bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serial mediation of the association between adverse childhood experiences, suicidality and self-harm by sexual orientation discrimination and anhedonia in adolescents
Authors: Ma Qianshu , Xie Min , Cai Jia , Liu Yunjia , Zhao Zhengyang , Lv Qiuyue , Tao Shiwan , Zhang Jiashuo , Zou Min , Wang Qiang 
Published: July 2024

Abstract

Background
The rate of suicidality and non-suicidal self-injury (NSSI) among youth has been rising. Previous studies have shown adverse childhood experiences (ACEs) are risk factors for psychological issues and children exposed to ACEs are more sensitive to discrimination. This study investigates the relationship between adverse childhood experiences (ACEs) and suicidality and NSSI in adolescents, with a specific focus on the sequential mediating roles of perceived sexual orientation discrimination and anhedonia.
Methods
We included 11,880 children aged 9 to 10 years in the Adolescent Brain and Cognitive Development (ABCD) cohort. Data collection for one baseline and two follow-up surveys were completed from 2016 to 2018. Logistic regression and longitudinal mediation analyses were conducted to assess the association between exposures and outcomes and to investigate whether perceived discrimination and anhedonia sequentially mediate the impact of ACEs on adolescent suicidality and NSSI.
Results
The findings show ACEs were associated with increased risk of perceived discrimination against gay/lesbian/bisexual (OR = 1.28, 95% CI = 1.16, 1.41), and anhedonia (OR = 1.13, 95% CI = 1.06, 1.21), suicidality (OR = 1.17, 95% CI = 1.08, 1.26) and NSSI (OR = 1.14, 95% CI = 1.03, 1.26). In addition, perceived discrimination against gay/lesbian/bisexual was associated with an elevated risk of anhedonia (OR = 1.53, 95% CI = 1.02, 231), suicidality (OR = 2.22, 95% CI = 1.46, 3.35) and NSSI (OR = 2.99, 95% CI = 1.86, 4.81). Also, anhedonia was associated with an increased risk for suicidality (OR = 3.25, 95% CI = 2.54, 4.15) and NSSI (OR = 3.31, 95% CI = 2.44, 4.50). The associations between ACEs and suicidality and NSSI were sequentially mediated by perceived discrimination against gay/lesbian/bisexual and anhedonia.
Conclusions
Our study underscored the significant predictive roles of ACEs, perceived discrimination, and anhedonia in adolescent suicidality and NSSI. Findings may support the idea that eliminating specific discrimination and addressing anhedonia may help reduce suicidality and NSSI risk in adolescents who have experienced ACEs.
Characteristics and pregnancy outcomes of subtypes of gestational diabetes mellitus based on HOMA-IR and BMI
Authors: jiang li , Li An-qiong 
Published: July 2024

Abstract

Aims To identify the characteristics and pregnancy outcomes across different subtypes of gestational diabetes mellitus (GDM) based on insulin resistance and body mass index.Methods This retrospective study included 1804 women who underwent a 75g-OGTT during 22-28weeks of gestation, categorized into normal glucose tolerance (NGT) and GDM. Metabolic indicators were measured, and equation of homeostatic model assessment (HOMA) were used to calculate indices of insulin resistance (HOMA-IR), β-cell secretory (HOMA-B), and insulin sensitivity (HOMA-%S) in early and mid-pregnancy .The cut-off value of HOMA-IR in early pregnancy was determined by ROC curve(1.75), which was combined with pre-pregnancy BMI to group NGT and GDM groups into six subgroups each ,stratified according HOMA-IR ≥ 1.75 or HOMA-IR < 1.75 and BMI < 18.5kg/m2 or 18.5 ≤ BMI < 25kg/m2 or BMI ≥ 25kg/m2.Results Compared with women with NGT (1487), women with GDM(317[17.57%]of the total cohort), were significantly older, had higher BMI, fasting plasma glucose(FPG) ,insulin and lipids in early pregnancy, more pronounced insulin resistance in early and mid-pregnancy, and worse outcomes. Analysis of subgroups provided further information. In early pregnancy, except for the GDM subgroup with HOMA-IR ≥ 1.75/BMI ≥ 25kg/m2 having higher FPG than the control subgroup, other subgroups had similar FPG, fasting insulin, HOMA-IR, HOMA-B, and HOMA-%S compared with the NGT subgroups. At the time of OGTT, the peak of glucose and insulin were out of sync in GDM subgroups, accompanied by increased HOMA-IR and HOMA-B and decreased HOMA-%S except for the GDM subgroup with HOMA-IR < 1.75/BMI < 18.5kg/m2. Compared with the corresponding NGT subgroups, the GDM subgroup had higher rates of neonatal jaundice (36.5% vs 12.5, p < 0.001), LGA (28.8% vs 14.3%, p = 0.004), macrosomia (3.6% vs 3.2%, p = 0.007), NICU (12.2% vs 5.5%, p = 0.046) in women with HOMA-IR > 1.75/18.5kg/m2 ≤ BMI < 25 kg/m2, the rates of LGA and macrosomia were 28.4% and 16% in women with HOMA-IR > 1.75/BMI ≥ 25 kg/m2. While the GDM subgroup had the highest rates of PROM and postpartum hemorrhage in women with HOMA-IR < 1.75/BMI < 18.5kg/m2 and 1-minute Apgar score in women with HOMA-IR < 1.75/18.5kg/m2 ≤ BMI < 25 kg/m2.Conclusion GDM presents a more adverse metabolic profile and severe insulin resistance from early pregnancy, with a greater risk of adverse pregnancy outcomes. Subgrouping based on early BMI and IR in GDM reveals different β-cell function at the time of OGTT, along with varying outcomes.
Acute appendicitis in children with malignancies
Authors: Chen Wei , Zhang Tingchong , Wang Dayong , Liu Tingting , Chen Yajun 
Published: July 2024

Abstract

Objective: To elucidate the clinical characteristics and treatment strategies for acute appendicitis in pediatric patients with cancer.
Methods: A retrospective analysis was conducted on the clinical data of 31 pediatric patients with cancer who were diagnosed and treated for acute appendicitis at Beijing Children’s Hospital from March 2007 to October 2023.
Results: The cohort comprised 31 patients with a mean age of 5.2 years (range 13 months to 15.3 years) and a male-to-female ratio of 4.2:1. The most prevalent underlying malignancy was acute lymphoblastic leukemia (22, 71%). The most common clinical manifestations were abdominal pain (23, 74%) and fever (27, 87%). Neutropenia was present in 81% of the patients. Nine patients underwent initial surgical treatment, while 22 received conservative management. The proportion of complicated appendicitis was significantly higher in the surgical group compared to the conservative treatment group (78% vs 23%, p = 0.012). However, the absolute neutrophil count was lower in the conservative treatment group compared to the surgical group (0.06 vs 0.35 × 109/L, p = 0.006). The length of hospital stay was significantly shorter for patients who underwent laparoscopic surgery compared to the conservative treatment group (5 vs 9.0 days; p = 0.037). All patients were successfully treated for acute appendicitis with no mortality.
Conclusion: Both surgical and conservative management are safe and effective treatment options for acute appendicitis in cancer children. Laparoscopic appendectomy may be a more advantageous approach, reducing hospital stay and potentially benefitting the management of the underlying malignancy.
Growth patterns of the Golden Lancehead and their determinants: Conservation strategies for critically endangered species
Authors: Banci Karina Rodrigues Silva , Siqueira Lucas Henrique Carvalho , Marques Otavio Augusto Vuolo 
Published: July 2024

Abstract

The Golden Lancehead, Bothrops insularis, is a critically endangered viperid species, endemic to Queimada Grande Island. The diet of adults relies mainly on migratory birds, which peaks in March and July on the island. Herein, we describe the growth rate of the Golden Lancehead for the very first time, testing the hypothesis that growth and adult body size may decrease as a result of resource scarcity and environmental variability in the island, in comparison to a captive population. Our findings suggest that both food intake, temperature, and reproductive requirements might influence body size, growth rate, and sexual maturity of B. insularis. More specifically, wild animals attain smaller body size and mass, show lower growth rate, and attain sexual maturity later, in comparison to the captive individuals of the same sex, possibly as a result of lower food availability. This situation is more evident among males, and, apparently, morphological constraints make it difficult for them to explore large prey at the island. Females are the largest sex, possibly as a result of fecundity optimization. Fecundity also depends on energy reserve for vitellogenesis, and, due to the metabolic costs involved, females take a longer time to mature, showing, therefore, delayed maturity when compared to males. These aspects are especially important for conservation. Concerning species conservation, the impact of the larger body size in captive animals on other traits, such as habitat use, must be considered, especially if reintroduction of these animals become necessary. As for the Golden Lanceheads in the island, it is mandatory that the conservation strategies encompass the maintenance of the population of the migratory birds, in order to ensure the energetic income to the snakes.
Clinical balance assessment tools for children with hearing loss: A scoping review
Authors: Mbhele Sphilile , Rogers Christine , Saman Yougan 
Published: July 2024

Abstract

Balance dysfunction exists in children with hearing loss, especially sensorineural loss, impacting on cognitive development, socio-emotional development and literacy. However, there is limited assessment of balance in this population, which has further impedes childhood development. The objective of this review was to identify clinical, low- technology and inexpensive tools used to evaluate balance in children with hearing loss. Methods: A scoping review method with reference to the JBI, was used where a search was conducted on electronic databases including EBSCOHost, MEDLINE, PubMED, Web of Science and Wiley. In addition, gray literature and hand searches were also used. The review included children between 3 – 15 years of age with hearing loss. Results: A total of 53 articles were found where 53% of the tests were norm-referenced tests, 44% were criterion referenced tests and 2% could not be identified. Conclusion: Tests such as the Tandem gait test, Pediatric Balance Scale (PBS), Clinical Test of Sensory Interaction for Balance (mCTSIB)/Pediatric Version of Clinical Test for Sensory Interaction of Balance (P-CTSIB), Dynamic Gait Index and the Timed-up-and-Go were identified to be relatively inexpensive and low-technology based clinical tools and have thus, been summarized in this review.
Efficacy and safety of INTERCEED® in rabbit trabeculectomy model
Authors: Shiotani Nobutaka , Mizobuchi Kei , Honzawa Koki , Ito Ryosuke , Horiguchi Hiroshi , Gunji Hisato , Nakano Tadashi 
Published: July 2024

Abstract

The purpose of this study was to evaluate the efficacy and safety of INTERCEED® (Johnson & Johnson, New Brunswick, NJ, USA) with a rabbit trabeculectomy model. This study included six eyes of six rabbits that were categorized into groups 1 and 2. Group 1 received trabeculectomy with mitomycin C (MMC) (applied by a cellulose sponge). Group 2 received trabeculectomy with INTERCEED®. Clinical examinations, including intraocular pressure (IOP) measurement, slit-lump examination (bleb scores), and anterior-segment optical coherence tomography (AS-OCT), were conducted for all cases on postoperative days 1, 7, 28, 56, and 84. All experiments were performed under general anesthesia. All rabbits were underwent surgery without any significant complications and were observed for general and ophthalmic conditions for 84 days postoperatively. There were no significant differences in the clinical course of IOP, slit-lamp photo findings, and bleb score between the INTERCEED® and MMC groups. Regarding the AS-OCT findings, filtering bleb was confirmed in both groups in the early period after trabeculectomy but hardly confirmed in the MMC group in the late period. Conversely, the scleral flap and traffic into the anterior chamber were visible in the INTERCEED® group even a long time after trabeculectomy. Our results indicated INTERCEED® could act as an effective and safe method for eye surgery and be helpful in preventing adhesion after trabeculectomy.
Prevalence, Predictors and Effect of Vitamin D Probiotics Fortification on Asymptomatic Urinary Tract Infections Among Pregnant Women: A Prospective Cohort Study
Authors: Ayamah Vivian , Apprey Charles , Owusu Eric , Annan Reginald , Senu Ebenezer 
Published: July 2024

Abstract

Background
Maternal urinary tract infections (UTIs) remains the commonest non-intestinal infection globally, and it is a major public health concern. Moreover, Vitamin D is a known immunomodulator, and its deficiency is common in pregnant women. Few evidence shows vitamin D deficiency may expose the urinary tract to infections. For the first time, this study investigated the prevalence, associated factors and effect of Vitamin D probiotics fortification on asymptomatic UTIs among pregnant women in Ghana.
Methods
This prospective cohort study included 126 pregnant women aged 18 years and above without symptoms of UTI attending antenatal care at the Ejisu Government Hospital and Juaben Government Hospital in Ejisu-Juaben Municipality in the Ashanti Region, Ghana. Pregnant women were further divided into Vitamin D probiotics fortified group (63) and non-fortified group (63) and follow-up for 6 months. Sociodemographic and clinical data were collected. Venous blood samples were also collected at baseline and end line for laboratory analyses. Quantification of serum 25(OH)D levels was done using ELISA (Thermo scientific). Statistical analyses were done in SPSS version 26.0 and GraphPad version 8.0 at p < 0.05 and 95% confidence interval.
Results
This study found 23.6% prevalence of UTI among pregnant women with most isolated bacteria being Escherichia coli (69.0%) and staphylococcus spp. (17.2%). In a logistics regression prediction model, inadequate knowledge on UTI (cOR: 2.85, 95% CI: (1.00-8.14); p = 0.049) was significantly associated with 3-odds increased likelihood of UTI, and poor attitude towards UTI (aOR: 3.00, 95% CI: (1.22–7.37); p = 0.017) was independent predictor of increased chances of UTI among pregnant women. At end line of treatment, the prevalence of UTI among Vitamin D fortified group reduced from 21.0–3.2% and among non-fortified group reduced from 26.2% 16.4%, indicating a drastic effects of Vitamin D fortification in reducing UTI among pregnant women.
Conclusion
The prevalence of UTI remains high among pregnant women. Inadequate knowledge on UTI and poor attitude towards UTI contributes significantly to increasing chances of UTI among pregnant women. However, public health strategies incorporating Vitamin D supplementation could reduce UTI incidences and related adverse maternal and neonatal outcomes.
Establishing a Learning Health System through the implementation of a health service wide Continuous Quality Improvement program: A qualitative evaluation
Authors: Bierbaum Mia , Hillier Susan , Ellis Louise A. , Clay-Williams Robyn , Hibbert Peter 
Published: July 2024

Abstract

Introduction
Continuous quality improvement (CQI) initiatives are commonly used to enhance patient safety and quality of care. A novel South Australian Local Health Network (SALHN) Continuous Improvement Program (CIP009) has integrated a top-down model of executive-directed change initiatives, with a bottom-up approach of clinician designed interventions to address an organisational-wide goal of improved patient flow. This study evaluated the strengths and challenges of CIP009 implementation from the perspective of participants and deliverers.
Methods
A qualitative study was conducted to evaluate the implementation of CIP009 and 12 associated quality improvement projects. Semi-structured interviews, document review, and observations were guided by the Consolidated Framework for Implementation Research (CFIR). Interviews, focus groups and observations were conducted with key stakeholders (executives, coaches and participants). Data were analysed inductively using thematic analysis, then deductively mapped against the five CFIR domains.
Results
Thirty-one participants were interviewed, two presentation days and six team meetings were observed, and 78 documents were reviewed. Seven key themes were identified highlighting key challenges and strengths of CIP009 implementation within the SALHN setting. These included four key strengths: the CIP framework and culture (the flexible framework, common language, training, and a culture of flattened hierarchy); the benefits of support from a dedicated, internal improvement Faculty (wrap around support from coaches); the advantages of an enthusiastic participant disposition and incentives (vested interests to enhance workflow and patient outcomes); and effective teams and team composition (teams comprised of senior clinician change agents). Three key challenges included: workforce and organisation-level challenges (individual workloads, workforce capacity, and data access); team cohesion, logistics and stakeholder engagement challenges (issues in the way teams worked together); and training and support shortcomings (the training course, and the top-down nature of CIP009).
Conclusion
This evaluation identified that CIP009 was considered an effective multifaceted CQI program. The strengths of CIP009 support a learning health system (a data driven model, utilising systematic frameworks, with commitment from leadership, and a culture of continuous learning). Further integration of implementation science principles may support the program to overcome the key challenges identified.
Single-access MPCNL with flexible cystoscopy vs. multi-access MPCNL for complex renal stones: a prospective, randomized controlled study
Authors: Tang Qing-lai , Wang Qing , Ji Jun-biao , Yang Tian-xiao , Wang Du-jian , Zhou Xing-zhu , Wu Jie , Tao Rong-zhen 
Published: July 2024

Abstract

Objective To observe the efficacy and safety of single-access minimally invasive percutaneous nephrolithotomy (MPCNL) combined with flexible cystoscopy and multi-access MPCNL in patients with complex renal stones (CRS).
Patients and Methods A total of 195 patients with CRS were prospectively randomized into twogroups. Ninety-eight in the single-access MPCNL group and 97 cases as control in the multi-access MPCNL group. The stone-free rates (SFRs) at different times (Postoperative 2nd day and 4th week end) were considered as the primary outcome of the study. The secondary end points were operative time, hemoglobin decrease, postoperative hospital stay and operation-related complications.
Results There was no obvious difference between two groups in patients’ demographics and preoperative clinical characteristics (all P > 0.05). Postoperative data showed that mean decrease in hemoglobin level was less in single-access MPCNL group than that in multi-access MPCNL group (7.3 vs. 13.4 g/L, P < 0.001). Postoperative hospital stay in single-access MPCNL group was more shorten than that in multi-accessMPCNL group (4.2 vs. 5.1 days, P < 0.001). Moreover, the SFRs of the postoperative 2nd day and 4th week in single-access MPCNL group were both significantly higher than those in multi-access MPCNL group (88.8% vs. 74.2%, P = 0.009; 94.9% vs. 85.6%, P = 0.028, respectively). However, in terms of the rates of low back pain, perirenal hematoma and renal artery embolization, multi-accessMPCNL group were all significantly higher than single-access MPCNL group (18.5 vs. 7.1%, P = 0.017; 13.4 vs. 4.1%, P = 0.021; 4.1 vs. 0.0%, P = 0.042; respectively).
Conclusions Our study shows that single-access MPCNL and flexible cystoscopy are ideal complementary techniques in the treatment of CRS, satisfying both high SFR and minimized renal injury. This method was safe and reproducible in clinical practice.
Single nucleotide polymorphism (SNP) analysis reveals ancestry and genetic diversity of cultivated and wild grapevines in Croatia
Authors: Marinov Luka , Magris Gabriele , Gaspero Gabriele Di , Morgante Michele , Maletić Edi , Bubola Marijan , Pejić Ivan , Zdunić Goran 
Published: July 2024

Abstract

Background
Croatia is a geographically small country, but it has a remarkable genetic diversity of cultivated and wild grapevines. Local germplasm has been characterised by microsatellite markers, but a detailed analysis based on single nucleotide polymorphisms (SNPs) is still lacking. Here we characterize the genetic diversity of 149 accessions from three germplasm repositories and four natural sites using 516,101 SNPs to identify complete parent-offspring trios and their relations with spontaneous populations, offering a proof-of-concept for the use of reduced-representation genome sequencing in population genetics and genome-wide association studies.
Results
Principal component analysis revealed a clear discontinuity between cultivated (V. vinifera) and spontaneous grapevines, supporting the notion that the latter represent local populations of the wild progenitor (V. sylvestris). ADMIXTURE identified three ancestry components. Two vinifera components are alternatively predominant in cultivars grown either in northern Adriatic Croatia and Continental Croatia or in Dalmatia (i.e. central and southern Adriatic Croatia). A sylvestris component, which is predominant in accessions from natural sites, is a minor ancestry component in cultivated accessions. TREEMIX provided evidence of a unidirectional gene flow from the vineyards to natural sites, suggesting that the introduced domesticated germplasm has colonized local wild populations stronger than vice versa. Identity-by-descent analysis indicated an extensive kinship network, including 14 complete parent-offspring trios and involving only cultivated accessions, and 6 full-sibling relationships, and invalidated a presumed pedigree of the most intriguing ones, the one of ‘Plavac Mali’. Despite this strong population structure, significant association was found between 143 SNPs and berry skin colour and between 2 SNPs and leaf hairiness, across two known QTL regions.
Conclusions
The genetic separation between Croatian cultivars and sylvestris excluded the hypothesis that cultivars originated from independent events of local domestication. On the other hand, the evidence of a crop-to-wild gene flow, especially in but not limited to the Modro jezero population, signals the need for an urgent adoption of conservation strategies that preserve the genetic integrity of wild relatives. The SNP panel enables enhanced parentage assignment for grapevine cultivars historically grown in Croatia.