and digital transformation: The role of outsider CEOs
Authors: Firk Sebastian , Hennig Jan C , Meier Julian , Wolff Michael
Published: March 2024

The widespread diffusion of digital technologies forces incumbent firms to drive their digital transformation. Digital transformation not only involves a change in strategy but also requires new institutional logics for firms helping to operate in digital business environments. Firms increasingly hire outsider CEOs to cope with this development, but the necessary institutional change questions whether outsider CEOs can indeed realize digital transformation. We draw on the institutional entrepreneurship perspective to make sense of the role of outsider CEOs in digital transformation. We theorize that digital transformation awareness stemming from prior experience with digital transformation enables outsider CEOs to act as institutional entrepreneurs and realize digital transformation. We further argue that outsider CEOs with digital transformation awareness particularly benefit firms facing abrupt rather than accumulative digital transformations. To test our hypotheses, we introduce a novel, machine-learning-based digital transformation measure. Panel data regressions provide support for our predictions. Our findings contribute to a more nuanced understanding of the role of outsider CEOs as change agents.
Comparison of long-term outcomes of endoscopic ultrasound-guided hepaticogastrostomy and choledochoduodenostomy for distal malignant biliary obstruction: a multicenter retrospective study
Authors: Oh Dongwook , Han Sung Yong , Lee Sang Hyub , Kim Seong-Hun , Paik Woo Hyun , Chon Hyung-Ku , Song Tae Jun , Park Se Woo , Cho Jae Hee
Published: March 2024

Background:

Endoscopic ultrasound-guided biliary drainage (EUS-BD), classified as choledochoduodenostomy (CDS) and hepaticogastrostomy (HGS), is a feasible and effective alternative for distal malignant biliary obstruction (MBO) in failed endoscopic retrograde cholangiopancreatography. However, the preferred technique for better outcomes has not yet been evaluated.

Objectives:

We compared the long-term outcomes between the techniques.

Design:

Retrospective comparative study.

Methods:

We reviewed consecutive patients who underwent EUS-CDS or EUS-HGS with transmural stent placement for distal MBO between 2009 and 2022. The primary outcome was the stent patency. The secondary outcomes were technical and clinical success, adverse events (AEs) of each technique, and independent risk factors for stent dysfunction.

Results:

In all, 115 patients were divided into EUS-CDS ( n = 56) and EUS-HGS ( n = 59) groups. Among them, technical success was achieved in 98.2% of EUS-CDS and 96.6% of EUS-HGS groups. Furthermore, clinical success was 96.4% in EUS-CDS and 88.1% in EUS-HGS groups, without significant difference ( p = 0.200). The mean duration of stent patency for EUS-CDS was 770.3 days while that for EUS-HGS was 164.9 days ( p = 0.010). In addition, the only independent risk factor for stent dysfunction was systematic treatment after EUS-BD [hazard ratio and 95% confidence interval 0.238 (0.066–0.863), p = 0.029]. The incidence of stent dysfunction of EUS-HGS was higher than EUS-CDS (35.1% versus 18.2%, 0.071), despite no significant differences even in late AEs.

Conclusion:

In distal MBO, EUS-CDS may be better than EUS-HGS with longer stent patency and fewer AEs. Furthermore, systematic treatment after EUS-BD is recommended for the improvement of stent patency.
Preliminary Experience With Commercially Available Trabecular Metal Tibial Cones Combined With a Retrograde Locked Intramedullary Nail for Bony Defects in Tibiotalocalcaneal Arthrodesis
Authors: Pinzur Michael S. , Schiff Adam P. , Hamid Kamran , LeDuc Ryan
Published: March 2024

Critical sized bone defects in the ankle are becoming increasingly more common in patients undergoing limb reconstruction with tibiotalocalcaneal arthrodesis. Bulk allografts have not fared well over time. There have been scattered preliminary reports using custom spinal cages or 3D-printed Titanium Implants to address the critical bony defect; however, the cost of these devices is prohibitive in many clinical practice settings. The purpose of this investigation is to report the preliminary experience using a commercially available Trabecular Metal (Zimmer-Biomet) tibial metaphyseal cone combined with a retrograde locked intramedullary nail to address this challenging problem. Eight consecutive patients underwent tibiotalocalcaneal arthrodesis using a commercially available Trabecular Metal tibial metaphyseal cone combined with a retrograde locked intramedullary nail. Five developed bone loss secondary to neuropathic (Charcot) bony resorption and 3 underwent surgery for failed total ankle arthroplasty. All 8 patients eventually achieved clinical and radiographic healing and were able to ambulate with standard footwear. One patient developed a postoperative wound infection at the site of calcaneal locking screws, which resolved with debridement and parenteral antibiotic therapy. Critical bone defects about the ankle have successfully addressed with custom 3D titanium implants. This small series suggests that similar clinical outcomes can be achieved with the use of a commercially available porous tantalum metaphyseal spacer borrowed from our arthroplasty colleagues, combined with the use of a retrograde locked intramedullary nail.

Levels of Evidence: Level 4: Retrospective case series
Utilizing the Pronated Forearm Technique for Measuring Glenohumeral External Rotation in Baseball Players
Authors: Sciascia Aaron , Smith Michael , Holstedt Joseph , Mattingly Logan , Kibler W. Ben
Published: March 2024

Background:

Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and total range of motion (TROM) have been linked with increased injury risk. GER capacity has been measured routinely with the forearm in neutral rotation (GERN), but a recent study reported GERN was greater than GER with the forearm in pronation (GERP) in Minor League pitchers. This work has not yet been replicated or extended to other groups.

Hypothesis:

GERP would be significantly less than GERN in Independent League baseball pitchers, and there would be no difference in GERP or GERN measurements between this new group and the previous group of Minor League pitchers.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

Goniometric measurements were recorded for bilateral GIR, GERN, and GERP, and resulting TROM for 37 Independent League baseball pitchers. These data were compared with the previous study. All motions were compared individually between groups, between throwing and nonthrowing arm, and both within and between techniques (forearm neutral or pronated).

Results:

GERP was significantly less than GERN for both arms within each group tested ( P < 0.01). Independent League pitchers had greater between arm differences for GIR (-16.9° vs -6.9°), GERN (+15.1° vs -0.6°), and GERP (+13.1° vs -5.9°) compared with Minor League pitchers. TROM for the Independent League pitchers was not statistically different for either measurement technique, while TROM for the throwing arm of the Minor League pitchers was statistically reduced with varying effect sizes ( d = 0.35-0.99) compared with the nonthrowing arm ( P < 0.01).

Conclusion:

This study confirmed earlier findings that the pronated forearm resulted in decreased GER capacity, illustrating the adaptive response to throwing and the need to evaluate for this variable.

Clinical Relevance:

GERP should be evaluated in all groups of pitchers, but there may be variations within tested groups.
Explaining Pre-Service Early Childhood Teachers’ Intention of Implementing Museum Visits: An Extension of the Theory of Planned Behavior
Authors: Wu Di
Published: March 2024

Museums are traditionally considered public service settings with educational functions and practical learning resources for students. Early childhood teachers’ intention to implement class visits to museums is still very low. This paper synthesizes the theory of planned behavior model (TPB) and core determinants of the technology acceptance model (TAM) to hypothesize an extended TPB model to explain preschool teachers’ perceptions and intentions to implement museum visits. The results revealed that early childhood teachers’ intention of implementing class visits to museums was significantly influenced by attitude, perceived usefulness, and perceived behavioral control. The implications of this study are provided.
Carbon Footprint of Minor Foot and Ankle Surgery: A Randomized Controlled Trial
Authors: Parker Emily B. , Bluman Eric M. , Chiodo Christopher P. , Martin Elizabeth A. , Smith Jeremy T.
Published: March 2024

Background:

Climate change poses a substantial threat to human health, and operating rooms (ORs) have an outsized environmental impact. The Program for Research in Sustainable Medicine (PRiSM) designed a protocol for minor foot and ankle surgery intended to reduce waste, streamline instrument trays, and minimize laundry. We conducted a randomized controlled trial to compare the carbon footprint of procedures performed using the PRiSM protocol vs a traditional protocol.

Methods:

Forty adult patients undergoing foreign body removal, hammertoe correction, toe amputation, hardware removal, mass excision, or gastrocnemius recession were randomized to the PRiSM or our “Traditional” protocol. The PRiSM protocol used a smaller instrument tray, fewer drapes and towels, and minimal positioning blankets. No changes were made to surgical site preparation or operative techniques. Environmental impact was estimated using the carbon footprint, measured in kilograms of carbon dioxide equivalents (CO2e). Emissions associated with OR waste, instrument processing, and laundry were calculated.

Results:

On average, PRiSM cases had a smaller carbon footprint than Traditional cases (17.3 kg CO2e [SD = 3.2] vs 20.6 kg CO2e [SD = 2.0], P < .001). Waste-associated emissions from PRiSM cases were reduced (16.0 kg CO2e [SD = 2.7] vs 18.4 kg CO2e [SD = 1.8], P = .002), as were modeled instrument processing–related emissions (0.34 vs 0.91 kg CO2e). One superficial surgical site infection occurred in each group.

Conclusion:

We found a small but statistically significant reduction in the environmental impact of minor foot and ankle surgery when using the PRiSM vs Traditional protocol. The environmental impact of these cases was dominated by plastic waste–related emissions. Orthopaedic surgeons should think critically about what components of their surgical setup are truly necessary for patient care, as minor changes in product utilization can have significant impacts on waste and greenhouse gas emissions.

Level of Evidence:

Level I, randomized controlled trial.
Heart Failure in CKD Population
Authors: Madarasu Rajasekara Chakravarthi , Marri Harikrishna Prasad
Published: March 2024

The population with chronic kidney disease (CKD) is unique in the sense that they are more prone to heart failure and ischemic heart disease. This is mainly due to the presence of hypertension, anemia, and associated fluid overload, which is common to them. Managing heart failure in this cohort of patients is challenging as treatment of heart failure leads to worsening of kidney parameters.
Assessment Practices and Beliefs of Secondary Choir Teachers
Authors: Kambs Ben
Published: March 2024

Previous research findings of assessment in choir indicated that teachers favor non-performance criteria such as attendance and attitude over music knowledge and skill. Music education researchers have encouraged teachers to instead use measurable learning goals that inform teaching practices and document student growth. New assessment technologies designed to assist teachers with individual assessment may have affected the assessment practices of secondary choir teachers. The purpose of this study was to describe the current assessment practices and beliefs among secondary choir teachers in Indiana. Respondents ( N = 182) completed an online survey regarding their use of formative and summative assessments in choir. Findings suggest that choir teachers in this study continued to rely upon non-achievement data such as attendance and participation in assessment. Given these findings, I offer implications and suggestions for practicing choral music educators.
The burden of headache disorders in North India: methodology, and validation of a Hindi version of the HARDSHIP questionnaire, for a community-based survey in Delhi and national capital territory region
Authors: Duggal Ashish , Chowdhury Debashish , Krishnan Anand , Amarchand Ritvik , Steiner Timothy J.
Published: March 2024

Background

Knowledge of the prevalence and attributable burden of headache disorders in India is sparse, with only two recent population-based studies from South and East India. These produced conflicting results. A study in North India is needed. We report the methodology of such a study using, and validating, a Hindi translation of the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) questionnaire developed by Lifting The Burden (LTB). Almost half of the Indian population speak Hindi or one of its dialects.

Methods

The study adopted LTB’s standardized protocol for population-based studies in a cross-sectional survey using multistage random sampling conducted in urban Delhi and a surrounding rural area. Trained interviewers visited households unannounced, randomly selected one adult member from each and applied the Hindi version of HARDSHIP in face-to-face interviews. The most bothersome headache reported by participants was classified algorithmically into headache on ≥ 15 days/month (H15 +), migraine (including definite and probable) or tension-type headache (including definite and probable). These diagnoses were mutually exclusive. All participants diagnosed with H15 + and a 10% subsample of all others were additionally assessed by headache specialists and classified as above. We estimated the sensitivity and specificity of HARDSHIP diagnoses by comparison with the specialists’ diagnoses.

Results

From 3,040 eligible households, 2,066 participants were interviewed. The participating proportions were 98.3% in rural areas but 52.9% in urban Delhi. In the validation subsample of 291 participants (149 rural, 142 urban), 61 did not report any headache (seven of those assessed by HARDSHIP, eight by headache specialists and 46 by both) [kappa = 0.83; 95% CI: 0.74-0.91]. In the remaining 230 participants who reported headache in the preceding year, sensitivity, specificity and kappa with (95% CI) were 0.73 (0.65-0.79), 0.80 (0.67-0.90) and 0.43 (0.34-0.58) for migraine; 0.71 (0.56-0.83), 0.80 (0.730.85) and 0.43 (0.37-0.62) for TTH and 0.75 (0.47-0.94), 0.93 (0.89-0.96) and 0.46 (0.34-0.58) for H15 + respectively.

Conclusion

This study validates the Hindi version of HARDSHIP, finding its performance similar to those of other versions. It can be used to conduct population surveys in other Hindi-speaking regions of India.
Effect of transcutaneous electrical acupoint stimulation on the quality of postoperative recovery: a meta-analysis
Authors: Zhang Meng , Zhang Huanhuan , Li Pan , Li Jianli
Published: March 2024

Background

The purpose of the present study was to systematically delve into the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) on the quality of recovery after general anesthesia.

Methods

Randomized controlled trials related to TEAS improving postoperative recovery quality were searched in Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP, Wanfang and Chinese biomedical database from the inception of each database to June 2023. After literature screening and data extraction, Stata15 software was employed for meta-analysis, and the quality of the included literature was evaluated utilizing ROB2.

Results

The study included 10 articles involving 2,383 patients in total. The meta-analysis results unveiled that TEAS could improve 24-hour and 48-hour postoperative QoR-40 scores as well as 24-hour postoperative QoR-40 dimension scores [WMD = 8.52, 95%CI (5.12, 11.91), P < 0.001; WMD = 1.99, 95%CI (0.91, 3.07), P < 0.001], emotional state [WMD = 1.38, 95%CI (0.66, 2.09), P < 0.001], physical comfort [WMD = 2.99, 95%CI (1.59, 4.39), P < 0.001], psychological support [WMD = 0.63, 95%CI (0.36, 0.90), P < 0.001], and physical independence [WMD = 0.76, 95%CI (0.22, 1.30), P = 0.006]; pain [WMD = 1.81, 95%CI (0.87, 2.75), P < 0.001]; decrease 24-hour postoperative VAS pain scores [WMD = -0.84, 95%CI (-1.45, -0.23), P = 0.007] and the incidence of postoperative nausea and vomiting [RR = 0.88, 95%CI (0.81, 0.97), P = 0.006; RR = 0.62, 95%CI (0.52, 0.73), P < 0.001].

Conclusion

TEAS can improve postoperative QoR-40 scores and the quality of recovery, relieve pain, and decrease the incidence of nausea and vomiting after surgery in patients who underwent general anesthesia.

Trial registration

CRD42023433959.
Outcomes post Ozaki procedure among children with aortic valve disease at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania: a retrospective descriptive study
Authors: Kalezi Zawadi Edward , Simbila Alphonce Nsabi , Mongella Stella , Nkya Deogratias , Sharau Godwin , Shonyela Felix , Mlawi Vivienne , Majani Naizihijwa
Published: March 2024

Background

Aortic valve reconstruction using glutaraldehyde-treated autologous pericardium, also called Ozaki procedure, is a surgical procedure for patients with aortic valve disease. Gratifying results have been reported in adult patients, however, limited published data is available in paediatric population. This study looked at clinical characteristics and early outcomes of children who underwent Ozaki procedure at our Institute.

Methods

This was a retrospective descriptive study conducted on children who underwent aortic valve reconstruction at Jakaya Kikwete Cardiac Institute (JKCI) from January 2019 through December 2022. Medical records of these children were reviewed to extract data on demographics, clinical characteristics, redo surgical interventions and survival.

Results

A total of 10 children underwent Ozaki procedure during the study period. Eight children had severe aortic regurgitation while 2 had severe aortic stenosis preoperatively. All children had either none or trivial aortic regurgitation immediately after surgery. None of them had redone operations throughout the follow-up period. There was no in-hospital mortality, however, one child died one-year after surgery. The mean follow-up period was 1.6 years with the longest follow-up time of 4 years.

Conclusion

Ozaki procedure showed encouraging early results among children with aortic valve disease who underwent surgical repair by this technique. Future studies with larger sample sizes and longer follow up periods to evaluate long-term results in this population are recommended.
Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study
Authors: Gu Liyan , Zhang Jingwen , Chen Wenyao , Weng Yanqiu , Chen Lan , Zhang Lingjuan
Published: March 2024

Background

The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs).

Methods

The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT).

Results

The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0–3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP.

Conclusions

This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents.

Trial registration

ChiCTR2000035236 (registration date: 04/08/2020).
Circular RNA hsa_circ_0005519 contributes to acute kidney injury via sponging microRNA-98-5p
Authors: Jiang Linsen , Huang Manxin , Ge Jun , Zhang Xuefeng , Liu Ye , Liu Hang , Liu Xiaoming , Jiang Lili
Published: March 2024

Background

This study intends to explore the role and molecular mechanism of hsa_circ_0005519 in acute kidney injury (AKI).

Methods

We conducted reverse transcription-qPCR for human serum to determine levels of hsa_circ_0005519 in AKI patients and healthy controls. Hsa_circ_0005519 was inhibited for expression in HK-2 cells using specific siRNAs. A number of techniques, MTT and ELISA assays, were used to analyze the potential role of hsa_circ_0005519 in cell viability, oxidative stress, and inflammation of LPS-induced HK-2 cells.

results

The serum of patients with AKI exhibited a significant increase in hsa_circ_0005519 expression, compared with healthy controls. Hsa_circ_0005519 was knockdown by siRNA, and its knockdown led to cell viability increase in LPS-induced HK-2 cells. Inhibition of hsa_circ_0005519 can reverse the TNF-α, IL-6 and IL-1β increase in LPS-induced HK-2 cells. Inhibiting hsa_circ_0005519 led to downregulation of MPO and MDA levels. MiR-98-5p was a downstream miRNA for hsa_circ_0005519. MiR-98-5p can offset the effects of hsa_circ_0005519 on LPS-induced HK-2 cells. IFG1R was a target gene for miR-98-5p.

Conclusions

These findings indicate that the highly expressed hsa_circ_0005519 plays a promoting role in AKI.
Clinicopathological study of ophthalmic cutaneous and mucocutaneous non-langerhans cell histiocytic lesions
Authors: Alkatan Hind Manaa , Fatani Dalal R. , Maktabi Azza M.Y. , Alzahem Tariq A.
Published: March 2024

Background

The “C group” of the histiocytic disorders is characterized by non-Langerhans-cell histiocytic lesions in the skin, mucosal surfaces, or both, out of which Juvenile xanthogranuloma (JXG) is the most common typically affecting the skin. The eye is the most common extra-cutaneous site of JXG., we aim at providing our clinical and histopathological experience with this group of diseases including the adult-onset xanthogranuloma (AXG).

Methods

This is a retrospective cohort study of all patients with the tissue diagnosis of ocular and periocular cutaneous and mucocutaneous non-LCH disorders who presented to us over a period of 25 years (January 1993 to December 2018).

Results

Twenty patients were diagnosed as “Group C” disease with an age range of 2 months-60.9 years. Eleven patients were females (55%) and nine were males (45%). The involvement was mostly unilateral in 80.9%. All cases fell into the xanthogranuloma family with 11 JXG patients, 8 AXG patients of skin and ocular surface, and one patient with solitary reticulohistiocytoma (SRH). The clinical site of involvement in JXG was primarily in the eyelid in 5 patients (45%), ocular surface lesions in 2 (18%), iris in 2 (18%), choroidal and bilateral orbital lesions in 1 patient each (9%). The group of AXG, presented equally with eyelid lesions in 4/8 and ocular surface lesions in 4/8. The non-Langerhans’ histiocytic infiltrate showed supportive immunohistochemical staining properties (reactive to CD68 marker and negative to S-100 and langerin markers).

Conclusion

Among the rare histiocytic disorders, xanthogranulomatosis is the commonest and has wide clinical manifestations. Accurate diagnosis needs to be supported by typical histopathological findings. JXG was the commonest in our study with relatively older mean age at presentation and frequent eyelid rather than iris involvement. AXG is often confused with xanthelasma when involving the eyelids with corneal limbal involvement is relatively frequent.
Diabetes mellitus and associated risk factors among HIV infected patients on HAART
Authors: Kanyara Lucy , Lel Rency , Kageha Sheila , Kinyua Joyceline , Matu Sophie , Ongaya Asiko , Matilu Mary , Mwangi Paul , Okoth Vincent , Mwangi Joseph , Olungae Dama
Published: March 2024

Background

Understanding the impact of disease associations is becoming a priority in Kenya and other countries bearing the load of infectious diseases. With the increased incidences of non-communicable diseases and the endemicity of infectious diseases in Sub-Saharan Africa, their co-existence poses significant challenges to patients, health workers and an overwhelmed health sector. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation. HIV and its treatment have been identified as potential contributors especially to patients with family history of confirmed diabetes cases. Co-infections frequently observed during HIV infection also significantly influence both the epidemiological and pathophysiological of the link between HIV and diabetes. Understanding the correlates of HIV and diabetes is crucial to inform management and prevention strategies of the twin infections. We therefore aimed to determine the prevalence of diabetes mellitus and risk factors in a population of HIV infected patients on HAART. This study determined the association of diabetes/impaired glucose regulation in the context of HIV-1. A cross-sectional study was conducted at a comprehensive care clinic in Nairobi (Kenya). Participants were screened for diabetes and impaired glucose regulation using random blood glucose and glycated haemoglobin (HbA1c) This paper describes the prevalence of diabetes mellitus in Human Immunodeficiency Virus positive individuals and the associated risk factors. We have demonstrated that family history is a risk factor for diabetes. While age and BMI are known risk factors, they were not associated with diabetes in this study.
Association between joint physical activity and healthy dietary patterns and hypertension in US adults: cross-sectional NHANES study
Authors: Zhu Yanzhou , Wang Zhigang
Published: March 2024

Background

Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults.

Methods

We used data collected from the 2007–2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension.

Results

A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65–0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76–1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76–1.06) were not associated with hypertension.

Conclusion

In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.
Human-centered participatory co-design with children and adults for a prototype lifestyle intervention and implementation strategy in a rural middle school
Authors: Watkins Janette M. , Greeven Sarah J. , Heeter Kathleen N. , Brunnemer Julia E. , Otile Jacob , Solá Paola A. Fernández , Dutta Sandeep , Hobson James M. , Evanovich Justin M. , Coble Cassandra J. , Werner Nicole E. , Martinez Kercher Vanessa M. , Kercher Kyle A.
Published: March 2024

Purpose

The significance of regular physical activity (PA) in reducing cardiovascular disease (CVD) risk is widely acknowledged. However, children in rural areas encounter specific barriers to PA compared to their urban counterparts. This study employs human-centered participatory co-design, involving community stakeholders in developing a multi-level PA intervention named Hoosier Sport. The primary hypothesis is the co-design sessions leading to the development of a testable intervention protocol.

Methods

Two co-design teams, each consisting of six children and six adults, were formed using human-centered participatory co-design facilitated by research faculty and graduate students. The process involved five co-design sessions addressing problem identification, solution generation, solution evaluation, operationalization, and prototype evaluation. Thematic analysis was employed to identify key themes and intervention components.

Results

Child co-designers (n = 6) ranged from 6th to 8th grade, averaging 12.6 years (SD = 1.8), while adult co-designers (n = 6) averaged 43.3 years (SD = 8.08). Thematic analysis revealed children emphasizing autonomy, the freedom to choose physical and non-physical activities, and the importance of building peer relationships during PA. Adult interviews echoed the importance of autonomy and choice in activities, with a focus on relatedness through positive role modeling.

Conclusion

The prototype intervention and implementation strategies developed constitute a testable intervention aligned with Phase 1 of the ORBIT model. This testable prototype lays the groundwork for a collaborative campus-community partnership between the university and the local community, ensuring mutual benefits and sustainable impact.
The common drivers of children and young people’s health and wellbeing across 13 local government areas: a systems view
Authors: O’Halloran Siobhan A. , Hayward Joshua , Valdivia Cabrera Melissa , Felmingham Tiana , Fraser Penny , Needham Cindy , Poorter Jaimie , Creighton Doug , Johnstone Michael , Nichols Melanie , Allender Steven
Published: March 2024

Background

System dynamics approaches, including group model building (GMB) and causal loop diagrams (CLDs), can be used to document complex public health problems from a community perspective. This paper aims to apply Social Network Analysis (SNA) methods to combine multiple CLDs created by local communities into a summary CLD, to identify common drivers of the health and wellbeing of children and young people.

Methods

Thirteen community CLDs regarding children and young people health and wellbeing were merged into one diagram involving three steps: (1) combining variable names; (2) CLD merging, where multiple CLDs were combined into one CLD with a set of unique variables and connections; (3) paring, where the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was used to generate a cut-point to reduce the number of variables and connections and to rank the overall importance of each variable in the merged CLD.

Results

Combining variable names resulted in 290 variables across the 13 CLDS. A total of 1,042 causal links were identified in the merged CLD. The DEMATEL analysis of the merged CLD identified 23 common variables with a net importance between 1.0 and 4.5 R + C values and 57 causal links. The variables with the highest net importance were ‘mental health’ and ‘social connection & support’ classified as high net receivers of influence within the system.

Conclusions

Combining large CLDs into a simple diagram represents a generalisable model of the drivers of complex health problems.
Malnutrition in children under five years in a squatter settlement of Karachi: a case-control study
Authors: Ara Gati , Fawad Bina , Shabbir Shumaila
Published: March 2024

Background

Multidimensional factors such as socioeconomic or environmental factors influence malnutrition. Several studies have strongly linked malnutrition to poverty. Some international studies point to the worse nutritional status of urban slum children than rural children. Limited data is available regarding the nutritional status of slum children in Karachi. This study aimed to determine characteristics of malnourished children in an urban squatter settlement in Karachi, Pakistan.

Methods

A case- control study was carried out at the primary healthcare center of a squatter settlement in Karachi, Pakistan. All children under five years of age visiting the primary healthcare center were recruited consecutively. Cases were defined as children with z scores < -2 SD of WHO reference measurements of WFA, HFA, WFH and OFC. The controls were similar in terms of age group but had z scores between − 2SD and + 2SD. A self- structured risk factor questionnaire that included information about sociodemographic, economic and environmental factors as well as child- related characteristics was researcher administered via face-to-face interviews with the mothers of children. Univariate and multivariate logistic regression analyses were conducted. Crude and adjusted odds ratios were calculated with 95% confidence interval.

Results

A total of 280 participants including 140 cases and 140 controls participated in the study. A larger proportion of the sample originated from individuals with low household income. After adjusting for the confounders, childhood malnutrition was significantly associated with a low education level of father (aOR 4.86, 95% CI 2.23–10.60), a monthly income less than 25,000 PKR (89 USD) per month (aOR 7.13, 95% CI 1.67–30.54), pour pit latrine type of toilet (aOR 4.41, 95% CI 2.67–7.3), less than six months of exclusive breast feeding (aOR 3.578, CI 1.58–8.08), inappropriate weaning age (aOR 3.71, 95% CI 1.53-9).

Conclusion

Malnutrition in children under five years of age in the community is associated with low family income, low paternal education, poor toilet facilities, lack of exclusive breastfeeding and inappropriate weaning age. The implementation of poverty reduction programs, sanitation provision at affordable rates, community-based breast feeding and weaning education intervention are urgently required to efficiently improve children’s nutritional status.
Reliability of muscle stiffness measures in popliteus, medial and lateral gastrocnemius muscles by ultrasound shear wave elastography in participants with knee osteoarthritis accompanied by myofascial trigger points
Authors: Shams Mohsen , Karimi Noureddin , Vahedi Mohsen , Hakim Peyman Kamali , Zeinalkhani Fahimeh , Rahnama Leila
Published: March 2024

Background

The objective of this investigation is to evaluate the consistency of intra-rater and inter-rater assessments utilizing ultrasound elastography to examine the muscle stiffness of the popliteus and gastrocnemius (medial and lateral heads) in patients with knee osteoarthritis accompanied by myofascial trigger points.

Methods

Thirty individuals with knee osteoarthritis accompanied by myofascial trigger points were assessed. Two examiners independently measured the muscle stiffness levels of the popliteus and gastrocnemius (medial and lateral heads) three times using ultrasound elastography in the first session. The second session was conducted one week later.

Results

In the initial test session, the mean shear modulus values for the popliteus and gastrocnemius (medial and lateral heads) muscles were measured as follows for tester 1 (12.75, 13.72, 14.13 kPa) and tester 2 (11.66, 12.81, 13.17 kPa). During the retest session, the previously measured variables by tester 1 and tester 2 yielded the following values: (12.61, 13.43, 14.26 kPa) and (11.62, 12.87, 13.30 kPa) respectively." Good to excellent intra-rater reliability (ICC = 0.912—0.986) and inter-rater reliability (ICC = 0.766—0.956) were reported for the shear moduli of the popliteus, medial and lateral gastrocnemius muscles.

Conclusions

The assessment of muscle stiffness in the popliteus and gastrocnemius (medial and lateral heads) using ultrasound elastography is a reliable method in patients with knee osteoarthritis accompanied by myofascial trigger points.