bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding willingness and barriers to participate in clinical trials during pregnancy and lactation: findings from a US study
Authors: Jacobson Melanie H. , Yost Emily , Sylvester Shirley V. , Renz Cheryl , Wyszynski Diego F. , Davis Kourtney J.
Published: July 2024

Background

Due to the exclusion of pregnant and lactating people from most clinical trials, there is an incomplete understanding of the risks and benefits of medication use in these populations and therapeutic decision-making is often conducted without adequate evidence. To change this paradigm, it is imperative to understand the perspectives of pregnant and lactating individuals concerning their participation in clinical trials.

Objectives

To describe attitudes, perceptions, barriers, and preferences of pregnant and postpartum people in the United States (US) regarding participation in clinical trials and to identify factors influencing participation.

Methods

In November 2022, individuals aged ≥ 18 residing in the US who self-identified as pregnant or pregnant within the last 12 months were invited to complete an online survey about their perspectives regarding clinical trial participation. The survey included questions about demographic characteristics, health history, behaviors, and willingness to participate in clinical trials while pregnant and/or lactating. Multivariable logistic regression models were fit to identify predictors of clinical trial participation.

Results

Among the 654 respondents, 34.8% and 40.9% reported being likely or extremely likely to participate in a clinical trial for a new medication while pregnant or lactating, respectively; and 24.5% and 41.7% for a new vaccine while pregnant or lactating, respectively. Higher educational attainment (≥ Bachelor’s degree) was associated with greater likelihood of clinical trial participation in pregnancy (odds ratio (OR) = 1.50, 95% Confidence Interval (CI): 1.01, 2.25 for medications; OR = 2.00, 95% CI: 1.28, 3.12 for vaccines). Chronic medical conditions were associated with a greater likelihood of participation in clinical trials for vaccines during lactation (OR = 1.59, 95% CI: 1.07, 2.36). The most cited motivator for participation in a clinical trial while pregnant or lactating was anticipated personal medical benefit (85.8% and 75.6%, respectively), while the primary deterrent was possible risk to the fetus or baby (97.9% and 97.2%, respectively).

Conclusions

Willingness of a US sample to participate in clinical trials while pregnant or lactating varied by demographics and health status, with safety to the fetus being a nearly universal concern. These findings have implications for enhancing inclusion of pregnant and lactating people in clinical research and developing effective and equitable recruitment strategies.
Exploring the role of salon professionals in identifying sex trafficking and violence victims in Indiana
Authors: Hughes-Wegner Alexandra T. , DeMaria Andrea L. , Schwab-Reese Laura M. , Bolen Ashley , DeMark Meagan R. , Ucpinar Kayra , Seigfried-Spellar Kathryn C.
Published: July 2024

Background

Sex trafficking victims often have touchpoints with salons for waxing, styling, and other body modification services required by traffickers. Recently, some states have administered laws requiring salon professionals to receive intimate partner violence (IPV)-related training, with even fewer states mandating training on identifying sex trafficking. This study aimed to understand how salon professionals have witnessed evidence of violence, including IPV and sex trafficking, in the workplace and to explore the differences in their approach to each type of victim.

Methods

In-depth interviews were conducted with salon professionals (N = 10) and law enforcement professionals/policymakers (N = 5). Content and thematic analysis techniques were used.

Results

Salon professionals typically identified potential violence through signs such as bruises, odd behavior, and client disclosures, prompting them to engage in cautious conversations. Yet, few were trained to identify and intervene. Often, they responded to suspected violence by talking with the client, sharing concerns with salon leadership, directly intervening on the client’s behalf, or contacting the police. Law enforcement and salon professionals had suggestions about improving salon professionals’ recognition of and response to violence, including training on victim-focused resources, creating a safe environment, and building relationships with law enforcement. They also suggested strengthening community partnerships to increase resource advocacy and reporting.

Conclusions

One-on-one salon services may provide a unique opportunity to intervene and identify victims of violence, especially when empowered through additional training and collaborative partnerships with community-oriented policing initiates. Implementing training and community-based initiatives could aid salon professionals in gaining greater confidence in knowing what to do when serving a client who is a victim of IPV or sex trafficking.
MALAT1 predicts the prognosis of severe community-acquired pneumonia in pediatric patients
Authors: Yang Mei , Xuan Aili , Liu Qian , Zhu Guoji
Published: July 2024

Background

To evaluate the role of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in the prognosis of severe community-acquired pneumonia (CAP) in children.

Methods

According to the median MALAT1 value of 3.2 at baseline, 93 pediatric patients with severe CAP were divided into low (n = 46, median MALAT1 level = 1.9) or high (n = 47, median MALAT1 level = 4.5) MALAT1 groups. Another 93 age-, gender-, and body mass index (BMI)-matched healthy individuals were included in the control group using the propensity-score matching (PSM) method. A multivariate Cox proportional hazards model was used to explore the association of MALAT1 level with the 28-day mortality after controlling for potential confounding factors.

Results

The MALAT1 expressions were significantly higher in the patients with severe CAP compared with those in the healthy controls (3.2 vs. 0.9, P < 0.01). The receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) was 0.927 when the cut-off value of MALAT1 was 1.5. Moreover, the MALAT1 expressions were substantially lower in survivals than non-survivals (3.8 vs. 2.6, P < 0.01), and the multivariate Cox regression analysis indicated a positive association between MALAT1 levels and mortality risk (HR = 3.32; 95% CI: 1.05–10.47; P = 0.04).

Conclusion

MALAT1 might be a promising marker for predicting the prognosis of severe CAP in pediatric patients.
Acromioclavicular joint dislocation with loop double endobutton fixation assisted by orthopaedic surgery robot positioning system
Authors: Yang Chengzhi , Liu Gang , Lan Wanjie , Li Lu , Wang Renchong , Tang Jingli , Wu Hao , Hu Juzheng
Published: July 2024

Objective

Acute acromioclavicular (AC) joint dislocation is a common orthopedic injury that can significantly impair shoulder function and reduce quality of life. Effective treatment methods are essential to restore function and alleviate pain. To investigate the short-term clinical efficacy of the minimally invasive closed-loop double endobutton fixation assisted by orthopaedic surgery robot positioning system (TiRobot) in the treatment of AC joint dislocation, and to evaluate its feasibility and safety.

Methods

The clinical data of 19 patients with AC joint dislocation who underwent treatment with closed-loop double Endobutton fixation assisted by TiRobot between May 2020 and December 2022 were retrospectively analyzed. Visual Analog Scale (VAS) pain scores, the Constant Murley Score (CMS), and shoulder abduction range of motion were assessed and compared preoperatively and at the last follow-up. Computed tomography (CT) parameters of the acromioclavicular joint, including acromioclavicular distance (ACD), the distance between the upper and lower Endobutton (DED), the horizontal distance between the anterior edge of the distal clavicle and the anterior edge of the acromion (DACC), the diameter of the clavicular tunnel (DCT), and coracoid tunnel diameter (DC), were compared at 2 days, and 1 month after surgery, as well as at the last follow-up, along with the evaluation of intraoperative and postoperative complications.

Results

The postoperative VAS, CMS, and shoulder-abduction range of motion were significantly improved compared with the preoperative (all, P<0.05). The statistical analysis showed no significant difference in the CT image parameters of the acromioclavicular joint at 2 days and 1 month after surgery(all, P>0.05). Comparisons of DCT and DC revealed statistically significant differences between the last follow-up and 1 month after surgery (P<0.05), and no statistically significant difference was found in ACD, DED, and DACC(all, P>0.05). There were no complications such as infection or vascular or neurological damage, no cases of rostral or clavicle fractures, loss of reduction, heterotopic ossification, shoulder stiffness, and no loosening or breaking of internal fixations.

Conclusion

Closed-loop double endobutton internal fixation assisted by TiRobot is an ideal method for the treatment of acute acromioclavicular (AC) joint dislocation. This method has the advantages of relatively simple operation, more accurate localization of bone tunnel during operation, less surgical trauma, and good recovery of shoulder function.
Association between flavonoids intake and dental caries in children and adolescents: a cross-sectional study from the NHANES database
Authors: Fan Jianing , Liu Siqi , Zhang Qian , Qiao Li , Chu Qingsong
Published: July 2024

Background

Worldwide, dental caries is a bacterial biofilm-mediated condition with a high morbidity in children and adolescents. Flavonoids are a class of active natural products with antibacterial and anti-inflammatory effect. In vivo and in vitro studies have shown that they can promote tooth mineralization and reduce inflammation. However, the association of flavonoids intake and dental caries in children and adolescents remain unclear.

Aim

This study was to evaluated the association of flavonoid and its subclass intake and dental caries in children and adolescents.

Methods

Data of participants aged 2-17 years were extracted from the National Health and Nutrition Examination Survey (NHANES) database (2017-2018). Dental caries was measured via the decayed or filled surfaces in primary teeth or permanent teeth (dfs/DFS) index. The weighted univariable and multivariable logistic regression models were utilized to explore the association of flavonoids intake with dental caries in children and adolescents, with odds ratios (ORs) with 95% confidence intervals (CIs). Subgroups analyses based on age, and overweight/obesity were further assessed the association. Subgroup analysis were further performed to explore whether the association between subclasses of anthocyanidins and catechins with dental caries was robust stratified by age and individual with overweight/obesity.

Results

Among totally 1,818 children and adolescents, 786 (43.2%) had dental caries. High intake of anthocyanidins (OR=0.69, 95%CI: 0.52-0.92) and catechins (OR=0.64, 95%CI: 0.44-0.92) were associated with lower odds of dental caries. Similar results were discovered in individuals aged ≥6 years (anthocyanidins, OR=0.62, 95%CI: 0.43-0.90; catechins, OR=0.62, 95%CI: 0.40-0.96), and without overweight/obesity (anthocyanidins, OR=0.58, 95%CI: 0.37-0.90; catechins, OR=0.51, 95%CI: 0.31-0.84). Further investigation found that high intake of cyanidin, petunidin, malvidin, peonidin, (+)-Catechin, (-)-Epigallocatechin, and (-)-epicatechin were associated with lower odds of dental caries in children and adolescents.

Conclusion

High intake of anthocyanidins and catechins were associated with lower odds of dental caries in children and adolescents and are a promising intervention to be further explored in children and adolescents.
The development of a novel bidirectional fine-tuning mandibular advancement device
Authors: Lei Huijia , Wang Zijing , Yang Yang , Chen Mo
Published: July 2024

Objective

To develop a novel mandibular advancement device (MAD) with high comfort, good compliance, and bidirectional fine-tuning capability for patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and to evaluate the therapeutic efficacy of the new MAD.

Methods

The MAD, featuring upper and lower dental splints with a fine-tuning mechanism for mandibular adjustment, incorporates improved design elements such as partial dental coverage, shortened baffles, and memory resin lining. The novel MAD was used to treat 30 OSAHS patients in the study, comparing pre- and post-treatment scores on the Epworth Sleepiness Scale (ESS), the Apnea-Hypopnea Index (AHI), and the lowest oxygen saturation (LSO2).

Results

The novel MAD reduced size and side effects, enhancing comfort. All patients complied well, using it for an average of 95% over 30 days and ≥ 5 h nightly. After treatment, significant improvements were observed in ESS, AHI, and LSO2 (P < 0.05).

Conclusions

This novel bidirectional adjustable MAD provides high comfort and compliance, improving treatment precision. It is an effective choice for mild to moderate OSAHS patients and an alternative for those intolerant to CPAP or averse to surgery.
Influence of various fabrication techniques and porcelain firing on the accuracy of metal-ceramic crowns
Authors: Usta Kutlu İlknur , Hayran Yeliz
Published: July 2024

Background

The fit of a metal-ceramic restoration is essential to its long-term durability. Regarding marginal and internal fit, there is not enough information about the technologies used in the production of metal-ceramic restorations. The aim of this in vitro study is to compare, both before and after porcelain firing, the marginal, axial, axio-occlusal, and occlusal fit of metal-ceramic restorations manufactured using casting, additive or subtractive computer-aided design, and computer-aided manufacturing techniques (CAD/CAM).

Methods

CAD/CAM were used to create 50 prepared maxillary first molar-shaped Co-Cr die models, which were randomly divided into 5 groups (n = 10). Cobalt-chrome copings were produced by casting (C), hard metal milling (HM), soft metal milling (SM), selective laser melting (SLM), and selective laser sintering (SLS) techniques. Before and after porcelain firing, discrepancies of the copings were measured using the silicone replica technique. The data obtained by measurements with a stereomicroscope at x80 magnification were analyzed statistically in the SPSS program. The ROBUST three-way analysis of variance (ANOVA) method was used to compare the discrepancy values.

Results

There were statistically significant differences among fabrication methods (P < .001). The HM method showed the highest discrepancy (90.1 μm), and the C (63 μm) method showed the lowest discrepancy in terms of the die model- crown fit. The C, SLS, and SM methods (63 μm; 61.6 μm; 67.7 μm) were statistically similar (P > .001). The highest discrepancy was observed on the occlusal area (87.1 μm), and the lowest discrepancy was observed on the axial area (47.7 μm) of the coping. Porcelain firing had a decrease in the discrepancy values (P = .001).

Conclusion

All CAD/CAM techniques are appropriate for clinical use; selective laser sintering and soft milling can be the more recommended methods for the compatibility of metal-porcelain restorations, as they have lower discrepancy values than the SLM and HM methods.
How end-of-life care was limited during the first 18 months of the COVID-19 pandemic: a longitudinal survey study among healthcare providers (the CO-LIVE study)
Authors: Zee Masha S. , Pasman H. Roeline , Witkamp Erica , Goossensen Anne , Korfage Ida J. , Becqué Yvonne N. , Nierop-van Baalen Corine , van der Heide Agnes , Onwuteaka-Philipsen Bregje D.
Published: July 2024

Background

During the COVID-19 pandemic, the way in which end-of-life care was provided, underwent a lot of changes and therefor different domains of end-of-life care were impacted. The aim of this study is to describe whether health care providers considered end-of-life care (in medical, nursing, psychosocial and spiritual care) limited by the pandemic through the first 18 months of the COVID-19 pandemic, and examine associations with COVID-19 related circumstances of care (e.g. visit restrictions) and health care providers’ characteristics.

Methods

A longitudinal survey study among healthcare providers from different healthcare settings who provided end-of-life care during the pandemic’s first 18 months. Data of four time periods were analyzed using descriptive statistics and Generalized Estimating Equation.

Results

Of the respondents (n = 302) the majority had a nursing background (71.8%) and most worked in a hospital (30.3%). Especially in the first wave end-of-life care in all aspects was limited according to a substantial part of health care providers (between 29.7 and 57.7%). Psychosocial and spiritual care were more limited than medical and nursing care during all time periods. Care being limited according to health care providers was associated with visit restrictions, shortness of personal protective equipment or restrictions in caring for the deceased and decreased over time.

Conclusion

The COVID-19 pandemic impacted different aspects of end-of-life care throughout the pandemic’s first 18 months. Over the course of the pandemic health care providers seemed to have invented ways to adjust their work in order to minimize the effect of limiting measures. More involvement of health care providers in decision-making may improve the prioritization of measures to deal with crisis situations in care. These reflections highlight priorities during crises and the role healthcare providers could play in maintaining good end-of-life care. This remains relevant in new health crises, where care may differ from what is considered good quality of care.
Moringa oleifera flowers: insights into their aroma chemistry, anti-inflammatory, antioxidant, and enzyme inhibitory properties
Authors: Fahmy Nouran M. , Fayez Shaimaa , Mohamed Radwa Wahid , Elissawy Ahmed M. , Eldahshan Omayma A. , Zengin Gokhan , Singab Abdel Nasser B.
Published: July 2024

Background

Moringa oleifera is a highly nutritious plant widely used in traditional medicine.

Results

The aroma constituents present in the fresh flowers of M. oleifera versus the hydrodistilled oil and hexane extract were studied using GC-MS. Aldehydes were the major class detected in the fresh flowers (64.75%) with E-2-hexenal being the predominant component constituting > 50%. Alkane hydrocarbons, monoterpenes, and aldehydes constituted > 50% of the hydrodistilled oil, while alkane hydrocarbons exclusively constitute up to 65.48% of the hexane extract with heptacosane being the major component (46.2%). The cytotoxicity of the hexane extract was assessed on RAW 264.7 macrophages using the MTT assay which revealed no significant cytotoxicity at concentrations of 1 µg/mL and displayed IC50 value at 398.53 µg/mL as compared to celecoxib (anti-inflammatory drug) with IC50 value at 274.55 µg/ml. The hexane extract of Moringa flowers displayed good anti-inflammatory activity through suppression of NO, IL-6, and TNF-α in lipopolysaccharide-induced RAW 264.7 macrophages. The total phenolic and flavonoid content in the hexane extract was found to be 12.51 ± 0.28 mg GAE/g extract and 0.16 ± 0.01 mg RuE/g extract, respectively. It displayed moderate antioxidant activity as indicated by the in vitro DPPH, ABTS, CUPRAC, FRAP, and phosphomolybdenum (PBA) assays. No metal chelating properties were observed for the extract. The enzyme inhibitory potential of the hexane extract was evaluated on acetyl- and butyrylcholinesterases (for neuroprotective assessment), α-amylase and α-glucosidase (for antihyperglycemic assessment), and tyrosinase (for dermoprotective assessment) revealing promising results on cholinesterases, tyrosinase, and α-glucosidase.

Conclusion

Our findings suggested that M. oleifera leaves can be considered as a multidirectional ingredient for preparing functional applications.

Graphical abstract
The evaluation of health, disability and aged care-sector engagement with resources designed to support optimisation of the allied health assistant workforce: a qualitative study
Authors: Whelan Lucy , McLean Sharon , Edwards Alexandra , Huglin Jessica , Farlie Melanie K.
Published: July 2024

Background

Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. In an Australian context historically, AHAs have been sub-optimally utilised. Prior research has identified that AHAs and AHPs working in health, disability and aged care sectors, and the Vocational Education and Training (VET) industry, may benefit from access to resources to support the optimisation of the AHA workforce. As a part of a Victorian department of health funded project, several resources were developed in line with workforce recommendations for use in each of the above sectors. Recommendations and resources covered the broad areas of pre-employment training, workforce planning and governance, consumer-centred therapy and supports, recruitment and induction and workplace training and development. This study aimed to evaluate the engagement with these newly designed resources to support optimisation of AHAs in the Victorian context.

Methods

Semi-structured interviews were conducted to evaluate engagement with resources, from the perspective of AHAs, AHPs and allied health leaders (AHLs) in the health, aged care or disability sectors, and educators and managers of allied health assistance training. Thematic analysis was conducted using team-based framework analysis.

Results

Thematic framework analysis of the interview data identified four themes; Why participants accessed the resources; How participants engaged with the resources; What (if any) changes in practice occurred as a result of engaging with the resources in a participant’s local context, How did participants envision the resources being utilised for AHA workforce optimisation in the future. Responses were mapped to the AHA workforce career pathway at the career preparation, career development and career trajectory tiers.

Conclusions

Appetite for AHA workforce development and optimal utilisation is evident across Victoria, Australia. Readily accessible resources that inform AHA role and scope of practice, delegation practice, or improve the ability for an AHA to state their own development needs, were identified as useful by participants. The potential for these resources to assist in the optimal utilisation and development of AHA workforces across the career continuum differs according to the role, sector and geographical location of the resource user. Further study is needed to investigate the transferability of these resources to national and global contexts.
What could improve surgical data system at health facilities with high surgical volume in Ethiopia?
Authors: Godebo Melaku , Bete Dawit , Minass Seye , Liyew Tewodros , Gebreyesus Ftalew , Bryce Emily , Varallo John , Ashengo Tigistu
Published: July 2024

Background

The effective management of surgical and anesthesia care relies on quality data and its readily availability for both patient-centered decision-making and facility-level improvement efforts. Recognizing this critical need, the Strengthening Systems for Improved Surgical Outcomes (SSISO) project addressed surgical care data management and information use practices across 23 health facilities from October 2019 to September 2022. This study aimed to evaluate the effectiveness of SSISO interventions in enhancing practices related to surgical data capture, reporting, analysis, and visualization.

Methods

This study employed a mixed method, pre- post intervention evaluation design to assess changes in data management and utilization practices at intervention facilities. The intervention packages included capacity building trainings, monthly mentorship visits facilitated by a hub-and-spoke approach, provision of data capture tools, and reinforcement of performance review teams. Data collection occurred at baseline (February – April 2020) and endline (April – June 2022). The evaluation focused on the availability and appropriate use of data capture tools, as well as changes in performance review practices. Appropriate use of registers was defined as filling all the necessary data onto the registers, and this was verified by completeness of selected key data elements in the registers.

Results

The proportion of health facilities with Operation Room (OR) scheduling, referral, and surgical site infection registers significantly increased by 34.8%, 56.5% and 87%, respectively, at project endline compared to baseline. Availability of OR and Anesthesia registers remained high throughout the project, at 91.3% and 95.6%, respectively. Furthermore, the appropriate use of these registers improved, with statistically significant increases observed for OR scheduling registers (34.8% increase). Increases were also noted for OR register (9.5% increase) and anesthesia register (4.5% increase), although not statistically significant. Assessing the prior three months reports, the report submissions to the Ministry of Health/Regional Health Bureau (MOH/RHB) rose from 85 to 100%, reflecting complete reporting at endline period. Additionally, the proportion of surgical teams analyzing and displaying data for informed decision-making significantly increased from 30.4% at baseline to 60.8% at endline period.

Conclusion

The implemented interventions positively impacted surgical data management and utilization practice at intervention facilities. These positive changes were likely attributable to capacity building trainings and regular mentorship visits via hub-and-spoke approach. Hence, we recommend further investigation into the effectiveness of similar intervention packages in improving surgical data management, data analysis and visualization practices in low- and middle-income country settings.
Acceptability and feasibility of using a blended quality improvement strategy among health workers to monitor women engagement in Option B+ program in Lilongwe Malawi
Authors: Kumwenda Wiza , Bengtson Angela M. , Wallie Shaphil , Chikaonda Tarsizious , Matoga Mitch , Bula Agatha K. , Villiera Jimmy Ba , Kamanga Edith , Hosseinipour Mina C. , Mwapasa Victor
Published: July 2024

Option B + provides lifelong ART to pregnant and breastfeeding women with HIV to reduce mother-to-child transmission of HIV (eMTCT) and improve maternal health. The effectiveness of Option B + relies on continuous engagement, but suboptimal monitoring of HIV care hinders our measurements of engagement. Process mapping and quality improvement (PROMAQI) is a quality improvement strategy for healthcare workers (HCWs) to optimize complex processes such as monitoring HIV care. We assessed the acceptability and feasibility of the PROMAQI among HCWs and identified barriers and facilitators for PROMAQI implementation. A cross-sectional study using a mixed method approach was conducted from August 2021 to March 2022 across five urban health facilities participating in PROMAQI implementation n the Lilongwe district, Malawi. We assessed PROMAQI acceptability and feasibility at the end of the study. A 5-point Likert (1 = worst to 5 = best) scale tool was administered to 110 HCWs (n = 15–33 per facility) involved in PROMAQI implementationThese data were analysed using descriptive statistics Among the 110 HCWs, twenty-two (QI team (n = 11) and QI implementers (n = 11)) were purposively selected for in-depth interviews. Thematic analysis was conducted using deducted and inductive approaches. The theoretical framework for acceptability (TFA) was used to identify reasons for acceptability. The Consolidated Framework for Implementation Research (CFIR) was used to characterize the barriers and facilitators of PROMAQI implementation. HCWs recruited had a median age of 37 (32–43) years, 82.0% of whom were female. Most (42%) had completed secondary education, and 84% were nurses and community health workers. The median (IQR) acceptability and feasibility scores for the PROMAQI were 5 (IQR 4–5) and 4 (IQR 4–5), respectively. Reasons for high PROMAQI acceptability included addressing a relevant gap and improving performance. Perceived implementation barriers included poor work attitudes, time constraints, resource limitations, knowledge gaps, and workbook difficulties. The facilitators included communication, mentorship, training, and financial incentives. PROMAQI is a highly acceptable and feasible tool for monitoring engagement of women in Option B + . Addressing these barriers may optimize the implementation of PROMAQI. Scaling up PROMAQI may enhance retention in the Option B + program and facilitate eMTCT.
Late-onset sepsis in newborns caused by Bacillus Cereus: a case report and literature review
Authors: Zhang Wang , Ma Caihua , Hu Linghui , Wang Ling , Xu Falin
Published: July 2024

Bacillus cereus is a bacterium capable of causing late-onset neonatal sepsis. By analyzing 11 cases, this study investigates the diagnosis, treatment, and prognosis of Bacillus cereus infections, aiming to provide insights into clinical diagnosis and therapy. The study scrutinized 11 instances of late-onset neonatal sepsis, including two fatalities attributable to Bacillus cereus, one accompanied by cerebral hemorrhage. An examination and analysis of these cases’ symptoms, signs, laboratory tests, and treatment processes, along with a review of related literature from 2010 to 2020, revealed a high mortality rate of 41.38% in non-gastrointestinal infections caused by Bacillus cereus. Our findings underscore the critical importance of rapid diagnosis and effective antimicrobial therapy in reducing mortality rates. Once the source of infection is identified, implementing effective infection control measures is essential.
Surgical hip dislocation technique through the femoral head fovea fenestration and impaction bone grafting for the treatment of non-traumatic osteonecrosis of the femoral head: a retrospective study
Authors: Liang Dawei , Pei Jia , Zhang Xiaohui , Pei Ruoyan , Chen Xiantao
Published: July 2024

Background

Osteonecrosis of the femoral head (ONFH) often leads to the collapse of the femoral head, ultimately resulting in patients undergoing premature total hip arthroplasty (THA). The surgical hip dislocation (SHD) technique is a type of hip-preserving surgery aimed at delaying or avoiding THA. This study aims to evaluate the clinical efficacy of SHD techniques through femoral head fovea fenestration and impaction bone grafting for the treatment of non-traumatic ONFH.

Methods

A retrospective analysis was conducted on the clinical data of 39 patients (39 hips) with non-traumatic ONFH who underwent SHD for treatment from 2016 to 2017. The Harris hip score (HHS) and the minimum clinically important difference (MCID) are used to evaluate clinical outcomes, while radiographic evaluations are conducted using X-rays. Kaplan-Meier survival analysis defined clinical failure as further THA, and conducted univariate survival analysis and Cox regression analysis. Any complications were recorded.

Results

All patients were followed up for 24–72 months, with an average of (60 ± 13.0) months. At the last follow-up, based on the HHS, 25 patients (64.1%) reported excellent and good clinical outcomes. 29 patients (74.3%) achieved MCID. Imaging evaluation of the postoperative femoral head status showed that 6 cases improved, 20 cases remained stable, and 13 cases showed progressed. Out of 39 hips, 12 hips had postoperative clinical failure, resulting in a clinical success rate of 69.2%. Association Research Circulation Osseous (ARCO) stage, China-Japan Friendship Hospital (CJFH) classification, and postoperative crutch-bearing time are risk factors for clinical failure. Postoperative crutch-bearing time of less than 3 months is an independent risk factor for clinical failure. After surgery, there was one case of sciatic nerve injury and one case of heterotopic ossification. There were no infections or non-union of the greater trochanter osteotomy.

Conclusion

The SHD technique through the femoral head fovea fenestration and impaction bone grafting provides a safe and effective method for treating non-traumatic ONFH, with good mid-term clinical outcomes. ARCO staging, CJFH classification, and postoperative crutch-bearing time are risk factors that affect clinical outcomes after surgery and lead to further THA. Insufficient postoperative crutch-bearing time is an independent risk factor for clinical failure.
Ultrasound-guided procedures for plantar fasciitis: a randomized clinical study
Authors: Montes-Salas Rubén , Mahillo-Durán Ramón , Gómez-Carrión Álvaro , Gómez-Aguilar Estela , Fernández-Gibello Alejandro , Castillo-Lopez José Manuel
Published: July 2024

Background

Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis.

Methods

The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia.

Results

Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P < 0.001). Pain did not improve significantly after 120 days with ultrasound-guided corticosteroid injection, whereas significant pain reduction was observed with ultrasound-guided multipuncture.

Conclusion

Corticosteroid injection provides better short-term results in terms of VAS pain and FFI scores. However, ultrasound-guided multipuncture shows superior outcomes in VAS pain and FFI scores at 120 days.
Rehabilitation for spinal muscular atrophy patients in China: a national cross-sectional study
Authors: Wang Duan , Zhang Ting , Li Yi , Liu Jiayu , Jia Yongzhu , Xiao Nong
Published: July 2024

Background

The management of Spinal Muscular Atrophy (SMA) requires a multidisciplinary treatment approach, wherein rehabilitation constitutes an integral element. In this study, we examined the effects of rehabilitation among Chinese SMA patients and assessed the real-world efficacy of rehabilitation interventions.

Methods

We conducted a cross-sectional online survey on SMA patients from June 9, 2023, to June 30, 2023, through the Meier Advocacy & Support Center using data from the Center’s database and electronic questionnaires. The rehabilitation situation of the participants over the past 14 months were investigated. Logistic binary regression was used to analyze the relationship between Pediatric Quality of Life Inventory(PedsQL™) scores and rehabilitation.

Result

A total of 186 questionnaires were finally analyzed. Only 29 patients did not rehabilitated in the past 14 months. A significant correlation between age and type of rehabilitation, as well as between age and duration of rehabilitation. Patients receiving no rehabilitation or solely home-based rehabilitation exhibited a higher median age of 8.4 compared to those undergoing standard rehabilitation or a combination of standard and home-based rehabilitation, with a median age of 4.9 (z-score = -4.49, p-value < 0.001). In addition, long-term rehabilitation (OR = 0.314, 95%CI = 0.106–0.927, p = 0.04) were negatively correlated with lower PedsQL™ Neuromuscular Module scores, and PedsQL scores in the long-term rehabilitation group were higher than those in the short-term and no-rehabilitation groups (54.2 ± 15.1 vs. 45.9 ± 14.4 and 42.3 ± 14.3, p = 0.01), with the most significant difference observed in the physical function section (59.0 ± 15.8 vs. 46.8 ± 15.2 and 45.6 ± 15.9, p < 0.01). Mobility and exercise (OR = 0.26, 95%CI = 0.08–0.81, p = 0.02), as well as assistive technology (OR = 0.28, 95%CI = 0.10–0.82, p = 0.02), were independently associated with a lower score in a negative direction.

Conclusion

The study found that long-term rehabilitation was linked to higher PedsQL scores in SMA patients, highlighting the need for standardized rehabilitation programs to enhance function and quality of life.
Performance of standardized patient reported outcomes developed for spondyloarthritis in primary and concomitant forms of fibromyalgia
Authors: Tsiami Styliani , Dukatz Piet , Gkelaki Maria , Sewerin Philipp , Kiltz Uta , Baraliakos Xenofon
Published: July 2024

Background

In spondyloarthritides (SpA) and fibromyalgia (FM), patients suffer from generalized pain. The impact of FM on PRO validated in SpA has not been systematically studied.

Objective

Study the performance of PROs developed for SpA in patients with primary (p) FM without chronic inflammatory-rheumatic disease vs. SpA without and with concomitant (c) FM.

Methods

Patients with pFM, axSpA or PsA and indication for treatment adaptation were prospectively included. Standardized PROs were assessed: BASDAI, ASDAS-CRP, DAPSA, patient´s global assessment, BASFI, LEI, MASES, SPARCC Enthesitis Score and FIQ.

Results

300 patients were included (100/diagnosis). More males were found in axSpA vs. PsA and pFM group (67, 33 and 2/100, respectively), while 12 axSpA (axSpA+) and 16 PsA (PsA+) patients had cFM. pFM patients showed significantly higher scores in all assessments vs. axSpA or PsA, with exception of ASDAS-CRP (3.3 ± 0.6 in FM vs. 3.1 ± 1.0 in axSpA) and duration of low lumbar morning stiffness. Similar results were also found in the subanalysis of female patients only. In addition, patients with axSpA + or PsA + showed no differences to patients with pFM, while significantly higher scores were found for FM, axSpA + and PsA + for almost all FIQ items compared to axSpA- or PsA-.

Conclusions

PROs originally developed for axSpA or PsA need to be interpreted differently in the presence or absence of cFM. ASDAS-CRP and duration of lumbar morning stiffness were not affected by cFM. FM-specific questionnaires also showed high scores in patients with SpA with cFM but not in those without.
Association of caffeine intake with all-cause and cardiovascular mortality in diabetes and prediabetes
Authors: Yao Haipeng , Li Lamei , Wang Xiabo , Wang Zhongqun
Published: July 2024

Backgroud

The association between caffeine intake and mortality in prediabetes and diabetes is not well defined. This study was designed to investigate the association between caffeine intake and all-cause mortality and cardiovascular disease (CVD) mortality in adults with prediabetes and diabetes in the United States.

Methods

This analysis included 18,914 adult patients with diabetes and prediabetes from the National Health and Nutrition Examination Survey (NHANES) 2003–2018. Follow-up extended to December 31, 2019. Weighted Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality and CVD mortality.

Results

During 142,460 person-years of follow-up, there were 3,166 cases of all-cause mortality and 1,031 cases of CVD mortality recorded. In the fully adjusted models, caffeine intake showed a significant dose-response association with the risk of all-cause mortality and CVD mortality in individuals with diabetes and prediabetes. When comparing extreme quartiles of caffeine intake, the multivariable-adjusted hazard ratio for all-cause mortality was 0.78 (0.67–0.91) (P for trend = 0.007); however, there was no significant association with the risk of CVD mortality. Results remained consistent in stratified analyses by sex, age, race/ethnicity, education level, family income-poverty ratio, BMI, hypertension, smoking status, alcohol intake, and HEI-2015.

Conclusions

This study suggests that caffeine intake is significantly inversely associated with the risk of all-cause mortality in individuals with diabetes and prediabetes. In individuals with prediabetes, there is also a significant inverse association between caffeine intake and CVD events, but this association is not present in those with diabetes.

Graphical Abstract
Biochar & fly ash amendments lower mortality and increase antioxidant activity in chlorpyrifos-exposed earthworms
Authors: Kumari Tamanna , Phogat Deepak , Phogat Jatin , Shukla Vineeta
Published: July 2024

The investigation presented a novel finding regarding mitigating stress induced by chlorpyrifos in Eisenia fetida by incorporating biochar derived from rice straw and fly ash as soil amendments. It was observed that phenolic compounds exhibit solubility in methanol, and the methanolic fraction exhibited notable inhibitory effects on lipid peroxidation and displayed antioxidant properties. The defence mechanism of E. fetida, comprising catalase (CAT), peroxidase (POD), ascorbate peroxidase (APX), and various other enzymes, remained effective in neutralizing stressors without disruption when the earthworm was subjected to diverse chemical agents or stressful conditions. These enzymes served as indicative markers of toxicity induced by pesticide exposure, even at sublethal concentrations. The scavenging of free radicals by these enzymes ultimately safeguarded the organism. Fly ash and biochar emerged as two organic alternatives capable of alleviating stress by providing a protective mechanism. In this context, the study examined the impact of biochar and fly ash amendments on earthworm biomarkers. The mortality rate at the median lethal concentration of chlorpyrifos was reduced to less than 50% through 3% and 5% modifications. In contrast to the non-amendment group exposed to sublethal doses, the amendment group exhibited higher levels of oxidative stress and lower protein content. This observation indicated the presence of stress induced by the accumulation of free radicals, which increased in number with higher doses of chlorpyrifos. Moreover, the study highlighted the interconnected nature of total antioxidant capacity and total phenolic capacity values, with a decrease in these parameters signifying a shift in earthworm biomarkers.

Graphical abstract
Infusion and delivery strategies to maximize the efficacy of CAR-T cell immunotherapy for cancers
Authors: Gu Xinyu , Zhang Yalan , Zhou Weilin , Wang Fengling , Yan Feiyang , Gao Haozhan , Wang Wei
Published: July 2024

Chimeric antigen receptor (CAR) T-cell therapy has achieved substantial clinical outcomes for tumors, especially for hematological malignancies. However, extending the duration of remission, reduction of relapse for hematological malignancies and improvement of the anti-tumor efficacy for solid tumors are challenges for CAR-T cells immunotherapy. Besides the endeavors to enhance the functionality of CAR-T cell per se, optimization of the infusion and delivery strategies facilitates the breakthrough of the hurdles that limited the efficacy of this cancer immunotherapy. Here, we summarized the infusion and delivery strategies of CAR-T cell therapies under pre-clinical study, clinical trials and on-market status, through which the improvements of safety and efficacy for hematological and solid tumors were analyzed. Of note, novel infusion and delivery strategies, including local-regional infusion, biomaterials bearing the CAR-T cells and multiple infusion technique, overcome many limitations of CAR-T cell therapy. This review provides hints to determine infusion and delivery strategies of CAR-T cell cancer immunotherapy to maximize clinical benefits.
Genomic insights into renal diseases: advancements and implications
Authors: Aderinto Nicholas , Olatunji Gbolahan , Kokori Emmanuel , Ogieuhi Ikponmwosa Jude , Babalola Adetola Emmanuel , Ayodeji Komolafe Babajide , Bisola Muhammadul-Awwal Irodatullah , Oluwatomiwa Ajekiigbe Victor , Ishola Ibukunoluwa V.
Published: July 2024

Renal diseases pose significant challenges to global health. With conditions like chronic kidney disease (CKD) on the rise, there is an urgent need for deeper insights into their underlying mechanisms and risk factors to improve patient outcomes. Genomic research has emerged as a powerful tool in unraveling the complex genetic architecture of renal diseases, offering opportunities for personalized medicine, early diagnosis, and targeted therapies. This paper provides an overview of recent advancements in genomic research related to renal diseases and their implications for clinical practice. Through genomic analyses such as genomic-wide association studies (GWAS), whole exome sequencing (WES), and functional genomics, researchers have identified numerous genetic variants, metabolic pathways, and molecular mechanisms contributing to different kidney diseases. Furthermore, through functional genomic approaches and polygenic risk scores (PRS), studies have made significant strides in predicting disease risk and stratifying high-risk individuals for early intervention. The integration of genomic insights into clinical practice enables more accurate risk assessment and tailored treatment strategies, although challenges such as genetic heterogeneity and population-specific variations remain. The search for effective biomarkers in nephrology has gained momentum in recent years, driven by the limitations of traditional markers like serum creatinine and the need for more precise diagnostic and prognostic tools. Despite significant progress, challenges remain in translating these findings into clinical practice, including the need for cost-effective validation methods and the integration of genomic data into routine patient care.
Feeding behavioral problems among Egyptian children with autism spectrum disorder
Authors: Omara Alzahra Mohammed , Abu-Elenin Mira M. , Serag El Deen Shaima Mohamed , Orabi Ghada Tarek , Sidhom Rania Makram
Published: July 2024

Background

Eating problems are prevalent among children with autism spectrum disorder (ASD). The Brief Autism Mealtime Behaviors Inventory (BAMBI) has great potential for helping physicians quickly detect feeding issues in autistic children. This study aimed to evaluate feeding behavioral problems and their correlation to ASD severity among children with ASD using the BAMBI and Childhood Autism Rating Scale (CARS). This cross-sectional study enrolled 52 Egyptian children with an ASD. An Arabic version of BAMBI was administered to the parents of these children. Data about the participants’ sociodemographics as well as BAMBI and CARS were collected.

Results

Our main findings revealed that limited food variety features, such as preferring crunchy food or only sweet foods, were significant problems (57.7% and 52%). The means of the BAMBI and the CARS were 48.11 ± 12.2 and 39.9 ± 9.8, respectively. Living in rural areas, having limited income, elementary education of mothers, unemployed fathers, low birth weight, and neonatal care unit admission, were significantly associated with the BAMBI scale. Children with more severe ASD have a limited variety of behavior during eating than the minimal and moderate ASD groups (p = 0.01 and 0.03, respectively). A statistically positive correlation was observed between the BAMBI and CARS (r = 0.4 and p = 0.02).

Conclusions

Using the BAMBI scale, Egyptian children with more severe ASD were found to have limited food selectivity. The BAMBI scale was significantly correlated with the CARS, suggesting that the BAMBI may be an effective measure of the severity in autistic children.