bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of sociodemographic factors on parental health‐seeking behavior for illnesses among the pediatric age group in Karachi: A cross‐sectional study
Authors: Tarar Hamna Mukhtar , Azhar Ayesha , Ismail Kiran , Oduoye Malik Olatunde , Asim Omama , Omer Rida 
Published: May 2024

AbstractBackgroundHealth‐seeking behavior (HSB) is an individual's reaction to sickness, for which they seek medical attention, regardless of the form such care may take. Poor HSB is frequently associated with lower health outcomes and greater mortality and disease rates in a nation. Sociodemographic factors, including age, gender, family structure, occupation, ethnicity, and rates of literacy and poverty, can influence a person's HSB. This study would benefit Pakistani parents of the paediatric population to make more informed health choices for their children.AimThis study aims to determine the influence of sociodemographic factors on parental HSB for illnesses among the pediatric age group in Karachi.Materials and MethodsA cross‐sectional study was conducted in which 214 parents were interviewed about their choices for health‐seeking healthcare for their pediatric children of the pediatric age group (birth–18 years), who were attending the pediatric OPD and wards at Dr. Ruth Pfau Civil Hospital, Karachi in May 2023. Only parents or guardians with sick children were included. Their sociodemographic characteristics and health‐seeking choices were asked. Informed consent was obtained, and all data were recorded. SPSS version 25 was used for analysis.ResultsFor the first choice, the majority of parents (82.7%) preferred to seek healthcare for their children from medical doctors, followed by spiritual healers (10.7%), traditional healers (5.6%), and homoeopathic doctors (0.9%). For the second choice, the highest percentage was for a doctor (76.2%), followed by a spiritual healer (18.7%), a homoeopathic doctor (3.3%), and a traditional healer (1.9%). A significant correlation was found between the first visit and the decision makers (p = 0.019), the father's education level of the father (p = 0.001), the mother's occupation of the mother (p = 0.019), and the mother's education level of the mother (p = 0.001).ConclusionSociodemographic characteristics greatly influence parents' HSBs of parents for their children. Despite having low‐paying jobs and being uneducated, most people choose to refer to a doctor for their child due to awareness.
Level of and factors associated with foot self‐care among people with diabetes in Idlib Province of Northwest Syria: A cross‐sectional study
Authors: Al‐Ashkar Tareq , Alhussein Thaer , Eido Mohammad S. , Al‐Hassan Shaimaa , Alam Ali , Fathallah Maryam , Al‐Abdullah Muhammad , Alhiraki Omar , Al‐Busaidi Ibrahim S. 
Published: May 2024

AbstractBackground and aimsDiabetic foot and lower limb problems are among the most neglected complications during the Syrian armed conflict due to the absence of a functioning health infrastructure, including early detection and timely management of limb‐threatening wounds. This study aimed to determine self‐reported diabetes‐related foot disease (DRFD), adherence to recommended foot self‐care (FSC) practices, and associated factors among people with diabetes in war‐torn Northwest Syria (NWS).MethodsThis was a cross‐sectional study conducted at six primary care clinics in Idlib, NWS, between March 27 and April 17, 2022, utilizing the validated interviewer‐administered Diabetes Foot Disease and Foot Care Questionnaire. Data on demographic characteristics, DRFD, and FSC practices were collected. FSC score was determined by adding the points from all 12 FSC items, with a maximum score of 48, and were categorized into very poor (≤12), poor (13–24), moderate (25–36), and good (37–48). A convenience sample of 331 consecutive Syrians, aged ≥18 years, with diabetes, were invited. Multiple linear regression was used to identify variables associated with FSC practices.ResultsA total of 328 patients completed the questionnaire (response rate: 99.1%). The overall FSC score was average (mean total score 27.24, SD 7.03). Over one‐third (37.8%) had a very poor/poor score, 50.3% had an average score, and 11.9% had a good score. Household income/month of ≥51 USD (β = 2.6, 95% confidence interval [95% CI]:1.06–4.1, p = 0.001) and diabetes duration of ≥10 years (β = 1.8, 95% Cl: 0.2–3.4, p = 0.027) significantly predicted better FSC practice.ConclusionA significant proportion of participants had inadequate adoption FSC behaviors. Higher socioeconomic status was associated with better FSC practices. Future research should evaluate diabetic foot education and professional foot care in this population.
The importance of blood‐count‐derived inflammatory markers in predicting methotrexate success in patients with tubal ectopic pregnancy
Authors: Dereli Murat Levent , Savran Üçok Belgin , Özkan Sadullah , Sucu Sadun , Topkara Serap , Fıratlıgil Fahri Burçin , Ercan Emel Ebru , Uğur Merve , Akdaş Reis Yıldız , Engin Üstün Yaprak 
Published: May 2024

AbstractObjectiveTo investigate the systemic immune‐inflammation index (SII) and neutrophil‐to‐lymphocyte ratio (NLR) in predicting a successful methotrexate response in tubal ectopic pregnancy (TEP).MethodsWomen treated for TEP at a tertiary hospital between 2017 and 2021 were retrospectively reviewed. A total of 502 (100%) eligible patients who received methotrexate were included and divided into two groups based on whether or not they were successfully treated with methotrexate alone. Inflammatory parameters derived from the patients' hemograms at hospital admission were compared.ResultsIn total, 434 (86.4%) patients were successfully treated with methotrexate alone (Group 1), while 68 (13.6%) patients underwent surgery after methotrexate failure (Group 2). Median neutrophil count, NLR, platelet‐to‐lymphocyte ratio, monocyte‐to‐lymphocyte ratio, SII, largest ectopic mass diameter, and β‐human chorionic gonadotropin (β‐hCG) were significantly lower, whereas median lymphocyte and platelet counts were significantly higher in Group 1. According to the receiver operating characteristic analysis performed for the discriminatory power of NLR, β‐hCG, and SII for methotrexate response, the area under the curve values were 0.742, 0.730, and 0.699, respectively.ConclusionLow NLR and SII are associated with methotrexate success and could be used to refine decision making regarding β‐hCG for predicting successful response to methotrexate in patients with TEP.
Expecting the unexpected: Stressed scenarios for economic growth
Authors: González‐Rivera Gloria , Rodríguez‐Caballero C. Vladimir , Ruiz Esther 
Published: May 2024

SummaryWe propose the construction of conditional growth densities under stressed factor scenarios to assess the level of exposure of an economy to small probability but potentially catastrophic economic and/or financial scenarios, which can be either domestic or international. The choice of severe yet plausible stress scenarios is based on the joint probability distribution of the underlying factors driving growth, which are extracted with a multilevel dynamic factor model (DFM) from a wide set of domestic/worldwide and/or macroeconomic/financial variables. All together, we provide a risk management tool that allows for a complete visualization of the dynamics of the growth densities under average scenarios and extreme scenarios. We calculate growth‐in‐stress (GiS) measures, defined as the 5% quantile of the stressed growth densities, and show that GiS is a useful and complementary tool to growth‐at‐risk (GaR) when policymakers wish to carry out a multidimensional scenario analysis. The unprecedented economic shock brought by the COVID‐19 pandemic provides a natural environment to assess the vulnerability of US growth with the proposed methodology.
Ethnicity‐related differences in mitochondrial regulation by insulin stimulation in diabetes
Authors: Neikirk Kit , Kabugi Kinuthia , Mungai Margaret , Kula Bartosz , Smith Nathan , Hinton Antentor O. 
Published: May 2024

AbstractMitochondrial dysfunction has long been implicated in the development of insulin resistance, which is a hallmark of type 2 diabetes. However, recent studies reveal ethnicity‐related differences in mitochondrial processes, underscoring the need for nuance in studying mitochondrial dysfunction and insulin sensitivity. Furthermore, the higher prevalence of type 2 diabetes among African Americans and individuals of African descent has brought attention to the role of ethnicity in disease susceptibility. In this review, which covers existing literature, genetic studies, and clinical data, we aim to elucidate the complex relationship between mitochondrial alterations and insulin stimulation by considering how mitochondrial dynamics, contact sites, pathways, and metabolomics may be differentially regulated across ethnicities, through mechanisms such as single nucleotide polymorphisms (SNPs). In addition to achieving a better understanding of insulin stimulation, future studies identifying novel regulators of mitochondrial structure and function could provide valuable insights into ethnicity‐dependent insulin signaling and personalized care.
Expectancy from, and acceptance of augmented reality in dental education programs: A structural equation model
Authors: Toker Sacip , Akay Canan , Basmaci Fulya , Kilicarslan Mehmet Ali , Mumcu Emre , Cagiltay Nergiz Ercil 
Published: May 2024

AbstractObjectiveDental schools need hands‐on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior‐knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use.MethodsA correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience‐sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's ɑ, and composite reliability. Ten primary research hypotheses are tested with path analysis.ResultsA total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, β = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior‐knowledge readiness (B = −0.056, β = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior‐knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, β = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = −0.056, β = −0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior‐knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior‐knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, β = 0.046, L = 0.026, U = 0.086, p = 0.054).ConclusionInfrastructure and prior‐knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior‐knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands‐on experience and program performance by providing training options anywhere and anytime.
Nanomechanical collective vibration of SARS‐CoV‐2 spike proteins
Authors: Cao Changfeng , Zhang Guangxu , Li Xueling , Wang Yadi , Lü Junhong 
Published: May 2024

AbstractThe development of effective therapeutics against COVID‐19 requires a thorough understanding of the receptor recognition mechanism of the SARS‐CoV‐2 spike (S) protein. Here the multidomain collective dynamics on the trimer of the spike protein has been analyzed using normal mode analysis (NMA). A common nanomechanical profile was identified in the spike proteins of SARS‐CoV‐2 and its variants. The profile involves collective vibrations of the receptor‐binding domain (RBD) and the N‐terminal domain (NTD), which may mediate the physical interaction process. Quantitative analysis of the collective modes suggests a nanomechanical property involving large‐scale conformational changes, which explains the difference in receptor binding affinity among different variants. These results support the use of intrinsic global dynamics as a valuable perspective for studying the allosteric and functional mechanisms of the S protein. This approach also provides a low‐cost theoretical toolkit for screening potential pathogenic mutations and drug targets.
Discovery and mechanistic study of Imperatorin that inhibits HBsAg expression and cccDNA transcription
Authors: Ren Fang , Zhao Shiqiao , He Xin , Lo Hanghong , Wong Vincent Kam Wai , Law Betty Yuen Kwan , Wu Anguo , Zhang Juan 
Published: May 2024

AbstractChronic hepatitis B virus (HBV) infection remains a significant global health challenge due to its link to severe conditions like HBV‐related cirrhosis and hepatocellular carcinoma (HCC). Although current treatments effectively reduce viral levels, they have limited impact on certain HBV elements, namely hepatitis B surface antigen (HBsAg) and covalently closed circular DNA (cccDNA). This highlights the urgent need for innovative pharmaceutical and biological interventions that can disrupt HBsAg production originating from cccDNA. In this study, we identified a natural furanocoumarin compound, Imperatorin, which markedly inhibited the expression of HBsAg from cccDNA, by screening a library of natural compounds derived from Chinese herbal medicines using ELISA assay and qRT‐PCR. The pharmacodynamics study of Imperatorin was explored on HBV infected HepG2‐NTCP/PHHs and HBV‐infected humanized mouse model. Proteome analysis was performed on HBV infected HepG2‐NTCP cells following Imperatorin treatment. Molecular docking and bio‐layer interferometry (BLI) were used for finding the target of Imperatorin. Our findings demonstrated Imperatorin remarkably reduced the level of HBsAg, HBV RNAs, HBV DNA and transcriptional activity of cccDNA both in vitro and in vivo. Additionally, Imperatorin effectively restrained the actions of HBV promoters responsible for cccDNA transcription. Mechanistic study revealed that Imperatorin directly binds to ERK and subsequently interfering with the activation of CAMP response element‐binding protein (CREB), a crucial transcriptional factor for HBV and has been demonstrated to bind to the PreS2/S and X promoter regions of HBV. Importantly, the absence of ERK could nullify the antiviral impact triggered by Imperatorin. Collectively, the natural compound Imperatorin may be an effective candidate agent for inhibiting HBsAg production and cccDNA transcription by impeding the activities of HBV promoters through ERK‐CREB axis.
The interplay between glucose and ketone bodies in neural stem cell metabolism
Authors: Molloy Joseph W. , Barry Denis 
Published: May 2024

AbstractGlucose is the primary energy source for neural stem cells (NSCs), supporting their proliferation, differentiation, and quiescence. However, the high demand for glucose during brain development often exceeds its supply, leading to the utilization of alternative energy sources including ketone bodies. Ketone bodies, including β‐hydroxybutyrate, are short‐chain fatty acids produced through hepatic ketogenesis and play a crucial role in providing energy and the biosynthetic components for NSCs when required. The interplay between glucose and ketone metabolism influences NSC behavior and fate decisions, and disruptions in these metabolic pathways have been linked to neurodevelopmental, neuropsychiatric, and neurodegenerative disorders. Additionally, ketone bodies exert neuroprotective effects on NSCs and modulate cellular responses to oxidative stress, energy maintenance, deacetylation, and inflammation. As such, understanding the interdependence of glucose and ketone metabolism in NSCs is crucial to understanding their roles in NSC function and their implications for neurological conditions. This article reviews the mechanisms of glucose and ketone utilization in NSCs, their impact on NSC function, and the therapeutic potential of targeting these metabolic pathways in neurological disorders.
Unearthing the therapeutic benefits of culinary‐medicinal mushrooms for humans: Emerging sustainable bioresources of 21st century
Authors: Thomas Lebin , Mago Payal 
Published: May 2024

AbstractGlobal interest in mushroom farming techniques has grown in the last few years. Despite not making up a large amount of the human diet at the moment, the nutritional worth of mushrooms has prompted their usage. The three main segments of the global mushroom industry are wild, culinary (edible), and medicinal mushrooms. The quality food that mushrooms provide can be utilized to build agricultural ecosystems that are more sustainable for increasing productivity and enhancing the effectiveness of resource usage. This is mostly because mushrooms can be utilized for the recycling of biomass and remains from crop production. Culinary‐medicinal mushrooms are becoming more and more important because of their nutrient density, dietary value, and health advantages. Given its many bioactive components, which include polysaccharides, proteins, vitamins, minerals, dietary fiber, and secondary metabolites, mushrooms have been utilized extensively as health foods. These mushrooms exhibit pharmacological activities and possess prebiotic and antibacterial capabilities. This review provides information on the latest advancements in the sustainable cultivation of mushrooms, particularly with nontraditional substrates, and their potential therapeutic uses. Furthermore, some of the newest developments and difficulties in the production of mushrooms are explored.
Bayesian pairwise meta‐analysis of time‐to‐event outcomes in the presence of non‐proportional hazards: A simulation study of flexible parametric, piecewise exponential and fractional polynomial models
Authors: Freeman Suzanne C. , Sutton Alex J. , Cooper Nicola J. , Gasparini Alessandro , Crowther Michael J. , Hawkins Neil 
Published: May 2024

AbstractBackgroundTraditionally, meta‐analysis of time‐to‐event outcomes reports a single pooled hazard ratio assuming proportional hazards (PH). For health technology assessment evaluations, hazard ratios are frequently extrapolated across a lifetime horizon. However, when treatment effects vary over time, an assumption of PH is not always valid. The Royston‐Parmar (RP), piecewise exponential (PE), and fractional polynomial (FP) models can accommodate non‐PH and provide plausible extrapolations of survival curves beyond observed data.MethodsSimulation study to assess and compare the performance of RP, PE, and FP models in a Bayesian framework estimating restricted mean survival time difference (RMSTD) at 50 years from a pairwise meta‐analysis with evidence of non‐PH. Individual patient data were generated from a mixture Weibull distribution. Twelve scenarios were considered varying the amount of follow‐up data, number of trials in a meta‐analysis, non‐PH interaction coefficient, and prior distributions. Performance was assessed through bias and mean squared error. Models were applied to a metastatic breast cancer example.ResultsFP models performed best when the non‐PH interaction coefficient was 0.2. RP models performed best in scenarios with complete follow‐up data. PE models performed well on average across all scenarios. In the metastatic breast cancer example, RMSTD at 50‐years ranged from −14.6 to 8.48 months.ConclusionsSynthesis of time‐to‐event outcomes and estimation of RMSTD in the presence of non‐PH can be challenging and computationally intensive. Different approaches make different assumptions regarding extrapolation and sensitivity analyses varying key assumptions are essential to check the robustness of conclusions to different assumptions for the underlying survival function.
Preparation, characterization, and in vitro evaluation of microemulsion based cream formulations for the topical treatment of acne vulgaris
Authors: Çağlar Emre Şefik , Reis Rengin , Karadağ Ayşe Esra , Demirci Fatih , Sipahi Hande , Aydın Ahmet , Üstündağ Okur Neslihan 
Published: May 2024

AbstractBy lowering the significant adverse effects of traditional medications, this study intends to create cream formulations based on microemulsions that contain extract from Allium sativum L. for the treatment of acne vulgaris. Characterization experiments were carried out on the developed cream formulations based on microemulsions. Textural profile analysis and spreadability tests were conducted. Furthermore, cell culture studies and toxicity analysis were performed. As a result, the pH and viscosity values of the developed formulations were found between 6.43 ± 0.00 and 6.66 ± 0.01, and between 13.90 ± 0.080 and 137.20 ± 8.02 P, respectively. The highest‐performing empty and loaded cream formulations in terms of spreadability and textural profile analysis were those with the highest beeswax content. The highest‐performing empty and loaded cream formulations in terms of spreadability and textural profile analysis were those with the highest beeswax content. According to the visual physical evaluation of the formulations, it was observed that the developed formulations were neat, smooth, and homogeneous. The optimum formulation developed was non‐cytotoxic, which maintained cell viability by over 90%. Additionally, the skin irritation experiment was also non‐irritant with a relative cell viability of 92.6%. In conclusion, the developed A. sativum extract‐loaded microemulsion‐based cream formulations appear to be promising formulations for the acne vulgaris treatment, without malodors.
Flavonoids with lipase inhibitory activity from lemon squeezing waste: isolation, multispectroscopic and in silico studies
Authors: Cardullo Nunzio , Calcagno Damiano , Pulvirenti Luana , Sciacca Claudia , Pittalà Maria Gaetana Giovanna , Maccarronello Anna Elisabetta , Thevenard Fernanda , Muccilli Vera 
Published: May 2024

AbstractBACKGROUNDObesity is recognized as a lifestyle‐related disease and the main risk factor for a series of pathological conditions, including cardiovascular diseases, hypertension and type 2 diabetes. Citrus limon is an important medicinal plant, and its fruits are rich in flavonoids investigated for their potential in managing obesity. In the present work, a green extraction applied to lemon squeezing waste (LSW) was optimized to recover pancreatic lipase (PL) inhibitors.RESULTSThe microwave‐assisted procedure yielded an extract with higher lipase inhibitory activity than those obtained by maceration and ultrasound. The main compounds present in the extract were identified by high‐performance liquid chromatographic–mass spectrometric analysis, and hesperidin, eriocitrin and 4′‐methyllucenin II were isolated. The three compounds were evaluated for in vitro PL inhibitory activity, and 4′‐methyllucenin II resulted in the most promising inhibitor (IC50 = 12.1 μmol L−1; Ki = 62.2 μmol L−1). Multispectroscopic approaches suggested the three flavonoids act as competitive inhibitors and the binding studies indicated a greater interaction between PL and 4′‐methyllucenin II. Docking analysis indicated the significant interactions of the three flavonoids with the PL catalytic site.CONCLUSIONThe present work highlights flavonoid glycosides as promising PL inhibitors and proposes LSW as a safe ingredient for the preparation of food supplements for managing obesity. © 2024 Society of Chemical Industry.