bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproduction of human dental models using different 3D printing techniques
Authors: Juneja Mamta , Bajaj Divya , Thakur Niharika , Jindal Prashant
Published: April 2024

A three-dimensional (3D) printing has been contributing enormously across areas of dentistry including treatment planning, prosthesis designing, dental restorations, and surgical procedures. A successful dentistry treatment with minute analysis can be done more effectively, using 3D printing as compared to conventional fabrication methods. In this article, four different 3D printing techniques namely PolyJet, fused deposition modelling (FDM), selective laser sintering (SLS), and stereolithography (SLA) were used to reproduce dental models of five subjects as references. Critical dimensions of these 3D printed dental models including crown height and width were then compared with Standard Tessellation Language (STL) digital image files. Average relative errors for SLA, SLS, PolyJet, and FDM printed models with their respective STL files were calculated as 0.3%, 0.4%, 0.8%, and 1.7%, respectively, for crown height and 0.2%, 0.4%, 1.0%, and 2.0% for crown width in the same order, indicating a relative error trend as SLA < SLS < PolyJet < FDM in ascending order. Raw material cost for 3D printing a single dental model used in FDM ($3.12) was most economical in comparison to SLS ($3.63), SLA ($5.18), and PolyJet ($7.84). Time consumed for 3D printing the same model was highest for SLA (180 min) in comparison to FDM (120 min), PolyJet (55 min), and SLS (40 min). Therefore, a combination of factors such as dimensional accuracy, time consumption, and cost-effectiveness essential in manufacturing have been considered to suggest the most suitable 3D printing technique in the field of dentistry for treatment planning, prosthesis designing, dental restorations, and surgical procedures.
Significance of Rosseland’s radiative heat transfer and dissipative heat on MHD viscous flow over a slandering sheet in the presence of Darcy-Forchheimer and Lorentz forces
Authors: Algehyne Ebrahem A , Alamrani Fahad Maqbul , Shahab Sana , Khan Zeeshan , Lone Showkat Ahmad , Saeed Anwar
Published: April 2024

The main emphasis of this research is to investigate computationally an innovative viscous, time-independent, and Darcy-Forchheimer flow of an electrically based incompressible nanofluid on a slandering stretched surface. The thermal conductivity and viscosity of this flow will be discussed. Incorporating an outer heat source into the thermal transfer process enhances the effect of dissipative heat and thermal radiation. When chemical processes are included, the effects of heat and solvent transport are influenced by the use of convective constraints at boundary. The flow characteristics are governed by the mathematical form which is further transferred to ordinary differential equations (ODEs) via appropriate assumptions regarding similarity variables and stream functions. The analytical technique for such highly nonlinear equations sometimes doesn't work effectively due to the strong nonlinearity. As a result, these transformed ODEs are solved numerically by means of bvp4c approach. Graphs depict the impacts of different substantial factors on velocity, temperature, and solutal concentration distributions. Numerical computations of physical quantities including magnetic parameters, inertial coefficient, permeable coefficient, thickness factor, heat transfer Biot number, Radiation parameter, Prandtl number, Eckert number, mass transfer Biot number, Schmidt number, heat source factor, and chemical reaction are evaluated and tabulated. The current findings are compared to previously known results, and they are in great agreement. The main outcomes of the study are thoroughly explained in the results and discussion section. Heat transfer Biot number raises the energy distribution and mass transfer Biot number strengthened the concentration profile while wall thickness quantity reduces the temperature and concentration of fluid as well. The enhanced variable viscosity is augmented by the longitudinal velocity profile and the rate of shear stress.
Identity in university students: The semiotic work of making sense of yourself
Authors: Marais Kobus , Naudé Luzelle
Published: April 2024

The development of a deepened sense of self in young adults is a complex process. In this paper, we report on an interdisciplinary research project on identity formation among students at the University of the Free State from the perspective of semiotic work. Based on work in psychology and semiotics, we interviewed fifty-seven students about their identity. In particular, we asked students to bring along ‘something’ that they thought represents their identity, and we asked them to explain their choice. We first performed a semiotic analysis on the representations the students brought and then coded their motivations for themes. We found identity formation along the lines suggested by existing literature, with themes related to the importance of finding both an authentic and relational sense of self in a growth process that contains elements of hardship and strength. The study did, however, find two points of interests, namely the fact that very few students brought a material representation with them as well as the fact that students oscillated between resilience and succumbing to pressure.
Substructural damage identification in a digital twin framework using heterogeneous response reconstruction
Authors: Zhang Guangcai , Zhou Zhenwei , Wan Chunfeng , Ding Zhenghao , Wu Zhishen , Xie Liyu , Xue Songtao
Published: March 2024

The external excitations, interface forces and responses at the interface degrees-of-freedom are normally required in many existing substructural condition assessment methods, while they are difficult or even impossible to be accurately measured. To address this issue, a digital twin framework for output-only substructural damage identification with data fusion of muti-type responses is proposed in the present paper. First, heterogeneous responses including displacements, strains and accelerations from the target substructure are measured and divided into two sets. The multi-type responses in measurement set 2 are reconstructed with the first set of responses and transmissibility matrix in time domain. Then, a recovery method is introduced to obtain angular displacements from translational displacements and strains, to acquire angular accelerations from translational accelerations and the second order derivatives of strains by continuous wavelet transform. The recovered angular displacements and angular accelerations are involved into the evaluation of objective function. Besides, to avoid the single and monotonous search operation of traditional optimization algorithms, a reinforced learning-assisted Q-learning hybrid evolutionary algorithm (QHEA) by integrating Q-learning algorithm, differential evolution algorithm, Jaya algorithm, is developed as a search tool to solve the optimization-based inverse problem. The most suitable search strategy among DE/rand/1, DE/rand/2, DE/current-to-best/1, Jaya mutation in each iteration is selected and implemented under the guidance of Q-learning algorithm. Numerical studies on a three-span beam structure are performed to verify the effectiveness of the proposed approach. The results demonstrates that the proposed output-only substructural damage identification approach can accurately identify locations and severities of multiple damages even with high noise-polluted responses.
Promoting Safety While Addressing Dangerous Behavior via Telehealth: A Clinical Case Investigation Serving the Family of an Autistic Adolescent Living in India
Authors: Rajaraman Adithyan , Whelan Cory J. , Jessel Joshua , Gover Holly C.
Published: March 2024

When clinicians address dangerous behavior via remote telehealth consultation, it may be especially important to ensure remote implementers can apply behavioral interventions in a manner that keeps recipients and implementers safe while still achieving effective outcomes. We present the case of a 13-year-old autistic adolescent with limited communication skills, living in South India, whose dangerous behavior was escalating and becoming more pervasive during the pandemic quarantine, putting himself and his family at risk. In this study, we evaluated the effects of an enhanced choice model of skill-based treatment—informed by a practical functional assessment of dangerous behavior. We systematically replicated and extended procedures that have been shown to address dangerous behavior while avoiding difficult situations that place the individual and others at risk. The intervention yielded elimination of dangerous and associated non-dangerous behavior and socially valid acquisition of multiple alternative behaviors. We report multiple strategies to overcome barriers unique to remotely addressing dangerous behavior and discuss implications for the safe, telehealth application of behavior analysis in research and practice.
Desire and Delusion: Fetish of Brazilian Favela in Videogame (Mis)representation
Authors: Martins Ricardo
Published: April 2024

Video games have emerged as one of the most ubiquitous forms of media globally, exerting a considerable influence on our perceptions of other cultures. However, contemporary video games have perpetuated negative stereotypes about Brazilian favelas and their residents, prioritizing aesthetics and themes that fetishize poverty, precarity, and violence. This essay critically examines the (mis)representations of Brazilian favelas in video games, exploring their far-reaching implications for global perceptions of favelas and their residents, and their role in perpetuating negative stereotypes.
Implementing Lifestyle Medicine Competencies in Didactic and Clinical Settings for Allied Health Professionals: A Call to Action
Authors: Brown Zipporah , Räisänen Anu M.
Published: April 2024

In this article, we discuss and reflect on the essential components of our concurrent session presentation at the American College of Lifestyle Medicine (ACLM) annual conference LM2023, “Implementing Lifestyle Medicine Competencies in Didactic and Clinical Settings for Allied Health Professionals.” We illustrate the necessity of interdisciplinary lifestyle medicine approaches through a conscious fusion of analysis and storytelling. This review concludes with a call to action empowering the medical community to embrace interdisciplinary lifestyle medicine approaches in effort to increase access to equitable healthcare.
Does Manufacturing Transfer Improved Land Use Efficiency?
Authors: Han Jun , Jiang Tianhe , Sun Xiaoke
Published: April 2024

This paper aims to investigate the relationship between manufacturing industry transfer and land use efficiency in china. Our study found that industrial transfer does not have a significant impact on land use efficiency in the full sample. However, when differentiating between the direction of manufacturing transfer, we found that in areas where manufacturing moves out, it inhibits land use efficiency significantly. Whereas in areas where manufacturing moves in, it has no significant impact on land use efficiency. We further analyzed the impact of manufacturing adjustment range and adjustment quality on land use efficiency. The results show that manufacturing structure adjustment has a positive impact on land use efficiency in the full sample and manufacturing immigration areas. In manufacturing emigration areas, manufacturing adjustment quality inhibits land use efficiency significantly, while manufacturing adjustment range improves land use efficiency significantly. Based on these findings, we suggest some policy recommendations to improve land use efficiency through manufacturing transfer.
Labor Pains: Work-Related Barriers to Access to Health Care for People Living with HIV in Hyderabad, India
Authors: Azhar Sameena , Dean Casey , Lerner Riya , Gandham Sabitha , Oruganti Ganesh , Yeldandi Vijay
Published: April 2024

To explore themes regarding work-related barriers to access to health care, we conducted 32 interviews, 16 with third gender people and 16 with cisgender women, all of whom were all living with HIV in Hyderabad, India. Most respondents were members of Dalit castes and had been living with HIV for several years at the time of the interview. Using thematic content analysis, interviews were coded by two researchers using a social determinants of health conceptual framework. Themes highlighted in this study include the burden of taking time off from work, the loss of pay associated with missing work, and the interruption of gendered care work responsibilities that respondents faced when seeking treatment. Findings from this study support the claim that equitable work policies and practices for marginalized laborers can increase access to medical care for people living with HIV.
Estimating cost of prostate cancer management: an experience from Tanzania
Authors: Nyongole Obadia Venance , Kivuyo Nashivai Elias , Akoko Larry Onyango , Saronga Happiness , Kimu Njiku
Published: April 2024

Background

Prostate cancer (PC) is a significant public health problem affecting men worldwide and ranks third in incidence and mortality in East Africa. Cost of prostate cancer management is high in low-income countries because majority of patients presents with advanced (metastatic) PC. The cost related to management of PC including castrate resistant cancer in Tanzania has remained unknown; hence, policy makers do not have enough information for planning and resource allocation. This study therefore aimed to document costs related to the management of patients with prostate cancer including castrate resistant prostate cancer (CRPC) at Muhimbili National Hospital in Tanzania.

Methods

This was a retrospective descriptive hospital-based study which was conducted at Muhimbili National Hospital (MNH). Case notes of patients who were treated for prostate cancer were retrieved from medical records for review. A structured checklist was used to extract information regarding age, clinical presentation, investigations, stage of disease, type of treatment, payment modality and reimbursement. We considered data on the direct costs of prostate cancer management (diagnosis, treatment and follow-up) based on hospital price list of different categories. Costs reported were based on payment category in total and unit cost but also source of funding. Descriptive statistics were prepared and summarized as tables and figures.

Results

A total of 292 case notes of patients with prostate cancer were reviewed of which 189 patients received androgen deprivation therapy. Ninety-six (50.8%) met the criteria for the diagnoses of CRPC, and their mean age was 71.23 ± 4.2. Most of the patients had a poorly differentiated histology with prostate-specific antigen (PSA) over 100 ng/l. Bilateral orchiectomy was the most common treatment modality offered for advanced prostate cancer. Total cost for all PC patients was $148,136.4, equivalent to a unit cost per patient of $507.3. However, patients were in different categories of payment, 53% were public patients with an average cost of $471.3 per patient; 36.6% were cost sharing patients with an average cost of $441.8 per patient; 8.2% were National Health Insurance (NHIF) patients with an average cost of $893.8 per patient; and only 2.2% were private patients with an average cost of $1060.9 per patient.

Conclusion

Costs related to prostate cancer management need harmonization to accommodate different categories of patients in need.
MicroRNA-542-3p targets Pten to inhibit the myoblasts proliferation but suppresses myogenic differentiation independent of targeted Pten
Authors: Li Dandan , Yue Yongqi , Feng Xinxin , Lv Weibing , Fan Yilin , Sha Peiran , Zhao Te , Lin Yaqiu , Xiong Xianrong , Li Jian , Xiong Yan
Published: April 2024

Background

Non-coding RNA is a key epigenetic regulation factor during skeletal muscle development and postnatal growth, and miR-542-3p was reported to be conserved and highly expressed in the skeletal muscle among different species. However, its exact functions in the proliferation of muscle stem cells and myogenesis remain to be determined.

Methods

Transfection of proliferative and differentiated C2C12 cells used miR-542-3p mimic and inhibitor. RT-qPCR, EdU staining, immunofluorescence staining, cell counting kit 8 (CCK-8), and Western blot were used to evaluate the proliferation and myogenic differentiation caused by miR-542-3p. The dual luciferase reporter analysis and rescued experiment of the target gene were used to reveal the molecular mechanism.

Results

The data shows overexpression of miR-542-3p downregulation of mRNA and protein levels of proliferation marker genes, reduction of EdU+ cells, and cellular vitality. Additionally, knocking it down promoted the aforementioned phenotypes. For differentiation, the miR-542-3p gain-of-function reduced both mRNA and protein levels of myogenic genes, including MYOG, MYOD1, et al. Furthermore, immunofluorescence staining immunized by MYHC antibody showed that the myotube number, fluorescence intensity, differentiation index, and myotube fusion index all decreased in the miR-542-3p mimic group, compared with the control group. Conversely, these phenotypes exhibited an increased trend in the miR-542-3p inhibitor group. Mechanistically, phosphatase and tensin homolog (Pten) was identified as the bona fide target gene of miR-542-3p by dual luciferase reporter gene assay, si-Pten combined with miR-542-3p inhibitor treatments totally rescued the promotion of proliferation by loss-function of miR-542-3p.

Conclusions

This study indicates that miR-542-3p inhibits the proliferation and differentiation of myoblast and Pten is a dependent target gene of miR-542-3p in myoblast proliferation, but not in differentiation.
Restoration of gut dysbiosis through Clostridium butyricum and magnesium possibly balance blood glucose levels: an experimental study
Authors: Tayyib Hafiz Muhammad Ubaid , Ali Amjed , Jabeen Shaista , Habib-ur-Rehman  , Kamran Hafsa , Bajaber Majed A. , Usman Muhammad , Zhang Xiao
Published: April 2024

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by an elevated level of blood glucose due to the absence of insulin secretion, ineffectiveness, or lack of uptake of secreted insulin in the body. The improperly diagnosed and poorly managed DM can cause severe damage to organs in the body like the nerves, eyes, heart, and kidneys. This study was aimed at investigating the effect ofClostridium butyricum(probiotic) with magnesium supplementation to evaluate the effect on gut microbial dysbiosis and blood glucose levels. In the laboratory, 6–8 weeks old 24 male albino rats weighing 200–250 g were given free access to water and food. Diabetes was induced using streptozotocin (60 mg/kg) in overnight fasted rats. Diabetic rats were randomly divided into four groups (n = 6, 6 replicates in each group). Metformin (100 mg/kg/day) with a standard basal diet was provided to control group (G0),Clostridium butyricum(1.5 × 105CFU/day) with standard basal diet was provided to treatment group (G1), magnesium (500 mg/kg/day) was provided to group (G2).Clostridium butyricum(1.5 × 105CFU/day) and magnesium (300 mg/kg/day) in combination with a standard basal diet was provided to group (G3). Blood Glucose, Magnesium blood test and microbial assay were done. Random blood glucose levels were monitored twice a week for 21 days and were represented as mean of each week. The results conclude thatClostridium butyricum(1.5 × 105CFU) is very effective in balancing random blood glucose levels from 206.6 ± 67.7 to 85.1 ± 3.8 (p = 0.006) compared to other groups (p > 0.005). The results of stool analysis showed thatClostridium butyricumas probiotic restores microbial dysbiosis as evident by the 105CFUClostridium butyricumload in G1, which was higher than G0, G2and G3which were 103and 104CFU respectively. The findings of this study conclude thatClostridium butyricumsupplementation improved blood glucose levels and intestinal bacterial load in type II diabetes mellitus.
Integrated transcriptomic and WGCNA analyses reveal candidate genes regulating mainly flavonoid biosynthesis in Litsea coreana var. sinensis
Authors: Xie Na , Guo Qiqiang , Li Huie , Yuan Gangyi , Gui Qin , Xiao Yang , Liao Mengyun , Yang Lan
Published: April 2024

Litsea coreana Levl. var. sinensis (Allen) Yang et P. H. Huang is a popular ethnic herb and beverage plant known for its high flavonoid content, which has been linked to a variety of pharmacological benefits and crucial health-promoting impacts in humans. The progress in understanding the molecular mechanisms of flavonoid accumulation in this plant has been hindered due to the deficiency of genomic and transcriptomic resources. We utilized a combination of Illumina and Oxford Nanopore Technology (ONT) sequencing to generate a de novo hybrid transcriptome assembly. In total, 126,977 unigenes were characterized, out of which 107,977 were successfully annotated in seven public databases. Within the annotated unigenes, 3,781 were categorized into 58 transcription factor families. Furthermore, we investigated the presence of four valuable flavonoids—quercetin-3-O-β-D-galactoside, quercetin-3-O-β-D-glucoside, kaempferol-3-O-β-D-galactoside, and kaempferol-3-O-β-D-glucoside in 98 samples, using high-performance liquid chromatography. A weighted gene co-expression network analysis identified two co-expression modules, MEpink and MEturquoise, that showed strong positive correlation with flavonoid content. Within these modules, four transcription factor genes (R2R3-MYB, NAC, WD40, and ARF) and four key enzyme-encoding genes (CHI, F3H, PAL, and C4H) emerged as potential hub genes. Among them, the R2R3-MYB (LcsMYB123) as a homologous gene to AtMYB123/TT2, was speculated to play a significant role in flavonol biosynthesis based on phylogenetic analysis. Our findings provided a theoretical foundation for further research into the molecular mechanisms of flavonoid biosynthesis. Additionally, The hybrid transcriptome sequences will serve as a valuable molecular resource for the transcriptional annotation of L. coreana var. sinensis, which will contribute to the improvement of high-flavonoid materials.
Acute myocardial infarction due to giant coronary artery aneurysm and arteriovenous fistula: a challenging case report and review of the literature
Authors: Vassilikou A. , Xenitopoulou MP , Ziampa K. , Evangeliou AP , Mitsiadis S. , Syrnioti A. , Petrakis G. , Tossios P. , Vassilikos V. , Tzikas S.
Published: April 2024

Background

A coronary artery aneurysm (CAA) is an abnormal dilation of a coronary artery segment often accompanied by coronary artery fistula (CAF), leading to communication between a coronary artery and a cardiac chamber or a part of the coronary venous system. Both CAAs and CAFs can present with symptoms and signs of myocardial ischemia and infarction.

Case presentation

We describe the case of a 46-year-old woman with non-ST-elevation myocardial infarction (NSTEMI) caused by a “giant” CAA. Various imaging modalities revealed a thrombus-containing aneurysm located at the right-posterior cardiac border, with established arteriovenous communication with the distal part of left circumflex artery (LCx). After initial treatment with dual antiplatelet therapy, a relapse of pain was reported along with a new increase in troponin levels, electrocardiographic abnormalities, reduced left ventricular ejection fraction (LVEF) and thrombus enlargement. Surgical excision of the aneurysm was favored, revealing its true size of 6 cm in diameter. Τhe aneurysm was excised without complications. The patient remained asymptomatic during follow-up.

Conclusions

Management of rare entities such as “giant” CAAs and CAFs can be challenging. Cases such as this can serve as precedents to facilitate treatment plans and develop consistent recommendations, emphasizing the importance of personalized strategies for future patients.
Paramedic attitudes and experiences working as a community paramedic: a qualitative survey
Authors: Paramalingam Aarani , Ziesmann Andrea , Pirrie Melissa , Marzanek Francine , Angeles Ricardo , Agarwal Gina
Published: April 2024

Background

Community paramedicine (CP) is an extension of the traditional paramedic role, where paramedics provide non-acute care to patients in non-emergent conditions. Due to its success in reducing burden on hospital systems and improving patient outcomes, this type of paramedic role is being increasingly implemented within communities and health systems across Ontario. Previous literature has focused on the patient experience with CP programs, but there is lack of research on the paramedic perspective in this role. This paper aims to understand the perspectives and experiences, both positive and negative, of paramedics working in a CP program towards the community paramedic role.

Methods

An online survey was distributed through multiple communication channels (e.g. professional organizations, paramedic services, social media) and convenience sampling was used. Five open-ended questions asked paramedics about their perceptions and experiences with the CP role; the survey also collected demographic data. While the full survey was open to all paramedics, only those who had experience in a CP role were included in the current study. The data was qualitatively analyzed using a comparative thematic analysis.

Results

Data was collected from 79 respondents who had worked in a CP program. Three overarching themes, with multiple sub-themes, were identified. The first theme was that CP programs fill important gaps in the healthcare system. The second was that they provide paramedics with an opportunity for lateral career movement in a role where they can have deeper patient connections. The third was that CP has created a paradigm shift within paramedicine, extending the traditional scope of the practice. While paramedics largely reported positive experiences, there were some negative perceptions regarding the slower pace of work and the “soft skills” required in the role that vary from the traditional paramedic identity.

Conclusions

CP programs utilize paramedic skills to fill a gap in the healthcare system, can improve paramedic mental health, and also provide a new pathway for paramedic careers. As a new role, there are some challenges that CP program planners should take into consideration, such as additional training needs and the varying perceptions of CP.
Overcoming denominator problems in refugee settings with fragmented electronic records for health and immigration data: a prediction-based approach
Authors: Erdmann Stella , Jahn Rosa , Rohleder Sven , Bozorgmehr Kayvan
Published: April 2024

Background

Epidemiological studies in refugee settings are often challenged by the denominator problem, i.e. lack of population at risk data. We develop an empirical approach to address this problem by assessing relationships between occupancy data in refugee centres, number of refugee patients in walk-in clinics, and diseases of the digestive system.

Methods

Individual-level patient data from a primary care surveillance system (PriCarenet) was matched with occupancy data retrieved from immigration authorities. The three relationships were analysed using regression models, considering age, sex, and type of centre. Then predictions for the respective data category not available in each of the relationships were made. Twenty-one German on-site health care facilities in state-level registration and reception centres participated in the study, covering the time period from November 2017 to July 2021.

Results

445 observations (“centre-months”) for patient data from electronic health records (EHR, 230 mean walk-in clinics visiting refugee patients per month and centre; standard deviation sd: 202) of a total of 47.617 refugee patients were available, 215 for occupancy data (OCC, mean occupancy of 348 residents, sd: 287), 147 for both (matched), leaving 270 observations without occupancy (EHR-unmatched) and 40 without patient data (OCC-unmatched). The incidence of diseases of the digestive system, using patients as denominators in the different sub-data sets were 9.2% (sd: 5.9) in EHR, 8.8% (sd: 5.1) when matched, 9.6% (sd: 6.4) in EHR- and 12% (sd 2.9) in OCC-unmatched. Using the available or predicted occupancy as denominator yielded average incidence estimates (per centre and month) of 4.7% (sd: 3.2) in matched data, 4.8% (sd: 3.3) in EHR- and 7.4% (sd: 2.7) in OCC-unmatched.

Conclusions

By modelling the ratio between patient and occupancy numbers in refugee centres depending on sex and age, as well as on the total number of patients or occupancy, the denominator problem in health monitoring systems could be mitigated. The approach helped to estimate the missing component of the denominator, and to compare disease frequency across time and refugee centres more accurately using an empirically grounded prediction of disease frequency based on demographic and centre typology. This avoided over-estimation of disease frequency as opposed to the use of patients as denominators.
Iron status determined changes in health measures induced by nordic walking with time-restricted eating in older adults– a randomised trial
Authors: Kortas Jakub Antoni , Reczkowicz Joanna , Juhas Ulana , Ziemann Ewa , Świątczak Aleksandra , Prusik Katarzyna , Olszewski Szczepan , Soltani Nakisa , Rodziewicz-Flis Ewa , Flis Damian , Żychowska Małgorzata , Gałęzowska Grażyna , Antosiewicz Jędrzej
Published: March 2024

Background and aims

This study evaluated whether stored iron determines the adaptive response induced by Nordic walking (NW) training combined with 10 hours’ time-restricted eating (TRE) in older adults.

Trial design and methods

Twenty-four participants underwent 12-week NW training supported by 10 h of TRE. The group was divided due to baseline ferritin concentration low < 75 ng/ml (LF) and high level ≥ 75 ng/ml (HF). Body composition, physical fitness and blood collection were assessed at baseline and post-intervention.

Results

NW + TRE induced a statistically significant decrease in ferritin levels in all participants (p = 0.01). Additionally, statistically significant intergroup differences in the LF vs. HF in the reduction of serum ferritin levels (p = 0.04) were observed. The procedure NW + TRE diminished HbA1c levels (p < 0.01) and glucose in all participants (p = 0.05). The range of HbA1c drop was more pronounced among those participants who experienced a greater decrease in the stored iron (p = 0.04, $$ {\eta }_{p}^{2}$$=0.17, F=4.59). Greater changes in body weight and percent of body fat were recorded in the HF group (for both p<0.01).

Conclusion

Body iron stores determine the effects of a 12-week NW + TRE intervention on serum ferritin. The changes in HbA1c are more pronounced in subjects with a higher decrease in serum ferritin.

Trial registration

All experimental protocols were approved by the Bioethical Committee of the Regional Medical Society in Gdansk, Poland (NKBBN/330/2021) according to the Declaration of Helsinki. We confirm that all methods were carried out in accordance with relevant guidelines and regulations. The trial was registered as a clinical trial (NCT05229835, date of first registration: 14/01/2022, direct link: https://classic.clinicaltrials.gov/ct2/show/NCT05229835). Informed consent was obtained from all subjects.
The clinical profile and outcomes of drug resistant tuberculosis in Central Province of Zambia
Authors: Chanda Evaristo
Published: April 2024

Background

The emergence of Drug Resistant Tuberculosis (DR-TB) is one of the main public health and economic problems facing the world today. DR-TB affects mostly those in economically productive years and prevents them from being part of the workforce needed for economic growth. The aim of this study was to determine the Clinical Profile and Outcomes of DR-TB in Central Province of Zambia.

Methods

This was a retrospective cross sectional study that involved a review of records of patients with confirmed DR-TB who were managed at Kabwe Central Hospital’s Multi-Drug Resistant TB (MDR-TB) Ward from the year 2017 to 2021. 183 patients were managed during this period and all were recruited in the study. Data was collected from DR-TB registers and patient files and then entered in SPSS version 22 where all statistical analyses were performed.

Results

The study revealed that the prevalence of DR-TB among registered TB patients in Central Province was 1.4%. Majority of those affected were adults between the ages of 26 and 45 years (63.9%). The study also found that more than half of the patients were from Kabwe District (60.7%). Other districts with significant number of cases included Kapiri Mposhi 19 (10.4%), Chibombo 12 (6.6%), Chisamba 10 (5.5%), Mumbwa 7 (3.8%) and Mkushi 7 (3.8%). Furthermore, the analysis established that most of the patients had RR-TB (89.6%). 9.3% had MDR-TB, 0.5% had IR-TB and 0.5% had XDR-TB. RR-TB was present in 93.8% of new cases and 88.9% of relapse cases. MDR-TB was present in 6.2% of new cases and 10% of relapse cases. With regard to outcomes of DR-TB, the investigation revealed that 16.9% of the patients had been declared cured, 45.9% had completed treatment, 6% were lost to follow up and 21.3% had died. Risk factors for mortality on multivariate analysis included age 36–45 years (adjusted odds ratio [aOR] 0.253, 95% CI [0.70–0.908] p = 0.035) and male gender (aOR 0.261, 95% CI [0.107–0.638] p = 0.003).

Conclusion

The research has shown beyond doubt that the burden of DR-TB in Central Province is high. The study recommends putting measures in place that will help improve surveillance, early detection, early initiation of treatment and proper follow up of patients.
Multicenter registry of pediatric inflammatory bowel disease from a developing country
Authors: Tanpowpong Pornthep , Jitwongwai Settapong , Kijmassuwan Teera , Sriphongphankul Hansa , Osatakul Seksit , Damrongmanee Alisara , Ukarapol Nuthapong , Treepongkaruna Suporn
Published: April 2024

Background

Despite the rising incidence of pediatric inflammatory bowel disease (PIBD) globally, multicenter collaborative studies of PIBD children among developing countries remain sparse. We therefore aimed to define the initial presentation and short-term outcomes of Thai children with PIBD from a multicenter registry.

Methods

Four teaching hospitals participated in this study. A diagnosis of PIBD requires gastrointestinal endoscopy and histopathology in children aged < 19 years. Besides demographics, we collected clinical information and treatment with the data at 1-year follow up.

Results

We included 35 Crohn’s disease (CD), one IBD-unclassified, and 36 ulcerative colitis (UC) children (total n = 72 with 60.6% males). The mean age at diagnosis was 7.9 years (SD 4.1) with 38% being very early onset IBD (VEO-IBD). When compared with UC, the CD children were more likely to exhibit fever (42.3 vs. 13.9%), weight loss/failure to thrive (68.6 vs. 33.3%), and hypoalbuminemia (62.9 vs. 36.1%) but less likely to have bloody stools (51.4 vs. 91.7%) (all P < 0.05). No significant differences in demographics, clinical data and medications used with regards to VEO-IBD status. At 1 year after diagnosis (n = 62), 30.7% failed to enter clinical remission and 43.7% remained on systemic corticosteroids. Diarrhea (OR 9.32) and weight issues (OR 4.92) at presentation were independent predictors of failure to enter clinical remission; and females (OR 3.08) and CD (vs. UC) (OR 3.03) were predictors of corticosteroids use at 1-year follow-up.

Conclusions

A high proportion of VEOIBD is noted, and CD was more likely to present with significant inflammatory burden. Diarrhea and weight issues at presentation were independent predictors of failure to enter clinical remission; and females and CD (vs. UC) were predictors of corticosteroids use at 1-year follow-up.
Child abuse and pubertal timing: what is the role of child sex and identity of the perpetrator?
Authors: Steger V. , Stadelmann S. , White L. , Döhnert M.
Published: April 2024

Background

This study investigated the association between child abuse [child neglect (CN), emotional (CEA) and physical abuse (CPA)] and early puberty with special regard to sex-specific effects concerning child and parental perpetrator.

Methods

Data assessment took place within the framework of the LIFE Child Depression study, a longitudinal study on the development of depressive symptoms and disorders between child- and adulthood in Leipzig, Germany. A sample of 709 children (8–14 years) was recruited from the general population and via psychiatric hospitals. Data on pubertal status were assessed using an instrument for self-assessment of tanner stages (scales of physical pubertal development). Information on menarche was provided by parents. The Parent–Child Conflict Tactics Scales (CTS-PC) served for data on child abuse.

Results

Regarding physical puberty markers, significant correlations were found, especially with child neglect (CN) and child emotional abuse (CEA). Regression analyses, controlling for Body-Mass-Index (BMI) and Socioeconomic Status (SES), revealed that children affected by child neglect perpetrated by mother (CNm) and child emotional abuse (CEA) parent-non-specifically enter puberty significantly earlier. Sex-specific analyses identified child neglect perpetrated by mother (CNm) to be associated with early puberty in girls and child emotional abuse perpetrated by father (CEAf) with early puberty in boys. Concerning the onset of menstruation, there was a significant positive correlation between early menarche and parent-specific and non-specific child neglect (CN), as well as between early menarche and child emotional abuse perpetrated by the mother (CEAm). In regression models that controlled for Body-Mass-Index (BMI) and Socioeconomic Status (SES) no significant associations were maintained. Child physical abuse (CPA) was not associated with early puberty.

Conclusion

Results outlined child neglect (CN) and child emotional abuse (CEA) to be sex- and perpetrator-specific risk factors for early pubertal development. Knowledge of sex- and perpetrator-specific effects could help clinicians to specify their diagnostic process and to define differential prevention and treatment goals for children with experiences of CN and CEA. Further research on the sex-specific impact of parental CN and CEA on girls’ and boys’ puberty is needed.
Mobilizing community-driven health promotion through community granting programs: a rapid systematic review
Authors: Clark Emily C. , Baidoobonso Shamara , Phillips Karen A. M. , Noonan Laura Lee , Bakker Jiselle , Burnett Trish , Stoby Karlene , Dobbins Maureen
Published: April 2024

Background

Effective health promotion responds to the unique needs of communities. Community granting programs that fund community-driven health promotion initiatives are a potential mechanism to meet those unique needs. While numerous community health-focused programs are available, the various strategies used by granting programs to foster engagement, administer grants and support awardees have not been systematically evaluated. This rapid systematic review explores the administration of community granting programs and how various program components impact process and population health outcomes.

Methods

A systematic search was conducted across three databases: Medline, SocINDEX, and Political Science Database. Single reviewers completed screening, consistent with a rapid review protocol. Studies describing or evaluating community granting programs for health or public health initiatives were included. Data regarding program characteristics were extracted and studies were evaluated for quality. A convergent integrated approach was used to analyze quantitative and qualitative findings.

Results

Thirty-five community granting programs, described in 36 studies, were included. Most were descriptive reports or qualitative studies conducted in the USA. Program support for grant awardees included technical assistance, workshops and training, program websites, and networking facilitation. While most programs reported on process outcomes, few reported on community or health outcomes; such outcomes were positive when reported. Programs reported that many funded projects were likely sustainable beyond program funding, due to the development of awardee skills, new partnerships, and securing additional funding. From the perspectives of program staff and awardees, facilitators included the technical assistance and workshops provided by the programs, networking amongst awardees, and the involvement of community members. Barriers included short timelines to develop proposals and allocate funds.

Conclusions

This review provides a comprehensive overview of health-related community granting programs. Grant awardees benefit from technical assistance, workshops, and networking with other awardees. Project sustainability is enhanced by the development of new community partnerships and grant-writing training for awardees. Community granting programs can be a valuable strategy to drive community health, with several key elements that enhance community mobilization.

Registration

PROSPERO #CRD42023399364.
Effectiveness of workplace choice architecture modification for healthy eating and daily physical activity
Authors: Rantala Eeva , Vanhatalo Saara , Valtanen Mikko , Lindström Jaana , Pihlajamäki Jussi , Poutanen Kaisa , Absetz Pilvikki , Karhunen Leila
Published: April 2024

Background

Modifying the choice architecture of behavioural contexts can facilitate health behaviour change, but existing evidence builds mostly on small-scale interventions limited in duration, targets, strategies, and settings. We evaluated the effectiveness of a one-year hybrid type 2 implementation-effectiveness trial aimed at promoting healthy eating and daily physical activity with subtle modifications to the choice architecture of heterogeneous worksites. The intervention was contextualised to and integrated into the routine operations of each worksite. Effectiveness was evaluated in a quasi-experimental pre-post design.

Methods

Intervention sites (n = 21) implemented a median of two (range 1–9) intervention strategies for healthy eating and one (range 1–5) for physical activity. Questionnaires pre (n = 1126) and post (n = 943) intervention surveyed employees’ behavioural patterns at work (food consumption: vegetables/roots, fruit/berries, nuts/almonds/seeds, sweet treats, fast food, water; physical activity: restorative movement, exercise equipment use, stair use). The post-intervention questionnaire also measured employees’ perception of and response to three intervention strategies: a packed lunch recipe campaign, a fruit crew-strategy, and movement prompts. Multi- and single-level regression models evaluated effectiveness, treating intervention as a continuous predictor formed of the site-specific dose (n intervention strategies employed) and mean quality (three-point rating per strategy halfway and at the end of the intervention) of implementation relevant to each outcome.

Results

Multinomial logistic regression models found the intervention significantly associated with a favourable change in employees’ fruit and berry consumption (interaction effect of time and implementation p = 0.006) and with an unfavourable change in sweet treat consumption (p = 0.048). The evidence was strongest for the finding concerning fruit/berry consumption—an outcome that sites with greater dose and quality of implementation targeted by using strategies that reduced the physical effort required to have fruit/berries at work and by covering multiple eating-related contexts at the worksite. The quality of implementation was positively associated with the perception of (p = 0.044) and response to (p = 0.017) the packed lunch recipes, and with response to the fruit crew-strategy (p < 0.001).

Conclusions

The results suggest that a contextualised, multicomponent choice architecture intervention can positively influence eating behaviour in diverse real-world settings over a one-year period, and that higher implementation quality can enhance intervention perception and response. However, outcomes may depend on the type of intervention strategies used and the extent of their delivery.
Efficacy and safety of prophylactic balloon occlusion in the management of placenta accreta spectrum disorder: a retrospective cohort study
Authors: Chen Kai , Chen Junyao , Ma Youliang , Gan Yanping , Huang Liyun , Yang Fang , Chen Yue , Zhong Linlin , Su Sha , Long Yu
Published: April 2024

Objective

Placenta accreta spectrum disorder (PAS) is a serious obstetric complication associated with significant maternal morbidity and mortality. Prophylactic balloon occlusion (PBO), as an intravascular interventional therapies, has emerged as a potential management strategy for controlling massive hemorrhage in patients with PAS. However, current evidence about the clinical application of PBO in PAS patients are still controversial. This study aimed to evaluate the effectiveness and safety of PBO in the management of PAS.

Methods

A retrospective cohort study including PAS patients underwent cesarean delivery was conducted in a tertiary hospital from January 2015 to March 2022. Included PAS patients were further divided into balloon and control groups by whether PBO was performed. Groups were compared for demographic characteristics, intraoperative and postoperative parameters, maternal and neonatal outcomes, PBO-related complication and follow up outcomes. Additionally, multivariate-logistic regression analysis was performed to determine the definitive associations between PBO and risk of massive hemorrhage and hysterectomy.

Results

A total of 285 PAS patients met the inclusion criteria were included, of which 57 PAS patients underwent PBO (PBO group) and 228 women performed cesarean section (CS) without PBO (control group). Irrespective of the differences of baseline characteristics between the two groups, PBO intervention did not reduce the blood loss, hysterectomy rate and postoperative hospital stay, but it prolonged the operation time and increased the cost of hospitalization (All P < 0.05) Additionally, there were no significant differences in postoperative complications, neonatal outcomes, and follow-up outcomes(All P > 0.05). In particular, patients undergoing PBO were more likely to develop the venous thrombosis postoperatively (P = 0.001). However, multivariate logistic regression analysis showed that PBO significantly decreased the risk of massive hemorrhage (OR 0.289, 95%CI:0.109–0.766, P = 0.013). The grade of PAS and MRI with S2 invasion were the significant risk factors affecting massive hemorrhage(OR:6.232 and OR:5.380, P<0.001).

Conclusion

PBO has the potential to reduce massive hemorrhage in PAS patients undergoing CS. Obstetricians should, however, be aware of potential complications arising from the PBO. Additionally, MRI with S2 invasion and PAS grade will be useful to identify PAS patients who at high risk and may benefit from PBO. In brief, PBO seem to be a promising alternative for management of PAS, yet well-designed randomized controlled trials are needed to convincingly demonstrate its benefits and triage the necessity of PBO.