bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis
Authors: Rehman Anees ur , Khattak Mahnoor , Mushtaq Usman , Latif Muhammad , Ahmad Imran , Rasool Muhammad Fawad , Shakeel Sadia , Hayat Khezar , Hussain Rabia , Alhazmi Ghaidaa Ali , Alshomrani Afnan Owedah , Alalawi Mohammed Ibrahim , Alghamdi Saleh , Imam Mohammad Tarique , Almarzoky Abuhussain Safa S. , Khayyat Sarah M. , Haseeb Abdul 
Published: November 2023

BackgroundThe existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.AimTo investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.MethodologyThe PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.ResultsTuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60–0.96, p &lt; 0.001). Heterogeneity observed among included studies was moderate (I2 = 38%). No significant change was observed in the results after sub-group analysis by study design (HR 0.81, 95% CI: 0.61–0.96, p &lt; 0.000). In the case of treatment failure, TB-DM patients were at higher risk to experience treatment failure rates as compared to TB-non-DM patients (HR 0.46, 95% CI: 0.27–0.67, p &lt; 0.001).ConclusionThe results showed that DM had a significant impact on the emergence of MDR-TB in TB-diabetes comorbid patients as compared to TB-non-DM patients. DM enhanced the risk of TB treatment failure rates in TB-diabetes patients as compared to TB-non-DM patients. Our study highlights the need for earlier screening of MDR-TB, thorough MDR-TB monitoring, and designing proper and effective treatment strategies to prevent disease progression.
A system science perspective on burn-out: development of an expert-based causal loop diagram
Authors: Barsties Lisa S. , van den Berg Saskia W. , Leone Stephanie S. , Nicolaou Mary , van Oostrom Sandra H. 
Published: November 2023

IntroductionBurn-out leads to reduced worker well-being, long-term absenteeism, and high costs for employers and society. Determinants at different levels may affect burn-out in an interrelated and dynamic manner. The aim of the present study was to apply a broader systems perspective by exploring and visualizing the complex system of determinants at different levels (living conditions, working conditions, and societal developments) underlying the prevalence of burn-out in the Netherlands.MethodsDuring three group model building (GMB) sessions with in total eight experts on workers’ mental health, a causal loop diagram (CLD) was developed and relevant feedback loops were identified. For the selection of determinants to be included in the CLD a recently published overview of determinants on burn-out at different levels was used. Experts could also add factors that were not listed in the overview.ResultsThe final CLD consists of 20 factors and depicts a central position of working conditions. Societal developments (e.g., access to mental health care, size of the working population, rougher social climate, etc.) were mostly located at the outside of the CLD and barely integrated in feedback loops. Several reinforcing feedback loops resulting in an increase of the prevalence of burn-out were identified in which the factors (very) high workload, imbalance between work and private life, and insufficient recovery time play an important role. Also, several balancing loops were found that visualize the crucial role of functional support from supervisors to prevent burn-out among workers.DiscussionApplying a broader systems perspective, including determinants at different levels, offers new insights into dynamic feedback loops that contribute to the prevalence of burn-out. Supervisors, amongst others, have a considerable impact on the system underlying the high prevalence of burn-out and may therefore contribute to its prevention. Even though societal developments were less integrated in feedback loops, they might be considered drivers of existing feedback loops. The results from this study confirm that determinants at various levels underly the prevalence of burn-out. To be able to address the diversity of determinants underlying a high prevalence of burn-out, a complex system approach can be helpful.
Promoting public skin health through a national continuing medical education project on cosmetic and dermatologic sciences: a 15-year experience
Authors: Li Yiming , Shu Xiaohong , Huo Wei , Wang Xi 
Published: November 2023

BackgroundThe developments in cosmetic sciences and technologies have generated a gap between the cosmetics and their users. Users including regular customers, clinicians, industry personnel, researchers, testing agencies, beauty salon workers, and mass media hardly possess the ability to distinguish truth from falsehood. The gap remained as one major reason for inappropriate cosmetics usage, insufficient efficacy, and even cosmetics adverse reactions (CARs).MethodsAiming at enhancing the relevant practitioners’ cosmetic and dermatologic sciences, we launched a cosmetic and dermatologic sciences continuing medical education (CME) since 2008. The objective of the current study was to evaluate the effectiveness of the CME. We summarized and analyzed the project for the last 15 years. Meanwhile, an online survey consisted of three parts was performed to evaluate the CME and to collect the trainees’ comments.ResultsA total of 3,923 trainees have participated in the CME project from 2008 to 2022. The trainees included clinicians, industry staffs, biomedical researchers, third-party cosmetics testing staffs, beauty salon staffs, students, and media staffs. The trainees had theory courses on cosmetic and dermatologic sciences, cosmetics DIY practice &amp; video watching, and an optional guided tour during the 4.5-day CME. Eight hundred and twenty-three trainees and 586 control subjects responded to the online survey. The comprehensive test in the second part of the survey demonstrated that compared with the control group, the CME project significantly enhanced the trainees’ perception and knowledge regarding the cosmetics formula sciences, basic dermatologic sciences, cosmetics usage, noninvasive measurements, new advances, CARs, and laws (p = 0.000). Trainees of all occupations ranked “basic dermatologic sciences and skin diseases” as the most significant sections. Trainees of all occupations believed the CME has contributed most in “understand the function &amp; efficacy of cosmetics.” We noticed the occupational variances. Over 97% of trainees were willing to recommend the CME to the others.ConclusionThe CME project significantly enhanced the trainees’ cosmetic and dermatologic sciences, which bridged the gap between cosmetics and public skin health. This multidisciplinary CME also contributed to establishing an interdisciplinary interaction and cooperation platform for the multiple occupations involved in the public skin health maintenance and promotion.
Prevalence and determinants of health literacy among the adult population of Qatar
Authors: Ahmed Salma , Kehyayan Vahe , Abdou Mariam , Bougmiza Iheb 
Published: November 2023

IntroductionHealth literacy (HL) is both a direct determinant and a mediator of health outcomes. Research on the prevalence and determinants of HL in terms of its functional, communicative, and critical domains is scarce in the state of Qatar and its surrounding regions. Thus, this study aims to fill the knowledge gap in this area, estimate the levels of functional, communicative, and critical health literacy among the general adult population, and identify its determinants in the state of Qatar.MethodsAn analytical cross-sectional study with a disproportionate stratified random sampling technique was conducted in 2022. A representative sample of phone numbers was obtained from the Cerner database at Hamad Medical Corporation and approached via well-trained data collectors. A socio-demographic and health-relevant factor questionnaire and the validated All Aspects of Health Literacy scale (AAHLS) were used to collect the data on functional, communicative, and critical HL and their determinants. Descriptive analysis, independent sample t-test, ANOVA, and linear regression were used and yielded the outcomes on HL levels as low, adequate, and high in percentages and the HL determinants.ResultsA total of 770 participants were included. The study found that 41.5%, 29.3%, and 29.2% of them have adequate, high, and low overall HL levels consecutively. People who participated in the study are older adult, are of Arabic ethnicity, are of Qatari ethnicity, have a lower level of education, have close relatives with a lower level of education, have a lower income, are non-migrants, are not living within a family, sought medical care within the last week, and who do not know if they have a chronic disease or do not have lower overall HL levels compared to the other groups. After linear regression analysis, only the participant's level of education and “last time sought medical care within last week” variable predict the overall HL score.ConclusionAlmost half of Qatar's adult population has an adequate HL level, comparable to the HL levels in other regions, despite the limitation in comparison due to variation in context and the HL measurement tools used. The possible determinants are amenable factors to focus on while designing HL interventions and providing healthcare.
The effect of exercise intensity types on the self-rated health status of young-old comorbidities patients: a cross-sectional study in Guangdong, China
Authors: Li Linjin , Dai Fengfeiyue , Zhang Dan 
Published: November 2023

ObjectiveExplore the effect of different types of exercise intensity on the self-rated health status of young-old comorbid patients with cardiovascular disease and metabolic disease, as well as the differences in effect among different genders. Provide more references and suggestions for chronic disease management in older comorbidities patients based on the results of the study.MethodsA multi-stage stratified cluster random sampling method was used to select older (≥60 years old) comorbidities patients from communities in Guangdong Province as the survey subjects. Using the “Survey Questionnaire on the Current Status and Influencing Factors of older Comorbidities Patients,” face-to-face interviews were conducted with 1,300 old patients. Data from 965 young-old patients (aged 60–74) who simultaneously suffered from cardiovascular and metabolic diseases were selected. Unordered multifactor Logistic regression analysis was used to explore the association between the type of exercise intensity and self-rated health. Stratified analysis was performed based on gender.ResultsThe results of unordered multivariate logistic regression analysis showed that compared with young-old comorbidities patients with poor self-rated of health status, young-old comorbidities patients who underwent vigorous-intensity exercise were more likely to have better self-rated of health status (OR = 4.368, 95% CI: 2.491–7.661, p &lt; 0.05). Stratified analysis based on gender showed that for young-old comorbidities male patients, those who engaged in vigorous-intensity exercise were more likely to have better self-rated of health status (OR = 2.924, 95% CI = 1.266–6.751, p &lt; 0.05); for young-old comorbidities female patients, those who were encouraged by their family to exercise (OR = 2.460, 95% CI: 1.143–5.291, p &lt; 0.05), participate in social activities (OR = 6.173, 95% CI: 2.285–16.678, p &lt; 0.05), and engage in vigorous-intensity (OR = 4.232, 95% CI: 1.869–9.583, p &lt; 0.05) or moderate-intensity exercise (OR = 4.555, 95% CI: 1.825–11.368, p &lt; 0.05) were more likely to have better self-rated of health status.ConclusionIf the physical condition allows, vigorous-intensity exercise has a significant positive effect on the self-rated of health status of young-old comorbidities patients with cardiovascular disease and metabolic disease. Specifically, for young-old comorbidities male patients, those who engage in vigorous-intensity exercise are more likely to self-evaluate their health as good; for young-old comorbidities female patients, both vigorous-intensity and moderate-intensity exercise can improve their self-rated of health status.
Diversity of antimicrobial resistance, stress resistance, and virulence factors of Salmonella, Shiga toxin-producing Escherichia coli, and Listeria monocytogenes from produce, spices, and tree nuts by whole genome sequencing
Authors: Hu Lijun , Brown Eric W. , Zhang Guodong 
Published: November 2023

IntroductionThe objective of this study was to analyze antimicrobial resistance (AMR), stress resistance, and virulence factors through whole genome sequencing (WGS) of 192 isolates comprising 164 Salmonella isolates, 8 non-O157 Shiga toxin-producing Escherichia coli (STEC) isolates, and 20 Listeria monocytogenes isolates.MethodsThese isolates were sourced from a national survey conducted between 2010 and 2017, involving 31,322 samples of produce (31 isolates), nuts (43 isolates), and spices (118 isolates).ResultsThe findings yielded several key insights: (1) Within all Salmonella isolates studied, the most prevalent Salmonella serotypes included Give, Kentucky, Senftenberg, Mbandaka, Anatum, Newport, and Weltevreden. (2) All eight non-O157 STEC isolates were found to carry the genes blaEC, acrF, and mdtM, while all 20 L. monocytogenes isolates possessed fosX and lin genes. The Salmonella isolates displayed diverse AMR gene profiles, with 3.65% exhibiting multi-drug resistance. (3) Both Salmonella and non-O157 STEC isolates were discovered to carry stress genes associated with acid resistance, but none of the L. monocytogenes isolates carried an acid resistance gene. Salmonella isolates were found to carry multiple metal-resistance genes. The non-O157 STEC isolates universally exhibited acid resistance genes, and 4 out of the 20 L. monocytogenes isolates were equipped with resistance genes against biocides. (4) All of the STEC isolates (100%) carried stx1 and stx2 genes, while none of them carried eae and wyz genes. Most L. monocytogenes isolates were found to contain 29 virulence genes and 1 pathogenicity island. All Salmonella isolates carried SPI-9, but lacked SPI-7, SPI-10, SPI-11, SPI-12, mig-5, prefA, tviA, and viaB genes.ConclusionThese findings on AMR, stress resistance, and virulence factors among the investigated isolates highlight the potential risks they pose to public health and provide the scientific foundation for the development of preventative and control strategies and guidance pertaining to these major foodborne pathogens.
Comparison of transoral endoscopic thyroidectomy vestibular approach and open conventional thyroidectomy regardıng inflammatory responses, pain, and patient satisfaction: a prospective study
Authors: Ünlü Mehmet Taner , Aygun Nurcihan , Serin Erdinc , Uludag Mehmet 
Published: November 2023

IntroductionThe application of transoral endoscopic thyroidectomy vestibular approach (TOETVA) is becoming widespread throughout the world. We primarily aimed to evaluate the severity of surgical trauma in TOETVA and conventional open thyroidectomy (COT) regarding the inflammatory response including the comparison of surgical stress markers [interleukin-6 (IL-6), C-reactive protein (CRP), white blood cell (WBC)].Material and methodThis non-randomized prospective study enrolled two groups with 20 patients each: COT group and TOETVA group. Patients aged 18–65 years with benign thyroid disease; with fine needle aspiration biopsy results of Bethesda III, IV or Bethesda V, VI (&lt;1 cm nodule); thyroid volume &lt;50 cm3; nodule diameter &lt;4 cm; female gender without a previous neck, chin, and/or oral surgery; without vocal cord paralysis preoperatively; and patients in euthyroid state were enrolled to the study. Preoperative, postoperative second hour, first day, and second day CRP, WBC, and IL-6 levels were evaluated. Pain intensity was evaluated with the visual analog scale (VAS) score on the 2nd and 12th hour, 1st and 2nd days postoperatively.ResultsAll the patients were female and mean age was significantly higher in the COT group. The operative time was significantly longer in the TOETVA group. No significant difference was found between the two groups regarding IL-6 levels. In the TOETVA group, postoperative second hour WBC value (p = 0.044) and first (p = 0.002) and second day (p = 0.005) CRP values were significantly higher. In the TOETVA group, the lower lip and lower chin VAS scores were significantly higher at 2nd and 12th hour, on the first and second days. The anterior neck VAS score was significantly higher in the TOETVA group at the second hour (p = 0.025). General and cosmetic satisfactions were similar at the 15th and 30th days in both groups.ConclusionThe longer operative time and higher postoperative CRP level and VAS score in the chin and lower lip in the TOETVA group suggested that the method is not a minimally invasive technique compared to COT. However, the presence of similar total complication rates and early postoperative general and esthetic satisfaction that improves over time in both groups suggests that the clinical effect of increased magnitude of systemic inflammatory response in TOETVA might be temporary and acceptable.
Normal variation of clinical mobility of the mandibular symphysis in dogs
Authors: Minei Sergio , Auriemma Edoardo , Bonacini Serena , Kent Michael S. , Gracis Margherita 
Published: November 2023

IntroductionThe primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in dogs, and evaluate possible associations with breed, bodyweight, age, sex, and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were also evaluated.MethodsMedical records of dogs that underwent anesthetic procedures for maxillofacial, oral and dental evaluation from April 2015 to December 2021 were included.Results567 dogs of 95 different breeds were included, with a total of 695 evaluations. Body weight ranged from 0.8 kg to 79 kg (median 14.4 kg) and age from 3 months to 16 years and 4 months (median 6 years and 9 months). Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale, in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified as being fused or open. The open symphyses were further radiographically divided in having parallel or divergent margins. At the time of the first evaluation DV mobility was 0 in 551 cases (97.2%) and 1 in 16 cases (2.8%). LM mobility was 0 in 401 cases (70.7%), 1 in 148 cases (26.1%) and 2 in 18 cases (3.2%). There was not a significant change in mobility over time for cases examined more than once (P= 0.76). All cases had an intraoral radiographic examination. 83.8% of the radiographs were included in the statistical analysis. Two symphyses (0.4%) were classified as fused and 473 (99.6%) as open, 355 (74.7%) having divergent margins and 118 (24.8%) parallel margins. Logistic regression models exploring factors that affected DV and LM mobility were statistically significant (P &lt; 0.0001; P &lt; 0.0001), with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in age and in bodyweight was associated with a decrease in mobility. There was no statistical difference in clinical mobility across specific breeds or sexes. Increased probability of a divergent symphysis and increased DV mobility was found to be associated with a brachycephalic conformation. The increase in LM mobility was comparatively higher in small brachycephalic breeds compared with larger brachycephalic breed.DiscussionThe majority of the cases showed little to no mobility of the mandibular symphysis and radiographically bony fusion can be rarely seen.
The plantar proximal cortex of the third metatarsal bone shows raised longitudinal ridges at the suspensory ligament enthesis in normal equine isolated limbs – a radiographic, computed tomography, and MRI study
Authors: Dancot Michaël , Joostens Zoë , Audigié Fabrice , Busoni Valeria 
Published: November 2023

IntroductionKnowledge of normal radiographic appearance is essential to avoid misinterpretation of radiographs. This study aimed to assess the computed tomographic (CT) appearance of the plantar surface of the proximal metatarsus and evaluate the influence of the radiographic angle on the trabecular/cortical interface of the proximal plantar metatarsal cortex on lateromedial and slightly oblique radiographs.MethodsEight hindlimbs were collected from six horses with no known history of lameness and euthanized for reasons unrelated to the study. Limbs underwent computed tomographic (CT) and radiographic examination (dorsoplantar, lateromedial, and slightly oblique radiographic views obtained by angling the beam dorsally and plantarly from the plane used for the lateromedial projection). Standing magnetic resonance (MR) imaging and computed tomography (CT) were used to confirm normalcy. Images were compared side-by-side by two experienced readers.ResultsLimbs were normal at MR imaging. Longitudinal linear ridges were present on the proximal plantar metatarsal surface in all limbs (1–2 sagittal ridges and 1 ridge located at the medial or lateral margin of the suspensory ligament). Longitudinal ridges were positioned facing an adipose-muscular bundle of the suspensory ligament on CT images and were visible as linearly increased opacities on dorsoplantar radiographs. The delineation of the trabecular/cortical interface of the proximal metatarsus changed with radiographic projection and was the sharpest on the plantaro 85° lateral to the dorsomedial oblique view.ConclusionThe proximal third metatarsal bone shows individual morphological variations, with longitudinal linear ridges that alter the bone homogeneity on dorsoplantar radiographs. An oblique plantaro 85° lateral to the dorsomedial view is suggested to better assess the presence of subcortical sclerosis when proximal suspensory enthesopathy is suspected.