bluuebunny/crossref_metadata_2025_split huggingface dataset:
Probiotics as a Promising Therapy in Improvement of Symptoms in Children With ADHD: A Systematic Review
Authors: Nahidi Mahsa , Soleimanpour Saman , Emadzadeh Maryam 
Published: February 2024

Background: ADHD is widely recognized as the most prevalent neurodevelopmental disorder in children. Recently, the potential role of gut microbiota as an etiological factor in ADHD has gained attention. This systematic review aims to investigate the potential impact of probiotic supplements on alleviating ADHD symptoms and influencing behavior. Methods: PubMed, Web of Science, Cochrane Library, and SCOPUS were searched from inception to May 2023. Only randomized controlled trials that have suitable data of the effects of probiotics/synbiotics on children with ADHD were enrolled. The risk of bias of the included studies was assessed by Cochrane Collaboration risk of bias tool. Results: Five related randomized controlled trial were evaluated in the current review. Types of interventions ranged from single/multi strain probiotics to synbiotic. The duration of intervention in all of the studies were 2 to 3 months. The assessed outcomes were very diverse and different tools were used to report the symptoms in children. Among those which used Conners’ Parent Rating Scale, a decrease in the total score occurred in the probiotic group, compared to the placebo group. An improvement in both intervention and control groups was seen in one study which used ADHD-Rating Scale. Conclusion: In summary, the combined findings from the reviewed studies suggest that probiotic supplements might potentially serve as a complementary intervention for ADHD. However, given the small number of studies, limited sample sizes, and the diversity of probiotic strains, further research is needed to clarify the effects of probiotics in children with ADHD. The observed tolerability of probiotics is noteworthy as none of the studies report adverse effects.
Does-dual mobility still offer improved stability in smaller cup sizes? A computer modelling comparison of stability with 22-mm versus 28-mm inner heads in dual-mobility versus single-bearing constructs
Authors: Atrey Amit , Navacchia Alessandro , Ward Sarah E , Rister David , Brillantes Jacqueline , Stavrakis Alexandra , Khoshbin Amir 
Published: February 2024

Purpose: Dislocation remains 1 of the leading causes of revision after primary total hip arthroplasty (THA) and there is clear evidence the dual-mobility (DM) is used more frequently to minimise this. But in smaller cups, whether the use of DM with smaller 22-mm heads imparts any increased stability compared to standard bearing is unknown; especially when those smaller cups now allow for large single-bearing (SB) heads. Methods: 3 primary cup sizes (48 mm, 50 mm, 52 mm) were chosen a priori for modelling. Head sizes trialled for the standard bearing (SB) constructs group were 28-0 mm, 32-0 mm and 36-0 mm against neutral polyethylene liners. In the modular sub-hemispheric DM constructs the inner head sizes for the DM constructs were altered where appropriate (22-0 mm vs. 28-0 mm). Cup position, stem offset, and stem size were standardised. Results: Both DM constructs outperformed all SB constructs because of a statistically significant jump distance increase ( p < 0.001). However, there was no difference in range of motion (ROM) or jump distances between the 22-mm and 28-mm DM inner heads. The ROM angle before impingement between the DM (with 22-mm or 28-mm heads) and SB (with different head sizes where appropriate) showed no statistically significant difference. However, DM constructs presented significantly larger jump distances than SB constructs for both provocative dislocation tests across all 3 cup sizes. Of interest, for 50-mm and 52-mm cup sizes (for which this particular DM construct design can accommodate both 22-mm and 28-mm inner heads), there were no differences in ROM or jump distance between 22-mm versus 28-mm inner heads. Conclusions: In this computer-modelling study, DM constructs are advantageous over SB constructs for improving jump distances in clinically provocative positions, but not range of motion angles. Inner head diameter of DM has no effect on stability.
Hybrid Closed-Loop Versus Manual Insulin Delivery in Adults With Type 1 Diabetes: A Post Hoc Analysis Using the Glycemia Risk Index
Authors: Lee Melissa H. , Vogrin Sara , Jones Timothy W. , O’Neal David N. 
Published: February 2024

Background: Glycemia risk index (GRI) is a novel composite metric assessing overall glycemic risk, accounting for both hypoglycemia and hyperglycemia and weighted toward extremes. Data assessing GRI as an outcome measure in closed-loop studies and its relation with conventional key continuous glucose monitoring (CGM) metrics are limited. Methods: A post hoc analysis was performed to evaluate the sensitivity of GRI in assessing glycemic quality in adults with type 1 diabetes randomized to 26 weeks hybrid closed-loop (HCL) or manual insulin delivery (control). The primary outcome was GRI comparing HCL with control. Comparisons were made with changes in other CGM metrics including time in range (TIR), time above range (TAR), time below range (TBR), and glycemic variability (standard deviation [SD] and coefficient of variation [CV]). Results: GRI with HCL (N = 61) compared with control (N = 59) was significantly lower (mean [SD] 33.5 [11.7] vs 56.1 [14.4], respectively; mean difference −22.8 [−27.2, −18.3], P = .001). The mean increase in TIR was +14.8 (11.0, 18.5)%. GRI negatively correlated with TIR for combined arms ( r = −.954; P = .001), and positively with TAR >250 mg/dL ( r = .901; P = .001), TBR < 54 mg/dL ( r = .416; P = .001), and glycemic variability (SD [ r = .916] and CV [ r = .732]; P = .001 for both). Conclusions: Twenty-six weeks of HCL improved GRI, in addition to other CGM metrics, compared with standard insulin therapy. The improvement in GRI was proportionally greater than the change in TIR, and GRI correlated with all CGM metrics. We suggest that GRI may be an appropriate primary outcome for closed-loop trials.
Advancing equity in challenging times: A qualitative study of telehealth expansion and changing patient–provider relationships in primary care settings during the COVID-19 pandemic
Authors: Aijaz Monisa , Lewis Valerie A , Murray Genevra F 
Published: February 2024

Objective The patient–provider relationship is critical for achieving high-quality care and better health outcomes. During the COVID-19 pandemic, primary care practices rapidly transitioned to telehealth. While telehealth provided critical access to services for many, not all patients could optimally utilize it, raising concerns about its potential to exacerbate inequities in patient–provider relationships. We investigated technical and workforce-related barriers to accessing telehealth and the impacts on patient–provider relationships for vulnerable populations. Methods Qualitative, semi-structured interviews from May 2021 to August 2021 with 31 individuals (medical directors, physicians, and medical assistants) working at 20 primary care practices in Massachusetts, North Carolina, and Texas. Thematic analysis to better understand how barriers to using telehealth complicated patient–provider relationships. Results Interviewees shared challenges for providers and patients that had a negative effect on patient–provider relationships, particularly for vulnerable patients, including older adults, lower socio-economic status patients, and those with limited English proficiency. Providers faced logistical challenges and disruptions in team-based care, reducing care coordination. Patients experienced technological challenges that made accessing and engaging in telehealth difficult. Interviewees shared challenges for patient–provider relationships as commonly used telephone-only telehealth reduced channels for non-verbal communication. Conclusion This study indicates that barriers to virtual interaction with patients compared to in-person care likely led to weaker personal relationships that may have longer-term effects on engagement with and trust in the healthcare system, particularly among vulnerable patient groups. Additional support and resources should be available to primary care providers to optimize telehealth utilization.
Clinical decision support system using a machine learning model to assist simultaneous cardiopulmonary auscultation: Open-label randomized controlled trial
Authors: Hirosawa Takanobu , Sakamoto Tetsu , Harada Yukinori , Tokumasu Kazuki , Shimizu Taro 
Published: February 2024

Background The utility of a clinical decision support system using a machine learning (ML) model for simultaneous cardiac and pulmonary auscultation is unknown. Objective This study aimed to develop and evaluate an ML system's utility for cardiopulmonary auscultation. Methods First, we developed an ML system for cardiopulmonary auscultation, using cardiopulmonary sound files from our previous study. The technique involved pre-processing, feature extraction, and classification through several neural network layers. After integration, the output class was categorized as “normal,” “abnormal,” or “undetermined.” Second, we evaluated the ML system with 24 junior residents in an open-label randomized controlled trial at a university hospital. Participants were randomly assigned to the ML system group (intervention) or conventional auscultation group (control). During training, participants listened to four cardiac and four pulmonary sounds, all of which were correctly classified. Then, participants classified a series of 16 simultaneous cardiopulmonary sounds. The control group auscultated the sounds using noise-cancelling headphones, while the intervention group did so by watching recommendations from the ML system. Results The total scores for correctly identified normal or abnormal cardiopulmonary sounds in the intervention group were significantly higher than those in the control group (366/384 [95.3%] vs. 343/384 [89.3%], P = 0.003). The cardiac test score in the intervention group was better (111/192 [57.8%] vs. 90/192 [46.9%], P = 0.04); there was no significant difference in pulmonary auscultation. Conclusions The ML-based system improved the accuracy of cardiopulmonary auscultation for junior residents. This result suggests that the system can assist early-career physicians in accurate screening.
A Survey of Sleep Quality From a Post-COVID Clinic
Authors: Punj Mantavya , Schwartz Michael , Morris Anjali , Cheung Joseph , Munipalli Bala 
Published: February 2024

Objectives: To assess the prevalence of sleep disturbance among patients evaluated at a clinic for patients afflicted with Post-acute sequelae of COVID-19 (PASC). Methods: Sleep disturbance was assessed with the Patient-Reported Outcomes Measurement Information System-Sleep Disturbance (PROMIS-SD) framework among adult patients of the PASC clinic. Results: Among 312 patients, the mean age was 46.2 years, and 70.2% were women. About 41.0% of patients had no sleep disturbance; sleep disturbance was mild to moderate in 51.3% and severe in 7.7%. PROMIS-SD score was negatively correlated with the time from the initial positive COVID-19 test to the initial consultation in the PASC clinic (Pearson r = −.094; r2 = .0088). Conclusions: The PROMIS-Sleep Disturbance framework can serve as a tool to assess the burden of sleep disturbances in PASC patients.
Comparative Evaluation of the Efficacy of Different Ni-Ti Rotary Instruments in Removal of Gutta-Percha During Root Canal Retreatment: An in vitro Study
Authors: Kumar S. Kishore , Kumar Mohit , Sharma Nikita , Arora Pulkit , Bhatt Megna , Akkanapally Sravyanjali 
Published: February 2024

Aim: An assessment and comparison of three retreatment files was conducted to determine their effectiveness in the retrieval of gutta-percha. Materials and Method: In the investigation, 60 extracted single-rooted human teeth having straight canals and complete apices were used. The ProTaper Universal file system was used to prepare teeth and obturated using gutta-percha with sealant AH Plus utilizing down pack and backfill obturation technique. Removal was performed with ProTaper, D-RaCe files, MTwo, and R-Endo retreatment files. Using a stopwatch, the time needed to take out the GP was also calculated in seconds. We used ANOVA along with the post hoc Tukey’s test to analyze the quantity of obturating material in apical, middle, and coronal third following decoronation and longitudinal splitting. Results: The average percentage of gutta-percha points removed across root levels varied significantly among the ProTaper, D-RaCe MTwo, and R-Endo groups. With the exception of the ProTaper group, when the middle level displayed the most removal, the coronal level showed much higher removal than the mid-root level, while the apical level often exhibited the highest removal. Conclusion: ProTaper retreatment files outperformed MTwo, D-RaCe, and R-Endo among the four groups in terms of removing root canal filling material. However, none of the experimental groups removed gutta-percha completely from root canals.
Incidence and Mortality of Salivary Gland Cancer Worldwide and Its Correlation with Tobacco Use (Smoking and Chewing) and With the Human Development Index
Authors: Hernández-Morales Antonio , González-López Blanca Silvia , Scougall-Vilchis Rogelio José , Velázquez-Enríquez Ulises , Ortiz Mario I. , Veras-Hernández Miriam Alejandra , Casanova-Rosado Juan Fernando , Casanova-Rosado Alejandro José , Medina-Solís Carlo Eduardo , Maupomé Gerardo 
Published: February 2024

Aim: The aim of this study was to quantify the association between the incidence and mortality of salivary gland cancer (SGC) with the consumption of tobacco and with the Human Development Index (HDI). Materials and Methods: An ecological study was designed using SGC incidence and mortality data in 172 countries in 2020, reported per 100,000 population with an age range of 10–85 years. Such dependent variables were obtained from the Global Cancer Observatory (GLOBOCAN). The prevalences of smoked and chewed tobacco were obtained from reports made in 2019, sourced from Global Burden of Diseases Study, while the HDI was obtained from the Human Development Report (2019) presented by the United Nations Development Program, and were considered independent variables. Statistical analysis was performed in Stata using Spearman’s correlation test. Results: In 2020, there were 53,583 new cases of SGC worldwide, and countries with very high HDI exhibited a higher incidence. In terms of mortality, there were 22,778 cases worldwide, and countries with a moderate HDI showed a higher number of deaths. SGC mortality was associated with chewing tobacco use overall and in women. Surprising negative associations were found with the incidence of SGC and tobacco smoking in men, as well as with mortality of SGC and smoking overall and in women. CGS mortality was negatively associated with the HDI and all its components. Conclusion: In this international overview, SGC mortality is associated with chewing tobacco in women, as well as with the HDI and its components.
Analysing the Total Factor Productivity Change Among Urban Cooperative Banks in India: The Malmquist Productivity Approach
Authors: Zaman Aadil Ummar , Zaman Mohammad Shahid 
Published: February 2024

This study investigates the total factor productivity (TFP) growth among urban cooperative banks in India during 2014–2020. The measurement of productivity is done using the data envelopment analysis-based Malmquist productivity index. We use two different models, viz., the intermediation approach and the production approach, to see how productivity estimates vary with the change in inputs and outputs. Our results show a large asymmetry in productivity estimates both among banks and over time. TFP estimates were consistently higher under the production approach vis-à-vis the intermediation approach. Further, the empirical results show that productivity gains were mainly determined by technological progress rather than efficiency improvements. Thus, collaborations in technological know-how can be beneficial to productivity growth. JEL Classifications: G15, G21, G34
Risk Factors Associated With Poor Outcomes After Quadriceps Tendon Repair
Authors: Coladonato Carlo , Hanna Adeeb Jacob , Patel Neel K. , Sonnier John Hayden , Connors Gregory , Sabitsky Matthew , Johnson Emma , Mazur Donald W. , Brahmabhatt Shyam , Freedman Kevin B. 
Published: February 2024

Background: Ruptures of the quadriceps tendon present most frequently in older adults and individuals with underlying medical conditions. Purpose: To examine the relationship between patient-specific factors and tear characteristics with outcomes after quadriceps tendon repair. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective review was conducted on all patients who underwent quadriceps tendon repair between January 1, 2016, and January 1, 2021, at a single institution. Patients <18 years and those with chronic quadriceps tendon tears (>6 weeks to surgery) were excluded. Information was collected regarding patient characteristics, presenting symptoms, tear characteristics, physical examination findings, and postoperative outcomes. Poor outcome was defined as a need for revision surgery, complications, postoperative range of motion of (ROM) <110° of knee flexion, and extensor lag of >5°. Results: A total of 191 patients met the inclusion criteria. Patients were aged 58.5 ± 13.2 years at the time of surgery, were predominantly men (90.6%), and had a mean body mass index (BMI) of 32.2 ± 6.3 kg/m2. Patients underwent repair with either suture anchors (15.2%) or transosseous tunnels (84.8%). Postoperatively, 18.5% of patients experienced knee flexion ROM of <110°, 11.3% experienced extensor lag of >5°, 8.5% had complications, and 3.2% underwent revision. Increasing age (odds ratio [OR], 1.03 [95% CI, 1.004-1.07]) and female sex (OR, 3.82 [95% CI, 1.25-11.28]) were significantly associated with postoperative knee flexion of <110°, and increasing age (OR, 1.08 [95% CI, 1.04-1.14]) and greater BMI (OR, 1.14 [95% CI, 1.05-1.23]) were significantly associated with postoperative extensor lag of >5°. Current smoking status (OR, 15.44 [95% CI, 3.97-65.90]) and concomitant retinacular tears (OR, 9.62 (95% CI, 1.67-184.14]) were associated with postoperative complications, and increasing age (OR, 1.05 [95% CI, 1.02-1.08]) and greater BMI (OR, 1.08 [95% CI, 1.02-1.14]) were associated with risk of acquiring any poor outcome criteria. Conclusion: Patient-specific characteristics—such as increasing age, greater BMI, female sex, retinacular involvement, and current smoking status—were found to be risk factors for poor outcomes after quadriceps tendon repair. Further studies are needed to identify potentially modifiable risk factors that can be used to set patient expectations and improve outcomes.
Complementarity Versus Substitution Relationship between Outward FDI and Exports: Evidence from India
Authors: Goldar Bishwanath , Parida Yashobanta , Goldar Anindita 
Published: February 2024

The article is concerned with the relationship between foreign direct investment (FDI) flows and exports and asks if these two flows are substitutes or complement each other. Empirical work in this area employing industry- or country-level data has generally found a positive or complementary relationship between exports and FDI. Our empirical strategy is different in that we try to throw some light on the issue of substitution versus complementarity between FDI and exports by carrying out econometric analyses directed at assessing how India’s mass termination of bilateral investment treaties (BITs) in March 2017 and such BIT terminations during September–December 2016 and April 2017 to December 2018 impacted India’s FDI inflows and imports. Our finding of a significant negative effect of BIT termination on FDI inflows, corroborating the findings of two earlier studies and the finding of a significant positive impact of BIT termination of India’s imports is conceivably reconcilable only if there is a substitution relationship between FDI and exports. Hence, we find some empirical evidence of a substitution relationship between FDI and exports—at least, this has been the relationship between India’s inflow of FDI and the inflow of goods as imports, if not valid for other countries. JEL codes: C31, C33, K33, F21
Adsorption of atrazine and paraquat on montmorillonite loaded with layered double hydroxide and active site energy distribution analysis
Authors: Liu Rui , Ma Chao , Chen Huanliang , Li Changsuo , Zuo Lei , Zhang Peng , Wang Yaqing , Wang Ru 
Published: February 2024

AbstractClay minerals are effective adsorbents for the remediation of pesticides in wastewater due to their large superficial areas and excellent cation-exchange capabilities. However, this adsorption effect can be reduced by the accumulation of adsorbents on clay minerals, amongst other problems. Therefore, in this study, montmorillonite (Mnt) modified by layered double hydroxide (LDH) with different loading amounts was successfully prepared using an in situ method. The results from X-ray diffraction, Fourier-transform infrared spectrometry, Brunauer–Emmet–Teller (BET) and scanning electron microscopy analyses revealed that LDH structures were successfully combined with the Mnt layer and formed a porous structure. However, excess LDH still caused the aggregation and accumulation of layers. The adsorption performance of LDH@Mnt for atrazine (ATZ) and paraquat (PQ) was investigated, and the removal efficiency of the LDH@Mnt composite was higher than those of Mnt and LDH alone. The kinetic study revealed that the adsorption process fitted the pseudo-second-order model and internal diffusion model, and 3-LDH@Mnt had the greatest absorbability efficiency for both ATZ and PQ, indicating the adsorption process was controlled by the number of active sites of the adsorbent. The generalized Langmuir model accurately characterized the adsorption process of ATZ and PQ elimination in the adsorption isotherm investigation, indicating that the adsorption energies of the active sites on the adsorbents were different. 3-LDH@Mnt had better absorbability performance for ATZ/PQ, and the sorption capacities were 7.03 and 91.9 mg g–1, respectively. According to site energy distribution theory, the amount of sorption sites of the composite adsorbent was large and the average adsorption energy was high, both of which being beneficial for the adsorption of ATZ and PQ. The effects of pH, coexisting anions and reuse experiments were also tested, indicating that the LDH@Mnt composite possessed high adsorption stability. This excellent removal performance represents a promising strategy for the remediation and elimination of pesticide contaminations from the environment.