bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatoprotective Effect of Nano Selenium Derived from Neem Leaf Extracts against Infection with Eimeria papillata in C57BL/6 Mice
Authors: Al-Malki Esam S. , Abdel-Gaber Rewaida , Almutairy Najwa , Al-Hoshani Nawal , Alonaizan Rasha , Meryk Andreas , Al-Shaebi Esam M. , Dkhil Mohamed A. , Al Quraishy Saleh 
Published: January 2025

Background Coccidiosis is considered a protozoan disease affecting wild and domestic animal species which leads to economic losses. Regarding drug resistance, scientists are focused on alternative sources rather than coccidiostats with fewer side effects. Recently, nanotechnology has been a new trend against parasitic infections by manipulating atoms and molecules at the nanoscale. Purpose This study assessed the hepatoprotective effects of biosynthesized nano selenium (BSN) derived from Azadirachta indica leaf extracts on biological, biochemical, and oxidative stress markers in mice infected with Eimeria papillata. Methods The formation of nano selenium was achieved using leaf extract from A. indica, and their morphology and size were characterized using scanning electron microscopy (SEM). Twenty-five male C57BL/6 mice were divided into five groups, with five mice in each group. The first group received distilled water, while the second group was administered 0.5 mg/kg of BSN. The third, fourth, and fifth groups were infected with the parasite’s oocysts. For 5 days, the fourth group received BSN (0.5 mg/kg), and the fifth group was treated with amprolium (120 mg/kg). Oocyst shedding was assessed on day 5 post-infection (p.i.). After sacrificing the mice, the liver and blood from each mouse were collected and processed for histological, biochemical, and oxidative damage analyses. Results Oocyst shedding in the feces of mice decreased following oral treatment with BSN. Eimeria infection reduced feed consumption to 31.44%, but this increased to 45.57% after BSN treatment. The infection caused significant liver damage, as evidenced by pathological changes and a notable increase in liver function parameters, including glutamic-pyruvic transaminase (ALT), glutamic-oxaloacetic transaminase (AST), alkaline phosphatase (ALP), and direct bilirubin. These parameters improved after treatment with BSN. Additionally, Eimeria infection disrupted nutrient homeostasis. Levels of soluble proteins and carbohydrates in the liver tissue decreased, while blood glucose and total protein levels increased. Treatment with BSN in mice infected with E. papillata significantly improved nutrient homeostasis. Our research also demonstrated that BSN significantly reduced levels of nitric oxide (NO) and hydrogen peroxide (H2O2), while increasing levels of catalase (CAT) and superoxide dismutase (SOD) to help mitigate oxidative damage during Eimeria infection. Conclusion Our findings demonstrate that BSN has a significant in vivo hepatic response against murine coccidiosis and could be valuable as a coccidiostat in treating the disease.
Determining Predictors of Self-reported Adherence to Rehabilitation Home Programs for Persons with Acquired Brain Injury: A Prospective Observational Study
Authors: Donoso Brown Elena V. , Wallace Sarah E. , Tichenor Seth E. , Blemler Rebecca , Foundas Brooke 
Published: January 2025

BACKGROUND Persons with acquired brain injury are often prescribed home programs to extend rehabilitation services and support recovery, however adherence to these recommendations is often low. OBJECTIVE The purpose of this study was to determine factors that predict differing levels of self-reported adherence. METHODS This was a prospective observational study that was completed from June 2022 to December 2023. We recruited persons with acquired brain injury who met specific inclusion and exclusion criteria. Before leaving the inpatient rehabilitation hospital, they completed a medical history form, home program description interview, and a modified version of the Self-Efficacy for Exercise Scale. Then, participants completed a weekly survey regarding self-reported home program adherence. At the end of six months, the participants did a closing interview. RESULTS Seventy-seven participants completed the intake procedures and at least one weekly survey. Several models were developed to determine predictive factors. Higher self-efficacy, fewer reported barriers, and the perception of social support were all predictors of self-reported home program adherence. CONCLUSION The predictors identified here can be leveraged by therapists to determine the need for additional support or intervention around home program adherence.
Anterior chamber morphological and refractive outcomes following phacoemulsification in pseudoexfoliative eyes: A case-control study
Authors: Cunha Bruna , Gil Pedro , Barão Catarina , Hipólito-Fernandes Diogo , Maduro Vítor , Feijão João , Alves Nuno 
Published: January 2025

Purpose To compare changes in angle morphology, anterior chamber depth (ACD) and refractive prediction error (PE) after phacoemulsification between pseudoexfoliative (PEX) and non-PEX eyes. Methods Prospective case-control study of eyes submitted to cataract surgery. Biometric data and angle parameters – Anterior Chamber Angle (ACA), Angle Opening Distance (AOD), Scleral Spur Angles (SSA) and Trabecular Iris Space Area (TISA) – were measured preoperatively and 1-month postoperatively through swept-source anterior segment optical coherence tomography. Postoperative refractive prediction error (PE) was calculated using an optimized A-constant and the Kane formula. Results Sixty eyes (30 PEX and 30 non-PEX) of 60 patients were included. Preoperative angle analysis revealed a lower ACA, AOD, SSA and TISA in PEX group ( p < 0.05), without biometric differences ( p > 0.05). A tendency for a higher magnitude of morphometric angle changes in PEX eyes was observed, with a superior increase of SSA at 500 µm (0°) and TISA at 750 µm (0°) ( p = 0.030 and p = 0.041, respectively). The anterior chamber deepened in both groups ( p = 0.01), with arithmetic and percentile change being higher in PEX group ( p = 0.017 and p = 0.047, respectively). A significant PE hyperopic shift was observed ( p = 0.035) only in PEX group. Conclusions Pseudoexfoliative eyes with cataract have narrower angles, revealing a tendency for higher angle opening after surgery, along with an increased ACD deepening compared to non-PEX eyes, which may be explained by PEX-associated zonular laxity. Moreover, a significant hyperopic shift was observed in PEX eyes, a relevant fact to take into consideration when selecting intraocular lens power.
Concurrent Perioperative Benzodiazepine and Opioid Utilization in Opioid-Naive Patients Undergoing Soft Tissue Hand Surgery
Authors: Zhuang Thompson , Berns Ellis M. , Lee Hannah H. , Sobel Andrew D. 
Published: January 2025

Background: While concomitant opioid and benzodiazepine use is discouraged due to an increased risk of sedation/overdose, the extent of perioperative opioid utilization in hand surgery patients already using benzodiazepines is unknown. Methods: Using an administrative claims database, we identified adults undergoing carpal tunnel, DeQuervain, or trigger finger release, palmar fasciectomies, ganglion/mucoid cyst removals, and hand/wrist soft tissue mass excisions from 2011 to 2021. We identified opioid-naive patients with a benzodiazepine prescription within 90 days before surgery. Outcomes included the percentage of patients prescribed opioids and the amount of opioids prescribed, new persistent opioid utilization, postoperative emergency department (ED) visits, hand therapy utilization, and opioid overdose. We used multivariable regression models to adjust for age, sex, region, insurance, procedure, and comorbidities. Results: Patients with benzodiazepine utilization had a higher adjusted odds of perioperative opioid prescriptions, amount of opioids filled, and new, persistent opioid use compared with patients without benzodiazepine use (all P < .001). In the multivariable analysis, patients with benzodiazepine use received +30.8 (95% CI: 28.9-32.8) morphine milligram equivalents and had an odds ratio of 1.48 (95% CI: 1.44-1.52) for developing new, persistent opioid use compared with patients without benzodiazepine use. Patients with preoperative benzodiazepine use also had increased postoperative ED visits and hand therapy utilization. Conclusions: Opioid-naive patients undergoing soft tissue hand surgery who are using benzodiazepines were prescribed opioids more frequently/at higher amounts and experienced an increased odds of developing new, persistent opioid use. Surgeons could consider reducing opioid prescriptions in patients already using benzodiazepines in favor of nonopioid pain strategies.
Determinants of Familiarity and Experience with HIV Pre-Exposure Prophylaxis in Primary Care Providers in Ontario, Canada
Authors: Martinez-Cajas Jorge , Alvarado Beatriz , Rapino Carmela , Nagy Emma , Guan T. Hugh , Cofie Nicholas , Dalgarno Nancy , Camargo Pilar , Stoner Bradley 
Published: January 2025

Background: Despite increased access to HIV pre-exposure prophylaxis (PrEP) in Canada, familiarity and experience among primary care providers (PCPs)—including family doctors and those working with key populations—remains limited. To understand the barriers and facilitators of PrEP familiarity and experience, we conducted a situational analysis in PCPs in sub-urban and rural Ontario. Methods: We surveyed a non-probabilistic sample of PCPs using an online questionnaire, designed with the Consolidated Framework for Implementation Research (CFIR). Poisson regressions with robust variance were used to assess the relationship between CFIR domains, sociodemographic, and practice characteristics on both PrEP familiarity and experience. Results: A total of 54 PCPs participated (6% response rate), comprising 80% physicians and 20% nurses. Nearly 30% of the sample worked with key populations, including sexual health clinics and community care centers, 18% of respondents reported high familiarity with PrEP, and 44% reported PrEP experience (referred, started a conversation, or prescribed). PrEP familiarity and experience were associated with working in an organization serving key populations, working with gender minorities, and having colleagues providing PrEP. Providers with a positive perception of PrEP and its necessity for populations at risk were more likely to have PrEP-related experience. Higher familiarity and experience were reported by PCPs with specific clinical skills related to PrEP, and with the perception that PrEP was compatible with their practice as primary provider. Conclusions: Our findings suggest that organizational support, and additional training and education would facilitate PrEP provision by PCPs in suburban/rural Ontario.
Sedentary Behavior and Physical Activity Assessment Following Botulinum Toxin A Treatment in Stroke Patients: A Comparative Pilot Study
Authors: Bastani Andisheh , Ayala Ana María Contardo , Lizama L. Eduardo Cofré , Elmalik Alaeldin , Amatya Bhasker , Khan Fary , Galea Mary P. 
Published: January 2025

Background In most patients with stroke, sedentary behaviors (SED) increase, and physical activity (PA) decreases over time. This has cumulative effects on the efficacy of physical rehabilitation interventions. This study aimed to determine the effects of botulinum toxin injections (BoNT-A) on SED and PA, and to determine the agreement between device-measured and self-report methods in stroke survivors with spasticity. Methods SED and PA were assessed in 17 chronic stroke survivors (mean age 49.7 years) with upper or lower limb spasticity following BoNT-A injections. Clinical assessments included spasticity, neurological impairment, functional ambulation, independence, and quality of life. SED and PA were also measured at baseline (T0), 6 weeks (T1), and 12 weeks (T2) using accelerometry and the International Physical Activity Questionnaire (IPAQ), categorizing activity into SED, low [light intensity physical activity (LIPA)], and moderate physical activity (MPA)-to-vigorous physical activity (VPA) levels. Multilevel mixed-effects linear regression models were used to determine the effects of BoNT-A on time spent in SED and PA. Bland–Altman plots were used to determine the agreement between the device measured and self-report methods. Results Accelerometry revealed a significant reduction in sedentary time and an increase in low-LIPA times at T2 only, whereas IPAQ-reported SED significantly decreased and LIPA increased at T1 and T2. Substantial increases in LIPA, MPA, and VPA times were also found with IPAQ at T2 only. IPAQ significantly underestimated the time spent in SED and overestimated VPA compared to accelerometry. Conclusions BoNT-A injections reduced SED time and increased light-intensity PA in stroke survivors with spasticity. Self-report measures, such as the IPAQ, may not measure the true impact of interventions, such as BoNT-A, on PA in patients with stroke.
Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI
Authors: Felbel Dominik , Fackler Sabrina , Michalke Rachel , Paukovitsch Michael , Gröger Matthias , Keßler Mirjam , Nita Nicoleta , Teumer Yannick , Schneider Leonhard , Imhof Armin , Buckert Dominik , Rottbauer Wolfgang , Markovic Sinisa 
Published: January 2025

Abstract

Background
ST-elevation myocardial infarction (STEMI) demands near-time reperfusion to reduce the risk of long-term heart failure. This study evaluates the proportion of impaired left ventricular ejection fraction (LVEF) following STEMI in the context of current healthcare settings at a tertiary care center equipped with the most advanced and up-to-date standards of care.

Methods
Patients experiencing STEMI as their first manifestation of coronary artery disease were analyzed, as these individuals had no prior experience with heart-related chest pain. LVEF was assessed by levocardiography at admission and semiautomatically using TOMTEC in patients with eligible full-cycle echocardiography of 2- and 4-chamber view available at discharge and 1-year follow-up (FU). Pain-to-balloon time was divided into quartiles (Q) [0-111, 112–159, 160–246 and 247–784 min]. Multiple logistic regression analysis identified independent predictors of reduced LVEF < 50% at 1-year FU.

Results
A total of 1,379 consecutive STEMI patients were reviewed from 2010 to 2017, with 130 meeting the inclusion criteria. Mean age was 63 ± 12 years, 75% were male, 14% had diabetes, 72% had arterial hypertension, and 56% had history of smoking. LVEF was reduced in 94% of patients at admission, 69% at discharge, and remained reduced in 45% at the 1-year follow-up. Anterior wall myocardial infarction (OR 3.2 [95%-CI 1.2–6.9], p = 0.018) and increasing pain-to-balloon time across quartiles (Q2: OR 15.7 [95%-CI 1.8–140.4], p = 0.014; Q4: OR 33.7 [3.4–278.7] p = 0.002) were independently associated with reduced LVEF at 1 year.

Conclusion
Despite optimal medical management and advanced healthcare structures, nearly half of patients with STEMI as their first presentation of coronary artery disease continue to exhibit reduced LVEF at 12-months. Anterior wall myocardial infarction and pain-to-balloon time exceeding 2 h remain independent predictors of left ventricular dysfunction. Further improvements in healthcare systems and public education are essential to reduce treatment delays and improve long-term outcomes.
Neonatal indicator data in Tanzania District Health Information System: evaluation of availability and quality of selected newborn indicators, 2015-2022
Authors: Shabani Josephine , Salim Nahya , Bohne Christine , Day Louise Tina , Kumalija Claud , Makuwani Ahmad Mohamed , Bundala Felix , Ismail Habib , Lawn Joy E. , Ohuma Eric O. 
Published: January 2025

Abstract

Background
The Every Newborn Action Plan (ENAP) indicators are essential in monitoring neonatal healthcare coverage and quality. The District Health Information System (DHIS2), an open-source platform in over 80 countries, supports health data collection and analysis, enabling progress tracking at national and subnational levels. This study evaluates the availability and quality of maternal and newborn health indicators, explicitly focusing on ENAP indicators within Tanzania’s DHIS2.

Methods
Using the EN-MINI tool, we assessed data availability for 20 ENAP indicators by analysing their numerators and denominators in Tanzania’s DHIS2 (2015–2022) across all healthcare levels. World Health Organization’s (WHO) data quality framework was adapted to examine four dimensions: (a) availability of indicators, (b) completeness of indicator reporting, (c) internal consistency of related indicators, and (d) indicator plausibility by comparing DHIS2 data with population-based Demographic and Health Survey (DHS) data.

Results
Of the 20 ENAP indicators, 14 were available in Tanzania’s DHIS2, with definitions, numerators and denominators aligned with WHO standards. Between 2015 and 2022, the number of facilities reporting at least one delivery annually increased by 19% from 5,898 to 7,016. During this period, 75% to 97% of facilities consistently reported data on skilled attendance at birth and early breastfeeding initiation. In contrast, 4% to 54% of facilities reported on maternal and newborn outcomes, including complications such as stillbirths and maternal mortality. Internal consistency was high (> 94%). However, neonatal mortality rates reported in DHIS2 were lower than those reported in Tanzania DHS for similar periods, even after a 20% adjustment to account for home births.

Conclusion
Tanzania’s DHIS2 captures many ENAP indicators; however, notable variability in data quality persists, with substantial data gaps related to maternal and newborn outcomes and complications. To address these challenges, it is crucial to strengthen routine data review, implement robust quality checks, enhance validation processes, provide targeted training, deliver constructive feedback, and conduct supportive supervision. Placing greater emphasis on using DHIS2 data to monitor progress will help identify gaps and drive improvements in data quality, ultimately supporting better maternal and newborn health outcomes.
Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
Authors: Chua Kevin Yiqiang , Tan Kelvin Bryan , Tong Rachel , Barrenetxea Jon , Koh Woon-Puay , Chen Cynthia 
Published: January 2025

Abstract

Background
Weak handgrip strength and slow timed up-and-go (TUG) time are known risk factors for hospitalization among older adults; however, few studies have investigated the relationships between these physical tests and future hospitalization costs.

Methods
We used data from 13,613 participants in the population-based Singapore Chinese Health Study who underwent assessment for handgrip strength and TUG time at a mean age of 74 years. Hospitalization costs for the subsequent year, among those who survived for at least one year thereafter, were ascertained via linkage with administrative healthcare finance data. We analyzed costs using a two-part model that contained a probit regression model in the first part, and a generalized linear regression model with gamma distribution and log link in the second.

Results
Handgrip strength showed a dose-dependent inverse relationship with hospitalization costs (P
trend<0.001). Compared to the strongest quartile, participants in the weakest quartile experienced a 38.2% (95% CI: 18.0-58.5%) increase of US$599 (US$281-US$917) in mean costs. Conversely, TUG time demonstrated a dose-dependent positive association with hospitalization costs (P
trend<0.001). Compared to the fastest quartile, participants in the slowest quartile had a 103.0% (72.1-133.9%) increase of US$1431 (US$1002-US$1859) in mean costs. We then examined combinations of handgrip strength and TUG time. Compared to participants who were both strong and fast, participants who were either weak or slow only had 12.9–48.7% higher mean costs. Meanwhile, participants who were both weak and slow experienced a 99.9% (68.5-131.4%) increase of US$1630 (US$1116-US$2144) in mean costs.

Conclusions
Weak handgrip strength and slow TUG time were independently associated with increased hospitalization costs among older adults.
Use of extracorporeal shockwave therapy combined with standard rehabilitation following anterior cruciate ligament reconstruction: a systematic review with meta-analysis
Authors: Shin Jaehyung , Rhim Hye Chang , Kim James , Guo Raymond , Elshafey Ramy , Jang Ki-Mo 
Published: January 2025

Abstract

Background
Anterior cruciate ligament (ACL) injuries are one of the most common sports injuries, accounting for approximately 50% of knee-related injuries. Extracorporeal shockwave therapy (ESWT), in the form of the radial (R-SWT) or focused shockwave (F-SWT), has been shown effective in treating various orthopaedic conditions. Recently, studies have investigated whether ESWT combined with standard rehabilitation may improve outcomes following anterior cruciate ligament reconstruction (ACLR). Therefore, this study aimed to determine whether ESWT can improve clinical outcomes following ACLR.

Methods
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched PubMed, Embase, and Web of Science and included studies involving ESWT treatment following ACLR, which consisted of randomized controlled trials (RCTs) and cohort studies. Two authors independently extracted the outcome measurements and used a revised Cochrane risk-of-bias tool (RoB 2) for RCTs and the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) for a cohort study to assess the risk of bias. A random effects pairwise meta-analysis was used to compare patient-reported outcomes between ESWT and controlled treatments.

Results
Five studies (Level I: 4; Level II: 1) with 242 participants (male: 167; female: 75) were included. Regarding the patient-reported outcomes, the risk of bias for all RCTs was ‘high’ and ‘serious’ for a non-randomized study. The meta-analysis demonstrated that the Lysholm scores were significantly higher in ESWT groups than those of controls at 12 months (Weighted mean difference [WMD]: 7.037, 95% confidence interval [CI]: 6.172–7.902, I2: 0%) and 24 months (WMD: 5.463, 95% CI: 2.870–8.056, I2: 0%). Furthermore, the International Knee Documentation Committee (IKDC) scores were also significantly higher in the ESWT group than that of the control at 12 months (WMD: 6.371, 95% CI: 3.397–9.344, I2: 68.8%). However, the WMDs for these outcomes between the two groups did not exceed the minimal clinically important difference (MCID).

Conclusion
Based on the meta-analyses performed with a few studies, ESWT combined with standard rehabilitation may potentially lead to better patient-reported outcomes. However, these differences may not be clinically significant. Further high-quality studies are needed to confirm our review’s findings.