bluuebunny/crossref_metadata_2025_split huggingface dataset:
3D printed Si-CaP scaffold released SiO32- and Ca2+ to synergistically promote angiogenesis
Authors: Mo Yongqiang , He Weitao , Hu Shiqi , Guo Hongchun , Li Shuangzuo , Zhang Jingwei , Wang Xintao 
Published: November 2023

Background and Purpose Structuring scaffold with both osteogenic and angiogenesis capabilities is a challenge for bone tissue engineering. Powder structured Si-CaP materials have shown excellent osteogenic properties and induction of stem cell differentiation. Our research group have successful produced 3D printed Si-CaP scaffolds by DLP technology. This study aims to explore the angiogenic effects of SiO32- and Ca2+ released by 3D printed Si-CaP scaffold, and whether there is a synergistic effect between the two ions. Methods The 3D printed Si-CaP scaffolds were immersed in endothelial cell medium solution for 24 h. The Si, Ca ion released was detected by Inductively coupled plasma–optical emission spectrometry. We used detected data as a standard to prepare the simulated solution to investigate the effect of SiO32-, Ca2+ separately. Experiment was divided into control group, Si ion group, Ca ion group and Si + Ca ion group. We evaluated different ionic effect on HUVECs viability, proliferation, migration, gene expression, and tube formation on different groups. Results The concentration of SiO32- was detected as 15.71 ± 0.04 μg/mL, Ca2+ as 67.14 ± 0.95 μg/mL. Na2SiO3 and CaCl2 were used to prepare the simulated solution. There were no statistically difference between simulated solution from ion released by scaffold. Si + Ca group promoted the gene expression significantly compared with the control group, p < .01. Expression of vascular-associated protein in Si + Ca ion group was higher than that in Si ion group, Ca ion group and control group. Si + Ca ion group significantly enhanced endothelial cell on migration and tube formation assay. Conclusion The 3D printed Si-CaP scaffold can release effective physiological concentrations of Si, Ca ions. Si and Ca ions have a synergistic effect on promoting angiogenesis of HUVECs. 3D printed Si-CaP scaffold is promising in vascularized bone tissue engineering application.
Pyogenic spondylodiscitis in HIV-positive patients under antiretroviral therapy: A case series
Authors: Kitchen Maria , Gasslitter Irina , Gisinger Martin , Deeg Johannes , Rieger Armin , Sarcletti Mario 
Published: November 2023

Background: The incidence of pyogenic spondylodiscitis has been increasing in countries of Europe and North America, probably due to an increasing number of persons with risk factors for this infection. It is unclear whether HIV infection in the era of antiretroviral therapy (ART) increases the risk for spondylodiscitis. Method: We present 7 cases of pyogenic spondylodiscitis of the cervical, thoracic, and lumbar spine in six individuals living with HIV under ART with suppressed viral load. Results: All patients presented with severe non-radicular pain and elevated inflammatory markers. Diagnosis was confirmed by magnetic resonance imaging (MRI) scan and isolation of the pathogen. Staphylococcus aureus was the causative pathogen in five patients. One patient suffered from an infection with Klebsiella pneumoniae followed by a mixed infection with Cutibacterium acnes and Bacillus circulans 18 months later. All patients needed surgical intervention, and the mean duration of antibiotic treatment was 17 weeks (range 12–26). Five patients recovered fully, including two persons who also suffered from endocarditis. One patient died from multi-organ failure. Conclusion: Spondylodiscitis may be seen more frequently in persons living with HIV as they grow older and suffer from comorbidities which put them at risk for this infection. HIV physicians should be aware of the infection and its risk factors.
The Dairy Meltdown
Authors: Krishnakumar Dipali , Sethi Madhvi 
Published: November 2023

The case highlights the bankruptcy case of Kwality Limited, a significant Indian dairy company. Haldiram Snacks submitted a final bid of ₹1.45 billion to the Committee of Creditors for Kwality Limited, which is currently undergoing bankruptcy proceedings LiveMint (2019). This bid, a slight increase from their earlier rejected bid of ₹1.42 billion, has raised concerns due to its inadequate coverage of the company’s substantial outstanding debt of ₹19 billion Despite extensions, Haldiram Snacks remains the sole bidder, presenting a resolution plan under the Indian Insolvency and Bankruptcy Code (2016). The bankruptcy process was initiated in 2018 by financial creditors KKR India Financial and Punjab National Bank. The bid’s insufficiency, covering less than 10% of the debt, prompts reflections on overlooked warning signs and preventive strategies for the future. The larger context of the Indian dairy industry is provided, highlighting significant production and consumption figures, the growing organized dairy sector and the demand for value-added products. Kwality’s growth and expanding farmer network are briefly touched upon. The case overviews Kwality Limited’s bankruptcy, Haldiram Snacks’ bid, the company’s history and performance, and the broader Indian dairy industry landscape. It underlines the bid’s shortfall in comparison to the outstanding debt and raises pertinent questions about the company’s downfall and preventive measures moving forward.
Combination of Rivaroxaban and Amiodarone Increases Bleeding in Patients With Atrial Fibrillation
Authors: Wang Zi , Li Xiaoyu , Zou Ye , Li Xiaoye , Lv Qianzhou 
Published: November 2023

Background: Rivaroxaban and amiodarone are commonly used for treating patients with atrial fibrillation. Drug-drug interactions between rivaroxaban and amiodarone may increase exposure to rivaroxaban. However, the clinical relevance of this drug-drug interaction is still not clear. Objective: The aim was to investigate the risk of bleeding in patients receiving a combination of rivaroxaban and amiodarone. Methods: This was a prospective observational study in which we included atrial fibrillation patients treated with rivaroxaban. The patients were divided into the rivaroxaban group and the combination of rivaroxaban and amiodarone group (the combination group). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to adjust between-group differences. The primary endpoint was defined as the time to the first occurrence of a composite of major, clinically relevant nonmajor, and minor bleeding. Results: In total, 481 atrial fibrillation patients were included in the analysis. After PSM, 154 patients in the rivaroxaban group were matched with 154 patients in the combination group. The bleeding events mainly consisted of clinically relevant nonmajor and minor bleeding. Only one patient experienced major bleeding. The primary outcome was recorded in 26.0% of patients in the combination group and 10.4% of patients in the rivaroxaban group (hazard ratio = 2.76, 95% CI = 1.55-4.93, P < 0.001). The bleeding risk was significantly higher in the combination group compared with that in the rivaroxaban group in the IPTW and stabilized IPTW analyses (hazard ratio = 2.17, 95% CI = 1.32-3.56, P = 0.002). Conclusion and Relevance: The combination of rivaroxaban and amiodarone increased the risk of bleeding in patients with atrial fibrillation, especially clinically relevant nonmajor and minor bleeding. Physicians prescribing rivaroxaban and amiodarone together should be concerned about an increase in the risk of nonmajor bleeding.
Does Emotion-Related Impulsivity Relate to Specific ADHD Symptom Dimensions, and Do the Effects Generalize Across Comorbid Internalizing and Externalizing Syndromes?
Authors: Rosenthal Emily A. , Broos Hannah C. , Timpano Kiara R. , Johnson Sheri L. 
Published: November 2023

Background: Recent work highlights the role of emotion dysregulation in the pathology of Attention-Deficit/Hyperactivity Disorder (ADHD). As such, emotion-related impulsivity (ERI), the trait-like tendency toward disinhibited thoughts (Pervasive Influence of Feelings, PIF) and actions (Feelings Trigger Action, FTA) during heightened emotional states, may be particularly relevant. We explored whether Inattention (IN) and Hyperactivity/Impulsivity (HI), two core symptom dimensions of ADHD, would relate to distinct facets of ERI, and whether externalizing and internalizing symptoms would moderate these relations. Method: Using structural equation modeling, we examined hypotheses among 364 adults recruited for high internalizing and externalizing symptoms. Results: We identified significant paths for FTA regressed on HI and PIF regressed on IN, supporting our hypotheses about main effects. Moderating paths were not significant. Conclusions: IN and HI correlate with distinct forms of ERI, These effects appear to generalize across co-occurring internalizing and externalizing symptoms. Theoretical and clinical implications are discussed.
Improving Treatment Outcome for Cervical Cancer Using 2-Point Assessment of Quality of Life Among Nigerian Women: A Protocol for a Multi-Center Study
Authors: Umemmuo Maureen Uche , Eleje George Uchenna , Oluwasola Timothy A , Ezeanochie Michael , Usman Hadiza Abdullahi , Galadanci Jawhara Shehu , Agbanu Chiemezie Mac-Kingsley , Rabiu Ayyuba 
Published: November 2023

Background: Cervical cancer is the fourth most common cancer among women globally, with quality of life (QOL) being a major concern for patients with cervical cancer, especially in low- and middle-income countries (LMICs). This is largely due to the advanced nature of the disease at presentation. Although there are a higher number of studies focusing on the QOL of high-income countries, the QOL of cervical cancer patients in LMICs is not available. The aim of this study is to evaluate QOL among women with cervical cancer in Nigeria using a 2-point assessment. Methods: A multi-center prospective cohort study will be conducted in 6 tertiary health facilities randomly selected from the 6 geopolitical zones of Nigeria and consisting of a 2-point assessment of the QOL of participants at the time of diagnosis of cervical cancer and after treatment. Women who were recently diagnosed with histologically confirmed cervical cancer (treatment naïve) will be included. QOL will be assessed using Quality of Life Questionnaire domains (EORTC QLQ30) as developed by the European Organization for Research and Treatment of Cancer (EORTC). In addition to the QOL assessment, relevant and clinicopathological variables will be obtained using a self-structured data extraction sheet designed for this study. All data will be anonymized and will be analyzed using SPSS version 25. Levels of QOL will be calculated using EORTC QLQ30. Ethical approval was obtained from National Health Research Ethics Committee (NHREC/01/01/2007-08/11/2021). Discussion: In view of the paucity of data on QOL in LMICs like Nigeria, where most women with cervical cancer present with advanced disease, this research was designed to help in formulating evidence-based interventions to improve the QOL and treatment outcomes provided to women with cervical cancer in Nigeria and other LMICs. The study is expected to fill these knowledge gaps.
The Impact of Spiritual Well-Being on the Quality of Life of Cancer Patients: A Cross-Sectional Study
Authors: Jetan Mohamad , Daifallah Aiman , Rabayaa Maha Khalid , Qadri Rana , Nassorah Mahmoud , Nouri Ahmed , Al-Othaman Nihad 
Published: November 2023

Background: Quality of life is a multidimensional concept that involves physical, social, emotional, and functional well-being. Spirituality represents a potentially influential factor in the quality of life. This study aimed to evaluate the quality of life and spirituality among cancer patients. Methods: A cross-sectional study was carried out on 354 cancer patients in Palestine. A self-administered questionnaire was used for data collection. The questionnaire was made up of 4 sections: sociodemographic factors, clinical data, FACT-G, and FACIT-sp. Results: A total of 354 cancer patients with a mean age of 46.4 ± 15.3 years were enrolled in the study. The spiritual well-being of patients reported in this study was measured by using the median FACIT-Sp total score, and it was 35 (IQR: 29-42). The quality of life of patients was measured using the median of the FACT-G total score, and it was 63 (IQR: 52-85). The FACT-G score was significantly variable based on several factors including age, marital status, cancer type, presence of metastasis, presence of treatment side effects, and the period since diagnosis ( P-value < .05). The FACIT-Sp total score had a significantly strong positive relationship with FACT-G total score ( r = .705, P < .001). Moreover, moderate to strong significant correlations were found between spirituality and quality of life subscales. Conclusions: Quality of life among cancer patients is affected by their basic and clinical characteristics and is highly correlated with their spirituality level. Thus, addressing palliative support through spiritual care besides primary clinical treatment is of great importance to improve the quality of life among cancer patients.
Rapid Carotid Screening by Duplex: A Prospective Single Centre Assessment
Authors: Phair Alison S. , Rogers Steven K. , Ghosh Jonathan , Smith Craig J. , McCollum Charles N. 
Published: November 2023

Objective A novel carotid quick scan (CQS) protocol was developed to rapidly screen for carotid atherosclerosis greater than 50% stenosis in a vascular outpatient setting. This study assessed accuracy and time saved. Material & Methods The CQS was developed by consensus agreement between vascular surgeons and accredited clinical vascular scientists through a modified Delphi technique. The protocol comprised a rapid B-mode then colour flow transverse sweep of the common and internal carotid arteries, with internal carotid artery velocity assessment. One hundred outpatients attending with peripheral artery disease or abdominal aortic aneurysm were recruited. CQS sensitivity, specificity and accuracy was assessed against a conventional full carotid duplex study, performed to UK and ESVS guidelines. Results Twenty four percent of patients (n = 100) had >50% carotid NASCET stenosis. CQS achieved an excellent accuracy of 96.5% in detecting >50% stenosis when compared to full duplex; Cohen’s ƙ = .88, (95%CI .79-.97; P < .001), sensitivity 91.4%, specificity 97.6%, positive predictive value (PPV) 88.9% and negative predictive value (NPV) 98.2%. Median (IQR) time to complete the CQS was 13 sec (±12) per side, compared to 151 sec (±78) per side for the full carotid duplex. In the presence of >50% carotid disease, median CQS time was 25 sec (±31) per side compared to 214 (±104) by full scan. Conclusion CQS as a carotid screening tool is rapid, accurate and acceptable to the population and workforce. It would be simple to roll out in all vascular laboratories to reduce the time and cost burden of excluding significant carotid disease in any group.
Determining a risk-proportionate approach to the validation of statistical programming for clinical trials
Authors: Gamble Carrol , Lewis Steff , Stocken Deborah , Juszczak Edmund , Bradburn Mike , Doré Caroline , Kean Sharon 
Published: November 2023

Background The contribution of the statistician to the design and analysis of a clinical trial is acknowledged as essential. Ability to reconstruct the statistical contribution to a trial requires rigorous and transparent documentation as evidenced by the reproducibility of results. The process of validating statistical programmes is a key requirement. While guidance relating to software development and life cycle methodologies details steps for validation by information systems developers, there is no guidance applicable to programmes written by statisticians. We aimed to develop a risk-based approach to the validation of statistical programming that would support scientific integrity and efficient resource use within clinical trials units. Methods The project was embedded within the Information Systems Operational Group and the Statistics Operational Group of the UK Clinical Research Collaboration Registered Clinical Trials Unit network. Members were asked to share materials relevant to validation of statistical programming. A review of the published literature, regulatory guidance and knowledge of relevant working groups was undertaken. Surveys targeting the Information Systems Operational Group and Statistics Operational Group were developed to determine current practices across the Registered Clinical Trials Unit network. A risk-based approach was drafted and used as a basis for a workshop with representation from statisticians, information systems developers and quality assurance managers (n = 15). The approach was subsequently modified and presented at a second, larger scale workshop (n = 47) to gain a wider perspective, with discussion of content and implications for delivery. The approach was revised based on the discussions and suggestions made. The workshop was attended by a member of the Medicines for Healthcare products Regulatory Agency Inspectorate who also provided comments on the revised draft. Results Types of statistical programming were identified and categorised into six areas: generation of randomisation lists; programmes to explore/understand the data; data cleaning, including complex checks; derivations including data transformations; data monitoring; or interim and final analysis. The risk-based approach considers each category of statistical programme against the impact of an error and its likelihood, whether the programming can be fully prespecified, the need for repeated use and the need for reproducibility. Approaches to the validation of programming within each category are proposed. Conclusion We have developed a risk-based approach to the validation of statistical programming. It endeavours to facilitate the implementation of targeted quality assurance measures while making efficient use of limited resources.
Should a Narrow Corridor Be a Contraindication for Performing Oblique Lateral Interbody Fusion Procedure or Not?
Authors: Singhatanadgige Weerasak , Chatareeyagul Panupong , Tanasansomboon Teerachat , Phutrakool Phanupong , Kotheeranurak Vit , Yingsakmongkol Wicharn , Limthongkul Worawat 
Published: November 2023

Study Design Retrospective study. Objectives We investigated the effect of corridor width on the postoperative outcomes of patients who underwent the OLIF procedure. Methods Patients who underwent OLIF surgery, which included L4-5, between 2015 and 2021 were retrospectively studied. The patients were divided into three groups by the width of the corridor: not more than 10 mm, between 10 and 20 mm, and 20 mm or more. We compared clinical and radiographic outcomes and complications between these groups. Results A total of 81 patients were included. There were no significant differences in VAS leg and back pain scores, ODI scores, or complications between each group. The radiographic findings, including cage position, anterior and posterior disc height, segmental Cobb angle, and foraminal height, also showed no significant differences between each group. The only radiographic finding that showed a significant difference between each group was the angle of the cage. We found significantly less degree of angle in the wider than 20 mm group when compared to the other two groups. ( P-value = .01). There was no recorded incidence of major vascular complications. Conclusions The width of oblique corridor does not affect clinical outcomes, complications, or radiographic findings, including position of the cage, anterior and posterior disc height, segmental angle, and foraminal height after OLIF procedure, including L4-5 level. Thus, the OLIF procedure can be performed safely even in patients with limited oblique corridors, especially at L4-5.
Exploring Antenatal Exercise: Knowledge, Attitudes, Practices, and Influencing Factors among Pregnant Women in Libya
Authors: Jahan Alhadi M , Anaiba Salima M 
Published: November 2023

Background: Antenatal exercise is crucial in promoting pregnant women’s health and well-being. However, no research in Libya examined the knowledge, attitudes, and practices of antenatal exercise among pregnant women. Methods: This cross-sectional study aimed to explore the knowledge, attitudes, and practices related to antenatal exercise among pregnant women in Libya. A convenience sample of pregnant women (n = 205) receiving prenatal care at Misrata Medical Center and having no contraindication for exercise participated in the study. A self-administered, previously elaborated questionnaire was used to assess participants’ awareness, knowledge, attitudes, and practice of antenatal exercise. Descriptive statistics and binary logistic regression analysis were employed using SPSS version 28. Results: The findings revealed that nearly half of the participants demonstrated good knowledge (56.1%) and a positive attitude (47.8%) regarding antenatal exercise. Less than one-third (30.2%) of participants engaged in some form of exercise during pregnancy. The logistic regression results showed that age, income, and practice of exercise before pregnancy significantly contributed to the knowledge score. The analysis indicated that the unemployment status (AOR = 2.42, 95% CI [0.78-6.38], P = .03) and practicing exercise before pregnancy (AOR = 1.97, 95% CI [0.92-4.24], P = .02) were significantly associated with a higher likelihood of engaging in antenatal exercise. The main subjective reasons for pregnant women not engaging in antenatal exercise were lack of time, poor knowledge, fatigue, and worries about harming the baby. Conclusion: This study sheds light on the current state of antenatal exercise among pregnant women in Libya and highlights the factors shaping these behaviors. The findings underscore the importance of promoting accurate knowledge, addressing misconceptions, and providing support and resources to overcome barriers and encourage safe and effective antenatal exercise practices in Libya. Future studies should consider employing qualitative or mixed methods research designs to examine antenatal exercise from different perspectives.
Relationship between the thrombospondin-1/Toll-like receptor 4 (TSP1/TLR4) pathway and vitamin D levels in obese and normal weight subjects with different metabolic phenotypes
Authors: Khairy Eman Y. , Saad Azza 
Published: November 2023

AbstractThrombospondin-1 (TSP1) contributes to obesity-associated inflammation via activating Toll-like receptor 4 (TLR4). The regulatory role of vitamin D on this pathway has been suggested. This study aimed to investigate the relationship between TSP1/TLR4 pathway and vitamin D in obese and normal weight subjects with different metabolic phenotypes. Thirty obese and thirty normal weight men were selected. Anthropometric parameters and serum TSP1, TLR4, TNF-α, vitamin D, and metabolic profile were determined. Metabolic phenotypes of obese and normal weight subjects were determined. Findings revealed enhanced TSP1/TLR4/TNF-α levels and reduced 25(OH)D levels in obese compared to normal weight subjects and metabolically unhealthy compared to metabolically healthy subjects. TSP1 correlated positively with parameters of unhealthy metabolic profile. TSP1, TLR4 and TNF-α levels significantly negatively correlated with vitamin D levels. In conclusion, vitamin D might exert a regulatory role on TSP1/TLR4 pathway, providing a potential mechanism that links hypovitaminosis D with risk of metabolic dysfunction.