bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of extubation failure and factor associated among pediatrics patient admitted to Pediatrics intensive care unit at Tikur Anbessa Specialized Hospital, Ethiopia
Authors: Belayhun Yosef , Damtie Addisalem , Ambachew Semienew , Arega Gashaw 
Published: May 2024

Abstract

Introduction: a critical component of pediatrics intensive care therapy is mechanical ventilation. It is used when the patient spontaneous breathing is inadequate. In pediatrics ICU the need of mechanical ventilation range from 20% to over 60% depending on the setting. Respiratory failure is the primary indication for the initiation of ventilator support in pediatrics as a result of airway or lung disease, multi organ failure or for post-operative care.
Objective: To asses prevalence of extubation failure and factor associated with extubation failure among pediatrics patients (0-14years) admitted to PICU, At TASH, Ethiopia 2024.
Methods: facility based cross-sectional study was conducted among pediatrics patient (0-14 years) who had been admitted to TASH, PICU from September, 2019 to September, 2023 G, C. A total of 155 samples were included in the study. The data was collected using check list entered using Epi-info software and exported to SPSS version 25 and analyzed. Multivariable logistic regression analysis was used to identify factors associated with extubation failure. Variable with P value of < 0.05 were taken as statically significant Hosmer and Leme show goodness of fit test was used to check model fitness. Adjusted odds ratio with the corresponding 95% confidence interval was used to measure the strength of the association between outcome variable and independent variable.
Result:the outcome of the study showed that 18.1% of intubated and extubated patients had extubation failure (CI: 12.9 - 24.5). The odds of extubation failure in those patient who stayed longer in the hospital, i.e longer than 30 days (AOR=2.81, 95%: CI 5.23-15.60) and 10 -30days (AOR=2.31, 95%: CI 3.10-17.76). Extubation failure is found to be 2.14 times higher for those patients who are not nebulized immediately after extubation than those who are nebulized. (AOR=2.14,95%:CI5.87-9.46).
Conclusion: The study revealed that the extubation failure rate being 18.1%. Prolonged hospital stay and failure to nebulize after extubation were found to be determinate for extubation failure.
Safety and Effectiveness of a Novel Liposomal Intra-Articular Lubricant in Symptomatic Knee Osteoarthritis: A First in Human Study
Authors: Shemesh Shai , Dolkart Oleg , Goldberg Ronit , Jahn Sabrina , Khoury Amal , Warschawski Yaniv , Schermann Haggai , Salai Moshe , Agar Gabriel , Drexler Michael 
Published: May 2024

Abstract

Background: Osteoarthritis (OA) is a common disease that affects almost half the population at some point in their lives, causing pain and decreased functional capacity. New conservative treatment modalities are being proposed to provide symptomatic relief and delay surgical intervention. This study aimed at evaluating the safety of the novel liposomal boundary lubricant, injected intra-articulary in patients with moderate knee OA. Additionally, the effect on the functionality and life quality was assessed.
Methods: Eighteen of the 20 screened subjects met inclusion criteria and were enrolled in the study. After receiving a single IA injection of AqueousJoint, patients were prospectively evaluated at baseline and then at 2,4,8,12 and 26 weeks.
Numeric Pain Rating Scale (NRS), Knee injury and Osteoarthritis Outcome Score (KOOS), Short Form Health Survey (SF12) and range of motion were also recorded.
Results: The final analysis was conducted on 18 subjects. No adverse events related to the Investigational Product were observed in the study. No serious adverse events were observed at all. A significant decrease in pain was demonstrated at all time points VS baseline (Friedman X2 = 35.08, p < .001). Significant improvement was demonstrated in KOOS pain, symptoms, sports and ADL subscales (p < .001).
Conclusions: Despite a relatively small sample, it was demonstrated that single IA AqueousJoint injection is a safe procedure, resulting in significant pain reduction, higher ADL score, and higher KOOS sport scores. The effects lasted up to 6 months.
Sociodemographic and work-related factors associated with psychological resilience in South African healthcare workers: a cross-sectional study
Authors: Mcizana Thandokazi , Adams Shahieda , Khan Saajida , Ntatamala Itumeleng 
Published: May 2024

Abstract

Background: Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers.
Objectives: To determine the prevalence and factors associated with psychological resilience in a group of South African medical doctors and ambulance personnel.
Materials and Methods: This analytical cross-sectional study used secondary data obtained from studies conducted with healthcare workers. Factors associated with resilience, as measured by the Connor-Davidson Resilience Scale-10 (CD-RISC-10), were evaluated.
Results: A total of 647 healthcare workers were included in the study. Resilience scores were low overall (27.6 ± 6.6) but higher for ambulance personnel (28.0 ±6.9) than for doctors (27.1 ± 6.0) (p=0.006). The factors associated with high resilience scores in doctors were male gender (p< 0.001), higher income (p=0.020), and current smoking (p=0.012), while for ambulance personnel, there was previous alcohol use (p=0.002). Significantly lower resilience was observed in participants with mental health conditions (doctors: p=0.037; ambulance personnel: p=0.010) who were receiving treatment for mental health conditions (ambulance personnel: p=0.029). Multivariable analysis confirmed that the protective factors for doctors were current smoking status (β= 3.52, p=0.009) and a higher salary (β= 5.11, p=0.006), while for ambulance personnel, the protective factor was previous alcohol use (β=3.22, p=0.003). Female gender (β=-1.77, p=0.032) and working overtime with doctors (β=-5.11 p=0.006) increased the likelihood of low resilience.
Conclusions: Resilience was relatively low in this group of South African healthcare workers. The strong association between low resilience and individual and workplace factors provides avenues for early intervention and building resilience in healthcare workers.
Association of remnant cholesterol with Coronary Artery Ectasia: A Cross-Sectional Study
Authors: Mu Jing , Weng Yihan , Xiao Jiquan , Huang Yusi , He Xiang , Xie Zhixin , Yu Huimin 
Published: May 2024

Abstract

Objective
Coronary Artery Ectasia (CAE) is a condition characterized by the localized or widespread dilation of one or more coronary arteries. The majority of CAE cases do not present with clinical symptoms, and the exact cause of CAE remains unclear. Therefore, in our study, we conducted a retrospective analysis to explore potential causes of CAE.
Methods
We conducted a retrospective analysis of patients who underwent coronary angiography at Guangdong Provincial People’s Hospital between 2017 and July 2022, of which 679 patients ultimately enrolled in our study. Among them, 260 patients were diagnosed with CAE, whereas 419 patients with normal coronary results served as the control group. Remnant cholesterol (RC) was calculated by total cholesterol (TC) minus high-density lipoprotein cholesterol (HDL-C) minus low-density lipoprotein cholesterol (LDL-C). Association between RC levels and CAE was assessed using multivariable logistic models.
Results
Out of the 679 patients who participated in this study, with an average age of 59.9 years, 38.3% were diagnosed with CAE. Patients with CAE had higher RC levels compared to those without CAE (P = 0.001). A significant positive association was observed between RC levels and CAE, with a multivariable adjusted OR of 1.950 (95% CI: 1.163–3.270). There was a significant positive association between RC levels and CAE in both single-vessel and multivessel dilation cases, as well as in isolated CAE and dilation secondary to coronary atherosclerosis. In the subgroup analyses, RC levels were positively associated with CAE in participants with hypertension (OR, 1.065; 95% CI, 1.034–1.098).
Conclusion
Elevated RC levels are positively correlated with an increased risk of CAE, implying that a focus on RC could be beneficial in the research of CAE.
Predictors of Endocrine Resistance in a Cohort of Mexican Breast Cancer Patients
Authors: González-Ruíz Jonathan , Terry Mary Beth , Cabrera-Galeana Paula , Monroy-Chargoy Alberto , Horowitz Carol , Bickel Nina , García-Cuellar Claudia , Ramírez Andrea , Bargalló Enrique , Diaz-Chavez José , Barquet-Muñoz Salim , Cantú-de-León David , Prada Diddier 
Published: May 2024

Abstract

Purpose
This study aimed to determine the prevalence of endocrine resistance in a cohort of Hispanic Mexican breast cancer (BC) patients receiving care at Instituto Nacional de Cancerología (INCan). Additionally, the clinical-pathological factors associated with endocrine resistance were identified, and their impact on patient survival was explored.
Methods
A retrospective analysis of 200 BC patients who attended INCan between 2012 and 2016 with estrogen receptor (ER) and progesterone receptor (PR) positive tumors was made. Endocrine resistance was defined according to the International Consensus Guidelines for Advance Breast Cancer 2 definition. Their clinicopathological characteristics were analyzed to determine the association with endocrine resistance presence. We used sensitivity analyses and multivariate-adjusted logistic regressions, Kaplan-Meier curves, and multivariate-adjusted Cox regressions. P-value < 0.05 was considered as statistically significant.
Results
Endocrine resistance was observed in 32.5% of patients included in this study. The distinction between hormone resistance and sensitivity was influenced by tumor size and node status. It had a mean diameter of 7.15 cm in endocrine resistance cases compared to 5.71 cm in non-endocrine, with N3 status present in 20% of endocrine resistance cases versus only 2.2% in non-endocrine (p-value < 0.001). The clinical stage exhibited a strong association with endocrine resistance (Risk Ratio [RR] 4.39, 95% confidence interval [95%CI] 1.50, 11.43). Furthermore, endocrine resistance significantly impacted mortality during the follow-up, with a Hazard Ratio [HR] of 23.7 (95%CI 5.20, 108.42) in multivariable-adjusted models. However, a complete pathological response reduced the endocrine resistance risk, as demonstrated by a Risk Ratio (RR) of 0.15 (95% CI 0.03, 0.75).
Conclusions
Advanced clinical stage at diagnosis predicted endocrine resistance in Hispanic Mexican BC patients. Complete pathologic response in locally advanced disease patients was also a key predictor of endocrine resistance. These results indicated that endocrine resistance was a critical factor in BC during follow-up.
Development of a New Accurate Lateral Flow Immunoassay for Enhanced Diagnosis of Human Leptospirosis
Authors: Pujato Nazarena , Gimenez Juan Manuel , Peretti Leandro E. , Landolt Noelia Y. , Jacob Paulina , Chiani Yosena T. , Schmeling Maria F. , Miraballes Iris , Vanasco Norma B. 
Published: May 2024

Abstract

Purpose
Leptospirosis is a global neglected disease. Current diagnostic methods are technically complex, expensive, and often inaccurate, primarily confined to specialized laboratories. New simple and accurate tests are mandatory to decentralize and improve diagnosis. Here, we introduced a new lateral flow immunoassay (Lepto-LF) for human leptospirosis.
Methods
We conducted a double-blinded assay using 104 serum samples from patients with or without leptospirosis, diagnosed according to the standard algorithm. Diagnostic performance of Lepto-LF was estimated across various days from onset of symptoms (dpo), comparing it with the current methods: enzyme-linked immunosorbent assay (IgM-ELISA) and the slide agglutination test using temperature-resistant antigen (SATR).
Results
Lepto-LF exhibited perfect diagnostic performance with a Youden´s index J = 1, from the acute phase starting at 6 dpo. IgM-ELISA gave slightly lower accuracy (J = 0.91) with 95.5% sensitivity (Se) and specificity (Sp), while SATR showed very poor diagnostic yield (J = 0.41, Se = 95.5%, Sp = 45.5%). Performances remained similar in the convalescence phase of the disease (> 10 dpo).
Conclusion
Lepto-LF proved to be a reliable test with performance similar to current screening methods but with significant advantages. Due to its simplicity and speed, it can be used in low/medium-complexity labs, providing rapid results for early disease detection and timely treatment during the acute phase when antibiotics are highly effective. Additionally, Lepto-LF can serve as a confirmatory test, especially where the standard MAT is unavailable. Lepto-LF holds promise for remote areas and vulnerable environments, promoting decentralized diagnosis and ensuring equal access nationwide.
Sociodemographic inequalities related to the initiation of antenatal care visits during gestation in Peruvian women: an analysis of the Demographic and Family Health Survey between 2019 and 2022
Authors: Intimayta-Escalante Claudio 
Published: May 2024

Abstract

Methods
A cross-sectional analysis with data from the 2019–2022 Demographic and Family Health Survey in Peru was conducted. Weighted Cox regression models helped calculate adjusted Hazard Ratios (aHR), and the Slope Index of Inequality (SII) was used to measure how sociodemographic factors like age, education, location, insurance, and ethnicity influenced the timing of antenatal care initiation.
Results
The study included 22668 Peruvian women aged 18 to 49. Among these women, the mean age was 31.45 years. Only 30.63% of women started their antenatal care visits in the first month of pregnancy. Additionally, women without education (aHR: 0.74, 95%CI: 0.63 to 0.85, p < 0.001), those in urban areas (aHR: 0.94, 95%CI: 0.89 to 0.98, p = 0.003), and individuals of Quechua or Aymara descent (aHR: 0.91, 95%CI: 0.87 to 0.95, p < 0.001) were less likely to initiate antenatal care in the first months. Furthermore, individuals aged 18 to 29 (SII: -0.22, 95%CI: -0.26 to -0.18, p < 0.001), those without education (SII: -0.03, 95%CI: -0.04 to -0.02, p < 0.001), residing in rural areas (SII: -0.75, 95%CI: -0.78 to -0.71, p < 0.001), or living outside the capital (SII: -0.65, 95%CI: -0.70 to -0.60, p < 0.001) exhibited similar patterns.
Conclusion
Sociodemographic inequalities exist in the early beginning of antenatal care visits are evident among Peruvian women, especially impacting individuals in rural or non-capital regions with lower education levels and belonging to the Quechua or Aymara ethnic communities.
Oligomeric amyloid beta prevents myelination in a clusterin-dependent manner
Authors: Beiter Rebecca M. , Raghavan Tula P. , Suchocki Olivia , Ennerfelt Hannah E. , Rivet-Noor Courtney R. , Merchak Andrea R. , Phillips Jennifer L. , Bathe Tim , Lukens John R. , Prokop Stefan , Dupree Jeffrey L. , Gaultier Alban 
Published: May 2024

Abstract

Background:
White matter loss is a well-documented phenomenon in Alzheimer's disease (AD) patients that has been recognized for decades. However, the underlying reasons for the failure of oligodendrocyte progenitor cells (OPCs) to repair myelin deficits in these patients remain elusive. A single nucleotide polymorphism (SNP) in Clusterin has been identified as a risk factor for late-onset Alzheimer's disease and linked to a decrease in white matter integrity in healthy adults, but its specific role in oligodendrocyte function and myelin maintenance in Alzheimer’s disease pathology remains unclear.
Methods:
To investigate the impact of Clusterin on OPCs in the context of Alzheimer's disease, we employed a combination of immunofluorescence and transmission electron microscopy techniques, primary culture of OPCs, and an animal model of Alzheimer's disease.
Results:
Our findings demonstrate that Clusterin, a risk factor for late-onset AD, is produced by OPCs and inhibits their differentiation into oligodendrocytes. Specifically, we observed upregulation of Clusterin in OPCs in the 5xFAD mouse model of AD. We also found that the phagocytosis of debris, including amyloid beta (Aβ), myelin, and apoptotic cells leads to the upregulation of Clusterin in OPCs. In vivo experiments confirmed that Aβ oligomers stimulate Clusterin upregulation and that OPCs are capable of phagocytosing Aβ. Furthermore, we discovered that Clusterin significantly inhibits OPC differentiation and hinders the production of myelin proteins. Finally, we demonstrate that Clusterin inhibits OPC differentiation by reducing the production of IL-9 by OPCs.
Conclusion:
Our data suggest that Clusterin may play a key role in the impaired myelin repair observed in AD and could serve as a promising therapeutic target for addressing AD-associated cognitive decline.
How are autistic traits associated with mental health among Chinese university students: An examination of the mediating role of alexithymia and social camouflaging
Authors: Xie Qianyi , Li Xiangpeng , Lin Lizi , Weng Xuchu , Wang Sanmei , Zhang Kai , Pan Ning , Wang Xin 
Published: May 2024

Abstract

Background
Autistic traits are distributed along a continuum ranging from clinical presentations to the general population, being associated with high-risk of mental health problems. However, the underlying mechanism remains unclear. Given that alexithymia, which contributes to emotional difficulties related to autistic traits, along with the utilization of social camouflaging as a potential mechanism for coping, may exacerbate mental health issues. This study aimed to examine the mediating effects of alexithymia and social camouflaging in the associations between autistic traits and symptoms of anxiety/depression.
Methods
A total of 1085 Chinese university students (age: 21.8 ± 2.7 years, 51.9% males) were recruited through an online survey which measured autistic traits, mental health problems (anxiety and depression), alexithymia, and social camouflaging. The mediator effects of alexithymia and social camouflaging on the associations of autistic traits with anxiety and depression were conducted, and two serial mediation models were verified by regression analysis.
Results
The findings revealed a significant positive association of autistic traits with symptoms of anxiety and depression. The manifestation of anxiety symptoms was found to be influenced by autistic traits, mediated sequentially by alexithymia and social camouflaging (β = 0.022, 95% confidence interval [CI]: 0.011–0.035). Differently, the depression symptoms were linked to autistic traits solely through alexithymia (β = 0.499, 95%CI: 0.423–0.578). According to the subgroup analysis, the results within the female group were consistent with the observations made in the overall sample. However, in the male group, the statistical significance of the mediating effect of social camouflaging between autistic traits and anxiety was no longer evident.
Limitations
This study can only identify associations between autistic traits and social camouflaging, not causal relationships. Neuroimaging research is necessary to unravel the neural mechanisms that underlie these associations.
Conclusions
Our findings found that alexithymia and social camouflaging play a serial mediating role in the relationship between autistic traits and mental health problems in Chinese university students, especially anxiety. The associations between autistic traits and mental health issues may vary between males and females. This study highlights a significant pathway that has the potential to improve mental well-being in individuals exhibiting high autistic traits.
Modified Sclerobanding ( Rubber Band Ligation combined with 3% Polidocanol Foam Sclerotherapy ) for the Treatment of Second and Third-Degree Hemorrhoidal Disease: clinical efficacy and safety evaluation—a retrospective study
Authors: Wang Wei , Lu Jun , Yang Mian , Yu Jiazi 
Published: May 2024

Abstract

Purpose: Sclerobanding (SB) is a novel technique that merges rubber band ligation with 3% polidocanol foam sclerotherapy for hemorrhoidal disease (HD) treatment. This study assessed the effectiveness and safety of Modified Sclerobanding (mSB) for second- and third-degree HD.
Methods:Consecutive patients with grade II or III internal hemorrhoids underwent RBL treatment from January 2021 to December 2021, followed by mSB from January 2022 to December 2022 at Ningbo Medical Center of Lihuili Hospital. Primary outcomes, such as postoperative treatment failure rate and delayed bleeding (DB) incidence, and secondary outcomes, including postoperative complications (pain, swelling, anal edema, bleeding grade variation), were reviewed retrospectively. Long-term follow-up outcomes, including the Hemorrhoidal Disease Symptom Score (HDSS), Short Health Scale adapted for Hemorrhoidal Disease (SHSHD), and Patient Satisfaction (PS), were also assessed.
Results: Among 307 enrolled patients, 162 received mSB and 125 underwent traditional RBL. Baseline characteristics showed no significant differences between groups, except for anticoagulant history and hospital stay length (P < 0.05). No delayed major bleeding occurred in the mSB group, contrasting with 5 cases in the RBL group. The mSB group exhibited a lower recurrence rate (6.8% vs. 17.0%) and treatment failure rate (6.8% vs. 18.6%) compared to the RBL group (P < 0.05). While postoperative complications did not significantly differ between groups, bleeding improvement on the 7th day was superior in the mSB group (P < 0.05). Long-term outcomes showed no significant differences in HDSS, SHS-HD, and PS scores.
Conclusion: The mSB procedure combines the advantages of sclerosant injection therapy and RBL, reducing the number of ligation sessions while lowering the risk of DB and decreasing the treatment failure rate. The modified injection method does not increase the incidence of postoperative complications.
Prevalence of Irritable Bowel Syndrome and associated factors among medical students at the University of Gondar, Northwest Ethiopia, 2023
Authors: Mengistu Segenet Bizuneh , Asnakew Melat Mesfin , Eskinder Mahlet , Sisay Mahlet , Zewdu Mahlet , Mamo Matiwos , Mulugeta Matyas , Gebrehana Alazar Wogayehu 
Published: May 2024

Abstract

Introduction: Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. Medical students are exposed to high levels of stress, irregular eating habits, and academic pressure, which may predispose them to a higher risk of developing IBS.
Objective:To determine prevalence and associated factors of IBS among medical students at the University of Gondar, North West Ethiopia,2023.
Methods: Institution based cross-sectional study was conducted on 450 medical students at UOG-CMHS from December 11 to 31, 2023. We used simple random sampling by computer based lottery method to select 218 participants to our study. Data was collected by using a structured questionnaire on sociodemographic, symptoms of IBS using Rome IV criteria and possible risk factors and the data was entered in to SPSS cleaned, coded and analyzed.
Result: Fifty (23%) of participated medical students met the criteria for IBS, 40% of them had constipation dominant, 17.1% had diarrhea dominant and 42.9% had mixed type of IBS.
Emotional stress (P=0.01) and anxiety (P=0.023) were found to be significantly associated with IBS.