bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of maggot debridement therapy on the bacterial flora of hard-to-heal wounds
Authors: Gieroń Monika , Słowik-Rylska Małgorzata , Kucharczyk Monika , Cyran-Stemplewska Sylwia , Gieroń Bartłomiej , Czerwonka Grzegorz , Kozieł Dorota , Kręcisz Beata 
Published: October 2024

Objective: Maggot debridement therapy (MDT) is increasingly being used in clinical practice as an alternative treatment for hard-to-heal (chronic) wounds. Among the many benefits of using MDT is its antimicrobial effect. Maggots secrete substances that are known to have antibacterial properties against both Gram-negative and Gram-positive bacteria. Clinically, this results in the effective eradication of pathogenic species and consequently, a faster healing process. The aim of this study was to evaluate the effect MDT has on the bacterial flora of hard-to-heal ulcers. Method: Patients with venous, mixed arteriovenous, decubitus, diabetic and neuropathic wounds were treated with larvae of Lucilia sericata enclosed in bags. Dressings were applied to the wounds for 72 hours. Before and after the therapy, a swab was taken from the wound, and bacterial diversity and bacterial growth scores were assessed. While 16 patients were treated only once, the treatment had to be repeated in four cases until the wounds were fully debrided. Results: Bacteria of the species Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus and Enterococcus faecalis were the most common strains observed. Of the 20 patients treated, the total number of bacterial strains decreased in eight wounds, but increased in five wounds, while no difference was observed in nine wounds. The average number of bacterial strains in wounds decreased after MDT. A lower incidence of alarm pathogens was also reported. In cases where multiple applications of larvae were administered, greater decreases in bacterial growth scores were observed than in cases with a single application of dressing (37.5% vs 18.1%, respectively). In 18 cases, after disinfection of the wound by larvae, it was reinfected by strains not detected before. Wounds healed completely after MDT in two patients. Conclusion: In this study, MDT changed the bacterial diversity of hard-to-heal wounds. The larvae reduced overall bacterial growth scores and acted on both Gram-positive and Gram-negative bacteria as well as on alarm pathogens. Cleaned wounds appeared to become vulnerable to infection by opportunistic bacteria. The bacterial burden decreased as the number of applications of biological dressings increased.
Hospital-acquired pressure ulcers among adult ICU patients in tertiary hospitals in Oman: a one-year prevalence study
Authors: Al-Mamari Fatma , Al-Rawajfah Omar , Al Sabei Sulaiman , Al-Wahaibi Khalifa 
Published: October 2024

Background: Hospital-acquired pressure ulcer (HAPU) is a significant problem in healthcare settings and is associated with negative impacts on patient health. Although monitoring of pressure ulcers (PUs) among hospitalised patients was started more than a decade ago in Oman, no previous studies have been completed to estimate the prevalence and risk factors of HAPUs among patients in the intensive care unit (ICU). The aim of this study was to estimate the prevalence and identify risk factors for HAPUs among adult ICU patients in selected tertiary hospitals in Oman. Method: A retrospective, cross-sectional, nested, case–control design was used to identify the prevalence rate of HAPUs and risk factors for a cohort of adult ICU patients over one calendar year (1 January–31 December 2019) in two tertiary hospitals in Oman. Results: The prevalence rate for HAPU among ICU patients in Oman was 36.4%. However, when excluding cases of stage 1 ulcer, the rate was 30.37%. The most prevalent location was the sacrum (64.1%), and the most common stage was stage 2 (73.1%). The risk factors for HAPU included male sex (odds ratio (OR): 0.37; p=0.023), organ failure (OR: 3.2; p=0.033), cancer (OR: 3.41; p=0.049), cerebrovascular accident (OR: 12.33; p=0.001), mechanical ventilator (OR: 9.64; p=0.025) and ICU length of stay (OR: 1.24; p<0.001). Conclusion: HAPUs among ICU patients constitute a significant problem associated with severe clinical consequences and result in substantial adverse healthcare outcomes worldwide, including in Oman. Identifying the risk factors and the impact on the healthcare system is the foundation for preventing and managing HAPUs.
TPF stitching imaging of rubber tree leaves
Authors: Liu Meng , Hou Guozhong , Li Yuan , Deng Yanyan , Zhang Yuan , Song Kaiyuan , Xu Chang , Liu Xinlong , Xia Yuanqin , Zhang Yong 
Published: October 2024

This paper presents a two-photon fluorescence (TPF) microscopy platform based on a femtosecond oscillator. The system images rubber tree leaf samples by exciting and detecting TPF signals generated by the tissue using broadband femtosecond pulses. The imaging system utilizes a detection window of 565–615 nm to capture TPF signals from flavin adenine dinucleotide (FAD) in the rubber tree leaf tissue. Additionally, multiple TPF images were acquired through sample movement and Z-axis scanning, followed by image stitching to achieve large-area comprehensive visualization of the rubber tree leaf samples. This study provides detailed observations and analyses of various biological structures within the rubber tree leaf samples, contributing significantly to the understanding of plant growth, physiological functions, and environmental adaptability.
Soft X-ray chemically sensitive ptychographic imaging of 3D nano-objects
Authors: Krasnov Vitaly , Makhotkin Igor , Scheerder Jeroen E. , Loetgering Lars , Soltwisch Victor , van der Heide Paul A. W. , Fleischmann Claudia 
Published: October 2024

The results of a soft X-ray chemically sensitive ptychographic imaging of non-planar nanoscale 3D objects - atom probe tomography tips, with resolution down to 12 nm at 800 eV using scanning X-ray microscope at the electron storage ring BESSY II are presented. We validate that this approach can be used to determine the tip (emitter) shape, and to resolve inner nano-scale structures as relevant for semiconductor applications and even for quantitative chemical composition analysis. Imaging of buried interfaces with below 30 nm resolution is demonstrated. This work might pave the way for contactless, ptychographic in-situ characterization of APT tips with tabletop coherent EUV sources.
“Someone who hates themself doesn’t come for their drugs”: Experiences of mental health along the HIV care continuum in South-Central, Uganda
Authors: West Nora S. , Ddaaki William , Murray Sarah M. , Nakyanjo Neema , Isabirye Dauda , Nakubulwa Rosette , Nalugoda Fred , Surkan Pamela J. , Hutton Heidi E. , Kennedy Caitlin E. 
Published: October 2024

Introduction
Poor mental health occurs more frequently among people living with HIV. Understanding what mental health problems occur and at what point during the continuum of HIV care is critical to ensure these problems are identified and appropriately addressed. We explored how mental health is experienced along the HIV care continuum in Rakai, Uganda.

Methods
We conducted qualitative semi-structured in-depth interviews with 20 adults living with HIV and 10 health workers from March to December 2020. Interviews followed a timeline approach. Responses were analyzed using content analysis.

Results
At the time of HIV diagnosis, nearly all participants described a range of strong emotions, including shock, fear and intense worry. Most participants described continued fear and intense worry leading up to, and at the time of, ART initiation. However, they said these emotions often subside after ART is initiated and viral suppression is achieved. Across interviews and at multiple points of the continuum, participants discussed how fear and worry led individuals to be “thinking too much” or be in “deep thoughts” and experience self-hatred. Individuals who stopped taking ART were thought to have more severe mental health problems (“madness”, psychosis, suicidality). Participants were divided about the mental health of persons who returned to care after disengagement.

Conclusion
In this setting, mental health problems experienced by people living with HIV are dynamic across the care continuum. With expanded HIV testing campaigns and Universal Test and Treat policies, targeted interventions for psychosocial support at the time of testing and ART initiation remain critical.
From genes to reproductive health: Immune cell influences on abortion
Authors: Shen Dan , Xu Wendi , Zheng Jingyi , Cao YiZhou , Bo Xinyi , Fu FeiXian , Wen Bing , Zhou Fuqiang , Cao Jing 
Published: October 2024

Background
The relationship between dysregulation of the immune system and reproductive health, particularly in the context of abortion, is an area of critical research. Identifying the immunological factors that contribute to abortion could provide valuable insights into its prevention and management.

Methods
This study used bidirectional two-sample Mendelian Randomization (MR) approach to evaluate the causal link between 731 immune cell features and the risk of abortion. The study analyzed GWAS data from 257,561 Europeans, including 7,069 cases and 250,492 controls, by utilizing genetic variation as instrumental variables. The immune phenotypes included several cell types, including B cells, T cells, TBNK cells, Treg cells, and monocytes. These were analyzed using the ’TwoSampleMR’ package in R software.

Results
The study identified 34 immune phenotypes that have a significant causal relationship with abortion risk. Notably, Results from the B cell group showed a positive correlation between abortion and certain phenotypes, including Unsw mem %B cell, PB/PC %B cell, IgD+ CD24+ %B cell and Naive-mature B cell %lymphocyte. In the T cell group, certain maturation stages such as Naive CD8br %T cell and CD4 on CD45RA+ CD4+ exhibited negative causal links, whereas CCR7 on naive CD8br showed a positive association. The group of Treg cells showed both positive and negative causal relationships with abortion, highlighting the complexity of immune regulation in reproductive health.

Conclusions
This study reflects the causal relationship between different subtypes of different immune cells and abortion. The results underscore the importance of the immune system in reproductive health and suggest potential therapeutic interventions targeting these immunological pathways.
The Work and Social Adjustment Scale (WSAS): An investigation of reliability, validity, and associations with clinical characteristics in psychiatric outpatients
Authors: Lundqvist Jakob , Lindberg Martin Schevik , Brattmyr Martin , Havnen Audun , Hjemdal Odin , Solem Stian 
Published: October 2024

Objective
This study, the first to assess the reliability and validity of the Work and Social Assessment Scale (WSAS) in Norwegian routine mental health care, examines differences in functional impairment based on sick leave status, psychiatric diagnosis, and sex.

Method
Including 3573 individuals from community mental health services (n1 = 1157) and a psychiatric outpatient clinic (n2 = 2416), exploratory factor analysis (EFA) on subsample 1 and confirmatory factor analysis (CFA) on subsample 2 were utilized to replicate the identified factor structure.

Results
EFA supported a one-factor model, replicated by the CFA, with high internal consistency (α = .82, ω = .81). Patients on sick leave reported greater impairments in all aspects of functioning, except for relationships, with the largest effect size observed in the reported ability to work (d = .39). Psychiatric outpatients with major depressive disorder were associated with difficulties in home management, private leisure activities, and forming close relationships. Patients with attention-deficit/hyperactivity disorder reported less impairment than those with other disorders. Patients with personality disorders reported more relationship difficulties than those with PTSD, ADHD, and anxiety. No differences were found in the perceived ability to work between diagnoses. Women had a higher impairment in private leisure activities, whereas men reported more impairment in relationships.

Conclusion
The demonstrated reliability and validity suggest that WSAS is a valuable assessment tool in Norwegian routine mental health care. Variations in functional impairment across sick leave status, sex, and psychiatric diagnoses highlight the importance of integrating routine assessments of functional impairment into mental health care practices. Future research should combine WSAS with register data to allow for a broader understanding of treatment effectiveness, emphasizing improvements in functional outcomes alongside symptom alleviation.
Bridging the gap between recommendation and reality: Improving dietary adherence of heart failure populations a cross-sectional study in Ethiopia
Authors: Tamir Takla , Nigussie Jemberu , Endawoke Migbaru 
Published: October 2024

Background
Heart failure (HF), a complex condition arising from impaired ventricular function, necessitates strict adherence to dietary recommendations for optimal patient management. However, information regarding adherence and its influencing factors remains limited.

Aim
This study aimed to assess dietary recommendation adherence and its associated factors among HF patients at Southern Ethiopia public hospitals.

Methods and results
A cross-sectional study involving 521 participants employed systematic random sampling. Data collection utilized pre-tested, interviewer-administered questionnaires and medical chart reviews. Data were entered and analyzed using Epi Data 3.1 and SPSS 20.0 software. Descriptive statistics were performed. Variables with p-values < 0.25 in binary logistic regression were included in multivariable logistic regression analyses. Statistical significance was set at p < 0.05 with a 95% confidence interval. Results are presented in text, tables, and figures.
With a 97.4% response rate, adherence ranged from 20.3% (vegetables and fruits) to 60.3% (fat-free diet). Only 8.1% achieved good adherence across all parameters, with overall adherence at 33.4% (95% CI: 29–37). Multivariable analysis revealed that patients aged 41–60 years (AOR: 1.7), with a history of admission (AOR: 2.5), free from comorbidities (AOR: 0.58), and possessing a favorable attitude (AOR: 0.45) had statistically significant associations with good adherence.

Conclusion
Dietary adherence among HF patients remains a challenge. Healthcare providers, particularly those in chronic follow-up settings, should prioritize improving patient attitudes towards proper dietary practices. Tailored education programs targeting younger patients and those free from comorbidities should be implemented. Continuous monitoring, evaluation, and staff recognition for effective client counseling are crucial.
Burden of leprosy and associated risk factors for disabilities in Tanzania from 2017 to 2020
Authors: Mrema George , Hussein Ally , Magoge Welema , Mmbaga Vida , Simba Azma , Balama Robert , Nkiligi Emmanuel , Shunda Paul , Kamara Deus , Kisonga Riziki , Kwesigabo Gideon 
Published: October 2024

Background
Leprosy is caused by Mycobacterium leprae which affects skin, nerves, eyes, and nasal mucosa. Despite global elimination efforts, Tanzania remains among 13 countries reporting more than 1000 leprosy cases annually. In 2021, Tanzania identified 1,511 new cases, with 10% having grade II disability. Moreover, 14 councils recorded leprosy rates exceeding 10 cases per 100,000 population. This study aimed to assess the burden of leprosy and associated risk factors for disabilities in Tanzania from 2017 to 2020.

Methodology
A retrospective cross-sectional study was conducted to investigate all registered treated leprosy patients from January 2017 to December 2020. The Leprosy Burden Score (LBS) was used to assess the disease burden, while binary logistic regression was employed to evaluate the risk factors for disability.

Result
A total of 6,963 leprosy cases were identified from 2017 to 2020. During this period, the point prevalence of leprosy declined from 0.32 to 0.25 per 10,000 people, and the new case detection rate decreased from 3.1 to 2.4 per 100,000 people; however, these changes were not statistically significant (p > 0.05). Independent risk factors for leprosy-related disabilities included male sex (Adjusted Odds Ratio (AOR) = 1.38, 95% Confidence Interval (CI) 1.22–1.57), age 15 years and above (AOR = 2.42, 95% CI 1.60–3.67), previous treatment history (AOR = 2.18, 95% CI 1.69–2.82), and positive Human Immunodeficiency Virus (HIV) status (AOR = 1.60, 95% CI 1.11–2.30).

Conclusion
This study identified male sex, older age, positive HIV status, and prior treatment history as independent risk factors for leprosy-related disabilities. Additionally, despite the observed decline in point prevalence and new case detection rates, these changes were not statistically significant. To address leprosy-related disabilities, it is crucial to implement specific prevention strategies that focus on high-risk groups. This can be accomplished by enhancing screening and contact tracing efforts for early patient identification to prevent delays in intervention. Further research is warranted to analyze the burden of leprosy over a more extended period and to explore additional risk factors not covered in this study.
Association of lymphocyte count and serum albumin concentration with telomere length in Chinese sanitation workers
Authors: Song Xingxu , Lin Dafeng , Wang Dianpeng , Weng Shaofan , Qiu Shuyi , Zhou Wei , Xiao Aipin , Zhang Naixing 
Published: October 2024

Objective
This study aimed to examine the association between inflammation-related indicators (IRIs) and telomere length (TL) in Chinese sanitation workers.

Methods
This study adopted a case-control design, conducted from January to December 2022 in Shenzhen, a city in eastern China. A total of 80 sanitation workers, as well as 80 matched controls, were randomly recruited from the Luohu district of Shenzhen city in China. Their blood samples were collected and analyzed for the IRIs and TL in the Medical Laboratory of Shenzhen Prevention and Treatment Center for Occupational Diseases. The relationship between IRIs and TL was analyzed using multivariate linear regression, and their dose-response relationship was explored using restricted cubic spline analysis.

Results
The systemic inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were significantly elevated in the sanitation workers in comparison to the controls. Moreover, the lymphocyte count (LYM), serum albumin concentration (ALB), and TL were found to be lower in the sanitation workers compared to the controls (P < 0.05). After adjusting for potential confounding variables, LYM was negatively correlated with TL in the sanitation workers (β = -0.31, 95% CI: -0.57, -0.05), whereas no correlation was observed in the controls. Furthermore, ALB demonstrated a non-linear relationship with TL in sanitation workers.

Conclusion
We found higher novel inflammatory markers (SII, PLR, and NLR) in the sanitation workers, and identified a correlation between LYM and ALB with shortened TL in them, providing new evidence for the effect of elevated inflammation on accelerated aging in Chinese sanitation workers.
Scalp dose analysis for transient and permanent alopecia following conventional cranial irradiation using Image Guided Radiotherapy (IGRT): A prospective study
Authors: Jia-Mahasap Bongkot , Nobnop Wannapha , Sripan Patumrat , Tharavichitkul Ekkasit , Chakrabandhu Somvilai , Klunklin Pitchayaponne , Onchan Wimrak , Muangwong Pooriwat , Chitapanarux Imjai 
Published: October 2024

Purpose
The dosimetry of scalp dose was prospectively studied and correlated with alopecia following conventional cranial irradiation in primary brain tumors patients.

Materials and methods
Patients with primary brain tumors who required conventional radiotherapy were enrolled. A hairline marker was applied to the patient’s scalp to identify the entire scalp region. The maximal dose to 2% volume of interest (D2) for the entire scalp region were obtained. The radiation dosages at the localized hair-loss areas were evaluated during the final week of RT (transient alopecia) and six months after completing RT (permanent alopecia). Kruskal-Wallis tests were used to compare the dosimetric parameter values with statistical significance set as p < 0.05.

Results
Forty-eight patients were included in the analysis. The prescribed radiation doses ranged from 50.4 to 60.0 Gy. Thirty-two patients experienced alopecia (27 transient and 5 permanent). The median D2 values adjusted for the entire scalp were higher in the alopecia group (38.40 Gy for transient alopecia and 47.84 Gy for permanent alopecia vs 11.90 Gy for no alopecia, p < 0.001). The D2 value was determined as a predictive parameter for alopecia. The threshold values for transient and permanent alopecia over the entire scalp were 22.15 Gy and 36.81 Gy, respectively. At the localized hair-loss areas, the D2 values for transient and permanent alopecia were higher at 44.82 Gy and 50.00 Gy, respectively. The radiation intensity at the localized hair-loss areas was also related to the severity of alopecia, with D2 values of 35.14 Gy and 46.39 Gy for clinically assigned grade 1 and grade 2 transient alopecia, respectively, with the D2 value being even higher for permanent alopecia.

Conclusions
The D2 parameter value could be used to predict the type and severity of alopecia.
Efficacy and safety of pembrolizumab in cervical cancer: Protocol for systematic review and meta-analysis of randomized clinical trials
Authors: Dantas Dary Medeiros , de Souza Amaxsell Thiago Barros , de Araújo Santos Camargo Juliana Dantas , Costa Ana Paula Ferreira , Samento Ayane Cristine Alves , de Santana Gomes Andrea Juliana Pereira , de Azevedo Eduardo Pereira , de Medeiros Kleyton Santos , dos Santos Isis Kelly , Cobucci Ricardo Ney 
Published: October 2024

Purpose
This paper reports a systematic review and meta-analysis protocol that will be used to evaluate the efficacy and safety of pembrolizumab, alone or combined with bevacizumab and other therapies, in adult women with cervical carcinoma from stage IB2 onwards.

Methods
The protocol follows PRISMA-P recommendations and was registered on PROSPERO (CRD42024531233). The search will be conducted without restrictions on language and year of publication in the following databases: Pubmed, Embase, Scopus, Web of Science, Cancerlit, The World Health Organization (WHO), International Clinical Trials Registry Platform (ICTRP) and Clinical Trials Registry Platform. Grey literature will be searched using the following sources: Clinicaltrials.gov, Google Scholar and Opengrey. Manual search will be carried out for the reference lists of eligible studies. The studies will be selected independently by two reviewers and all completed or ongoing randomized clinical trials that evaluated the efficacy and safety of pembrolizumab, used alone or combined with chemotherapy, radiotherapy, bevacizumab or surgery, in adult women diagnosed with cervical cancer, will be included. The data extraction will include population characteristics, type of treatment and main outcomes of studies. The methodological quality of the studies will be assessed using the Cochrane Risk of Bias 2.0. The certainty of the evidence will be rated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).

Conclusions
The findings will be presented in narrative summary tables and a quantitative synthesis will be conducted using the ‘meta’ package of R software, version 4.3.1. This future systematic review may contribute with quality evidence for clinical decision-making on the use of pembrolizumab in women with cervical cancer.