bluuebunny/crossref_metadata_2025_split huggingface dataset:
Icariin protects testicular damage in streptozotocin-induced diabetic rats through regulation of glycolysis pathway
Authors: Liu Fang , Liao Biyun , Ling Yan-Lan , Meng Xian-Zong , Wang Jun-Li , Hu Lin-Lin , Luo Xiao-Qiong , Yang Feng-Lian 
Published: August 2024

Objective This study aims to investigate potential beneficial actions of icariin (ICA) on testicular spermatogenic function in male rats with streptozotocin (STZ)-induced diabetes and to explore the underlying mechanisms. Background: ICA was found to reduce blood glucose, regulate the endocrine function of the reproductive system, and improve testicular spermatogenic function. Methods Adult rats were intraperitoneally injected with STZ (65 mg/kg) to induce type 1 diabetes mellitus (T1DM). Diabetic rats were randomly classified intoT1DM ( n = 6) and T1DM + ICA ( n = 6) groups. Rats without STZ and ICA treatment were assigned as control group ( n = 6). The morphology of testicular tissues was examined by histological staining. The mRNA and protein expression levels were determined by quantitative real-time PCR, Western blot and immunostaining, respectively. Results Rats from T1DM group showed a reduction in epididymis and testis weight, and a decrease in sperm count when compared to control group ( p < 0.01), which was attenuated by ICA treatment ( p < 0.05) Diabetic rats from T1DM group also exhibited reduced diameter and area of seminiferous tubules, along with decreased spermatogonia and primary spermatocytes number when compared to control group ( p < 0.01), which was partially reversed by ICA treatment ( p < 0.05) Rats from T1DM group exhibited down-regulation of PCNA mRNA and protein in the testis when compared to control group ( p < 0.01); while ICA treatment up-regulated PCNA expression in the testis of diabetic rats compared to T1DM group ( p < 0.05). Rats from T1DM group showed up-regulation of Bax and capase-3 and down-regulation of Bcl-2, PKM2, HK2 and lactate dehydrogenase A in the testes when compared to control group ( p < 0.05), which was reversed by ICA treatment ( p < 0.05). Conclusion These findings suggest that ICA may exert its protective effects on testicular damage in diabetic rats through modulation of glycolysis pathway and suppression of apoptosis.
Ultrasound guided percutaneous sharp recanalization for restoring patency from peripheral chronic total occlusions of hemodialysis accesses
Authors: Ho Pei , Lu Mingxi , Meng Lingyan , Hongsakul Keerati 
Published: August 2024

Objective: Resistant chronic total occlusion (CTO) lesions present an ongoing challenge for conventional endovascular interventions to restore functional hemodialysis (HD) access. This study endeavors to present a novel endovascular approach utilizing ultrasound (USG)-guided percutaneous sharp recanalization to cross the resistant occlusions and evaluates its effectiveness. Methods: This is a multi-center retrospective review of consecutive patients received USG guided sharp recanalization for the treatment of resistant CTO lesions of their HD access between 1st January 2019 and 31st July 2023. Data encompassing patient demographics, access and lesion characteristics, procedural specifics, associated complications, immediate clinical outcomes, and outcomes during follow-up were collected. The procedural technical and clinical success, Kaplan-Meier estimated target lesion (TLPP), access circuit primary patency (ACPP), and index access secondary patency (SP) were reported. Results: During the study period, 22 patients underwent USG-guided sharp recanalization procedures in the three participating centers with median follow-up of 14.5 months. Both the technical and clinical success were 100%. Only two patients experienced minor complications of localized hematoma over the access, with no instances of major complication. Kaplan-Meier estimated TLPP and ACPP at 3-, 6-, and 12 months were 90.9%, 68.2%, 56.8%, and 90.9%, 63.6%, 52.1% respectively. The SP rates were 100%, 95.5%, and 84.1% at 3-, 6-, and 12 months respectively. Conclusion: USG guided percutaneous sharp recanalization is an effective and safe endovascular approach to treat resistant CTO lesions of dysfunctional HD access.
Compare efficacy and safety of autologous blood clot injection with C-clamp vascular closure device in treatment of iatrogenic pseudoaneurysm after femoral artery puncture
Authors: Mansouri Mohammad Hadi , Mansouri Pejman , Hashemi Mohammad , Hashemi Seyedeh Melika , Mirshafiee Shayan , Amirpour Afshin 
Published: August 2024

Introduction: Iatrogenic femoral artery pseudoaneurysm (FAP) is a complication following femoral artery puncture, with an incidence rate of 0.2%–5.5% post-cardiac catheterization procedures. Management typically involves observation or interventional treatments such as ultrasound-guided compression (UGC) or ultrasound-guided thrombin injections. This study compares the efficacy and safety of ultrasound-guided autologous blood clot injection (UGCI) with C-clamp vascular closure device-assisted UGC in treating FAP. Materials and methods: Conducted at a high-volume training and research center, this prospective study enrolled patients with iatrogenic FAP post-femoral artery puncture. Patients were randomized into two treatments: UGC with a C-clamp device or UGCI. Primary endpoints were thrombosis induction within 24 h, average procedure time, and length of hospital stay (LOS). Results: The study included 105 patients with 51 undergoing UGCI and 54 undergoing UGC. UGCI achieved a primary success rate of 96% versus 63% for UGC. The mean procedure duration for UGCI was significantly shorter (22 min) compared with UGC (49 min, p ⩽ 0.0001). LOS was also reduced in the UGCI group (1.5 days) compared to the UGC group (4.5 days). Complication rates were low for both procedures, with one deep vein thrombosis and one infection observed in the UGC group. Conclusion: UGCI demonstrated to be a safe, efficient, and faster alternative for treating iatrogenic FAPs with a higher success rate, reduced LOS, and similar low complication rates compared to UGC. This study suggests that UGCI could be considered a preferred method for the management of FAP post-femoral artery catheterization.
Breast Cancer Awareness and Uptake of Breast Cancer Screening Services Among Undergraduate Female Students in the Oldest University of Tanzania: A Cross-Sectional Study
Authors: Mally Mary , Tesha Novatus , Anaeli Amani 
Published: August 2024

Background: Breast cancer is the leading cause of cancer-related death among women worldwide. Mortality from breast cancer can be reduced through early detection and prevention. Despite the availability of breast cancer screening methods, the uptake of screening services remains very low, especially in low-resource countries like Tanzania. This low uptake of screening services may be attributed to a lack of awareness regarding the importance of early detection of the disease. Objectives: This study was set to determine breast cancer awareness and the uptake of breast cancer screening services among undergraduate female students in Dar es Salaam, Tanzania. Design: The study was a descriptive cross-sectional study using the quantitative approach. Methods: The sample size calculated for this study was 434 undergraduate female students. The tool used for data collection was self-administered questionnaires, with data collection taking place in July 2022. Data were analyzed using Stata Version 15 and presented using descriptive and inferential statistics. Results: We found that most of the participants (92.38%) had heard about breast cancer, and only 39% of the participants were able to correctly identify the risk factors for breast cancer. Participants who had ever used breast cancer screening services by at least 1 method were 37 (9.23%), and the most common screening method practiced by the study participants was breast self-examination (48.65%). Conclusions: Most of the participants were not aware of the screening methods for early detection of breast cancer. In addition, they lacked knowledge of some of the risk factors as evidenced by the low uptake of breast cancer screening services among the study participants. This calls for an awareness-raising campaign on the importance of breast cancer screening.
Reflections on co-creating a model for the value assessment of artificial intelligence technologies
Authors: Karlsson Anne Wettergren , Janssens Astrid , Barkler Astrid , Schmidt Thomas , Rasmussen Benjamin Schnack Brandt , Fasterholdt Iben 
Published: August 2024

Aims: A multidisciplinary group of experts and patients developed the Model for ASsessing the value of Artificial Intelligence (MAS-AI) to ensure an evidence-based and patient-centered approach to introducing artificial intelligence technologies in healthcare. In this article, we share our experiences with meaningfully involving a patient in co-creating a research project concerning complex and technically advanced topics. Methods: The co-creation was evaluated by means of initial reflections from the research team before the project started, in a continuous logbook, and through semi-structured interviews with patients and two researchers before and after the active co-creation phase of the project. Results: There were initial doubts about the feasibility of including patients in this type of project. Co-creation ensured relevance to patients, a holistic research approach and the debate of ethical considerations. Due to one patient dropping out, it is important to foresee and support the experienced challenges of time and energy spent by the patient in future projects. Having a multidisciplinary team helped the collaboration. A mutual reflective evaluation provided insights into the process which we would otherwise have missed. Conclusions: We found it possible to create complex and data-intense research projects with patients. Including patients benefitted the project and gave researchers new perspectives on their own research. Mutual reflection throughout the project is key to maximise learning for all parties involved.
Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures – Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders
Authors: Joaquim Andrei F. , Bigdon Sebastian F. , Bransford Richard , Chhabra Harvinder Singh , Yurac Ratko , Kumar Vishal , El-Sharkawi Mohammad , Benneker Lorin M. , Karamian Brian A. , Canseco Jose A. , Scherer Julian , Hassan Ahmed Abdelazim , Schroeder Gregory D. , Öner Cumhur F. , Rajasekaran Shanmuganathan , Vialle Emiliano , Kanna Rishi M. , Vaccaro Alexander R. , Tee Jin , Camino-Willhuber Gaston , Fisher Charles G. , Dvorak Marcel F. , Schnake Klaus J. ,   on behalf of the AO Spine Knowledge Forum Trauma & Infection
Published: August 2024

Study Design Literature review with clinical recommendations. Objective To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders. Methods 4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology. Results 4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. Conditional recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. Strong recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. Conditional recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A conditional recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF. Conclusions Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice.
Occipital nerve stimulation for cluster headache: lessons to learn from the ‘voltage tuners’
Authors: Kollenburg Linda , Arnts H. , Heitkamp M. , Geerts S. , Robinson C. , Dominguez M. , Mulleners W. , Kurt E. 
Published: August 2024

Abstract
Background
Cluster headache (CH) is a significant health concern due to its major socioeconomic consequences and most patients being refractory to conventional strategies. For treatment resistant CH, occipital nerve stimulation (ONS) is considered an effective treatment option. Whereas most patients do not adjust the amplitude of the ONS system, a subset changes the amplitude on a regular basis using their remote control, and are therefore referred to as ‘voltage tuners’. Anxiety and self-control are thought to be central themes to this behavior. Research on this voltage tuning behavior could provide new insights in the use of ONS as acute attack treatment. To date, voltage tuning has not been assessed for CH. Hence this is a unique study aiming to investigate the occurrence and efficacy of voltage tuning in patients with CH and ONS.

Methods
For this analysis, patients with CH who received ONS from 2020–2024, at our university medical center, were included. All patients underwent bilateral ONS implantation. Data on attack frequency, intensity and duration were collected retrospectively. Outcomes on the response, frequency, moment during the day, duration, rationale, sensation, average increase in amplitude, and efficacy of voltage tuning were collected with prospective interviews.

Results
Thirty-three patients (M = 20) (42 ± 12.7 years) were included in the current analysis. At 1y follow-up, an overall response rate of 70% (23/33) was found for ONS. In total, 48% (18/33) of patients were defined as voltage tuners. Voltage tuning was performed with an average increase in amplitude of 92 (20–360)%, a frequency of 1–20 times/month and duration of 20 minutes-48 hours. Sensations of voltage tuning were described as “tingling” and/or “pinching”. The rationale for voltage tuning in patients varied from prevention and ceasing to lowering the intensity and enhance control of CH attack.

Conclusions
Outcomes show that voltage tuning may cease and/or terminate CH attacks and therefore raise interests in the use of ONS as acute attack treatment for patients with resistant CH treated with ONS. Future research on the occurrence and potential of voltage tuning will provide valuable insights for achieving optimal efficacy of ONS and quality of life in patients with CH.
Downregulation of Klebsiella pneumoniae RND efflux pump genes following indole signal produced by Escherichia coli
Authors: Salama Galila G. , El-Mahdy Taghrid S. , Moustafa Walaa H. , Emara Mohamed 
Published: August 2024

Abstract
Background
More than a century has passed since it was discovered that many bacteria produce indole, but research into the actual biological roles of this molecule is just now beginning. The influence of indole on bacterial virulence was extensively investigated in indole-producing bacteria like Escherichia coli. To gain a deeper comprehension of its functional role, this study investigated how indole at concentrations of 0.5-1.0 mM found in the supernatant of Escherichia coli stationary phase culture was able to alter the virulence of non-indole-producing bacteria, such as Pseudomonas aeruginosa, Proteus mirabilis, and Klebsiella pneumoniae, which are naturally exposed to indole in mixed infections with Escherichia coli.

Results
Biofilm formation, antimicrobial susceptibility, and efflux pump activity were the three phenotypic tests that were assessed. Indole was found to influence antibiotic susceptibly of Pseudomonas aeruginosa, Proteus mirabilis and Klebsiella pneumoniae to ciprofloxacin, imipenem, ceftriaxone, ceftazidime, and amikacin through significant reduction in MIC with fold change ranged from 4 to 16. Biofilm production was partially abrogated in both 32/45 Pseudomonas aeruginosa and all eight Proteus mirabilis, while induced biofilm production was observed in 30/40 Klebsiella pneumoniae. Moreover, acrAB and oqxAB, which encode four genes responsible for resistance-nodulation-division multidrug efflux pumps in five isolates of Klebsiella pneumoniae were investigated genotypically using quantitative real-time (qRT)-PCR. This revealed that all four genes exhibited reduced expression indicated by 2^−ΔΔCT < 1 in indole-treated isolates compared to control group.

Conclusion
The outcomes of qRT-PCR investigation of efflux pump expression have established a novel clear correlation of the molecular mechanism that lies beneath the influence of indole on bacterial antibiotic tolerance. This research provides novel perspectives on the various mechanisms and diverse biological functions of indole signaling and how it impacts the pathogenicity of non-indole-producing bacteria.
Prevalence of classic and non-classic pain sites of coronary artery disease: a cross-sectional study
Authors: Abdullatef Mayar , Omran Maya , Bitar Anas , Alsaid Bayan 
Published: August 2024

Abstract
Study objective
This study aims to assess the prevalence of both classic and non-classic pain sites in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding non-classic symptoms.

Methods
This cross-sectional study included 100 patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Syria. classic pain was identified as pain located in the precordial area, with or without radiation to the neck, jaw, left shoulder or arm. Patients’ demographics and previous medical history were documented to investigate any potential associations with non-classic pain.

Results
62% of the patients experienced non-classic pain, while 12% had no precordial pain. For those without precordial pain, the most common pain site was the left chest (66.7%). Non-classic pain was significantly associated with smoking, with 72.2% of smokers experiencing non-classic pain compared to 35.7% non-smokers (p = 0.001). Additionally, patients with previous heart disease were more likely to have non-classic pain (71.7%), compared with patients with no history of heart disease (51.1%) (p = 0.03). Other factors such as age, sex, and diabetes were not statistically significant.

Conclusion
Non-classic pain is common, affecting 62% of individuals, primarily in the right shoulder, right arm, and back. This type of pain could be associated with smoking and prior heart disease. Misdiagnosing coronary artery disease can have serious consequences, as patients with non-classic symptoms may miss important pre-hospital procedures like ECG.
Prevalence of heart failure and trends in its pharmacological treatment between 2000 and 2017 among very old people
Authors: Svahn Sofia , Appelblad Leona , Lövheim Hugo , Gustafson Yngve , Olofsson Birgitta , Gustafsson Maria 
Published: August 2024

Abstract
Purpose
The aim of this study was to describe a population of very old people with heart failure (HF), to analyse the use of cardiovascular drugs over time, and to explore factors influencing cardiovascular drug treatment for this group.

Methods
All participants with information regarding HF diagnosis were selected from the Umeå 85+/Gerontological Regional Database (GERDA). The people in GERDA are all ≥85 years old. Trained investigators performed structured interviews and assessments. Information regarding medications and diagnoses was obtained from the participants and from medical records. Medical diagnoses were reviewed and confirmed by an experienced geriatrician.

Results
In this very old population, the prevalence of HF was 29.6% among women and 30.7% among men. Between 2000 and 2017, there was an increase in the use of renin-angiotensin (RAS) inhibitors (odds ratio [OR] 1.107, 95% confidence interval [CI] 1.072–1.144) and beta-blockers (BBs) (OR 1.123, 95% CI 1.086–1.161) among persons with HF, whereas the prevalence of loop diuretics (OR 0.899, 95% CI 0.868–0.931) and digitalis (OR 0.864, 95% CI 0.828–0.901) decreased (p < 0.001 for all drug classes). Higher age was associated with lower use of RAS inhibitors and BBs.

Conclusion
In this HF population, the use of evidence-based medications for HF increased over time. This may be a sign of better awareness among prescribers regarding the under-prescribing of guidelines-recommended treatment to old people. Higher age associated with a lower prevalence of RAS inhibitors and BBs. This might indicate that further improvement is possible but could also represent a more cautious prescribing among frail very old individuals.
Determining behavioral intention and its predictors toward preconception care use among reproductive age women in Arba Minch town, Southern Ethiopia, 2022: a cross-sectional study based on the theory of planned behavior
Authors: Tena Habtamu Alemu , Fikadu Kassahun , Birgoda Gebremariam Temesgen , Cherkos Abel Belete , Hadaro Tesfahun Simon , Lahole Begetayinoral Kussia 
Published: August 2024

Abstract
Background
Preconception care is a highly effective, evidence-based intervention aimed at promoting the health of reproductive-age women and reducing adverse pregnancy-related outcomes. The Ethiopian Ministry of Health plans to integrate preconception care services into the country’s existing healthcare system. However, women’s preferences may be influenced by their values and customs. Therefore, this study used the theory of planned behavior to assess women’s intention toward preconception care use and its predictors among reproductive-age women in Arba Minch town, southern Ethiopia.

Methods
A community-based cross-sectional study was conducted in Arba Minch town from May 1 to 30, 2022. A simple random sampling technique was employed to select 415 study participants for data collection. Data were collected through a face-to-face interview using a pretested, structured questionnaire. Epi Data version 4.6 and SPSS version 26 were used for the entry and analysis of data, respectively. Multiple linear regression was performed to identify independent predictors of intention to use preconception care. The standardized β-coefficient was used as a measure of association. A P value of less than 0.05 was used to declare statistical significance.

Results
This study had 415 participants, giving a response rate of 98.3%. The mean age of the participants was 28.4 (SD 5.18). The mean intention to use preconception care was 21.43 (SD 2.47). Direct perceived behavioral control (β = 0.263, p < 0.001), direct attitude (β = 0.201, p = 0.001), direct subjective norm (β = 0.158, p = 0.006), and age (β=-0.115, p = 0.023) were significant predictors of women’s behavioral intention to use preconception care.

Conclusion
The study identified perceived behavioral control as the strongest predictor, followed by attitude and subjective norms, influencing the intention to use preconception care. These findings underscore the importance of integrating these predictors into health intervention programs aimed at promoting the implementation of preconception care services.