bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia
Authors: Tesfaye Behailu Terefe , Bosho Dula Dessalegn , Dissassa Gashahun Mekonnen , Tesfaye Mikiyas Gashaw , Yizengaw Mengist Awoke 
Published: December 2023

Abstract
Background: Evidence shows that potentially inappropriate medication (PIM) use in older adults significantly increases the utilization of healthcare resources. According to studies, PIM is widely prescribed, but little is known about the correlation between PIM use and the utilization of healthcare resources in Africa, particularly Ethiopia. Therefore, the primary aim of this study was to provide local evidence on the presence of an association between healthcare expenditure and the frequency of PIM.
Methods: This observational study was conducted from 06 September 2021 to 30 December 2022. A total of 151 hospitalized older adult patients were included in the study. The data collection format was designed to capture relevant information. STATA V.15.0 was used for analysis. Descriptive statistics and a generalized linear model regression were conducted. Statistical significance was set at a p-value <0.05. The findings are presented in tables, figures, and text.
Results: The total healthcare expenditure was higher in PIM users (385368.6 ETB) than in non-PIM users (131267.7 ETB). The median expenditures for medical supplies (p=0.025), investigations (p=0.033), and total healthcare expenditure (p=0.023) were significantly higher in patients with ≥2 PIMs than in those with no or one PIM. However, after model adjustment, the total healthcare expenditure was not significantly different across the frequency of PIMs used. Number of medications (adjusted B=0.068, 95% CI: 0.035, 0.101, p<0.001) and taking blood and blood-forming organ class of medication (adjusted B=0.151, 95% CI: 0.005, 0.297, p=0.042) were associated with higher total healthcare expenditure, whereas the total healthcare expenditure was significantly lower in those patients with diseases of the nervous system (adjusted B= -0.307, 95% CI: -0.502, -0.112, p=0.002) and respiratory system (adjusted B= -0.196, 95% CI: -0.327, -0.065, p=0.003).
Conclusion: The total healthcare expenditure is nearly three times higher in PIM users. However, its association with the frequency of PIM use was not statistically significant in the final model. Strengthening assessment and interventions on the possibility of deprescribing medications may help reduce total healthcare expenditures. The authors also recommend a similar, adequately powered local study.
Association of lipid levels, adipokines and multiple myeloma: a two-sample multivariate Mendelian randomization study
Authors: Ding Yi , Zhang Yudong , Zhang Xiaoshan , Shang Mingrong , Dong Fan 
Published: December 2023

Abstract

Background: Many observational studies and experiments have found a strong association between lipid levels and adipokines and multiple myeloma(MM), but the causal relationship between lipid levels, adipokines and MM remains to be determined.
Methods: We performed a two-sample and multivariate MR analysis to investigate the causal relationship between lipid levels, adipokines and MM. Total cholesterol(TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were used to represent lipid levels, and adiponectin, leptin, and resistin were used to represent adipokines. Genetic data for each index and MM were obtained from the Integrated Epidemiology Unit (IEU) Genome-Wide Association Study (GWAS) database, and two-sample MR analyses were performed, as well as multivariate MR analyses of adipokines for causality of MM using BMI as an adjusting factor.
Results: In the analyzed results, no significant causal association was found between adipokines , lipid levels and multiple myeloma, and after adjusting for BMI, an association between adipokines and MM was still not found.
Conclusion: The results of this MR study do not support an association between genetically predicted adipokines, lipid levels, and risk of MM, but we cannot rule out the existence of a weak association. The mechanisms need to be further investigated.
Analysis of the efficacy and complications of laparoscopic Cohen's ureteral reimplantation in the treatment of pediatric vesicoureteral reflux
Authors: Zhang Tao , Cao Yongsheng , Zhu Wenwen , Mao Changkun 
Published: December 2023

Abstract

Purpose
To analyze the efficacy of Cohen’s laparoscopic ureteral reimplantation in the treatment of pediatric vesicoureteral reflux and the associated common postoperative complications and their management.
Materials and methods
The clinical data of children with vesicoureteral reflux who underwent Cohen’s laparoscopic ureteral reimplantation at our hospital between January 2018 and December 2022 were retrospectively analyzed. Subsequently, the postoperative complications were managed and summarized.
Results
The average duration of Cohen's laparoscopic ureteral reimplantation surgery was 190.8 ± 52.9 min. The median blood loss was 10 mL. The inner diameter of ureter was 0.6 ± 0.3 cm, and the anterior-posterior diameter of the kidney pelvis was 0.9 ± 0.4 cm after surgery and exhibited significant reductions when compared to the pre-surgical measurements (1.1 ± 0.5 cm and 2.2 ± 1.2 cm, respectively). The thickness of the kidney cortex (0.56 ± 0.18 cm) displayed a significant increase relative to its preoperative measurement (0.45 ± 0.15 cm). The surgical intervention resulted in a substantial decrease in the occurrence of reflux in children, dropping from 100% preoperatively to 3.1% postoperatively. Similarly, the rate of urinary tract infection after surgery significantly decreased to 15.6%, compared to the preoperative percentage of 90.6%. seven children developed bladder spasm, five experienced postoperative hydronephrosis, and one had ureteral obstruction. Additionally, nine children experienced bladder dysfunction such as urinary frequency and urgency post-surgery.
Conclusions
Cohen’s laparoscopic ureteral reimplantation is an effective treatment for primary vesicoureteral reflux in children. Although it is not always possible to entirely prevent postoperative complications, active management can aid in their gradual recovery.
The correlation between interprofessional collaboration and nursing empowerment within interprofessional educational environments enhanced by clinical simulation (SIM-IPE) and in real-world care scenarios
Authors: Casòliva Laura Macià , Olid Clara Selva , Claret Carlota Riera 
Published: December 2023

Abstract

Objectives: Investigating the correlation between interprofessional collaboration and nursing empowerment.
Methodology: Qualitative study of an interpretive phenomenological type with purposive sampling until data saturation. Data collection involves non-participant observation in Simulation-Enhanced Interprofessional Education environments (SIM-IPE), semi-structured interviews with six participating nurses, observation in a semi-critical care unit during the arrival of COVID-19, and eight interviews with participating nurses. Analysing the entire data corpus reveals 35 codes subsumed into eight categories and two final themes.
Results: It was possible to determine the existence of factors influencing perceptions of the nursing profession in interprofessional teams, including a positive team atmosphere, perceived safety within the environment, generation of emotions, recognition of key aspects, and opportunities for individual and collective improvement. Additionally, the study identifies the implications of nursing empowerment in interprofessional teams, such as introspection, self-analysis, awareness of impact, and positive perceptions.
Conclusions: The research highlights interactive elements within interprofessional teams contributing to nursing empowerment, along with positive implications for the effective functioning of interprofessional teams resulting from the empowerment of the nursing group.
Genomic insights into colistin and tigecycline resistance in ESBL- producing Escherichia coli and Klebsiella pneumoniae harboring blaKPC genes in Ecuador
Authors: Ortega David , Vinueza-Burgos Christian , Canto Felipe Del , Barba Pedro , Rios Rafael , Diaz Lorena , Reyes Jinnethe , Arias Cesar A. , Zurita Jeannete 
Published: December 2023

Abstract

Escherichia coli and Klebsiella pneumoniae are resistant to third-generation cephalosporins, carbapenems, colistin, and tigecycline, becoming a major public health priority. Mainly within the developing world. However, their genomic epidemiology and possible determinants of resistance remain to be elucidated. Thus, this study aimed to perform genomic characterizations for E. coli and K. pneumoniae that are resistant to last-line antibiotics, isolated from humans, and poultry, ther with a dairy-farm environment within Ecuador. This study analyzed, at the genomic level, nine 3CG-resistant E. coli isolates harboring the mcr-1 gene (six from poultry farms, two from human infections, and one from dairy-farm compost), together with ten isolated colistin and carbapenem-resistant K. pneumoniae clinical samples. E. coli isolates of human origin belonged to ST609 and phylogroup A, while poultry and compost isolates belonged to differing STs and phylogroups A, B1, E, and F. K. pneumoniae isolates were ST13 (five isolates), ST258 (four isolates) and ST86 (one isolate). Within E. coli isolates, blaCTX-M-55, blaCTX-M-65, blaCTX-M-15, and blaCTX-M-2 genes were identified. This study also identified blaCMY-2 and blaKPC-3 (the latter in a carbapenem-susceptible isolate). The plasmid-borne mcr-1.1 gene was identified across all E. coli isolates within an IncI2 plasmid (reference for assembling CP018669). Tigecycline-reduced susceptibility or resistance was related to missense-sense mutations in marA and acrA genes. Within K. pneumoiae, blaCTX-M-15 and blaCTX-M-65 blaKPC-2 and blaKPC-3, encoding ESBLs and carbapenemases, were detected. The blaKPC-2 genes were identified in a ̴ 10-kb Tn4401 transposon, with genetic context being: tnpR-tnpA-istA-istB-blaKPC-2-tnpA. This investigation identified a nonsense mutation in mgrB (K3*) and several mis-sense mutations within arnB, eptA, pmrB, pmrJ, and phoQ, linked to colistin resistance. Tigecycline resistance was linked to nonsense and mis-sense mutations within the ramR gene. Additionally, this study identified several integrons, including Int191(5’CS-dfrA14-3’CS), which was the most prevalent integron among E. coli and K. pneumoniae isolates, followed by Int0 (5’CS-3'CS) and int18 (5’CS-dfrA1-3'CS). These results could contribute to future MDR E. coli and K. pneumoniae epidemiological studies.
WITHDRAWN: Analysis of Colorectal Cancer Trends, Clinicopathological Features, Surgical Treatment Patterns, Prognoses, and Nomogram for Survival Predicting: A Retrospective Cohort Study on Patients Managed from 2019 to 2021 at West Kazakhstan
Authors: Imanbayev Nauryzbay , Iztleuov Yerbolat , Kaliyev Asset , Mussin Nadiar , Zare Afshin , Aldyngurov Daulet , Kairatovich Izdenov , Zhilisbayeva Kulyash , Tamadon Amin 
Published: December 2023

Abstract
Background/Objective
This retrospective cohort study aimed to comprehensively analyze colorectal cancer (CRC) trends, clinico-pathological features, surgical treatment patterns, and prognoses among patients managed from 2019 to 2021 at the West Kazakhstan Medical University.
Methods
Medical records of 420 patients diagnosed with CRC were retrospectively analyzed. Univariate and multivariate regression analyses were conducted to explore the impact of demographic, clinical, and molecular factors on CRC characteristics, progression, treatment, and cancer-related mortality.
Results
Univariate analyses revealed that age, tumor morphology, tumor stage, tumor infiltration depth, lymph node involvement, and metastasis significantly influenced CRC outcomes. Notably, older age (> 65 years) was associated with reduced cancer progression. Adenocarcinomas with higher grades displayed negative correlations with disease progression, and tumor stage exhibited strong associations with progression and prognosis. Multivariate analyses confirmed these findings, highlighting the complex interactions between these factors.
Conclusion
This study provides a comprehensive assessment of CRC trends, clinico-pathological features, treatment patterns, and prognoses. The integration of univariate and multivariate analyses enhances our understanding of the intricate interplay of demographic, clinical, and molecular factors in shaping CRC outcomes. Personalized treatment approaches considering these interactions could improve CRC care.
Electroacupuncture attenuates ferroptosis by promoting Nrf2 nuclear translocation and activating Nrf2/SLC7A11/GPX4 pathway in ischemic stroke
Authors: yang xichen , yang xichen 
Published: December 2023

Abstract

Objective
Electroacupuncture has been shown to play a neuroprotective role following ischemic stroke, but the underlying mechanism remains poorly understood. The ferroptosis has been shown to play a key role in the injury process. In present study we wanted to explore whether electroacupuncture could inhibit ferroptosis by promoting nuclear factor erythroid-2-related factor 2(Nrf2) nuclear translocation.
Methods
The ischemic stroke model was established by middle cerebral artery occlusion/reperfusion(MCAO/R) in adult rats. These rats have been randomly divided into the EA + MCAO/R group, the MCAO/R group, the EA + MCAO/R + Brusatol group(the inhibitor of Nrf2) and the EA + MCAO/R + DMSO group, and the Sham group. The EA + MCAO/R group, EA + MCAO/R + Brusatol group and the EA + MCAO/R + DMSO group received EA intervention at 24 hours after modeling for consecutive 7 days. The behavioral function was evaluated by Neurologic severity score(NSS), Garcia score, Foot-fault Test and Rotarod Test. The infarct volume were detected by TTC staining..The levels of Fe2+, reactive oxygen species (ROS), superoxide dismutase(SOD) and malondialdehyde(MDA) were measured by ELISA. The immunofluorescence and Western blotting was used to detect the expression of Total Nrf2, p-Nrf2, Nuclear Nrf2 and Cytoplasmic Nrf2, and the essential ferroptosis proteins, including glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11(SLC7A11) and ferritin heavy chain 1(FTH1). The mitochondria were observed by transmission electron microscopy(TEM).
Results
Electroacupuncture improved neurological deficits in rats model of MCAO/R, decrease the brain infarct volume, and inhibited the Fe2+, ROS and MDA accumulation, increased SOD levels, increased the expression of GPX4, SLC7A11 and FTH1, and rescued injured mitochondria. Especially, we found that the electroacupuncture up-regulated the expression of Nrf2, and promote phosphorylation of Nrf2 and nuclear translocation,However, Nrf2 inhibitor Brusatol reversed the neuroprotective effect of electroacupuncture.
Conclusion
These findings indicate that electroacupuncture confers neuroprotection against ischemic stroke through inhibitting ferroptosis. The underlying mechanism may be that electroacupuncture promote Nrf2 nuclear translocation and activate Nrf2/SLC7A11/GPX4 pathway.
Assessment of Awareness and Willingness to Adopt Solar Energy in Ghana – Perspective from End Users
Authors: Awuku Samuel Amo , Bennadji Amar , Muhammad-Sukki Firdaus , Prabhu Radhakrishna , Sellami Nazmi 
Published: December 2023

Abstract

The culture of sustainable and clean energy has become a top priority in many countries globally partly due to the issue of climate change and energy paucity. Solar energy is one of the most adopted energy sources due to its clean nature and availability, especially in areas with high sunlight. Despite the apparent benefits, its adoption is relatively low, especially in developing countries such as Ghana. This study thus employs a quantitative approach to assess the awareness and adoptability of solar energy in Ghana. It reaches out to 412 respondents across all 16 regions of the country through survey questionnaires. The results indicate that the respondents' awareness of solar energy was high (97.1%) partly because most had formal education (first degree). 73.7% of the respondents indicated that they heard about it from the media (news, radio, and outdoor adverts). Also, 87% were willing to adopt solar energy for their homes should there be a flexible loan facility that could be paid for over 10 years. It was also discovered that the level of education has an impact on awareness and adoption of solar energy. This study recommends that stakeholders should prioritise mechanisms to increase solar energy awareness, and a viable financial scheme must be made available to help boost the adoption of solar energy in Ghana. Additionally, efforts must be made by stakeholders to train hands-on technicians to boost adopter confidence. This study is expected to serve as a resourceful reference for policymakers, researchers, and stakeholders.
The Impact of Gold Nanoparticles Conjugated with Albumin on Prostate and Breast Cancer Cell Lines: Insights into Cytotoxicity, Cellular Uptake, Migration, and Adhesion Potential
Authors: Mahmoud Nouf N , Salman Talah M. , Al-Dabash Sabaa , Abdullah Maha , Abu-Dahab Rana 
Published: December 2023

Abstract

Breast and prostate cancers are prevalent in women and men, respectively. The process of metastasis plays a crucial role in cancer advancement. Herein, two distinct forms of gold nanoparticles (GNP) were prepared and modified with bovine serum albumin (BSA) to create gold nanorods-BSA (GNR-BSA) and gold nanospheres-BSA (GNS-BSA). Various aspects of biological interactions of these nanoparticles with two prostate cancer cell lines (DU-145 and PC-3) and a breast cancer cell line (MDA-MB-231) have been investigated. The cell viability of DU-145 and PC-3 ranged from 17% to 95% across concentrations of 0.55 to 34.5 µg/mL, and for MDA-MB-231 ranged from 17% to 85%. GNS-BSA exhibited no significant cytotoxicity against the cancer cell lines. Regarding cellular uptake, GNR-BSA demonstrated uptake rates of 10%, 14%, and 5% for DU-145, PC-3, and MDA-MB-231 cell lines, respectively, while GNS-BSA showed uptake of less than 0.4% for all the cell lines investigated. Notably, GNR-BSA significantly impeded the cellular migration of DU-145 and PC-3 cells over 48 hr and MDA-MB-231 cells over 24 hr compared to controls. GNS-BSA inhibited cell migration over 48 hours for DU-145 and over 24 hours for PC-3 and MDA-MB-231. Adhesion assay showed a moderate reduction of PC-3 adhesion ability (~ 20%) by GNS-BSA, while a minimum effect was observed on DU-145 (~5%). GNR-BSA have minimally affected the adhesion ability of both PC-3 (~8%), and DU-145 (~13%) and no adhesion ability reduction was observed on MDA-MB-231 by both GNP-BSA. This study suggests that GNP-BSA could be promising potential agents for combating cancer and inhibiting cellular invasion, and they could serve as promising platforms for drug delivery.
Methamphetamine enhancement of HIV-1 gp120-mediated NLRP3 inflammasome activation and resultant proinflammatory responses in rat microglial cultures
Authors: Dutta Debashis , Liu Jianuo , Xu Enquan , Xiong Huangui 
Published: December 2023

Abstract
Background
Human Immunodeficiency Virus type 1 (HIV-1)-associated neurocognitive disorders (HAND) remain prevalent in HIV-1-infected individuals despite the evident success of combined antiretroviral therapy (cART). The mechanisms under HAND prevalence in the cART era remain perplexing. Ample evidence indicates that HIV-1 envelope glycoprotein protein 120 (gp120), a potent neurotoxin, plays a pivotal role in the HAND pathogenesis. Methamphetamine (Meth) abuse exacerbates HAND. How Meth exacerbates HAND is not fully understood. This study was to test the hypothesis that Meth exacerbates HAND by enhancing gp120-mediated proinflammatory responses in the brain, worsening the pathogenesis of HAND.
Methods
Experiments were carried out on primary microglial cultures prepared from neonatal SD rats. The purity of microglia was determined by staining with anti-CD11b. Meth and gp120 were applied to microglial cultures. Microglial activation was revealed by immunostaining and Iba-1 expression. The protein expression levels of Pro-IL-1β, Il-1β, Iba-1, iNOS, NLRP3, GSDMD and GSDMD-N were detected by western blotting analyses. The levels of proinflammatory cytokine and NO production in the microglia culture supernatants were assayed by ELISA and Griess reagent systems, respectively. NLRP3 activation was uncovered by fluorescent microscopy images displaying NLRP3 puncta labeled by anti-NLRP3 antibody. NLRP3 co-localization with caspase-1 was labeled with antibodies. One-way ANOVA with post hoc Tukey’s multiple comparison tests was employed for statistical analyses.
Results
Meth enhanced gp120-induced microglia activation revealed by immunostaining and Iba-1 expression, and potentiated gp120-mediated NLRP3 expression, IL-1β processing and release assayed by immunoblot and ELISA. Meth also augmented the co-localization of NLRP3 and caspase-1, increased the numbers of NLRP3 puncta and ROS production, elevated levels of iNOS expression and NO production, and enhanced levels of cleaved gasderminD (GSDMD-N, an executor of pyroptosis) in gp120-primed microglia. The Meth-associated effects were attenuated or blocked by MCC950, an NLRP3 inhibitor, or Mito-TEMPO, a mitochondrial superoxide scavenger, indicating the involvement of mitochondria in Meth enhancement of NLRP3 inflammasome activation in gp120-primed microglia.
Conclusions
These results suggest that Meth enhanced gp120-associated microglial NLRP3 activation and resultant proinflammatory responses via mitochondria-dependent signaling.
Face and content validity of the EMPOWER-UP questionnaire: a generic measure of empowerment in relational decision-making and problem-solving
Authors: Marqvorsen Emilie Haarslev Schröder , Lund Line , Biener Sigrid Normann , Due-Christensen Mette , Husted Gitte R. , Jørgensen Rikke , Mathiesen Anne Sophie , Olesen Mette Linnet , Petersen Morten Aagaard , Pouwer François , Rasmussen Bodil , Rothmann Mette Juel , Thomsen Thordis , Winkley Kirsty , Zoffmann Vibeke 
Published: December 2023

Abstract

Background
Decision-making and problem-solving processes are powerful activities occurring daily across all healthcare settings. Their empowering potential is seldom fully exploited, and they may even be perceived as disempowering. We developed the EMPOWER-UP questionnaire to enable assessment of healthcare users’ perception of empowerment across health conditions, healthcare settings, and healthcare providers’ professional backgrounds. This article reports the initial development of EMPOWER-UP, including face and content validation.
Methods
Four grounded theories explaining barriers and enablers to empowerment in relational decision-making and problem-solving were reviewed to generate a preliminary item pool, which was subsequently reduced using constant comparison. Preliminary items were evaluated for face and content validity using an expert panel of seven researchers and cognitive interviews in Danish and English with 29 adults diagnosed with diabetes, cancer, or schizophrenia.
Results
A preliminary pool of 139 items was reduced to 46. Independent feedback from expert panel members resulted in further item reduction and modifications supporting content validity and strengthening the potential for generic use. Forty-one preliminary items were evaluated through 29 cognitive interviews, resulting in a 36-item draft questionnaire deemed to have good face and content validity and generic potential.
Conclusions
Face and content validation using an expert panel and cognitive interviews resulted in a 36-item draft questionnaire with a potential for evaluating empowerment in user-provider interactions regardless of health conditions, healthcare settings, and healthcare providers’ professional backgrounds.