bluuebunny/crossref_metadata_2025 huggingface dataset:
The oxytocin-oxytocin receptors system — a new pathogenetic mechanism in the development of diabetic phenotype of heart failure with preserved ejection fraction in women
Authors: Starchenko A. D. , Liskova Yu. V. , Stadnikov A. A.
Published: October 2024

Aim. To determine the pathogenetic role of the oxytocinergic system in the development of myocardium structural and functional changes in women with heart failure with preserved ejection fraction (HFpEF) associated with type 2 diabetes mellitus (DM2T) (diabetic phenotype of HFpEF).

Material and methods. The study included 60 women aged 67.0±4.9 years with HFpEF stage I-IIA, FC I-III, 30 of them had DM2T who were admitted for elective coronary artery bypass grafting. The development of HFpEF is caused by coronary artery disease (CAD) and arterial hypertension (AH). Prior to surgery, all patients underwent a standard examination, blood levels of NT-proBNP, oxytocin (Ox), echocardiography were determined to find the types of left ventricular (LV) myocardial remodeling and diastolic dysfunction (DD). Myocardium biopsies of the right atrium auricle obtained during coronary bypass surgery were studied by microscopy, morphometry and immunohistochemistry (the expression of oxytocin receptors (OxR), a marker of proliferation ki-67).

Results. According to echocardiography, eccentric LV hypertrophy (46.7/36.7%) and DD type 2 (47/17%, p=0.003) prevailed in the group of women with the diabetic phenotype of HFpEF. A higher content of NT-proBNP (480.72±241.87/434.46±282.78 ng/ml, p=0.06) and a lower concentration of Ox (102.11±35.89/320.37±294.71 pg/ml, p=0.0016) in blood serum were established, as well as an increase in the number of cardiomyocytes (CMC) with a high expression level OxR (63.69±19.47/12.16±23.09%, p=0.000) in patients with the diabetic phenotype of HFpEF. Negative associations were determined between the blood level of Ox and the CMC diameter (r=-0.10, p=0.020), the area of their cytoplasm (r=-0.16, p=0.000) and the area of the nuclei (r=-0.11, p=0.015) in patients of both groups. A decrease in Ox concentration in the blood of patients with diabetic phenotype of HFpEF was accompanied by an increase in the number of CMCs with a high level of OxR expression (r=-0.63, p=0.000).

Conclusion. The study has shown the important involvement of oxytocinergic signaling pathways in the HFpEF pathogenesis. HFpEF associated with DM2T in women was characterized by more unfavorable structural and functional changes in the myocardium, a significant increase in the number of hypertrophied CMCs with a high level of OxR expression and Ox decrease in blood serum. The mechanisms of the first-established significant increase in the content of Ox in the blood of patients with HFpEF without diabetes and its significant decrease in patients with diabetic phenotype of HFpEF leading to more pronounced structural and functional changes in the myocardium, require further study.
Cantigi (Vaccinium varingiaefolium (Blume) Miq) Conservation Education Based on Local Wisdom for Communities in the Slopes of Mount Lawu, Tawangmangu, Karanganyar, Central Java
Authors: Efri Roziaty  , Putri Agustina  , Santhyami  , Dawud Fa’i Salsabila  , Muhammad Yahya Nur Sholihin  , Muhammad Asyam Fathin  , Salsa Anida Rahmania
Published: October 2024

Kompleks Gunung Lawu, Jawa Tengah, mempunyai hutan dengan luas sekitar ± 24.187,5 Ha. Gunung Lawu memiliki keanekaragaman vegetasi yang sangat beragam, salah satunya adalah Cantigi (Vaccinium varingiaufolium (Blume) Miq.). Masyarakat di kawasan Gunung Lawu perlu diberikan edukasi tentang konservasi cantigi. Hal ini penting dilakukan agar keberadaan cantigi sebagai tumbuhan asli dan endemik kawasan Gunung Lawu dapat dipertahankan kelestariannya. Luaran dari kegiatan pengabdian kepada masyarakat ini adalah pengetahuan masyarakat tentang konservasi cantigi. Berdasarkan kegiatan pengabdian kepada masyarakat diketahui bahwa secara umum masyarakat telah mengetahui tumbuhan Cantigi dan memiliki pengetahuan konservasi Cantigi. Upaya konservasi Cantigi perlu disebarluaskan ke masyarakat sekitar Gunung Lawu agar kelestarian Cantigi dapat terjaga.
UNA PROSPECTIVA DESDE LA HUELLA ANTROPOGÉNICA QUE AMPLIE LA TOMA DE CONCIENCIA
Authors: Juárez Carlos Ramón , Ferreiro Alejandro , Fernández Franco , Moyano Luis , Rigali Silvina , Raimondi Gabriela Giuliano
Published: October 2024

Currently, planet Earth cannot sustain the pace of exploitation of its natural resources, which tend to become products that, although they contribute to our well-being, are difficult to reuse and recycle. In the value chain for economic competitiveness and social prosperity, the growing needs for affordable access to energy are a priority. The energy supply is relevant because it overlaps with sustainable development, and must meet the requirements of energy security, social equity and reduction of environmental impact. Efforts at present are oriented towards an energy transition to mitigate global warming, mitigating greenhouse gas emissions through the decarbonization of energy systems, which involves moving from fossil fuels to sources with reduced or no emissions, such as renewables. The transition to cleaner and greener energy systems impacts lifestyles, livelihoods, societies and economies. Therefore, it is relevant to have a prospective vision to envision the future, encouraging reactions that tend to provide affordable access to clean energy to allow education and decent and supportive conditions for a hopeful future throughout the world, especially in rural areas with dispersed populations. while respecting the planet.
DOI: http://dx.doi.org/10.21017/rimci.2024.v11.n21.a151
FACTORES DE RIESGO EXTRALABORAL Y NIVELES DE ESTRÉS PRESENTES EN LOS ESTUDIANTES DE POSGRADO DE LA ESPECIALIZACIÓN EN SEGURIDAD Y SALUD EN EL TRABAJO, EN LA MODALIDAD VIRTUAL DE TRES INSTITUCIONES DE EDUCACIÓN SUPERIOR
Authors: Fuentes Rojas Gina Yurley
Published: October 2024

Stress levels have shown a significant increase thanks to the different stressors that the population faces at a general level. The multiple activities related to work, education, family and society have generated psychosocial risks that havesignificantly affected the life of the individual. Postgraduate students seek to improve their economic income through better professional qualifications in accordance with business needs, thus generating a multiplicity of roles which must be assumed to achieve their emotional stability[1]. This article analyzes the non-workplace risk factors and stress levels present in postgraduate students specializing in Occupational Health and Safety, who carry out studies in the virtual modality in three Higher Education Institutions. The study is descriptive with a qualitative approach, the sample was made up of 60 students from three universities in the virtual modality of postgraduate studies. The stress and extra-work risk factors questionnaire validated for the Colombian population was used[2]. The results allow us to observe that stress levels are present at the University of Medellín with high levels. Regarding non-work psychosocial risks, risks related to economic difficulties, family relationships, time away from work and emerging categories related to leadership, resilience are observed. and problem solving that allow them to face the difficult situations they face on a daily basis. It is concluded that indeed, in the presence of risks in people, protective factors must be enhanced in order to improve the mental health of postgraduate students.
DOI: http://dx.doi.org/10.21017/rimci.2024.v11.n21.a156
AUTOMATIZACIÓN DEL PROCESO PARA LA GENERACIÓN DE MODELOS 3D A PARTIR DE UNA INTELIGENCIA ARTIFICIAL
Authors: García Sarmiento Carolina Andrea , Infante Andrade Juan Esteban , Santa Quintero Ricardo Andres
Published: October 2024

The objective of the project is to describe the steps to automate the process of generating 3D models, from the use of artificial intelligence Point-E, the refinement with the Blender application and finally the insertion of these, in the Unityapplication, where a Showroom was made, this description was made after the research of specialized documentation and literature review, where it was found that such automation would be possible, if the steps for the generation of the necessary scripts are followed, in Google colab using the Python programming language, inside Blender by using the console to script with Python and in the Unity application creating scripts in the C# language. It is concluded that it is possible to perform the automation of the process described, in addition, by making use of this automation a great amount of time is saved compared to the process done manually.
DOI: http://dx.doi.org/10.21017/rimci.2024.v11.n21.a158
Reconciling tracked atmospheric water flows to close the global freshwater cycle
Authors: De Petrillo Elena , Fahrländer Simon , Tuninetti Marta , Andersen Lauren , Monaco Luca , Ridolfi Luca , Laio Francesco
Published: October 2024

Atmospheric moisture plays a vital role in the hydrological cycle, connecting evaporation sources to precipitationsinks. While high-resolution moisture-tracking models offer valuable insight, discrepancies to atmospheric re-analysis dataemerge. In this study, we reconcile tracked atmospheric water flows with reanalysis data, using the Iterative ProportionalFitting procedure (IPF). We apply IPF to the atmospheric moisture flows from the UTrack dataset (averaged over 2008-2017),aggregated within countries and ocean boundaries. This reconciled dataset ensures that the total tracked atmospheric moisture5equals the total precipitation at the sink and evaporation at the source on an annual basis. Country-scale discrepancies of upto 275% in precipitation and 225% in evaporation are amended, correcting fluxes by∼0.07%, on average. We find 45% ofthe total terrestrial precipitation (∼1.5·105km3yr−1) originates from land evaporation (9.8·104km3yr−1). Our reconciledcountry-scale dataset offers new ground to investigate transboundary atmospheric water flows which connect us globally.
Incidence, risk factors, and outcomes of transplant-associated thrombotic microangiopathy in pediatric patients after allogeneic hematopoietic cell transplantation: A single-institution prospective study
Authors: Koh Kyung-Nam , Yoon Su Hyun , Kang Sung Han , Kim Hyery , Choi Eun Seok , Im Ho Joon
Published: October 2024

Transplant-associated thrombotic microangiopathy (TA-TMA) is an increasingly recognized complication in hematopoietic cell transplantation (HCT). Given the rarity of prospective pediatric studies on TA-TMA, this study aimed to evaluate the incidence, survival outcomes, and risk factors for predicting early the development of TA-TMA in a pediatric population following allogeneic HCT. We conducted a prospective analysis of 173 pediatric patients to evaluate the incidence, survival outcome, and risk factors of TA-TMA. The cumulative incidence of TA-TMA at one-year post-HCT was 3.0% (95% CI, 1.1–6.5%). Patients with TA-TMA showed significantly poorer 1-year overall survival (OS) rate, 50.0% ± 17.7% compared to 85.4% ± 2.8% in those without TA-TMA (p = .008). Additionally, the non-relapse mortality (NRM) rate was higher in the TA-TMA group at 25.0% (95% CI, 3.7–55.8%) versus 5.8% (95% CI, 2.9–10.3%) (p = .038). A urine protein/creatinine ratio ≥ 1 mg/mg on day 30 post-HCT was significantly associated with TA-TMA occurrence (adjusted HR, 9.5; [95% CI], 1.28–70.39; p = .028). This study showed the significantly unfavorable clinical outcomes associated with TA-TMA in pediatric patients and emphasized the importance of early identification of patients at risk. Further research is needed to explore additional strategies for early detection and intervention to improve outcomes.
Patterns of Traditional Chinese Medicine Prescription During Assisted Reproduction in Taiwan: A Population-Based Study
Authors: Shen Yi-Chia , Yang Pei-Rung , Lee I-Yun , Shih Wei-Tai , Yang Yao-Hsu
Published: October 2024

Background
Traditional Chinese medicine (TCM) is widely applied in assisted reproductive technology (ART). However, TCM drug utilization and prescription patterns in assisted reproduction remain unclear. This study was conducted to analyze these patterns.
Methods
Using data from Taiwan’s Artificial Reproductive Database and National Health Insurance Research Database, we analyzed the frequency of TCM prescriptions and the proportions in which different herbal formulae and individual herbs were prescribed to patients undergoing ART procedures. In addition, common TCM prescription patterns were investigated through association rule learning.
Results
In total, 59,266 women undergoing 110,329 ART cycles were enrolled in this study. TCM was used in 27,782 ART cycles (25.18%). Jiawei xiaoyao san and tusizi (Semen cuscutae) were the most commonly used herbal formulae and individual herbs used during ART procedures.
Conclusions
This study demonstrates TCM use patterns in assisted reproduction. Further studies are necessary to evaluate the efficacy and safety of TCMs prescribed during assisted reproduction.
Investigating Waste and Land Use Changes Effects on Air Pollution Using Google Earth Engine in Jakarta Metropolitan in Indonesia
Authors: UMWANZISIWEMUREMYI OSCAR , ABIDIN ZAENAL , SETIAWAN YUDI
Published: October 2024

In recent years, air pollution has intensified due to a continuous rise in atmospheric pollutants. Emissions from anthropogenic activities have exacerbated this problem, contributing to health, environmental, and climate issues. Researchers have identified energy production, industrial processes, wildfires, and volcanic eruption as leading contributors, with waste, changes in land use and land cover (LULC) being secondary factors. Consequently, the growing global waste production and alterations in LULC are among factors in increasing pollution levels, which we seek to emphasise in this research. We specifically investigated the effects of waste and LULC on carbon monoxide (CO), Sulphur dioxide SO2, nitrous dioxide (NO2), and formaldehyde (CH2O) emissions in the Jakarta Metropolitan region, Indonesia. Data were gathered from the Sentinel 2 and Sentinel-5 Precursor satellites and National Waste Management Information System Indonesia (SIPSN) from 2019 to 2023, we employed excel, image analysis, and Google Earth Engine (GEE) for data processing. ArcGIS 10.8 was used for advanced mapping. Our findings revealed that CO, SO2, NO2, and CH2O levels have increased the past five years in correlation with waste and LULC change, with a dip in 2020 during the COVID-19 lockdowns. Efforts to mitigate air pollution include curbing these emissions and promoting green urban planning.
Clinical efficacy of amlodipine and benazepril hydrochloride tablets in controlling morning blood pressure surge (MBPS) in patients with arteriosclerosis
Authors: Zhang Liqin , Ren Fang , Zhao Youying , Ma Hailiang , Shen Jianyao
Published: October 2024

Objective: This prospective, randomized, open-label, parallel-group clinical trial aimed to rigorously evaluate the influence of amlodipine besylate and benazepril hydrochloride tablets on nocturnal blood pressure patterns and morning blood pressure surge in a cohort of patients diagnosed with primary hypertension.
Methods: A total of 294 eligible patients with primary hypertension were randomly assigned to one of two treatment regimens: (1) Bisoprolol amlodipine tablets in the morning (Group A) or (2) Amlodipine besylate and benazepril hydrochloride tablets in the morning(Group B). After 24 weeks of intervention, the following parameters were meticulously compared between the two groups: office blood pressure, morning blood pressure surge, adverse events, 24-hour ambulatory blood pressure monitoring, and major adverse cardiovascular events (MACE). Additionally, the prognostic utility of morning blood pressure surge for predicting future MACE was explored.
Results: A total of 113 and 112 patients in Groups A and B, respectively, successfully completed the 24-week study protocol. Both treatment regimens elicited statistically significant reductions in blood pressure; however, the decrease in diastolic blood pressure was markedly greater in Group B versus Group A (p<0.05). Analysis of the 24-hour ambulatory blood pressure monitoring data revealed an interesting pattern. After 24 weeks, no between-group differences were detected in the variation of daytime ambulatory blood pressure. In contrast, the reductions in nighttime ambulatory systolic and diastolic blood pressure were significantly more pronounced in Group B versus Group A (p<0.05). Furthermore, the morning systolic and diastolic blood pressures were notably higher in Group A versus Group B at the end of the study. Importantly, the magnitude of the morning blood pressure surge was significantly lower in Group B versus Group A (p<0.05). During the subsequent 12-month follow-up period, a total of 42 MACE were observed, with 26 events occurring in Group A and 16 in Group B. Receiver operating characteristic (ROC) curve analysis identified optimal cutoff values for predicting MACE of 27.5 mmHg for morning systolic blood pressure surge (AUC=0.698) and 24.5 mmHg for morning diastolic blood pressure surge (AUC=0.701).
Conclusion: In this population of hypertensive patients, morning blood pressure surge demonstrates moderate prognostic value for future MACE. Importantly, the regimen of administering amlodipine besylate and benazepril hydrochloride tablets in the morning was found to be an effective strategy for improving nocturnal blood pressure, attenuating morning blood pressure surge, and conferring significant long-term cardiovascular benefits.
Prediction of Dementia Onset using the Short-Term Memory Recall Test
Authors: Oshiyama Chiaki , Kobayashi Naoto , Nishimura Takuichi , Niwa Shin-Ichi
Published: October 2024

The increased prevalence of dementia is serious that necessitates simple tests that can identify those at a high risk.
This study aimed to investigate the predictive ability of the Short-Term Memory Recall Test (STMT) for the development of dementia.
A total of 162 patients aged ≥40 years, examined twice at specific intervals ranging from 1 to 7 years, were included in the study. Herein, 96 of 162 patients were being treated for three known risk factors for dementia: hypertension, hyperlipidaemia, and diabetes. Binomial logistic regression analysis combined with receiver operating curve analysis was used to assess the likelihood of developing dementia. A prediction equation was developed using the STMT score and treatment statuses of the three aforementioned diseases as predictor variables. Finally, p-values calculated using the equation and actual prognoses were subjected to discriminant analysis to determine the hit rate, sensitivity and specificity.
Patients with lower STMT scores, older patients, women, and patients undergoing treatment for the three aforementioned diseases were more likely to develop dementia; in 96 patients, the hit rate for prediction was 75.0, with a sensitivity of 81.5 and a specificity of 61.3.
This study demonstrates the reliability of the STMT in predicting the onset of dementia.
Value of the lumbar MRI-based vertebral bone quality score (VBQ) for predicting vertebral fractures
Authors: Chen Ang , Feng Shangyong , She Dunmin , Yan Caifeng
Published: October 2024

Background VBQ is a new method for quantifying bone mass. This study analyzed the influencing factors of vertebral fractures and investigated the value of lumbar MRI-based VBQ for predicting vertebral fractures to provide evidence for clinical intervention.Methods This study included 863 patients who were hospitalized at Northern Jiangsu People’s Hospital from September 2022 to August 2023 and were divided into a vertebral fracture group and a nonvertebral fracture group. The correlations between vertebral fractures and every factor were calculated via the Spearman correlation test; the independent factors of vertebral fracture risk were derived via binary logistic regression analysis; ROC curves were drawn to calculate the independent predictive ability of the VBQ for vertebral fractures, and subgroups were analyzed according to age, sex, and BMI. Differences were considered to represent statistically significant at P < 0.05.Results A total of 863 patients were included in this study, including 489 with vertebral fractures and 374 without vertebral fractures. The serum CTX concentration, serum NTX concentration, and serum vitamin D concentration, minimum T value and VBQ score were independently correlated with vertebral fractures. A prediction model for predicting vertebral fractures was established, and it explained 41.9% of the causes of vertebral fractures. ROC curve analysis revealed that the accuracy of the VBQ score in predicting vertebral fractures was 89.2%, and its cutoff value used to predict vertebral fractures was 2.810, with a sensitivity of 85.9% and a specificity of 78.9%.Conclusion The VBQ score has high value in predicting vertebral fractures. The predictive value of the VBQ score was better in men, those who were younger and who with a greater BMI.
The impact of the COVID-19 pandemic on hospital admissions for psychiatric disorders: results from the multicentre CoMeH study on the Italian population Running title: The impact of COVID-19 on hospital admissions for psychiatric disorders
Authors: Aragona Massimiliano , Ventura Martina , Ciampichini Roberta , Napoli Anteo , Fano Valeria , Leone Sara , Pacifici Martina , Rosini Claudio , Silvestri Caterina , Voller Fabio , Zucchi Alberto , Napoli Christian , Petrelli Alessio
Published: October 2024

Background. To evaluate the impact of the COVID-19 pandemic on hospital admissions for psychiatric disorders, with a focus on the patients’ socioeconomic and demographic characteristics and/or the diagnostic group and type of admission. Methods. Open cohort of individuals aged ≥ 10 years resident for at least two years in one of three large areas of Italy. The outcome was the first admission for a psychiatric disorder (First Mental Health Admission: FMHA) during the study period (January 2018–December 2021). Municipality of residence, sex, census tract deprivation index, citizenship, type of admission and the diagnostic group were considered as covariates of interest. Incidence rate ratios of FMHAs were estimated via an interrupted time series (ITS) analysis using a step-change negative binomial model. Moreover, an ITS analysis was conducted on the monthly number of FMHAs to evaluate the impact of COVID-19 on the temporal trend of FMHAs. Results. Of the 5,159,363 subjects enrolled, 11,171 had an FMHA in the study period. The incidence of FMHAs decreased after the outbreak of the pandemic, overall and by sex, deprivation level and citizenship. Immigrants from high migration pressure countries (HMPCs) had a greater reduction in FMHAs during COVID-19. A decrease in FMHAs was observed for all diagnoses, the only exceptions being for post-traumatic stress and related disorders, which increased. Involuntary admissions also increased dramatically at the outbreak of the pandemic. Younger age (< 34) and high deprivation level were associated with higher risk of hospitalization. In the following post-outbreak period (March 2020-December 2021), a moderate but significant growing trend of FMHAs was observed, although not reaching the pre-pandemic levels. A more robust increase was found especially for patients with eating disorders, while FMHAs for patients with post-traumatic stress and related disorders decreased to the low pre-pandemic levels. Involuntary FMHAs also decreased in the post-outbreak period. Conclusions. The pandemic had a considerable, and in some cases dramatic, impact on hospitalizations for psychiatric disorders. However, the effect appeared temporary, suggesting that the expectations of a dramatic surge in mental health issues due to the pandemic could have been overemphasized, at least in the short term. Longer follow-up surveys are needed.
Efficacy of Continuous intravenous infusion of lidocaine on postoperative sore throat after laryngeal mask insertion: a randomized controlled trial
Authors: Jiang Jianxin , Wu Jimin , Shi Shuqi , Dong Xiaoli , Yin Jiaxiang , Wu Yini
Published: October 2024

Background
This randomized controlled trial was performed to explore efficacy of continuous intravenous infusion of lidocaine on postoperative sore throat after laryngeal mask insertion.
Methods
In this prospective trial one hundred and sixty general anesthesia surgery patients (20 to 60 years) using laryngeal mask airway were randomly divided into control group (Group C, saline as placebo), lidocaine gel group (Group LG, lidocaine gel applied to the surface of the laryngeal mask), single intravenous lidocaine group (Group SL, intravenous lidocaine 1.5 mg/kg at induction of anesthesia) and continuous infusion of lidocaine group (Group CL, a bolus of 1.5 mg/kg, followed by an infusion of 2 mg/kg/h until the end of the surgical). The primary outcomes were the incidence and severity of POST at the time of laryngeal mask removal (T1), 2 h (T2), 6 h (T3), and 24 h (T4) after removal. The secondary outcomes included the incidence of adverse events such as hoarseness, cough, and tongue numbness.
Result
Within 24 hours after extubation, the incidence and severity of POST was significantly lower in group CL than that in group C at all time points. In contrast, compared with group C, the incidence and severity of POST in group SL was lower only at T1. The incidence of hoarseness and cough in group CL were significantly lower than that in group C at T1 and T2. In group SL, the incidence of hoarseness and cough was lower than that in the group C only at T1. In group LG, the incidence of tongue numbness was significantly higher than that in group C only at T1, and there were no significant difference in the four groups at the other time points.
Conclusion
Continuous infusion of lidocaine is effective in reducing the incidence and severity of POST after laryngeal mask ventilation, as well as reducing the incidence of adverse effects such as hoarseness and cough.
Trial Registration:Chinese Clinical Trial Registry(ChiCTR2300070339,04/10/2023).
Endoscopic findings and predictors of outcome among patients with non-variceal upper gastrointestinal bleeding attending Benjamin Mkapa Hospital in Dodoma, Tanzania
Authors: Mziray Samwel , Alphonce Baraka , Sindato Emmanuel
Published: October 2024

Background
Non-variceal upper gastrointestinal bleeding (NVUGIB) is a medical emergency and is associated with poor outcomes. In our setting, there are increased trends of upper gastrointestinal diseases including liver cirrhosis with challenges in management; however, the published data are limited. This study aimed to assess the endoscopic findings and predictors of outcomes of patients with NVUGIB attending Benjamin Mkapa Hospital in Dodoma, Tanzania.
Methods
This prospective longitudinal study was conducted between October 2023 and April 2024. All eligible patients with NVUGIB attending Benjamin Mkapa Hospital were recruited. Consented participants who underwent endoscopic procedures aged 18 years or older were included. Baseline sociodemographic and clinical characteristics and endoscopic procedures were performed during inception. Patients with NVUGIB were followed up for 60 days to assess the outcomes. Data were summarized by descriptive analysis then, presented as a median and interquartile range (IQR) for continuous variables, and categorical variables were analyzed by Fisher exact and Mann-Whitney U tests and reported as numbers and proportions. Binary regression analysis used to assess the predictors of rebleeding within 60 days and reported using odds ratio. A two-tailed p-value of less than 0.05 was considered statistically significant.
Results
Among 124 patients, approximately 57.3% were male with a median age of 44 (IQR 27–61) years. Approximately, 70.2% had H. pylori infections and 42.7% were alcoholic. Median Haemoglobin level was 10.6 (IQR 6.1–15.9); median platelet count accounting for 67 (IQR 43–480) while median SBP was 94 (IQR 79–141 mmHg and median DBP of 64 (48–82) mmHg. Prevalence of NVUGIB was 24.2%. Among NVUGIB patients, 42% had Gastritis and 1.8% had esophageal tumors. Rebleeding was prevalent in 21.8%, whereas, 2.4% required an ICU admission and death was observed in 4%. Predictors of rebleeding included low Haemoglobin (AOR 2.24; 95% CI, 1.39–2.98, p = 0.002); Forest class 1 (AOR 2.51; 95% CI, 1.34–4.02, p = 0.031); Forest class 2 (AOR 1.81; 95% CI, 1.18–2.82, p = 0.044) and thrombocytopenia (AOR 1.43; 95% CI, 1.15–2.71, p = 0.011).
Conclusion
Rebleeding is a common outcome among patients with NVUGIB. Therefore, intensive management is crucial to improve patient outcomes. However, future research is warranted.
Effects of Green tea supplementation on the CRP, ESR, and CBC in the patients with COVID-19, a double-blind placebo-controlled clinical trial
Authors: Yousefi Mojtaba , Hosseinzade Zahra , Mahmoodi Sara , Mahmoodabadi Ali , Pourmahmoudi Azizollah , Saeedinejad Zaker , Hosseinikia Mahak , Naghmachi Mohsen , Malekzadeh Jan Mohamad , Panahande Seyed Bahman
Published: October 2024

Background
This study investigated the effects of green tea extract on biomarkers and signs of COVID-19 patients who were hospitalized.
Methods
This study was a double-blind clinical trial that involved 74 patients who were under hospital care. These individuals were randomly divided into two groups. One group received a 900mg/d dosage of green tea supplement along with standard patient care, while the other group received a placebo alongside standard patient care. This administration lasted for 14 days. Blood factors and anthropometric factors were measured before and after the intervention. Additionally, dietary intake was assessed during the study.
Results
After the intervention, there was a significant decrease in C-reactive protein (CRP) [Mean Differences (MD)18.34 and 95%CI (8.05 to 28.62)] and Erythrocyte Sedimentation Rate (ESR) [MD 16.68 and 95%CI (7.41 to 25.94)] levels in the green tea group compared to the placebo group. There were also significant changes in neutrophils, lymphocytes, red blood cells (RBC), and blood oxygen saturation in the green tea group(p < 0.05). However, there were no significant differences in other blood indices between the two groups.
Conclusions
The results suggest that green tea extract supplementation may positively affect inflammation and blood markers in COVID-19 patients and potentially improve blood oxygen saturation levels.
Trial registration
IRCT20150711023153N3 (https//irct.behdasht.gov.ir/trial/55948), Registration date 20210604
Therapeutic effects of probiotics on symptoms of depression in children and adolescents: a systematic review and meta-analysis
Authors: Chen Chia-Min , Liang Shun-Chin , Sun Cheuk-Kwan , Cheng Yu-Shian , Tang Yen-Hsiang , Liu Cheng , Hung Kuo-Chuan
Published: October 2024

Background
This meta-analysis aimed at investigating the therapeutic effects of probiotics against the symptoms of depression in children and adolescents as well as to identify the potential confounders.
Methods
Following PRISMA guidelines, major databases were searched for randomized controlled trials focusing on effects of probiotics against the symptoms of depression in children and adolescents to analyze the effect size (ES) for primary outcomes (i.e., improvement in depressive symptoms) expressed as standardized mean difference (SMD) and odds ratios (ORs) for continuous and categorical variables, respectively, with 95% confidence interval (CI).
Results
Meta-analysis of five studies (692 participants, mean age = 7.33 years, treatment duration 8–104 weeks) demonstrated no significant improvement in depressive symptoms in subjects receiving probiotics (SMD = 0.04, 95% CI: -0.33 to 0.41, p = 0.84, five studies, 692 participants). Subgroup analysis also showed no significant improvement associated with probiotic use relative to controls in the subgroup of studies focusing on individuals diagnosed with neurodevelopmental disorders (SMD= -0.11, 95% CI: -0.73 to 0.51, p = 0.72, three studies, 452 participants) and that recruiting the general population (SMD = 0.24, 95% CI: -0.43 to 0.91, p = 0.48, two studies, 240 participants). However, high levels of heterogeneity were found in both our primary results (I2 = 77%, p = 0.001) and subgroup analyses for those with neurodevelopmental disorders (I2 = 84%, p = 0.002) and the general population (I2 = 79%, p = 0.03).
Conclusions
The results did not support the use of probiotics for relieving depressive symptoms compared with controls in children and adolescents diagnosed with neurodevelopmental disorders or in the general population. Nevertheless, given the high level of heterogeneity across the included trials and a lack of studies focusing on those with diagnoses of anxiety or depression in the current meta-analysis, further large-scale clinical investigations are required to elucidate the therapeutic potential of probiotics against depressive symptoms in these populations, especially in those diagnosed with neurodevelopmental disorders or depression.
Improving the Accuracy and Precision of Disease Identification When Utilizing Ehr Data for Research: the Case for Hepatocellular Carcinoma
Authors: Wong Carrie R. , Flores Yvonne N. , Avila Analissa , Tieu Lina , Crespi Catherine M. , May Folasade P. , Bell Douglas , Glenn Beth , Bastani Roshan
Published: October 2024

Objective
We assessed the performance of ICD codes to identify patients with hepatocellular carcinoma (HCC) in a large academic health system and determined whether employing an algorithm using a combination of ICD codes could deliver higher accuracy and precision than single ICD codes in identifying HCC cases using electronic health record (EHR) data.
Results
The use of a single ICD code entry for HCC (ICD-9-CM 155.0 or ICD-10-CM C22.0) in our cohort of 1,007 established ambulatory care patients with potential HCC yielded 58% false positives (not true HCC cases) based on chart reviews. We developed an ICD code-based algorithm that prioritized positive predictive value (PPV), F-score, and accuracy to minimize false positives and negatives. The highest performing algorithm required at least 10 ICD code entries for HCC and the sum of ICD code entries for HCC to exceed the sum of ICD code entries for non-HCC malignancies. The algorithm demonstrated high performance (PPV 97.4%, F-score 0.92, accuracy 94%), which was internally validated (PPV 92.3%, F-score 0.90, accuracy 91%) using a separate sample of potential HCC cases. Our findings support the need to assess the accuracy and precision of ICD codes before using EHR data to study HCC more broadly.
Urethral instrumentation in men with artificial urinary sphincter: a national survey among Brazilian urologists
Authors: Pinto Vicktor Bruno Pereira , de Bessa Jose , Prezotti José Antonio Penedo , Anzolch Karin Marise Jaeger , Fernandes Jose Ailton , Gomes Cristiano Mendes
Published: October 2024

Purpose
Urethral instrumentation (UI) in patients with an artificial urinary sphincter (AUS) demands technical considerations and poses a risk of urethral erosion, leading to serious clinical and legal consequences. We conducted a national survey to evaluate the knowledge and experience of Brazilian urologists with UI in these patients.
Methods
This study used an electronic survey distributed to members of the Brazilian Society of Urology. The survey included 19 multiple-choice questions assessing sociodemographic characteristics, practice patterns, AUS training, knowledge of AUS components and functionality, experience with UI in AUS patients, and interest in further training. Urologists were classified as 'competent' in AUS manipulation if they had prior experience and confidence in performing UI.
Results
Among 536 participants (median age 47 years [39–55]), 72.8% reported involvement in urological emergencies, with 89.9% indicating inadequate AUS training during residency. Only 29.7% had occasional or regular involvement with AUS surgeries. Of the participants, 53.4% had performed UI in men with an AUS. Prior UI had been attempted by healthcare staff in 36.2% of cases. Only 46.8% reported knowledge of AUS components and 45.1% felt competent in deactivating it. Regarding urethral catheterization, 47.2% knew the safe catheter diameter, and 20.9% identified safe catheterization duration. Overall, 45.1% self-declared competence in UI, yet many gave incorrect answers on catheter size and duration. Competence strongly correlated with knowledge of AUS components, regular implant involvement, and prior experience. Most (89.3%) expressed interest in additional training for UI.
Conclusion
This study highlights significant gaps in training and knowledge among Brazilian urologists regarding UI in AUS patients. These deficiencies underscore the potential for enhanced education to improve patient outcomes and reduce AUS-associated complications in Brazil and possibly broader international contexts.
Influence of SARS-CoV-2 variants on COVID-19 epidemiological and clinical profiles: a comparative analysis of two waves of cases
Authors: Santos Pérola Rodrigues dos , Santos Uener Ribeiro dos , de Santana Íris Terezinha Santos , Fehlberg Hllytchaikra Ferraz , Ferreira Fabrício Barbosa , Albuquerque George Rego , Mariano Ana Paula Melo , Silva Murillo Ferreira da , Lemos Leonardo Santos , Piton Karoline Almeida , Silva Mylene de Melo , Fontana Renato , Aguiar Eric Roberto Guimarães Rocha , Marin Lauro Juliano , Gadelha Sandra Rocha
Published: October 2024

Background
The COVID-19 pandemic has been the most significant health challenge of the last century. Multiple and successive waves of COVID-19 cases, driven particularly by the emergence of new SARS-CoV-2 variants, have kept the world in a constant state of alert.
Methods
We present an observational, descriptive, cross-sectional study aimed at identifying SARS-CoV-2 variants circulating during two local waves of COVID-19 cases in southern Bahia, Brazil (late 2021 and late 2022), and analyzing the association between the detected variants and the epidemiological and clinical characteristics of the disease. For this purpose, data and nasopharyngeal samples from individuals in southern Bahia, Brazil, with suspected COVID-19 were included. Viral detection was performed by RT-qPCR, and SARS-CoV-2 variants were identified by next-generation viral sequencing.
Results
A total of 368 nasopharyngeal samples were tested. Approximately 23% of the samples from late 2021 tested positive for SARS-CoV-2, while in 2022, the positivity rate was about 56%. All sequenced samples from 2021 were identified as the Delta variant, while in 2022, all samples were classified as the Omicron variant. Overall, individuals who tested positive for SARS-CoV-2 in 2022 were younger than those who tested positive in 2021. Moreover, we observed significant differences in the clinical spectrum of SARS-CoV-2 infection when comparing the two periods. Individuals who presented with anosmia/ageusia were more likely to test positive for SARS-CoV-2 infection in 2021 but not in 2022. Additionally, fever, dry cough, pharyngalgia, headache, and rhinorrhea were more frequent among individuals infected with the Omicron variant than among those infected with the Delta variant.
Conclusions
The profile of COVID-19 in southern Bahia differed when analyzing two distinct waves of the pandemic in the region. These differences are likely related to the variants, which may differ in transmissibility and virulence, thereby altering the dynamics of the pandemic. This underscores the importance of genomic surveillance in better understanding the behavior of viral infections.
Gender Differences in Stress and Upper Respiratory Tract Infections: A Closer Look
Authors: Rüthrich Maria Madeleine , Ascone Leonie , Hammersen Jakob , Hilgendorf Inken , Kalkreuth Jana , Kurze Stephanie , Peters Eva Maria , Rachow Tobias , Rosendahl Jenny , von Lilienfeld-Toal Marie
Published: October 2024

Background:
Infectious diseases are influenced by both sex and gender, with psychosocial stress potentially playing a critical role, particularly in upper respiratory tract infections (URTIs). Despite existing evidence, a comprehensive analysis of the interplay between sex, gender, stress, and RTIs is lacking.
Methods:
Our monocentric, prospective study included 273 healthy individuals (cohort H) and 194 patients with hematological cancer (cohort P) who had undergone stem cell transplantation, enrolled between 11/2013 and 05/2017. Eligible participants were aged 18 years or older. Data collection encompassed demographics, household composition, smoking behavior, cancer-related characteristics, RTI-symptoms, and perceived stress, measured using the 4-item perceived stress scale (PSS-4). Participants were categorized based on biological sex, without assessing gender identity. For analysis, we assumed that sex and gender were aligned.
Results:
In cohort H, 50% of the participants were female, with most individuals aged ≤ 30 years. Women experienced notably more moderate to severe URTI symptoms than men (57% vs. 36%, p < .001, φ = 0.210). Additionally, women across all age groups also exhibited higher PSS-4 levels than men [t(271) = 2.84, p < .001, d = -0.636] and the PSS-4 was significantly affected by sex [F(1, 261) = 22.22, p < 0.001, η2 0.078]. In cohort P, 40.5% of the patients were female, with the majority aged ≥ 30 years. The occurrence and severity of RTI symptoms were more pronounced in men than women. The PSS-4 was not affected by sex. Unlike in cohort H, a significant correlation between the PSS-4 and RTI symptoms was found for both sexes in cohort P. In both groups, the lowest stress levels were observed in individuals over 60 years old.
Conclusion
Perceived stress was higher in younger women, as was the occurrence and severity of URTIs. However, a significant correlation between stress and URTIs was found only in patients with cancer, suggesting a more complex interaction between sex, gender, stress and URTIs in individuals with compromised health as compared to healthy individuals, which deserves further study.
Trial registration:
Registry: the German Clinical Trials Register
Echocardiographic Predictors and Incidence of Left Ventricular Dysfunction Following Transcatheter Patent Ductus Arteriosus Closure in Extremely Premature Infants
Authors: Adamson Marissa E. , Ligon Ronald Allen , Hamrick Shannon , Mills Marcos , Bhombal Shazia , RN Sarah Hash , Michelfelder Erik
Published: October 2024

Background:
Left ventricular (LV) dysfunction is a known complication after ligation of patent ductus arteriosus (PDA). An increasing number of premature and extremely low birth weight (ELBW) infants undergo transcatheter closure of PDAs. The aim of this study was to evaluate incidence and predictors of LV dysfunction after transcatheter PDA closure in ELBW infants.
Methods:
Subjects undergoing PDA closure from 2020–2022 who were ELBW (< 1 kg) and extremely premature (gestational age < 29 weeks) at birth were included. A single cardiologist reviewed each pre- and post-intervention echocardiogram and calculated LVEF.
Results:
67 subjects were included with a mean gestational age of 24.8 weeks and birth weight of 648.2 g. Mean age and weight at time of procedure were 7.9 weeks and 1722.4 g, respectively. All patients had normal LVEF pre-procedure (mean LVEF 67.0%) with a significant decline post-procedure to 60.3% (p < 0.001). Post-procedure, 81% of subjects maintained normal LVEF (> 53%). 55% of patients did have a decline in EF > 5%. There was no significant difference in post-procedure LV dysfunction in relation to pre-procedural PDA size, left atrial or LV dilation. All subjects recovered function with a median time to observed normal LVEF of 6 days.
Conclusions:
LV dysfunction develops in 19% of ELBW infants undergoing PDA device occlusion, is usually mild in severity, and normalizes in all subjects. The size of PDA, degree of left heart dilation does not predict LV dysfunction in this population.
Detection of Toxoplasma Gondii in the Brain of Pet Birds by Seizures with Loop-Mediated Isothermal Amplification (LAMP)
Authors: Esfahani Mohammad Neshatpour , Gholami-Ahangaran Majid , Sullivan William J
Published: October 2024

BACKGROUND
This study seeks to close this divide by assessing the occurrence of Toxoplasma gondii (T. gondii) in the brain tissues of pet birds displaying neurological symptoms, utilizing Nested Polymerase Chain Reaction (PCR) and Loop-mediated Isothermal Amplification (LAMP) methods. Furthermore, it aims to evaluate and contrast the sensitivity and specificity of different diagnostic procedures. Seventy bird samples, consisting of 50 sick and 20 asymptomatic samples, were assessed using various methods. Brain tissue DNA was isolated and then analyzed using nested PCR and LAMP assays targeting the T. gondii B1 gene and RE gene. Sensitivity and specificity assessments were conducted, and statistical evaluations were made using SPSS software.
RESULTS
No T. gondii cysts were detected in the smear preparations. T. gondii DNA was discovered in 6% of the sick birds using nested PCR, while LAMP identified T. gondii DNA in 8% of these individuals. Both techniques exhibited a high level of specificity; however, LAMP demonstrated higher sensitivity and faster processing times than nested PCR.
CONCLUSION
The study indicates that LAMP is an efficient diagnostic method for quickly and accurately detecting T. gondii in pet birds while also being cost-effective. The results emphasize the significance of molecular diagnostics in promptly identifying and treating toxoplasmosis in birds, which enhances our comprehension and regulation of the disease. To improve the surveillance and preventative strategies against T. gondii infections, it is advisable to do additional studies using more extensive and diversified bird populations.
The role of the BMI ≥40 kg/m² criterium in ASA-PS classification for metabolic surgery
Authors: Ede Elisabeth S. van , Nienhuijs Simon W. , Bouwman R. Arthur , Buise Marc P.
Published: October 2024

Purpose This study explores historical trends in ASA-PS scoring and evaluates whether the ASA-PS III classification based solely on a BMI ≥ 40 kg/m² effectively contributes to peri-operative risk stratification for patients undergoing metabolic surgery.
Methods Adult patients (January 2015-January 2023) were included from the Dutch Audit for the Treatment of Obesity registry. Logistic regression adjusted for confounders compared groups stratified by BMI and presence of systemic disease. Outcome measures: complication prevalence (peri-operative, ≤30days and >30days), Clavien-Dindo score, hospital stay (>2 days), ICU admission, readmission, and mortality rates.
Results A total of 75,871 patients (78.8% women, age 43.5 (SD 11.8) yrs, BMI 42.9 (SD 5.3) kg/m2) were included. The number of patients receiving ASA-PS III increased from 26% to 92% (BMI≥40 kg/m2), and from 20% to 64% (BMI<40 kg/m2), despite generally stable mean age, BMI, and concurrent diseases. From 2018, ASA-PS II was inaccurately assigned in 64%. Patients without severe systemic disease (BMI ≥ 40 kg/m2) were significantly less likely to experience complications, ICU admission, prolonged hospital stay, or readmission compared to patients with severe systemic disease (BMI < 40 kg/m²) (OR: 1.72, 95% CI: 1.43 – 2.08, p < 0.001).
Conclusion A large Dutch national registry on metabolic surgery showed that ASA-PS III patients with BMI ≥ 40 kg/m² only were less likely to experience complications after surgery compared to those with BMI < 40 kg/m² and severe systemic disease. This suggests that adhering to the BMI criterion may undermine the ASA-PS classification's effectiveness in risk stratifying these patients.