bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double-dose investigation of aflibercept in neovascular age-related macular degeneration (DIANA): a real-world study
Authors: Zhang Min , Liu Xing , Gong Yuanyuan , Qian Tianwei , Zhou Hao , Wang Yimin , Wu Jiali , Sun Xiaodong , Yu Suqin 
Published: May 2024

Abstract
Background
To investigate the clinical effects of double-dose (4 mg) aflibercept treatment in neovascular age-related macular degeneration (nAMD), compared with the standard-dose (2 mg) treatment.

Methods
A total of 108 eyes from 97 patients with nAMD and received intravitreal aflibercept 2 mg and/or 4 mg treatment were retrospectively reviewed. The changes of central macular thickness (CMT)/ pigmental epithelium detachment height and the recurrence rate of exudation during the 12-month follow-up were compared between the 2 mg group and the 4 mg group. Self-control comparisons (2 mg switch to 4 mg) were also made between two regimens.

Results
Compared with the 2 mg group, tendencies of lower intraretinal fluid incidence and more CMT reduction were observed in the 4 mg group. The later one was also observed when eyes switching from 2 mg to 4 mg regimen. The median remission interval was 5 months in the 4 mg group, 2 months longer than the 3 months in the 2 mg group (P = 0.452). Injections needed in the 4 mg group were 3.644 ± 1.670, less than the 4.286 ± 2.334 injections in the 2 mg group within 12 months as well (P = 0.151). However, no associated vision benefits were gained from the double-douse regimen. No markedly increased-intraocular pressure events, or other adverse events were found in two groups.

Conclusions
Compared to the aflibercept 2 mg treatment in nAMD, tendencies of anatomic gains and relieving treatment burden were brought by the aflibercept 4 mg treatment. This study may have additional importance, given the further application of high-dose aflibercept in real-world settings.
Prevalence and correlates of depression, anxiety and trauma-like symptoms in Chinese psychiatric patients during the fifth wave of COVID-19 pandemic: a cross-sectional study in Hong Kong
Authors: Nam Chan Joe Kwun , Chang Don Ho Hin , Fung Vivian Shi Cheng , Ching Chui Eileena Mo , Wong Corine Sau Man , Chu Ryan Sai Ting , So Yuen Kiu , Chan Jacob Man Tik , Chung Albert Kar Kin , Lee Krystal Chi Kei , Cheng Calvin Pak Wing , Lo Heidi Ka Ying , Law Chi Wing , Chan Wai Chi , Chang Wing Chung 
Published: May 2024

Abstract
Background
Psychiatric patients are susceptible to adverse mental health outcome during COVID-19 pandemic, but its associated factors are understudied. This observational cross-sectional study aimed to comprehensively examine prevalence and correlates of psychological distress, in terms of depression, anxiety and post-traumatic-stress-disorder (PTSD)-like symptoms, among Chinese adult psychiatric outpatients amidst the peak of fifth COVID-19 wave in Hong-Kong.

Methods
A total of 415 patients (comprising 246 patients with common-mental-disorders [CMD] and 169 with severe-mental-disorders [SMD]) and 399 demographically-matched controls without mental disorders were assessed with self-rated questionnaires between 28-March and 8-April-2022, encompassing illness profile, mental health symptoms, psychosocial measures (loneliness, resilience, coping styles) and COVID-19 related factors. Univariate and multivariable logistic regression analyses were conducted to determine variables associated with moderate-to-severe depressive, anxiety and PTSD-like symptoms among psychiatric patients.

Results
Our results showed that CMD patients had the greatest psychological distress relative to SMD patients and controls. Approximately 40–55% CMD patients and 25% SMD patients exhibited moderate-to-severe depression, anxiety and PTSD-like symptoms. Multivariable regression analyses revealed that female gender, lower educational attainment, single marital status, being housewife, more severe insomnia, psychotic-like symptoms and cognitive complaints, self-harm behavior, lower resilience, avoidance coping, never contracting COVID-19 infection, greater fear of contagion, and longer exposure to pandemic-related information were independently associated with depression, anxiety and/or PTSD-like symptoms in psychiatric patients.

Conclusions
Our results affirm increased vulnerability of psychiatric patients toward psychological distress during pandemic. An array of identified correlates facilitates early detection of high-risk psychiatric patients for targeted strategies to minimize pandemic-related negative psychological impact.
Living in urban or rural environments affect the sleep quality of the elderly in Bushehr (Southern Iran): emphasizing the active and inactive of the elderly
Authors: Delbari Ahmad , Ahmadi Fatemeh , Zar Abdossaleh , Zandvakili Atousa , Sadeghipour Hamid Reza , Sims Jamie 
Published: May 2024

Abstract
Introduction
Sleep disorders have a significant negative impact on mental and physical health, especially among the elderly. Various factors can affect the sleep quality of elderly people. The aim of this research to investigate the effect of urban and rural environments on the sleep quality of elderly people with emphasis on physical activity.

Method
Four hundred and thirty-nine elderly people (226 city residents and 213 village residents) in urban and rural areas of Bushehr (Southern Iran), volunteered to participate in the present study. Information was collected via the General information questionnaire and Petersburg Sleep Questionnaire.

Result
The results showed that active elderly women (p < 0.001), and total active elderly (male + female) (p < 0.001) living in urban areas compared to inactive elderly and also in rural areas active elderly women (p < 0.001), active elderly men (p < 0.001) and total active elderly (male + female) (p < 0.001) had better overall sleep quality in compared to inactive elderly. Also, elderly men (p < 0.001) and the total elderly (male + female) (p < 0.001) living in urban areas had better sleep quality than the elderly in rural areas.

Conclusion
Based on the findings, it can be concluded that the way of life (being active) as well as the living environment can affect the sleep quality of elderly people, so that active elderly people and also elderly people living in urban environments had better sleep quality.
The impact of healthy nutrition education based on traffic light labels on food selection, preference, and consumption in patients with acute coronary syndrome: a randomized clinical trial
Authors: Sadeghi Fereshteh , Pashaeypoor Shahzad , Nikpajouh Akbar , Negarandeh Reza 
Published: May 2024

Abstract
Background
Acute Coronary Syndrome is the most common heart disease and the most significant cause of death and disability-adjusted life years worldwide. Teaching a healthy eating style is one preventive measure to prevent the disease’s recurrence. This study aimed to determine the effect of healthy nutrition education with the help of traffic light labels on food selection, preference, and consumption in patients with acute coronary syndrome.

Methods
This randomized, single-blinded clinical trial was conducted with 139 participants (66 in the intervention group and 73 in the control group) from January 2021 to August 2021 in Shaheed Rajaie Hospital, Tehran, Iran. The control group received standard training. The intervention group, besides this, received additional bedside training with an educational poster on traffic light labels from the research team during their final hospitalization days. Data were collected using a researcher-made questionnaire on food selection, preference, and consumption.

Results
The Brunner-Munzel test showed no significant difference between the two groups in terms of selection (P = 0.127), preference (P = 0.852), and food consumption (P = 0.846) in the baseline, while after the intervention, there were significant differences in selection (P > 0.001), preference (P > 0.001), and consumption (p < 0.004). Comparing the difference between the two groups in the difference between the before and after scores for selection (p < 0.001), preference (p < 0.001), and food consumption (p = 0.011) with the Brunner-Munzel test indicated a significant difference in all outcome variables.

Conclusions
Teaching healthy eating styles with the help of traffic light labels affected food selection, preference, and consumption and led to healthier diets in these patients.

Clinical trial registration number
Clinical trial registration: It was prospectively registered in the Iran Clinical Trials Registration Center on this date 30/10/2020 (IRCT20200927048857N1).
Parental hesitancy toward children vaccination: a multi-country psychometric and predictive study
Authors: Sharif-Nia Hamid , She Long , Allen Kelly-Ann , Marôco João , Kaur Harpaljit , Arslan Gökmen , Gorgulu Ozkan , Osborne Jason W. , Rahmatpour Pardis , Khoshnavay Fomani Fatemeh 
Published: May 2024

Abstract
Aim
Understanding vaccine hesitancy, as a critical concern for public health, cannot occur without the use of validated measures applicable and relevant to the samples they are assessing. The current study aimed to validate the Vaccine Hesitancy Scale (VHS) and to investigate the predictors of children’s vaccine hesitancy among parents from Australia, China, Iran, and Turkey. To ensure the high quality of the present observational study the STROBE checklist was utilized.

Design
A cross-sectional study.

Method
In total, 6,073 parent participants completed the web-based survey between 8 August 2021 and 1 October 2021. The content and construct validity of the Vaccine Hesitancy Scale was assessed. Cronbach’s alpha and McDonald’s omega were used to assess the scale’s internal consistency, composite reliability (C.R.) and maximal reliability (MaxR) were used to assess the construct reliability. Multiple linear regression was used to predict parental vaccine hesitancy from gender, social media activity, and perceived financial well-being.

Results
The results found that the VHS had a two-factor structure (i.e., lack of confidence and risk) and a total of 9 items. The measure showed metric invariance across four very different countries/cultures, showed evidence of good reliability, and showed evidence of validity. As expected, analyses indicated that parental vaccine hesitancy was higher in people who identify as female, more affluent, and more active on social media.

Conclusions
The present research marks one of the first studies to evaluate vaccine hesitancy in multiple countries that demonstrated VHS validity and reliability. Findings from this study have implications for future research examining vaccine hesitancy and vaccine-preventable diseases and community health nurses.
Quantitative analysis of the effects of brushing, flossing, and mouthrinsing on supragingival and subgingival plaque microbiota: 12-week clinical trial
Authors: Min Kyungrok , Bosma Mary Lynn , John Gabriella , McGuire James A. , DelSasso Alicia , Milleman Jeffery , Milleman Kimberly R. 
Published: May 2024

AbstractBackgroundTranslational microbiome research using next-generation DNA sequencing is challenging due to the semi-qualitative nature of relative abundance data. A novel method for quantitative analysis was applied in this 12-week clinical trial to understand the mechanical vs. chemotherapeutic actions of brushing, flossing, and mouthrinsing against the supragingival dental plaque microbiome. Enumeration of viable bacteria using vPCR was also applied on supragingival plaque for validation and on subgingival plaque to evaluate interventional effects below the gingival margin.MethodsSubjects with gingivitis were enrolled in a single center, examiner-blind, virtually supervised, parallel group controlled clinical trial. Subjects with gingivitis were randomized into brushing only (B); brushing and flossing (BF); brushing and rinsing with Listerine® Cool Mint® Antiseptic (BA); brushing and rinsing with Listerine® Cool Mint® Zero (BZ); or brushing, flossing, and rinsing with Listerine® Cool Mint® Zero (BFZ). All subjects brushed twice daily for 1 min with a sodium monofluorophosphate toothpaste and a soft-bristled toothbrush. Subjects who flossed used unflavored waxed dental floss once daily. Subjects assigned to mouthrinses rinsed twice daily. Plaque specimens were collected at the baseline visit and after 4 and 12 weeks of intervention. Bacterial cell number quantification was achieved by adding reference amounts of DNA controls to plaque samples prior to DNA extraction, followed by shallow shotgun metagenome sequencing.Results286 subjects completed the trial. The metagenomic data for supragingival plaque showed significant reductions in Shannon-Weaver diversity, species richness, and total and categorical bacterial abundances (commensal, gingivitis, and malodor) after 4 and 12 weeks for the BA, BZ, and BFZ groups compared to the B group, while no significant differences were observed between the B and BF groups. Supragingival plaque vPCR further validated these results, and subgingival plaque vPCR demonstrated significant efficacy for the BFZ intervention only.ConclusionsThis publication reports on a successful application of a quantitative method of microbiome analysis in a clinical trial demonstrating the sustained and superior efficacy of essential oil mouthrinses at controlling dental plaque compared to mechanical methods. The quantitative microbiological data in this trial also reinforce the safety and mechanism of action of EO mouthrinses against plaque microbial ecology and highlights the importance of elevating EO mouthrinsing as an integral part of an oral hygiene regimen.Trial registrationThe trial was registered on ClinicalTrials.gov on 31/10/2022. The registration number is NCT05600231.
Mothers’ experiences living with diastasis recti abdominis – an interview study
Authors: Marander Viktoria , Råheim Målfrid , Haukenes Inger , Theodorsen Nina-Margrethe 
Published: May 2024

Abstract
Background
Diastasis recti abdominis (DRA) is a common postpartum condition. Knowledge is scarce on how mothers perceive living with DRA. The interaction between healthcare providers and patients plays a significant role in shaping the healthcare service experience. Women suffering from typical women’s diseases tend to experience not being taken seriously or listened to when seeking healthcare. The aim of this study was to explore mothers’ experiences living with DRA.

Methods
Semi-structured individual interviews were conducted with six Norwegian mothers, age 32–41, presenting with a clinically significant DRA. Topics discussed were how the condition is experienced, how it affects different aspects of day-to-day life and experiences with healthcare services. The data was analyzed using systematic text condensation.

Results
DRA had an impact on everyday life among the mothers included in this study. Three major themes emerged: (I) The path to obtaining knowledge and understanding of DRA, (II) DRA - intertwined with health issues and physical limitations and (III) A changed belly – on self-image & social interactions. The mothers experienced uncertainties and frustration when trying to learn about DRA. The limited knowledge of the condition made it hard to differentiate if the experienced symptoms were caused by presence of DRA or from other health issues. Several mothers felt misunderstood.

Conclusion
DRA is a multifaceted condition affecting many aspects of day-to-day life in various dimensions, like physical, emotional, and social. This study contributes to a wider understanding of living with DRA, which might guide healthcare professionals in providing support for mothers with this condition.
Efficacy and safety of chemotherapy as monotherapy in patients with recurrent intermediate/high-risk factors following radical hysterectomy for stage IB-IIA cervical cancer: a single-center retrospective analysis
Authors: Dong Bei , Zhou Su-Fang 
Published: May 2024

Abstract
Objective
The aim of this study is to explore the efficacy and safety of chemotherapy (CT) as a monotherapy in patients with recurrent intermediate/high-risk factors following radical hysterectomy for stage IB-IIA cervical cancer.

Methods
A retrospective analysis was conducted on the medical records of patients diagnosed with stage IB-IIA cervical cancer who underwent radical hysterectomy at the People’s Hospital of Suzhou High-tech District between 2010 and 2020. A total of 66 patients with intermediate or high-risk factors for recurrence were treated exclusively with CT. This cohort included 42 patients in the intermediate-risk group and 24 in the high-risk group. Treatment protocols consisted of 4–6 cycles of paclitaxel and cisplatin drugs for the intermediate-risk group, and 6 cycles for the high-risk group. The relapse-free survival (RFS), recurrence rates, and common CT-related adverse reactions, including bone marrow suppression, nausea and vomiting, and diarrhea, were assessed for both groups.

Results
(1) The cumulative 3-year RFS rates for the intermediate-risk and high-risk groups were 97.3% (36/37) and 82.4% (14/17), respectively, with cumulative 5-year RFS rates of 97.1% (34/35) and 82.4% (14/17), respectively. The Log rank test revealed no significant difference between the two groups (P > 0.05), (χ² = 2.718, P = 0.099). The 5-year recurrence rates in the intermediate-risk and high-risk groups were 2.38% (1/42) and 12.50% (3/24), respectively. (2) The incidence of grade III bone marrow suppression in the intermediate-risk and high-risk groups was 21.19% (11/42) and 25.00% (6/24), respectively, while the incidence of grade IV bone marrow suppression was 11.90% (5/42) and 8.33% (2/24), respectively. There was no statistically significant difference in bone marrow suppression grades between the two groups (P > 0.05).

Conclusion
CT with paclitaxel and cisplatin, administered as monotherapy post-radical hysterectomy for stage IB-IIA cervical cancer, demonstrates satisfactory survival benefits with an acceptable safety profile. Moreover, no significant differences were observed in prognosis or adverse reactions between the different risk groups treated solely with CT.
Efficacy of supplementing Aspergillus awamori in enhancing growth performance, gut microbiota, digestibility, immunity, and antioxidant activity of heat-stressed broiler chickens fed diets containing olive pulp
Authors: Abdel-Moneim Abdel-Moneim Eid , Khidr Raafat S. , Badran Aml M. M. , Amin Shimaa A. , Badri Faisal B. , Gad Ghada G. , Thabet Hany A. , Elbaz Ahmed M. 
Published: May 2024

Abstract
Background
Gut microbes play a significant role in digestion, developing immunity, and intestinal health. Therefore, direct-fed microbials are used to modify gut microbiota, maintain a healthy digestive system, enhance immunity, and promote the broilers’ performance. In addition, it has a role in improving the utilization of unconventional feed ingredients (olive pulp, OP). This study provides the potential role of Aspergillus awamori in enhancing gut microbial content, nutrient utilization, growth performance, and antioxidative status in heat-stressed broiler chickens fed diets containing olive pulp.

Methods
Three hundred chicks (Ross 308; one day old) were divided into four treatment groups (75 chick/ group) randomly, as follows; CON: chicks fed a basal diet based on corn and soybean meal, OP10: chicks fed a diet containing 10% OP, OA1: chicks fed a diet containing OP with A. awamori at 100 mg per kg, OA2: chicks fed a diet containing OP with A. awamori at 200 mg per kg.

Results
Adding A. awamori to the broiler diet that contains OP had a positive effect on productive performance via enhancing nutrition digestibility, body weight gain, feed conversion ratio, and carcass characteristics. A. awamori supplementation had a positive impact on immune responses by increasing serum immunoglobulin G and the relative weight of bursa of Fabricius (P < 0.05) compared to the other groups. Chickens fed A. awamori showed a noticeable improvement in the oxidative status through the increase in the level of serum superoxide dismutase, and glutathione peroxidase, and the decrease in the level of malondialdehyde. Feeding A. awamori also modified the intestinal microbial content by increasing the population of Lactobacillus (P < 0.05).

Conclusions
Our study indicated that adding 200 mg A. awamori reduced the negative effect of heat stress by modifying the microbial content of the intestine, immune response, and enhancing feed utilization, thus improving broiler performance, as well as, improving the nutritional value of the olive pulp. Therefore, adding A. awamori to the OP diet can be effectively used in heat-stressed broiler diets.
Aging and cancer
Authors: Montégut Léa , López-Otín Carlos , Kroemer Guido 
Published: May 2024

AbstractAging and cancer exhibit apparent links that we will examine in this review. The null hypothesis that aging and cancer coincide because both are driven by time, irrespective of the precise causes, can be confronted with the idea that aging and cancer share common mechanistic grounds that are referred to as ‘hallmarks’. Indeed, several hallmarks of aging also contribute to carcinogenesis and tumor progression, but some of the molecular and cellular characteristics of aging may also reduce the probability of developing lethal cancer, perhaps explaining why very old age (> 90 years) is accompanied by a reduced incidence of neoplastic diseases. We will also discuss the possibility that the aging process itself causes cancer, meaning that the time-dependent degradation of cellular and supracellular functions that accompanies aging produces cancer as a byproduct or ‘age-associated disease’. Conversely, cancer and its treatment may erode health and drive the aging process, as this has dramatically been documented for cancer survivors diagnosed during childhood, adolescence, and young adulthood. We conclude that aging and cancer are connected by common superior causes including endogenous and lifestyle factors, as well as by a bidirectional crosstalk, that together render old age not only a risk factor of cancer but also an important parameter that must be considered for therapeutic decisions.
Nonlinear association of triglyceride-glucose index with hyperuricemia in US adults: a cross-sectional study
Authors: Qiu Linjie , Ren Yan , Li Jixin , Li Meijie , Li Wenjie , Qin Lingli , Ning Chunhui , Zhang Jin , Gao Feng 
Published: May 2024

Abstract
Background
Despite abundant evidence on the epidemiological risk factors of metabolic diseases related to hyperuricemia, there is still insufficient evidence regarding the nonlinear relationship between triglyceride-glucose (TyG) index and hyperuricemia. Thus, the purpose of this research is to clarify the nonlinear connection between TyG and hyperuricemia.

Methods
From 2011 to 2018, a cross-sectional study was carried out using data from the National Health and Nutrition Examination Survey (NHANES). This study had 8572 participants in all. TyG was computed as Ln [triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The outcome variable was hyperuricemia. The association between TyG and hyperuricemia was examined using weighted multiple logistic regression, subgroup analysis, generalized additive models, smooth fitting curves, and two-piecewise linear regression models.

Results
In the regression model adjusting for all confounding variables, the OR (95% CI) for the association between TyG and hyperuricemia was 2.34 (1.70, 3.21). There is a nonlinear and reverse U-shaped association between TyG and hyperuricemia, with a inflection point of 9.69. The OR (95% CI) before the inflection point was 2.64 (2.12, 3.28), and after the inflection point was 0.32 (0.11, 0.98). The interaction in gender, BMI, hypertension, and diabetes analysis was statistically significant.

Conclusion
Additional prospective studies are required to corroborate the current findings, which indicate a strong positive connection between TyG and hyperuricemia among adults in the United States.