bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term prognostic factors and outcomes in mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes: a clinical and biochemical marker analysis
Authors: Gao Rui , Gu Lihua , Zuo Wenchao , Wang Pan 
Published: December 2024

BackgroundMELAS (Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes) is a common subtype of mitochondrial encephalomyopathy. However, few studies have explored the relationship between biochemical markers and prognosis. This study aimed to explore the relationship between clinical and biochemical markers and prognosis of patients with MELAS.MethodsThis was a retrospective single-center study. A total of 39 MELAS patients were followed for an average of 7.3 ± 4.7 (range 1–21 years). All patients underwent detailed demographic registration, neurological examinations, biochemical and mitochondrial DNA analyses, muscle biopsy. Throughout the follow-up period, the modified Rankin Scale (mRS) scores, recurrent strokes rates, and mortality were tracked.ResultsAll patients initially presented with stroke-like episodes. Of the 39 subjects who were followed, 8 died, primarily due to acute stroke-like episodes and status epilepticus. Univariate analysis showed a higher risk of mortality in patients with severe lactate elevation compared to those with normal and mildly elevated levels (OR = 5.714, 95% CI 1.086–30.071, p = 0.040). While the absence of anemia was associated with a lower risk of death compared to those with anemia (OR = 0.175, 95% CI 0.033–0.921, p = 0.040). In multivariate analysis, severe lactate elevation (OR = 7.279, 95% CI 1.102–48.086, p = 0.039) and anemia (OR = 0.137, 95% CI 0.021–0.908, p = 0.039) were identified as independent predictors of mortality. MRS scores were categorized as follows: 41% of patients scored 0 to 2, 38.5% scored 3 to 5, and 20.5% had a score of 6 or had died. There was a positive correlation between lactic acid levels and MRS scores (r = 0.460, p = 0.003). In contrast, hemoglobin levels were negatively correlated with MRS scores (r = −0.375, p = 0.015). Furthermore, a positive correlation was observed between MRS scores and the frequency of stroke-like episodes (r = 0.280, p = 0.042).ConclusionOur study found that the majority of patients with MELAS had poor clinical outcomes. Anemia and significantly increased lactate levels were identified as indicators of poor prognosis in MELAS. Early intervention may lead to improvements in clinical outcomes.
Neuroanatomical correlates of language impairment in non-fluent variant of primary progressive aphasia
Authors: Akhmadullina Diliara R. , Konovalov Rodion N. , Shpilyukova Yulia A. , Nevzorova Kseniya V. , Fedotova Ekaterina Yu. , Illarioshkin Sergey N. 
Published: December 2024

IntroductionNon-fluent variant of primary progressive aphasia (nfvPPA) is a neurodegenerative disorder with a predominantly speech and language impairment. Apraxia of speech and expressive agrammatisms along with decreased speech fluency and impaired grammar comprehension are the most typical disorder manifestations but with the course of the disease other language disturbances may also arise. Most studies have investigated these symptoms individually, and there is still no consensus on whether they have similar or different neuroanatomical foundations in nfvPPA. In addition, only few works have focused on the functional connectivity correlates. The aim of our study was to simultaneously investigate functional and structural brain-language associations in one group of nfvPPA.MethodsTwenty eight patients were enrolled and underwent brain MRI and language assessment. Apraxia of speech, expressive and receptive agrammatisms, repetition, naming and single word comprehension correlates were identified using voxel-based morphometry and resting-state functional MRI (ROI-to-ROI analysis).Results and discussionAmong the structural correlates, the most common were inferior frontal gyrus (was associated with fluency, both expressive and receptive agrammatisms) and supramarginal gyrus (apraxia of speech, receptive agrammatisms, naming and repetition). Apart from that, neuroanatomical foundations were different for each of the core nfvPPA language domains, including superior parietal lobule involvement in fluency, temporoparietal areas in receptive agrammatisms and supplemental motor area in apraxia of speech. Functional correlations were even more diverse. In general, connectivity decrease between temporoparietal structures was more typical for expressive and receptive agrammatisms, single word comprehension and naming, while apraxia of speech, fluency and repetition showed connectivity disruption mainly among the frontoparietal region and subcortical structures. Overall, extensive structural and functional changes are involved in the development of language and speech disturbances in nfvPPA with distinctive neuroanatomical foundations for each domain.
Teacher stress in social interactions in the light of polyvagal theory. An ambulatory assessment approach to teachers’ heart rate and heart rate variability
Authors: Kühne Fabienne , Wettstein Alexander , Jenni Gabriel , Schneider Ida , grosse Holtforth Martin , La Marca Roberto 
Published: December 2024

BackgroundTeaching is a genuinely social and highly demanding task. Drawing on Porges’ phylogenetic polyvagal theory with three evolved systems and three associated behavioral responses (social engagement, mobilization, and immobilization), we investigated teachers’ heart rate and heart rate variability in social interactions using ambulatory assessments.MethodsWe continuously measured heart rate and heart rate variability of 42 apparently healthy teachers on a work and leisure day with ambulatory electrocardiogram. We videotaped four consecutive, same-day lectures of each teacher. We trained observers to code student aggression and frontal teaching behaviors in an event sampling procedure with the behavior observation system for analyzing aggressive behavior in school settings. Additionally, perceived teacher-student relationship, social support from other teachers / school management, occupational complaints, and vital exhaustion were assessed by teacher self-reports.ResultsTeachers showed an increased heart rate and a decreased heart rate variability on a workday compared to a leisure day, anticipatory stress before classes, as well as insufficient recovery during lunchtime. Observed student aggression and high proportion of frontal teaching were associated with lower heart rate variability, while better perceived teacher-student relationship was correlated with higher heart rate variability. Differently, teachers’ psychological strain and heart rate variability were unrelated to each other.ConclusionCorresponding to polyvagal theory, results suggest that successful social interactions are fundamental for teachers’ favorable cardiological reactions.
Life-style and metabolic factors do not affect risk for glioma: a prospective population-based study (The Cohort of Norway)
Authors: Gheorghiu Anamaria , Brunborg Cathrine , Johannesen Tom B. , Helseth Eirik , Zwart John-Anker , Wiedmann Markus K. H. 
Published: December 2024

BackgroundThe identification of modifiable risk factors for intracranial glioma remains a significant challenge. While lifestyle factors and metabolic syndrome are well-established risk factors for various other cancers, their association with glioma risk remains unclear.ObjectivesThis study aims to conduct a comprehensive analysis of lifestyle factors and metabolic factors in relation to glioma risk.MethodsThe Cohort of Norway (CONOR) is a prospective, population-based health survey encompassing anthropometric measurements, blood tests and health questionnaires. CONOR data were linked to the National Cancer Registry to identify incident glioma cases. Follow-up time was calculated in person-years from the baseline examination until the date of glioma diagnosis, death, or the end of the follow-up period. Cox proportional hazards regression was used to calculate hazard ratios (HR).ResultsThe study cohort included 160,938 women and men. Over 2.8 million person-years of follow-up, 319 intracranial gliomas were diagnosed. Lifestyle factors such as physical activity, alcohol consumption, smoking, and marital status were not associated with glioma risk. There was no increased glioma risk among participants with diabetes mellitus or hypertension. Furthermore, metabolic syndrome in both women and men was not associated with an elevated risk of glioma. Blood lipids, including total cholesterol, triglycerides, and HDL, were not linked to glioma risk. However, increasing LDL levels were associated with a decreased risk of glioma in men (HR per category 0.84; 95% CI 0.74-0.96), but not in women.ConclusionThis is the first comprehensive prospective cohort study to evaluate potentially modifiable risk factors for glioma. Our findings do not support previously suggested associations between smoking, alcohol consumption, or metabolic syndrome and glioma risk.
Effects of non-invasive brain stimulation on emotion regulation in patients with attention deficit hyperactivity disorder: a systematic review
Authors: Shen Fang , Zhou Hui 
Published: December 2024

Background and objectiveA growing body of research evidence suggests that many patients with attention deficit hyperactivity disorder (ADHD) have difficulties with emotion regulation. Non-invasive brain stimulation (NIBS), which mainly includes transcranial electrical stimulation (tES) and repetitive transcranial magnetic stimulation (rTMS), has been considered a potential new direction in the treatment of emotion dysregulation in ADHD patients. The key components of tES are transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS). However, there is no systematic evaluation exploring the effects of non-invasive brain stimulation on emotion regulation in ADHD patients. Therefore, this systematic review aimed to summarize the effects of NIBS on emotion regulation in ADHD patients.MethodsThis systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, Web of Science, and the Cochrane Library electronic databases up to 1 July 2024. We also hand-searched the reference lists of retrieved articles and reviews. Assessing risk of bias using the Cochrane Assessment Tool.ResultsThrough database search, we obtained a total of 1134 studies, of which 5 met the inclusion criteria. Statistically significant improvements in emotion regulation in children with ADHD were observed in 1 study after treatment with tDCS. In the remaining 4 studies (2 with tDCS and 2 with rTMS), there were no statistically significant changes in emotion regulation in ADHD patients after treatment with either tDCS or rTMS.ConclusionsThe data from our preliminary study do not allow us to draw definitive conclusions that non-invasive brain stimulation improves emotion regulation in ADHD patients. This is because there is a paucity of literature on the effects of tES or rTMS on emotion regulation in ADHD patients and a limited number of randomized controlled trials. More high-quality multicenter randomized controlled trials exploring the efficacy of non-invasive brain stimulation on emotion regulation in ADHD patients are needed in the future to provide strong evidence for definitive conclusions before it can be considered as a potential treatment option.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024569041.
Supporting children’s wellbeing through outdoor time: opportunities to integrate consistent outdoor time into the elementary school day
Authors: Patchen Amie K. , Edwards Amanda , Rakow Donald A. , Meredith Genevive R. 
Published: December 2024

BackgroundTime in nature supports cognitive, psychological, academic, and health benefits. Outdoor time during school can provide young people with equitable access to these benefits, however, there are within-school constraints. Understanding if and how teachers can frequently and consistently incorporate outdoor time in the schoolyard into their classroom activities can inform broader implementation.MethodsA mixed-methods observational study was conducted with 17 teachers from five elementary schools. Teachers reported on how they incorporated outdoor time into their classes over an eight-week period. Data on outdoor time, activities, locations, barriers, motivations, and facilitators were collected through surveys on 15 randomly pre-selected days, and through a post-survey.ResultsOn the 15 randomly selected days surveyed, classes went outside 78% of the time, ranging from 6–15 outdoor days per class, and 0–285 min per day. Time, activities, locations, motivations, barriers, and facilitators varied across classes and days. The most common activities were free play (n = 138) and intentional engagement with nature (n = 57). Health benefits (n = 68) and having time (n = 58) were the most common motivations teachers reported for incorporating outdoor time.Implications for school health, policy, practice, and equityConsistent outdoor time in the school day can support students’ wellbeing and academic success. Encouraging free play, highlighting the health benefits, using a systems approach, and flexible implementation may help teachers increase their use of outdoor time during the school day.ConclusionTeachers consistently incorporated outdoor time, but implementation varied across classes and days. Implementation findings from this district could help inform practices at other schools.
Sustaining women’s empowerment for development in resource-limited settings: an exploratory qualitative approach
Authors: Wallole Wanno , Alano Abraham , Endriyas Misganu 
Published: December 2024

BackgroundWomen's empowerment is one of the fundamental issues for attaining sustainable development goals crossing multiple dimensions. In Ethiopia, Women’s Development Network (WDN), a network of women, was established in 2010 with development aims. Ensuring women’s empowerment critically needs collective efforts of platforms such as WDN. However, there was a paucity of information about the patterns of WDN functionalities, its contribution, and factors affecting its functionality in rural areas of Southern Ethiopia. Hence, this study aimed to explore WDN status and factors affecting their functionality in Southern Ethiopia.MethodologyThe study employed an exploratory qualitative design. Data were collected from purposively selected zones using focus group discussions and key informant interviews. Audio-taped materials were transcribed verbatim and analyzed using a thematic approach. Initially, data were coded (open coding) and after several reviews, themes were developed and interpreted in line with the study objectives.ResultWDN has passed several steps from its establishment up to now. It was seen skeptically at its early inception, very good level of acceptance in the middle, and staggering currently. However, WDN has contributed to improvements in household welfare resulting from increased ability to afford food, clothing, health, and education. Specific to health, WDN has contributed to general awareness creation, maternal and child health utilization, and environmental sanitation. On the other hand, the volunteer nature of the job put pressure on WDN and revealed socioeconomic stresses. Moreover, inconsistent support from stakeholders especially health extension workers, inadequate men’s engagement, and sidelining of WDN by some educated women remain challenges for the sustainable functionality.ConclusionWDN has contributed to multidimensional development goals, especially health services uptake and environmental sanitation. However, over time, it became flaccid and lost adequate emphasis from most of its stakeholders and supportive structures. Therefore, considering such vital inputs from community participation in resource-limited settings, stakeholders should offer adequate attention to WDN in terms of selection, training, orientation, follow-up, and acquainting with the community they serve. Moreover, efforts are needed to retain women voluntarily serving and build positive images across all stakeholders and fellow women receiving the services.
Comparing two large data repositories to understand the differences in demographics, health history, and behavioral attributes in populations
Authors: Nasiha Maliq Nihmath , Ong Toan , Giano Zachary , Rivera William , Tiwari Tamanna 
Published: December 2024

IntroductionThis study conducted a comparative analysis between two large data repositories, the All of Us (AoU) medical data and BigMouth dental data repositories.MethodsThe comparison analysis includes variables related to behavioral and systemic health, health literacy, and overall health status across race, ethnicity, and gender. The analytic approach used descriptive statistics, Chi-square, odds ratio, and 95% confidence intervals; significant comparisons were measured with Cohen's D effect sizes.ResultsIn the AoU dataset, 80.6% of Hispanic or Latino participants reported alcohol use compared to 16.8% in the BigMouth data repository. The female cohort in AoU showed 87.9% alcohol use, a contrast to BigMouth's 26.0%. Additionally, the diabetes prevalence among females was 8.8% in AoU vs. 21.6% in BigMouth. Differences in health literacy were observed, with 49.2% among Hispanic or Latino participants in AoU, in contrast to BigMouth's 3.2%. Despite this, 70.1% of Hispanic or Latino respondents in AoU reported satisfactory health status, while BigMouth indicated a much higher figure at 98.3%.DiscussionThese variations highlight the importance of targeted health interventions addressing racial/ethnic and gender influences. Differences may arise from recruitment approaches, participant demographics, and healthcare access. There is a need for collaboration, standardized data collection, and inclusive recruitment to remedy these discrepancies. Further research is imperative to understand the underlying causes, facilitate interventions that address the disparities, and advocate for a more inclusive healthcare system.
“Teledentistry” using a mobile app (Telesmile) to improve oral health among the visually impaired and hearing-impaired populations in Saudi Arabia: a randomized controlled study
Authors: Fageeh Hytham N. , Mansoor Manawar A. , Fageeh Hammam I. , Abdul Hina N. , Khan Hamza , Akkam Abdulrahman , Muhaddili Idris , Korairi Sultan , Bhati Ashok Kumar 
Published: December 2024

ObjectiveTo assess the efficacy of a “teledentistry” method using a mobile app (Telesmile) in enhancing knowledge of oral health conditions and oral hygiene practices among the blind and deaf populations in Jazan Province in Saudi Arabia.MethodsA randomized parallel design controlled study was conducted among 50 blind and 50 deaf subjects between the ages of 12–18 years, randomly chosen from blind and deaf schools. The participants were selected based on the inclusion and exclusion criteria. An innovative teledentistry platform named Telesmile, a mobile application for the Apple iOS App Store and Google Play Store, was developed. Multimedia Arabic dental sign language oral hygiene instructional videos were created and uploaded in the Telesmile mobile application under the deaf category. Similarly, oral hygiene instructions were audio recorded by experts and uploaded under the blind category in the Telesmile mobile application. Group I of the blind (n = 25) and deaf participants (n = 25) received regular oral hygiene instructions while Group II of the blind (n = 25) and deaf (n = 25) participants received the Telesmile mobile application intervention. The knowledge of the participants pertaining to oral health and oral hygiene practices was evaluated using a close-ended questionnaire comprising 14 questions at the initial visit (T0). Training sessions were conducted for all participants and the Telesmile mobile application was distributed among the participants in Group II. After 4 weeks (T1), the knowledge of the participants regarding oral health and hygiene practice was re-evaluated and compared between each group.ResultsThe chi-square test revealed that the marginal mean of the knowledge of the blind and deaf participants pertaining to oral health and oral hygiene practices was very poor at their initial visit (T0) and it significantly increased (p &lt; 0.001) after 4 weeks (T1) of using the Telesmile mobile application.ConclusionThe Telesmile mobile application can significantly enhance oral hygiene knowledge among blind and deaf people. The audio technique was an effective tool to deliver oral health education which could result in improving the oral health status of blind participants. The video demonstrations were also effective in enhancing the oral health and oral hygiene knowledge of deaf individuals.
Monitoring of Antibiotic Resistance Patterns Within Al-Karak Governmental Hospital, Jordan, in 2022
Authors: Aqel Amin A. , Al-Matarneh Tala M. , Al-Tarawneh Tayf K. , Alnawayseh Tahrir , Alsbou Mohammed , Gaber Yasser 
Published: December 2024

Background/Objectives: Antimicrobial resistance is considered one of the foremost global public health challenges, and its prevalence is increasing. In Jordan, particularly in Al-Karak Governorate, there is a lack of sufficient data on antimicrobial resistance to make accurate assessments. The main aim of the current study was to evaluate antibiotic resistance trends in clinical specimens from 2022 and assess antibiotic resistance patterns. The emphasis on the WHO antibiotic classification as Access, Watch, and Reserved (AWaRe) was adopted in the current study. Results: Among Gram-positive bacteria, Enterococcus faecalis exhibited 100% susceptibility to nitrofurantoin and 96% to vancomycin, Streptococcus viridans exhibited 100% susceptibility to teicoplanin, while CoNS (coagulase-negative Staphylococci) showed moderate resistance to Trimethoprim + Sulfamethoxazole (63%) and clindamycin (47%). Among Gram-negative bacteria, Escherichia coli and Klebsiella pneumoniae displayed high susceptibility to fosfomycin (E. coli: 95%, K. pneumoniae: 80%) and amikacin (E. coli: 93%, K. pneumoniae: 81%). Resistance was notable for trimethoprim + sulfamethoxazole (E. coli: 47%, K. pneumoniae: 53%) and nitrofurantoin (K. pneumoniae: 30%). Pseudomonas aeruginosa exhibited the highest proportion of XDR strains (15%), followed by K. pneumoniae (11%) and E. coli (4%), while PDR strains were found in P. aeruginosa (6%), K. pneumoniae (3%), and E. coli (0.6%). XDR was observed in 4% of CoNS and 3% of S. viridans (α), with Staphylococcus aureus exhibiting both XDR and PDR at 1%. Methods: A cross-sectional retrospective study of bacterial species and their antimicrobial susceptibility was carried out at a hospital in Al Karak, Jordan, from January to December of 2022, the study included 1187 isolates from all locations in Al-Karak Governmental Hospital. Conclusions: The significant prevalence of XDR and PDR strains in key pathogens, particularly P. aeruginosa and K. pneumoniae, underscores the need for a robust Antimicrobial Stewardship Program (ASP) and infection control measures at Al-Karak Governmental Hospital. High susceptibility in several Access group antibiotics (e.g., amikacin and nitrofurantoin) supports their prioritization in empirical therapy, while the emergence of resistance in Watch and Reserved antibiotics highlights the necessity for rational use. These findings are very important for adjusting the local strategies to lower the spread of resistant strains and improve clinical outcomes.