bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of hyaluronic acid gel and photobiomodulation therapy on wound healing after surgical gingivectomy: a randomized controlled clinical trial
Authors: Yakout Basma Khalil , Kamel Fatma Ramzy , Khadr Maha Abd El-Aziz Abou , Heikal Lamia Ahmed Hassan , El-Kimary Gillan Ibrahim 
Published: October 2023

Abstract
Background
Surgical gingivectomy can be considered the gold standard treatment for gingival enlargement. The healing of wound site after gingivectomy occurs slowly by secondary intention. To accelerate the wound healing process, several studies have been conducted evaluating the effect of various treatment modalities. Photobiomodulation therapy (PBMT) was proposed to provide minimally invasive and painless treatment as well as to decrease discomfort of the patient following the surgical process. Another factor that is expected to improve the healing after surgery is topical application of chemotherapeutic agents such as Hyaluronic acid (HA). This study aims to assess the effect of topically applied HA gel after PBMT on the healing of wound site after surgical gingivectomy.

Methods
This randomized controlled clinical trial included twenty-six surgical gingivectomy wound sites, equally divided into two groups, Group-I (test group): the surgical sites after gingivectomy were irradiated with a diode laser (980 nm, 0.2 W) then covered by 2% HA gel loaded in a special custom-made soft transparent tissue guard appliance for each patient. Group II (control group): the surgical sites were irradiated with a diode laser (980 nm, 0.2 W) only. Wound healing was assessed subjectively by Landry healing index on the 3rd, 7th, 14th and 21st days after surgery, and pain perception was assessed by the patients using visual analog scale (VAS) throughout the 21 days of the follow up period. Comparisons between the two study groups were performed using Mann-Whitney U test, while comparisons between different time points were performed using Friedman test. Significance was inferred at p value < 0.05.

Results
By the end of the follow-up period, surgical sites of the test group showed excellent healing compared to the control group. There were no significant differences in VAS scores between both groups (p > 0.05).

Conclusions
Application of 2% HA gel as an adjunctive to PBMT was found to have significant clinical effects and higher power of repair among test group when compared to that achieved by PBMT alone in control group.

Trial registration
This study was retrospectively registered on ClinicalTrials.gov and first posted on 28th of March 2023 with an identifier number: NCT05787912.
Drug take-back program: assessment of knowledge, practices, and barriers to safe disposal of unused medication among healthcare students in a Nigerian university
Authors: Akande-Sholabi Wuraola , Olaoye Damilola Q. , Adebisi Yusuff A. 
Published: October 2023

Abstract
Background
The safe disposal of unused medication is a critical public health issue, with risks including environmental pollution, accidental ingestion, and misuse. Inadequate adherence to proper disposal methods among healthcare students could affect the practice of safe disposal of unused medicines as future healthcare professionals. This study, conducted at a Nigerian university, aimed to assess the knowledge, adherence to safe disposal practices, and barriers faced by healthcare professional students regarding unused medication disposal.

Methods
A cross-sectional study was carried out among 930 healthcare students in a Nigerian University, comprising medical and surgery, nursing, pharmacy, physiotherapy, and medical laboratory science students. Information was gathered from respondents using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and participants’ knowledge and practice scores, while chi-square and logistic regression tests were used for categorical variables at p < 0.05.

Results
A total of 930 students participated in this study. The results revealed a significant gap in knowledge, with (67.7%; 630) of the participants unaware of proper disposal methods and most scoring either 0 (31.9%; 297) or 1 (46.0%; 428) out of 4 on a knowledge-based questionnaire. Pharmacy students were the most knowledgeable, with 44.4% falling into the high knowledge category. However, their knowledge did not always correspond to correct practices, with only (10.1%; 94) of participants reporting use of recommended disposal methods such as returning unused medicine to a pharmacy or a drug take-back program. Significant associations were found with course of study (χ²=12.14, p = 0.033) and awareness of correct disposal methods (χ²=4.035, p = 0.045). Those aware of the correct disposal method had a higher odds ratio of high knowledge score (OR = 1.62, 95% CI: 1.1–2.41, p = 0.018) compared to those who were not aware. In terms of disposal practices, those who had received training on safe disposal had significantly higher odds of good practice score (OR = 2.25, 95% CI: 1.36–3.74, p = 0.002). Major barriers identified included lack of access to drug take-back programs (50.4%; 469), lack of knowledge (36.8%; 342), and inconvenience (10.3%; 14).

Conclusion
A knowledge gap was revealed among the respondents regarding the safe disposal of unused medications. Despite the presence of knowledge and awareness, these do not necessarily translate into good disposal practices. This call for strategies to overcome identified barriers, with the aim to bridge the knowledge-practice gap and promote safe disposal of unused medication. The study underscores the urgent need for improved public health policies and educational programs on safe medication disposal.
Assessing anti-doping knowledge among Taiwanese pharmacists
Authors: Lee Yun-Chen , Chen Chung-Yu , Cheng Ya-Yun , Hsu Mei-Chich , Chen Ting-Ting , Chang William Chih-Wei 
Published: October 2023

Abstract
Background
Taiwan’s unique health behaviour, such as extensive exposure to Chinese Herbal Medicine (CHM), has introduced a risk of inadvertent doping among competing athletes. Pharmacy professionals have an imperative role in advising athletes on the safe use of medicines. This study provides an overview of anti-doping knowledge and educational needs among pharmacists in Taiwan and examines influencing factors.

Methods
A cross-sectional online questionnaire survey consisting of five domains, namely demographic characteristics, source of prohibited substances, identification of prohibited substances, understanding of doping control, and education needs on anti-doping, was distributed to the registered pharmacists in Taiwan. In total, 491 responses were included in the analyses.

Results
Respondents (65% female, aged 41.9 ± 11.4 years, with 68% having a Bachelor’s degree) reported a moderate anti-doping knowledge score of 37.2 ± 4.9, ranging from 21 to 48 (out of 51). Fifteen per cent of them had the experience of being counselled about drug use in sports. Higher knowledge scores were observed in younger respondents, showing an age-dependent effect (p < 0.001). Individuals practising in southern Taiwan (compared to northern Taiwan) and those working at clinics (compared to hospitals) exhibited lower knowledge. Most of the respondents (90%) knew that stimulant ephedrine is prohibited in sports, but few had recognised diuretic furosemide (38%) and CHM (7%) containing β2-agonist higenamine. Approximately 90% of respondents agreed with the need for anti-doping education.

Conclusions
This study highlights the heterogeneity of anti-doping knowledge among pharmacy professionals and provides practical relevance in organising future educational topics and research-based activities.
The muslim patient and medical treatments based on porcine ingredients
Authors: Bokek-Cohen Ya’arit , Gonen Limor D. , Tarabeih Mahdi 
Published: October 2023

AbstractPorcine-derived products serve as an effective solution for a wide range of human ailments; however, there may be objections to their use due to Islamic religious prohibitions on consuming products derived from pigs. In order to enhance the cultural competence of medical practitioners who treat Muslim individuals, which constitute about one fifth of the world population, this study aimed at evaluating the knowledge and positions of Muslim patients on this subject. A questionnaire presenting 15 uses of porcine-derived materials was filled out by 809 Muslims. The level of knowledge about the permissibility of these uses and participants’ position on whether it should be approved was assessed. Findings show that Muslims are not familiar with Islamic religious jurisprudence that permits the use of porcine products to save lives after it has undergone an essential transformation known as Istihala. The respondents expressed a negative attitude towards the medical use of porcine-derived substances based on imprecise knowledge about the permissibility of use of porcine-derived materials, devices and treatments. We offer recommendations for improving the informed consent obtained from Muslim patients prior to conducting porcine-based treatments.
The future of FemTech ethics & privacy – a global perspective
Authors: Alfawzan Najd , Christen Markus 
Published: October 2023

AbstractWe discuss the concept of women’s empowerment in FemTech, considering cultural and legal differences, ethical concerns, and legal consequences. We claim that it is crucial to prioritize privacy, a fundamental right, especially in the case of changes in laws related to women’s health, such as Roe v. Wade in the US.
General practitioners’ attitudes towards and frequency of collaboration with pharmacists in China: a cross-sectional study
Authors: Cai Songtao , Huang Xianghui , Van Connie , Li Wanchao , Yan Ming , Lu Yiting , Li Haixin , Deng Zhiling , Lu Panpan , Xu Zhijie 
Published: October 2023

Abstract
Background
Building interprofessional working relationships between general practitioners (GPs) and pharmacists is essential to ensure high-quality patient care. However, there is limited Chinese literature on GP–pharmacist collaboration, and few studies have explored GPs’ experiences with pharmacist integration into general practices. This study aimed to investigate GPs’ attitudes towards and frequency of collaboration with pharmacists in China.

Methods
This cross-sectional study used an online self-administered questionnaire integrating two scales, ATCI-GP and FICI-GP, which had been translated and validated to investigate 3,248 GPs from February 15 to March 15, 2023 across Zhejiang Province, China. Descriptive analyses were used, and the factors associated with GPs’ frequency of collaboration with pharmacists were explored using logistic regression analysis.

Results
A total of 2,487 GPs (76.6%) responded and consented to participate in the survey; 52.3% were male and the mean age was 35.4 years. Most GPs agreed that they shared common goals and objectives with pharmacists when caring for patients (90.0%), and pharmacists were open to working with them on patients’ medication management (80.8%). However, half of the GPs did not change or seldom changed the patient’s medication on the pharmacist’s advice (51.4%). Logistic regression analysis showed that GPs who were older and had more years of practice were more likely to agree that pharmacists were willing to collaborate, had common goals for treatment and that they would change the patient’s medication on the advice of the pharmacist. GPs who had regular communication protocols (adjusted odds ratio1 [aOR1] = 1.88, 95% CI 1.45–2.45; aOR2 = 3.33, 95% CI 2.76–4.02), participated in joint continuing education (aOR1 = 1.87, 95% CI 1.44–2.43; aOR2 = 2.27, 95% CI 1.91–2.70), provided recommendations for medication review (aOR1 = 3.01, 95% CI 2.07–4.38; aOR2 = 3.50, 95% CI 2.51–4.86), and communicated with pharmacists during resident training (aOR1 = 2.15, 95% CI 1.78–2.60; aOR2 = 1.38, 95% CI 1.18–1.62) were associated with a more positive attitude towards and higher frequency of cooperation.

Conclusions
GPs in China displayed a positive attitude towards cooperating with pharmacists, but they did not demonstrate a similar level of practice. As environmental determinants impact interdisciplinary collaboration, healthcare managers and policy-makers need to implement measures that foster a supportive environment conducive to interdisciplinary collaboration.
Glycemic control, HbA1c variability, and major cardiovascular adverse outcomes in type 2 diabetes patients with elevated cardiovascular risk: insights from the ACCORD study
Authors: Pei Junyu , Wang Xiaopu , Pei Zeyu , Hu Xinqun 
Published: October 2023

Abstract
Background
Although recent guidelines advocate for HbA1c target individualization, a comprehensive criterion for patient categorization remains absent. This study aimed to categorize HbA1c variability levels and explore the relationship between glycemic control, cardiovascular outcomes, and mortality across different degrees of variability.

Methods
Action to Control Cardiovascular Risk in Diabetes study data were used. HbA1c variability was measured using the HbA1c variability score (HVS) and standard deviation (SD). K-means and K-medians clustering were used to combine the HVS and SD.

Results
K-means clustering was the most stable algorithm with the lowest clustering similarities. In the low variability group, intensive glucose-lowering treatment significantly reduced the risk of adverse cardiovascular outcomes (HR: 0·78 [95% CI: 0·63, 0·97]) without increasing mortality risk (HR: 1·07 [0.81, 1·42]); the risk of adverse cardiovascular events (HR: 1·33 [1·14, 1·56]) and all-cause mortality (HR: 1·23 [1·01,1·51]) increased with increasing mean HbA1c. In the high variability group, treatment increased the risk of cardiovascular events (HR: 2.00 [1·54, 2·60]) and mortality (HR: 2·20 [1·66, 2·92]); a higher mean HbA1c (7·86%, [7·66%, 8·06%]) had the lowest mortality risk, when the mean HbA1c was < 7·86%, a higher mean HbA1c was associated with a lower mortality risk (HR: 0·63 [0·42, 0·95]). In the medium variability group, a mean HbA1c around 7·5% was associated with the lowest risk.

Conclusions
HbA1c variability can guide glycemic control targets for patients with type 2 diabetes. For patients with low variability, the lower the HbA1c, the lower the risk. For those with medium variability, controlling HbA1c at 7·5% provides the maximum benefit. For patients with high variability, a mean HbA1c of around 7·8% presents the lowest risk of all-cause mortality, a lower HbA1c did not provide cardiovascular benefits but instead increased the mortality risk. Further studies, especially those with patients that reflect the general population with type 2 diabetes undergoing the latest therapeutic approaches, are essential to validate the conclusions of this study.
C-reactive protein during pregnancy and in the early postpartum predicts adverse metabolic health outcomes at 1 year postpartum in women with gestational diabetes
Authors: Quansah Dan Yedu , Horsch Antje , Gilbert Leah , Donath Marc Y. , Puder Jardena J. ,   the MySweetheart research group, Arhab Amar , Bovet Pascal , Chiolero Arnaud , Di Bernardo Stefano , Epure Adina Mihaela , Younes Sandrine Estoppey , Gilbert Leah , Gross Justine , Horsch Antje , Lanzi Stefano , Mayerat Seyda , Mivelaz Yvan , Puder Jardena J. , Quansah Dan Yedu , Rossel Jean-Benoit , Sekarski Nicole , Simeoni Umberto , Stuijfzand Bobby , Via. Yvan 
Published: October 2023

Abstract
Background
Women with gestational diabetes mellitus (GDM) have higher insulin resistance and/or reduced secretion, an increased risk of future diabetes and cardiovascular disease, which may be due to a pathological activation of the innate immune system. C-reactive protein (CRP) is induced by inflammatory cytokines and reflects innate immune activity. We investigated the prospective associations between CRP during the perinatal period with adverse metabolic outcomes at 1 year postpartum in women with previous GDM.

Methods
We analyzed data from the MySweetheart trial that included 211 women with GDM at 28–32 weeks gestational age (GA). CRP was measured during pregnancy at 28-32 weeks GA, at 6–8 weeks and at 1 year postpartum. Metabolic outcomes at 1 year postpartum included weight, total and central body fat, measures of insulin resistance and secretion and presence of the metabolic syndrome (MetS). A 75 g oral glucose tolerance test was performed to measure glucose and insulin values every 30 min over 2 h to calculate indices of insulin resistance (MATSUDA, HOMA-IR) and of absolute (AUCins/glu, HOMA-B) and insulin resistance-adjusted insulin secretion (ISSI-2).

Results
CRP during pregnancy and at 6–8 weeks postpartum predicted increased weight, body fat and visceral adipose tissue (VAT), insulin resistance (higher HOMA-IR, lower MATSUDA), absolute insulin secretion (HOMA-B, AUCins/glu), a reduced adjusted insulin secretion (ISSI-2) and a higher prevalence of the MetS at 1 year postpartum (all p ≤ 0.036). These relationships particularly those concerning CRP during pregnancy, were independent of weight ( for VAT, insulin resistance and secretion indices, MetS; all p ≤ 0.032) and of body fat ( for VAT, MATSUDA, MetS; all p ≤ 0.038).

Conclusion
CRP during pregnancy and in the early postpartum predicted an adverse cardio-metabolic profile in women with prior GDM at 1 year postpartum independent of weight. The prospective association of CRP with increased insulin resistance and reduced adjusted insulin secretion hint to the role of inflammation in the development of impaired metabolism after GDM and could be used as an early marker for risk stratification.
Predictive value of the stress hyperglycemia ratio in dialysis patients with acute coronary syndrome: insights from a multi-center observational study
Authors: Xie Enmin , Ye Zixiang , Wu Yaxin , Zhao Xuecheng , Li Yike , Shen Nan , Gao Yanxiang , Zheng Jingang 
Published: October 2023

Abstract
Background
Various studies have indicated that stress hyperglycemia ratio (SHR) can reflect true acute hyperglycemic status and is associated with poor outcomes in patients with acute coronary syndrome (ACS). However, data on dialysis patients with ACS are limited. The Global Registry of Acute Coronary Events (GRACE) risk score is a well-validated risk prediction tool for ACS patients, yet it underestimates the risk of major events in patients receiving dialysis. This study aimed to evaluate the association between SHR and adverse cardiovascular events in dialysis patients with ACS and explore the potential incremental prognostic value of incorporating SHR into the GRACE risk score.

Methods
This study enrolled 714 dialysis patients with ACS from January 2015 to June 2021 at 30 tertiary medical centers in China. Patients were stratified into three groups based on the tertiles of SHR. The primary outcome was major adverse cardiovascular events (MACE), and the secondary outcomes were all-cause mortality and cardiovascular mortality.

Results
After a median follow-up of 20.9 months, 345 (48.3%) MACE and 280 (39.2%) all-cause mortality occurred, comprising 205 cases of cardiovascular death. When the highest SHR tertile was compared to the second SHR tertile, a significantly increased risk of MACE (adjusted hazard ratio, 1.92; 95% CI, 1.48–2.49), all-cause mortality (adjusted hazard ratio, 2.19; 95% CI, 1.64–2.93), and cardiovascular mortality (adjusted hazard ratio, 2.70; 95% CI, 1.90–3.83) was identified in the multivariable Cox regression model. A similar association was observed in both diabetic and nondiabetic patients. Further restricted cubic spline analysis identified a J-shaped association between the SHR and primary and secondary outcomes, with hazard ratios for MACE and mortality significantly increasing when SHR was > 1.08. Furthermore, adding SHR to the GRACE score led to a significant improvement in its predictive accuracy for MACE and mortality, as measured by the C-statistic, net reclassification improvement, and integrated discrimination improvement, especially for those with diabetes.

Conclusions
In dialysis patients with ACS, SHR was independently associated with increased risks of MACE and mortality. Furthermore, SHR may aid in improving the predictive efficiency of the GRACE score, especially for those with diabetes. These results indicated that SHR might be a valuable tool for risk stratification and management of dialysis patients with ACS.
Novel drug delivery strategies for antidepressant active ingredients from natural medicinal plants: the state of the art
Authors: Yuan Shun , Ma Ting , Zhang Ya-Nan , Wang Ning , Baloch Zulqarnain , Ma Ke 
Published: October 2023

AbstractDepression is a severe mental disorder among public health issues. Researchers in the field of mental health and clinical psychiatrists have long been faced with difficulties in slow treatment cycles, high recurrence rates, and lagging efficacy. These obstacles have forced us to seek more advanced and effective treatments. Research has shown that novel drug delivery strategies for natural medicinal plants can effectively improve the utilization efficiency of the active molecules in these plants and therefore improve their efficacy. Currently, with the development of treatment technologies and the constant updating of novel drug delivery strategies, the addition of natural medicinal antidepressant therapy has given new significance to the study of depression treatment against the background of novel drug delivery systems. Based on this, this review comprehensively evaluates and analyses the research progress in novel drug delivery systems, including nanodrug delivery technology, in intervention research strategies for neurological diseases from the perspective of natural medicines for depression treatment. This provided a new theoretical foundation for the development and application of novel drug delivery strategies and drug delivery technologies in basic and clinical drug research fields.Graphical Abstract