bluuebunny/crossref_metadata_2025 huggingface dataset:
Powerlifting participation and engagement across all ages: A retrospective, longitudinal, population analysis with comparison to community strength norms
Authors: van den Hoek Daniel J , Mallard Alistair , Garrett Joel M , Beaumont Patrick L , Howells Robert J , Spathis Jemima G , Pearson Joshua , Latella Christopher
Published: April 2024

Background

In Australia, one-third of people ≥15 years perform regular resistance training and 90% of those do not meet current health guidelines. All age groups should engage in regular resistance exercise, to maintain strength and function.

Objectives

To identify trends in powerlifting competition participation in Australia by sex and age group from 1968 to 2022, and to compare the strength of powerlifting competitors to population age- and sex-based normative values.

Method

The number of unique participants and total competition entries for each year were analysed using Australian powerlifting competition data. Subdomains of age and sex were investigated, and mean ± SD, frequency, range, and trend analyses reported. United Nations age classifications were used to identify age trends. Comparisons to population strength norms were explored descriptively.

Results

We included 21,514 individual competitors from 1942 powerlifting competitions between 1968 and 2022. Exponential growth was seen in competition entries from 115 in 1981, to 759 in 1994, 1014 in 2011, and to 6803 in 2022, (R2 = 0.86). At first participation 18–25-year olds (51.1%) followed by ≥36 years (16%) were most represented. Strength comparison to available population norms demonstrates superior upper- (bench press [most competitors above 70th percentile) and lower-body (squat [majority rated ‘excellent’) strength.

Conclusions

Superior strength levels of powerlifters further the evidence base for this sport as an effective way to develop muscular strength, with low injury. We advocate for public health promotion and additional support for powerlifting as an underutilised community health tool.
Machine Learning-Based Prediction of Stroke in Emergency Departments
Authors: Abedi Vida , Misra Debdipto , Chaudhary Durgesh , Avula Venkatesh , Schirmer Clemens M. , Li Jiang , Zand Ramin
Published: April 2024

Background:

Stroke misdiagnosis, associated with poor outcomes, is estimated to occur in 9% of all stroke patients.

Objectives:

We hypothesized that machine learning (ML) could assist in the diagnosis of ischemic stroke in emergency departments (EDs).

Design:

The study was conducted and reported according to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis guidelines. We performed model development and prospective temporal validation, using data from pre- and post-COVID periods; we also performed a case study on a small cohort of previously misdiagnosed stroke patients.

Methods:

We used structured and unstructured electronic health records (EHRs) of 56,452 patient encounters from 13 hospitals in Pennsylvania, from September 2003 to January 2021. ML pipelines, including natural language processing, were created using pre-event clinical data and provider notes in the EDs.

Results:

Using pre-event information, our model’s area under the receiver operating characteristics curve (AUROC) ranged from 0.88 to 0.92 with a similar range accuracy (0.87–0.90). Using provider notes, we identified five models that reached a balanced performance in terms of AUROC, sensitivity, and specificity. Model AUROC ranged from 0.93 to 0.99. Model sensitivity and specificity reached 0.90 and 0.99, respectively. Four of the top five performing models were based on the post-COVID provider notes; however, no performance difference between models tested on pre- and post-COVID was observed.

Conclusion:

This study leveraged pre-event and at-encounter level EHR for stroke prediction. The results indicate that available clinical information can be used for building EHR-based stroke prediction models and ED stroke alert systems.
From informal to formal - A case study about the impact of distant learning on formative feedback in Danish schools
Authors: Bechsgaard Vickie Ravn , Marchetti Emanuela , Lundtofte Thomas Enemark
Published: April 2024

Even though Denmark is a highly digitized country, the COVID-19 pandemic has pushed schools to adopt extreme forms of distant learning, as everything should be conducted online through digital platforms. Our study aims at analysing the impact of distant learning practice on feedback practice, from the perspective of teachers and pupils. More specifically we focus on pupils in Danish mid-school, who are subject to a final exam to qualify for access to high school. We have conducted a netnographic inquiry, combining virtual observations and interviews with teachers and pupils. Our results show that the new distant learning practice prevented teachers to engage in non-formal assessment and feedback practice, such as spontaneous walks across the classrooms and dialogue with pupils on their difficulties, hence making it hard to keep an overview on their pupils’ progress. To compensate for the lack of non-formal feedback practices, distant learning has turned feedback practices into formal evaluations, leading the pupils to feel under pressure and less engaged in their learning. Our study provides an original perspective regarding specific aspects, such as feedback practices, which require forms of spontaneous dialogue between teachers and pupils and are central for learning, hence providing meaningful insights for the implementation of distant learning in mid school and the importance of a close dialogue between pupils and teachers.
Role of Media Consumption, Governmental Distrust & Psychological Vulnerability in Predicting Affective Well-being of University Students & Healthcare Professionals during COVID-19
Authors: Anjum Gulnaz , Aziz Mudassar
Published: April 2024

The present research aimed to explore the role of media consumption, governmental distrust, and psychological vulnerability in predicting the practical well-being of university students and healthcare professionals during COVID-19. Two correlational studies were conducted. Study 1 was conducted with 411 university students (206 Women; 205 men), and it was conducted during the first lockdown in Pakistan. Study 2 was conducted during the thigh-intensity phase he COVID-19, and the sample comprised 375 healthcare professionals (198 women; 177 men). Both studies showed that higher levels of media consumption, governmental distrust, and psychological vulnerability were associated with lower levels of well-being. Our path models in both studies (with students and healthcare professionals) indicate that during the pandemic, participants’ level of media consumption, trust in the government, and their personal vulnerability were negatively associated with their affective well-being. These findings have implications for individuals’ affective well-being during healthcare crises such as the COVID-19 pandemic.
Examining the Beachside Oasis: A Competitive Analysis and Market Share Case Study
Authors: Reaves Emily , Schoffstall Donald G.
Published: April 2024

The Beachside Oasis has a mix of positives and challenges in critical operational areas for investigation and examination. This case study, based on typical asset management, provides an opportunity to examine key financial indicators, competitive analysis, and operating market segments with comparative resources including comparable geographic market information, HOST report by STR, and created property income statement. Students are required to conduct a comprehensive analysis and provide detailed recommendations to the hotel’s ownership, which will include the creation of plans to simulate future business growth.
Patient-Reported Outcomes After Surgically Treated Anterior Horn Tears in the Pediatric Discoid Meniscus
Authors: Talathi Nakul , Bennett Abbie , Chiou Daniel , Beck Jennifer
Published: April 2024

Background:

As a subset of symptomatic discoid lateral meniscal (DLM) tears, anterior horn (AH) meniscal tears are not well studied in the pediatric population. There are even fewer studies reporting patient-reported outcomes after surgical treatment of AH tears in DLM.

Purpose:

To compare reported outcomes after surgical treatment of DLM tears involving the AH versus other locations in pediatric patients.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review of prospectively collected patient data between 2013 and 2020 was conducted. Patients aged <18 years who underwent arthroscopic treatment of a symptomatic DLM were included. Pathology was classified as tears of the AH or tears not involving the anterior horn (NAH). Demographic data along with patient-reported outcome scores (Pediatric International Knee Documentation Committee [Pedi-IKDC] and Patient Assessment Questionnaire [PAQ]) were collected preoperatively through 24 months of follow-up.

Results:

A total of 41 patients were included (median age, 12.9 years; range, 7-17 years; 32% female, 68% male). The mean follow-up time for was 25 months (range, 8-58 months). There were 17 (41%) patients in the AH group and 24 (59%) patients in the NAH group. Of the AH group, 16 (94%) were treated with meniscal repair (vs menisectomy), while 19 (79%) of the NAH group were treated with meniscal repair. All patients achieved significant pre- to postoperative improvement on both the Pedi-IKDC and the PAQ. At 24-month follow-up, there were no differences between the AH and NAH groups on the Pedi-IKDC (92.51 vs 89.72; P = .18) or the PAQ (2.57 vs 2.61; P = .06).

Conclusion:

Patients who underwent meniscal repair for AH DLM reported positive postoperative outcomes.
Evaluation of a Virtual Reality-Based Open Educational Resource Software
Authors: Würstle Silvia , Spanke Lisa-Marie , Mehlhase Niklas , Stanley Gail , Koff Jonathan , Dimitriadis Stavros , König Sarah , Hann Alexander
Published: April 2024

OBJECTIVES

Virtual reality (VR) teaching methods have potential to support medical students acquire increasing amounts of knowledge. EVENT (Easy VR EducatioN Tool) is an open educational resource software for immersive VR environments, which is designed for use without programming skills. In this work, EVENT was used in a medical student VR course on pancreatic cancer.

METHODS

Medical students were invited to participate in the course. Before and after VR simulation, participants completed a multiple-choice knowledge assessment, with a maximum score of 10, and a VR experience questionnaire. The primary endpoint compared pre- and post-VR simulation test scores. Secondary endpoints included usability and factors that could affect learning growth and test results.

RESULTS

Data from 117 of the 135 participating students was available for analysis. Student test scores improved by an average of 3.4 points (95% CI 3.1-3.7, P < 0.001) after VR course. The secondary endpoints of gender, age, prior knowledge regarding the medical subject, professional training completed in the medical field, video game play, three-dimensional imagination skills, or cyber-sickness had no major impact on test scores or final ranking (top or bottom 25%). The 27 students whose post-VR simulation test scores ranked in the top 25% had no prior experience with VR. The average System Usability Scale score was 86.1, which corresponds to an excellent outcome for user-friendliness. Questionnaire responses post-VR simulation show students (81.2% [95/117]) interest in more VR options in medical school.

CONCLUSIONS

We present a freely available software that allows for the development of VR teaching lessons without programming skills.
Extracurricular Entrepreneurship and Enterprise Education: What, How, Why, for Whom, and When?
Authors: Fauchald Ragnhild Nordeng
Published: April 2024

This study investigated what, how, why, for whom, and when extracurriculars add to entrepreneurship and enterprise education to examine the roles of extracurriculars in entrepreneurship and enterprise students’ education and learning processes. A systematic literature review method was chosen as it enables to identify characteristics of extracurricular entrepreneurship and enterprise education (EEE) through synthesis of validated studies of the phenomena. Findings indicate that EEE differs from formal EE owing to the influence of voluntariness and students’ engagement in the EEE. Students’ engagement in EEE and the motivation behind their engagement will be fundamental in the understanding of why, when, whom and how students engage and the outcome of engaging. The study contributes to the EE literature by addressing how the uniqueness of voluntarily participating in EEE influences learning situations, which distinguishes EEE from formal EE. Thus, the study has implications for research regarding how EEE and different EEE activities and initiatives need to further be explored to understand the potential of learning from participation in extracurricular entrepreneurship and enterprising education. The study provides implications for practice in regard of how EEE can be organized to foster learning.
Modification of Noordhoff Flap for Tubercle Reconstruction in Unilateral Cleft Lip Repair
Authors: Prince Joel M. , Poole Erin , El Amm Christian
Published: April 2024

Background: Tubercle aesthetics are under-emphasized in unilateral cleft lip repair. Teenagers and adults with repaired cleft lip often display a central whistle deformity medial to the cleft lip scar. Lateral segment vermillion elements that are often discarded at the time of the initial repair can be used for tubercle reconstruction. Methods: We obtained anthropometric measurements of the dry vermilion around the central tubercle in neonates with unilateral cleft lip to determine the extent and morphology of deficiencies. A modification of the Noordhoff vermillion flap is proposed with a trapezoidal configuration to precisely match the measured, dry vermillion deficiency. Results: Photographic documentation illustrates the surgical technique and results. Conclusions: Tubercle reconstruction is described using a modification of the Noordhoff flap. Four-year results are encouraging. Observations through maturity are needed.
Metajournalistic Discourse on TikTok
Authors: Al-Rawi Ahmed
Published: April 2024

In this study, a mixed method was used to understand metajournalistic discourse on TikTok. Using convenience sampling, 30 journalists active on TikTok were selected and all their available 3270 TikTok videos were manually content analyzed. To understand these videos, a codebook was designed in which 5 major categories were identified as follows: 1. Educational news production; 2. News sharing/live reporting; 3. Personal anecdotes & opinions; 4. Interactions with audience; and 5. Dancing & challenges. In general, metajournalistic discourse on TikTok revolve around employing educational tips, entertainment, creativity, and music to engage and interact with wider audiences. To complement the study and gain a deeper understanding of journalism practice on TikTok, 17 journalists active on TikTok were interviewed mostly by email. Using thematic analysis, four major themes emerged from the interviews including personalized content, effective algorithms, audience outreach, and TikTok as a newsroom.
Cambodia's Imminent Graduation from Least Developed Country Status: What Will be the Impact of the TRIPS Agreement on Access to HIV and Hepatitis C Medicines in Cambodia?
Authors: Tenni Brigitte , Lexchin Joel , Phin Sovath , Gleeson Deborah
Published: April 2024

Cambodia has experienced exponential economic growth in recent years and is expected to graduate from least developed country (LDC) status within the next decade. Membership of the World Trade Organization (WTO) will require Cambodia to grant product and process patents for pharmaceuticals upon LDC graduation. This study aims to measure the impact of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) on the price of HIV and hepatitis C medicine in Cambodia once it graduates from LDC status and is obliged to make patents available for pharmaceutical products and processes. Using scenarios based on likely outcomes of accession to the TRIPS Agreement, it measures the impact on the price of the HIV treatment program and compares that impact with the hepatitis C treatment program. Graduation from LDC status would be expected to result in a modest increase in the cost of the antiretroviral (ARV) treatment program and very large increases in the cost of the direct acting antivirals (DAA) treatment program. If annual treatment budgets remain constant, patent protection could see 1,515 fewer people living with HIV able to access ARV treatment and 2,577 fewer people able to access DAA treatment (a drop in treatment coverage of 93%).
Unveiling the therapeutic potential of Dl-3-n-butylphthalide in NTG-induced migraine mouse: activating the Nrf2 pathway to alleviate oxidative stress and neuroinflammation
Authors: Liu Yingyuan , Gong Zihua , Zhai Deqi , Yang Chunxiao , Lu Guangshuang , Wang Shuqing , Xiao Shaobo , Li Chenhao , Chen Ludan , Lin Xiaoxue , Zhang Shuhua , Yu Shengyuan , Dong Zhao
Published: April 2024

Background

Migraine stands as a prevalent primary headache disorder, with prior research highlighting the significant involvement of oxidative stress and inflammatory pathways in its pathogenesis and chronicity. Existing evidence indicates the capacity of Dl-3-n-butylphthalide (NBP) to mitigate oxidative stress and inflammation, thereby conferring neuroprotective benefits in many central nervous system diseases. However, the specific therapeutic implications of NBP in the context of migraine remain to be elucidated.

Methods

We established a C57BL/6 mouse model of chronic migraine (CM) using recurrent intraperitoneal injections of nitroglycerin (NTG, 10 mg/kg), and prophylactic treatment was simulated by administering NBP (30 mg/kg, 60 mg/kg, 120 mg/kg) by gavage prior to each NTG injection. Mechanical threshold was assessed using von Frey fibers, and photophobia and anxious behaviours were assessed using a light/dark box and elevated plus maze. Expression of c-Fos, calcitonin gene-related peptide (CGRP), Nucleus factor erythroid 2-related factor 2 (Nrf2) and related pathway proteins in the spinal trigeminal nucleus caudalis (SP5C) were detected by Western blotting (WB) or immunofluorescence (IF). The expression of IL-1β, IL-6, TNF-α, Superoxide dismutase (SOD) and malondialdehyde (MDA) in SP5C and CGRP in plasma were detected by ELISA. A reactive oxygen species (ROS) probe was used to detect the expression of ROS in the SP5C.

Results

At the end of the modelling period, chronic migraine mice showed significantly reduced mechanical nociceptive thresholds, as well as photophobic and anxious behaviours. Pretreatment with NBP attenuated nociceptive sensitization, photophobia, and anxiety in the model mice, reduced expression levels of c-Fos and CGRP in the SP5C and activated Nrf2 and its downstream proteins HO-1 and NQO-1. By measuring the associated cytokines, we also found that NBP reduced levels of oxidative stress and inflammation. Most importantly, the therapeutic effect of NBP was significantly reduced after the administration of ML385 to inhibit Nrf2.

Conclusions

Our data suggest that NBP may alleviate migraine by activating the Nrf2 pathway to reduce oxidative stress and inflammation in migraine mouse models, confirming that it may be a potential drug for the treatment of migraine.

Graphical Abstract
The prevalence and demographic associations of headache in the adult population of Peru: a national cross-sectional population-based study
Authors: Quispe Guiovanna , Loza Cesar , Limaco Luis , Gallegos Ruth , Palomino Carlos , Cruz Ivett , Miranda Jacqueline , Rodriguez Liliana , Husøy Andreas , Steiner Timothy J
Published: April 2024

Background

The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains.

Methods

The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18–65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question (“Have you had headache in the last year?”) was followed by diagnostic questions based on ICHD-3 and demographic enquiry.

Results

The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5–66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8–41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8–1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1–3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m).

Conclusion

The Global Campaign’s first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.
Evaluation of elevated serum apelin-13 and D-dimer concentrations in individuals diagnosed with pulmonary embolism
Authors: Mehrban Alireza , Hajikolaei Fatemeh Ahmadi , Karimi Mehdi , Khademi Reza , Ansari Akram , Qujeq Durdi , Hajian-Tilaki Karimollah , Monadi Mahmood
Published: April 2024

Background

Given the limited specificity of D-dimer, there is a perceived need to discover a more precise marker for diagnosing individuals who are suspected of having pulmonary embolism (PE). In this study, by evaluating the increase in the serum level of Apelin-13 and D-dimer, we found valuable findings about Apelin-13, which can be suggested as an auxiliary and non-invasive diagnostic biomarker in individuals with suspected PE, based on the obtained results.

Methods

In this case-control study, 52 Iranian individuals were included, all of whom were suspected to have PE. These individuals were then divided into two groups based on the results of CT angiography, which is considered the gold standard imaging method for diagnosing PE. The two groups were patients with PE and patients without PE. Finally, the levels of certain markers in the serum were compared between the two groups.

Results

The mean serum D-dimer levels in patients with PE were significantly elevated (p < 0.001) in comparison to those without PE (1102.47 to 456.2 ng/ml). Furthermore, the mean level of Apelin-13 was significantly higher in patients with PE (49.8 to 73.11 ng/L) (p < 0.001). The cutoff point of Apelin-13 has been calculated at 58.50 ng/ml, with 90.9% sensitivity and 90% specificity. The D-dimer cutoff point was 500 ng/ml, with 95.5% sensitivity and 43.3% specificity.

Conclusions

Based on the results of this study, the serum level of Apelin-13 can be used as a novel diagnostic and screening biomarker in patients with pulmonary thromboembolism.
Hypobaric hypoxia exposure regulates tissue distribution of nanomedicine for enhanced cancer therapy
Authors: Tao Ye , Chen Zhongping
Published: April 2024

Background

Effective drug delivery of nanomedicines to targeted sites remains challenging. Given that hypobaric hypoxia and hyperbaric oxygen exposure can significantly change pharmacokinetics of drugs, it is interesting to determine whether they can regulate tissue distribution of nanomedicine, especially in tumor, for enhanced cancer therapy.

Results

Hypobaric hypoxia exposure improved the pharmacokinetics of paclitaxel-loaded liposomes and facilitated their distribution in the heart and liver, whereas hyperbaric oxygen exposure did not benefit and even impaired the pharmacokinetics and distribution. Particularly, both hypobaric hypoxia and hyperbaric oxygen exposure could not improve the distribution in subcutaneous tumor. Thus, we constructed orthotopic liver tumor model and discussed whether high distribution of the liposomal nanomedicine in the liver, facilitated by hypobaric hypoxia exposure, could ensure their effective accumulation in liver tumor for enhanced cancer therapy.

Conclusions

The liposomal nanomedicine with adjuvant hypobaric hypoxia exposure significantly inhibited the growth of orthotopic liver tumor for prolonged survival time, achieved by hypobaric hypoxia-promoted accumulation at tumor sites of the liver. It might be the first example of the application of adjuvant intermittent hypobaric hypoxia exposure in treating liver cancer.
CAT-DTI: cross-attention and Transformer network with domain adaptation for drug-target interaction prediction
Authors: Zeng Xiaoting , Chen Weilin , Lei Baiying
Published: April 2024

Accurate and efficient prediction of drug-target interaction (DTI) is critical to advance drug development and reduce the cost of drug discovery. Recently, the employment of deep learning methods has enhanced DTI prediction precision and efficacy, but it still encounters several challenges. The first challenge lies in the efficient learning of drug and protein feature representations alongside their interaction features to enhance DTI prediction. Another important challenge is to improve the generalization capability of the DTI model within real-world scenarios. To address these challenges, we propose CAT-DTI, a model based on cross-attention and Transformer, possessing domain adaptation capability. CAT-DTI effectively captures the drug-target interactions while adapting to out-of-distribution data. Specifically, we use a convolution neural network combined with a Transformer to encode the distance relationship between amino acids within protein sequences and employ a cross-attention module to capture the drug-target interaction features. Generalization to new DTI prediction scenarios is achieved by leveraging a conditional domain adversarial network, aligning DTI representations under diverse distributions. Experimental results within in-domain and cross-domain scenarios demonstrate that CAT-DTI model overall improves DTI prediction performance compared with previous methods.
Enhancing knowledge, attitude, and perceptions towards fall prevention among older adults: a pharmacist-led intervention in a primary healthcare clinic, Gemas, Malaysia
Authors: Manirajan Priya , Sivanandy Palanisamy , Ingle Pravinkumar Vishwanath
Published: April 2024

Background

Falls and fall-related injuries are very common among older adults, and the risk of falls increases with the aging process. The lack of awareness of falls and fall-related injuries among older adults can contribute to an increasing risk of falls. Hence, a study was carried out to improve the knowledge, attitude, and perception of falls and fractures among older adults in a primary care setting in Gemas, a rural area of the Selangor state of Malaysia.

Method

A structured educational intervention was provided to older adults who visited the primary care setting in Gemas and provided written informed consent to participate in the study. A total of 310 older adult patients was included in the study using a convenience sampling technique.

Results

Before the intervention, 74.84% of the respondents (n = 232) agreed that falls and related fractures are the leading causes of hospital admission among older adults. In post-intervention, the number of respondents who agreed with this statement increased to 257 (82.91%). At baseline, 28 respondents (9.03%) had poor knowledge, 160 respondents (51.61%) had average knowledge levels, and 122 respondents (39.35%) had good knowledge. In post-intervention, respondents with poor and average knowledge reduced to 1.93% (n = 6) and 29.35% (n = 91) respectively. A majority of respondents’ knowledge levels improved significantly after the intervention (n = 213; 68.71%). About eight respondents (2.58%) had a negative perception of falls. In post-intervention, the percentage reduced to 0.65% as only two respondents had a negative perception. A total of 32 types of fall-risk-increasing drugs (FRIDs) have been prescribed to the respondents. A strong correlation (r = 0.89) between pre- and post-intervention knowledge was shown among the respondents. Paired t-test analysis showed a statistically significant difference.

Conclusion

The pharmacist-led educational intervention significantly improved the knowledge, attitude, and perception of falls among older adults. More structured and periodical intervention programmes are warranted to reduce the risk of falls and fractures among older adults.
Antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods in selected towns of Ethiopia
Authors: Moges Mathewos , Rodland Ernst Kristian , Legesse Tesfaye , Argaw Ambelu
Published: April 2024

Background

Street foods are any foods or drinks prepared or sold by street vendors in an open space. The purpose of this study was to determine the Bacteriological safety and antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods.

Method

A laboratory-based cross-sectional study was used from December 2022 to February 2023 on street foods of Addis Ababa, Hawassa, Dire Dawa, and Jimma towns of Ethiopia. 525 street foods and 175 water samples were taken from 175 street food vending stalls. Proportional allocation to the total town population and stratified sampling techniques were used to select vending stalls. Samples were analyzed for the presence of bacteria following the standard microbiological methods used for the isolation, enumeration, and identification of bacteria. Pour plate technique was used to transfer the suspension to MacConkey agar, Mannitol Salt Agar, and Salmonella Shigella Agar. The antibiotic susceptibility test was performed using the Kirby-Bauer disk diffusion method. SPSS software was used to analyze the data.

Result

Out of 525 food samples, 279 (53%) were contaminated by bacteria. From 175 water samples, 95 (54.3%) were contaminated with Escherichia coli. From both samples in total, eleven bacterial species were isolated. Staphylococcus aureus was the most frequently isolated species. Shigella, Klebsiella, and Salmonella group A have statistically significant with the type of food. Erythromycin (54%), Streptomycin (17%), and Amoxicillin (14%) were the most resistant antibiotics. Least resistance was observed to Ciprofloxacin (5%).

Conclusion

Street foods of the selected towns were highly contaminated with various antibiotic-resistant organisms. Hence, the relevant authorities ought to ensure the proper handling of street food by enforcing safety measures. Additionally, they should initiate a widespread awareness campaign promoting the prudent use of antibiotics among both street food vendors and the broader population.
Neonatal outcomes in the surgical management of placenta accreta spectrum disorders: a retrospective single-center observational study from 468 Vietnamese pregnancies beyond 28 weeks of gestation
Authors: Nguyen Phuc Nhon , Vuong Anh Dinh Bao , Pham Xuan Trang Thi
Published: April 2024

Background

Placenta accreta spectrum disorders (PASDs) increase the mortality rate for mothers and newborns over a decade. Thus, the purpose of the study is to evaluate the neonatal outcomes in emergency cesarean section (CS) and planned surgery as well as in Cesarean hysterectomy and the modified one-step conservative uterine surgery (MOSCUS). The secondary aim is to reveal the factors relating to poor neonatal outcomes.

Methods

This was a single-center retrospective study conducted between 2019 and 2020 at Tu Du Hospital, in the southern region of Vietnam. A total of 497 pregnant women involved in PASDs beyond 28 weeks of gestation were enrolled. The clinical outcomes concerning gestational age, birth weight, APGAR score, neonatal intervention, neonatal intensive care unit (NICU) admission, and NICU length of stay (LOS) were compared between emergency and planned surgery, between the Cesarean hysterectomy and the MOSCUS. The univariate and multivariable logistic regression were used to assess the adverse neonatal outcomes.

Results

Among 468 intraoperatively diagnosed PASD cases who underwent CS under general anesthesia, neonatal outcomes in the emergency CS (n = 65) were significantly poorer than in planned delivery (n = 403). Emergency CS increased the odds ratio (OR) for earlier gestational age, lower birthweight, lower APGAR score at 5 min, higher rate of neonatal intervention, NICU admission, and longer NICU LOS ≥ 7 days with OR, 95% confidence interval (CI) were 10.743 (5.675–20.338), 3.823 (2.197–6.651), 5.215 (2.277–11.942), 2.256 (1.318–3.861), 2.177 (1.262–3.756), 3.613 (2.052–6.363), and 2.298 (1.140–4.630), respectively, p < 0.05. Conversely, there was no statistically significant difference between the neonatal outcomes in Cesarean hysterectomy (n = 79) and the MOSCUS method (n = 217). Using the multivariable logistic regression, factors independently associated with the 5-min-APGAR score of less than 7 points were time duration from the skin incision to fetal delivery (min) and gestational age (week). One minute-decreased time duration from skin incision to fetal delivery contributed to reduce the risk of adverse neonatal outcome by 2.2% with adjusted OR, 95% CI: 0.978 (0.962–0.993), p = 0.006. Meanwhile, one week-decreased gestational age increased approximately two fold odds of the adverse neonatal outcome with adjusted OR, 95% CI: 1.983 (1.600–2.456), p < 0.0001.

Conclusions

Among pregnancies with PASDs, the neonatal outcomes are worse in the emergency group compared to planned group of cesarean section. Additionally, the neonatal comorbidities in the conservative surgery using the MOSCUS method are similar to Cesarean hysterectomy. Time duration from the skin incision to fetal delivery and gestational age may be considered in PASD surgery. Further data is required to strengthen these findings.
Closed head injury combined with orbital blowout fracture and displacement of the eyeball into the maxillary sinus in a 14-year-old boy: a case report
Authors: Fu Yue , He Ying , Xie Huixuan , Sun Kongliang , Dai Hanjun
Published: April 2024

Background

Trauma-induced orbital blowout fracture (OBF) with eyeball displacement into the maxillary sinus is rare.

Case presentation

We present the case of a 14-year-old with a closed head injury, OBF, and displacement of the eyeball into the maxillary sinus following a car accident. A prompt transconjunctival access surgery was performed for eyeball repositioning and orbital reconstruction in a single session, mitigating anaesthesia-related risks associated with multiple surgeries. At the 12-month follow-up, his visual acuity was 20/200. Despite limited eye movement and optic nerve atrophy, overall satisfaction with the ocular appearance was achieved.

Conclusions

This report offers novel insights into the mechanisms of OBF occurrence and the development of postoperative complications.
Contents analysis of thyroid cancer-related information uploaded to YouTube by physicians in Korea: endorsing thyroid cancer screening, potentially leading to overdiagnosis
Authors: Kang EunKyo , Ju HyoRim , Kim Soojeong , Choi Juyoung
Published: April 2024

Background

Thyroid cancer overdiagnosis is a major public health issue in South Korea, which has the highest incidence rate. The accessibility of information through the Internet, particularly on YouTube, could potentially impact excessive screening. This study aimed to analyze the content of thyroid cancer-related YouTube videos, particularly those from 2016 onwards, to evaluate the potential spread of misinformation.

Methods

A total of 326 videos for analysis were collected using a video search protocol with the keyword “thyroid cancer” on YouTube. This study classified the selected YouTube videos as either provided by medical professionals or not and used topic clustering with LDA (latent dirichlet allocation), sentiment analysis with KoBERT (Korean bidirectional encoder representations from transformers), and reliability evaluation to analyze the content. The proportion of mentions of poor prognosis for thyroid cancer and the categorization of advertising content was also analyzed.

Results

Videos by medical professionals were categorized into 7 topics, with “Thyroid cancer is not a ‘Good cancer’” being the most common. The number of videos opposing excessive thyroid cancer screening decreased gradually yearly. Videos advocating screening received more favorable comments from viewers than videos opposing excessive thyroid cancer screening. Patient experience videos were categorized into 6 topics, with the “Treatment process and after-treatment” being the most common.

Conclusion

This study found that a significant proportion of videos uploaded by medical professionals on thyroid cancer endorse the practice, potentially leading to excessive treatments. The study highlights the need for medical professionals to provide high-quality and unbiased information on social media platforms to prevent the spread of medical misinformation and the need for criteria to judge the content and quality of online health information.
Hidden risk factors and the mediating role of sleep in work-related musculoskeletal discomforts
Authors: Darvishi Ebrahim , Osmani Hiva , Aghaei Abbas , Moloud Emran Ali
Published: April 2024

Objective

Musculoskeletal discomforts (MSDs) are prevalent occupational health issues that are associated with a wide range of risk factors. This study aimed to investigate some of the occupational hidden risk factors and the mediating role of sleep in work-related musculoskeletal discomforts.

Methods

In a cross-sectional study, the role of job stress and shift work as two hidden risk factors and sleep problems as the mediator in work-related musculoskeletal discomforts was investigated in 302 healthcare workers using the path analysis models. For this aim, healthcare workers’ Occupational Stress and musculoskeletal discomforts were evaluated using the Health and Safety Executive questionnaire and Cornell questionnaire, respectively. Moreover, the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) were used to examine the sleep characteristics of participants. Shift work and job stress as predictor variables and sleep characteristics as mediating variables were analyzed.

Results

The results showed that the path coefficients of job stress on indexes of quality sleep and insomnia severity were significant. Also, the path coefficient of shift work on quality sleep index was significant. In return, the path coefficients of shift work on the insomnia severity index were not significant. Additionally, there was a mutually significant association between indexes of quality sleep and the severity of insomnia and musculoskeletal discomforts. The direct effect coefficient of job stress on MSDs was significant, whereas the direct effect coefficient of shift work on MSDs was insignificant. This means that shift work alone does not significantly impact these disorders.

Conclusion

It would seem that shift work and job stress as two occupational hidden risk factors can mediate sleep indexes and indirectly play a critical role in the incidence of musculoskeletal discomforts. Moreover, sleep disorders and musculoskeletal discomforts are mutually related and have a bidirectional relationship.
Abdominal obesity as assessed by anthropometric measures associates with urinary incontinence in females: findings from the National Health and Nutrition Examination Survey 2005–2018
Authors: Long Ting , Cheng Bohuai , Zhang Ke
Published: April 2024

Background

Urinary incontinence (UI) is significantly link to abdominal obesity. This study aimed to assess the association between anthropometric indices of abdominal obesity, including body roundness index (BRI), conicity index (CI), and waist-to-height ratio (WHtR), and UI risk in adult females.

Methods

We analyzed data from 10, 317 adult females in the National Health and Nutrition Examination Survey (NHANES) database (2005–2018). Weighted multivariable-adjusted regression analysis was conducted to determine the odds ratio (OR) and 95% confidence intervals (CI) for the association between BRI, CI, WHtR, and UI. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) analyses were used to assess the predictive value of UI.

Results

All indices of abdominal obesity investigated were positively and independently associated with the prevalence and severity of three types of UI. After adjusting for all relevant confounding variables, a significantly positive association between BRI and the prevalence of UI were observed (OR quartile 4 vs. quartile 1: urge UI (UUI): 1.93, 95% CI 1.61–2.30; stress UI (SUI): 2.29, 95% CI 1.94–2.70; mixed UI (MUI): 2.26, 95% CI 1.82–2.82; all P < 0.0001, P for trend < 0.0001, respectively), as well as WHtR and CI, which particularly prominent for female in premenopausal. Moreover, a one-unit increment of BRI was significantly associated with an increased severity index of UUI (β: 0.06, 95% CI 0.04–0.09, P < 0.0001), SUI (β: 0.10, 95% CI 0.07–0.13, P < 0.0001) and MUI (β: 0.07, 95% CI 0.04–0.10, P < 0.0001), which this trend was also observed in each subtype of UI for WHtR and CI. Furthermore, the ROC analysis demonstrated a higher diagnostic efficacy of BRI and WHtR compared with BMI in discriminating UI with an AUC of 0.600 for SUI, 0.617 for UUI, and 0.622 for MUI (all P < 0.05).

Conclusions

An increased BRI, CI, and WHtR are significantly associated with higher prevalence and severity of UI in females.
Nanoformulated herbal compounds: enhanced antibacterial efficacy of camphor and thymol-loaded nanogels
Authors: Abdollahi Abbas , Fereydouni Narges , Moradi Hamid , Karimivaselabadi Abolfazl , Zarenezhad Elham , Osanloo Mahmoud
Published: April 2024

Herbal components are highly useful assets for the advancement of novel antibacterial drugs. Nanotechnology holds great promise as an approach to enhance the effectiveness and develop the composition of these substances. The study developed nanogels incorporating camphor, thymol, and a combination derived from the initial nanoemulsions with particle sizes of 103, 85, and 135 nm, respectively. The viscosity of nanogels and the successful loading of compounds in them were examined by viscometery and ATR-FTIR studies. The bactericidal properties of the nanogels were examined against four bacterial strains. The nanogel containing camphor and thymol at 1250 µg/mL concentration exhibited complete growth suppression against Pseudomonas aeruginosa and Staphylococcus aureus. The thymol nanogel at 1250 µg/mL and the camphor nanogel at 2500 µg/mL exhibited complete inhibition of growth on Listeria monocytogenes and Escherichia coli, respectively. Both nanogels showed favorable effectiveness as antibacterial agents and could potentially examine a wide range of pathogens and in vivo studies.
Inpatient-level care at home delivered by virtual wards and hospital at home: a systematic review and meta-analysis of complex interventions and their components
Authors: Shi Chunhu , Dumville Jo , Rubinstein Fernando , Norman Gill , Ullah Akbar , Bashir Saima , Bower Peter , Vardy Emma R. L. C.
Published: April 2024

Background

Technology-enabled inpatient-level care at home services, such as virtual wards and hospital at home, are being rapidly implemented. This is the first systematic review to link the components of these service delivery innovations to evidence of effectiveness to explore implications for practice and research.

Methods

For this review (registered here https://osf.io/je39y), we searched Cochrane-recommended multiple databases up to 30 November 2022 and additional resources for randomised and non-randomised studies that compared technology-enabled inpatient-level care at home with hospital-based inpatient care. We classified interventions into care model groups using three key components: clinical activities, workforce, and technology. We synthesised evidence by these groups quantitatively or narratively for mortality, hospital readmissions, cost-effectiveness and length of stay.

Results

We include 69 studies: 38 randomised studies (6413 participants; largely judged as low or unclear risk of bias) and 31 non-randomised studies (31,950 participants; largely judged at serious or critical risk of bias). The 69 studies described 63 interventions which formed eight model groups. Most models, regardless of using low- or high-intensity technology, may have similar or reduced hospital readmission risk compared with hospital-based inpatient care (low-certainty evidence from randomised trials). For mortality, most models had uncertain or unavailable evidence. Two exceptions were low technology-enabled models that involve hospital- and community-based professionals, they may have similar mortality risk compared with hospital-based inpatient care (low- or moderate-certainty evidence from randomised trials). Cost-effectiveness evidence is unavailable for high technology-enabled models, but sparse evidence suggests the low technology-enabled multidisciplinary care delivered by hospital-based teams appears more cost-effective than hospital-based care for those with chronic obstructive pulmonary disease (COPD) exacerbations.

Conclusions

Low-certainty evidence suggests that none of technology-enabled care at home models we explored put people at higher risk of readmission compared with hospital-based care. Where limited evidence on mortality is available, there appears to be no additional risk of mortality due to use of technology-enabled at home models. It is unclear whether inpatient-level care at home using higher levels of technology confers additional benefits. Further research should focus on clearly defined interventions in high-priority populations and include comparative cost-effectiveness evaluation.

Trial registration

https://osf.io/je39y.
NR2F2 alleviates pulmonary fibrosis by inhibition of epithelial cell senescence
Authors: Wan Ruyan , Long Siqi , Ma Shuaichen , Yan Peishuo , Li Zhongzheng , Xu Kai , Lian Hui , Li Wenwen , Duan Yudi , Zhu Miaomiao , Wang Lan , Yu Guoying
Published: April 2024

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fatal, and aging-associated interstitial lung disease with a poor prognosis and limited treatment options, while the pathogenesis remains elusive. In this study, we found that the expression of nuclear receptor subfamily 2 group F member 2 (NR2F2), a member of the steroid thyroid hormone superfamily of nuclear receptors, was reduced in both IPF and bleomycin-induced fibrotic lungs, markedly in bleomycin-induced senescent epithelial cells. Inhibition of NR2F2 expression increased the expression of senescence markers such as p21 and p16 in lung epithelial cells, and activated fibroblasts through epithelial-mesenchymal crosstalk, inversely overexpression of NR2F2 alleviated bleomycin-induced epithelial cell senescence and inhibited fibroblast activation. Subsequent mechanistic studies revealed that overexpression of NR2F2 alleviated DNA damage in lung epithelial cells and inhibited cell senescence. Adenovirus-mediated Nr2f2 overexpression attenuated bleomycin-induced lung fibrosis and cell senescence in mice. In summary, these data demonstrate that NR2F2 is involved in lung epithelial cell senescence, and targeting NR2F2 may be a promising therapeutic approach against lung cell senescence and fibrosis.