bluuebunny/crossref_metadata_2025 huggingface dataset:
Pelvic floor dysfunction: prevalence and associated factors
Authors: Peinado-Molina Rocío Adriana , Hernández-Martínez Antonio , Martínez-Vázquez Sergio , Rodríguez-Almagro Julián , Martínez-Galiano Juan Miguel
Published: October 2023

Background

Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions.

Objective

Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women.

Material and methods

This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated.

Results

One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia.

Conclusions

The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.
Effects of rehabilitation therapy based on exercise prescription on motor function and complications after hip fracture surgery in elderly patients
Authors: Che Yan-Jun , Qian Zongna , Chen Qi , Chang Rui , Xie Xiaofeng , Hao Yue Feng
Published: October 2023

Background

Exercise rehabilitation training is an important measure for improving the prognosis of patients with hip fractures. However, the particular program that works effectively and the efficiency of exercise therapy are still controversial.

Objective

To compare the effects of usual postoperative care combined with rehabilitation based on exercise prescription on motor function and complications in elderly patients who underwent surgery for hip fracture.

Methods

This was an observational study. A total of 71 elderly patients with hip fractures who were treated with hip arthroplasty and internal fixation of the proximal femur with an intramedullary nail at Suzhou Municipal Hospital from October 2020 to December 2021 were included; 11 cases were excluded (eight cases were excluded due to loss of follow-up, two due to deaths from other causes, and one due to other reasons). Finally, 60 patients (18 males and 42 females) were included. Patients were randomly assigned to the control (n = 30) and experimental (n = 30) groups using a random number generator. Patients in the control group received usual postoperative care, whereas those in the experimental group received usual postoperative care combined with rehabilitation training based on the principles of exercise prescription. We recorded the motor function (Harris hip score), daily living ability (Barthel Index), and complications at discharge and 1, 3, and 6 months postoperatively for statistical analysis.

Results

The Harris hip score and Barthel Index score were significantly higher at 1, 3, and 6 months postoperatively than at discharge in both groups (p < 0.05). The Harris hip score and Barthel Index score at discharge and 1, 3, and 6 months postoperatively were significantly higher in the experimental group than in the control group (p < 0.05). The incidence of complications at 6 months postoperatively was significantly lower in the experimental group than in the control group (13% vs. 37%).

Conclusions

Rehabilitation therapy based on exercise prescription helps improve hip function and the ability to perform activities of daily living and related postoperative complications after hip fracture surgery in elderly patients. The findings of our study will guide decision-making in clinical practice and improve the clinical management of hip fractures in elderly patients postoperatively.
Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study
Authors: Liu Guanyi , Zhao Jinsong , Yuan Liyong , Shi Fangling , Zhang Liangguang
Published: October 2023

Objective

This study aimed to report our experience with spinal anesthesia (SA) in patients undergoing L5-S1 interlaminar endoscopic lumbar discectomy (IELD) and clarify its advantages and disadvantages.

Methods

One hundred twelve patients who underwent IELD for an L5-S1 disc herniation under SA were retrospectively analyzed. SA with 0.5% ropivacaine was administered using a 27-gauge fine needle. Intraoperatively, the volume and level of SA, surgical time, blood loss, and cardiopulmonary complications were documented. Postoperative data was collected included the number of patients who ambulated on the day of surgery, incidence of complications and were then statistically analyzed.

Results

Analgesia was complete throughout the entire operation in all patients and no other adjuvant intraoperative analgesic drugs were needed. Mean visual analog scale scores for intraoperative and early postoperative (24 h) pain were 0 and 2.43 ± 1.66. SA was administered at the L3-4 interspace in 34 patients (30.4%) and the L2-3 interspace in 78 (69.6%). Administration was successful with the first attempt in all patients. Mean operation time was 70.12 ± 6.52 min. Mean intraoperative blood loss volume was 20.71 ± 5.26 ml. Ninety-eight patients ambulated on the same day as surgery. Mean length of hospital stay was 24.36 ± 3.64 h. Dural injury without damaging the nerve root occurred in one patient. One patient experienced recurrent disc herniation. Intraoperative hypotension and respiratory distress occurred in five (4.5%) and three (2.7%) patients, respectively. Three patients (2.7%) received postoperative analgesia therapy and two (1.8%) experienced nausea. Two patients (1.8%) developed urinary retention. Spinal headache, cauda equina syndrome, and neurotoxicity did not occur.

Conclusion

SA can achieve satisfactory pain control for patients undergoing IELD with a low incidence of adverse events. SA may be a useful alternative to local and general anesthesia for IELD surgery. Future randomized controlled trials are warranted to investigate.
Drug resistance and influencing factors of biofilm bacteria in upper urinary calculi patients with double J stent indwelling
Authors: Chen Qian , Ye JunBing , Li Xiao Bin , Zeng Ke , Zeng Shiping
Published: October 2023

Objective

To analyze the distribution and drug resistance of biofilm bacteria infected with upper urinary calculi patients with double J stent indwelling, and to explore the influencing factors of Biofilm Bacteria Infections.

Methods

A total of 400 patients with upper urinary calculi who adopted double J stent inserting in our hospital from January 2019 to January 2022 were included. Urine and double J stent samples were collected, pathogen cultures were performed, and then drug sensitivity test analysis was carried out for isolates. Univariate and multivariate logistic regression analyzes were used to analyze the influencing factors of patients with double J stent associated biofilm bacteria infections.

Results

A total of 13 strains (3.2%) of biofilm bacteria were detected in urine samples and 168 strains (42%) in double J stent samples (P < 0.05), 95 strains (23.7%) of pathogenic bacteria were separated from urine samples and 117 strains (29.2%) from double J-stent samples (P > 0.05). Escherichia coli were the most common bacteria. There was significantly higher drug resistance observed in biofilm bacteria versus urine-cultured pathogens (P < 0.05). Advanced age, long-term catheterization, inadequate water intake, hypoproteinemia, abnormal renal function, and diabetes mellitus were independent risk factors for biofilm bacteria infection associated with double J stent(P < 0.05).

Conclusion

Among the upper urinary calculi patients with double J stent indwelling, the positive rate and drug resistance of biofilm bacteria obtained from double J stent were significantly higher than that from urine. More attention should be paid to the factors that influence biofilm bacteria infections.
Associations of adverse childhood experiences with caries and toothbrushing in adolescents. The Young-HUNT4 Survey
Authors: Myran Lena , Sen Abhijit , Willumsen Tiril , Havnen Audun , Kvist Therese , Rønneberg Anne , Dahllöf Göran , Høvik Hedda
Published: October 2023

Background

Adverse childhood experiences (ACEs) are associated with poor oral health. Using a life course theoretical framework, this study explored the associations of specific and cumulative ACEs with caries and toothbrushing frequency in a Norwegian adolescent population.

Methods

Participants were adolescents (n = 6351) age 13–17 years from The Young-HUNT4 Survey. Clinical data were retrieved from dental health records. Oral health outcomes were toothbrushing frequency, dentine caries experience (Decayed, Missing, and Filled Teeth – DMFT), and enamel caries. ACE exposure variables were physical abuse, sexual abuse, witness to violence, parental separation/divorce, parental alcohol problems, and bully victimization. Negative binominal regression models (incident rate ratios, IRRs; 95% confidence intervals, CIs) were used to determine the associations of the various ACEs with caries; logistic regression analyses (odds ratios, ORs; 95% CIs) were used to estimate associations with toothbrushing frequency. Potential effect modification by age was assessed using likelihood ratio test.

Results

Adolescents exposed to physical abuse by others, sexual abuse by peers, parental separation/divorce, bullying, or who had witnessed violence, were more likely to report non-daily toothbrushing compared with those with no exposure to the given ACEs. Each cumulative increase in ACE exposure was associated with a 30% higher likelihood of non-daily toothbrushing (OR 1.30, 95% CI 1.19–1.42). Similarly, increasing number of adversities were associated with both higher dentine caries experience (IRR 1.06, 95% CI 1.02–1.09) and higher enamel caries (IRR 1.07, 95% CI 1.03–1.11). This effect was modified by age (13–15 vs. 16–17 years) for dentine caries experience. Furthermore, there was evidence of effect modification by age with bully victimization for both toothbrushing frequency (Pinteraction = 0.014) and dentine caries experience (Pinteraction < 0.001). Specifically, bully victimization was associated with a higher likelihood of non-daily toothbrushing (OR 2.59, 95% CI 1.80–3.72) and higher dentine caries experience (IRR 1.30, 95% CI 1.14–1.50) among 16–17-year-olds.

Conclusions

Several specific ACEs were associated with non-daily toothbrushing and a higher caries experience among Norwegian adolescents in the Young-HUNT4 Survey.
The effect of an adapted Mindfulness-Based Stress Reduction program on mental health, maternal bonding and birth outcomes in psychosocially vulnerable pregnant women: a study protocol for a randomized controlled trial in a Danish hospital-based outpatient setting
Authors: Skovbjerg S , Sumbundu A , Kolls M , Kjærbye-Thygesen A , Fjorback LO
Published: October 2023

Background

Stress and mental disorders in pregnancy can adversely affect the developing fetus. Women with a preconception history of mental disorders or of psychosocial vulnerabilities are at increased risk of experiencing perinatal stress or mental health problems. Mindfulness-Based-Stress-Reduction (MBSR) is an acceptable intervention for pregnant women and has a growing evidence-base with meta-analyses consistently pointing to reductions in symptoms of stress, anxiety and depression. This study protocol aim to address the need for a wider array of evidence-based and non-pharmacological options during pregnancy to reduce stress and improve mental health in a psychosocially highly vulnerable group of women.

Methods

Pregnant women with a preconception history of mental disorders or psychosocial vulnerabilities (n = 240) will be recruited from an obstetric ambulatory clinic at Copenhagen University Hospital, Hvidovre, Denmark. Recruitment for the study began in March 2022 and will continue until the desired number of participants is reached. Consenting pregnant women will be randomized to one of two study arms, an adapted MBSR program as add on to usual care or usual care alone. The primary outcome is mental wellbeing at nine months post-randomization. Secondary and exploratory outcomes include stress, anxiety, depression, and maternal antenatal attachment, experience of childbirth, delivery and mode of delivery. Mindfulness and self-compassion are examined as possible mediators of the effect on outcomes.

Discussion

Teaching the skills of mindfulness meditation to a psychosocially vulnerable group of pregnant women could prove a viable and non-pharmacological approach to improve mental health and wellbeing during pregnancy, reduce stress and support the transition to parenthood. Mindfulness-Based Stress Reduction does not target a particular group, and results from the study is thus of potential relevance for pregnant women in general as a means of reducing stress and improving perinatal mental health and wellbeing.

Trial registration

ClinicalTrials.gov: NCT05300646. Registered March 29, 2022.
Adapting group care to the postpartum period using a human-centered design approach in Malawi
Authors: Gresh Ashley , Batchelder Anne , Glass Nancy , Mambulasa Janet , Kapito Esnath , MacDonald Amy , Ngutwa Nellie , Plesko Cori , Chirwa Ellen , Patil Crystal L.
Published: October 2023

Background

Responsive and resilient strategies to reduce high rates of maternal and infant mortality and clinician shortages are needed in low- and middle-income countries (LMICs). Malawi has some of the highest maternal and infant mortality rates globally. Group healthcare is a service delivery model that integrates these strategies. Although primarily implemented during the prenatal period, its potential for improving both maternal and infant health outcomes during the postpartum period has not been realized. The purpose of this study was to adapt and co-design the prototype for an evidence-based group care model for the postpartum period using a human-centered design approach with key stakeholders in Malawi.

Methods

We completed steps of a framework guiding the use of human-centered design: 1) define the problem and assemble a team; 2) gather information through evidence and inspiration; 3) synthesize; and 4) intervention design: guiding principles and ideation. Qualitative methods were used to complete steps 2–4. In-depth interviews (n = 24), and incubator sessions (n = 6) that employed free listing, pile sorting and ranking were completed with key stakeholders. Data analysis consisted of content analysis of interviews and framework analysis for incubator sessions to produce the integrated group postpartum and well-child care model prototype. The fifth step is detailed in a separate paper.

Results

All stakeholders reported a desire to participate in and offer group care in the postpartum period. Stakeholders worked collaboratively to co-create the prototype that included a curriculum of health promotion topics and interactive activities and the service delivery structure. Health promotion topic priorities were hygiene, breastfeeding, family planning, nutrition, and mental health. The recommended schedule included 6 sessions corresponding with the child vaccination schedule over the 12-month postpartum period.

Conclusions

Using a human-centered design approach to adapt an evidence-based group care model in an LMIC, specifically Malawi, is feasible and acceptable to key stakeholders and resulted in a prototype curriculum and practical strategies for clinic implementation.
The physiological and pathological properties of Mead acid, an endogenous multifunctional n-9 polyunsaturated fatty acid
Authors: Kawashima Hiroshi , Yoshizawa Katsuhiko
Published: October 2023

Mead acid (MA, 5,8,11-eicosatrienoic acid) is an n-9 polyunsaturated fatty acid (PUFA) and a marker of essential fatty acid deficiency, but nonetheless generally draws little attention. MA is distributed in various normal tissues and can be converted to several specific lipid mediators by lipoxygenase and cyclooxygenase. Recent pathological and epidemiological studies on MA raise the possibility of its effects on inflammation, cancer, dermatitis and cystic fibrosis, suggesting it is an endogenous multifunctional PUFA. This review summarizes the biosynthesis, presence, metabolism and physiological roles of MA and its relation to various diseases, as well as the significance of MA in PUFA metabolism.
Microglia preserve visual function in the aging retina by supporting retinal pigment epithelial health
Authors: Karg Margarete M. , Moorefield May , Hoffmann Emma , Philipose Hannah , Krasniqi Drenushe , Hoppe Cindy , Shu Daisy Y. , Shirahama Shintaro , Ksander Bruce R. , Saint-Geniez Magali
Published: October 2023

Background

Increased age is a risk factor for the development and progression of retinal diseases including age-related macular degeneration (AMD). Understanding the changes that occur in the eye due to aging is important in enhancing our understanding of AMD pathogenesis and the development of novel AMD therapies. Microglia, the resident brain and retinal immune cells are associated with both maintaining homeostasis and protection of neurons and loss of microglia homeostasis could be a significant player in age related neurodegeneration. One important characteristic of retinal aging is the migration of microglia from the inner to outer retina where they reside in the subretinal space (SRS) in contact with the retinal pigment epithelial (RPE) cells. The role of aged subretinal microglia is unknown. Here, we depleted microglia in aged C57/BL6 mice fed for 6 weeks with a chow containing PLX5622, a small molecule inhibitor of colony-stimulating factor-1 receptor (Csf1r) required for microglial survival.

Results

The subretinal P2RY12 + microglia in aged mice displayed a highly amoeboid and activated morphology and were filled with autofluorescence droplets reminiscent of lipofuscin. TEM indicates that subretinal microglia actively phagocytize shed photoreceptor outer segments, one of the main functions of retinal pigmented epithelial cells. PLX5622 treatment depleted up to 90% of the retinal microglia and was associated with significant loss in visual function. Mice on the microglia depletion diet showed reduced contrast sensitivity and significantly lower electroretinogram for the c-wave, a measurement of RPE functionality, compared to age-matched controls. The loss of c-wave coincided with a loss of RPE cells and increased RPE swelling in the absence of microglia.

Conclusions

We conclude that microglia preserve visual function in aged mice and support RPE cell function, by phagocytosing shed photoreceptor outer segments and lipids, therefore compensating for the known age-related decline of RPE phagocytosis.
Intron-mediated enhancement of DIACYLGLYCEROL ACYLTRANSFERASE1 expression in energycane promotes a step change for lipid accumulation in vegetative tissues
Authors: Cao Viet Dang , Luo Guangbin , Korynta Shelby , Liu Hui , Liang Yuanxue , Shanklin John , Altpeter Fredy
Published: October 2023

Background

Metabolic engineering for hyperaccumulation of lipids in vegetative tissues is a novel strategy for enhancing energy density and biofuel production from biomass crops. Energycane is a prime feedstock for this approach due to its high biomass production and resilience under marginal conditions. DIACYLGLYCEROL ACYLTRANSFERASE (DGAT) catalyzes the last and only committed step in the biosynthesis of triacylglycerol (TAG) and can be a rate-limiting enzyme for the production of TAG.

Results

In this study, we explored the effect of intron-mediated enhancement (IME) on the expression of DGAT1 and resulting accumulation of TAG and total fatty acid (TFA) in leaf and stem tissues of energycane. To maximize lipid accumulation these evaluations were carried out by co-expressing the lipogenic transcription factor WRINKLED1 (WRI1) and the TAG protect factor oleosin (OLE1). Including an intron in the codon-optimized TmDGAT1 elevated the accumulation of its transcript in leaves by seven times on average based on 5 transgenic lines for each construct. Plants with WRI1 (W), DGAT1 with intron (Di), and OLE1 (O) expression (WDiO) accumulated TAG up to a 3.85% of leaf dry weight (DW), a 192-fold increase compared to non-modified energycane (WT) and a 3.8-fold increase compared to the highest accumulation under the intron-less gene combination (WDO). This corresponded to TFA accumulation of up to 8.4% of leaf dry weight, a 2.8-fold or 6.1-fold increase compared to WDO or WT, respectively. Co-expression of WDiO resulted in stem accumulations of TAG up to 1.14% of DW or TFA up to 2.08% of DW that exceeded WT by 57-fold or 12-fold and WDO more than twofold, respectively. Constitutive expression of these lipogenic “push pull and protect” factors correlated with biomass reduction.

Conclusions

Intron-mediated enhancement (IME) of the expression of DGAT resulted in a step change in lipid accumulation of energycane and confirmed that under our experimental conditions it is rate limiting for lipid accumulation. IME should be applied to other lipogenic factors and metabolic engineering strategies. The findings from this study may be valuable in developing a high biomass feedstock for commercial production of lipids and advanced biofuels.

Graphical abstract
Translation and localization the Persian version of diabetes distress scale among type 2 diabetes
Authors: Jafari Alireza , Tehrani Hadi , Mansourian Mohammadjavad , Nejatian Mahbobeh , Gholian‑Aval Mahdi
Published: October 2023

Introduction

The aimed of this psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale in type 2 diabetes.

Methods

This psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale among 1028 type 2 diabetes in Mashhad city, Iran, 2022. Cluster sampling method was used for selection the participants. The validity and reliability of diabetes distress scale designed and evaluated by Polonsky was assessed in this study. The validity of diabetes distress scale was evaluated by face validity, content validity, and structural validity. Twenty-six type 2 diabetes were selected for evaluation the reliability of scale.

Results

The factor loading of all questions of diabetes distress scale were more than 0.4 and the results of goodness-of-fit indexes showed acceptable values (for example: RMSEA = 0.076, IFI = 0.909, AGFI = 0.819, PNFI = 0.758). Cronbach’s alpha coefficient, McDonald omega coefficient and Intraclass Correlation Coefficient (ICC) showed a value of 0.950, 0.955, and 0.903, respectively for all items of diabetes distress scale. Cronbach's alpha coefficient, McDonald omega coefficient and ICC showed a value of 0.914, 0.917, and 0.893, respectively for Core Level of Distress (8 items). Also, Cronbach's alpha coefficient, McDonald omega coefficient, and ICC showed a value of 0.920, 0.928, and 0.884, respectively for all factors of Sources of Distress (21 items).

Conclusion

The Persian form of diabetes distress scale with 29 items and two parts of Core Level of Distress with 8 items and Sources of Distress with 21 items and 7 factors (Hypoglycemia with 3 items, Long-term Health with 3 items, Healthcare Provider with 3 items, Interpersonal Issues with 3 items, Shame/Stigma with 3 items, Healthcare Access with 3 items, and Management Demands with 3 items) is a good scale to evaluation the status of diabetes distress in Iranian type 2 diabetes.
Systematic review: fluid biomarkers and machine learning methods to improve the diagnosis from mild cognitive impairment to Alzheimer’s disease
Authors: Blanco Kevin , Salcidua Stefanny , Orellana Paulina , Sauma-Pérez Tania , León Tomás , Steinmetz Lorena Cecilia López , Ibañez Agustín , Duran-Aniotz Claudia , de la Cruz Rolando
Published: October 2023

Mild cognitive impairment (MCI) is often considered an early stage of dementia, with estimated rates of progression to dementia up to 80–90% after approximately 6 years from the initial diagnosis. Diagnosis of cognitive impairment in dementia is typically based on clinical evaluation, neuropsychological assessments, cerebrospinal fluid (CSF) biomarkers, and neuroimaging. The main goal of diagnosing MCI is to determine its cause, particularly whether it is due to Alzheimer’s disease (AD). However, only a limited percentage of the population has access to etiological confirmation, which has led to the emergence of peripheral fluid biomarkers as a diagnostic tool for dementias, including MCI due to AD. Recent advances in biofluid assays have enabled the use of sophisticated statistical models and multimodal machine learning (ML) algorithms for the diagnosis of MCI based on fluid biomarkers from CSF, peripheral blood, and saliva, among others. This approach has shown promise for identifying specific causes of MCI, including AD. After a PRISMA analysis, 29 articles revealed a trend towards using multimodal algorithms that incorporate additional biomarkers such as neuroimaging, neuropsychological tests, and genetic information. Particularly, neuroimaging is commonly used in conjunction with fluid biomarkers for both cross-sectional and longitudinal studies. Our systematic review suggests that cost-effective longitudinal multimodal monitoring data, representative of diverse cultural populations and utilizing white-box ML algorithms, could be a valuable contribution to the development of diagnostic models for AD due to MCI. Clinical assessment and biomarkers, together with ML techniques, could prove pivotal in improving diagnostic tools for MCI due to AD.
Dual antiplatelet management in the perioperative period: updated and expanded systematic review
Authors: Premji Alykhan M. , Blegen Mariah B. , Corley Alyssa M. , Ulloa Jesus , Booth Marika S. , Begashaw Meron , Larkin Jody , Shekelle Paul , Girgis Mark D. , Maggard-Gibbons Melinda
Published: October 2023

Background

Antiplatelet agents are central in the management of vascular disease. The use of dual antiplatelet therapy (DAPT) for the management of thromboembolic complications must be weighed against bleeding risk in the perioperative setting. This balance is critical in patients undergoing cardiac or non-cardiac surgery. The management of patients on DAPT for any indication (including stents) is not clear and there is limited evidence to guide decision-making. This review summarizes current evidence since 2015 regarding the occurrence of major adverse events associated with continuing, suspending, or varying DAPT in the perioperative period.

Methods

A research librarian searched PubMed and Cochrane from November 30, 2015 to May 17, 2022, for relevant terms regarding adult patients on DAPT for any reason undergoing surgery, with a perioperative variation in DAPT strategy. Outcomes of interest included the occurrence of major adverse cardiac events, major adverse limb events, all-cause death, major bleeding, and reoperation. We considered withdrawal or discontinuation of DAPT as stopping either aspirin or a P2Y12 inhibitor or both agents; continuation of DAPT indicates that both drugs were given in the specified timeframe.

Results

Eighteen observational studies met the inclusion criteria. No RCTs were identified, and no studies were judged to be at low risk of bias. Twelve studies reported on CABG. Withholding DAPT therapy for more than 2 days was associated with less blood loss and a slight trend favoring less transfusion and surgical re-exploration. Among five observational CABG studies, there were no statistically significant differences in patient death across DAPT management strategies. Few studies reported cardiac outcomes. The remaining studies, which were about procedures other than exclusively CABG, demonstrated mixed findings with respect to DAPT strategy, bleeding, and ischemic outcomes.

Conclusion

The evidence base on the benefits and risks of different perioperative DAPT strategies for patients with stents is extremely limited. The strongest signal, which was still judged as low certainty evidence, is that suspension of DAPT for greater than 2 days prior to CABG surgery is associated with less bleeding, transfusions, and re-explorations. Different DAPT strategies’ association with other outcomes of interest, such as MACE, remains uncertain.

Systematic review registration

A preregistered protocol for this review can be found on the PROSPERO International Prospective Register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO/; registration number: CRD42022371032).
Integrating long-acting injectable treatment to improve medication adherence among persons living with HIV and opioid use disorder: study protocol
Authors: Langdon Kirsten J. , Hitch Anthony E. , Collins Alexandra B. , Beckwith Curt G. , Becker Sara , Tashima Karen , Rich Josiah D.
Published: October 2023

Background

Oral antiretroviral therapy (ART) has been effective at reducing mortality rates of people with HIV. However, despite its effectiveness, people who use drugs face barriers to maintaining ART adherence. Receipt of opioid agonist treatment, in the context of HIV care, is associated with medication adherence and decreased HIV viral loads. Recent pharmacological advancements have led to the development of novel long-acting, injectable, medications for both HIV (cabotegravir co-administered with rilpivirine) and OUD (extended-release buprenorphine). These therapies have the potential to dramatically improve adherence by eliminating the need for daily pill-taking. Despite the extensive evidence base supporting long-acting injectable medications for both HIV and OUD, and clinical guidelines supporting integrated care provision, currently little is known about how these medications may be optimally delivered to this population. This paper presents the study design for the development of a clinical protocol to guide the delivery of combined treatment for HIV and OUD using long-acting injectable medications.

Methods

The study aims are to: (1) develop a clinical protocol to guide the delivery of combined LAI for HIV and OUD by conducting in-depth interviews with prospective patients, clinical content experts, and other key stakeholders; and (2) conduct This single group, open pilot trial protocol to assess feasibility, acceptability, and safety among patients diagnosed with HIV and OUD. Throughout all phases of the study, information on patient-, provider-, and organizational-level variables will be collected to inform future implementation.

Discussion

Findings from this study will inform the development of a future study to conduct a fully-powered Hybrid Type 1 Effectiveness-Implementation design.
Coexistence of specialist and generalist species within mixed plastic derivative-utilizing microbial communities
Authors: Schaerer Laura , Putman Lindsay , Bigcraft Isaac , Byrne Emma , Kulas Daniel , Zolghadr Ali , Aloba Sulihat , Ong Rebecca , Shonnard David , Techtmann Stephen
Published: October 2023

Background

Plastic-degrading microbial isolates offer great potential to degrade, transform, and upcycle plastic waste. Tandem chemical and biological processing of plastic wastes has been shown to substantially increase the rates of plastic degradation; however, the focus of this work has been almost entirely on microbial isolates (either bioengineered or naturally occurring). We propose that a microbial community has even greater potential for plastic upcycling. A microbial community has greater metabolic diversity to process mixed plastic waste streams and has built-in functional redundancy for optimal resilience.

Results

Here, we used two plastic-derivative degrading communities as a model system to investigate the roles of specialist and generalist species within the microbial communities. These communities were grown on five plastic-derived substrates: pyrolysis treated high-density polyethylene, chemically deconstructed polyethylene terephthalate, disodium terephthalate, terephthalamide, and ethylene glycol. Short-read metagenomic and metatranscriptomic sequencing were performed to evaluate activity of microorganisms in each treatment. Long-read metagenomic sequencing was performed to obtain high-quality metagenome assembled genomes and evaluate division of labor.

Conclusions

Data presented here show that the communities are primarily dominated by Rhodococcus generalists and lower abundance specialists for each of the plastic-derived substrates investigated here, supporting previous research that generalist species dominate batch culture. Additionally, division of labor may be present between Hydrogenophaga terephthalate degrading specialists and lower abundance protocatechuate degrading specialists﻿.
Young people’s happiness in the context of negative life events and coping strategies: a latent profile and latent class analysis
Authors: Polatcı Sema , Antalyalı Ömer Lütfi , Alparslan Ali Murat , Yastıoğlu Seher
Published: October 2023

Young people have to cope with many negative life events and stress factors to maintain their happiness. Although there are studies on how they benefit from different coping strategies and their results, there is no study that profiles/groups young people according to negative life events and coping styles. From this point of view, the study aims to determine different life events classes and stress coping profiles in young people, and to examine the differences in happiness among the new groups created according to the discovered classes and profiles. Participants consisted of 1093 young people (M = 21.08) from different state universities in Turkey. Latent profile analysis (LPA) was conducted, resulting in a 3 profile solution characterizing coping strategies: Positive-oriented (26.8%), slightly positive-oriented (50%), and negative-oriented (23.2%) coping strategy profiles. Latent class analysis (LCA) was conducted, resulting in a 2 class solution characterizing negative life events: More negative (40.1%) and less negative (59.9%) life events classes. For the purpose of the study, the profiles created with the latent profile analysis and the latent class analysis were considered together and the participants were divided into 6 groups. These groups differed significantly in terms of happiness. The group with the highest level of happiness is the group with positive-oriented coping strategies and less negative life conditions (μ = 4.35, p < .001), and the group with the lowest level of happiness is the group with negative-oriented coping strategies and more negative life conditions (μ = 3.48, p < .001). However, the findings indicated that a positive-oriented coping strategy profile (the profile that scored high on positive coping strategies and low on negative coping strategies) offers the most promising route to happiness whether experienced negative life events are less or more.
Behaviour of anadromous brown trout (Salmo trutta) in a hydropower regulated freshwater system
Authors: Dahlmo Lotte S. , Velle Gaute , Nilsen Cecilie I. , Pulg Ulrich , Lennox Robert J. , Vollset Knut W.
Published: October 2023

Many Norwegian rivers and lakes are regulated for hydropower, which affects freshwater ecosystems and anadromous fish species, such as sea trout (Salmo trutta). Lakes are an important feature of many anadromous river systems. However, there is limited knowledge on the importance of lakes as habitat for sea trout and how hydropower affects the behaviour of sea trout in lakes. To investigate this, we conducted an acoustic telemetry study. A total of 31 adult sea trout (532 ± 93 mm total length) were captured by angling in river Aurlandselva, Norway, and tagged between July 20 and August 12, 2021. The tags were instrumented with accelerometer, temperature, and depth sensors, which provided information on the sea trout’s presence and behaviour in lake Vassbygdevatnet. Our results indicate that there was a large prevalence of sea trout in the lake during the spawning migration, and that the sea trout were less active in the lake compared to the riverine habitats. An increase in activity of sea trout in the lake during autumn might indicate that sea trout spawn in the lake. However, the discharge from the high-head storage plant into the lake did not affect the depth use or activity of sea trout in the lake. Furthermore, the large prevalence of spawners in the lake during autumn will likely cause an underestimation of the size of the sea trout population in rivers with lakes during annual stock assessment. In conclusion, our results could not find evidence of a large impact of the discharge on the behaviour of sea trout in the lake.
Probabilistic seismic hazard assessments for Myanmar and its metropolitan areas
Authors: Yang Huan-Bin , Chang Yuan-Kai , Liu Wei , Sung Guan-Yi , Gao Jia-Cian , Thant Myo , Maung Maung Phyo , Chan Chung-Han
Published: October 2023

Although Myanmar is an earthquake-prone country, there has not been proposed an official national seismic hazard map. Thus, this study conducted a probabilistic seismic hazard assessment for Myanmar and some of its metropolitan areas. Performing this assessment required a set of databases that incorporates both earthquake catalogs and fault parameters. We obtained seismic parameters from the International Seismological Centre, and the fault database includes fault parameters from paper reviews and the database. Based on seismic activities, we considered three categories of seismogenic sources—active fault source, shallow area source, and subduction zone source. We evaluated seismic activity of each source based on the earthquake catalogs and fault parameters. Evaluating the ground-shaking behaviors for Myanmar requires evaluation of ground-shaking attenuation; therefore, we validated existing ground motion prediction equations (GMPEs) by comparing instrumental observations and felt intensities for recent earthquakes. We then incorporated the best fitting GMPEs into our seismic hazard assessments. By incorporating theVs30(the average shear velocity down to 30 m depth) map from an analysis of topographic slope, we utilized site effect and assessed national probabilistic seismic hazards for Myanmar. The assessment shows highest seismic hazard levels near those faults with high slip rates, including the Sagaing Fault and along the Western Coast of Myanmar. We also assessed seismic hazard for some metropolitan cities, including Bagan, Bago, Mandalay, Sagaing, Taungoo and Yangon, in the forms of hazard curves and disaggregation by implementing detailedVs30maps from micro-tremor surveys. The city-scale assessments show higher hazards for sites close to an active fault or/and with a lowVs30, demonstrating the importance of investigating site conditions. The outcomes of this study will be beneficial to urban planning on a city scale and building code legislation on a national scale.
Risk Factors for Concussion in Under 18, Under 22 and Professional Men's Rugby Union: A Video Analysis of 14,809 Tackles
Authors: Kawasaki Takayuki , Kawakami Yuta , Nojiri Shuko , Hasegawa Yoshinori , Kuroki Manabu , Sobue Shogo , Shibuya Kenta , Takazawa Yuji , Ishijima Muneaki
Published: October 2023

Objective

This study aimed to identify the risk factors for tackle-related concussion observed in matches involving under (U) 18, U 22 and professional men’s Rugby Union players through video analysis.

Study Design

Descriptive epidemiology study.

Methods

Twenty Rugby Union matches each for high school (U18), university/college (U22) and professional (Elite) were randomly selected from 202 matches in the 2018/2019 season. Both one-on-one and tackles involving multiple tacklers were analyzed for the 60 matches. The 28 categorical and continuous variables (e.g., tackle characteristics and duration before the tackle) were applied as risk factors to a least absolute shrinkage and selection operator (Lasso) regression analysis. To identify high-risk situations, a simulation model with coefficients obtained from the Lasso regression was used. Statistical analysis was conducted according to tackle direction.

Results

A total of 14,809 tackles and 41 concussions involving 1800 players were included in the analyses. The incidence rate of concussions (injuries/1000 tackles) was greater in Elite players (4.0) compared with U18 (1.9) and U22 (2.4) players. The factors most highly associated with concussions were head-in-front tackles (where the tackler’s head is placed forward, impeding a ball carrier’s forward movements, 11.26/1000 tackles), and were more often observed among U18 players. A simulation model predicted that the highest risk tackle situation in Elite players was a head-in-front, side-on tackle below the hip of the ball carrier (predicted incidence rate 18.07/1000 tackles).

Conclusion

The risk factors associated with concussion need to be assessed cautiously. Avoiding head-in-front, side-on tackles to the lower extremities of a ball carrier should be considered to reduce injury risks.
A prototype variable corresponding to the proportion of ischemia for the comparison between robotic and open partial nephrectomy: a meta-analysis accompanied by sensitivity analysis
Authors: Artsitas Sotirios , Artsitas Dimitrios , Koronaki Irene , Toutouzas Konstantinos G. , Zografos George C.
Published: October 2023

Background

The primary objective of this study involves the formulation of a novel variable, derived from initial data related to ischemia duration and operative time in partial nephrectomies. The aim was to determine the proportion of ischemia for the comparison between robotic and open approaches in terms of their relative ischemic requirements.

Main body

The literature search was conducted from August 2022 to June 2023, primarily encompassing non-randomized comparative studies in the English language. Ultimately, a total of 62 studies involving data from 26,072 patients were included. Following appropriate transformation of the original data under the assumption of normal distribution, the proportion of ischemia (I) was formulated for each study and comparison arm, using estimator functions. Subsequent analysis of the generated data was performed for both the original variables and the I outcome. Statistical significance was only observed regarding the surgical duration, with a mean difference of 19.74 min (CI95% = [11.56; 27.92]) in favor of robotic access. The mean difference in I was estimated on the entire dataset as well as carefully selected subgroups based on publication year, patient matching, the number of referral centers, and risk of bias class. Additionally, meta-regression analysis and four-level sensitivity analysis were conducted. In none of these investigations did statistically significant differences emerge between the two surgical approaches. These findings lead us to hypothesize that the proportion of ischemia in partial nephrectomies may represent an inherent characteristic of the procedure, typically manifesting as baseline ischemia (12–13% of operative time), with fluctuations depending on the chosen strategy or the complexity of the specific intervention.

Short conclusion

There is no difference in the proportion of ischemia between robotic and open partial nephrectomies. In overall, ischemia time appears to be primarily determined by the overall duration of the procedure and the effectiveness in achieving adequate hemostasis.
Complex spherical-wave seismic inversion in anelastic media for the P-wave minimum quality factor
Authors: Cheng Guangsen , He Chuanlin , Zong Zhaoyun , Liang Zhanyuan , Yin Xingyao , Zhang Xiaoyu
Published: October 2023

Attenuation always exists when seismic waves propagate in underground anelastic media, especially in hydrocarbon-bearing reservoirs. Quality factor Q or attenuation factor 1/ Q can be used to quantify the seismic wave attenuation and has become an important hydrocarbon indicator. The relationship between the plane-wave reflection coefficient ([Formula: see text]) in anelastic media and P- and S-wave quality factors has been widely used in the plane-wave seismic inversion to estimate the quality factors. The [Formula: see text] provides an adequate approximation for the deeper subsurface. However, for the shallow subsurface and anelastic wavefields excited by point sources, the [Formula: see text] is inaccurate and its meaning involves some fundamental difficulties. In view of this, a Q-dependent P-P spherical-wave reflection coefficient ([Formula: see text]) in anelastic media is used here. Considering that having too many parameters to be inverted will lead to unstable and inaccurate inversion results, we further derive an approximate anelastic [Formula: see text] and anelastic spherical-wave impedance ([Formula: see text]), which are frequency dependent and are the functions of P- and S-wave velocities, density, and P-wave minimum quality factor ([Formula: see text]). Finally, a complex spherical-wave seismic inversion approach in anelastic media for the P-wave minimum quality factor is developed. Using the Bayesian inversion approach and complex convolution model, we first estimate the multilayer [Formula: see text] from the complex seismic traces with different frequencies and incidence angles. Based on the inverted angle- and frequency-dependent [Formula: see text], the P- and S-wave velocities, density, and P-wave minimum quality factor are further estimated using a nonlinear inversion tool. Synthetic examples verify the feasibility and robustness of the complex spherical-wave seismic inversion approach in anelastic media. In the shallow subsurface, the spherical-wave inversion is superior to plane-wave inversion. A field example further demonstrates the accuracy and great potential of our approach in hydrocarbon-bearing reservoir prediction.