bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Anatomy Education Throu€gh Flipped Classroom and Adaptive Learning A Pilot Project on Liver Anatomy
Authors: Vertemati Maurizio , Zuccotti Gian Vincenzo , Porrini Marisa
Published: June 2024

OBJECTIVES

Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This article presents a pilot project aimed at exploring the effectiveness of the Area9's Rhapsode platform, an intelligent tutoring system that uses artificial intelligence (AI) to personalize learning and collect data on mastery acquisition.

METHODS

The study focused on liver anatomy (microscopic and macroscopic anatomy, embryology, clinical anatomy) and employed a flipped classroom approach, incorporating adaptive learning modules and an interactive in-class session. A total of 123 first-year medicine students (55 M/68F) participated to the study. Content and resources of the module were adaptable to various digital devices. Statistics were compiled based, on the one hand, on the measurement of mastery for every single learning objective provided automatically by the platform via the student interactions with the system probes (questions); on the other hand, metacognition data were worked out by crossing mastery data with the self-awareness declared in every question and learning resource by each learner.

RESULTS AND CONCLUSIONS

At the outset of the study, students displayed a 18.11% level of conscious incompetence and a 19.43% level of unconscious incompetence. Additionally, 50.86% of students demonstrated conscious competence. By the conclusion of the learning module, the level of conscious incompetence had decreased to 1.87%, and 98.73% of students exhibited conscious mastery of the materials. The results demonstrated improved learning quality, positive repurposing of study time, enhanced metacognitive awareness among students, with most students demonstrating conscious mastery of the materials and a clear understanding of their level of competence. This approach, by providing valuable insights into the potential of AI-based adaptive learning systems in anatomy education, could address the challenges posed by limited teaching hours, shortage of anatomist, and the need for individualized instruction.
Acute astrocytic reaction is associated with 3-month functional outcome after stroke treated with endovascular therapy
Authors: Boutelier Ada , Ollivier Véronique , Mazighi Mikael , Kyheng Maeva , Labreuche Julien , Brikci-Nigassa Nahida , Solo Nomenjanahary Mialitiana , Delvoye Francois , Maier Benjamin , Paquet Claire , Ho-Tin-Noe Benoit , Desilles Jean-Philippe
Published: June 2024

Introduction:

More than 50% of large vessel occlusion (LVO) acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT) remain severely disabled at 3 months. We hypothesized that acute astrocytic inflammatory response may play a pivotal role in post-AIS brain changes associated with poor functional outcome. We proposed to evaluate the level of YKL-40, a glycoprotein mainly released by reactive astrocytes.

Patients and methods:

A monocentric prospective cohort study was conducted on consecutive LVO AIS patients treated with EVT. Three blood samples (before, within 1 and 24-hour post-EVT) were collected to measure plasma YKL-40 concentrations. Functional outcome was assessed according to the modified Rankin Scale (mRS) score at 3 months.

Results:

Between 2016 and 2020, 120 patients were included. The plasma concentration of YKL-40 before EVT was statistically and independently associated with 3-month worse functional outcome (adjusted cOR, 1.59; 95% CI [1.05–2.44], p = 0.027) but not the two following samples 1-hour and 24-hour post-EVT. Accordingly, we found that excellent functional outcome was associated with a lower level of YKL-40 before and within 1 h after EVT ( p = 0.005 and p = 0.003, respectively) but not when measured 24 h after EVT ( p = 0.2).

Discussion and conclusion:

This study suggests that the astrocytic reaction to acute brain hypoxia, especially before recanalization, is associated with worse functional outcome. Such early biomarker of the astrocytic response in AIS may optimize individualized care in the future.

Clinical Trial Registration-URL:

http://www.clinicaltrials.gov . Unique identifier: NCT02900833.
Temporal impact of urban indicators of land surface cover on land surface temperature: Case study of an Indian metropolitan city
Authors: Mandal Gitali , Gnanasambandam Subbaiyan
Published: June 2024

Land surface temperature (LST) is an important parameter for investigating surface urban heat islands (UHI) at different scales of urban development. Previous studies on UHI have been limited in quantifying the magnitude, and very few studies explored in-depth relations between built-up density classes and LST. This paper focuses on the land surface cover factors contributing to changes in urban LST. The impact of urban surface cover indicators such as land cover (LC) groups, built-up density classes, and pervious surface fraction (PSF) groups on LST was investigated in this study. Bengaluru metropolitan region was selected as the study area. Seasonal LSTs were calculated using the 2013–14, 2019, and 2023 Landsat 8 images and validated with MODIS LST images. LC for the three time periods were generated using supervised classification and related to respective LSTs. A 500 m × 500 m grid was considered a unit area to calculate the percentage of LC classes. One-way ANOVA tests revealed significant differences in seasonal mean LSTs among seven LC groups, six percentage built-up area (PBA) groups and nine PSF groups. The study has found a moderate negative relation between PBA groups and mean LSTs due to rapid urbanisation towards fringe areas in 2019 and 2023, which led to vacant lands with higher mean LST values converted into built-up areas with comparatively lesser mean LST. The mean LST of 2023 was lesser than in 2013 and 2019 due to an increment of vegetation cover by 16.8% during the last decade, which turned Bengaluru’s central area into a surface urban cool island (SUCI). However, the study has also found that the high-density built-up areas with no vegetation or waterbody located in the periphery of the outer ring road and the central commercial area of Bengaluru generated more urban hot spots in 2019 and 2023 than in 2013. This study, carried out at a local level of urban development, is more relevant to the urban planners’ formulation of guidelines for ameliorating surface UHI.
Exploring road safety through urban fabric characteristics and theory-driven prediction modeling with SEM-XGBoost
Authors: McCarty Dakota , Lee Dongwoo , Park Yunmi , Kim Hyun Woo
Published: June 2024

This study addresses the critical issue of road safety in urban environments, with a specific focus on the Greater London Area. Utilizing a novel, theory-driven approach, the study investigates the multifaceted impact of urban fabric factors on road safety, operationalized through a severity-weighted index of road accident frequency per capita. Through factorial analysis, six key factors (Urban Integration, Socioeconomic Challenges, Urban Amenities, Commuter Patterns, Housing and Mobility Barriers, and Major Urban Infrastructure) are identified. These factors are examined in relation to road safety using a structural equation model to uncover theoretical relationships, which inform predictive modeling with an XGBoost machine learning framework, enhanced by SHAP value analysis. Our findings reveal significant insights into the interplay between urban physical and social environments and road safety, revealing that integrated urban development strategies—encompassing improved urban integration, enhanced sustainable density, robust infrastructure development, alleviation of socioeconomic disparities, fostering of local employment, and integration of residents with transportation—are imperative for increasing road safety.
Review of Generalized Pustular Psoriasis: Prevalence, Diagnosis, and Treatment Options
Authors: Kozina Yuliya , Musiek Amy C. M. , Anadkat Milan J.
Published: June 2024

Background: Generalized pustular psoriasis (GPP) is a diagnostic challenge for clinicians and is relatively rare. Prevalence is currently reported to be higher in Asian countries and among female patients; peak age of onset is variable across studies.

Objective: This article provides clinicians with an overview of the global prevalence of GPP, common clinical presentation and diagnostic criteria, pathogenesis, and evolving treatment options.

Discussion: Clinical presentation is characterized by onset of generalized sterile pustules with erythema, and may include systemic inflammatory signs including fever and lab abnormalities. Diagnostic criteria vary globally. European Rare and Severe Psoriasis Expert Network (ERASPEN) criteria present a clinical diagnosis while Japanese criteria include a biopsy. Advancements in understanding of pathogenesis have uncovered the role of IL-36 as a driver of disease, and this is the target of new treatments including spesolimab, an anti-IL-36 receptor antibody.
Novel therapies for nausea and vomiting in advanced illness and supportive cancer care
Authors: Davis Mellar P.
Published: June 2024

Nausea and vomiting are common experiences and are often dreaded more than pain. This review discusses blonanserin, mirtazapine, and isopropyl alcohol as antiemetics. Blonanserin, an atypical antipsychotic with a high affinity for dopamine D2 and D3 receptors and serotonin receptor 5-HT2A, has less of a risk of extrapyramidal adverse effects. Transdermal blonanserin, available in Korea, Japan, and China in a small number of trials, has improved nausea in patients not responding to standard antiemetics. Mirtazapine is a noradrenergic and specific serotonergic antidepressant that has been used for multiple symptoms besides depression. There is little evidence that mirtazapine improves anorexia or nausea in advanced cancer but is as effective as olanzapine in reducing chemotherapy-induced nausea and vomiting. Isopropyl alcohol aromatherapy has been successfully used in the emergency department for nausea and vomiting with an onset to benefit more rapidly than standard antiemetics. Isopropyl alcohol prep pads can be used for home-going antiemetic therapy and as a bridge to treating acute nausea until standard antiemetics take effect.
Women’s willingness for cervical cancer screening and associated factors among women attending health services in Addis Ababa, Ethiopia
Authors: Demas Tangute , Biku Teshale , Getinet Tewodros , Fantahun Bereket , Bekele Delayehu , Woldehawariat Negat , Muzemir Rahel , Shoarega Martha
Published: June 2024

Background:

Cervical cancer is one of the most common causes of cancer-related morbidity and mortality globally. In developed countries, effective screening programs reduced its burden. However, in Ethiopia, cervical cancer remains a major public health problem despite the screening service being available free of charge.

Objective:

The aim of this study was to assess women’s willingness for cervical cancer screening services and associated factors among women attending health services in Addis Ababa, Ethiopia.

Design:

An institutional-based, analytic, cross-sectional study was conducted among sexually active women attending health facilities from August to September 2022.

Methods:

A pretested interviewer-administered questionnaire was used for data collection. Data were analyzed using SPSS version 25. Logistic regression was used to determine different variables’ frequencies and associated factors. A p value of <0.05 was considered statistically significant.

Result:

Four hundred twenty-two women were approached, and 394 (93.4%) met the study inclusion criteria. Study participants had a minimum of 1 and a maximum of 6 sexual partners in their lives. A total of 256 (64.9%) study participants had heard about cervical cancer. Among those who heard about cervical cancer, only 22 (8.6%) had been tested for cervical cancer. Of those who did not receive cervical cancer screening, only 175 (47.0%) are willing to receive cervical cancer screening. Age, religion, marital status, place of residence, educational level, occupation, and hearing about cervical cancer were found to be statistically significant. Women who heard about cervical cancer were 15.2 times more likely to take the test compared to those who never heard about cervical cancer before the study.

Conclusion:

Women’s willingness to be screened for cervical cancer is low despite many of the study participants having more than one partner in their lives and being at risk for cervical cancer. Only a few participants had been screened for cervical cancer. Women who had heard about cervical cancer were more likely to take the screening service compared to those who had never heard it before. This highlights the need to prioritize raising awareness about the benefits of cervical cancer screening services.
Mandibular Distraction in Robin Sequence – A Systematic Review of Morphologic Changes and Implications for Long-Term Growth
Authors: Prescher Hannes , Nathan Shelby L. , Ghosh Kanad , Henderson Charlotte , Reid Russell R.
Published: June 2024

Robin Sequence (RS) is a collection of distinct morphologic features involving the face and upper airway that results from the abnormal development of the neonatal mandible. Typically described as the triad of micrognathia, glossoptosis, and upper airway obstruction, it is frequently associated with a cleft palate and can be found in isolation or as part of a syndromic presentation. Owing to the intimate relationship between the mandible and its soft tissue attachments, micrognathia manifests clinically with respiratory and feeding difficulties. There is significant heterogeneity in both the degree of anatomic aberration and the associated physiological compromise, which dictates the medical and surgical treatment plan. In severe cases requiring surgical intervention, mandibular distraction osteogenesis (MDO) has been shown to be successful in relieving airway obstruction by correcting the morphologic deficiency of the mandible. However, controversy persists regarding the best treatment method as the exact relationship between the anatomic changes affected by MDO and the physiologic improvement remains poorly understood. This controversy is fueled by differing opinions about the natural growth potential of the abnormal mandible in patients with RS and the lack of long-term data on the maxillomandibular relationship at skeletal maturity of patients who underwent MDO in infancy. The objective of this systematic review is to provide a comprehensive summary of the morphologic changes to the mandible, upper airway, and hyoid bone affected by MDO and the impact of these changes on physiologic improvement and long-term growth.
Comparing subduction ground-motion models to observations for Cascadia
Authors: Smith James A , Moschetti Morgan P , Thompson Eric M
Published: June 2024

We evaluate Cascadia subduction ground-motion models (GMMs), considered for the 2023 US National Seismic Hazard Model (NSHM) update, by comparing observations to model predictions. The observations comprise regional recordings from intraslab earthquakes, including contributions from 2021 and 2022 events in southern Cascadia and global records from interface earthquakes. Since the 2018 NSHM update, new GMMs for Cascadia have been published by the Next Generation Attenuation (NGA)-Subduction Project that require independent evaluation. In the regional intraslab comparisons, we highlight a characteristic frequency dependence for Cascadia data, with short periods having lower ground motions and longer periods being comparable to other subduction zones. We evaluate differences in northern and southern Cascadia and find that the NGA-Subduction GMMs developed using southern Cascadia data perform better in this region than the model that did not consider these data. We compare ground-motion variability in Cascadia with the NGA-Subduction model predictions and find differences at short periods ( T = 0.1 s) due to the use of global versus regional data in the development of these models. Moreover, the within-event component of aleatory variability from the GMMs overpredicts the standard deviation of Cascadia recordings at very short periods ( T < 0.05 s). Using global interface earthquakes as a proxy to evaluate the Cascadia GMMs, we find long-period overprediction from a simulation-based GMM and some of the empirical GMMs. When comparing recent observations, we find a similar misfit to GMMs and the 2010 and 2022 Ferndale earthquakes. Finally, we observe different basin amplification factors arising in different subsets of the data, which indicate that differences in basin factors between empirical GMMs could arise from the data selection choices by the developers. As part of evaluating the regional basin terms, we apply basin amplification factors from the magnitude 9 Cascadia earthquake simulations to the empirical GMMs for interface earthquakes. The comparisons presented in this study indicate that the NGA-Subduction GMMs for Cascadia perform well relative to observations and older subduction GMMs.
Sleep disturbances are associated with greater healthcare utilization in children with autism spectrum disorder
Authors: Solomon Shirley , Elbedour Leena , Meiri Gal , Michaelovski Analya , Sadaka Yair , Ilan Michal , Faroy Michal , Dinstein Ilan , Menashe Idan
Published: June 2024

Background

Sleep disturbances are frequently reported in children with autism spectrum disorder (ASD) and are associated with the severity of co-occurring symptoms. This study’s aim was to examine the extent of healthcare utilization and clinical outcomes associated with sleep disturbances in children with ASD.

Study design

A retrospective, cross-sectional study of 541 children with ASD from the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) whose parents completed the Children’s Sleep Habits Questionnaire (CSHQ). Children with a total CSHQ score ≥ 48 were defined as having sleep disturbances. Sociodemographic characteristics, ASD diagnostic measures, chronic co-occurring conditions, medication usage, hospitalizations, visits to the emergency room (ER), and visits to specialists were compared in ASD children with and without sleep disturbances. Multivariate logistic regression models were then used to assess the independent association of sleep disturbances with clinical characteristics and healthcare utilization.

Results

Of the 541 children with ASD, 257 (47.5%) had sleep disturbances. Children with sleep disturbances exhibited higher rates of multiple (≥ 3) co-occurring conditions (19.1% vs. 12.7%; p = 0.0414) and prescribed medications (45.5% vs. 32.7%; p = 0.0031) than other children. Finally, ASD children with sleep disturbances were 1.72 and 2.71 times more likely to visit the ER and be hospitalized than their counterparts (aOR = 1.72; 99%CI = 1.01–2.95; and aOR = 2.71; 99%CI = 1.10–6.67, respectively).

Conclusions

Our findings suggest that sleep disturbances are associated with greater healthcare utilization among children with ASD. Further studies could examine whether treating sleep disturbances in children with ASD yields additional clinical benefits beyond improvements in sleep.
The relationship between liver enzymes, prehypertension and hypertension in the Azar cohort population
Authors: Somi Mohammd hossein , Faramarzi Elnaz , Jahangiry Sima , Sanaie Sarvin , Molani-Gol Roghayeh
Published: June 2024

Background

The incidence of hypertension (HTN) as a worldwide health problem is rising rapidly. Early identification and management of pre-HTN before HTN development can help reduce its related complications. We evaluated the relationship between liver enzymes levels and pre-HTN/HTN in the Azar cohort population.

Method

This cross-sectional study was based on data from the large Azar cohort study and a total of 14,184 participants were included. Pre-HTN and HTN were defined based on the American Heart Association guideline. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) levels were measured by Pars Azmoon kits. The relationship between pre-HTN/HTN and liver enzyme levels was evaluated by logistic regression.

Results

Of 14,184 participants, 5.7% and 39.6% had pre-HTN and HTN, respectively. In the adjusted model, AST levels of 19–23 IU/l were associated with an elevated risk of pre-HTN (OR [95% CI]: 1.24 [1.04–1.48]). A dose-response increase was seen in pre-HTN in relation to ALT, with the highest OR in the third tertile (1.34 [1.09–1.63]). The odds of pre-HTN also increased with GGT in the third tertile (1.25[1.03–1.52]). In addition, the odds of HTN increased with increased levels of AST, ALT, ALP, and GGT, such that the highest ORs were recorded in the third tertile (OR 1.22 [1.09–1.37], 1.51 [1.35–1.70], 1.19 [1.07–1.34], and 1.68 [1.49–1.89], respectively). Among these enzymes, GGT had the highest OR regarding HTN.

Conclusion

This study indicates that AST, ALT, ALP and GGT levels were associated with pre-HTN (except for ALP) and HTN, independent of known risk factors. Hence, it may be possible to use liver enzymes to predict the incidence of pre-HTN and HTN, empowering primary care providers to make the necessary interventions promptly.
‘Talking lines’: the stories of diagnosis and support as told by those with lived experience of rare forms of dementia
Authors: Rossi-Harries Samuel , Harrison Charles R. , Camic Paul M. , Sullivan Mary Pat , Grillo Adetola , Crutch Sebastian James , Harding Emma
Published: June 2024

Background

People living with, or caring for someone with, rare forms of dementia can encounter issues while obtaining a diagnosis and trying to access appropriate support. This can affect their wellbeing, quality of life, social relationships and employment status. This study makes use of an arts-based narrative approach to explore individual accounts of these experiences whilst also exploring how, in telling their stories, those affected by rare forms of dementia might invoke, and situate their stories in relation to, broader cultural narratives around dementia and illness.

Methods

Semi-structured interviews were conducted via video-conferencing software with participants (N = 27), living with, or caring for someone with, a rare forms of dementia. Participants used line drawings to depict their journey from initial symptoms to the present day, followed by prompts to verbally narrate their experiences. All interview transcripts and line drawings were subjected to narrative analysis. Four sets of transcripts and drawings were then subjected to more in-depth analysis.

Results

Analysis shed light on the struggles encountered by both care-partners and people with a diagnosis, while navigating a health and social care system that does not always understand their needs. This often led to individuals feeling isolated and unsupported. Accounts also depicted challenges to identity brought on by the process. The moment of diagnosis was also drawn in a complicated light. Individuals found comfort in gaining understanding, but felt fear at recognising upcoming challenges. Participants situated their own accounts against mainstream cultural narratives around what good support for cognitive impairment and dementia might look like, whilst also demonstrating the influential role they took on in pursuing the right care.

Conclusions

The use of line drawing, alongside narrative interviews, allowed participants to tell complicated, sometimes anachronistic, stories about difficult experiences, whilst also reflecting on, and attaching meaning to, them. These stories highlighted pressing gaps in healthcare services and shone a light on the various pieces of collective action individuals were engaged in in order to improve them. Finally, in modelling some elements of the participants’ service provision which were working, the narratives pointed to future directions services might move in.
Optimal dose and type of exercise to improve depressive symptoms in older adults: a systematic review and network meta-analysis
Authors: Tang Lili , Zhang Lin , Liu Yanbo , Li Yan , Yang Lijuan , Zou Mingxuan , Yang Huiran , Zhu Lingyu , Du Ruihong , Shen Ye , Li Haoyu , Yang Yong , Li Zhijun
Published: June 2024

Background

Depression is a prevalent issue among older adults, affecting their quality of life and overall well-being. Exercise is an effective means of relieving depressive symptoms in older adults, but the optimal dose for different exercise types remains unclear. As such, the aim of this meta-analysis was to examine the dose–response relationship between overall and specific types of exercise with depression symptoms in older adults.

Methods

This systematic review and network meta-analysis included a search of PubMed, Medline, Embase, PsycINFO, Cochrane library, and Web of Science for randomized controlled trials of exercise in older adults with depression symptoms from inception to 15 July 2023. Comprehensive data extraction covered dose, treatment regimen, demographics and study duration. Dosage metrics, encompassing METs-min/week, were scrutinized in correlation with the Minimal Clinically Importance Difference (MCID).

Results

A total of 47 studies involving 2895 participants and 7 kinds of exercise were included in the review. Without considering the dose, the results of our network meta-analysis indicated that Walking was the most effective in alleviating depression in older adults, in addition to Aerobic exercise (AE), Yoga, Qigong, Resistance training (RT), and Tai Chi (TC), which were equally effective. However, the results of the dose–response analysis found that Aerobic exercise was most effective at a dose of 1000 METs-min/week. It is noteworthy that Walking is significantly effective in alleviating depressive symptoms in older adults at very low doses. In terms of clinical benefits, we found that overall exercise doses in the range of 600 ~ 970 METs-min/week were clinically effective. Considering the specific types of exercise, Aerobic exercise, Resistance training, Walking, and Yoga were found to be effective at doses ranging from 820 ~ 1000 METs-min/week, 520 ~ 1000 METs-min/week, 650 ~ 1000 METs-min/week, 680 ~ 1000 METs-min/week, respectively. At the same time, we found that when the age exceeded 81 years, even when participating in exercise, it did not achieve the effect of alleviating depressive symptoms in older adults.

Conclusions

In conclusion, including Walking, AE, Yoga, Qigong, RT, and TC, effectively alleviate depressive symptoms in older adults. Furthermore, we established statistically and clinically significant threshold doses for various exercise types. Early initiation of exercise is beneficial, but its efficacy diminishes from the age of 80, and beyond 81, exercise no longer significantly alleviates depressive symptoms.
A comparison of the breast milk microbiota from women diagnosed with gestational diabetes mellitus and women without gestational diabetes mellitus
Authors: Rold Louise Søndergaard , Guldbæk Johan Mikkel , Lindegaard Caroline Steenberg , Kirk Stine , Nygaard Line Damkjær , Bundgaard-Nielsen Caspar , Holm-Jacobsen Julie Niemann , Leutscher Peter , Viuff Anne-Cathrine Finnemann , Hagstrøm Søren , Sørensen Suzette
Published: June 2024

Background

Human breast milk (HBM) is a contributing factor in modulating the infant’s gut microbiota, as it contains bacteria that are directly transferred to the infant during breastfeeding. It has been shown that children of women diagnosed with gestational diabetes mellitus (GDM) have a different gut microbiota compared to children of women without GDM. Our hypothesis is therefore that women with GDM have a different HBM microbiota, which may influence the metabolic function and capacity of the child later in life. The aim of this study was to investigate whether women with GDM have a different breast milk microbiota 1–3 weeks postpartum compared to women without GDM.

Methods

In this case-control study, a total of 45 women were included: 18 women with GDM and 27 women without GDM. A milk sample was collected from each participant 1 to 3 weeks postpartum and the bacterial composition was examined by 16 S rRNA gene sequencing targeting the V4 region.

Results

High relative abundances of Streptococcus and Staphylococcus were present in samples from both women with and without GDM. No difference could be seen in either alpha diversity, beta diversity, or specific taxa between groups.

Conclusion

Our results did not support the existence of a GDM-associated breast milk microbiota at 1–3 weeks postpartum. Further research is needed to fully understand the development of the gut microbiota of infants born to mothers with GDM.
Prevalence, risks factors, and control of hypertension in Guinean older adults in 2021: a cross-sectional survey
Authors: Camara Alioune , Koné Alpha , Millimono Thierno Mamadou , Sow Abdoulaye , Kaké Amadou , Preux Pierre-Marie , Balde Mamadou Dadhi , Jesus Pierre
Published: June 2024

Background

The incidence of arterial hypertension increases with the aging of the population, but its magnitude remains insufficiently assessed. The aim of this study was to investigate the prevalence of hypertension and associated factors in elderly people in Guinea.

Methods

Data were obtained from a cross-sectional general population survey, conducted among people aged ≥ 60 years. A stratified enumeration area random sample survey was conducted in the four natural regions of Guinea from February to April 2021. This study included an interview on sociodemographic data, and a clinical examination. Hypertension was defined as systolic blood pressure ≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg or previous diagnosis of hypertension (with or without antihypertensive medication). Hypertension control was defined as blood pressure below 140/90 mmHg during treatment. Age-standardized prevalence was calculated, and logistic regression was used to examine factors associated with hypertension.

Results

A total of 1698 adults (1079 men, mean age: 71.6 ± 9.4 years) had at least two blood pressure measurements. The standardized prevalence of hypertension was 61.4% [95% CI: 61.3–61.6], ranging from 52% in Middle Guinea to 67% in Upper Guinea, and was higher in women (65.2%: 65.0-65.4) than in men (59.1%:58.9–59.3). Among those with hypertension, 46.7% were unaware of their condition before the survey and 49.6% were on treatment and only 18.5% had controlled hypertension. Whatever the residence (rural or urban), increasing age, being unmarried, working as a trader or functionary, jobless, living in upper Guinea, low monthly income, intake of extra salt, known diabetic, overweight, and obesity increased the risk of hypertension. In urban area, female sex (AOR: 1.14: 1.12–1.17), living in lower Guinea (AOR: 3.08: 2.97–3.20), being Maninka (AOR: 1.26: 1.21–1.31), being Nguerze (AOR: 1.71: 1.63–1.81) increased the risk of hypertension, but living in forest Guinea (AOR: 0.88: 0.83–0.93), being Soussou (AOR: 0.88: 0.85–0.92) decreased the risk. In rural area, living in forest Guinea (AOR: 2.14: 2.03–2.26), being Soussou (AOR: 1.14: 1.12–1.17) increased the risk of hypertension, but female sex (AOR: 0.96: 0.94–0.98), living in lower Guinea (AOR: 0.87: 0.85–0.89), being Maninka (AOR: 0.94: 0.92–0.97), being Nguerze (AOR: 0.50: 0.47–0.52) decreased the risk.

Conclusion

Hypertension is a major problem in the elderly population in Guinea, and the level of treatment and control in elderly with known hypertension is inadequate. The place of hypertension among cardiovascular diseases and the identification of associated factors underlines the need to develop innovative approaches to control this major risk factor.
Comparative study of percutaneous endoscopic lumbar decompression and traditional revision surgery in the treatment of symptomatic adjacent segment degeneration
Authors: Guo Jianwei , Lv Changlin , Bai Tianyu , Li Guanghui , Ji Xiangli , Zhu Kai , Zhang Guoqing , Ma Xuexiao , Sun Chong
Published: June 2024

Objective

The objective of this study is to evaluate and compare the surgical outcomes and complications of Percutaneous Endoscopic Lumbar Decompression (PELD) and traditional revision surgery in treating symptomatic Adjacent Segment Degeneration (ASD). This comparison aims to delineate the advantages and disadvantages of these methods, assisting spine surgeons in making informed surgical decisions.

Methods

66 patients with symptomatic ASD who failed conservative treatment for more than 1 month and received repeated lumbar surgery were retrospectively collected in the study from January 2015 to November 2018, with the average age of 65.86 ± 11.04 years old. According to the type of surgery they received, all the patients were divided in 2 groups, including 32 patients replaced the prior rod in Group A and 34 patients received PELD at the adjacent level in Group B. Patients were followed up routinely and received clinical and radiological evaluation at 3, 6, 12 months and yearly postoperatively. Complications and hospital costs were recorded through chart reviews.

Results

The majority of patients experienced positive surgical outcomes. However, three cases encountered complications. Notably, Group B patients demonstrated superior pain relief and improved postoperative functional scores throughout the follow-up period, alongside reduced hospital costs (P < 0.05). Additionally, significant reductions in average operative time, blood loss, and hospital stay were observed in Group B (P < 0.05). Notwithstanding these benefits, three patients in Group B experienced disc re-herniation and underwent subsequent revision surgeries.

Conclusions

While PELD offers several advantages over traditional revision surgery, such as reduced operative time, blood loss, and hospital stay, it also presents a higher likelihood of requiring subsequent revision surgeries. Future studies involving a larger cohort and extended follow-up periods are essential to fully assess the relative benefits and drawbacks of these surgical approaches for ASD.
Experiences of formal caregivers of elderly inpatients with physical disabilities in China: a qualitative study
Authors: Sun Li-li , Zheng Li , Chen Liu-liu , Wang Zhao-di , Li Qian , Liu Li
Published: June 2024

Aim

To explore the views and experiences of formal caregivers caring for older inpatients with physical disabilities.

Methods

It was a qualitative phenomenological study. Using purposive sampling, twelve formal caregivers were chosen in a tertiary comprehensive hospital in Hangzhou, China. Semi-structured, face-to-face interviews were conducted, guided by open-ended questions that focused on gaining rich insights into participants’ views and experiences. Coding reliability thematic analysis was used to guide data analysis and categorize, based on Lazarus and Folkman’s theory of transactional coping.

Results

Four themes emerged from the data analysis: (1) Caregiving Threats. (2) motivations. (3) Responsibility Management. (4) Fear.

Conclusion

Despite facing significant pressure at work, formal caregivers of elderly inpatients with physical disabilities possess the drive and various coping strategies to excel in their role. Identifying caregivers’ experiences of care can be helpful in improving resilience to stress and maintaining stability in formal caregivers.
“I probably have access, but I can’t afford it”: expanding definitions of affordability in access to contraceptive services among people with low income in Georgia, USA
Authors: Newton-Levinson Anna , Griffin Kelsey , Blake Sarah C- , Swartzendruber Andrea , Kramer Michael , Sales Jessica M-
Published: June 2024

Background

Disparities in rates of contraceptive use are frequently attributed to unequal access to and affordability of care. There is a need to better understand whether common definitions of affordability that solely relate to cost or to insurance status capture the reality of individuals’ lived experiences. We sought to better understand how individuals with low incomes and the capacity for pregnancy conceptualized one domain of contraceptive access–affordability --in terms of health system and individual access and how both shaped contraceptive care-seeking in the US South.

Method

Between January 2019 to February 2020, we conducted twenty-five life-history interviews with low-income individuals who may become pregnant living in suburban counties in Georgia, USA. Interviews covered the ways individual and health system access factors influenced care-seeking for family planning over the life course. Interview transcripts were analyzed using a thematic analysis approach to identify experiences associated with individual and health system access.

Results

Affordability was identified as a major determinant of access, one tied to unique combinations of individual factors (e.g., financial status) and health system characteristics (e.g., cost of methods) that fluctuated over time. Navigating the process to attain affordable care was unpredictable and had important implications for care-seeking. A “poor fit” between individual and health system factors could lead to inequities in access and gaps in, or non-use of contraception. Participants also reported high levels of shame and stigma associated with being uninsured or on publicly funded insurance.

Conclusions

Affordability is one domain of contraceptive access that is shaped by the interplay between individual factors and health system characteristics as well as by larger structural factors such as health and economic policies that influence both. Assessments of the affordability of contraceptive care must account for the dynamic interplay among multilevel influences. Despite the expansion of contraceptive coverage through the Affordable Care Act, low-income individuals still struggle with affordability and disparities persist.
Effect of autologous platelet-rich plasma on the fertility and quality of cryopreserved buffalo bull semen: a comparative study using OptiXcell® and tris egg yolk extenders
Authors: Salama Maha S. , Ashour Mohey A. , Taher Ehab S. , Rashed Fatema , Ibrahim Ibrahim M. , El-Nablaway Mohammad , Ibrahim Ateya Megahed , Mihaela Ostan , Olga Rada , Mohammed Nourelhuda A. , Abdeen Ahmed , Shukry Mustafa
Published: June 2024

Background

Buffalo spermatozoa have a distinct membrane structure that makes them more vulnerable to cryopreservation, resulting in lower-quality post-thawed sperm. This decreases the success rate of artificial insemination in buffaloes. Understanding and addressing these specific vulnerabilities are essential for improving reproductive techniques in buffalo populations. The properties of cryopreserved buffalo bull semen were examined in this study regarding the impact of adding autologous platelet-rich plasma (PRP) to OptiXcell® or Tris egg yolk-based extenders. Ten buffalo bulls were used to collect semen. Each bull’s ejaculate was separated into two main equal amounts, each of which was then diluted with either OptiXcell® or Tris egg yolk-based extender, supplemented with various PRP concentrations (5%, 10%, and 15%), and the control (0%), before being cryopreserved according to established protocols. Following equilibration and thawing, the quality and functionality of the sperm were evaluated, along with the antioxidant enzyme activities (GSH and TAC), malondialdehyde (MDA) content, and in vivo fertilization rate of the thawed semen.

Results

All PRP concentrations in both extenders, particularly 10% PRP, improved the quality and functionality of the sperm in both equilibrated and frozen-thawed semen. Additionally, the antioxidant enzyme activities in both extenders were higher in the PRP-supplemented groups compared to the control group in thawed semen (P < 0.05). All post-thaw sperm quality, antioxidant enzyme activities, and functionality aside from DNA integrity were higher (P < 0.05) in the PRP-supplemented OptiXcell® than in the PRP-supplemented Tris egg yolk-based extender. The fertility of cryopreserved semen in the extenders supplemented with 10% and 15% PRP increased (P < 0.05) significantly more than that of the control extenders, with 10% PRP being the optimum concentration in OptiXcell® (80%) compared to that of Tris egg yolk-based extender (66.67%) and control of two extenders (53.33% and 46.67%, respectively).

Conclusions

Even though autologous PRP-supplemented extenders have a protective impact on equilibrated and cryopreserved semen, 10% PRP-supplemented OptiXcell® extenders are more effective at preserving post-thaw semen quality, functionality, and antioxidant capacity, which increases the in vivo fertility of buffalo bulls.
Feeding live yeast (Saccharomyces cerevisiae) improved performance of mid-lactation dairy cows by altering ruminal bacterial communities and functions of serum antioxidation and immune responses
Authors: Zhang Qian , Ma Lifeng , Zhang Xiaoqing , Jia Hao , Tana  , Guo Yu , Zhang Jize , Wang Jianlong
Published: June 2024

Background

The utilization of live yeast (Saccharomyces cerevisiae, YE) in dairy cows is gaining traction in dairy production as a potential strategy to improve feed efficiency and milk yield. However, the effects of YE on dairy cow performance remain inconsistent across studies, leaving the underlying mechanisms unclear. Hence, the primary aim of this study was to investigate the impact of YE supplementation on lactation performance, ruminal microbiota composition and fermentation patterns, as well as serum antioxidant capacity and immune functions in dairy cows.

Results

Supplementation with YE (20 g/d/head) resulted in enhancements in dairy cow’s dry matter intake (DMI) (P = 0.016), as well as increased yields of milk (P = 0.002) and its components, including solids (P = 0.003), fat (P = 0.014), protein (P = 0.002), and lactose (P = 0.001) yields. The addition of YE led to significant increases in the concentrations of ammonia nitrogen (NH3-N) (P = 0.023), acetate (P = 0.005), propionate (P = 0.025), valerate (P = 0.003), and total volatile fatty acids (VFAs) (P < 0.001) in rumen fermentation parameters. The analysis of 16s rRNA gene sequencing data revealed that the administration of YE resulted in a rise in the relative abundances of three primary genera including Ruminococcus_2 (P = 0.010), Rikenellaceae_RC9_gut_group (P = 0.009), and Ruminococcaceae_NK4A214_group (P = 0.054) at the genus level. Furthermore, this increase was accompanied with an enriched pathway related to amino acid metabolism. Additionally, enhanced serum antioxidative (P < 0.05) and immune functionalities (P < 0.05) were also observed in the YE group.

Conclusions

In addition to improving milk performance, YE supplementation also induced changes in ruminal bacterial community composition and fermentation, while enhancing serum antioxidative and immunological responses during the mid-lactation stage. These findings suggest that YE may exert beneficial effects on both rumen and blood metabolism in mid-lactation dairy cows.
Moderate to advanced periodontitis contributes to increased oxidative stress in cats: a case-control study
Authors: Moosavian Hamidreza , Gholikhani Marzie , Tamai Iraj Ashrafi , Fazli Mahsa
Published: June 2024

Background

Periodontal diseases are the most frequently diagnosed problem in cats. It has been well-established that periodontal diseases could not only cause various oral health issues but could also contribute to systemic diseases. Oxidative stress is a possible link between systemic diseases and periodontitis. Our study aimed to illustrate the influence of periodontitis on oxidative stress development in cats. Furthermore, the changes in the bacterial flora of the gums were investigated.

Methods

Based on the clinical and laboratory examinations, fifty cats were divided into two groups normal (n = 25) and moderate to advanced periodontitis (n = 25). Serum total antioxidant capacity (TAC), total oxidant status (TOS), reduced (GSH) and oxidized glutathione (GSSG) were measured. In addition, samples were taken from the subgingival plaques of all cats for bacterial culture.

Results

Serum TOS, GSSG, GSSG to GSH ratio, and oxidative stress index (OSI), calculated as the ratio of TOS to TAC in cats with periodontal disease were significantly higher, and TAC was significantly lower (p < 0.05) compared with controls. The results of bacterial culture indicated that the number of isolated bacterial colonies is higher in patients than in the control group. Additionally, the analysis of these data showed a positive association between periodontal index and oxidative stress.

Conclusions

Our results revealed that periodontitis in cats is related to a main oxidative stress. Furthermore, oxidant factors such as TOS and OSI, compared to antioxidant factors, may better indicate the presence of oxidative stress conditions in patients with periodontitis.
Association between serum vitamin D level and Graves’ disease: a systematic review and meta-analysis
Authors: Pang Boxian , Li Leyang , Liu Xin , Cao Zhengmin , Pang Tieliang , Wang Qiuhong , Wei Junping
Published: June 2024

Objective

This meta-analysis aims to analyze the relationship between serum vitamin D (VD) levels and Graves’ disease (GD).

Methods

We conducted a search for publications on VD and GD in the English language. Our search encompassed databases such as PubMed, Embase, Web of Science, and the Cochrane Library, covering publications available through August 2023. A meta-analysis was performed using Cochrane RevMan 5.4 software. The standardized mean difference (SMD) and 95% confidence interval (CI) were used for outcome calculation. We used R software to test for publication bias.

Results

Twelve studies were selected, comprising 937 (22.4%) cases with GD and 3254 (77.6%) controls. The overall meta-analysis revealed that patients with GD are significantly more likely to have low VD levels (SMD = − 0.66; 95% CI: −1.05, − 0.27; p = 0.001) than those in the control group. Egger’s test results indicated no publication bias (p = 0.0791). These studies exhibited a high degree of heterogeneity (chi-square = 205.86, p < 0.00001; I2 = 95%). Subgroup analysis was conducted based on assay method, geographic location, and mean age of the case group to explore the heterogeneity sources. Assay methods and geographic locations were identified as potential heterogeneity sources. Based on the mean age, there were no statistically significant differences found in the subgroup analysis of the included studies.

Conclusion

There is promising evidence that low serum VD levels may increase the risk of GD. Further rigorous and long-term trials are needed to explore the role of VD in the onset and treatment of GD.