bluuebunny/crossref_metadata_2025_split huggingface dataset:
ANDROID and A/G ratio are correlated with sarcopenia among type 2 diabetes patients
Authors: Zhang Dongxiao , Li Chen , Hu Wenchao , He Lanjie 
Published: August 2024

Background: Fat distribution plays an important role in impaired glucose tolerance. Android adiposity (ANDROID) and gynoid adiposity (GYNOID) have been proven to be linked with insulin resistance. A higher risk of sarcopenia is associated with type 2 diabetes mellitus (T2DM). In this study, ANDROID, GYNOID, and ANDROID to GYNOID ratios (A/G ratios) were evaluated in T2DM patients to determine if they were associated with sarcopenia. Methods: We recruited 1086 T2DM patients, measured skeletal muscle index (SMI), ANDROID, GYNOID, and collected clinical data. Results: T2DM patients with 119 male subjects had sarcopenia (20.24%), and 72 female subjects had sarcopenia (16.51%). All patients with T2DM who had high ANDROID and A/G ratios were at a reduced risk of sarcopenia. The SMI showed a correlation with ANDROID and A/G ratios among subjects with T2DM. Conclusion: ANDROID and A/G ratios are inversely related to sarcopenia in T2DM patients.
First case of feline cryptococcosis in Bosnia and Herzegovina
Authors: Glavinić Aida , Šupić Jovana , Alić Amer , Spahija Nermina , Maksimović Alan , Šunje-Rizvan Amila 
Published: August 2024

Case summary A 2-year-old domestic longhair crossbred female cat was referred for a second opinion on a non-healing surgical wound after left eye enucleation. In addition to the left orbital lesion, ulcerative granular masses protruding from the left nostril and on the base of the left ear were noted. A diagnosis of cryptococcosis was established using histopathological examination and a latex cryptococcal antigen agglutination test. The cat was successfully treated with itraconazole. Relevance and novel information Cryptococcosis, commonly reported in Australia, western Canada and the western USA, is rarely reported in companion animals in Europe. This marks the first report of cryptococcosis in cats in Bosnia and Herzegovina, emphasising the need to raise awareness within the veterinary community, both local and regional, about this disease.
How to establish digital health ecosystems from the perspective of health service-organizations: A taxonomy developed based on expert interviews conducted as modified Delphi approach
Authors: Huettemann Robin , Sevov Benedict , Meister Sven , Fehring Leonard 
Published: August 2024

Objective Digital health ecosystems may be the next revolution in improving citizens’ well-being, health delivery, data management, and health system processes, but solutions have not yet been broadly established. Reasons could be that health service-organizations have misaligned interests or lack capabilities. This study investigates reasons from a multi-health-service-organization perspective, differentiating between payers, insurers, healthcare providers, and innovators, detailing the expected value-adds, preferred participation roles, and required capabilities including a rating assessment. Methods Findings are based on a taxonomy development methodology, which combines a literature review with semi-structured qualitative expert interviews, conducted using a modified Delphi approach. Interviews were thematically analysed. Results In total, 21 experts across the four health service-organization groups were interviewed. The capability taxonomy includes a total of 16 capabilities, categorized in three themes: ‘Health market’, ‘organizational’, and ‘technology and informatic’. Providers expect a value-add from strengthening their health process economics through efficiency gains but reveal the largest capability gaps, especially in ‘interoperability’ and ‘platform’. Innovators’ ‘technology and informatic’ capabilities complement well with those of payers for the ‘health market’. Conclusions We present a health service-organization-specific three-stage approach for establishing digital health ecosystems. Payers and insurers should address their ‘technology and informatic’ capability gaps, using technical enablers or forming new entities to reduce dependencies from legacy information technology systems. Innovators should clarify their monetization models and create positive awareness for their services, possibly entering the market directly. Providers must address interoperability issues and may require incentives to encourage their participation. Findings suggest governmental policymakers to prioritize three health policy initiatives.
Re-hospitalization factors and economic characteristics of urinary tract infected patients using machine learning
Authors: Lee Yul Hee , Baik Young Seo , Kim Young Jae , Shi Hye Jin , Moon Jong Youn , Kim Kwang Gi 
Published: August 2024

Objective Urinary tract infection is one of the most prevalent bacterial infectious diseases in outpatient treatment, and 50–80% of women experience it more than once, with a recurrence rate of 40–50% within a year; consequently, preventing re-hospitalization of patients is critical. However, in the field of urology, no research on the analysis of the re-hospitalization status for urinary tract infections using machine learning algorithms has been reported to date. Therefore, this study uses various machine learning algorithms to analyze the clinical and nonclinical factors related to patients who were re-hospitalized within 30 days of urinary tract infection. Methods Data were collected from 497 patients re-hospitalized for urinary tract infections within 30 days and 496 patients who did not require re-hospitalization. The re-hospitalization factors were analyzed using four machine learning algorithms: gradient boosting classifier, random forest, naive Bayes, and logistic regression. Results The best-performing gradient boosting classifier identified respiratory rate, days of hospitalization, albumin, diastolic blood pressure, blood urea nitrogen, body mass index, systolic blood pressure, body temperature, total bilirubin, and pulse as the top-10 factors that affect re-hospitalization because of urinary tract infections. The 993 patients whose data were collected were divided into risk groups based on these factors, and the re-hospitalization rate, days of hospitalization, and medical expenses were observed to decrease from the high- to low-risk group. Conclusions This study showed new possibilities in analyzing the status of urinary tract infection-related re-hospitalization using machine learning. Identifying factors affecting re-hospitalization and incorporating preventable and reinforcement-based treatment programs can aid in reducing the re-hospitalization rate and average number of days of hospitalization, thereby reducing medical expenses.
Computer Assisted Navigation Does Not Improve Outcomes in Posterior Fusion for Adolescent Idiopathic Scoliosis
Authors: Singh Aaron , Kotzur Travis , Peterson Blaire , Koslosky Ezekial , Emukah Chimobi , Chaput Christopher 
Published: August 2024

Study Design Retrospective Cohort Study. Objective The aim of this study was to compare the efficacy of CT-based computer assisted navigation (CAN) to conventional pedicle screw placement for patients with Adolescent Idiopathic Scoliosis (AIS). Methods This retrospective cohort study drew data from the National Readmissions Database, years 2016-2019. Patients undergoing posterior fusion for AIS, either via CAN or fluoroscopic-guided procedures, were identified via ICD-10 codes. Multivariate regression was performed to compare outcomes between operative techniques. Negative binomial regression was used to asses discharge disposition, while Gamma regression was performed to assess length of stay (LOS) and total charges. Patient demographics and comorbidities, measured via the Elixhauser comorbidity index, were both controlled for in our regression analysis. Results 28,868 patients, 2095 (7.3%) undergoing a CAN procedure, were included in our analysis. Patients undergoing CAN procedures had increased surgical complications (Odds Ratio (OR) 2.23; P < 0.001), namely, blood transfusions (OR 2.47; P < 0.001). Discharge disposition and LOS were similar, as were reoperation and readmission rates; however, total charges were significantly greater in the CAN group (OR 1.37; P < 0.001). Mean charges were 191,489.42 (119,302.30) USD for conventional surgery vs 268 589.86 (105,636.78) USD for the CAN cohort. Conclusion CAN in posterior fusion for AIS does not appear to decrease postoperative complications and is associated with an increased need for blood transfusions. Given the much higher total cost of care that was also seen with CAN, this study calls into question whether the use of CAN is justified in this setting.
Association Between Low-Dose Ketamine After Periacetabular and/or Femoral Osteotomy and Postoperative Opioid Requirements
Authors: Girardi Nicholas G. , Malin Sean , Zielenski Christopher , Lee Jessica H. , Henry Kaleigh , Kraeutler Matthew J. , Mei-Dan Omer 
Published: August 2024

Background: Previous studies have sought to determine the effect of inpatient ketamine therapy on postoperative pain in a variety of surgical specialties. Purpose: To determine the effects of postoperative ketamine analgesia after periacetabular osteotomy (PAO) and/or derotational femoral osteotomy (DFO) on opioid requirements, pain, and discharge time. Study Design: Cohort study; Level of evidence, 3. Methods: Prospective data were collected on 145 patients who underwent PAO and/or DFO by the senior author between January 2021 and December 2022. Hip arthroscopy was performed 3 to 10 days before addressing any intra-articular pathology. In 2021, patients (n = 91 procedures; control group) received a traditional postoperative multimodal pain regimen. In 2022, postoperative low-dose ketamine (0.1-1 mg/kg/h) was added to the multimodal analgesic approach until 24 hours before discharge (n = 81 procedures; ketamine group). The ketamine and control groups were matched based on procedure type. Total opioid consumption was collected using milligram morphine equivalents (MMEs) for both groups. Postoperative pain was measured using the Defense and Veterans Pain Rating Scale (DVPRS), which was analyzed as the mean score per day. Data on the mean MME and DVPRS were analyzed for up to 7 days postoperatively. Linear mixed statistical analysis was performed to determine the significance of low-dose postoperative ketamine on postoperative pain and opioid utilization. Results: Patients who did not receive ketamine after PAO and/or DFO utilized a mean of 181 ± 335 MMEs and had a mean DVPRS score of 4.18 ± 1.63. Patients who received postoperative ketamine required a mean of 119 ± 291 MMEs and had a mean DVPRS score of 4.34 ± 1.61. The ketamine group was found to consume a significantly lower total MME dose per day ( P < .001). No significant difference was found in the mean DVPRS score between the ketamine and control groups ( P = .42). Also, no significant difference was found on the day of discharge ( P = .79). Conclusion: Patients who received postoperative ketamine after PAO and/or DFO had a significant decrease in MME dose when compared with a control group of patients who did not receive ketamine. Surgeons should consider adding ketamine to their postoperative multimodal pain control protocol to decrease opioid consumption while adequately addressing postoperative pain.
Effect of Soccer Boot Outsole Configuration on Translational Traction Across Both Natural and Artificial Playing Surfaces
Authors: Loud Danyon , Grimshaw Paul , Kelso Richard , Robertson William S.P. 
Published: August 2024

Background: Soccer boots are produced with different stud patterns and configurations to provide players with extra traction on specific surface types to minimize slipping and improve player performance. Excessive traction, however, can lead to foot fixation injuries, particularly anterior cruciate ligament tears. Purpose/Hypothesis: The purpose of this study was to explore the translational traction properties of 5 different outsole configurations moving in 4 different directions across both natural grass and artificial grass (AG) playing surfaces. It was hypothesized that longer studs or studs with an asymmetric shape would yield a higher traction coefficient compared with the recommended stud configuration for the given playing surface. Study Design: Descriptive laboratory study. Methods: A custom-built testing apparatus recorded the translational traction of 5 different soccer boots moving in an anterior, posterior, medial, or lateral direction on both natural grass and AG playing surfaces. A 3-way analysis of variance was performed to determine the effect of outsole configuration on the traction, and a post hoc Tukey analysis was performed to compare different outsole configurations with a control. Results: For the natural grass playing surface, the longer and asymmetric studs yielded a significantly higher ( P < .05) traction coefficient on 75% of loading scenarios, while on AG, they yielded a significantly higher traction on 50% of loading scenarios. Conclusion: Some soccer boots yielded higher traction values compared with the recommended configuration. Clinical Relevance: The results highlight the importance of boot selection on different playing surfaces. Higher traction values could increase the injury risk for players due to excessive traction and foot fixation.
Oral Care and Positioning to Prevent Ventilator-Associated Pneumonia: A Systematic Review
Authors: Mohammad Eslam Bani , Al Eleiwah Amani A. , Qurdahji Banan T. , Rayan Ahmad , Alshraideh Jafar A. , Al Hadid Lourance A. , Al Kharabsheh Muna S. , Hudhud Heba N. , Jakalat Suad 
Published: August 2024

Introduction Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in critical patients. The negative impacts of VAP on patient outcomes emphasize the importance of effective preventive measures such as oral care and patient positioning. The aim of this review was to investigate the impact of oral care and positioning on the prevention of VAP among patients in the intensive care unit. Methods This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed. The methodological quality of included studies was appraised using Joanna Briggs Institute checklists. Results In total 13 studies were included, all of them were randomized controlled trials. Six out of nine studies about oral care have significant results on VAP incidence. Regarding the position, Patients positioned at a 45-degree were less likely to develop VAP than those positioned at a 30-degree and those in a supine position. Conclusion Although patients positioned at 45-degree angle were less likely to develop VAP than those at 30-degree, it is necessary to individualize this practice before recommending it, once there are some contraindications, such as neurocritical patients. Regarding oral care to prevent VAP, considering the current guidelines' recommendation not to use oral chlorexidine, further studies evaluating alternatives are needed.
Views of nutrition needs in patients with systemic sclerosis
Authors: Samm De-arne , Macoustra Aimee , Crane Rhiannon , McWilliams Leah , Proudman Susanna , Chapple Lee-anne S 
Published: August 2024

Background and aims: Systemic sclerosis is a debilitating inflammatory condition synonymous with gastrointestinal symptoms which have the potential to impact dietary intake and nutritional status. This study aimed to describe symptoms experienced by patients with systemic sclerosis that may impact on dietary intake and assess nutrition education preferences in this cohort. Methods: A 24-item online qualitative and quantitative survey distributed via REDCap® was conducted in adult patients (aged ⩾18 years) living with systemic sclerosis and attending outpatient services at a single healthcare setting from January to March 2022. Data were collected on demographics, symptoms that may impact dietary intake, nutrition priorities and preferred nutrition education models. Data are mean ± standard deviation or number (%). Results: Of 322 eligible patients, 156 (48%) participated (63 ± 12 years, 86% female, body mass index 27 ± 7 kg/m2). Most patients experienced gastrointestinal conditions (n = 123/155; 79%), which occurred daily in 26% (n = 40/155) of patients. A third of patients (n = 48/156; 31%) reported diet manipulation for symptom management. Recent weight loss was common (n = 36/154; 23% of patients). Less than a third of patients had seen a dietitian (n = 45; 29%), while 69% of patients (n = 107) desired dietetic consultancy. The preferred methods of consultation were written resources and face-to-face, respectively, and systemic sclerosis symptom management (n = 100; 64%) and losing weight (n = 53; 34%) were the most desired education topics reported. Conclusion: Gastrointestinal conditions are common and occur frequently in patients with systemic sclerosis. Patients want to engage with dietetics services to better manage symptoms via face-to-face consultations and written resources. These results will inform future dietetic service delivery.
Societal, Political, and Psychological Challenges Facing MSM in Nigeria
Authors: Amoo Olubunmi Elizabeth , Sanni Olaniyi Felix , Abiodun Paul Olaiya 
Published: August 2024

Background: Men that have sex with men (MSM) have kept their sexual orientation hidden for fear of being discovered, discriminated, and punished. Therefore, the study assesses the societal, political, and psychological challenges facing MSM in Nigeria. Methodology: The study was a quantitative cross-sectional survey conducted across 3 local government areas (LGAs): Ukum, Makurdi, and Oturkpo LGAs in the 3 geopolitical zones of Benue State from August 26 to September 28, 2021. A multistage cluster sampling method was adopted, and structured questionnaires were used to gather respondents’ data. Data analysis was done using IBM-Statistical Package for Social Sciences version 25.0 for Windows IBM Corp., Armonk, NY, USA. Results: The study found that about four-fifths (83.4%) had experienced stigmatization/discrimination. The stigmatization and discrimination had an emotional effect on them as a significant proportion (47.2%) feared going out in the community, school, church, and hospital. The rate at which they experienced physical abuse is fearsome, as about 60.0% had been physically abused, and 88.8% had experienced gender-based violence. A significant proportion (61.6%) were denied housing, and 76.8% claimed that people changed their attitudes after discovering their sexual identity. Conclusion: MSM suffer several kinds of abuse; hence, a review of the Same-Sex Marriage Prohibition Act is needed to curb the incidence of stigmatization, discrimination, and violence against MSM.
The Mechanism of Anti-Viral Activity of a Novel, Hydroponically Selenium-Enriched Garlic Powder (SelenoForce®) Against SARS-CoV-2 Virus
Authors: Majeed Muhammed , Nagabhushanam Kalyanam , Lawrence Lincy , Prakasan Priji , Mundkur Lakshmi 
Published: August 2024

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is far from over as new strains are emerging all over the world. Selenium as a micronutrient is important for immunity and also has anti-viral activity. Objective The study evaluated the activity of a Selenium enriched garlic powder (SeGP or SelenoForce®) against SARS-CoV-2 viral replication in vitro and explored its possible mechanism of action. Methods The anti-SARS-CoV-2 activity assay was carried out in Vero E6 cells in vitro. Human lung carcinoma A549 cells were used to study the antioxidant activity, expression of angiotensin converting enzyme (ACE), transmembrane protease, serine 2 (TMPRSS2) and the activity of proprotein convertase, and furin. Anti-inflammatory activity was evaluated in lipopolysaccharide-activated RAW 264.7 cells. Results SeGP inhibited the replication of SARS-CoV-2 in Vero E6 cells with an IC50 of 19.59 μg/ml. It exhibited significant antioxidant activity in vitro with IC50 value determined as 43.45 μg/ml. The Selenium enriched product inhibited the expression of ACE and TMPRSS2 and also showed inhibition of furin protease activity. In the presence of SeGP, the secretion of nitric oxide, interleukin −6 and TNF-α were reduced in activated RAW 264.7 macrophages. Conclusion The results of the study suggest that Selenium enriched garlic powder could inhibit SARS-CoV-2 multiplication in vitro, reduce oxidative stress and inflammatory mediators suggesting that it could be developed as an effective supplement or adjunct therapy to combat viral infections.
Time is lung: higher preservation of lung function in severe asthma patients after earlier mepolizumab treatment
Authors: González-Barcala Francisco-Javier , Bobolea Irina , Domínguez-Ortega Javier , Bañas-Conejero David , Antelo-Cea Esteban , Martínez-Moragón Eva , Carrillo-Díaz Teresa , Blanco-Aparicio Marina , Domingo Christian 
Published: August 2024

IntroductionSevere asthma involves a persistent inflammation of the airways that is associated with a greater risk of exacerbations. Exacerbations are associated with a higher lung function decline over time. The prevention of lung function decline could become a strategy for disease modification, and this could be more likely to happen in patients with an earlier therapeutic approach. Thus, this study means to analyse the effect of asthma duration in clinical outcomes such as lung function in patients from the REDES study. REDES was an observational real-world study that assessed the effectiveness and safety of mepolizumab 100 mgs.c.every 4 weeks for 12 months in 318 patients with severe asthma in Spain.MethodsThispost hocanalysis evaluated how disease duration affected the study results through a stratification according to quartiles on their disease progression. Continuous analyses were also performed to assess the impact of confounder variables on forced expiratory volume in 1 s (FEV1) (%).ResultsAt baseline, patients with shorter time of disease had a significantly higher lung function than patients with longer asthma duration. At 12 months, pre-bronchodilator (BD) FEV1values and the proportion of patients with ≥80% pre-BD FEV1were higher according to a shorter disease persistence (Q1>Q2>Q3>Q4).ConclusionThese results support that time of disease persistence contributes to the lung function decline of patients with severe asthma, uncontrolled while on previous treatment, and that an earlier approach with mepolizumab may imply a higher preservation of their lung function.