bluuebunny/crossref_metadata_2025_split huggingface dataset:
Activities of daily living interventions on activity performance of inpatients post-stroke: A systematic review and meta-analysis
Authors: Triantis Elyse , Liu Karen PY 
Published: June 2024

Introduction: Inpatient rehabilitation is the best time window to improve patient performance post-stroke. Little is known about the type and effectiveness of activity interventions. This study aims to review activities of daily living interventions and evaluate their effectiveness on activity performance for stroke inpatients. Method: MEDLINE, Embase, CINAHL and Web of Science were searched. Randomised controlled trials investigating the effects of activities of daily living interventions for stroke inpatients were included. Two reviewers independently selected the studies and extracted data. Meta-analysis was conducted on relevant data with a random effect model with 95% CI. Results: Fourteen randomised controlled trials involving 602 stroke inpatients, were included. Both experimental and control groups offered activities of daily living interventions. Thirteen experimental groups offered added components, such as imagery and repetitive practice. Five studies reported significant improvement in activity performance within experimental and control groups. A meta-analysis of 12 randomised controlled trials with 512 participants revealed non-significant results for activity performance between the two groups. Conclusion: Both experimental and control groups in the included studies provided activities of daily living interventions. Added components were included in 13 out of 14 experimental groups. Meta-analysis revealed no significant difference between the two groups as they both offered activities of daily living interventions.
Moral reckoning among nurses: A directed qualitative content analysis
Authors: Montazeri Akram Sadat , Khoddam Homeira , Borhani Fariba , Kolagari Shohreh 
Published: June 2024

Background When nurses face ethical challenges, they attempt to accept responsibility for their actions and start moral reckoning. Moral reckoning is the personal evaluation of one’s behaviors or others’ behaviors during ethically challenging situations. Research Aim This study aimed at exploring the concept of moral reckoning and its stages among Iranian nurses using Nathaniel’s moral reckoning Theory. Research Design This descriptive qualitative study was conducted in 2022 using directed content analysis. Participants and Research context Eighteen nurses were purposively recruited from three teaching hospitals affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Data were collected via in-depth semi-structured interviews which lasted 50 minutes on average and were concurrently analyzed via the three-step directed content analysis method proposed by Elo and Kyngas. Ethical considerations This study earned the ethical approval of the Ethics Committee of Golestan University of Medical Sciences, Gorgan, Iran (code: IR.GOUMS.REC.1400.171). Findings During data analysis, 157 final codes were developed and categorized into 23 subcategories, 10 categories, and four themes. The themes of the study are ease (with the two categories of becoming and interacting), upset (with the two categories of mental upset and behavioral upset), resolution (with the two categories of making a stand and giving up), and reflection (with the four categories of remembering, telling the story, examining conflicts, and living with consequences). Conclusion Ethically challenging situations alter the ease stage of moral reckoning among nurses, cause them mental and behavioral upset, and thereby, require them to make stand or give up. Then, they continuously examine events in their mind and finally, live with the positive and negative consequences of the events.
3M™ Defib-Pads as a Reusable Alternative to Commercial Ultrasound Gel in Resource-Limited Settings
Authors: Todorovich Sydney M. , Van Aarsen Kristine , Freeman Shane R. , Slomer Adam , Myslik Frank 
Published: June 2024

Introduction With point-of-care ultrasound (POCUS) use in austere environments comes the challenge of having an ever-available coupling medium for image generation. Commercial gel has numerous drawbacks that can limit its utility in these settings, and no studies have evaluated the potential for a reusable coupling medium. This study aimed to determine whether 3M™ Defib-Pads could be utilized as a reusable alternative to commercial gel for image generation in resource-limited settings. Methods A descriptive, cross-sectional survey of Canadian physicians with POCUS interest was conducted to evaluate the interpretability of various POCUS images in a blinded fashion. Three anatomic regions (cardiac, abdominal, and nerve) were utilized, and image generation from the commercial gel and 7 Defib-Pad conditions were evaluated. These included pads that were 1) newly opened, 2) dirtied then rinsed, 3) air dried, 4) rinsed after being air dried, 5) frozen then thawed, 6) used in double thickness, and 7) used with a probe cover. Results Compared to commercial gel, 3M™ Defib-Pads performed similarly, with adequate image interpretability of up to 100% in some conditions. The exception was pads that had prolonged air exposure, which produced images that were never interpretable. However, subsequent rinsing of these pads with water resulted in restored image generation. Conclusion 3M™ Defib-Pads were found to produce interpretable POCUS images under multiple environmental stressors and with different modalities of use, suggesting that 3M™ Defib-Pads can perform as a reusable gel alternative in resource-limited settings.
A Beam Angle Selection Method to Improve Plan Robustness Against Position Error in Intensity-Modulated Radiotherapy for Left-Sided Breast Cancer
Authors: Ding Zhen , Kang Kailian , Yuan Qingqing , Zhang Wenjue , Sang Yong 
Published: June 2024

Purpose We report a dosimetric study in whole breast irradiation (WBI) of plan robustness evaluation against position error with two radiation techniques: tangential intensity-modulated radiotherapy (T-IMRT) and multi-angle IMRT (M-IMRT). Methods Ten left-sided patients underwent WBI were selected. The dosimetric characteristics, biological evaluation and plan robustness were evaluated. The plan robustness quantification was performed by calculating the dose differences (Δ) of the original plan and perturbed plans, which were recalculated by introducing a 3-, 5-, and 10-mm shift in 18 directions. Results M-IMRT showed better sparing of high-dose volume of organs at risk (OARs), but performed a larger low-dose irradiation volume of normal tissue. The greater shift worsened plan robustness. For a 10-mm perturbation, greater dose differences were observed in T-IMRT plans in nearly all directions, with higher Δ D98%, Δ D95%, and Δ Dmean of CTV Boost and CTV. A 10-mm shift in inferior (I) direction induced CTV Boost in T-IMRT plans a 1.1 (Δ D98%), 1.1 (Δ D95%), and 1.7 (Δ Dmean) times dose differences greater than dose differences in M-IMRT plans. For CTV Boost, shifts in the right (R) and I directions generated greater dose differences in T-IMRT plans, while shifts in left (L) and superior (S) directions generated larger dose differences in M-IMRT plans. For CTV, T-IMRT plans showed higher sensitivity to a shift in the R direction. M-IMRT plans showed higher sensitivity to shifts in L, S, and I directions. For OARs, negligible dose differences were found in V20 of the lungs and heart. Greater Δ Dmax of the left anterior descending artery (LAD) was seen in M-IMRT plans. Conclusion We proposed a plan robustness evaluation method to determine the beam angle against position uncertainty accompanied by optimal dose distribution and OAR sparing.
Correlation Between Calcium Scoring and Abdominal Aortic Aneurysm Endovascular Repair Outcomes
Authors: Farres Houssam , Lanka Santh Prakash , Nussbaum Sam , Shoukry Mira , Hanouneh Tareq , Alexander Lauren , Sella David , Jarmi Tambi 
Published: June 2024

Objectives Endovascular aneurysm repair, though minimally invasive and has the benefit of relatively low perioperative complication rates, it is associated with significant long term reintervention rates related to endoleaks. Several variables have been studied to predict the outcomes of endovascular aneurysm repair, 1 of which is the calcium burden of the vasculature. This prompted us to study the association between calcium burden measured by the standardized Agatston scoring system and the outcomes of Endovascular aneurysm repair. Methods This is a retrospective study of patients who underwent Endovascular aneurysm repair from 2008 to 2020 at our institution and who had a non-contrast computerized tomography scan preoperatively, accounting for 87 patients. The calcium burden of the vasculature was measured by the Agatston scoring system allowing for better reproducibility, and the outcome variables included mortality and endoleaks. Results Patients with higher median total calcium scores (≥12966.9) had significantly lesser survival (79.8% vs 52.3% ( P = .002) at five years compared to patients with lower median total calcium score (<12966.9). Also, patients with type 2 endoleaks had higher calcium scores in above the aneurysm level ((1591.2 vs 688.2), P = .05)) compared to patients with no type 2 endoleaks. Conclusion Calcium score assigned using a standardized Agatston scoring system can be used as a predictor of mortality risk assisting in deciding the treatment of choice for patients.
Lipid-lowering therapies and long-term stroke prevention in East Asians: A systematic review and meta-analysis of randomized controlled trials
Authors: Guo Bao-Qiang , Li Hong-Bin , Xu Peng-Wei , Zhao Bing 
Published: June 2024

Background: Stroke prevention is a pressing global health priority, with reducing elevated lipids recognized as a key strategy. East Asians, constituting more than 1.6 billion individuals and the largest racial group worldwide, are a key demographic in this effort. Yet, the effectiveness of lipid-lowering therapies for stroke prevention in this population remains uncertain. Aims and Methods: We conducted a systematic review and meta-analysis of large-scale randomized controlled trials (RCTs) with at least 3 years of follow-up to evaluate the long-term impact of lipid-lowering therapies on stroke incidence in East Asians. We systematically searched four electronic databases up to 11 January 2024. The association was quantified using relative risk (RR) with a 95% confidence interval (CI), and between-study heterogeneity was evaluated using the I2 statistic. In addition, we utilized the Cochrane Risk of Bias Tool to assess the risk of bias in each included RCT and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to evaluate the certainty of the evidence. Results: This study incorporated data from nine large-scale RCTs involving 54,354 participants. Our findings of overall analyses revealed that lipid-lowering therapies did not significantly affect the long-term incidence of all strokes (9 RCTs; 54,354 participants; RR = 0.98 (95% CI = 0.87–1.10); P = 0.75), ischemic stroke (7 RCTs; 52,059 participants; RR = 0.91 (95% CI, = 0.79–1.04); P = 0.16), or hemorrhage stroke (7 RCTs; 52,059 participants; RR = 1.24 (95% CI = 0.97–1.59); P = 0.09) in East Asians. Notably, there was no evidence of heterogeneity or publication bias, and the quality of evidence assessed using GRADE methodologies was rated as high. Sensitivity analyses confirmed the robustness of our results, with no single study significantly affecting the overall findings. Furthermore, subgroup analyses consistently supported the conclusions, further bolstering the reliability of our study. Conclusions: Lipid-lowering therapies did not demonstrate any beneficial effects on long-term stroke prevention among East Asians.
What influences post-operative opioid requirements for tibial fractures?
Authors: Zhang James , Limonard Aaron , Bradshaw Florence , Hussain Ishrat , Josipović Maša , Krkovic Matija 
Published: June 2024

Introduction Currently there are few opioid prescribing guidelines for orthopaedic fractures. Long-term post-surgical analgesia requirements, understandably, vary between orthopaedic cases. Our study aims to provide detailed information to clinicians and policy makers, on the opioid requirement associations for patients sustaining tibial fractures. Methods This study reviewed all patients sustaining an isolated tibial fracture at a major trauma centre that were operated on within 1 month of injury, from 2015 to 2022. The total opioid dosage used each month in morphine milligrams equivalents (MME) and the number of days opioids were used each month, within the first-year post-surgery were collected, representing the strength and coverage of opioid analgesia in the post-operative stage, respectively. We compared opioid strength and coverage requirements with types of definitive fracture fixations, location, fracture type and concurrent patient medical comorbidities to assess for any trends. Results A total of 1814 patients sustaining a combined of 1970 fractures were included in the study. Tibial plateau fractures had the highest opioid strength and coverage requirements in each month and the entire year ( p < .05). Across all fracture locations, Ex Fix frame showed higher opioid strength and coverage requirements compared to both IM nailing and plate ORIF. With regard to opioid coverage in the presence of specific comorbidities, only chronic kidney disease (quotient: 1.37, 95% Confidence interval [95%CI] = 1.19–1.55, p = .002) and hypertension (quotient: 1.34, 95%CI = 1.14–1.53, p = .009) showed significance at the 1-year overall level. For opioid strength, Chronic Kidney Disease (quotient: 1.72, 95%CI = 1.41–2.03 p = .005) and COPD (quotient: 1.90, 95%CI = 1.44–2.36, p = .014), show significance at the 1-year overall level. Conclusion Our study details opioid requirements post-surgery amongst tibial fractures with subgroup analysis assessing opioid needs amongst specific fracture locations, types, surgical techniques and medical comorbidities. This framework aids clinicians in anticipating rehabilitation and assists in risk stratifying patients at injury onset.
The Correlation of MicroRNA-21 With the Nephrin, Podocin, and Urinary Albumin-Creatinine Ratio in Patients With Type 2 Diabetes and Albuminuria: A Cross-Sectional Study
Authors: Nugroho Pringgodigdo , Susanto Tri Hadi , Bonar Maruhum , Rizka Aulia , Lydia Aida , Koesno Soekamto , Soewondo Pradana , Shatri Hamzah , Chundiawan Carissa Cornelia , Hermanto Fidel 
Published: June 2024

Background: Diabetic kidney disease (DKD) is the most common and deranging microvascular complication of diabetes mellitus (DM). Podocytopathy is a key component of glomerular damage in DKD. Micro RNA-21 (miRNA-21) is an epigenetic regulator that plays a role in podocyte damage; however, the results of previous studies have not resolved the controversy about the role of miRNA-21 in the pathogenesis of DKD. Objective: The objective was to investigate the correlation between miRNA-21 levels and urinary nephrin, podocin, and urinary albumin-creatinine ratio (UACR) in patients with type 2 DM and albuminuria. Design: This is a cross-sectional study. Setting: This study was carried out in internal medicine outpatient clinic of Cipto Mangunkusumo Hospital Jakarta, Indonesia. Patients: This study consisted of 42 adults with type 2 DM and albuminuria. Measurements: The measurements include (1) Serum miRNA-21; (2) urinary podocin, nephrin, and albumin-creatinine ratio; and (3) serum miRNA-21 correlated to urinary podocin, nephrin, and albumin-creatinine ratio. Methods: The Spearman bivariate analysis to assess the correlation of miRNA-21 with nephrin, podocin, and UACR. Results: The mean relative expression of miRNA-21 was 0.069 (0.024), the median for nephrin, podocin, and UACR was 35.5 (15.75-51.25) ng/mL, 0.516 (0.442-0.545) ng/mL, and 150 (94.56-335.75) ng/mL, respectively. A correlation between miRNA-21 and nephrin was observed (r = 0.598; P < .0001). There was a correlation between miRNA-21 and UACR (r = 0.604; P < .0001). No correlation was found between miRNA-21 and podocin. Limitations: A lack of non-DM and non-albuminuric control population and small sample size. We could not exclude concurrent disease, and all other potential confounding variables, particularly those related to inflammation. Conclusions: The miRNA-21 can be considered an early biomarker for podocytopathy and albuminuria in DM, highlighting its potential for early diagnostic and therapeutic interventions. Further research is required to confirm these findings and explore their clinical applications, which could significantly alter management strategies for DKD.
Quality controlled YouTube content intervention for enhancing health literacy and health behavioural intention: A randomized controlled study
Authors: Park Yujin , Kim Su Hwan , Yoon Hyung-Jin 
Published: June 2024

Background Individuals increasingly turn to the Internet for health information, with YouTube being a prominent source. However, the quality and reliability of the health information vary widely, potentially affecting health literacy and behavioural intentions. Methods To analyse the impact of health information quality on health literacy and behavioural intention, we conducted a randomized controlled trial using a quality-controlled YouTube intervention. Health information quality on YouTube was evaluated using the Global Quality Score and DISCERN. We randomly allocated (1 : 1) to the intervention group to watch the highest quality-evaluated content and to the control group to watch the lowest quality-evaluated content. Health literacy and health behavioural intention were assessed before and after watching YouTube. The trial was set for two different topics: interpreting laboratory test results from health check-up and information about inflammatory bowel disease (IBD). Results From 8 April 2022 to 15 April 2022, 505 participants were randomly assigned to watch either high-quality content (intervention group, n = 255) or low-quality content (control group, n = 250). Health literacy significantly improved in the intervention group (28.1 before and 31.8 after; p < 0.01 for health check-up; 28.3 before and 31.3 after; p < 0.01 for IBD). Health behavioural intention significantly improved in the intervention group (3.5 before and 4.1 after; p < 0.01 for health check-up; 3.6 before and 4.0 after; p < 0.01 for IBD). Control groups had no such effect. Conclusion High-quality health information can enhance health literacy and behavioural intention in both healthy individuals and those with specific conditions like IBD. It stresses the significance of ensuring reliable health information online and calls for future efforts to curate and provide access to high-quality health content.
Chronic effects of commercial pesticide preparations on biomarkers and reproductive success in earthworm Eisenia andrei
Authors: Lončarić Željka , Lackmann Carina , Bjedov Dora , Šimić Antonio , Ečimović Sandra , Seiler Thomas-Benjamin , Hollert Henner , Velki Mirna 
Published: June 2024

AbstractChemical pollution resulting from pesticide usage has been a continuous issue since the 1960s, despite comprehensive European Union legislation designed to safeguard human health and the environment from the adverse effects of pesticides. While regulatory risk assessments primarily focus on the active ingredients, recent research indicates ecotoxicological impacts of commercial preparations on non-target organisms, particularly within the soil ecosystem where key species such as earthworms play a vital role in maintaining soil quality and fertility. Therefore, the aim of this study was the assessment of the long-term effects of the following respective commercial preparations: the insecticides Sumialfa (esfenvalerate) and Calypso (thiacloprid), as well as the herbicides Frontier (dimethenamid-p) and Filon (prosulfocarb) on the earthworm Eisenia andrei in standardized soil during long-term exposures of 7, 14, and 28 days. To study the possible effects on different levels of biological organization, enzymatic biomarkers: acetylcholinesterase (AChE), carboxylesterase (CES) glutathione S-transferase (GST), glutathione reductase (GR), glutathione peroxidase (GPx); non-enzymatic biomarkers: multixenobiotic resistance activity (MXR), levels of glutathione (GSH), and reactive oxygen species (ROS) as well as reproductive success were investigated. While Calypso appeared to be the least toxic substance, all pesticides showed significant effect on multiobiomarker response in E. fetida. That being said, the response of MXR activity was significantly altered by all tested pesticides indicating MXR being the most sensitive endpoint of the present research. Recovery of MXR was observed after 28 days, however, only in case of exposure to Filon, while the recovery of CAT activity was recorded after 28 days as well, subsequent to Sumialfa exposure. Reproductive success was negatively impacted regarding the Frontier and Sumialfa exposure at the highest concentration (100 mg/kg) reflected in reduced number of cocoons, while only the exposure to Frontier (100 mg/kg) reduced the number of juveniles. Based on the results, it is important to include commercial pesticide formulations in pesticide risk assessments. The toxicity classifications of the studied pesticides suggest the potential detrimental consequences to the key soil species in terrestrial ecosystems at various concentrations. Future studies should include other soil species as well as investigation of higher levels of biological organization, i.e., behavioral endpoints, to determine the potential risks to terrestrial ecosystems.
Genetic association analysis in sugarcane (Saccharum spp.) for sucrose accumulation in humid environments in Colombia
Authors: Saavedra-Díaz Carolina , Trujillo-Montenegro Jhon Henry , Jaimes Hugo Arley , Londoño Alejandra , Villareal Fredy Antonio Salazar , López Luis Orlando , Valens Carlos Arturo Viveros , López-Gerena Jershon , Riascos John J. , Quevedo Yeison Mauricio , Aguilar Fernando S. 
Published: June 2024

AbstractBackgroundSucrose accumulation in sugarcane is affected by several environmental and genetic factors, with plant moisture being of critical importance for its role in the synthesis and transport of sugars within the cane stalks, affecting the sucrose concentration. In general, rainfall and high soil humidity during the ripening stage promote plant growth, increasing the fresh weight and decreasing the sucrose yield in the humid region of Colombia. Therefore, this study aimed to identify markers associated with sucrose accumulation or production in the humid environment of Colombia through a genome-wide association study (GWAS).ResultsSucrose concentration measurements were taken in 220 genotypes from the Cenicaña’s diverse panel at 10 (early maturity) and 13 (normal maturity) months after planting. For early maturity data was collected during plant cane and first ratoon, while at normal maturity it was during plant cane, first, and second ratoon. A total of 137,890 SNPs were selected after sequencing the 220 genotypes through GBS, RADSeq, and whole-genome sequencing. After GWAS analysis, a total of 77 markers were significantly associated with sucrose concentration at both ages, but only 39 were close to candidate genes previously reported for sucrose accumulation and/or production. Among the candidate genes, 18 were highlighted because they were involved in sucrose hydrolysis (SUS6, CIN3, CINV1, CINV2), sugar transport (i.e., MST1, MST2, PLT5, SUT4, ERD6 like), phosphorylation processes (TPS genes), glycolysis (PFP-ALPHA, HXK3, PHI1), and transcription factors (ERF12, ERF112). Similarly, 64 genes were associated with glycosyltransferases, glycosidases, and hormones.ConclusionsThese results provide new insights into the molecular mechanisms involved in sucrose accumulation in sugarcane and contribute with important genomic resources for future research in the humid environments of Colombia. Similarly, the markers identified will be validated for their potential application within Cenicaña’s breeding program to assist the development of breeding populations.