bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary function in swimmers exposed to disinfection by-products: a narrative review
Authors: Boraczyński Michał , Balcerek Tomasz , Rożkiewicz Nikola , Pabiszczak Monika , Harasymczuk Michał , Sławska Aneta , Lutomski Przemysław
Published: January 2025

Swimming produces many psychophysiological effects, including blood, hormonal, enzymatic, pulmonary, cardiovascular and energetic adaptations. However, asthma and allergies are becoming increasingly prevalent medical issues among elite endurance-trained swimmers, where exercise-induced asthma or bronchospasm is frequently reported. Heavy endurance swimming training, especially under adverse conditions, stresses the airway mucosa, leading to inflammatory changes, as observed in induced sputum in competitive swimmers. In addition, chlorine-based disinfectants (CBDs) are commonly used in indoor pools due to their effectiveness and lower relative cost. Many of these substances have carcinogenic and genotoxic properties, and exposure to DBPs have been linked to adverse respiratory effects. The association between long-term exposure to a chlorinated swimming pool and elevated serum sIgE levels suggests a link between allergens, chlorine exposure and the development of various pulmonary dysfunctions. Thus, the combination of intense and repeated physical endurance training over extended periods, along with suboptimal environmental conditions, may contribute to the development of rhinitis, asthma and bronchial hyperresponsiveness in athletes. While occasional or low-level exposure to chlorine might not be harmful, regular swimmers, especially those at competitive levels, are at a higher risk of developing respiratory disorders. Because these potential risks of exposure to CBDs must be balanced against the benefits of swimming and the risk of microbial infections in pools, we recommend better pool management and regular health checks for swimmers. Fortunately, the reduction of bronchial symptoms in swimmers who reduce training volume and intensity suggests that the negative effects on pulmonary function may be reversible. For these reasons, it is crucial to develop effective respiratory protection strategies, including medical interventions and modifications to the pool environment. Practical steps such as reducing chlorine use, ensuring proper hygiene before swimming and using swim caps can minimise risks. Research should also explore safer alternatives to CBDs, such as ozonation, and improved ventilation to reduce air pollutants.
Muscle power is associated with higher levels of walking capacity and self-reported gait performance and physical activity in individuals with cerebral palsy
Authors: Pontiff Mattie E. , Batra Abhinandan , Li Li , Moreau Noelle G.
Published: January 2025

Introduction

The purpose of this study was to investigate the relationships between a Power Leg Press test (PLP) with walking capacity and self-reported performance and participation in individuals with Cerebral Palsy (CP), and to compare the strength of the associations between two power tests (PLP and isokinetic (IsoK)) with walking capacity.

Methods

Ambulatory individuals with CP (n = 33; age 17.89 ± 7.52 years) performed five inclined power leg presses at 40%–50% of their 1-repetition maximum “as fast as possible”. A linear position transducer was attached to the weight bar, and the displacement, total load, and angle of the sled were used to calculate peak power for each trial. Isokinetic knee extensor power was measured at 60 deg/sec. Walking capacity was measured using the 10-m walk test fast (FS) and self-selected (SS) speeds and the 1-min walk test (1MWT). Self-reported performance and participation measures were the Activities Scale for Kids-performance (ASKp), Patient-Reported Outcomes Measurement Information System (PROMIS®), and the Gait Outcomes Assessment List (GOAL). Pearson’s correlation coefficients determined relationships between power measures with walking capacity and self-report measures (α < 0.05).

Results

PLP and IsoK power were significantly correlated to SS (r = 0.361, r = 0.376), FS (r = 0.511, r = 0.485), and 1MWT (r = 0.583. r = 0.443), respectively (p < 0.05). There was no significant difference between the strength of the associations between walking capacity and each test of power (PLP and Isok) (p > 0.05). PLP power was significantly correlated to composite scores on the ASKp (r = 0.690) and GOAL (r = 0.577) and to four components of the PROMIS, including physical function (r = 0.588) (p < 0.01). The Gait and Mobility subscale of the GOAL (r = 0.705) and the Locomotion (r = 0.636), Transfers (r = 0.547), and Standing (r = 0.521) subscales of the ASKp had strong relationships to peak power produced during the PLP test (p < 0.01).

Discussion

PLP power was significantly correlated with walking capacity and self-reported walking performance and mobility-based participation in ambulatory individuals with CP. Higher movement velocities associated with the PLP test may explain the significant associations of power with faster gait speeds. Self-reported mobility performance and physical activity also showed moderate to strong relationships with lower extremity power. Overall, these results suggest a strong link between decreased muscle power generation and walking limitations in individuals with CP.
Can Latin America play a more influential role in a shifting world order?
Authors: Cattafi Carmelo , Papp Robert
Published: January 2025

Latin America has played a secondary role in international challenges to a unipolar world order in today’s space for influence in managing the critical challenges transnational security and conflict. This article relations with a focus on Latin America’s role in the relations between Latin America and the great global systemic configuration. So, it analyzes Latin strategic vision, and narratives towards the rest that derive from its economic competition, energy of nearshoring, internal and international security, to the region. Finally, it will attempt to answer the rising impact of the Global South, the influence countries, and political and ideological changes, to play a more important role than in the past.
Children’s emerging concepts of resilience: insights from using body mapping in an East London cohort sample of 7-10-year-old children
Authors: Murray Aisling , Smith Scott Dominie Mahala , Nikolajeva Milena , Porricelli Daniele , van Loggerenberg Francois , Ougrin Dennis , Lau Jennifer Y. F.
Published: January 2025

Background

Understanding resilience factors in children is essential for developing early mental health interventions. Middle childhood is an understudied developmental stage, with many quantitative measures lacking validation for this age group and not capturing diverse experiences. This study aimed to use body mapping, an arts-based method, as a novel approach to understand 7-10-year-old children’s concepts of resilience (including definitions and factors that contribute to resilience) in East London. An advisory group of six children commented on the findings.

Methods

Body mapping was included in the Development of Emotional Resilience (DEER) Study. Participants drew a resilience symbol, wrote recent worries and colored on an A4-sized body map to signal where they embody stress. Demographic data were collected via self- and parent-report surveys and school records. Manifest content analysis identified four thematic categories related to worries, somatic stress and resilience.

Results

196 children (48.47% boys, 46.43% girls; 35.20% White, 30.10% Asian, 11.22% Black) across school years 3–5 completed body mapping. Concepts of resilience included perseverance and metaphorical representations of personal strength. We also identified socioecological factors that contributed to resilience, mainly at the individual and interpersonal levels. Boys more often depicted Sports whilst more girls depicted Engagement in the arts and Social networks. 11 worry categories emerged, including education, relationships and physical health. Of the body categories colored (n = 51), the most common were the head, hands and abdomen/stomach.

Conclusion

Children expressed dominant and abstract symbols of resilience and identified factors that contributed to resilience. Hobbies and strong relationships may be particularly important in middle childhood, corroborated by the advisory group’s experiences. Body mapping revealed diverse worries (e.g., education, change and uncertainty and global and societal concerns) and somatic experiences of stress (e.g., the head, chest and torso). Through prioritising children’s perspectives, body mapping holds promise in clinical and educational settings.
A research-driven flowchart to approach change in couples
Authors: Capozzi Francesca
Published: January 2025

In most cases, couple therapists systemically see couples’ distress as the result of reciprocal maladaptive patterns to which each partner contributes. Yet, therapists can struggle to share with the couple such a relational understanding of their distress and identify goals for change accordingly, as structured, step-by-step methods are not available in the extant literature. This perspective paper reviews research across various domains of relationship science to summarize cohesively the best practices for goal identification in a step-by-step flowchart. The flowchart is divided into three main areas, derived from the available literature: establishing couple therapy appropriateness, determining general goals, and conceptualizing specific goals from a systemic perspective. Aimed at facilitating training, the resulting recommendations will broadly support a goal-focused approach to systemic assessment.
Exploring the well-being of professional female musicians: a self-determination theory perspective
Authors: Perrier Laurence , Latreille-Gagné Laurence , Khoriaty Florence , Fortin Maude , Bonneville-Roussy Arielle
Published: January 2025

Background

This study investigated the well-being of 16 professional female musicians through the lens of Self-Determination Theory, focusing on the satisfaction of their psychological needs for autonomy, competence, and relatedness, as well as the unique challenges they encounter in their careers.

Methods

Semi-structured interviews were undertaken and analyzed using thematic analysis.

Results and discussion

Three broad themes and 10 sub-themes emerged from the interviews. The findings demonstrate that the well-being of female musicians is closely tied to the satisfaction of their psychological needs for autonomy, competence, and relatedness. Conversely, when these needs are frustrated, their well-being is negatively impacted. Other themes that emerged from the interviews are intrinsic motivation and the gender specific challenges within the music industry.

Conclusion

The study highlights the need for supportive environments to enhance the well-being of female musicians (and performers as a whole), addressing both their psychological needs and the specific gender-related challenges they face.
Learning to play to learn in pediatric physical therapy
Authors: Håkstad Ragnhild B. , Dusing Stacey C. , Girolami Gay L. , Øberg Gunn Kristin , De Jaegher Hanne
Published: January 2025

Introduction

Play is a way for children to develop and learn about themselves in conjunction with the world. Using play as part of pediatric physical therapy is broadly recommended. This study investigates this integration of play and seeks to answer the research question: How do pediatric physical therapists (PPT) understand and manage embedding play in pediatric physical therapy with children aged 0–3?

Methods

This is a qualitative study in which we connect to an enactive theoretical framework. We interviewed 14 PPTs about their use of play, including video-elicited questions while viewing recordings of their therapy sessions. Our results were developed through an abductive thematic analysis.

Results

The PPTs acknowledge play as a foundation of children’s learning and a vital component of physical therapy. They explain that play and therapy often co-exist and intertwine, but they also experience tensions when they strive to make play therapeutic. The PPTs find it taxing to engage in play with children who present with limited interaction and play skills, and voice concern for children who struggle to engage in interactional play.

Discussion

Trusting play and letting play emerge through shared sense-making can resolve challenges and enable PPTs to discover new therapeutic opportunities. A child’s striving and overcoming of resistance can be infused with playfulness and make play thrive. We invite PPTs to experiment with the emerging opportunities and boundaries between therapy and play during treatment sessions. Respect for the child’s autonomy, attention to the child’s play experience, and repairs of interactional mismatches are crucial in this process. Therapeutic guidance and mutuality in interactions can empower children to learn to play to learn new skills and experience mastery as they explore and venture beyond what they already know.
The moderating role of parent–child interaction in the relationship between maltreatment and psychological well-being among preschool children
Authors: Zhang Cheng , Huang Chuican , Zhang Chunhui , Wu Weijia , Huang Zhenning , Xia Xue , Liu Sijia , Wang Chen , Luo Qing , Fan Lichun
Published: January 2025

Objective

This study aimed to examine the relationship between maltreatment and psychological well-being among preschool children and explore parent–child interaction’s moderating role on this association.

Methods

This study employed a cross-sectional design and multistage stratified cluster random sampling method. Between December 2022 and January 2023, 180 kindergartens in the Hainan province—encompassing 4,886 newly enrolled children as participants—were selected. All data were collected using an online platform, on which parents or caregivers reported their children’s history of abuse and completed the Strengths and Difficulties Questionnaire and Chinese Parent–Child Interaction Scale.

Result

The reporting rate of child abuse in Hainan Province was 61.81%. Specifically, frequent physical abuse (odds ratio [OR] = 1.44, 95% confidence interval [CI] = 1.15–1.80), occasional physical neglect (OR = 1.75, 95% CI = 1.37–2.11), frequent physical neglect (OR = 1.57, 95% CI = 1.31–1.87), and frequent emotional abuse (OR = 1.57, 95% CI = 1.31–1.87) were associated with a higher overall rate of difficulties. Frequent physical abuse (OR = 1.33, 95% CI = 1.08–1.64) and frequent emotional abuse (OR = 1.36, 95% CI = 1.16–1.61) were correlated with a higher rate of prosocial problems. A significant interaction was observed between parent–child interaction and occasional physical neglect on psychological well-being (OR = 0.73, 95% CI = 0.54–0.98, p = 0.035).

Conclusion

Preschool children who experience maltreatment exhibit an increased risk of developing psychological health issues, indicating a cumulative effect. Our study indicates that positive parent–child interaction mitigates occasional physical neglect’s negative impact on preschool children’s psychological well-being but does not exhibit a moderating effect on frequent physical neglect or other forms of maltreatment.
The relationship between social media fatigue and online trolling behavior among college students: the mediating roles of relative deprivation and hostile attribution bias
Authors: Huang Lexin , Chen Liangkun , Ma Suwei
Published: January 2025

Based on the General Aggression Model (GAM), this study explores the relationship between social media fatigue and online trolling behavior among Chinese college students, focusing on the mediating roles of relative deprivation and hostile attribution bias as key affective and cognitive mechanisms proposed by GAM. Using a cross-sectional survey design, data were collected from 349 college students from Guangdong via an online questionnaire. Key variables, including social media fatigue, relative deprivation, and hostile attribution bias, were measured using validated scales: the SNS Fatigue Questionnaire, the Personal Relative Deprivation Scale, the Word Sentence Association Paradigm for Hostility, and the revised Global Assessment of Internet Trolling. Structural equation modeling (SEM) was employed to test the hypothesized relationships and mediating effects. The results indicate that social media fatigue is positively associated with online trolling behavior. Furthermore, relative deprivation and hostile attribution bias serve as significant mediating mechanisms in this relationship, forming a chain mediation model. These findings suggest that when users experience social media fatigue, they may feel deprived relative to others, which can lead to a hostile interpretation of others’ behaviors, thereby increasing the likelihood of engaging in trolling. The study highlights the importance of understanding psychological factors that contribute to negative online behaviors and offers insights into potential intervention strategies to mitigate such behaviors by addressing the underlying psychological mechanisms.
Increasing stress resilience in older adults through a 6-week prevention program: effects on coping strategies, anxiety symptoms, and cortisol levels
Authors: Richer Marie-Josée , Grenier Sébastien , Lupien Sonia , Plusquellec Pierrich
Published: January 2025

Introduction

As people age, chronic stress, resulting in prolonged or repeated activation of the hypothalamic–pituitary–adrenal (HPA) axis, has been associated with long-term adverse health outcomes. Coping strategies and social support have been recognized as contributing to resilience to stress in older adults. Few studies have evaluated stress management training (SMT) interventions based on psychoneuroendocrinology that were designed to be delivered to healthy older adults in community settings.

Methods

In this study, a total of 170 older adults (mean age = 76.07, SD = 7.67) participated in a cluster-randomized trial designed to compare the delivery of an SMT intervention with a waitlist condition.

Results

The effect of SMT on coping strategies, stress, anxiety, and depression was measured 3 weeks and 3 months after the intervention. In addition, we tested the effect on basal cortisol secretion over 2 days from saliva samples upon awakening and the total diurnal cortisol output [area under the curve with respect to ground (AUCg)]. Results from repeated measures analyses of variance showed that participants who received the intervention demonstrated a significant increase in problem-solving coping strategies and a decrease in anxiety scores 3 weeks after the intervention compared to the waitlist group. STM participants also demonstrated lower cortisol levels on the AUCg index. At the 3-month follow-up, gains were maintained only on the AUCg index.

Discussion

This type of brief preventive program could reduce basal cortisol levels in older adults, which may be an important protective factor against health outcomes associated with chronic HPA activation. Our results provide sufficient evidence to warrant further research to improve the effectiveness of O’stress in different settings.
The dual impact: physiological and psychological effects of rapid weight loss in wrestling
Authors: Sarıakçalı Barış , Şahin Fatma Neşe , Başoğlu Burhan , Ceylan Levent , Güler Özkan , Yamak Bade , Arıkan Gökhan , Acar Gizem Ceylan , Sekban Gülşah , Durmuşoğlu Mehmet Vakıf , Çimen Polat Sezen , Küçük Hamza
Published: January 2025

Introduction

Athletes competing in weight-class sports often seek to gain an advantage by competing at lower weights. Athletes competing in weight-class sports often seek to gain an advantage by competing at lower weights. To achieve this, they aim to lose weight during the competition period, leading to various physiological and psychological changes. This study aimed to investigate the biochemical, hormonal, and psychological effects of weight reduction in elite wrestlers during the competition phase.

Methods

Thirty-seven elite male free style wrestlers (age: 19.02 ± 1.27) participated in the study. Samples were collected 5 days before and on the day of the match.

Results

A significant decrease in body weight was observed (p < 0.05). Levels of creatine, BUN, sodium, hematocrit, hemoglobin, LDH, and cortisol increased, while albumin, testosterone, and FSH levels decreased. There were no significant differences in potassium, ALT, AST, TSH levels. State and trait anxiety scores of the wrestlers increased significantly during the RWL period.

Conclusion

The study concluded that elite wrestlers experienced significant changes in physiological and psychological parameters during the competition periods. These findings underscore the importance of careful monitoring of RWL strategies by coaches and athletes to mitigate the adverse effects on nutritional status, psychological well-being, and physical performance.
Basolateral amygdala volume in affective disorders using 7T MRI in vivo
Authors: Kürzinger Benedikt , Schindler Stephanie , Meffert Martin , Rosenhahn Anja , Trampel Robert , Turner Robert , Schoenknecht Peter
Published: January 2025

Background

The basolateral complex of the amygdala is a crucial neurobiological site for Pavlovian conditioning. Investigations into volumetric alterations of the basolateral amygdala in individuals with major depressive disorder (MDD) have yielded conflicting results. These may be reconciled in an inverted U-shape allostatic growth trajectory. This hypothesized trajectory unfolds with an initial phase of volumetric expansion, driven by enhanced dendritic arborization and synaptic plasticity. The increase in volume is followed by a reduction phase, as glucocorticoid exposure cumulatively results in excitotoxic damage, reflecting allostatic load.

Methods

7T magnetic resonance brain imaging was conducted on a total of 84 participants (mean age 38 ± 12 years), comprising 20 unmedicated and 20 medicated individuals with MDD, 21 individuals suffering from bipolar disorder and 23 healthy controls. We employed FreeSurfer 7.3.2 for automatic high-resolution segmentation of nine amygdala subnuclei. We conducted analyses of covariance, with volumes of the basolateral complex, the lateral nucleus and, exploratively, the whole amygdala, as dependent variables, while controlling for the total intracranial volume and sex. Quadratic regressions were computed within the MDD group and in relevant subgroups to investigate the presence of a U-shaped relationship between the number of preceding major depressive episodes or the duration of the disease since the first episode and the dependent variables.

Results

Diagnostic groups did not exhibit statistically significant differences in the volumes of the basolateral amygdala (left F (3,75) = 0.66, p >.05; right F (3,76) = 1.80, p >.05), the lateral nucleus (left F (3,75) = 1.22, p >.05; right F (3,76) = 2.30, p >.05)), or the whole amygdala (left F (3,75) = 0.48, p >.05; right F (3,76) = 1.58, p >.05). No quadratic associations were observed between surrogate parameters of disease progression and any of the examined amygdala volumes. There were no significant correlations between subregion volumes and clinical characteristics.

Conclusion

We found no evidence for the hypothesis of an inverted U-shaped volumetric trajectory of the basolateral amygdala in MDD. Future research with larger sample sizes, including the measurement of genetic and epigenetic markers, will hopefully further elucidate this compelling paradigm.
Case report: Recurrence of psychosis after the surgical resection and radiation of a temporal lobe astrocytoma
Authors: Perekopskiy David , Zoghi Shervin , Dobrick Jenna , Aboud Orwa , Bourgeois James Alan
Published: January 2025

It is estimated that the incidence of first episode psychotic disorder is about 33 people out of 100,000 each year. Beyond primary psychotic illness (e.g., schizophrenia, schizophreniform disorder), some of these patients will develop psychotic disorder due to a complex interplay of genetics, anatomical variations, traumatic brain injury (TBI), environment, substance use, and/or other causes. A small subset of patients will develop psychotic disorder due to a structural anatomic lesion, such as a CNS tumor. Here we present a 35-year-old male with worsening auditory hallucinations after surgical resection and radiation of a right temporal lobe astrocytoma in the setting of co-morbid methamphetamine usage. This case report helps illustrate how a neuroimaging work-up is important for the first incidence of psychotic disorder and how a tumor can produce a psychotic disorder that persists after oncologic treatment. This paper adds to the literature on the presentation and treatment of post-resection tumor-induced psychotic disorder.
Reduced prefrontal hemodynamic responses measured using near-infrared spectroscopy in adults with autism spectrum disorder
Authors: Kamikawa Kohei , Yamamuro Kazuhiko , Mizui Ryo , Kashida Natsuko , Ishida Rio , Okada Takashi , Iwata Nakao , Makinodan Manabu
Published: January 2025

Aim

Functional neuroimaging studies have suggested that prefrontal cortex dysfunction occurs in individuals with autism spectrum disorder (ASD). Near-infrared spectroscopy (NIRS) is a noninvasive optical tool used to investigate oxygenation and hemodynamic responses in the cerebral cortex by measuring changes in oxygenated hemoglobin. Previous studies using NIRS have suggested that male children with ASD exhibit reduced hemodynamic responses in the dorsolateral prefrontal cortex; however, only a few studies examined this response in adults with ASD.

Methods

We examined the characteristics of prefrontal hemodynamic responses in 114 adults with ASD and 84 typically developing controls. Relative concentrations of oxygenated hemoglobin were measured with frontal probes every 0.1 s during the Stroop color-word task, using 24-channel NIRS.

Results

Our findings demonstrated that the oxygenated hemoglobin changes in the ASD group were significantly smaller than those in the control group at channels 19, 20, 23, and 24- located over the orbitofrontal cortex and frontal pole (p <0.05 for all three channels). The differences in oxygenated hemoglobin changes at Ch 20 were significantly correlated with the Autism-Spectrum Quotient Japanese version (AQ-J) total score and attention switching score, which is a symptom cluster of AQ-J (p = 0.043 and p = 0.009, respectively).

Conclusion

Adults with ASD have reduced prefrontal hemodynamic responses as measured using near-infrared spectroscopy and the reduced activity of the frontal pole in particular is related to reduced attentional function.
“A quality of heart, of presence, and of really caring”: toward affirmative intersex health communication in Canada
Authors: Knoppers Terese , Voutsinas Angelica , Palmour Nicole , Saulnier Kaleb , Holmes Morgan , Charron Marilou , Gallois Hortense , Jamali Narges , Ordal Leslie , Joly Yann
Published: January 2025

Introduction

This qualitative research study aimed to better understand and help improve the Canadian context for health communication with intersex adults by centering the voices of those directly involved and impacted.

Methods

We conducted 22 semi-structured interviews with intersex individuals (14) and healthcare practitioners (HCPs, 8) from diverse areas of care. Interviews were analyzed via template thematic analysis and filtered through a conceptual lens that brought together agency-based and social-ecological models of health communication.

Results

Findings produced three interlocking axes for change: HCP skills and approaches, structural access to care, and norms and discourses. Participant accounts depict a landscape for intersex health communication where practices are improving, but adverse experiences are still commonplace and intersex individuals cannot assume HCPs will be competent in intersex care. Rather, they utilize a variety of strategies and expend considerable efforts navigating structural gaps and barriers to access affirmative HCPs, who themselves often gained their expertise via individual initiative. Interviewees advocated for HCPs to get a baseline background in intersex care during their medical training, as well as skills in accessible health communication and person-centered and trauma-informed approaches. They also connected broader societal stigma and pathologization to harmful medical practices and called for naturalization and normalization of intersex variations.

Conclusion

This study highlights the need for collaborative efforts across multiple sectors and by multiple stakeholders to drive meaningful change. Findings can help guide HCPs, medical educators, researchers, advocates, and policymakers towards accessible, affirmative, and agency-based care.
The impact of the COVID-19 pandemic on musculoskeletal disorders-related sick leave among healthcare workers: a retrospective analysis of Slovenian national data
Authors: Zerbo Šporin Dorjana , Kozinc Žiga , Prijon Ticijana , Metličar Tanja , Šarabon Nejc
Published: January 2025

Purpose

Musculoskeletal disorders (MSDs) are one of the main causes of health-related absenteeism. MSDs were a known problem among healthcare workers (HCWs) even before COVID-19. The pandemic, with its associated stresses and changes in working conditions, may have influenced the incidence and duration of MSDs-related sick leave (SL) among HCWs. The aim of this study was to compare the incidence and duration of MSDs-related SL among HCWs before and during the COVID-19 pandemic, with a focus on differences between age and gender groups.

Methods

A retrospective analysis was conducted using Slovenian national SL data on work-related MSDs within NACE Rev. 2 “Human health activities” for 2019, 2020, and 2021, categorized by gender and age.

Results

The study found that older HCWs, particularly women, consistently had a higher incidence of work-related MSDs SL than their younger counterparts. However, during the pandemic, MSDs were more common among younger men, while the average duration of SL was longer among younger women. On the other hand, in older HCWs, the average SL incidence decreased during the pandemic, while the SL duration substantially increased.

Conclusion

The dynamics of MSDs related SL among HCWs are complex and influenced by several factors, including the challenges posed by the COVID-19 pandemic. Healthcare managers should implement tailored strategies to address MSDs-related absenteeism among specific groups of HCWs to promote a healthier workforce and ensure a resilient healthcare system during health crises.
Association between exposure to environmental pollutants and increased oral health risks, a comprehensive review
Authors: Zhu Li , Tang Mengchen , Cai Yinyin , Wang Panpan
Published: January 2025

The burden of disease and death attributable to environmental pollution is a growing public health challenge worldwide, particularly in developing countries. While the adverse effects of environmental pollution on oral health have garnered increasing attention, a comprehensive and systematic assessment remains lacking. This article delves into the intricate relationship between environmental pollution and oral health, highlighting significant impacts on various aspects such as dental caries, periodontal diseases, oral facial clefts, cancer, as well as other oral diseases. Our results suggested that secondhand smoke, particulate matters (PM) and heavy metals are the most important risk factors affecting oral health. Additional contributors, such as radiation pollutants, electronic cigarette, phthalates, gaseous air pollutants, pesticides, solvents, wood dust, formaldehyde and excessive fluoride were investigated, though evidence for their impacts remains limited and often inconclusive. The review also explores potential mechanisms underlying these impacts, including microorganism, inflammation, oxidative stress, genetic influences, and toxicant exposures from heavy metals and other pollutants. For instance, PM2.5 may contribute to dental caries by disrupting oral pH balance and absorbing heavy metals such as lead and cadmium which have been considered as caries promoting elements. It is also associated with adverse inflammatory responses and tissue damage in periodontal tissues by causing oxidative stress, potentially leading to periodontitis. Drawing on current evidence, it provides a comprehensive analysis of these associations, offering critical insights to guide the development of preventive strategies and public health interventions. The findings highlight the pressing need for future research to validate the causal links between environmental pollution and oral diseases and to unravel the underlying biological mechanisms. Ultimately, greater attention must be directed toward addressing the relationship between environmental pollution and oral diseases, with a focus on pollution control and the reduction of preventable environmental risks to safeguard oral health on a broader scale.
LGBTQ+ status and sex of record in Veterans with post-traumatic stress disorder: demographics, comorbidities, and outpatient encounters
Authors: Workman Terri Elizabeth , Goulet Joseph L. , Brandt Cynthia A. , Skanderson Melissa , O’Leary John , Gordon Kirsha S. , Treitler-Zeng Qing
Published: January 2025

Objectives

This study aims to analyze differences between lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and non-LGBTQ+ Veterans with post-traumatic stress disorder (PTSD) in terms of demographics, comorbidities, and medical care usage, including differences by sex of record, including separate analyses for transgender and non-transgender Veterans.

Methods

Chi-square, t-test, ANOVA Welch one-way testing, and absolute standardized difference analyses were conducted on a cohort of 277,539 Veterans diagnosed with PTSD.

Results

The study found significant differences, particularly concerning positive LGBTQ+ status and sex of record. There were significant differences found in age, marital status, and medical care usage, as well as pain, mental health, and substance use disorder diagnoses. Differences in having experienced military sexual trauma, crime, or maltreatment were especially significant, with increased percentages among LGBTQ+ individuals, and sex of record females. In separate analyses, there were similar differences among transgender and non-transgender Veterans, with similar increased risks for sex of record females.

Conclusion

Our findings suggest an intersectionality of LGBTQ+ status and sex of record in the context of PTSD. These findings may help guide future research, policy, and interventions.
Negative effects of adverse childhood experiences and absence of positive childhood experiences on healthcare employees: survey findings built on 10 years of trauma-informed development
Authors: Williamson Laneita , Daniel Stephanie S. , Carter Jennifer , Ridenhour Adam , Pulgar Camila A. , Gay Yasmin , Debinski Beata
Published: January 2025

Introduction

Existing data on how history of trauma and adversity affects healthcare professionals is limited. This study sought to describe the prevalence of Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) and their association with present-day workplace and wellbeing outcomes among a sample of healthcare teammates overall, as well as specifically among nurses. The paper also describes local trauma-informed care initiatives that supported study feasibility.

Methods

Cross-sectional online survey data were collected in conjunction with promoting hospital-wide trauma-informed care training opportunities on two campuses that are part of an academic health system. Scales and items assessed independent variables PCEs and ACEs, and dependent variables including burnout, compassion fatigue, organizational belonging, adult resilience, access to support, and workplace violence (WPV). Demographic data were not collected to limit identifiability and encourage participation. Multivariable, hierarchical models regressed categorized total ACEs (ref 0, 1–3, 4–10) and total PCEs (ref 6–7, 3–5, 0–2) together on dichotomized dependent variables. Sub-analyses also adjusted for whether the participant was a nurse or reported serving in a different role.

Results

Participants included 349 clinical and non-clinical employees, of whom 61.1% had at least one reported ACE, but 24.9% reported 4–10 ACEs. 29.9% reported only having 3–5 PCEs in their childhood, while 23.2% reported 0–2 positive childhood experiences. Even when adjusting for ACEs, having 0–2 PCEs was associated with significantly reduced odds of getting needed emotional or social support (AOR = 0.14, 95% CI: 0.07, 0.29). Having 0–2 PCEs relative to 6–7 PCEs was also significantly associated with greater odds of past 2-week compassion fatigue, a lower resilience score, and decreased odds of reported organizational belonging measures. Adjusting for ACEs and PCEs, nurses reported lower resilience and higher workplace violence compared to all other participant roles combined.

Discussion

Teammate history of adversity was widespread and having fewer PCEs was associated with poorer adult workplace outcomes. These findings point to the value of a trauma-informed approach in healthcare, which offers healthcare organizations a framework for recognizing how trauma experiences affect wellbeing and intersect with the healthcare system, as well as how to create environments that are supportive of patients, staff, and providers.
DNA methylation, histone acetylation in the regulation of memory and its modulation during aging
Authors: Singh Padmanabh , Paramanik Vijay
Published: January 2025

Memory formation is associated with constant modifications of neuronal networks and synaptic plasticity gene expression in response to different environmental stimuli and experiences. Dysregulation of synaptic plasticity gene expression affects memory during aging and neurodegenerative diseases. Covalent modifications such as methylation on DNA and acetylation on histones regulate the transcription of synaptic plasticity genes. Changes in these epigenetic marks correlated with alteration of synaptic plasticity gene expression and memory formation during aging. These epigenetic modifications, in turn, are regulated by physiology and metabolism. Steroid hormone estrogen and metabolites such as S-adenosyl methionine and acetyl CoA directly impact DNA and histones’ methylation and acetylation levels. Thus, the decline of estrogen levels or imbalance of these metabolites affects gene expression and underlying brain functions. In the present review, we discussed the importance of DNA methylation and histone acetylation on chromatin modifications, regulation of synaptic plasticity gene expression and memory consolidation, and modulation of these epigenetic marks by epigenetic modifiers such as phytochemicals and vitamins. Further, understanding the molecular mechanisms that modulate these epigenetic modifications will help develop recovery approaches.
Co-designing a film showcasing the dental experiences of community returners (ex-offenders)
Authors: Booth Joelle , McMullen Heather , Rodriguez Andrea , Muirhead Vanessa
Published: January 2025

Background

The oral health of over 90,000 individuals in UK prisons is four times worse than the general population. A recent scoping review on the oral health of prisoners inside the justice system highlighted the lack of research about what happens when they transition out of prison to become community returners.

Objectives

To co-design a film to showcase the dental experiences of community returners before and after they transition out of prison, change perceptions and inform oral health research priorities.

Methods

This action research involved five community returners, recruited through third sector organisations, who attended virtual workshops. Participants in the first workshop designed the storyboard; community returners incorporated their own stories into fictional characters to portray their lived experiences. They developed the character stories and wrote the script in the second workshop. A community film production company produced the film and used professional actors who had contact with the justice system to depict the characters in the film.

Results

The final film, titled “My Story, My Words, My Mouth” explored themes such as self-care oral health behaviours, dental care provision in prison, access to healthcare, stigmatisation, disclosure and improving oral health to support societal reintegration. The film was screened at an open event for stakeholders and included a question-and-answer session and recorded videos where viewers shared their feedback to inform future research projects.

Conclusion

Co-design can be an empowering platform to hear the voices of community returners. Using the medium of film an oral health promotion tool can build understanding about the oral health needs of underrepresented groups. This egalitarian and power-sharing approach can also provoke critical discussion and actively involve underrepresented people in research that impacts their lives to develop strategies, to set priorities and improve their oral health.
Effects of clear aligners treatment in growing patients: a systematic review
Authors: D’Antò Vincenzo , De Simone Vittoria , Caruso Silvia , Bucci Paolo , Valletta Rosa , Rongo Roberto , Bucci Rosaria
Published: January 2025

Introduction

In recent years, the use of Clear aligners (CA) has been diffused among children and adolescents. This systematic review aimed to summarize the literature regarding the effects of CA therapy in growing patients, including dentoalveolar and skeletal effects, periodontal changes, and quality of life measurements.

Methods

An electronic search on four databases was performed until September 2023, and studies including patients <18 years, treated with CA were selected. Studies with less than 10 patients and in vitro/laboratory studies were excluded. Study selection, data extraction, and risk of bias assessment were independently performed by two reviewers. The “Risk of Bias 2” (RoB 2) and the “Risk of Bias in Non-randomized Studies of Interventions” (ROBINS-I) tools were applied to assess the methodological quality of the included studies. Due to the heterogeneity in methodologies and outcomes encountered in the included studies, a qualitative synthesis of the results was provided.

Results and conclusions

The search resulted in 32 papers (3 RCTs), with sample sizes ranging between 15 and 113. The overall risk of bias in the RCT was low, while the risk of bias in the non-RCT ranged between moderate and serious for most of the included studies. Dentoskeletal and periodontal effects were the most frequently reported outcomes. The most common comparison group was multibracket fixed therapy, while only 5 studies had an untreated control group. Significant changes in the transversal maxillary arch width after treatment with CA were reported in some studies. However, while dentoalveolar effects have been reported consistently, controversial findings were found regarding the changes in skeletal bases after treatment with CA. Concerning the results on the sagittal plane, the current literature does not support the effectiveness of CA with mandibular advancement features in correcting dentoskeletal Class II, compared to traditional functional orthopedic appliances. In the short-term evaluation, periodontal variables and bacterial levels seemed to be better controlled during CA therapy, compared to the fixed multibracket therapy. With regard to quality of life measurements, there are inconsistent findings to support differences between CA therapy and fixed multibracket appliances. Nevertheless, additional high-quality studies are required to formulate more reliable conclusions.

Systematic Review Registration

https://osf.io/wmerq.
The carbon footprint and energy consumption of liver transplantation
Authors: De Simone Paolo , Lai Quirino , Ducci Juri , Campani Daniela , Biancofiore Giandomenico
Published: January 2025

Background and aims

There is growing interest in the environmental impact of surgical procedures, yet more information is needed specifically regarding liver transplantation. This study aims to quantify the total greenhouse gas emissions, or carbon footprint, associated with adult whole-size liver transplantation from donors after brain death, including the relevant back-table graft preparation.

Methods

The carbon footprint was calculated retrospectively using a bottom-up approach. This approach sums the volumes of energy consumption (kWh), volatile anesthetics (ml), solid waste (kg), and units of blood products transfused for each transplant. These consumption values were converted using validated conversion factors to the equivalent mass of carbon dioxide released into the environment (kg CO2e).

Results

A total of 147 patients with a mean age of 55 years (male, 78.9%) who underwent liver transplants between 2021 and 2022 were analyzed, resulting in 45.5 tons CO2e. The mean (SD) carbon footprint for each procedure was 309.8 (33.2) kg CO2e [95% CI: 304.4; 315.3]. Total energy power consumption was 96.5 MW, contributing 65.4% of greenhouse emissions (29.8 tons CO2e), while volatile anesthetics, solid waste, and blood product transfusions contributed 8.0% (3.64 tons CO2e), 5.9% (2.7 tons CO2e), and 20.6% (9.4 tons CO2e), respectively. The duration of surgery (t = 29.0; p < 0.001), transfused red blood cells (t = 13.1; p < 0.001), fresh frozen plasma (t = 11.1; p < 0.001), platelets (t = 8.9; p < 0.001), and the use of an extracorporeal pump machine (t = 3.6; p < 0.001) had the greatest effects on greenhouse gas emissions.

Conclusions

Liver transplantation requires significant energy and is associated with considerable greenhouse gas emissions, particularly during longer procedures. Transplant clinicians, hospital administrators, policymakers, and patients should be aware of the environmental impact of liver transplantation and collaborate to adopt sustainable energy practices.
Ageing, clinical complexity, and exercise therapy: a multidimensional approach
Authors: Corrao Salvatore , Cerasola Dario , Lucini Daniela , Argano Christiano
Published: January 2025

Ageing is a multidimensional concept related to the progressive decline in physiological functions. The decrease of physical autonomy due to the ageing process leads to frailty, which in turn is associated with disability and comorbidity. Ageing represents the primary risk factor for chronic degenerative diseases, especially involving cardiovascular, metabolic, respiratory, and osteoarticular systems, determining the decrease in activities and quality of daily life. Regular physical activity can significantly reduce the risk of chronic degenerative diseases, moderate or severe functional limitations, and premature death in older adults. In light of the relationship between ageing, sedentary lifestyle, disability, comorbidity, and physical activity, a clear need emerges within the health system. Better control on the territory of pathologies related to ageing with the management of clinical and care complexity, multidimensional and multi-professional evaluation of the elderly complex and fragile patient, also through the definition of specific outpatient packages for pathology that allow the simplification of the evaluation process. There is a need for integration between local services, hospitals, and social assistance services. Aim of this review is to highlight the importance of the multidimensional approach is essential to be able to classify the complex elderly patient according to a multi-professional vision aimed at evaluating comorbidities and frailties, including sarcopenia, nutritional deficits, functional capacity, and planning a personalized and monitored motor training program, to improve motor, metabolic, cardiovascular and respiratory functions. In addition, developing an integrated hospital-community-care services management program to follow up with patients post-care is crucial.