bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified thoracoabdominal nerve block via perichondral approach: an alternative for perioperative pain management in laparoscopic cholecystectomy in a middle-income country
Authors: Castillo-Dávila Luisa Fernanda , Torres-Anaya Carlos Jesús , Vazquez-Apodaca Raquel , Borboa-Olivares Hector , Espino-y-Sosa Salvador , Torres-Torres Johnatan 
Published: August 2024

Abstract
Background
Laparoscopic cholecystectomy is known for its minimally invasive nature, but postoperative pain management remains challenging. Despite the enhanced recovery after surgery (ERAS) protocol, regional analgesic techniques like modified perichondral approach to thoracoabdominal nerve block (M-TAPA) show promise. Our retrospective study evaluates M-TAPA’s efficacy in postoperative pain control for laparoscopic cholecystectomy in a middle-income country.

Methods
This was a retrospective case-control study of laparoscopic cholecystectomy patients at Hospital General de Mexico in which patients were allocated to the M-TAPA or control group. The data included demographic information, intraoperative variables, and postoperative pain scores. M-TAPA blocks were administered presurgery. Outcomes: opioid consumption, pain intensity, adverse effects, and time to rescue analgesia. Analysis of variance (ANOVA) compared total opioid consumption between groups, while Student’s t test compared pain intensity and time until the first request for rescue analgesia.

Results
Among the 56 patients, those in the M-TAPA group had longer surgical and anesthetic times (p < 0.001), higher ASA 3 scores (25% vs. 3.12%, p = 0.010), and reduced opioid consumption (p < 0.001). The M-TAPA group exhibited lower postoperative pain scores (p < 0.001), a lower need for rescue analgesia (p = 0.010), and a lower incidence of nausea/vomiting (p = 0.010).

Conclusion
Bilateral M-TAPA offers effective postoperative pain control after laparoscopic cholecystectomy, especially in middle-income countries, by reducing opioid use and enhancing recovery.
Pelvic floor muscle training for female urinary incontinence: development of a programme theory from a longitudinal qualitative case study
Authors: Bugge Carol , Hay-Smith Jean , Hagen Suzanne , Grant Aileen , Taylor Anne , Dean Sarah 
Published: August 2024

Abstract
Background
Urinary incontinence (UI) negatively affects the well-being of women globally. Pelvic Floor Muscle Training (PFMT) is a complex intervention that aims to decrease UI symptoms. Information about how the multiple complex components involved in PFMT achieve and maintain the desired effect are rarely studied as a whole. The evidence base lacks data about how women experience PFMT over time and in the longer-term. This study explored women’s experiences of biofeedback-assisted PFMT and PFMT alone, to identify and understand what influenced self-reported adherence to PFMT, and UI outcomes over time.

Methods
This rigorous longitudinal qualitative case study, nested within a randomised controlled trial, recruited forty cases (women with stress or mixed UI; 20 in biofeedback-assisted and 20 in PFMT alone group). A case included up to four semi-structured interviews with each woman (prior to starting PFMT, end of treatment [6 months], 12 months, 24 months). Analysis followed case study analytic traditions, resulting in a Programme Theory about PFMT from the perspectives of women with UI.

Findings
The theory demonstrates factors that motivated women to seek UI treatment, and how these influenced long-term adherence. Therapists who delivered PFMT played a crucial role in supporting women to know how to undertake PFMT (to have capability). Some, but not all, women developed self-efficacy for PFMT. Where women did not have PFMT self-efficacy, adherence tended to be poor. When women had PFMT self-efficacy, the conditions to support adherence were present, but contextual factors could still intercede to inhibit adherence. The intercession of contextual factors was individual to a woman and her life, meaning any particular contextual factor had inconsistent influences on PFMT adherence over time for individual women and exerted varying influences across different women.

Conclusion
Long term adherence to PFMT is a complex interaction between many different factors. Enquiring about an individual woman’s motivation to seek treatment and understanding the contextual factors that affect an individual woman will enable a practitioner to support longer-term adherence.
Opportunities and challenges of a dynamic consent-based application: personalized options for personal health data sharing and utilization
Authors: Lee Ah Ra , Koo Dongjun , Kim Il Kon , Lee Eunjoo , Yoo Sooyoung , Lee Ho-Young 
Published: August 2024

Abstract
Background
The principles of dynamic consent are based on the idea of safeguarding the autonomy of individuals by providing them with personalized options to choose from regarding the sharing and utilization of personal health data. To facilitate the widespread introduction of dynamic consent concepts in practice, individuals must perceive these procedures as useful and easy to use. This study examines the user experience of a dynamic consent-based application, in particular focusing on personalized options, and explores whether this approach may be useful in terms of ensuring the autonomy of data subjects in personal health data usage.

Methods
This study investigated the user experience of MyHealthHub, a dynamic consent-based application, among adults aged 18 years or older living in South Korea. Eight tasks exploring the primary aspects of dynamic consent principles–including providing consent, monitoring consent history, and managing personalized options were provided to participants. Feedback on the experiences of testing MyHealthHub was gathered via multiple-choice and open-ended questionnaire items.

Results
A total of 30 participants provided dynamic consent through the MyHealthHub application. Most participants successfully completed all the provided tasks without assistance and regarded the personalized options favourably. Concerns about the security and reliability of the digital-based consent system were raised, in contrast to positive responses elicited in other aspects, such as perceived usefulness and ease of use.

Conclusions
Dynamic consent is an ethically advantageous approach for the sharing and utilization of personal health data. Personalized options have the potential to serve as pragmatic safeguards for the autonomy of individuals in the sharing and utilization of personal health data. Incorporating the principles of dynamic consent into real-world scenarios requires remaining issues, such as the need for powerful authentication mechanisms that bolster privacy and security, to be addressed. This would enhance the trustworthiness of dynamic consent-based applications while preserving their ethical advantages.
Suggested solutions to barriers in accessing healthcare by persons with disability in Uganda: a qualitative study
Authors: Ssemata Andrew Sentoogo , Smythe Tracey , Sande Slivesteri , Menya Abdmagidu , Hameed Shaffa , Waiswa Peter , Mbazzi Femke Bannink , Kuper Hannah 
Published: August 2024

Abstract
Background
There are 1.3 billion people with disabilities globally, and they frequently face barriers to accessing healthcare, contributing to their worse health and higher mortality. However, little research has explored patient-reported approaches to improve healthcare for persons with disabilities. Consequently, this study aimed to explore possible solutions and recommendations to address the existing barriers to access to healthcare for persons with disabilities in rural Uganda.

Methods
We conducted 27 semi-structured interviews with individuals with various disabilities in rural Luuka district, Eastern Uganda, between September and November 2022. The participants included individuals with visual impairment (n = 5), physical impairment (n = 5), hearing impairment (n = 6), multiple impairments (n = 5), intellectual/cognitive impairment (n = 5), and albinism (n = 1). Interviews were recorded, transcribed verbatim, and thematically analysed. We categorized the solutions using the Missing Billion disability-inclusive health systems framework.

Results
Our findings, framed within the health systems framework, revealed several critical themes. On the demand side, suggested solutions emphasized advocacy and sensitization for persons with disabilities, their communities, and caregivers about healthcare needs. Socio-economic empowerment and community-based health services were also highlighted as essential. On the supply side, participants stressed the importance of training healthcare workers on disability, facilitating dialogue and experience-sharing sessions, and employing health workers with disabilities. Additional recommendations included improving accessibility and reasonable accommodation, organizing inclusive services like special clinic days and outreaches, ensuring representation in health facility management, and establishing comprehensive rehabilitation services with affordable assistive devices.

Conclusion
The multifaceted solutions proposed by persons with disabilities highlight the complex challenges they face in accessing healthcare services and highlight the necessity for comprehensive, sustainable interventions. The call to action for policymakers and healthcare providers is to prioritise the incorporation of disability-inclusive practices and explore multi-dimensional approaches that foster a more inclusive healthcare environment that adequately meets the needs of persons with disabilities.
Comparing mapped park and greenspace boundaries in Philadelphia: implications for exposure assessment in health studies
Authors: Fry Dustin , Roman Lara A. , Kondo Michelle C. 
Published: August 2024

AbstractAn important consideration in studies of the relationship between greenspace exposure and health is the use of mapped data to assign geographic exposures to participants. Previous studies have used validated data from municipal park departments to describe the boundaries of public greenspaces. However, this approach assumes that these data accurately describe park boundaries, that formal parks fully capture the park and greenspace exposure of residents, and (for studies that use personal GPS traces to assign participant exposures) that time spent within these boundaries represents time spent in greenspace. These assumptions are tested using a comparison and ground-truthing of four sources of mapped park and greenspace data in Philadelphia, Pennsylvania: PAD-US-AR, Philadelphia Parks and Recreation, the Delaware Valley Regional Planning Commission, and Open Street Maps. We find several important differences and tradeoffs in these data: the incorporation of highways and building lots within park boundaries, the inclusion or exclusion of formal park spaces (federal, state, and nonprofit), the exclusion of informal parks and greenspaces, and inconsistent boundaries for a linear park. Health researchers may wish to consider these issues when conducting studies using boundary data to assign park exposure.
Scrolling through adolescence: unveiling the relationship of the use of social networks and its addictive behavior with psychosocial health
Authors: Brand Caroline , Fochesatto Camila Felin , Gaya Anelise Reis , Schuch Felipe Barreto , López-Gil José Francisco 
Published: August 2024

Abstract
Background
Understanding the relationship of social network use and addictive behaviors with adolescent psychosocial health is crucial in today’s digital age.

Aim
To verify the associations between social network use, messaging applications, and the addictive behaviors to social network with psychosocial health in Spanish adolescents.

Methods
A cross-sectional study was developed with 632 adolescents, aged 12 to 17 years from the Region of Murcia, Spain. The assessment of social network use (Facebook, Twitter, Instagram, Snapchat, and TikTok) involved evaluating the frequency of use of each social network individually using a single-item scale with five response options. WhatsApp use (i.e., a messaging application) was evaluated in the same manner. The Short Social Networks Addiction Scale-6 Symptoms was employed to assess potential addictive behaviors to social network use. The psychosocial health was assessed using the Strengths and Difficulties Questionnaire. Generalized linear regression models were conducted, and predictive probabilities of having psychosocial health problems were calculated.

Results
The predicted probability of presenting psychosocial health problems in the medium users and high users of social networks was 19.3% (95% confidence interval [CI] 13.0 to 27.7), and 16.2% (95% CI 10.2 to 24.6) higher compared to low users, respectively. High usage of Instagram, TikTok, Snapchat, and Facebook was associated with increased probabilities of psychosocial health problems, with Facebook showing the highest probabilities, at 31.3% (95% CI 14.8 to 54.2) for medium users and 51.9% (95% CI 26.5 to 76.3) for high users. Additionally, adolescents with addictive behaviors to social network use had from 19.0 to 25.2% probabilities of experiencing psychosocial health problems. Finally, the highest probabilities of having psychosocial health problems were identified in adolescents with high addictive behaviors when using social networks (28.9%; 95% CI 19.3 to 40.8%) and the lowest in those with low addictive behaviors (6.8%; 95% CI 3.3 to 13.6%).

Conclusion
Adolescents who use social networks more frequently and exhibit more addictive behaviors related to their use are more likely to experience psychosocial health problems compared to those who do not. Facebook showed the strongest association, followed by Snapchat, Instagram, and TikTok. Our data also revealed that adolescents exhibit various signs of addictive behaviors to social network use.
Variability in forgoing life-sustaining treatment practices in critically Ill patients with hospital-acquired bloodstream infections: a secondary analysis of the EUROBACT-2 international cohort
Authors: Wozniak Hannah , Tabah Alexis , De Waele Jan J. , Timsit Jean-François , Buetti Niccolò ,   EUROBACT-2 Study Group,   the European Society of Intensive Care Medicine (ESICM),   the European Society of Clinical Microbiology,   the Infectious Diseases (ESCMID) Study Group for Infections in Critically Ill Patients (ESGCIP),   the OUTCOMEREA Network
Published: August 2024

Abstract
Background
The decision to forgo life-sustaining treatment in intensive care units (ICUs) is influenced by ethical, cultural, and medical factors. This study focuses on a population of patients with hospital-acquired bloodstream infections (HABSI) to investigate the association between patient, pathogen, center and country-level factors and these decisions.

Methods
We analyzed data from the EUROBACT-2 study (June 2019–January 2021) from 265 centers worldwide, focusing on non-COVID-19 patients who died in the hospital or within 28 days after HABSI. We assessed whether death was preceded by a decision to forgo life-sustaining treatment, examining country, center, patient, and pathogen variables. To assess the association of each potentially important variable with the decision to forgo life-sustaining treatment, univariable mixed logistic regression models with a random center effect were performed.

Results
Among 1589 non-COVID-19 patients, 519 (32.7%) died, with 191 (36.8%) following a decision to forgo life-sustaining treatment. Significant geographical differences were observed, with no reported decisions to forgo life-sustaining treatment in African countries and fewer in the Middle East compared to Western Europe, Australia, and Asia. Once a center effect was considered, only health expenditure (Odds ratio 1.79, 95%CI: 1.45–2.21, p < 0.01) and age (Odds ratio 1.02, 95%CI: 1.002–1.05, p = 0.03) were significantly associated with decisions to forgo life-sustaining treatment, while other patient and pathogen factors were not.

Conclusion
Economic and regional disparities significantly impact end-of-life decision-making in ICUs. Global policies should consider these disparities to ensure equitable end-of-life care practices.
Antimicrobial metabolites from Probiotics, Pleurotus ostreatus and their co-cultures against foodborne pathogens isolated from ready-to-eat foods
Authors: Bamisi Oluwaferanmi Esther , Ogidi Clement Olusola , Akinyele Bamidele Juliet 
Published: August 2024

Abstract
Background
The incidence of foodborne pathogens in ready- to-eat (RTE) can be attributed to various foodborne diseases. Most of the isolated microorganisms from RTE foods are resistant to common antibiotics and thus, resulted to treatment failure when commercially available antibiotics are administered. However, the secondary metabolites secreted by microorganisms can serve as alternative therapy that are reliable and safe. Secondary metabolites obtained from mono- and co-culture microorganisms can inhibit the growth of antibiotic-resistant microorganisms. Bioactive compounds in the secreted metabolites can be identified and utilized as sources of new antibiotics. In this study, antimicrobial activity of secondary metabolites from Lactobacillus fermentum, Saccharomyces cerevisiae, Pleurotus ostreatus, and their co-cultures were tested against foodborne pathogens isolated from RTE foods using agar well diffusion. The bioactive compounds in the metabolites were identified using gas chromatography-mass spectrometry.

Results
From a total of 100 RTE foods examined, Salmonella enterica, Shigella dysenteriae, Escherichia coli, Klebsiella pneumoniae (subsp ozaenae), Pseudomonas fluorescens, Clostridium perfringes, Bacillus cereus, Listeria monocytogens, and Staphylococcus aureus, Penicillium chrysogenum, Aspergillus flavus, and Aspergillus niger were isolated and displayed multiple antibiotic resistance. The secondary metabolites secreted by co-culture of L. fermentum + P. ostreatus + S. cerevisiae, and co-culture of P. ostreatus + S. cerevisiae have the highest (P ≤ 0.05) zones of inhibition (23.70 mm) and (21.10 mm) against E. coli, respectively. Metabolites from mono-cultured L. fermentum, P. ostreatus, and S. cerevisiae showed zones of inhibition against indicator microorganisms with values ranging from 8.80 to 11.70 mm, 9.00 to 14.30 mm, and 9.30 to 13.00 mm, respectively. Some of the bioactive compounds found in the metabolites of co-cultured microorganisms were alpha-linolenic acid (25.71%), acetic acid 3-methylbutyl ester (13.83%), trans-squalene (12.39%), pentadecylic acid (11.68%), 3- phenyllactic acid (30.13%), linolelaidic acid methyl ester (15.63%), and 4-O-methylmannose (53.74%).

Conclusion
RTE foods contain multiple antibiotics resistance pathogens. The pronounced antimicrobial activity of the secondary metabolites against microorganisms from RTE foods could be attributed to the presence of bioactive compounds in the metabolites. These metabolites can be exploited as alternative food preservatives, biopharmaceuticals and can be used towards better health delivering systems.
Bone marrow toxicity in patients with locally advanced cervical cancer undergoing multimodal treatment with VMAT/IMRT: are there dosimetric predictors for toxicity?
Authors: Hallqvist D. , Kormann C. , Pigorsch S. , Kiechle M. , Combs S. E. , Habermehl D. 
Published: August 2024

Abstract
Purpose
For women with locoregionally advanced cervical cancer, the standard of care treatment is the curatively intended chemoradiation therapy (CRT). A relationship between bone marrow (BM) dose–volume histograms (DVHs) and acute hematological toxicity (HT) has been debated recently. Aim of this study was the evaluation of BM dose constraints and HT in a contemporary patient cohort.

Methods
Radiation treatment plans of 31 patients with cervical cancer (FIGO stage IIB–IVB) treated with intensity-modulated radiotherapy and simultaneous chemotherapy were explored retrospective. Pelvic bones (PB) and femoral heads (FH) were contoured and DVHs were correlated with white blood cells (WBC), hemoglobin levels and platelets.

Results
Comparing the absolute blood levels with the dose volumes of both FH and PB the data showed a significant correlation between WBC and the median dose of the FH and the median dose, V30Gy, V40Gy and V50Gy of the PB. A correlation between the toxicity grade of anemia and mean dose, maximum dose and V5Gy of the PB was found. Counting the highest grade of HT of all three blood levels of each patient, significant correlations were found for the mean and median dose, V30Gy, V40Gy and V50Gy of the PB.

Conclusion
The results show that blood levels may correlate with distinct dosimetric subvolumes of critical bone marrow compartments with a potential impact on therapeutic outcome and treatment-related toxicity. The data presented are in line with the previous findings on the relevance of dosimetric exposure of pelvic bony subvolumes.
Longitudinal multiomics analysis of aggressive pituitary neuroendocrine tumors: comparing primary and recurrent tumors from the same patient, reveals genomic stability and heterogeneous transcriptomic profiles with alterations in metabolic pathways
Authors: Taniguchi-Ponciano Keiko , Hinojosa-Alvarez Silvia , Hernandez-Perez Jesus , Chavez-Santoscoy Rocio A. , Remba-Shapiro Ilan , Guinto Gerardo , Magallon-Gayon Erika , Telles-Ramirez Benjamin , de Leon-Conconi Rodrigo Ponce , Vela-Patiño Sandra , Andonegui-Elguera Sergio , Cano-Zaragoza Amayrani , Martinez-Mendoza Florencia , Kerbel Jacobo , Loza-Mejia Marco , Rodrigo-Salazar Juan , Mendez-Perez Alonso , Aguilar-Flores Cristina , Chavez-Gonzalez Antonieta , Ortiz-Reyes Elenka , Gomez-Apo Erick , Bonifaz Laura C. , Marrero-Rodriguez Daniel , Mercado Moises 
Published: August 2024

AbstractPituitary neuroendocrine tumors (PitNET) represent the vast majority of sellar masses. Some behave aggressively, growing rapidly and invading surrounding tissues, with high rates of recurrence and resistance to therapy. Our aim was to establish patterns of genomic, transcriptomic and methylomic evolution throughout time in primary and recurrent tumors from the same patient. Therefore, we performed transcriptome- and exome-sequencing and methylome microarrays of aggressive, primary, and recurrent PitNET from the same patient. Primary and recurrent tumors showed a similar exome profile, potentially indicating a stable genome over time. In contrast, the transcriptome of primary and recurrent PitNET was dissimilar. Gonadotroph, silent corticotroph, as well as metastatic corticotroph and a somatotroph PitNET expressed genes related to fatty acid biosynthesis and metabolism, phosphatidylinositol signaling, glycerophospholipid and phospholipase D signaling, respectively. Diacylglycerol kinase gamma (DGKG), a key enzyme in glycerophospholipid metabolism and phosphatidylinositol signaling pathways, was differentially expressed between primary and recurrent PitNET. These alterations did not seem to be regulated by DNA methylation, but rather by several transcription factors. Molecular docking showed that dasatinib, a small molecule tyrosine kinase inhibitor used in the treatment of chronic lymphocytic and acute lymphoblastic leukemia, could target DGKG. Dasatinib induced apoptosis and decreased proliferation in GH3 cells. Our data indicate that pituitary tumorigenesis could be driven by transcriptomically heterogeneous clones, and we describe alternative pharmacological therapies for aggressive and recurrent PitNET.