bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weak acid and pepsin reflux induce laryngopharyngeal mucosal barrier injury: A rabbit-model-based study
Authors: Hou Chenjie , Zhou Liqun , Zheng Yujin , Chen Ting , Hu Renyou , Zheng Jingyi , Liu Chaofeng , Liu Yaqi 
Published: January 2025

Objective
Using rabbit models, this study simulated the laryngopharynx’s response to the synergistic effects of various acidic reflux environments and pepsin to investigate the response mechanism underlying weak acid reflux and pepsin in the mucosal barrier injury of laryngopharyngeal reflux.

Methods
The rabbits were divided into six groups, and the original larynx was recorded for each group. During the study period, rabbits were sprayed with different doses of acid and pepsin solutions and monitored for hypopharyngeal mucosal transient impedance before and after modeling. After the experiment, laryngeal mucosal tissues were collected, observed using hematoxylin and eosin staining, and assessed for E-cadherin expression. The width of the intercellular space and lanthanum staining penetrating the intercellular space were also observed using electron microscopy.

Results
Eight weeks post-modeling, evidence of laryngopharyngeal mucosa inflammatory responses was observed in each group. Downregulation of E-cadherin expression significantly positively correlated with acid strength (p < 0.05). The pepsin and acid intervention groups showed a significantly widened space between mucosal epithelial cells in the posterior ring area (p < 0.05). Meanwhile, in the experimental group, a large amount of stained lanthanum penetrated the intercellular spaces; however, no significant difference was observed in the mucosal impedance (MI).

Conclusion
This study demonstrated that acid, weak acid, and pepsin could damage the laryngeal mucosal barrier; pepsin was an independent factor associated with tissue damage; the downregulation of hypopharyngeal cadherin was associated with acid-intensity exposure. Transient LP-MI cannot be applied directly.
Long-acting reversible and permanent contraceptives utilization and its associated factors among married women who desire no more children in Ethiopia: A multilevel analysis
Authors: Tsega Nuhamin Tesfa , Biset Wondimnew Mersha , Aragaw Getie Mihret , Abiy Saron Abeje , Godana Tilahun Nega , Dagnaw Abera Dessie , Haile Gashaw Awoke , Belay Daniel Gashaneh , Mengistie Berihun Agegn 
Published: January 2025

Objective
This study aimed to investigate long-acting reversible and permanent contraceptives (LARPCs) utilization and its associated factors among married women who desire no more children in Ethiopia.

Methods
Secondary datasets from the 2016 Ethiopian Demographic and Health Survey was used for the study. A total weighted sample of 3,756 married or in union reproductive age women who desire no more children were included in the analysis. Data was cleaned, weighted, and analyzed using STATA Version 14 software. A multi-level logistic regression analysis was conducted to consider the hierarchal nature of the demographic and health survey data. In a multivariable multilevel logistic regression model, an adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) and p value <0.05 was used to declare the significant associated factors of LARPCs utilization.

Results
The overall utilization of LARPCs among married women who desire no more children was 12% [95%CI: 10.99, 13.07]. In the multivariable multilevel analysis; being female household heads [AOR = 0.60; 95%CI: 0.40, 0.92], husband primary level of education [AOR = 1.57; 95%CI: 1.18, 2.07], employed women [AO R = 1.34; 95%CI: 1.04, 1.74], women from middle wealth index [AOR = 1.45; 95%CI: 1.02, 2.07], women who visited health facility in the last 12 months [AOR = 0.69; 95%CI: 0.54, 0.88], women residing in small peripherals [AOR = 0.20, 95%CI: 0.05, 0.82], and women from communities with low poverty [AOR = 2.25, 95%CI: 1.26, 3.99] were significantly associated with LARPCs utilization.

Conclusion
In Ethiopia, LARPCs utilization among married women who desire no more children was very low. Both individual and community-level factors were significantly associated with LARPCs utilization. Thus, individual and community-level interventions that encourage husband education, maternal occupation, and giving special attention for women who live in small peripheral areas and female-headed households are better.
Enhancing trauma cardiopulmonary resuscitation simulation training with the use of virtual reality (Trauma SimVR): Protocol for a randomized controlled trial
Authors: Lintschinger Josef Michael , Metelka Philipp , Kapral Lorenz , Kahlfuss Florian , Reischmann Lena , Kaider Alexandra , Holaubek Caroline , Kaiser Georg , Wagner Michael , Ettl Florian , Sixt Leonhard , Schaden Eva , Hafner Christina 
Published: January 2025

Background
With the increasing availability and use of digital tools such as virtual reality in medical education, there is a need to evaluate their impact on clinical performance and decision-making among healthcare professionals. The Trauma SimVR study is investigating the efficacy of virtual reality training in the context of traumatic in-hospital cardiac arrest.

Methods and analysis
This study protocol (clinicaltrials.gov identifier: NCT06445764) for a single-center, prospective, randomized, controlled trial focuses on first-year residents in anesthesiology/intensive care, traumatology, and emergency medicine. The study will compare the clinical performance in a simulated scenario between participants who received virtual reality training and those who received traditional e-learning courses for preparation. The primary endpoint is the time to a predefined intervention to treat the underlying cause of the simulated traumatic cardiac arrest. Secondary endpoints include protocol deviations, cognitive load during simulated scenarios, and the influence of gender and personality characteristics on learning outcomes. The e-learning and the virtual reality training content will be developed in collaboration with experts from various medical specialties and nursing, focusing on procedural processes, guideline adherence specific to trauma patient care, and traumatic in-hospital cardiac arrest.

Results
The results of this study will provide valuable insights into the efficacy of virtual reality training, contributing to the advancement of medical education, and serve as a foundation for future research in this rapidly evolving field.
Efficacy of videoconferencing-delivered cognitive behavioural therapy to reduce anxiety disorder severity in LGBTQ+ people: An exploratory trial protocol
Authors: Dunn Isaac B. J. M. D. , Power Emma , Casey Liam J. , Wootton Bethany M. 
Published: January 2025

Objective
Cognitive behavior therapy (CBT) is a well-established treatment for anxiety disorders in the general population. However, the efficacy of CBT for lesbian, gay, bisexual, transgender, queer, questioning, and otherwise non-heterosexual or non-cisgender (LGBTQ+) people with anxiety disorders is still emerging in the literature. This protocol proposes an exploratory, two-group, randomized controlled trial comparing the efficacy of CBT for anxiety disorders against a waitlist control group.

Methods
The trial will recruit 52 LGBTQ+ adults with a primary anxiety disorder diagnosis. The treatment will consist of videoconferencing-delivered CBT using the Unified Protocol (UP). The treatment will be provided in eight weekly individual sessions. Following treatment completion, the waitlist control participants will receive an LGBTQ+ adapted CBT intervention delivered via videoconferencing. The control group will receive the LGBTQ+ adapted UP in weekly sessions for eight weeks. Diagnostic status and symptom severity will be assessed at baseline, post-treatment, and three-month follow-up. Post-treatment qualitative exit interviews will collect participant perspectives on treatment acceptability.

Results
Outcome measures will be compared across groups and benchmarked with existing literature to assess efficacy and feasibility, while qualitative analysis will explore intervention acceptability.

Conclusion
The results are anticipated to inform best-practice remote transdiagnostic treatment of anxiety disorders in LGBTQ+ people.
Association between asymptomatic submicroscopic and microscopic malaria infections and anemia: A study in southern Benin
Authors: Chaves Alejandro Rojas , Dossou Yannelle , Djènontin Armel , Adimi Elisée , Akoho Romuald , Bailly Justine , Bouraïma Aziz , Matondo Déborah , Sissinto Yolande , Houinato Dismand , Massougbodji Achille , Dechavanne Célia , Cottrell Gilles 
Published: January 2025

Introduction
Recently, efforts to eliminate malaria have shifted focus from symptomatic cases alone to include asymptomatic carriers, who are now recognized as significant contributors to the disease’s transmission and control. This study examines the relationship between asymptomatic malaria infection and hemoglobin levels in Benin.

Methods
A cohort in Benin was enrolled and categorized into three age groups (under 5 years, 5–15 years, and over 15 years) for follow-up from August to November 2021. Participants were monitored over two months and assessed for malaria infection through microscopy and polymerase chain reaction (PCR) during their three visits. A questionnaire was employed to gather general and clinical characteristics. Multivariate models were utilized to analyze the associations between asymptomatic infection, anemia, and hemoglobin levels.

Results
Among 393 participants, 58.2% were diagnosed at enrolment with malaria via PCR, and 30.5% through microscopy. Anemia, defined as hemoglobin levels < 11 g/dL, was observed in 40.5% of the cohort. The risk of anemia declined with increasing age (OR for ages 5–15: 0.64, 95% CI [0.37; 1.09]; OR for over 15 years: 0.34, 95% CI [0.20; 0.59]) compared to children under 5. Individuals with both microscopic and submicroscopic infections exhibited higher odds of anemia (respectively OR = 4.15, 95% CI [2.41; 7.13] and OR = 2.09 [1.22; 3.57]) relative to those uninfected. Hemoglobin levels were consistently lower in participants with microscopic malaria across all age groups (β = -2.73, 95% CI [-3.41; -2.05] for those under 5, β = -1.35, 95% CI [-1.89; -0.82] for ages 5–15, and β = -0.72, 95% CI [-1.34; -0.07]) compared to non-infected individuals.

Discussion
Our findings suggest that asymptomatic malaria infections, including submicroscopic cases, are associated with anemia and decreased hemoglobin levels. This underscores the importance of employing ultrasensitive diagnostic methods for such infections and acknowledging their potential health implications.
Study protocol for a hybrid implementation-effectiveness trial of Game Changers for Cervical Cancer Prevention in Uganda
Authors: Wagner Glenn J. , Bogart Laura M. , Matovu Joseph K. B. , Gwokyalya Violet , Beyeza-Kashesya Jolly , Ober Allison , Green Harold D. , Nakami Sylvia , Juncker Margrethe , Namisango Eve , Luyirika Emmanuel , McBain Ryan K. , Bouskill Kathryn , Wanyenze Rhoda K. 
Published: January 2025

Introduction
Cervical cancer (CC) is the leading cause of cancer-related deaths among Uganda women, yet rates of CC screening are very low. Training women who have recently screened to engage in advocacy for screening among women in their social network is a network-based strategy for promoting information dissemination and CC screening uptake.

Methods
Drawing on the Exploration, Preparation, Implementation and Sustainment (EPIS) framework for implementation science, this hybrid type 1 randomized controlled trial (RCT) of a peer-led, group advocacy training intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), will examine efficacy for increasing CC screening uptake as well as how it can be implemented and sustained in diverse clinic settings. In the Preparation phase we will prepare the four study clinics for implementation of GC-CCP and the expected increase in demand for CC screening, by using qualitative methods (stakeholder interviews and client focus groups) to identify and address structural barriers to easy access to CC screening. In the Implementation phase, GC-CCP will be implemented over 36 months at each clinic, with screened women (index participants) enrolled as research participants receiving the intervention in the first 6 months as part of a parallel group RCT overseen by the research study team to evaluate efficacy for CC screening uptake among their enrolled social network members. All research participants will be assessed at baseline and months 6 and 12. Intervention implementation and supervision will then be transitioned to clinic staff and offered as part of usual care in the subsequent 30 months as part of the Sustainability phase. Using the RE-AIM framework, we will evaluate engagement in GC-CCP and CC advocacy (reach), alter CC screening (effectiveness), adoption into clinic operations, implementation outcomes (acceptability, feasibility, fidelity, cost-effectiveness) and maintenance.

Discussion
This is one of the first studies to use a network-driven approach and empowerment of CC screened peers as change agents to increase CC screening. If shown to be an effective and sustainable implementation strategy for promoting CC screening, this peer advocacy model could be applied to other preventative health behaviors and disease contexts.

Trial registration
NIH Clinical Trial Registry NCT06010160 (clinicaltrials.gov; date: 8/17/2023).
Estimating the prevalence of adults at risk for advanced hepatic fibrosis using FIB-4 in a Swiss tertiary care hospital
Authors: Strajhar Petra , Berzigotti Annalisa , Nilius Henning , Nagler Michael , Dufour Jean-François 
Published: January 2025

Background & aims
Chronic liver diseases pose a serious public health issue. Identifying patients at risk for advanced liver fibrosis is crucial for early intervention. The Fibrosis-4 score (FIB-4), a simple non-invasive test, classifies patients into three risk groups for advanced fibrosis. This study aimed to estimate the prevalence of patients at risk for advanced hepatic fibrosis at a Swiss tertiary care hospital by calculating the FIB-4 score in routine blood analysis.

Methods
A retrospective study was conducted using data from 36,360 patients who visited outpatient clinics at eight main clinics of the University Hospital Bern in Switzerland. The data collection period ran from January 1st to December 31st, 2022. Patients attending the hepatology outpatient clinic were excluded. We then calculated the overall and clinic-specific prevalence of patients falling into the high risk category for advanced fibrosis according to FIB-4.

Results
Among the 36,360 patients, 26,245 (72.2%) had a low risk of advanced fibrosis (FIB-4 <1.3), whereas 3913 (10.8%) and 2597 (7.1%) patients were flagged to have a high risk of advanced fibrosis (FIB-4 >2.67 and FIB-4 >3.25 respectively). Geriatrics and Cardiology had the highest proportions of patients at risk for advanced fibrosis over all clinics.

Conclusions
This study demonstrates a high prevalence of high FIB-4 score in a Swiss tertiary care hospital. The implementation of the automatically generated FIB-4 score in daily practice, not only in primary care, but also within tertiary care hospitals, could be crucial for early identification of outpatients at high risk of advanced liver fibrosis requiring further hepatological investigations.
Increased sagittal abdominal diameter is associated with a higher risk of kidney stones
Authors: Song Wei , Li Shugen , Wang Guangchun , Gao Shang 
Published: January 2025

Background
This study investigates the relationship between sagittal abdominal diameter (SAD), a measure of abdominal obesity, and kidney stone disease (KSD) in the U.S. population. Additionally, it explores potential underlying mechanisms and evaluates the clinical utility of a predictive model.

Methods
Data were collected from 11,671 participants, including 1,136 cases of KSD. Univariate and multivariate logistic regression analyses, dose-response curves, and mediation effect assessments were employed to examine the association between SAD and KSD. A predictive model was developed and validated using calibration curves, receiver operating characteristic (ROC) curves, and clinical decision curves. Additionally, hematological indicators were analyzed to identify potential mediating factors.

Results
SAD showed a strong and positive association with KSD, even after adjusting for confounders such as gender, age, and education. The predictive model demonstrated moderate accuracy (AUC =  0.661) and clinical utility. Hematological analyses indicated that granulocyte count (GRAN) significantly mediated the relationship between SAD and KSD (P <  0.001).

Conclusions
SAD is a significant risk factor for KSD, underscoring the role of abdominal obesity in kidney stone formation. The predictive model demonstrates potential clinical applications for early risk assessment and management of KSD.
Real sounds influence postural stability in people with vestibular loss but not in healthy controls
Authors: Lubetzky Anat V. , Cosetti Maura , Harel Daphna , Sherrod Marlee , Wang Zhu , Roginska Agnieszka , Kelly Jennifer 
Published: January 2025

Objective
What we hear may influence postural control, particularly in people with vestibular hypofunction. Would hearing a moving subway destabilize people similarly to seeing the train move? We investigated how people with unilateral vestibular hypofunction and healthy controls incorporated broadband and real-recorded sounds with visual load for balance in an immersive contextual scene.

Design
Participants stood on foam placed on a force-platform, wore the HTC Vive headset, and observed an immersive subway environment. Each 60-second condition repeated twice: static or dynamic visual with no sound or static white noise or real recorded subway station sounds [real] played from headphones.

Setting
Human motion laboratory.

Participants
41 healthy controls (mean age 52 years, range 22–78) and 28 participants with unilateral peripheral vestibular hypofunction (mean age 61.5, 27–82)

Main outcome measures
We collected center-of-pressure (COP, anterior-posterior, medio-lateral) from the force-platform and head (anterior-posterior, medio-lateral, pitch, yaw, roll) from the headset and quantified root mean square velocity (cm/s or rad/s)

Results
Adjusting for age, the vestibular group showed significantly more sway than controls on: COP medio-lateral (no sound or real with static or dynamic visual); COP anterior-posterior (only on dynamic visuals in the presence of either sound); head medio-lateral and anterior-posterior (all conditions), head pitch and yaw (only on dynamic visuals in the presence of either sound). A significant increase in sway with sounds was observed for the vestibular group only on dynamic visuals COP anterior-posterior and head yaw (real) and head anterior-posterior and pitch (either sound).

Conclusions
The addition of auditory stimuli, particularly contextually-accurate sounds, to a challenging, standing balance task in real-life simulation increased sway in people with vestibular hypofunction but not in healthy controls.

Trial registration

Clinical trial registration
This study was registered on clinicaltrials.gov at the following link: https://clinicaltrials.gov/study/NCT04479761.
Validation of the somatic symptom disorder—B Criteria Scale (SSD-12) in Bangladesh
Authors: Habib Sumaiya , Mozumder Muhammad Kamruzzaman 
Published: January 2025

Background
The absence of a reliable and valid Bangla instrument for measuring somatic symptom disorder hinders research and clinical activities in Bangladesh. The present study aimed at translating and validating the Somatic Symptom Disorder-B criteria (SSD-12).

Method
A cross-sectional design was used with purposively selected clinical (n = 100) and non-clinical (n = 100) samples. The clinical sample was collected from psychiatric departments at three hospitals, while the non-clinical sample was drawn from the local community. Exploratory (EFA) and confirmatory factor analysis (CFA) were conducted on the SSD-12, along with reliability and validity assessments.

Results
Results indicated satisfactory internal consistency reliability (Cronbach’s alpha = .94, split-half r = .93); criterion-related validity (r = .86, with Morey’s Somatic Complaints Scale); and construct validity (r = .64 with anxiety subscale and r = .57 with depression subscale of the Hospital Anxiety and Depression Scale) of the translated scale. In contrast to the three-factor structure of the original SSD-12, the Bangla version indicated a single-factor structure (accounting for 61.29% of the total variance). This scale also demonstrates its ability to distinguish between clinical and non-clinical participants (t198 = 16.74, p < .01).

Conclusion
The Bangla translated SSD-12 has demonstrated strong psychometric properties, indicating its suitability for use in Bangladesh. This tool is expected to aid mental health practitioners in their clinical work by providing them with a quick assessment of their patients having somatic complaints.
Demographics and regional trends of ischemic heart disease-related mortality in older adults in the United States, 1999–2020
Authors: Latif Fakhar , Nasir Muhammad Moiz , Rehman Wajeeh Ur , Hamza Mohammed , Mattumpuram Jishanth , Meer Komail Khalid , Silvet Helme , Yarkoni Alon , Sabouni Mouhamed Amr , Braiteh Nabil , Patel Keyoor , Nashwan Abdulqadir J. 
Published: January 2025

Background
Ischemic heart disease (IHD) has a significant impact on public health and healthcare expenditures in the United States (US).

Methods
We used data from the CDC WONDER database from 1999–2020 to identify trends in the IHD-related mortality of patients ≥ 75 years in the US. AAMRs per 100,000 population and APC were calculated and categorized by year, sex, race, and geographic divisions.

Results
Between 1999 and 2020, a total of 8,124,568 IHD-related deaths were recorded. Notable declines in AAMR were observed from 1999 to 2014 (APC: -3.86) and from 2014 to 2018 (APC: -2.55), with an overall increase from 2018 to 2020 (APC: 3.76). Older men consistently demonstrated higher AAMRs than older females, with AAMRs for both sexes decreasing steadily from 1999 to 2018 and increasing in 2020. When stratified by race/ethnicity, Whites (1931.7) had the highest AAMR, followed by Blacks (1836.5), American Indians (1510.5), Hispanics (1464.4), and Asians (1093.6). Furthermore, nonmetropolitan areas (2015.2) showed greater AAMRs than metropolitan areas (1841.8). The ≥ 85-year group consistently exhibited higher IHD-related mortality rates compared to the 75–84 years group. In comparison, the older group [≥75 years] (1873.0) consistently exhibited higher IHD-related AAMRs than the younger group [<75 years] (64.0) throughout the study, showing a significant disparity. Chronic IHD (1552.0) consistently showed the highest AAMRs throughout the study, surpassing myocardial infarction (515.6), other ischemic heart diseases (24.0), and angina pectoris (5.6).

Conclusion
Targeted interventions and resource allocation are crucial for areas with high IHD-related mortality. Public health policies should address demographic and geographical disparities, with further research for effective strategies.