bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a predictive nomogram for switching immunosuppressive drugs in pediatric liver transplant recipients
Authors: Gu Guangxiang , Zhou Tao , Zong Zhipeng , Zhang Jianjun 
Published: October 2023

BackgroundTacrolimus (TAC) is the preferred calcineurin inhibitor (CNI) for pediatric liver transplant recipients. However, some recipients may not achieve the desired therapeutic window concentration of TAC, leading to poor prognosis. This study aimed to develop a clinical model that can predict the effectiveness of TAC in pediatric liver transplant recipients and help clinicians quickly identify cyclosporin as an alternative.MethodsWe retrospectively analyzed data from 2,032 pediatric liver transplant recipients who underwent surgery at Renji Hospital, Shanghai Jiaotong University School of Medicine between 2006 and 2019. Demographic, comorbidity and pre-operative laboratory data were collected, and a nomogram was constructed using multivariate logistic regression analysis to estimate the risk of poor therapeutic outcomes for TAC-based immunosuppression.ResultsThe constructed nomogram included seven parameters, namely recipient CYP3A4 genotype, pre-transplant cholangitis, GRWR, spleen long diameter, serum albumin, graft volume reduction, and donor CYP genotype. The nomogram showed good discriminative ability with an area under the receiver operating characteristic curve (AUC) of 74.5% and good calibration. Decision curve analysis indicated a high potential clinical application of the model.ConclusionThis simple clinical model effectively predicts the risk of poor therapeutic outcomes in pediatric liver transplant recipients who receive TAC-based immunosuppression. Clinicians can use the model to identify cyclosporin as an alternative quickly, potentially improving patient prognosis.
Chronic exposure to mercury increases arrhythmia and mortality post-acute myocardial infarction in rats
Authors: Bello Keren A. S. , Wilke Maria Clara B. , Simões Rakel P. , Landim-Vieira Maicon , Langa Paulina , Stefanon Ivanita , Vassallo Dalton Valentim , Fernandes Aurélia Araújo 
Published: October 2023

Introduction: Mercury (Hg) is a heavy metal that causes a variety of toxic effects in eukaryotic cells. Previous studies have reported detrimental effects of mercury toxicity in the cardiovascular system. Given the importance of understanding the relationship between Hg and cardiovascular disease, we sought to investigate if the Hg could worsen the myocardial repercussions following ischemic injury. We demonstrated that once mercury toxicity is established, it can influence the outcome of myocardial infarction (MI).Methods: Male Wistar rats received intramuscular injections of either saline (NaCl 0.9%) or mercuric chloride (HgCl2, first dose of 4.6 μg/kg, and subsequent doses of 0.07 μg/kg/day) for 4 weeks. Three weeks post-exposure, we induced transmural infarction in the left ventricle free wall through coronary artery occlusion surgery. Results: ECG recordings obtained from MI groups demonstrated alterations in the rhythm of the heartbeat/heart electrical activity, as expected, including ventricular extrasystoles and ventricular tachycardia. However, the MI group exposed to Hg (MI-Hg) exhibited augmented ventricular extrasystoles and ventricular tachycardia compared to the MI group. Also, Basckó coefficient revealed that the arrhythmic events—after MI—were aggravated by Hg exposure.Discussion: Our results indicate that the significantly increased mortality in MI-Hg groups when compared to MI (21%, MI vs 32%, MI-Hg) is correlated with greater occurrence of arrhythmias. In conclusion, this study further supports the idea that exposure to mercury (Hg) should be recognized as a significant risk factor that exacerbates the impact of cardiac ischemic injury, potentially leading to an increased mortality rate among patients experiencing acute MI.
Fluctuations and individual differences in empathy interact with stress to predict mental health, parenting, and relationship outcomes
Authors: Shalev Ido , Eran Alal , Uzefovsky Florina 
Published: October 2023

IntroductionEmpathy is a complex, multifaceted ability allowing for the most basic forms of social communication and plays a prominent role in multiple aspects of everyday lives. In this intensive longitudinal study, we assessed how empathy interacts with stress to predict central domains of psychosocial functioning: mental health, romantic relationships, and parenting.MethodsFluctuations and individual differences in empathy were assessed across eight time points, where participants from the general population (N = 566) self-reported their empathy, stress, depressive symptoms, romantic satisfaction, and parental functioning.ResultsBoth trait and state aspects of empathy were associated with all psychosocial outcomes, with state empathy showing a stronger effect. Additionally, empathy components interacted with stress—emotional empathy better-predicted outcomes under high stress, while cognitive empathy under low stress.DiscussionOur findings advance the theoretical understanding of empathy, emphasizing the effects of state-dependent empathy fluctuations on our everyday mental and social lives.
A latent class analysis of resilience and its association with patient-reported symptoms in patients with esophageal cancer after esophagectomy
Authors: Li Yanran , Zhang Zonghao , Ma Xuanxuan , Zhang Xue , Li Shuwen 
Published: October 2023

PurposeTo identify the latent classes of resilience in patients with esophageal cancer after esophagectomy and develop a deeper understanding of the association between these classes and patient-reported symptoms.BackgroundChina accounts for more than half of the global burden of esophageal cancer, and patients with esophageal cancer experience numerous symptoms that affect their quality of life and prognosis. Given that resilience is a key element that alleviates the progression of symptoms, it may represent a potential means of to enhancing cancer patients’ physical and psychological well-being.MethodsThe study was implemented in the thoracic surgery departments of three tertiary hospitals in eastern China. The participants were patients who were still hospitalized after esophagectomy. Data were gathered by self-report questionnaires, and a latent class analysis was utilized to identify different categories of resilience among the patients.ResultsA total of 226 patients were recruited. The three classes of resilience identified included high strength and striving (53.5%), medium resilience but weak self-recovery (35.9%), and minimal tenacity and external support (10.6%). Patients with low income (OR = 12.540, p = 0.004) were more likely to be in the minimal tenacity and external support class. Patients without comorbidities (OR = 2.413, p = 0.013) and aged 66–70 years (OR = 4.272, p &lt; 0.001) were more likely to be in the high strength and striving class. The patient-reported symptoms and symptom-related interference of patients after esophagectomy varied considerably among the three categories of resilience.ConclusionAccurate interventions should be devised and executed according to the features of each type of resilience in patients after esophagectomy to maximize intervention efficacy. These findings highlight the important role of precision nursing.
Risk factors associated with postoperative delirium in elderly patients undergoing hip surgery
Authors: Liu Xiao-Hong , Zhang Qing-Fu , Liu Ying , Lu Qing-Wang , Wu Jian-Hua , Gao Xiao-Hua , Chen Zhi-Yuan 
Published: October 2023

ObjectiveWe retrospectively analyzed the occurrence of postoperative delirium following hip surgery and the associated risk factors. The aim was to establish a clinical foundation for preventing postoperative delirium after hip surgery.MethodsWe retrospectively selected elderly patients who had hip surgery at our hospital between January 2022 and August 2022. We included patients who experienced delirium in the observation group and those who did not encounter delirium in the control group. We then proceeded to compare various indicators among these two groups of patients.ResultsWe analyzed a total of 97 cases of hip surgery, and among them, 32 cases experienced postoperative delirium, resulting in an incidence rate of 32.9%. Various factors were found to be linked to the development of postoperative delirium, including age, height, gender (male), preoperative erythrocyte sedimentation rate (ESR), postoperative ESR, preoperative lactate levels, pain scores on the first day after surgery, type of surgical procedure, and the occurrence of delirium in the post-anesthesia care unit (PACU delirium). Additionally, it was observed that 75% of patients who had PACU delirium also experienced postoperative delirium.ConclusionPostoperative delirium in patients who have hip surgery had an incidence rate of 32.9%. This phenomenon is linked to various factors that pose a risk, such as the patient age, height, gender, preoperative ESR levels, postoperative ESR levels, preoperative lactate levels, pain scores on the day following surgery, and the specific surgical procedure performed. The likelihood of experiencing delirium increases by 12% for every additional 10 years in patient age. Additionally, the occurrence of delirium in the PACU is a strong indicator of the likelihood of experiencing postoperative delirium.
The mediating role of physical activity and health status between a health-supportive environment and well-being: a cross-sectional study
Authors: Liao Yi , Cheng Xiaoyu , Li Zhuangzhuang , Li Yanyan 
Published: October 2023

ObjectiveBased on the social-ecological systems theory and social support theory, this study aims to explore the relationship between a health-supportive environment and well-being among residents. It further examined the mediating role of physical activity and health status in the pathway between a health-supportive environment and well-being.MethodsThe study utilized data from 2,717 samples of the China General Social Survey (2021) and conducted multiple regression analysis and mediation analysis using statistical software Stata 16.0 and SPSS PROCESS 3.3.Results(1) A health-supportive environment had a significant impact on residents’ well-being (t = 8.476, p &lt; 0.001). (2) Among the three dimensions of natural environment, built environment, and neighborhood social environment, the influence of neighborhood social relationship environment had the strongest influence on residents’ well-being (t = 8.443, p &lt; 0.001). (3) Physical activity and health status played a mediating role in the relationship between a health-supportive environment and residents’ well-being. The mediating effect was as follows: health-supportive environment → physical activity → well-being with a mediation effect of 0.020; health-supportive environment → health status → well-being with a mediation effect of 0.029; health-supportive environment → physical activity → health status → well-being with a mediation effect of 0.008.ConclusionA health-supportive environment not only directly influences residents’ well-being but also indirectly affects it through physical activity and health status. It is essential to focus on improving both the natural and built environment as well as the neighborhood social relationship environment in enhancing residents’ well-being. Physical activity serves as an important means to improve residents’ health level and promote their well-being.
Utilizing PRISM and RE-AIM to implement and evaluate the Rural Telementoring Training Center (RTTC) for health care workforce development in rural communities
Authors: Melhado Trisha V. , Schneegans Suyen , Rochat Andrea , Kawasaki Keito , Finley Erin P. , Wheeler Denna , Allison Waridibo E. 
Published: October 2023

IntroductionAmid rural health worker shortages and hospital closures, it is imperative to build and maintain the local workforce. Telementoring (TM) or technology-enabled mentoring, is a tool for improving health care quality and access by increasing workforce capacity and support. The national Rural Telementoring Training Center (RTTC) was developed to compile and disseminate TM best practices by delivering free training, tools, and technical assistance to support the implementation, sustainability, and evaluation of new and current TM programs for rural health workers. This paper details how the Practical, Robust Implementation and Sustainability Model (PRISM) was used to understand the context that shaped implementation as well as how Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) was concurrently applied to frame outcomes.MethodsThe RTTC has three implementation strategies: outreach, training and technical assistance (TTA), and a Quality Measure Toolkit. Ongoing periodic reflections with the RTTC team, informed by PRISM, were collected, as were RE-AIM outcomes. Central to this design was the continuous review of incoming data in team meetings to inform programmatic changes by identifying challenges and applying modifications to strategies in real time.ResultsMajor implementation changes discussed during reflections included providing timely and relevant messaging through various platforms, streamlining and customizing a TTA approach, and offering different options for accessing the Toolkit. The outreach strategy resulted in high Reach across the US, with over 300 organizations contacted. The effectiveness of the RTTC was demonstrated by counts of people engaging with outreach (ex. over 8,300 impressions on LinkedIn), the website (over 6,400 views), and e-bursts (33% open rate). Moreover, there were 32 TTA requests and 70 people accessing the Toolkit. Adoption was demonstrated by 27 people participating in TTA and 14 individuals utilizing the Toolkit.DiscussionThe integration of PRISM and RE-AIM frameworks promoted a holistic implementation and evaluation plan. Using PRISM, the RTTC team was able to reflect on the implementation strategies through the lens of contextual factors and make rapid programmatic changes within team meetings. That process resulted in outcomes framed by RE-AIM. The integration of two frameworks in tandem provided an adaptive and comprehensive approach to implementing a large-scale, national program.
Women’s Sexual Empowerment and Its Relationship to Contraceptive Use in Bangladesh: Findings From a Recent National Survey
Authors: Khatun Nishi , Howlader Sihab , Rahman Md. Mosfequr 
Published: October 2023

Objectives: This study aimed to assess the relationship between women’s sexual empowerment and contraceptive use among married Bangladeshi women from a nationally representative sample.Methods: Secondary data analysis was conducted using the Bangladesh Demographic and Health Survey (BDHS) 2017–18. The investigation covered a total of 14,515 married, non-pregnant women who were residing with their spouses. Multivariable logistic regression analysis was fitted to assess the relationship between the variables of interest.Results: A unit increase in the sexual empowerment scale increases the odds of contraceptive use by 13%. While increasing age, being Muslim, having a spouse who is older by more than 10 years, and living in rural areas are associated with lower odds of using contraceptives than their respective counterparts, secondary or higher levels of education, having more living children, exposure to TV or radio, and employment are associated with higher odds of using contraceptives.Conclusion: The study’s findings point to the need for addressing women’s perceptions of their right to sexual and reproductive health and equity in order to further efforts to achieve universal access to reproductive health services.
Effects of Alkaline Hydrogen Peroxide and Cellulase Modifications on the Physicochemical and Functional Properties of Forsythia suspensa Dietary Fiber
Authors: Yan Kejing , Liu Jiale , Yan Wensheng , Wang Qing , Huo Yanxiong , Feng Saisai , Zhang Liangliang , Hu Qingping , Xu Jianguo 
Published: October 2023

Besides active substances, Forsythia suspensa is rich in dietary fiber (DF), but it is often wasted or discarded and not put to good use. In order to improve the function of Forsythia DF, it was modified using alkaline hydrogen peroxide (AHP) and cellulase (EM). Compared to the control DF (ODF), the DF modified using AHP (AHDF) and EM (EMDF) had a looser microstructure, lower crystallinity, and higher oil holding capacity (OHC) and cation exchange capacity (CEC). The AHP treatment significantly increased the water holding capacity (WHC) and water swelling ability (WSA) of the DF, while the EM treatment achieved just the opposite. Moreover, the functional properties of AHDF and EMDF, including their cholesterol adsorption capacity (CAC), nitrite ion adsorption capacity (NAC), glucose adsorption capacity (GAC), glucose dialysis retardation index (GDRI), α-amylase inhibitory activity, and DPPH radical scavenging activity, were far better than those of ODF. Together, the results revealed that AHP and EM modifications could effectively improve or enhance the physicochemical and functional properties of Forsythia suspensa DF.
Esquistossomose e o potencial bioeconômico brasileiro
Authors: Gomes Nelson Bretas de Noronha , Silva Felipe Freire Souza , Wasim Naema , Iabrudi Regina Celia , Da Silva Simone , Brioso Paulo Sérgio Torres , Varricchio Marcia Cristina Braga Nunes , Pyrrho Alexandre dos Santos 
Published: October 2023

O presente estudo visa contribuir, através da análise de estudo de revisão bibliográfica, quanto às publicações sobre o potencial de produtos naturais com diversificados mecanismos de ação inibidores sobre doença de importância na Saúde Ambiental (ramo da Saúde Pública). Também visa chamar atenção quanto à possibilidade de produtos naturais de origem vegetal e marinha para ensaios em todo ciclo ambiental da Esquistossomose, devido ao seu potencial biotecnológico e em bioeconomia. Aponta-se assim para um modelo de articulação multidisciplinar, interdisciplinar e transdisciplinar cuja repercussão é somatória, sendo mais uma opção em pesquisa, em ensino e em bioética, promovendo equidade, dignidade, autonomia e incremento de ações ambientais em governança, rumo ao amadurecimento das mesmas sob a ótica do desenvolvimento sustentável.
ORAL DETECT-TRI TO IMPROVE DENTAL AND ORAL DISEASES DETECTION BEHAVIOUR IN HOUSWIVES
Authors: Ramdhani Astri , Fatmasari Diyah , Djamil Masrifan 
Published: October 2023

Background Riskesdas 2018 state that the largest proportion of dental problems in Indonesia are damaged/cavities/sick teeth (45.3%). Dental and oral health problems in Gowa Regency, South Sulawesi Province 75.08%, age group 35-44 years 72.86% with DMF-T index higher in women (69.43%) than men (30.57%) ). Community understanding of dental and oral diseases is still low, including housewives with high level of knowledge (9.10%), medium (43.63%), low (47.27%). This can be overcome with a system to detect dental and oral disease so that it is not more severe and early treatment before going to dentist. Objective prove the feasibility test and effectiveness of "Oral Detect-Tri" application in increasing behavior of detecting dental and oral diseases in housewives. Method used Research and Development with Quasy experimental research, Pretest-Posttest group design. Subjects in this study were housewives in Paccinongang Village, Gowa Regency, intervention group and housewives at the Posyandu Health Center Tamangapa for the control group; Intervention 30 people were given the "Oral Detect-Tri" Application and Control 30 people were given counseling by cadres. Data collection techniques in this study were interviews, questionnaires and observation. Data tested using pearson correlation test for validation test then Wilcoxon and Mann-Whitney for effectiveness test. Results of the application "Oral Detect-Tri" are feasible as a media for dental health education with expert validation results of 80% and a p-value of 0.002, and the results of the delta test stated that its application was effective in increasing intervention knowledge (3.83) control (0.166), intervention attitude (9.7) control (0.3), intervention measures (3.2) control (0.23) Conclusion Application of “Oral Detect-Tri” application is feasible and effective in changing the behavior of housewives in detecting dental and oral diseases.
Classical Notions and Problems in Thurston Geometries
Authors: Szirmai Jenő 
Published: October 2023

Of the Thurston geometries, those with constant curvature geometries (Euclidean $ E^3$, hyperbolic $ H^3$, spherical $ S^3$) have been extensively studied, but the other five geometries, $ H^2\times R$, $ S^2\times R$, $Nil$, $\widetilde{SL_2 R}$, $Sol$ have been thoroughly studied only from a differential geometry and topological	point of view. However, classical concepts highlighting the beauty and underlying structure of these geometries -- such as geodesic curves and spheres, the lattices, the geodesic triangles and their surfaces, their interior sum of angles and similar statements to those known in constant curvature geometries -- can be formulated. These have not been the focus of attention. In this survey, we summarize our results on this topic and pose additional open questions.
Anatomical Analysis of Foramen Magnum: A 3D Slicer CT Study
Authors: GÜRLEK ÇELİK Nihal , AKMAN Burcu 
Published: October 2023

Aim: To analyze the anatomical structure of foramen magnum in healthy individuals according to age/gender.
Material and Methods: Cranial Computed Tomography (CT) images of 130 healthy individuals (60 female, 70 male) the 18-84 age were included in our study. Using the 3D Slicer software package on these images, the Anterior-Posterior Diameter (APD), Transverse Diameter (TD), perimeter, area, angle between the posterior edge of the foramen magnum and the clivus (FMC) value, and index were found. The shapes of the foramen magnum were analysed.
Results: There was no statistical significance between age, FMC, and foramen magnum index values in both genders (p>0.05). APD, TD, perimeter, and area values of males were statistically higher (p0.05). Seven shapes of foramen magnum have been seen. The most common was the oval shape (27.7%) and the least common was the pentagon (1.5%).
Conclusion: Knowing the anatomical structure of the foramen magnum is important in terms of identity and ethnicity. We also think that our results may contribute to the surgical treatment of the foramen magnum and adjacent structures.
Konsep Doa Sebagai Persembahan Yang Murni Kepada Tuhan Menurut St. Aphrahat: Persembahan yang Tidak Terlihat
Authors: Hia Maritaisi , Hendi Hendi 
Published: October 2023

Doa adalah bagian penting yang harus ada dalam diri orang percaya. Di dalam doa seseorang mencurahkan segala isi hati kepada Tuhan, dan dilakukan ketika seseorang meminta apa yang dibutuhkan kepada Allah. Tetapi St. Aphrahat memberikan pemahaman yang lain tentang doa yaitu doa adalah persembahan murni yang dipersembahkan kepada Tuhan melalui hati yang murni. Dan inilah yang menjadi tujuan dari penelitian ini adalah orang percaya dapat mengetahui bahwa doa bukan hanya sekedar meminta kebutuhan kepada Tuhan tetapi doa sebagai sesuatu hal yang dapat diamalkan kepada Tuhan. Metode yang digunakan dalam penelitian ini adalah metode studi pustaka dengan dua buku sebagai sumber primer yaitu buku “Aphrahat the Persian Sage and the Temple of God A Study of Early Syriac Theological Anthropology” dan buku “Semitic Christianity St. Aphrahat the Sages of Babylonian Talmud”. Berdasarkan hasil penelitian ditunjukkan bahwa doa adalah persembahan yang tidak terlihat dipersembahkan di atas mezbah yang murni yaitu di dalam hati yang murni sehingga doa yang dipersembahkan dapat berkenan di hadapan Allah. Sehingga dapat disimpulkan bahwa doa murni yang di bawa ke dalam hati yang murni adalah pekerjaan yang dilakukan tanpa henti sehingga dengan demikian hal ini akan membuat seseorang semakin menyatu dan serupa dengan Kristus melalui doa yang di persembahkan dengan hati yang murni.