bluuebunny/crossref_metadata_2025_split huggingface dataset:
Household storage and disposal of unused and expired medicines in Dessie, Ethiopia: a cross-sectional study
Authors: Yimer Alebachew , Moges Getachew , Kahissay Mesfin Haile 
Published: October 2024

IntroductionHouseholds frequently store unwanted, unused, or expired medicines in their homes indefinitely or discard them through general municipal waste bins, sinks, or flush them into their toilets. Disposing unused or expired medicines through these unauthorized channels can affect the environment and lives of individuals. This study assessed the household storage and disposal practices of unused and expired medicines in the Dessie City Administration in northeast Ethiopia.MethodsA community-based cross-sectional study was conducted using a semi-structured interview. The data were collected during November 1–30, 2019. A Multistage sampling technique was employed to recruit participants. The data were analyzed using SPSS version 23.ResultsThe study found that 62.4% of households stored unused or expired medicines, with analgesics, antibiotics, and cold and flu drugs being the most commonly used. The primary reasons for storing these medicines included future use, discontinuation of medication, and sharing with others, if needed. Most people preferred to dispose of these medicines by trashing them in household garbage, while some disposed of them in their original form and a few diluted them with water before disposal. Multivariate logistic regression analysis identified key factors associated with medicine storage: housewives and government employees were less likely to store unused medicines compared to students and daily workers, and obtaining medicines from private dispensaries was linked to reduced storage. Additionally, households that received advice from physicians were less inclined to store unused medicines.ConclusionThis revealed the widespread storage of unused medicines, primarily analgesics and antibiotics. Improper disposal practices are common and emphasize the need for public education. Employment status, source of medicines, and healthcare advice influenced storage behaviors. Healthcare providers play a vital role in improving medication management and reducing waste.
Food insecurity and oral health in older adults
Authors: Merchant Anwar T. , Fallahi Afsaneh , Huda Arissa , Lohman Matthew 
Published: October 2024

IntroductionHousehold food insecurity, defined as inconsistent access to sufficient food in a household, affects 1 in 15 individuals over the age of 60 years in the US. In these individuals it is associated with numerous chronic conditions, medication underuse leading to poorly controlled conditions such as diabetes and hypertension, and poor oral health. However, the relationship between food insecurity and oral health is understudied. We therefore evaluated the associations between food insecurity and aspects of oral health in older US adults.MethodsWe prospectively evaluated a subset of participants of the Health and Retirement Study (HRS) who responded to questions evaluating food insecurity in 2013 and a supplemental questionnaire regarding dental health and dental health services in 2018 (N = 472).ResultsApproximately 1 in 5 people in our study reported being food insecure in the last year. Food insecurity was correlated with poor oral health-related quality of life scores and more tooth loss. Individuals who were food insecure reported worse self-rated oral health (OR = 2.67), greater odds of losing 8 or more teeth (OR = 2.35), and lower odds of receiving oral care (OR = 0.60) compared to their food secure peers.ConclusionsThough individuals experiencing food insecurity were likely to have more unmet oral health needs than their peers, they were less likely to seek dental care. To improve the oral health status of this group, in addition to making oral health care more accessible, it may also be necessary to address the social and environmental factors preventing these people from seeking oral health care.
The effects of endurance training on muscle oxygen desaturation during incremental exercise tests: a systematic review and meta-analysis
Authors: Yogev Assaf , Arnold Jem I. , Nelson Hannah , Rosenblat Michael A. , Clarke David C. , Guenette Jordan A. , Sporer Ben C. , Koehle Michael S. 
Published: October 2024

ObjectiveMinimum muscle oxygen saturation (SmO2min) measured via near-infrared spectroscopy (NIRS) is a common measure during incremental exercise testing (IET). Our objective was to determine the effects of pre-to-post endurance training on SmO2min (ΔSmO2min) during an IET, using a meta-analysis.Data sourcesMEDLINE, EMBASE, and SPORTDiscus.Study selectionStudies including healthy individuals had to meet the following criteria: (1) endurance training intervention; (2) peripheral muscle NIRS; (3) incremental exercise test pre/post training; (4) SmO2 or analogous saturation parameter measured.AnalysisA PEDro scale was used for risk of bias analysis. A random effect meta-analysis model was used to synthesize the effect of training on ΔSmO2min in individual studies. Statistical heterogeneity was quantified using I2 statistic. A meta-regression was used to estimate the effect of training on the relationship between peak cycling power output (Wpeak), peak pulmonary oxygen uptake (V˙O2peak), and ΔSmO2min. A mixed-effect model was used to estimate categorical variables.ResultsFive studies met the inclusion criteria. No difference in SmO2min was detected following training pre- and post-intervention IETs. A trend for an effect of training on the relationship between Wpeak and ΔSmO2min was observed (p = 0.06).ConclusionThis meta-analysis showed no effects of endurance training on SmO2min during an IET. Our results showed a trend for an effect of training on the relationship between Wpeak and ΔSmO2min, with no effect for V˙O2peak and ΔSmO2min. It is possible that SmO2min is not affected by endurance training, and may be used as a physiological marker for improvements in submaximal performance rather than at peak.
The acute effect of verbal instructions on performance and landing when dropping from different heights: the ground reaction force-time profile of drop vertical jumps in female volleyball athletes
Authors: La Greca Stefano , Antonacci Gaetano , Marinelli Stefano , Cifelli Pierangelo , Di Giminiani Riccardo 
Published: October 2024

IntroductionThe drop vertical jump (DVJ) is extensively utilized for conditioning and evaluating physical performance, as well as reducing the likelihood of injury by enhancing joint stability through the coactivation of muscles acting on the joint. The execution of DVJ can be controlled by verbal instructions and evaluated by the vertical ground reaction force (vGRF)-time profile.MethodsOur hypothesis was that varying verbal instructions could have an impact on the DVJ's parameter, thereby optimizing vertical performance and minimizing the impact during landing in young female volleyball players. Sixteen female volleyball players volunteered to participate in this study (age: 21.3 ± 2.6 years; stature: 1.66 ± 0.1 m; body mass: 62.0 ± 8.1 kg and BMI: 22.2 ± 1.8). They executed DVJs following verbal instructions ranging from “jump as high as possible” (1A), “jump as quickly as possible” (2A), “jump as high as possible and during the landing attempt to dampen the impact at ground contact” (1B), and “jump as high as quickly as possible and during the landing attempt to damp the impact at ground contact” (2B). The reactive strength index (RSI), vGRF (1st and 2nd peaks), and flight time (FT) were evaluated.ResultsThe verbal instructions 1A improved the FT and the first peak of the vGRF (P &lt; 0.05), whereas 2A the RSI (P &lt; 0.05). On the contrary, “the damping” required in the 1B, and 2B verbal instruction reduced the 2nd peak of vGRF (P &lt; 0.05), without altering the task required during the jump (P &lt; 0.05).DiscussionThe instructions provided for the final landing (the second peak of vGRF) have the potential to enhance safety by reducing the peak of vGRF without affecting the performance required during the jump. When designing DVJ training, coaches or kinesiologists must consider the use of verbal instructions to induce specific adaptation over time.Clinical relevanceThe present study supports the use of specific verbal instructions to reduce impact forces in landing and injury risk.
Coverage of large soft tissue defects of the lower limb and foot with superficial inferior epigastric artery flap
Authors: Liu Dong , Xie Xingwen , Chu Ping An , Zhou Xin , Luo Lin , Li Ning 
Published: October 2024

BackgroundLarge soft tissue defects of the lower limb and foot are common occurrence in clinical practice and a considerable number of flaps have been used to treat them. However, there have been few reports using the superficial inferior epigastric artery (SIEA) flap. This review aims to present the experience of using the SIEA flaps for the repair of large soft tissue defects of the lower limb and foot.MethodsA retrospective review of data from 11 patients who underwent coverage of lower limb and foot defects exceeding 120 cm2 (15 × 9 cm) using SIEA flaps from March 2018 to July 2022 were retrospectively reviewed. The average size of the defects was 18 × 11 cm2 (range 15 × 9 cm2–32 × 16 cm2). Flap survival rates, surgical complications and overall long-term outcomes were recorded.ResultsAll 11 flaps survived. One flap was partially necrotic at the edge and healed after several changes of dressing. Additionally, one flap presented with mild venous congestion. The mean follow-up period was 18 months (ranging from 12 to 30 months). The mean size of the flaps was 20 × 12 cm2 (range 17 × 9 cm2–34 × 18 cm2). The flaps were observed to be aesthetically pleasing and exhibited a well-defined texture. The donor wounds were successfully closed primarily, with only linear scarring remaining.ConclusionsThe SIEA flap is characterised by concealed donor area, superficial vascular location, easy access and primary closure, which results in favourable aesthetic outcomes. It is an appropriate choice for the repair of large soft tissue defects of the lower limb and foot.
Mitigating Thermal Side-Channel Vulnerabilities in FPGA-Based SiP Systems Through Advanced Thermal Management and Security Integration Using Thermal Digital Twin (TDT) Technology
Authors: Benelhaouare Amrou Zyad , Mellal Idir , Oumlaz Maroua , Lakhssassi Ahmed 
Published: October 2024

Side-channel attacks (SCAs) are powerful techniques used to recover keys from electronic devices by exploiting various physical leakages, such as power, timing, and heat. Although heat is one of the less frequently analyzed channels due to the high noise associated with thermal traces, it poses a significant and growing threat to the security of very large-scale integrated (VLSI) microsystems, particularly system in package (SiP) technologies. Thermal side-channel attacks (TSCAs) exploit temperature variations, risking not only hardware damage from excessive heat dissipation but also enabling the extraction of sensitive data, like cryptographic keys, by observing thermal patterns. This dual threat underscores the need for a synergistic approach to thermal management and security in designing integrated microsystems. In response, this paper presents a novel approach that improves the early detection of abnormal thermal fluctuations in SiP designs, preventing cybercriminals from exploiting such anomalies to extract sensitive information for malicious purposes. Our approach employs a new concept called Thermal Digital Twin (TDT), which integrates two previously separate methods and techniques, resulting in successful outcomes. It combines the gradient direction sensor scan (GDSSCAN) to capture thermal data from the physical field programmable gate array (FPGA), which guarantees rapid thermal scan with a measurement period that could be close to 10 μs, a resolution of 0.5 ∘C, and a temperature range from −40 ∘C to 140 ∘C; once the data are transmitted in real time to a Digital Twin created in COMSOL Multiphysics® 6.0 for simulation using the Finite Element Method (FEM), the real time required by the CPU to perform all the necessary calculations can extend to several seconds or minutes. This integration allows for a detailed analysis of thermal transfer within the SiP model of our FPGA. Implementation and simulations demonstrate that the Thermal Digital Twin (TDT) approach could reduce the risks associated with TSCA by a significant percentage, thereby enhancing the security of FPGA systems against thermal threats.
Radiation-Induced Hemorrhagic Cystitis in Prostate Cancer Survivors: The Hidden Toll
Authors: Gatsinga René , Lim Benjamin J. H. , Kumar Navin , Tan Jacinda G. G. , Li Youquan , Wang Michael L. C. , Tan Terence W. K. , Tuan Jeffrey K. L. , Tan Yu Guang , Chen Kenneth , Yuen John S. P. 
Published: October 2024

Background and Objectives: Radiation therapy (RT) plays a crucial role in managing prostate cancer, offering effective disease control and improving survival rates in both localized and recurrent cases. However, RT can lead to hemorrhagic cystitis, a significant late complication resulting in chronic morbidity and other health issues. This study aims to evaluate the real-world incidence of radiation-induced hemorrhagic cystitis requiring surgical intervention. Materials and Methods: This retrospective cohort study analyzed data from prostate cancer survivors treated for hematuria at our center between January 2014 and January 2024. Patients were included if cystoscopy identified radiation cystitis as the cause of hematuria. Descriptive statistics were used, and binomial logistic regression analyses with univariate and multivariate analysis were performed to identify risk factors for worse outcomes. Results: Fifty-two patients met the inclusion criteria. The estimated cumulative incidence at a median follow-up of 5.3 years was 4.5%. Among the participants, 21.2% required more than two transurethral bladder fulguration (TUBF) procedures, and 38.5% needed more than two hospital admissions for hematuria management. The median time to the first fulguration was 64 months. Blood transfusions were necessary in 53.8% of cases, and 38.5% required hyperbaric oxygen therapy. Ultimately, 5.8% of the patients underwent cystectomy. Univariate analysis identified ischemic heart disease (IHD) and antiplatelet therapy as significant risk factors (OR: 5.17 and 5.18, respectively), along with longer time to first fulguration (OR: 5.02). Multivariate analysis confirmed antiplatelet therapy (OR: 2.8, p = 0.05) and time to first TUBF (OR: 1.8, p = 0.02) as significant predictors of multiple procedures. Conclusions: Radiation cystitis remains a significant burden on prostate cancer survivors. Patients on antithrombotic agents, those with delayed initial presentations, and those who received radiation as salvage therapy are more likely to experience higher morbidity.
Elevated Urotensin-II and TGF-β Levels in COPD: Biomarkers of Fibrosis and Airway Remodeling in Smokers
Authors: Kilinc Metin , Demir Ibrahim , Aydemir Semih , Gul Rauf , Dokuyucu Recep 
Published: October 2024

Background and Objectives: Small airway fibrosis plays a critical role in the progression of chronic obstructive pulmonary disease (COPD). Previous research has suggested that Urotensin-II (U-II) and transforming growth factor-β (TGF-β) may contribute to pathological fibrosis in various organs, including the cardiovascular system, lungs, and liver. However, their specific relationship with airway fibrosis in COPD has not yet been thoroughly investigated. This study aims to evaluate the concentrations of U-II and TGF-β in individuals with COPD, as well as in healthy smokers and non-smokers, to explore their potential roles in COPD-related fibrosis. Materials and Methods: The study included three distinct groups: a healthy non-smoker control group (n = 98), a healthy smoker group (n = 78), and a COPD group (n = 80). All participants in the COPD group had a smoking history of at least 10 pack-years. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, with only patients classified as GOLD stage 2 or higher being included in the study. Urotensin-II (U-II) and transforming growth factor-β (TGF-β) levels were measured using a commercially available ELISA kit. Results: COPD patients had a significantly lower FEV1 (58 ± 15.4%) compared to smokers (79 ± 4.5%) and non-smokers (92 ± 3.7%) (p < 0.001). Similarly, COPD patients had a lower FEV1/FVC ratio (55 ± 9.4%) compared to smokers (72 ± 4.2%) and non-smokers (85 ± 3.6%) (p < 0.01 and p < 0.05, respectively). SaO2 was significantly lower in COPD patients (87%) compared to smokers (96.5%) and non-smokers (98%) (COPD vs. smokers: p < 0.05 and smokers vs. non-smokers: p > 0.05). U-II levels were significantly higher in COPD patients (175.10 ± 62.40 pg/mL) compared to smokers (118.50 ± 45.51 pg/mL) and non-smokers (85.29 ± 35.87 pg/mL) (p < 0.001 and p < 0.05, respectively). COPD patients also had significantly higher levels of TGF-β (284.60 ± 60.50 pg/mL) compared to smokers (160.00 ± 41.80 pg/mL) and non-smokers (92.00 ± 25.00 pg/mL) (p < 0.001 and p < 0.05, respectively). Conclusions: Our study supports the growing body of evidence that U-II and TGF-β play central roles in the development and progression of fibrosis in COPD. The negative correlation between these markers and lung function parameters such as FEV1 and FEV1/FVC indicates that they may be key drivers of airway remodeling and obstruction. These biomarkers could serve as early indicators of fibrotic changes in smokers, even before the onset of COPD.
Allelopathic Interactions Between the Green-Tide-Forming Ulva prolifera and the Golden-Tide-Forming Sargassum horneri Under Controlled Laboratory Conditions
Authors: Sun Ruibin , Korboon Onjira , Ma Wenfei , Ren Xingyue , Wang Xiaonan , Muangmai Narongrit , Xing Qikun , Gao Xu , Li Jingyu 
Published: October 2024

Harmful algal blooms (HABs) represent a significant global marine ecological disaster. In the Yellow Sea, green and golden tides often occur simultaneously or sequentially, suggesting that interspecific competition involves not only spatial and resource competition but also allelopathy. This study investigated the allelopathic interactions between Ulva prolifera and Sargassum horneri using physiological and biochemical parameters, including relative growth rate (RGR), cell ultrastructure, chlorophyll fluorescence, enzyme activity, and metabolomics analysis. The results showed that S. horneri filtrate significantly inhibited U. prolifera growth, while U. prolifera filtrate had no significant effect on S. horneri. Both algal filtrates caused cellular damage and affected photosynthesis, enzyme activities, and metabolism. However, their allelopathic responses differed: U. prolifera may rely on internal compensatory mechanisms, while S. horneri may depend on defense strategies. These findings provide insights into the dynamics of green and golden tides and support the scientific control of HABs through allelopathy.
Feasibility and Acceptability of a Palliative Care Intervention among Older Adults with Advanced CKD and Their Caregivers
Authors: Saeed Fahad , Horowitz Robert K. , Allen Rebecca J. , Auinger Peggy , Epstein Ronald M. , Fiscella Kevin A. , Veazie Peter J. , Duberstein Paul R. 
Published: October 2024

Key Points

In the current pilot trial, palliative care (PC) consultation for older adults with advanced CKD was both feasible and acceptable.PC consultation was associated with significant improvements in the decision-making process for kidney therapy and in quality of life.A large-scale PC-based decision-support intervention for older adults with CKD aimed at examining person-centered outcomes is warranted.

Background
In non-nephrology settings, specialty palliative care (PC) improves decision making, patient's quality of life (QoL), advance care planning, and certain indicators of the quality of end-of-life (EoL) care. This pilot randomized control trial (RCT) explored the feasibility and acceptability of a PC intervention, CKD-EDU, for adults aged 75 years and older with eGFR ≤25 ml/min and their caregivers.

Methods
Participants randomized to the control group received standard nephrology care and routine kidney therapy education, whereas those randomized to CKD-EDU received a decision aid and met with a PC clinician up to three times to discuss kidney therapy decisions and EoL planning. Patients were assessed at baseline, 4–6, 12–14, and 24–26 weeks. Main outcomes included intervention feasibility and acceptability, decision conflict, and patient QoL. The mediating effects of reduced decision conflict on improved QoL were explored, as were the effects of CKD-EDU on advance care planning, EoL treatment intensity, and 6-month hospitalization. Statistical analyses encompassed descriptive analyses, adjusted repeated-measure models, mediation analyses, and logistic regression models.

Results
Among the 127 eligible patients screened, 58 (46%) consented: 30 were randomized to CKD-EDU and 28 to the control arm. All patients completed baseline assessments and 89% completed at least 1 intervention session (n=26/29), underscoring intervention adherence and feasibility. Similarly, assessment completion rates at 4 (83%, n=45/54), 12 (93%, n=42/45), and 24 (95%, n=40/42) weeks were high. The intervention received over 85% acceptability ratings for all questions. Patients exposed to CKD-EDU exhibited significant improvement in Decisional Conflict Scale scores (P = 0.003) at 4–6 weeks and improvements in QoL at 24–26 weeks (P = 0.02). Exploratory analyses were not statistically significant in this pilot study, but all effect sizes were in the predicted direction.

Conclusions
This study demonstrates the feasibility and acceptability of CKD-EDU. A larger scale trial is warranted to assess its effectiveness in improving key outcomes important to patients and families.

Clinical trial registry name and registration number:

NCT03465449.
Comunicação buco-sinusal após exodontia de terceiro molar superior - revisão de literatura
Authors: Silva Elison Barbosa da , Barbosa Flavia Marcela da Silva , Gomes Wendell Lucas Oliveira , Fonseca Tiago Silva da , Silva Alenildo Pereira da 
Published: October 2024

Considerando que a comunicação buco-sinusal é uma condição patológica que se caracteriza pela formação de uma passagem anormal entre a cavidade oral e o seio maxilar. O presente artigo tem por objetivo descrever os métodos de tratamento da comunicação buco-sinusal após exodontia de terceiros molares superiores. Para tanto, trata-se de uma Revisão Bibliográfica, as bases para pesquisa de periódicos foram: PubMED, SciELO, Google Acadêmico, sendo escolhidos os resumos publicados desde 2018 a 2024, tanto em língua portuguesa como na língua inglesa, incluindo clássicos literários. Desse modo, observa-se que diversos estudos têm demonstrado a prevalência e as características dessa complicação destacando a importância de uma abordagem cuidadosa e planejada durante os procedimentos odontológicos envolvendo os terceiros molares superiores. Conclui-se que a conscientização sobre a comunicação buco-sinusal após exodontias de terceiros molares superiores e a busca por abordagens preventivas e terapêuticas adequadas, tanto com técnicas cirúrgicas, como não cirúrgicas, são essenciais para melhorar a qualidade dos cuidados odontológicos e garantir resultados clínicos positivos a longo prazo.