bluuebunny/crossref_metadata_2025_split huggingface dataset:
Menstrual hygiene management practice and associated factors among high school and preparatory school adolescent students in Debre Markos town, Northwest, Ethiopia: a mixed-method study
Authors: Worku Yichalem , Kassa Getachew Mullu , Mekonen Bekele , Desta Melaku , Bishaw Keralem Anteneh , Gedfaw Mihretie , Tesfaw Eyerus , Degu Genet , Shiferaw Aster 
Published: July 2024

Abstract
Background
Despite being a normal occurrence, menstruation requires hygienic care and is associated with a number of myths and wrongdoings. Menstrual hygiene issues have been linked to major health issues, such as urinary tract and reproductive tract infections. Consequently, the purpose of this study was to evaluate the management of menstrual hygiene and related aspects among teenage students in Debre Markos town, North West, Ethiopia.

Methods
From March 15 to April 15, 2019, teenage pupils in Debre Markos town participated in a cross-sectional mixed study. An in-depth interview and a self-administered structured questionnaire were used to gather data. Quantitative information was imported into Epi Data and then exported to SPSS for examination. A 95% Confidence Interval of p-value ≤ 0.05 was used to declare significance. The method of thematic content analysis was used to examine the qualitative data.

Result
This study comprised 531 individuals in total, with a 96.2% response rate. Approximately 260 adolescent females (49%, 95% CI: 39.2, 59.2) had good management practices for menstrual hygiene. Girls whose mothers were private employees (AOR: 0.3, 95% CI: 0.09, 0.99), self-employed (AOR: 0.52, 95% CI: 0.28, 0.98) and housewives (AOR: 0.53, 95% CI: 0.29, 0.98), and parent-adolescent discussions about menstruation (AOR: 1.62, 95% CI: 1.40, 3.34) were significantly associated with good menstrual hygiene management. Adolescence aged 17 years or older (AOR: 2.13, 95% CI: 1.32, 3.44) were found to have good knowledge regarding menstrual hygiene (AOR: 1.59, 95% CI: 1.43, 2.94). The qualitative study found that ignorance, an unfavorable school climate, and cultural and economic factors were the main causes of teenagers’ poor menstrual hygiene.

Conclusion
Nearly half of adolescent girls had good menstrual hygiene practice. Menstrual hygiene practice was associated with adolescent age, knowledge of menstruation, maternal occupational and discussion with parents. Girls had difficulty to manage menstrual hygiene due to poor knowledge, unsafe school environment, and cultural barriers. Thus, school-based programs aimed at improving knowledge towards menstrual hygiene management are needed.
Antiplasmodial potential of isolated xanthones from Mesua ferrea Linn. roots: an in vitro and in silico molecular docking and pharmacokinetics study
Authors: Konyanee Atthaphon , Chaniad Prapaporn , Chukaew Arnon , Payaka Apirak , Septama Abdi Wira , Phuwajaroanpong Arisara , Plirat Walaiporn , Punsawad Chuchard 
Published: July 2024

Abstract
Background
Malaria is a major global health concern, particularly in tropical and subtropical countries. With growing resistance to first-line treatment with artemisinin, there is an urgent need to discover novel antimalarial drugs. Mesua ferrea Linn., a plant used in traditional medicine for various purposes, has previously been investigated by our research group for its cytotoxic properties. The objective of this study was to explore the compounds isolated from M. ferrea with regards to their potential antiplasmodial activity, their interaction with Plasmodium falciparum lactate dehydrogenase (PfLDH), a crucial enzyme for parasite survival, and their pharmacokinetic and toxicity profiles.

Methods
The isolated compounds were assessed for in vitro antiplasmodial activity against a multidrug-resistant strain of P. falciparum K1 using a parasite lactate dehydrogenase (pLDH) assay. In vitro cytotoxicity against Vero cells was determined using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. The interactions between the isolated compounds and the target enzyme PfLDH were investigated using molecular docking. Additionally, pharmacokinetic and toxicity properties were estimated using online web tools SwissADME and ProTox-II, respectively.

Results
Among the seven compounds isolated from M. ferrea roots, rheediachromenoxanthone (5), which belongs to the pyranoxanthone class, demonstrated good in vitro antiplasmodial activity, with the IC50 being 19.93 µM. Additionally, there was no toxicity towards Vero cells (CC50 = 112.34 µM) and a selectivity index (SI) of 5.64. Molecular docking analysis revealed that compound (5) exhibited a strong binding affinity of − 8.6 kcal/mol towards PfLDH and was stabilized by forming hydrogen bonds with key amino acid residues, including ASP53, TYR85, and GLU122. Pharmacokinetic predictions indicated that compound (5) possessed favorable drug-like properties and desired pharmacokinetic characteristics. These include high absorption in the gastrointestinal tract, classification as a non-substrate of permeability glycoprotein (P-gp), non-inhibition of CYP2C19, ease of synthesis, a high predicted LD50 value of 4,000 mg/kg, and importantly, non-hepatotoxic, non-carcinogenic, and non-cytotoxic effects.

Conclusions
This study demonstrated that compounds isolated from M. ferrea exhibit activity against P. falciparum. Rheediachromenoxanthone has significant potential as a scaffold for the development of potent antimalarial drugs.
The sensitivity outcome index system for home care of elderly liver transplant patients was developed based on the Omaha problem classification system
Authors: Wang Bin , Huang Xia , Liu Guofang , Zheng Taohua , Lin Hui , Qiao Yue , Sun Wenjuan 
Published: July 2024

Abstract
Objective
Based on the Omaha problem classification system, a sensitivity outcome index system for home nursing of elderly liver transplant patients was established.

Methods
Through a comprehensive literature review and rigorous application of the Delphi method, a panel of 20 experts completed two rounds of effective letter consultation to obtain expert consensus opinions. The contents of indicators were determined based on this process, and the analytic hierarchy process was employed to confirm the weightage assigned to each indicator. Consequently, we established a sensitivity outcome index system for home care in elderly liver transplant patients.

Results
The effective recovery rate of the questionnaire in two rounds of expert consultation was 100%, and the proportion of experts who gave opinions was 55% and 15%, respectively, indicating that the experts were highly active. The expert authority coefficients were calculated as 0.904 and 0.905, respectively, indicating a high degree of expert authority. In the second round, Kendall’s coordination coefficients for primary, secondary, and tertiary indicators were determined to be 0.419, 0.418, and 0.394 (P < 0.001), indicating that expert opinions tended to be consistent. Finally, we established a comprehensive sensitivity outcome index system comprising 4 first-level indexes, 20 s-level indexes, and 72 third-level indexes specifically designed for elderly liver transplantation patients.

Conclusion
The sensitivity outcome index system of home nursing for elderly liver transplant patients can provide theoretical basis for nursing staff to build accurate individualized continuous nursing model.
Residual effect of sequential 4-channel neuromuscular electrical stimulation evaluated by high-resolution manometry
Authors: Lim Jiwoon , Hyun Sung Eun , Kim Hayoung , Ryu Ju Seok 
Published: July 2024

Abstract
Background
High-resolution manometry (HRM) can quantify swallowing pathophysiology to evaluate the status of the pharynx. Sequential 4-channel neuromuscular electrical stimulation (NMES) was recently developed based on the normal contractile sequences of swallowing-related muscles. This study aimed to examine the effects of sequential 4-channel NMES for compensatory application during swallowing and to observe the residual effects after the application of NMES using HRM.

Results
Sequential 4-channel NMES significantly improved the HRM parameters, with respect to the maximal pressure and area of the velopharynx (VP), maximal pressure and area of the mesopharynx (MP), and upper esophageal sphincter (UES) activation and nadir duration. Furthermore, the improvement in the pressure and area variables of the VP and MP showed a tendency to maintain even when measured after NMES, but there are no significant differences.

Conclusions
The present study suggests that the sequential 4-channel NMES application of the suprahyoid and infrahyoid muscles during swallowing improves the pressure, area, and time variables of the oropharynx, as measured by HRM, and it is likely that the effects may persist even after stimulation.
Trial Registration Clinicaltrials.gov, registration number: NCT02718963 (initial release: 03/20/2016, actual study completion date: 06/24/2016, last release: 10/20/2020).
Global profiling of protein lactylation in microglia in experimental high-altitude cerebral edema
Authors: Jiang Xiufang , Gao Jiayue , Fei Xuechao , Geng Yanan , Yue Xiangpei , Shi Zibi , Cheng Xiang , Zhao Tong , Fan Ming , Wu Haitao , Zhao Ming , Zhu Lingling 
Published: July 2024

Abstract
Background
High-altitude cerebral edema (HACE) is considered an end-stage acute mountain sickness (AMS) that typically occurs in people after rapid ascent to 2500 m or more. While hypoxia is a fundamental feature of the pathophysiological mechanism of HACE, emerging evidence suggests that inflammation serves as a key risk factor in the occurrence and development of this disease. However, little is known about the molecular mechanism underlying their crosstalk.

Methods
A mouse HACE model was established by combination treatment with hypobaric hypoxia exposure and lipopolysaccharides (LPS) stimulation. Lactylated-proteomic analysis of microglia was performed to reveal the global profile of protein lactylation. Molecular modeling was applied to evaluate the 3-D modeling structures. A combination of experimental approaches, including western blotting, quantitative real-time reverse transcriptionpolymerase chain reaction (qRT-PCR), and enzyme-linked immunosorbent assay (ELISA), confocal microscopy and RNA interference, were used to explore the underlying molecular mechanisms.

Results
We found that hypoxia exposure increased the lactate concentration and lactylation in mouse HACE model. Moreover, hypoxia aggravated the microglial neuroinflammatory response in a lactate-dependent manner. Global profiling of protein lactylation has shown that a large quantity of lysine-lactylated proteins are induced by hypoxia and preferentially occur in protein complexes, such as the NuRD complex, ribosome biogenesis complex, spliceosome complex, and DNA replication complex. The molecular modeling data indicated that lactylation could affect the 3-D theoretical structure and increase the solvent accessible surface area of HDAC1, MTA1 and Gatad2b, the core members of the NuRD complex. Further analysis by knockdown or selectively inhibition indicated that the NuRD complex is involved in hypoxia-mediated aggravation of inflammation.

Conclusions
These results revealed a comprehensive profile of protein lactylation in microglia and suggested that protein lysine lactylation plays an important role in the regulation of protein function and subsequently contributes to the neuroinflammatory response under hypoxic conditions.
Serological response after COVID-19 infection compared to vaccination against COVID-19 in children with autoimmune rheumatic diseases
Authors: Šinkovec Savšek Tjaša , Zajc Avramovič Mojca , Avčin Tadej , Korva Miša , Avšič-Županc Tatjana , Toplak Nataša 
Published: July 2024

Abstract
Background
Paediatric patients with autoimmune rheumatic diseases (pARD) have a dysregulated immune system, so infections present a major threat to them. To prevent severe COVID-19 infections we aimed to vaccinate them as soon as possible. Studies have shown that the BNT162b2 vaccine is safe, effective, and immunogenic, however, in a short observation period, only.

Methods
The main objective was to compare the serological response between three groups of pARD: after SARS-CoV-2 infection, after vaccination against COVID-19 with two doses of the BNT162b2 vaccine, and after experiencing both events. Data on demographics, diagnosis, therapy, and serology (anti-SARS-CoV-2 IgG/IgA) were collected from March 2020 to April 2022. For statistical analysis ANOVA, Mann-Whitney U test, Chi-square test and Fisher’s exact test were applied. To compare adverse events (AE) after vaccination we included a control group of healthy adolescents.

Results
We collected data from 115 pARD; from 92 after infection and 47 after vaccination. Twenty-four were included in both groups. Serological data were available for 47 pARD after infection, 25 after vaccination, and 21 after both events. Serological response was better after vaccination and after both events compared to after infection only. No effect of medication on the antibody levels was noted. The safety profile of the vaccine was good. Systemic AE after the first dose of the vaccine were more common in healthy adolescents compared to pARD. In the observation period of 41.3 weeks, 60% of vaccinated pARD did not experience a symptomatic COVID-19 infection.

Conclusions
IgG and IgA anti-SARS-CoV-2 levels were higher after vaccination and after both events compared to after infection only. Six months after vaccination we observed an increase in antibody levels, suggesting that pARD had been exposed to SARS-CoV-2 but remained asymptomatic.

Trial registration
The study was approved by the Medical Ethics Committee of the Republic of Slovenia (document number: 0120–485/2021/6).
Management strategies for Docking Site refractures: a comparative analysis of 19 patient cases
Authors: Hamiti Yimurang , Abudureyimu Patiman , Lyu Gang , Yusufu Aihemaitijiang , Yushan Maimaiaili 
Published: July 2024

Abstract
Aims
This study aimed to compare the clinical effectiveness of intramedullary nailing (IMN), percutaneous external plate fixation (PEPF), and re-applied external fixation (REF) in the treatment of refracture at the consolidated docking site following the removal of external fixation in patients with tibial defects who had previously undergone the Ilizarov bone transport technique.

Methods
A retrospective review was performed on patients who received IMN, PEPF, or REF for refracture at the consolidated docking site subsequent to the removal of external fixation. A collection of data was made regarding the following parameters: age, gender, defect size, treatment methods, external fixation time (EFT), external fixation index (EFI), time of refracture (TOR) subsequent to fixation removal, and docking reunion time (DRT). Bone and functional outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system and the Lower Extremity Functional Scale (LEFS) questionnaire.

Results
The study included 14 males and 5 females with an average age of 38.1 ± 8.9 years (range, 26 to 55 years). Etiologies included post-traumatic osteomyelitis in 11 cases and post-traumatic bone loss in 8 cases. The median bone defect was 5.11 ± 0.87 cm (range, 3.8 to 6.8 cm). Following docking site refracture, 6 cases were treated with IMN, 8 with PEPF, and 5 with REF. All patients achieved both satisfactory bone union and functional outcomes, and there was no significant difference in preoperative baseline data or postoperative outcomes among the three groups.

Conclusion
IMN, PEPF, and REF were all demonstrated favorable postoperative bone and functional outcomes, suggesting their reliability as treatment options for managing docking site refracture following external fixation removal.
HDG methods for the unilateral contact problem
Authors: Zhao Mingyang , Zhou Liangjin 
Published: July 2024

AbstractThis article presents the HDG approximation as a solution to the unilateral contact problem, leveraging the regularization method and an iterative procedure for resolution. In our study, u represents the potential (displacement of the elastic body) and q represents the flux (the force exerted on the body). Our analysis establishes that the utilization of polynomials of degree $k (k \ge 1)$
k
(
k
≥
1
)
leads to achieving an optimal convergence rate of order $k+1$
k
+
1
in $L^{2}$

L
2

-norm for both u and q. Importantly, this optimal convergence is maintained irrespective of whether the domain is discretized through a structured or unstructured grid. The numerical results consistently align with the theoretical findings, underscoring the effectiveness and reliability of the proposed HDG approximation method for unilateral contact problems.
Flexural Improvement of RC Slabs by FRP or Steel Using Different Strengthening Systems and Novel Anchoring Techniques
Authors: Makhlouf Mohamed H. , El-Azab Ibrahim A. , Mansour M. H. 
Published: July 2024

AbstractAn experimental study on reinforced concrete one-way slabs strengthened by various methods and materials is introduced in this paper. Innovative anchorage procedures are presented and evaluated to prevent the strengthening elements with FRP system from de-bonding at the initial stages. Externally bonded embedded in concrete cover (EBECC) strengthening technology was proposed to save the fiber strips from being subjected to heat, degradation, and sabotage. Nine RC one-way slabs, including a control slab and eight strengthened slabs, were cast. One RC slab was strengthened using externally bonded embedded in concrete cover (EBECC), whereas the other tested RC slabs were strengthened using either externally bonded (EB) or near-surface mounted (NSM) procedures. The following test variables are used in this study: the proposed anchors, the area of steel, the kind of material utilized in NSM rods (carbon fiber reinforced polymer (CFRP), glass fiber reinforced polymer (GFRP), and steel), and the strengthening scheme. The ultimate and initial cracking loads, load–deformation response, cracking patterns, and failure behavior were recorded and discussed. Additionally, a comparison of the stiffness, ductility, and energy absorption of the examined slabs was reported. The strengthened slabs by various techniques showed a boost in flexural strength that varied from 67 to 107% compared to the control slab. In addition, RC slabs strengthened by NSM-CFRP bars showed a maximum flexural capacity when compared with slabs strengthened by GFRP and steel bars. Also, the results supported the superiority of a novel end anchorage. The ABAQUS program was employed to conduct a finite element analysis (FEA) employing 3-D geometries to compare and assess the numerical performance of the identical slabs under similar test settings. The results showed good agreement between the experimental and numerical findings.
Diet quality in medical trainees: a cross-sectional assessment comparing medical students and primary care residents using the Rapid Eating Assessment for Participants—shortened version
Authors: Khandalavala Birgit , Emig Stephanie , Yousef Mira , Geske Jenenne 
Published: July 2024

Abstract
Background
The diet quality of the US population is significantly unhealthy, with critical long-term implications for the nation’s health. A few studies have explored diet quality in the future primary care workforce. This cross-sectional study quantifies the diet quality of medical students and primary care residents at a Midwestern college of medicine in the United States.

Methods
250 medical students and 148 primary care residents were surveyed electronically utilizing the Rapid Eating Assessment for Participants—Shortened Version (REAP-S). The survey consists of 13 questions that can be scored on a scale from 1 to 3, along with 3 questions that are not scored. The average REAP-S score for a US omnivorous diet is 32 (range 13 to 39) with higher scores indicating a higher quality diet. We obtained average REAP-S scores for all respondents and descriptive summary statistics for individual REAP-S items. Students’ REAP-S total scores were compared to those of residents and the interaction between student/resident status and BMI category on REAP-S total scores were analyzed using analyses of variance. Differences between students and residents on BMI categories and other outcomes (individual REAP-S items, pandemic dietary and weight changes) were analyzed using Chi-Square Tests of Independence or Fisher’s Exact Tests.

Results
Medical students (n = 99; 39.6% response rate) had a significantly higher mean REAP-S score (30.5, SD = 3.9) than primary care residents (n = 72; 49% response rate) (mean = 28.6, SD = 3.9; p = 0.006). Total mean REAP-S scores were significantly higher for those with BMI < 25 (mean = 30.8, SD = 3.7) than for those with BMI > = 25 (mean = 28.3, SD = 4.0; p < 0.001). There was not a statistically significant interaction between role (student vs. resident) and BMI category on total REAP-S scores (p = 0.39). Most respondents (89.3%) indicated that they were willing to improve their diet.

Conclusion
Our data suggest that the diet quality of surveyed medical students and primary care residents, as quantified by the REAP-S, is suboptimal. Early detection and improvement of diet quality may be necessary for our medical profession trainees to avert potential long-term adverse cardiometabolic health outcomes, and to optimize the health of our future primary care workforce.
Swinepox virus: an unusual outbreak in free-range pig farms in Sicily (Italy)
Authors: Di Marco Lo Presti Vincenzo , Ippolito Dorotea , Cardeti Giusy , Cersini Antonella , Bertolotti Luigi , Amato Benedetta , Colitti Barbara , Giudice Chiara , Pruiti Ciarello Flavia , Vicari Domenico , Scicluna Maria Teresa , Capucchio Maria Teresa , Calogero Rosita , Fiasconaro Michele 
Published: July 2024

Abstract
Background
Two outbreaks of swinepox were investigated in free-range domestic pig farms located in the northeastern side of Sicily, Italy. The disease is generally self-limiting with a low mortality rate, but morbidity can reach high rates in case of poor sanitary conditions, improper husbandry practices and ectoparasitic infestation. The presented cases are the first ever reported on the island and part of the few cases reported in domestic pigs.

Case presentation
Carcasses condemned at the slaughterhouse and deceased pigs from Farm A and Farm B respectively, were referred for post-mortem examination and further investigations, with a strong suspect of SwinePox virus (SWPV) infection. Twelve deceased pigs were examined in total, showing poor body condition and pustular lesions scattered all over the cutaneous surfaces. Moreover, pigs from Farm B showed ocular lesions classified from Grade I to IV (from mild conjunctivitis to severe keratoconjunctivitis with corneal oedema, opacity, and ulcers). Final diagnosis was pursued by the microscopic assessment of skin lesions in both farms, which revealed the typical SWPV-lesion appearance, such as severe and disseminated ulcerative dermatitis and suspected inclusion bodies multifocally observed in the epidermis. Moreover, negative staining Electron Microscopy (nsEM) was performed on skin lesions and ocular swabs from Farm B, revealing in two samples the presence of brick-shaped viral particles, 220 nm long and 160 nm wide, with irregularly arranged surface tubules, identified as SWPV. The gene encoding the 482-bp fragment of the virus late transcription factor–3 was detected by PCR and sequencing revealed 99.79% identity and 100% query-cover with a strain previously isolated in Germany. Field clinical assessment was then performed in Farm B, revealing high overcrowding, poor sanitary conditions and improper husbandry practices, which are relevant risk factors for SWPV transmission.

Conclusions
The present is the first case report of SWPV in free-range pigs raised in Sicily, an island of the Southern coast of Italy, and wants to raise awareness on a neglected disease, and cause of animal health and welfare issues.