bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular Removal of Pulmonary Artery Bullet Embolus: Case Report and Literature Review
Authors: Ricci Caesar , Hughes Jonathan , Miles Gayla
Published: July 2024

The current state of the literature for a bullet embolization to the heart and/or pulmonary vasculature indicates the occurrence is rare but could increase due to the rise in civilian low-kinetic-energy firearm acquisition and use. We present the case of an older teenage male who sustained a gunshot wound to the left flank. The bullet entered the iliac vein, travelled through the heart and lodged in the pulmonary artery. Successful relocation of the bullet to the internal iliac vein was performed by the interventional radiologist. This article highlights the advancement of interventional radiology as a successful non-invasive endovascular technique for bullet embolus removal.
Social Network Size and Severe Tooth Loss among Persons With Diabetes: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Laniado Nadia , Shah Parth , Gallo Linda , Daviglus Martha , Isasi Carmen
Published: July 2024

Aims: The aims of this study were to examine the association of social network size with severe tooth loss and the number of missing teeth among Hispanic adults with diabetes in the United States and to assess whether the association varied by glycemic control. Methods: Data obtained from 1,007 adults who participated in the Hispanic Community Health Study were analyzed. Structural social support was measured with the Social Network Index (SNI), which assessed network size and frequency of social contacts. Tooth loss was measured by a count of the number of missing teeth and categorically as severe tooth loss (<9 remaining teeth). Descriptive statistical analyses were conducted to examine the sample characteristics. Logistic and negative binomial regression analyses were performed to examine the independent association between SNI and tooth loss and to test whether the association was modified by the glycemic target. Results: The prevalence of severe tooth loss was 5.91%. For each one-unit increase in SNI, the expected log count of the number of missing teeth was reduced by 3.3% ( p-value: 0.037). Conclusions: In this study, a larger social network size was associated with fewer missing teeth among Hispanic persons living with diabetes. Further examination of social support and oral health is warranted.
The Show, the Game, and the Old Gods: On the Ontological Reframing and the Fiction/Real Boundary
Authors: Waszkiewicz Agata
Published: July 2024

The recent decade brought increasing interest in metareferentiality in video games. The article builds upon the body of research regarding metaleptic transgression in games by discussing examples of specific occurrences in which a text or a character seemingly escapes from within the boundaries of their primary, fictional world in a way that resembles ontological metalepsis. Acknowledging that such transgression is impossible, the article proposes that discussed examples might not be examples of metalepsis but rather ontological reframing, a cognitive shift in perception. The case studies come from games by Daniel Mullins and Sam Lake.
Addressing Toxicity and Extremism in Games: Conversations with the Video Game Industry
Authors: Kilmer Elizabeth D. , Aslan Zeynep , Kowert Rachel
Published: July 2024

There has been an increased focus on reducing hate, harassment, and extremist exploitation in digital games through solutions from community management, trust and safety, and design perspectives. Despite this attention, the industry lacks basic standards around these issues and efforts in this area are stymied by the ubiquity of “toxic gamer culture” and fears in the industry about discussing extremism and hate within games. Today, a patchwork of strategies and tools exist. In this study, focus groups with industry professionals were conducted to increase understanding of industry professional's perceptions of these problems and solutions. Several primary themes regarding solutions emerged: game and social system design strategies, moderation and player report strategies, and wish list solutions.
Difference in right and left cardio-ankle vascular index as a useful marker for evaluation of leg ischemia in patients with lower extremity arterial disease
Authors: Sotoda Yoko , Hirooka Shigeki , Orita Hiroyuki , Wakabayashi Ichiro
Published: July 2024

Objectives

Cardio-ankle vascular index (CAVI) is a blood pressure-independent measure of heart-ankle pulse wave velocity and is used as an indicator of arterial stiffness. However, there is a paradox that CAVI is inversely associated with leg ischemia in patients with lower extremity arterial disease (LEAD). The aim of this study was to clarify the significance of the absolute value of left and right difference in CAVI (diff-CAVI).

Methods

The subjects were 165 patients with LEAD who had received medication therapy. Relationships between diff-CAVI and leg ischemia were investigated. Leg ischemia was evaluated by decrease in leg arterial flow using ankle-brachial index (ABI) and by symptoms using the Rutherford classification.

Results

There was a significant inverse correlation between diff-CAVI and ABI. The odds ratio for low ABI of the 3rd versus 1st tertile groups of diff-CAVI was 7.03 with a 95% confidence interval of 2.71 ∼ 18.22. In ROC analysis, the cutoff value of diff-CAVI for low ABI was 1.05 with a sensitivity of 61.1% and a specificity of 87.1%. The median of diff-CAVI was significantly higher in subjects with grade 2 of the Rutherford classification than in subjects with its grade 1.

Conclusions

diff-CAVI showed an inverse association with ABI and a positive association with symptoms of leg ischemia. Thus, diff-CAVI is thought to be a useful indicator of leg ischemia in LEAD patients.
Neonatal complications of premature rupture of membranes in mothers receiving cefotaxime and ampicillin: A randomized clinical trial
Authors: Boskabadi Hassan , Najafi Ali , Saghafi Nafiseh , Sayedi Sayed J , Moradi Ali , Zakerihamidi Maryam
Published: July 2024

Introduction

Premature rupture of membranes (PROM) is one of the most common and important causes of premature births and peripartum mortality. Maternal antibiotic treatment affects the infantile prognosis. This study was conducted to compare the efficacy of Ampicillin and Cefotaxime administered for the parturients on neonatal outcomes.

Material and Methods

A comparison between the effects of Cefotaxime and Ampicillin on infantile complications of PROM was done in this clinical trial. Two hundred and twenty parturients with PROM who needed antibiotic therapy were randomized in two groups of control (Ampicillin) and intervention (Cefotaxime) treatments. The maternal/fetal statuses up to accouchement and the infants’ status up to transfer to neonatal intensive care unit, death, or discharge from hospital were followed. The Apgar score, cardiac, respiratory and nervous systems, infection, immaturity, asphyxia, and mortality rates were compared in both groups.

Results

The differences between the two groups were significant in: Apgar score min1 and min5, need for resuscitation, asphyxia, need for hospitalization, infection, and mortality rate.

Conclusion

Administration of Cefotaxime in parturients with PROM improved the Apgar scores and decreased respiratory complications, infection, asphyxia, mortality rate, and need for ICU hospitalization in infants.
A review of mask fit testing data associated with protocols utilized in evaluating the efficacy of N95 masks for health care workers
Authors: Hook Jody , Sasko Louisa , Smith Sheree M
Published: July 2024

Background

Quantitative mask fit testing (QNFT) is the gold standard to confirm the correct fit of a N95/P2 mask to ensure health care workers protection from airborne viruses. Using the Occupational Safety and Health Administration (OSHA) guidance indicates a final fit test result is a cumulative score derived from manoeuvres within the OSHA protocol. The protocol-based manoeuvres mimic aspects of clinical care by health professionals and mask fit testing is conducted to provide protection from airborne viruses and pollutants within a care setting.

Objective(s)

To determine whether studies undertaking QNFT report the results of individual manoeuvres of the OSHA protocol.

Methods

A comprehensive search strategy for the systematic review was developed to determine eligible studies, published between May 2011 and May 2021. Two researchers independently screened all full text articles retrieved and all disagreements were resolved through discussion.

Results

The search found 557 studies. After removing 119 duplicates, 437 articles were reviewed based on title and abstract, 411 studies were excluded. Twenty-seven full text articles were assessed for eligibility, all were excluded for the following reasons: study did not report the results of the long or short OSHA protocol (12), study did not assess mask fit using the long or short OSHA protocol (10), article type (discussion/commentary/editorial) or wrong study type (1). Despite the use of very broad search terms no eligible studies were found and the result was declared an empty review.

Conclusion

Internationally accepted QNFT protocols have a number of manoeuvres that reflect health care workers’ physical movements during the delivery of clinical care. Studies of mask fit testing appear to lack the reporting of outcomes for each manoeuvre with only the cumulative results being provided. This finding raises the need to understand potential risk from a mask leak during the delivery of clinical care as evidenced by failing a manoeuvre during mask fit testing. Further research is required to understand the importance of passing each mask fit testing manoeuvre and the relationship to airborne protection during the delivery of clinical care.
Computed Tomography Signs of Sinonasal Inflammation in Patients with Acute Dacryocystitis
Authors: Yu Yueqi , Zhou Guangming , Li Xinyu , Wei Jinfei , Ke Xiaoyu , Wu Linjuan , Wu Wencan , Yu Bo
Published: July 2024

Background

Nasal and paranasal sinus abnormalities may be related to nasolacrimal duct obstructive disease but are strongly debated. Data of acute disease stage are lacking.

Objective

The purpose of this study was to determine if there are correlations between radiologic signs of sinus inflammation and acute dacryocystitis (AD).

Methods

This cross-sectional controlled study was conducted at Wenzhou, Zhejiang Province, China from February 2021 to November 2023. Forty-four consecutive patients with AD and 50 consecutive patients with orbital tumors (the control group), who completed preoperative computed tomography scans, were enrolled to evaluate the extent of their inflammatory sinonasal disease by the modified Lund-Mackay score system.

Results

The inflammation signs of the paranasal sinuses (total mean sinus scores, 95% CI [0.00, 2.00]; P < 0.001), namely the anterior ethmoid sinus(95% CI [0.00, 1.00]; P < 0.001), the posterior ethmoid sinus(95% CI [0.00, 0.00]; P = 0.003), the frontal sinus (95% CI [0.00, 0.00]; P = 0.02), and the ostiomeatal complex ( P < 0.001) were more extensive in patients with AD when compared with the controls. The disease course was negatively correlated with the anterior ethmoid ( P = 0.03) and frontal scores ( P = 0.01). The symptom of eyelid swelling was positively correlated with the anterior ethmoid ( P = 0.03), ostiomeatal complex ( P = 0.004), and total sinus scores ( P = 0.005).

Conclusion

Inflammatory sinus disease was found to be more frequent in patients with AD, which was gradually alleviated with the prolongation of the disease course. The mutual spread of inflammation particularly in the acute course may play an important role in lacrimal duct obstructive disease.
Is Arabic online patient-centered information about dental extraction trustworthy? An infodemiological study
Authors: Othman Ahmad A. , Alassaf Muath S. , Hasubah Saad M. , Aljuhani Mohammad , Kabli Ahmad M. , Alsulaimani Mahmoud
Published: July 2024

Background

Assessment of the Arabic online patient-centered information is understudied. The study aims to assess the quality and readability of the Arabic web-based knowledge about dental extraction.

Methods

The first 100 Arabic websites focusing on dental extraction were gathered using popular terms from Google, Bing, and Yahoo searches. These sites were organized and their quality was assessed using three key standards: the Journal of the American Medical Association ( JAMA) benchmark criteria, the DISCERN instrument, and the inclusion of the Health on the Net Foundation Code of Conduct (HON code) seal. Additionally, the ease of reading of these websites was evaluated through various online readability indexes.

Results

Out of 300 initially reviewed websites on dental extraction in Arabic, 80 met the eligibility criteria. Nonprofit organizations were most common (41.3%), followed by university/medical centers (36.3%), and commercial entities (21.3%). Government organizations were minimally represented (1.3%). All websites were medically oriented, with 60% offering Q&A sections. Quality assessment showed moderate scores on the DISCERN instrument, with no site reaching the highest score. JAMA benchmarks were poorly met, and none had the HON code seal. Readability was generally high, with most sites scoring favorably on readability scales.

Conclusions

The rapidly evolving online information about dental extraction lacks readability and quality and can spread misinformation. Creators should focus on clear, unbiased content using simple language for better public understanding.
Diagnostic performance of generative artificial intelligences for a series of complex case reports
Authors: Hirosawa Takanobu , Harada Yukinori , Mizuta Kazuya , Sakamoto Tetsu , Tokumasu Kazuki , Shimizu Taro
Published: July 2024

Background

Diagnostic performance of generative artificial intelligences (AIs) using large language models (LLMs) across comprehensive medical specialties is still unknown.

Objective

We aimed to evaluate the diagnostic performance of generative AIs using LLMs in complex case series across comprehensive medical fields.

Methods

We analyzed published case reports from the American Journal of Case Reports from January 2022 to March 2023. We excluded pediatric cases and those primarily focused on management. We utilized three generative AIs to generate the top 10 differential-diagnosis (DDx) lists from case descriptions: the fourth-generation chat generative pre-trained transformer (ChatGPT-4), Google Gemini (previously Bard), and LLM Meta AI 2 (LLaMA2) chatbot. Two independent physicians assessed the inclusion of the final diagnosis in the lists generated by the AIs.

Results

Out of 557 consecutive case reports, 392 were included. The inclusion rates of the final diagnosis within top 10 DDx lists were 86.7% (340/392) for ChatGPT-4, 68.6% (269/392) for Google Gemini, and 54.6% (214/392) for LLaMA2 chatbot. The top diagnoses matched the final diagnoses in 54.6% (214/392) for ChatGPT-4, 31.4% (123/392) for Google Gemini, and 23.0% (90/392) for LLaMA2 chatbot. ChatGPT-4 showed higher diagnostic accuracy than Google Gemini ( P < 0.001) and LLaMA2 chatbot ( P < 0.001). Additionally, Google Gemini outperformed LLaMA2 chatbot within the top 10 DDx lists ( P < 0.001) and as the top diagnosis ( P = 0.010).

Conclusions

This study demonstrated the diagnostic performance of generative AIs including ChatGPT-4, Google Gemini, and LLaMA2 chatbot. ChatGPT-4 exhibited higher diagnostic accuracy than the other platforms. These findings suggest the importance of understanding the differences in diagnostic performance among generative AIs, especially in complex case series across comprehensive medical fields, like general medicine.
Representation and Race in Adolescent Idiopathic Scoliosis Research: Disparities in Curve Magnitude and Follow-Up
Authors: Todderud Julia E. , Jilakara Bharadwaj , Kelly Michael P. , Marks Michelle C. , Fletcher Nicholas D. , Pahys Joshua M. , Brooks Jaysson T. , Newton Peter O. ,   Harms Study Group, Larson A. Noelle
Published: July 2024

Study Design

Prospective Cohort Study.

Objective

The present study aims to determine if the racial representation of patients enrolled in a large prospective scoliosis registry is reflective of the general United States population. Further, we studied whether there was an association between race, pre-operative parameters, outcomes and loss to follow-up.

Methods

Prospectively collected data for patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS) was reviewed, including self-reported race/ethnicity. The U.S. pediatric population and U.S. patients enrolled in the prospective registry were compared. The data obtained was analyzed for variations between races, for pre-operative variables and follow-up.

Results

Of the 2210 included patients in the registry 66% of patients reported as White, while 52% of the 2018 U.S. pediatric population reported as White. 15% of the registry reported as Hispanic/Latino compared to 22% of the U.S. pediatric population, 13% Black compared to 14% of the U.S. pediatric population, and 4% Asian compared to 5% of the U.S. pediatric population. Asian and White patients had statistically significant higher 2-year follow-up in all but one of six enrollment sites ( P < 0.001). Native American, Other, and Hispanic/Latino patients had the highest BMIs. Native American and Black patients had the highest pre-op thoracic Cobb angles. Pre-op ages of Black, Hispanic, and Native American patients were statistically lower ( P < 0.01).

Conclusion

This study demonstrates the association between race and patient follow-up and pre-operative factors in patients who underwent surgery for AIS. Black, Native American, and Hispanic populations were underrepresented both at pre-op and follow-up when compared to their relative proportion in the U.S. pediatric population.
Dadzine: Zine making with young fathers as a participatory and DIY approach to research
Authors: Way Laura
Published: July 2024

This article consider how zine making might be understood as a participatory and DIY approach to research through a focus on zine making workshops with young fathers. Drawing upon Fletcher's conceptualisation of ‘zine ethos’, zines’ DIY ethic, their democratic and participatory ideal and their transformative potential will each be considered reflexively, highlighting some of the ways these might be enacted through zine making in the context of research but also potentially constrained. This article extends existing empirical work concerning zines in the context of research and offers some fresh reflections on their value as a participatory and DIY approach to research.
The gender dynamics along the human–machine interface
Authors: Wang June , Miao Sherry Xueyue
Published: July 2024

By deconstructing the human–machine interface across China's economic history, this commentary on Luger and Schwarze's paper highlights the critical need to explore gender dynamics in post-industrial cities through the human–machine interface. We suggest two new concepts, subjectivity and deep interface, which may offer a way forward for us to move deeper into post-industrial cities for a more intricate understanding of the enduring inequalities shaping these urban landscapes.
Assistive Robotics for Upper Limb Physical Rehabilitation: A Systematic Review and Future Prospects
Authors: Guatibonza Andrés , Solaque Leonardo , Velasco Alexandra , Peñuela Lina
Published: July 2024

Physical assistive robotics are oriented to support and improve functional capacities of people. In physical rehabilitation, robots are indeed useful for functional recovery of affected limb. However, there are still open questions related to technological aspects. This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area. A bibliometric analysis was performed for the systematic literature review. Literature from the last six years, conducted between August 2020 and May 2021, was reviewed. The methodology for the literature search and a bibliometric analysis of the metadata are presented. After a preliminary search resulted in 820 articles, a total of 66 articles were included. A concurrency network and bibliographic analysis were provided. And an analysis of occurrences, taxonomy, and rehabilitation robotics reported in the literature is presented. This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation. The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.
Shallow water seeding cultivation enhances cold tolerance in tobacco seedlings
Authors: Tao Xuan , Yang Lei , Zhang Mingfa , Li Yangyang , Xiao Hanqian , Yu Lingyi , Jiang Chaowei , Long Zeyu , Zhang Yiyang
Published: July 2024

Cold stress can impact plant biology at both the molecular and morphological levels. We cultivated two different types of tobacco seedlings using distinct seeding methods, observing significant differences in their cold tolerance at 4 °C. After 12 h cold stress, shallow water seeding cultivation treatment demonstrates a relatively good growth state with slight wilting of the leaves. Tobacco grown using the float system exhibited short, thick roots, while those cultivated through shallow water seeding had elongated roots with more tips and forks. After cold stress, the shallow water seeding cultivation treatment demonstrated higher antioxidant enzyme activity, and lower malondialdehyde (MDA) content.

Transcriptome analysis was performed on the leaves of these tobacco seedlings at three stages of cold treatment (before cold stress, after cold stress, and after 3 days of recovery). Upon analyzing the raw data, we found that the shallow water seeding cultivation treatment was associated with significant functional enrichment of nicotinamide adenine dinucleotide (NAD) biosynthesis and NAD metabolism before cold stress, enrichment of functions related to the maintenance of cellular structure after cold stress, and substantial functional enrichment related to photosynthesis during the recovery period. Weighted gene co-expression network analysis (WGCNA) was conducted, identifying several hub genes that may contribute to the differences in cold tolerance between the two tobacco seedlings. Hub genes related to energy conversion were predominantly identified in shallow water seeding cultivation treatment during our analysis, surpassing findings in other areas. These include the AS gene, which controls the synthesis of NAD precursors, the PED1 gene, closely associated with fatty acid β-oxidation, and the RROP1 gene, related to ATP production.

Overall, our study provides a valuable theoretical basis for exploring improved methods of cultivating tobacco seedlings. Through transcriptome sequencing technology, we have elucidated the differences in gene expression in different tobacco seedlings at three time points, identifying key genes affecting cold tolerance in tobacco and providing possibilities for future gene editing.
Prevalence of rectal carbapenem resistant Enterobacterales carriage among patients attending healthcare facilities in Ibadan, Nigeria: a descriptive study
Authors: Adekanmbi Olukemi , Popoola Oluwafemi , Fowotade Adeola , Idowu Olusola , Ogunbosi Babatunde , Lakoh Sulaiman , Adebiyi Ini , Ayandipo Omobolaji , Iyun Ayodele Olukayode
Published: July 2024

Background

Carbapenem Resistant Enterobacterales (CRE) infections are increasingly associated with or directly responsible for morbidity and mortality from bacterial infections in sub-Saharan Africa where there are limited antibiotic options. CRE rectal colonization of patients in healthcare facilities provides a reservoir of these organisms and could potentially cause invasive infections in these settings. The prevalence of rectal carriage among patients attending healthcare facilities in Nigeria has not been previously described. We set out to assess the prevalence of rectal CRE carriage and their antibiotic susceptibility patterns among patients attending healthcare facilities in Nigeria.

Methods

A descriptive cross-sectional study was carried out from December 2021 to September 2022 in Ibadan, in which patients attending primary, secondary and tertiary healthcare facilities were screened for rectal carriage of CRE by microscopy, culture and sensitivity of rectal swab specimens.

Results

A total of 291 patients were screened; 45 (15.5%), 66 (22.7%) and 180 (61.8%) at primary, secondary and tertiary healthcare facilities, respectively. All but one of them had received a third-generation cephalosporin or carbapenem in the preceding 30 days. The mean age was 28.8 years and 55.7% were male. Overall, 51 (17.5%) participants had CRE colonization, with 5(11.1%), 9(13.6%) and 37(20.6%) at primary, secondary and tertiary healthcare facilities, respectively (p = 0.243). Regarding antimicrobial susceptibility, 43(84.3%) CRE isolates were resistant to at least 3 different classes of antibiotics while two Escherichia coli isolates were resistant to all 5 classes of antibiotics tested. The lowest rates of CRE resistance were to tigecycline (6, 11.5%) and colistin (8, 15.7%).

Conclusions

In this first study on CRE colonization in Nigeria, we found that a substantial proportion of patients in three levels of healthcare facilities had rectal carriage of CRE, including pan-resistant isolates. Active surveillance and appropriate infection prevention and control practices (IPC) need to be urgently strengthened to mitigate the risk of active CRE infection.

Trial registration

Not applicable.
Using natural language processing to facilitate the harmonisation of mental health questionnaires: a validation study using real-world data
Authors: McElroy Eoin , Wood Thomas , Bond Raymond , Mulvenna Maurice , Shevlin Mark , Ploubidis George B. , Hoffmann Mauricio Scopel , Moltrecht Bettina
Published: July 2024

Background

Pooling data from different sources will advance mental health research by providing larger sample sizes and allowing cross-study comparisons; however, the heterogeneity in how variables are measured across studies poses a challenge to this process.

Methods

This study explored the potential of using natural language processing (NLP) to harmonise different mental health questionnaires by matching individual questions based on their semantic content. Using the Sentence-BERT model, we calculated the semantic similarity (cosine index) between 741 pairs of questions from five questionnaires. Drawing on data from a representative UK sample of adults (N = 2,058), we calculated a Spearman rank correlation for each of the same pairs of items, and then estimated the correlation between the cosine values and Spearman coefficients. We also used network analysis to explore the model’s ability to uncover structures within the data and metadata.

Results

We found a moderate overall correlation (r = .48, p < .001) between the two indices. In a holdout sample, the cosine scores predicted the real-world correlations with a small degree of error (MAE = 0.05, MedAE = 0.04, RMSE = 0.064) suggesting the utility of NLP in identifying similar items for cross-study data pooling. Our NLP model could detect more complex patterns in our data, however it required manual rules to decide which edges to include in the network.

Conclusions

This research shows that it is possible to quantify the semantic similarity between pairs of questionnaire items from their meta-data, and these similarity indices correlate with how participants would answer the same two items. This highlights the potential of NLP to facilitate cross-study data pooling in mental health research. Nevertheless, researchers are cautioned to verify the psychometric equivalence of matched items.
Trends in traffic accident mortality and social inequalities in Ecuador from 2011 to 2022
Authors: Holguín-Carvajal Juan Pablo , Otzen Tamara , Sanhueza Antonio , Castillo Álvaro , Manterola Carlos , Muñoz Georgina , García-Aguilera Fernanda , Salgado-Castillo Fernanda
Published: July 2024

Background

Traffic accidents (TA) remain a significant global public health concern, impacting low—and middle-income countries. This study aimed to describe the trend in TA mortality and inequalities in Ecuador for 2011–2022, distributed by year, gender, age group, geographical location, type of accident, and social inequalities.

Methods

An ecological study was conducted using INEC national-level data on TA fatalities in Ecuador. Mortality rates were calculated per 100,000 population and analyzed by year, gender, age group, geographic region, and accident type. Annual percentage variation (APV) was determined using linear regression models. Inequality analyses examined associations between TA mortality and socioeconomic factors like per capita income and literacy rates. Complex measures such as the Slope Inequality Index (SII) were calculated to assess the magnitude of inequalities.

Results

There were 38,355 TA fatalities in Ecuador from 2011 to 2022, with an overall mortality rate of 19.4 per 100,000 inhabitants. The rate showed a non-significant decreasing trend (APV − 0.4%, p = 0.280). Males had significantly higher mortality rates than females (31.99 vs. 7.19 per 100,000), with the gender gap widening over time (APV 0.85%, p = 0.003). The Amazon region had the highest rate (24.4 per 100,000), followed by the Coast (20.4 per 100,000). Adults aged ≥ 60 years had the highest mortality (31.0 per 100,000), followed by those aged 25–40 years (28.6 per 100,000). The ≥ 60 age group showed the most significant rate decrease over time (APV − 2.25%, p < 0.001). Pedestrians were the most affected group after excluding unspecified accidents, with a notable decreasing trend (APV − 5.68%, p < 0.001). Motorcyclist fatalities showed an increasing trend, ranking third in TA-related deaths. Lower literacy rates and per capita income were associated with higher TA mortality risks. Inequality in TA mortality between provinces with the highest and lowest per capita income increased by 247.7% from 2011 to 2019, as measured by the SII.

Conclusion

While overall TA mortality slightly decreased in Ecuador, significant disparities persist across demographic groups and geographic regions. Older adults, males, pedestrians, and economically disadvantaged populations face disproportionately higher risks. The increasing trend in motorcycle-related fatalities and widening socioeconomic inequalities are particularly concerning.
Red blood cell folate level is associated with periodontitis in American adults: results from the NHANES 2009–2014
Authors: Liu Zefei , Luo Shiyi , Jiao Ruofeng , Li Wei , Jin Fuqian , Sun Jiangling , Ma Shu , Song Jukun , Chen Zhu
Published: July 2024

Background

Red blood cell (RBC) folate is an indicator of long-term folate nutrition. Whether there is an association between RBC folate and periodontitis is unclear. This study aimed to use the NHANES database to determine whether RBC folate is associated with moderate/severe periodontitis.

Methods

A cross-sectional analysis of 10,151 participants in the NHANES database from 2009 to 2014 was performed. Multivariate logistic regression was used to analyze the independent relationship between RBC folate and moderate/severe periodontitis. The generalized additive model (GAM), restricted cubic splines (RCS), smooth curve fitting, and threshold effect analysis were used to explore the dose–response relationship and the potential nonlinear relationship between RBC folate and periodontitis. Finally, subgroup analysis and interaction tests were performed to determine the effect of covariates on the relationship between RBC folate and moderate/severe periodontitis.

Results

After adjusting for all confounders, there was a negative association between RBC folate concentration and moderate/severe periodontitis. The lowest fraction Q1 (< 360 ng/mL) of RBC folate concentration was used as the reference group, multivariable-adjusted ORs and 95% CIs of the second (360-463 ng/mL), third (464-569 ng/mL), fourth (570-732 ng/mL), and the highest quintile (> 733 ng/mL) categories were 0.88 (0.77, 1.01), 0.83 (0.72, 0.96), 0.77 (0.67, 0.90), 0.65 (0.56, 0.77) respectively. Additionally, a threshold nonlinear association was found between RBC folate (ng/mL) log2 transformation and moderate/severe periodontitis.

Conclusion

This cross-sectional study revealed a negative relationship between RBC folate and moderate/severe periodontitis within a certain threshold range. Dentists and policymakers should pay closer attention to oral hygiene and health care for people with low or high RBC folate levels. Further causal and longitudinal research mechanisms are needed to validate our findings.
A systematic review and meta-analysis on early-childhood-caries global data
Authors: Maklennan Anastasia , Borg-Bartolo R. , Wierichs R. J. , Esteves-Oliveira M. , Campus G.
Published: July 2024

Objectives

The present study systematically reviewed and provided a meta-analysis on early childhood caries (ECC) global prevalence and its association with socioeconomic indicators, both geographical and regarding unemployment rate, national income as well as income inequalities.

Methods

Only cross-sectional or cohort studies covering ECC prevalence and experience in children younger than 71 months, reporting sample size, diagnostic criteria and conducted in urban and rural communities were considered. No language restriction was selected. Studies published from 2011 to 2022 available in PubMed, Web of Science, Embase and Open Grey literature were retrieved by ad hoc prepared search strings. The meta-analyses were conducted for both overall ECC prevalence and experience stratified by country of publication as well as measures of socioeconomic indicators using a random effects model using STATA 18®.

Results

One hundred publications reporting ECC data from 49 countries (published from 2011 to 2022) were included and summarized by meta-analysis. The lowest prevalence was reported in Japan (20.6%) and Greece (19.3%). The global estimated random-effect pooled prevalence of ECC was 49% (95%CI: 0.44–0.55). The random-effect pooled caries prevalence (ECC) was 34% (95%CI: 02.20–0.48) (Central/South America), 36% (95%CI: 0.25–0.47) (Europe), 42% (95%CI: 0.32–0.53) (Africa), 52% (95%CI: 0.45–0.60) (Asia-Oceania), 57% (95%CI: 0.36–0.77) (North America) and 72% (95%CI: 0.58–0.85) (Middle East). When stratified by gross national income (GNI) the ECC prevalence ranged from 30% ($20,000-$39,999) to 57% in countries with the lowest GNI (<$5000). Stratification by inequality index (Gini index) resulted in an ECC prevalence range of 39% (low inequality) to 62% (no inequality), while for life expectancy the ECC prevalence ranged from 28% in countries with the highest life expectancy (< 80 years) to 62% in countries with 71–75 years life expectancy.

Discussion

Within the limitations of this study (lack of certainty about the results as many countries are not represented and lack of uniformity in prevalence and experience data represented), results from 49 different countries reported a wide range of ECC prevalence. These reports indicated persisting high worldwide distribution of the disease. Both ECC prevalence and experience were associated with geographical areas and GNI.

Registration

PROSPERO: CRD-42,022,290,418.
Patient safety culture perceptions among dentists in the eastern region of Saudi Arabia
Authors: Al-Khalifa Khalifa S. , Shahin Suliman Y. , AlSharief Mishali , Asiri Amal , AlYousef Yousef , Nazir Muhammad
Published: July 2024

Objective

Safe patient care can help reduce treatment costs, morbidity, and mortality. This study aimed to assess dentists’ perceptions of patient safety culture and related factors in the Eastern region of Saudi Arabia.

Methods

This cross-sectional study used a sample of 271 dental professionals working in private and public dental hospitals and clinics in the Eastern region of Saudi Arabia. The Safety Attitude Questionnaire (SAQ), a validated tool consisting of 36 items on a 5-point Likert scale, was used to assess dentists’ perceptions of patient safety culture. The score of SAQ ranges from 0 to 100 and a cut-off ≥ 75 is considered a positive attitude toward patient safety culture.

Results

There were 53.9% males and 46.1% females in the study with a mean age of 35.56 ± 6.87 years. Almost half of the participants (52%) attended a course on patient safety and 22.1% experienced medical error in the last month. The mean score of the SAQ of the sample was 65.14 ± 13.03 and the patient safety score was significantly related to the marital status (P = 0.041), attendance of patient safety course (P < 0.001), and experience of medical error (P = 0.008). The highest mean score (73.27 ± 20.11) was for the job satisfaction domain, followed by the safety climate domain (67.69 ± 16.68), and working conditions domain (66.51 ± 20.43). About one-quarter of the participants (22.5%) demonstrated positive attitudes toward patient safety culture. Multiple logistic regression analysis showed that dental professionals who attended a patient safety course were 4.64 times more likely to demonstrate positive attitudes toward patient safety than those who did not attend a course (P < 0.001).

Conclusion

This study showed that patient safety culture was significantly related to the attendance of safety courses, marital status, and experiencing medical error. About one out of four dental professionals demonstrated a positive attitude towards patient safety culture which was significantly associated with the attendance of the safety course.
Postbiotic mediators derived from Lactobacillus species enhance riboflavin-mediated antimicrobial photodynamic therapy for eradication of Streptococcus mutans planktonic and biofilm growth
Authors: Pourhajibagher Maryam , Ghafari Hassan-Ali , Bahador Abbas
Published: July 2024

Background

Streptococcus mutans has been implicated as a primary causative agent of dental caries and one of its important virulence properties is an ability to form biofilm on tooth surfaces. Thus, strategies to prevent and control S. mutans biofilms are requested. The present study aimed to examine the eradication of S. mutans planktonic and biofilm cells using riboflavin (Rib)-mediated antimicrobial photodynamic therapy (aPDT) enhanced by postbiotic mediators derived from Lactobacillus species.

Materials and methods

Minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of Rib and postbiotic mediators were determined. The antimicrobial and anti-biofilm effects of Rib-mediated aPDT (Rib plus blue light), Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus casei (LC) (aPDT+ LC), and Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus plantarum (LP) (aPDT+ LP) were evaluated. The anti-virulence potential of Rib-mediated aPDT, aPDT+ LC, and aPDT+ LP were assessed by measuring the expression of the gtfB gene using quantitative real-time polymerase chain reaction (qRT-PCR) at the highest concentrations of Rib, LC, and LP, at which the S. mutans had proliferation as the same as in the control (non-treated) group.

Results

According to the results, the MIC doses of LC, LP, and Rib were 64 µg/mL, 128 µg/mL, and 128 µg/mL, respectively, while the MBC values of LC, LP, and Rib were 128 µg/mL, 256 µg/mL, and 256 µg/mL, respectively. Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC showed a significant reduction in Log10 CFU/mL of S. mutans compared to the control group (4.2, 4.9, and 5.2 Log10 CFU/mL, respectively; all P < 0.05). The most destruction of S. mutans biofilms was observed after treatment with aPDT+ LC followed by aPDT+ LP and Rib-mediated aPDT (77.5%, 73.3%, and 67.6%, respectively; all P < 0.05). The concentrations of 31.2 µg/mL, 62.5 µg/mL, and 62.5 µg/mL were considered as the highest concentrations of LC, LP, and Rib, respectively, at which S. mutans replicates as same as the control group and were used for gtfB gene expression assay using qRT-PCR during Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC treatments. Gene expression results revealed that aPDT+ LP and aPDT+ LC could decrease the gene expression level of gtfB by 6.3- and 5.7-fold, respectively (P < 0.05), while only 5.1-fold reduction was observed after Rib-mediated aPDT (P < 0.05).

Conclusion

Our findings indicate that aPDT+ LP and aPDT+ LC hold promise for use as a treatment to combat S. mutans planktonic and biofilms growth as well as anti-virulence as a preventive strategy to inhibit biofilms development via reduction of gtfB gene expression.
Using structural equation modeling to investigate students’ satisfaction with an undergraduate tutorial system
Authors: Wu Xiaorong , Liu Hui , Zhang Cong , Zhang Fangda , Xie Biao , Zhong Xiaoni
Published: July 2024

Background

The undergraduate tutorial system (UTS) is a crucial measure in China for adhering to the principle of prioritizing foundational education, innovating the undergraduate talent training mode, and building a powerful country of higher education. This study investigated undergraduate students’ satisfaction with UTS and the influencing factors, aiming to promote the healthy and sustainable development of UTS and provide practical implications and suggestions for universities.

Methods

Based on relevant theories, we conducted a survey study and leveraged structural equation modeling to assess students’ satisfaction with UTS and explore the influencing factors.

Results

Our Pearson correlation analysis showed that students’ satisfaction with mentors was positively correlated with dimensions such as humanistic care (r = 0.844, P < 0.05), mentor assistance (r = 0.906, P < 0.05), and mentor-student communication (r = 0.908, P < 0.05). Path analysis showed that mentor-student communication (β = 0.486, P < 0.01), mentor assistance (β = 0.228, P < 0.05), humanistic care (β = 0.105, P < 0.05) were positive factors affecting students’ satisfaction with mentors, while satisfaction with mentors (β = 0.923, P < 0.01) had a positive impact on students’ satisfaction with UTS. Students’ satisfaction with mentors explained 73.4% of the variation in students’ satisfaction with UTS, indicating that satisfaction with mentors was an important intermediary variable of UTS students.

Conclusion

The sustainable implementation of UTS requires the effort to improve student satisfaction, and the breakthrough of strengthening the targeted mentorship in “transmitting wisdom, imparting knowledge, and resolving doubts” for students. Efforts should also be devoted to fostering students’ comprehensive skills and better serving the cultivation of talents in the new era.
Predictors of successful transition of adolescents and young adults living with HIV from pediatric to adult-oriented care in southern Ethiopia: a retrospective cohort study
Authors: Shimbre Mulugeta Shegaze , Abay Gelila , Belete Abebe Gedefaw , Mengesha Melkamu Merid , Ma Wei
Published: July 2024

Background

The introduction of highly active antiretroviral therapy has significantly improved the life expectancies of children and adolescents living with HIV, leading to an increased number transitioning to adult care. However, there has been a lack of studies in Ethiopia focusing on factors influencing the success of this transition. Therefore, this study aimed to determine predictors of a successful transition from pediatric to adult HIV clinics among adolescents and young adults living with HIV in health facilities in southern Ethiopia.

Methods

A retrospective cohort study included 337 adolescents and young adults who transitioned to adult-oriented HIV care. Successful transition was defined as having a viral load of less than 1000 copies/ml and maintaining care during the first year post-transition. Patients’ antiretroviral therapy (ART) cards and monitoring charts were reviewed. Secondary data analysis was conducted using a multivariable binary logistic regression model to identify predictors of a successful transition. Using the variance inflation factor, we checked for multi-collinearity between variables and assessed model fitness with the Hosmer and Lemeshow goodness-of-fit test. Adjusted Odds Ratio (AOR) with 95% confidence intervals (CI) and P-value ≤ 0.05 measured the strength of association and statistical significance.

Results

Of 337 participants, 230 (68.25%) successfully transitioned (95% CI = 63.25, 73.25). Transitioning at age 18 or older (AOR = 4.25; 95% CI = 2.29, 7.87), residing in an urban area (AOR = 1.78; 95% CI = 1.04, 3.02), and being on antiretroviral therapy for more than two years (AOR = 4.25; 95% CI = 1.17, 4.94; P < 0.017) were identified as positive predictors and opportunistic infection (AOR = 0.34; 95% CI = 0.15, 0.75; P < 0.008) was identified as a negative predictor for a successful transition from pediatric to adult ART clinic.

Conclusion

This study sheds light on the challenges faced by HIV patients transitioning from pediatric to adult care, with less than 70% successfully navigating this critical phase. Factors such as age at transition, residence, duration of ART, and the presence of opportunistic infections were identified as key predictors of successful transition. The findings underscore the urgent need for tailored interventions, including standardized transition plans that address age and urban/rural disparities, to enhance transition outcomes for adolescents and young adults living with HIV in the region.
Machine learning models for predicting of PD-1 treatment efficacy in Pan-cancer patients based on routine hematologic and biochemical parameters
Authors: Yang Wenjian , Chen Cui , Ouyang Qiangqiang , Han Runkun , Sun Peng , Chen Hao
Published: July 2024

Immune checkpoint blockade therapy targeting the programmed death-1(PD-1) pathway has shown remarkable efficacy and durable response in patients with various cancer types. Early prediction of therapeutic efficacy is important for optimizing treatment plans and avoiding potential side effects. In this work, we developed an efficient machine learning prediction method using routine hematologic and biochemical parameters to predict the efficacy of PD-1 combination treatment in Pan-Cancer patients. A total of 431 patients with nasopharyngeal carcinoma, esophageal cancer and lung cancer who underwent PD-1 checkpoint inhibitor combination therapy were included in this study. Patients were divided into two groups: progressive disease (PD) and disease control (DC) groups. Hematologic and biochemical parameters were collected before and at the third week of PD-1 therapy. Six machine learning models were developed and trained to predict the efficacy of PD-1 combination therapy at 8–12 weeks. Analysis of 57 blood biomarkers before and after three weeks of PD-1 combination therapy through statistical analysis, heatmaps, and principal component analysis did not accurately predict treatment outcome. However, with machine learning models, both the AdaBoost classifier and GBDT demonstrated high levels of prediction efficiency, with clinically acceptable AUC values exceeding 0.7. The AdaBoost classifier exhibited the highest performance among the 6 machine learning models, with a sensitivity of 0.85 and a specificity of 0.79. Our study demonstrated the potential of machine learning to predict the efficacy of PD-1 combination therapy based on changes in hematologic and biochemical parameters.