bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical efficacy of nucleoplasty for uncontained lumbar disc herniation: a retrospective study
Authors: Choi Yong Cheol , Seo Jong Hun , Kim Pius 
Published: January 2024

Abstract
Background
There are insufficient in-depth studies on whether percutaneous lumbar nucleoplasty (PLN) is effective and safe for the treatment of uncontained lumbar disc herniation (ULDH). This study aimed to investigate the clinical efficacy of PLN on radiating leg pain caused by ULDH.

Methods
Patients who underwent PLN for ULDH and met the inclusion criteria between June 2018 and July 2022 were included. Clinical outcomes were evaluated using the numeric rating scale (NRS) for radiating pain preoperatively; at 1 day, 1 week, and 1 month postoperatively; and at the last follow-up. Patient satisfaction was assessed using MacNab criteria.

Results
Forty-one patients were enrolled. The mean age was 50.2 years (range 24–73 years). The mean and standard deviation of the preoperative NRS in 39 patients with radiating pain was 9.0 ± 1.2. The NRS scores at 1 day, 1 week, and 1 month postoperatively and at the last follow-up were 4.6 ± 3.2, 3.6 ± 3.3, 2.9 ± 3.2, and 1.4 ± 2.0, respectively, showing significant improvement (all, p < 0.001). The number of patients (percentage) with excellent or good satisfaction according to the MacNab criteria was 29 (70.7%). Major complications were not observed. Three patients underwent additional surgery after PLN because of persistent radiating pain.

Conclusions
PLN is a safe and feasible treatment option for ULDH. Treatment outcomes were favorable on average; however, the lack of consistency was a drawback.
Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population
Authors: Tsai Meng-Lun , Herng-Shouh Hsu Allen , Wu Cheng-Ta , Lin Po-Chun , Tan Timothy L , Kuo Feng-Chih 
Published: January 2024

Abstract
Background
The optimal timing for reimplantation for periprosthetic joint infection (PJI) has not been established and varies from a few weeks to several months. The aim of this study was to assess the commendable time between implant removal and reimplantation in patients who underwent two-stage exchange arthroplasty for PJI.

Methods
We retrospectively reviewed 361 patients who were treated with two-stage exchange arthroplasty for hip and knee chronic PJI at our institution between January 2000 and December 2018. Patient characteristics, comorbidities, surgical variables, microbiology data, and time to reimplantation were recorded. All patients were followed for a minimum of one year. Treatment failure was defined by Delphi criteria. Logistic regression analyses were used to calculate survival rates and adjusted odds ratios (ORs) of treatment failure.

Results
In final analysis, 27 (7.5%) had treatment failure. Factors related to treatment failure including interim spacer exchange (OR, 3.13; confidence interval (CI), 1.04–9.09, p = 0.036), higher ESR level at reimplantation (OR, 1.85; CI, 1.05–3.57; p = 0.04), and time to reimplantation (OR, 1.00; CI, 1.003–1.005, p = 0.04). Performing revision arthroplasty surgery from 16 to 20 weeks had highest successful rate. The reimplantation over 24 weeks had a lower successful rate. However, no statistical significance in comparing each interval group.

Conclusion
Our study emphasized the importance of timely reimplantation in achieving successful outcomes. Factors such as ESR levels, spacer exchange, and the duration of time to reimplantation influenced the likelihood of treatment failure in two-stage exchange arthroplasty for hip and knee PJI.
Pelvic girdle pain in pregnancy and early postpartum – prevalence and risk factors in a multi-ethnic cohort
Authors: Robinson Hilde Stendal , Vøllestad Nina K. , Bennetter Karin Elisabeth , Waage Christin W. , Jenum Anne Karen , Richardsen Kåre Rønn 
Published: January 2024

Abstract
Background
Pelvic girdle pain (PGP) is common during and after pregnancy. It has been assumed that Scandinavian women report more PGP than women of other ethnicities. However, there are few population-based studies on ethnic differences and few with ethnicity as risk factor for PGP. The purposes of the present study were: To examine the prevalence of self-reported PGP through pregnancy and early postpartum in a multi-ethnic cohort. To investigate how ethnicity and patient characteristics were associated with risk of PGP during pregnancy and early postpartum. To investigate if clinical and personal factors obtained in gestation week (GW) 15 were associated with PGP in GW28 and postpartum week (PPW) 14.

Methods
This study analyzed questionnaire data from 823 women from the Stork - Groruddalen mult-iethnic cohort study in Norway. Chi-square tests were used to investigate ethnic differences in prevalence of self-reported PGP, and logistic regression analyses to identify factors associated with self-reported PGP.

Results
Women from South-Asia and Middle East reported 10-20% higher prevalence of self-reported PGP at all time points compared with Western women. Ethnicity was associated with PGP in GW15 and PPW14, adjusted for parity. Pain locations in pelvic area (PGP locations) in GW15, especially combined symphysis and posterior PGP, gave the highest risk (OR=7.4) for PGP in GW28 and in PPW14 (OR = 3.9). Being multiparous was a risk for PGP in PPW14 (OR=1.9).

Conclusions
Women of South Asian and Middle Eastern background had higher risk of self-reported PGP than Western women. Ethnicity was associated with PGP in GW15 and PPW14, after adjustments for parity. PGP locations in GW15 was the most prominent risk factor for PGP in GW28 and PPW14, whilst ethnicity was not significant in multivariable analyses.
Sonic-assisted antibacterial photodynamic therapy: a strategy for enhancing lateral canal disinfection
Authors: Wang Yanhuang , Lei Lishan , Huang Jing , Cai Zhiyu , Huang Xiaojing 
Published: January 2024

Abstract
Background
Bacterial infections in lateral canals pose challenges for root canal treatment. This in vitro study aims to evaluate the antibacterial efficacy of sonic-assisted methylene blue mediated antimicrobial photodynamic therapy (MB-aPDT) against Enterococcus faecalis (E. faecalis) in infected lateral canals.

Methods
Sixty-five premolars infected with E. faecalis in lateral canals were randomly divided into five groups (n = 13) and treated with : (1) 5.25% NaOCl (positive control); (2) Saline (negative control); (3) Sonic-assisted MB-aPDT; (4) 3% NaOCl + MB-aPDT; (5) 3% NaOCl + sonic-assisted MB-aPDT, respectively. The antibacterial efficacy was evaluated by the colony- counting method (CCM) and scanning electronic microscope (SEM).

Results
Both 5.25% NaOCl and the 3% NaOCl + sonic-assisted MB-aPDT exhibited the most effective while comparable antibacterial effects without significant statistical difference (P > 0.05). Furthermore, the antibacterial effect of the 3% NaOCl + MB-aPDT group was significantly higher compared to that of the sonic-assisted MB-aPDT group (P < 0.05). The SEM results demonstrated notable morphological alterations in E. faecalis across all experimental groups, except for the negative control group.

Conclusion
The concentration of NaOCl can be reduced to a safe level while preserving its antibacterial efficacy through the synergism with the sonic-assisted MB-aPDT in this study.
Prognostic factors of patients with recurrent uterine malignancies undergoing secondary cytoreductive surgery
Authors: Fang Chenyan , Zhang Yingli , Zhang Ping , Zhu Tao 
Published: January 2024

Abstract
Background
Several studies have demonstrated that secondary cytoreductive surgery (SCS) for patients with recurrent uterine malignancies may improve the survival. However, the selection criteria for SCS remain to be defined. This study aimed to assess the outcome of SCS and to explore factors that may influence the prognosis.

Methods
Data of patients with recurrent uterine malignancies who received SCS in our hospital between January 2005 and January 2015 were retrospectively analyzed. Patients were assigned into endometrial carcinoma (EC) group and uterine sarcoma (US) group.

Results
84 cases in total were involved in the study, including 47 cases with recurrent EC and 37 cases with recurrent US. The 5-year survival of cases with recurrent EC and recurrent US was 59.6% and 33.3%, respectively. Recurrent EC cases with a lower tumor grade (G1/G1-G2/G2), size of the largest tumor ≤ 6 cm, single recurrent tumor, a history of adjuvant therapy, as well as recurrent US cases with younger age, a longer disease-free interval (DFI) before SCS (≥ 12 months), no peritoneal dissemination, and a history of complete cytoreduction were associated with a longer survival. The number of recurrent tumors was found as an independent prognostic factor of SCS.

Conclusion
Recurrent EC cases with a lower tumor grade, smaller tumor size, single tumor, a history of adjuvant therapy, as well as recurrent US cases with younger age, a longer DFI before SCS, no peritoneal dissemination, and a history of complete cytoreduction were more likely to benefit from SCS.
Psychosocial dimensions of access and their association with contraceptive use and intention to use
Authors: Zan Lonkila Moussa , Rossier Clémentine 
Published: January 2024

Abstract
Background
Several studies suggest that psychosocial accessibility appears to be the key remaining hurdle to contraceptive use when issues of geographic and financial accessibility have been resolved. To date, the literature has considered various dimensions of psychosocial accessibility, which are not well measured by the two main sources of contraceptive data (DHS and PMA2020). In a previous paper, we have designed a framework that outlines four subdimensions of cognitive and psychosocial access and their theoretical relationship to contraceptive use and intention to use. This paper aims to study the associations between the four dimensions of access to contraception with the contraceptive use and intention to use. It also aims to explore the mediation effect of these four dimensions of access in the relationships between classical individual characteristics and contraceptive use and intention to use.

Methods
The data we used came from the 6th round of the PMA2020 survey in Burkina Faso in 2018–19. This survey included 2,763 households (98.4% response rate) and 3329 women (97.7% response rate). In addition to PMA’s core questions, this survey collected data on psychosocial accessibility. Each group of questions was added to address one dimension. We use a multilevel generalized structural equation and mediation modeling to test the associations between psychosocial accessibility and contraceptive use while controlling for some individual and contextual characteristics.

Results
Approval, contraceptive knowledge, and agency were associated with contraceptive use, while fears of side effects were not. Approval and agency explain part of the effects of education and parity on contraceptive use. Exposure to family planning messages had a positive impact on women’s contraceptive agency.

Conclusion
FP messages can help enhance women’s contraceptive agency, and then, contraceptive use, regardless of age and parity. The analysis highlights the mediator effects of contraceptive approval and agency on the association between parity and education with contraceptive use.
Immunomodulatory effects of epiphytic Loranthus micranthus leaf extracts collected from two host plants: Psidium guajava and Parkia biglobosa
Authors: Idoko Ngozi Dorathy , Chukwuma Ifeoma Felicia , Nworah Florence Nkechi , Mba Sopuruchukwu Elizabeth , Joshua Parker Elijah , Nwodo Okwesilieze Fred Chiletugo , Abusudah Wafaa Fouzi , Almohmadi Najlaa Hamed , de Waard Michel 
Published: January 2024

AbstractBackgroundImmunological abnormalities are implicated in the pathogenesis of many chronic diseases. Due to the drug-related adverse effects of currently available orthodox immunomodulators, natural immunomodulators are being looked upon as potential agents to replace them in therapeutic regimens. This research aimed to investigate the immunomodulatory potential ofL. micranthusextracts epiphytic onPsidium guajava(LMPGE) andParkia biglobosa(LMPBE).MethodsPhytochemical screening and acute toxicity testing were carried out to identify the phytoconstituents and safety profiles of the extracts. The extracts’ innate and adaptive immunomodulatory potentials were determined in experimental animals using in vivo leucocyte mobilization, delayed-type hypersensitivity (DTH) response, hemagglutination antibody titre, and cyclophosphamide-induced myelosuppression models. Levamisole was used as the standard drug throughout the study.ResultsCompared to LMPBE, LMPGE contained significantly (p <  0.05) more tannins, cyanogenic glycosides, saponins, reducing sugars, glycosides, flavonoids, and alkaloids. Furthermore, the groups treated with the extracts had a significant (p <  0.05) increase in the total number of leucocytes, neutrophils, basophils, and antibody titers relative to the untreated control. In the same way, the treatment raised TLC in cyclophosphamide-intoxicated rats, with 250 mg/kg b. w. of LMPGE and LMPBE recording 9712.50 ± 178.00 and 8000.00 ± 105.00 ×  109 /L, respectively, compared to 3425.00 ± 2 5.00 × 109 /L in the untreated group. Overall, LMPGE was more effective.ConclusionsThe findings from this study suggest thatL. micranthusepiphytic inPsidium guajavaandParkia biglobosahas possible immune stimulating potential.
Shikonin reactivates TSGs GADD45B and PPP3CC to block NSCLC cell proliferation and migration through JNK/P38/MAPK signaling pathways
Authors: Zhao Yujia , Wu Dan , Fu Zhenkai , Liu Wenna , Yao Yu , Liang Ying 
Published: January 2024

Abstract
Background
Shikonin, a natural naphthoquinone compound extracted from the Chinese traditional herbal medicine “Lithospermum erythrorhizon”, possesses antitumor activity against various cancer types. Tumor-suppressor genes (TSGs) negatively regulate cell growth, proliferation, and differentiation, thereby inhibiting tumor formation. However, the molecular mechanism of action of shikonin on TSGs in non–small-cell lung cancer (NSCLC) remains unclear.

Methods
The inhibitory effect of shikonin on the proliferation and migration abilities of lung cancer cells were measured by Cell Counting Kit 8 (CCK8) and wound healing assays. The alteration of genes by shikonin treatment was detected by mRNA high-throughput sequencing and further confirmed by qPCR and western blotting experiments. The dominant functions of the upregulated genes were analyzed by GO and KEGG profiling.

Results
Shikonin inhibited the proliferation and migration of A549 and H1299 NSCLC cells in a dose-dependent manner. mRNA high-throughput sequencing revealed a total of 1794 upregulated genes in shikonin-treated NSCLC cells. Moreover, bioinformatic analysis of GO and KEGG profiling revealed that the up-regulated genes were mostly involved in the JNK/P38/MAPK signaling pathway, among which the expression of GADD45B and PPP3CC was significantly enhanced. Finally, we confirmed that GADD45B and PPP3CC were indeed upregulated in JNK/P38/MAPK pathway.

Conclusions
Taken together, these results suggested that shikonin might affect the expression of GADD45B and PPP3CC through the JNK/P38/MAPK pathway, therefore exerting an inhibitory effect on the proliferation and migration of cancer cells. To our knowledge, this is the first study reporting the role of shikonin in upregulating TSGs to activate the JNK/P38/MAPK signaling pathways in NSCLC.
Prevalence and varieties of complementary and alternative medicine usage among individuals with pre-dialysis chronic kidney disease in Taiwan: an investigative cross-sectional analysis
Authors: Tsai Ming-Yen , Huang Yu-Chuen , Cheng Ben-Chung , Chin Chieh-Ying , Hsu Yung-Tang , Lee Wen-Chin 
Published: January 2024

Abstract
Background
Complementary and alternative medicine (CAM) is frequently used in the general population, yet only limited data are available regarding the prevalence of these medications in patients with chronic kidney disease (CKD). Hence, our study aimed to explore the prevalence and types of CAM in Taiwanese patients with CKD.

Methods
A cross-sectional questionnaire survey was conducted by face-to-face interview of 275 pre-dialysis patients without dialysis treatment or kidney transplant at an outpatient nephrology clinic in Taiwan from March 2021 to June 2023. The study outcomes were the prevalence of CAM, CAM types, reasons for using CAM, and sources of information about CAM.

Results
Overall, 128 patients (46.5%) were using CAM, but no significant differences from non-CAM users in the various CKD stages (p = 0.156) were found. CAM usage was high in the age range of 20–60 years and duration of CKD ≤ 5 years (p < 0.05). The most commonly used type of CAM was nutritional approaches (79.7%), followed by other complementary health approaches (26.6%). The most commonly utilized modalities of CAM were vitamins and minerals (38.3%), and only 27.1% of patients disclosed their CAM use to their physicians. The most common sources of information about CAM were family and friends, cited by 66% of the participants. Health promotion and a proactive attitude were reported by 40% of users as the reasons for using CAM.

Conclusions
The present study provides data on the CAM usage among CKD patients and adds to the increasing evidence on CAM use. Because some of these practices have safety concerns, better education from healthcare providers on the risks and benefits of CAM therapy is needed by CKD patients.
Flaxseed oil fraction reverses cardiac remodeling at a molecular level: improves cardiac function, decreases apoptosis, and suppresses miRNA-29b and miRNA 1 gene expression
Authors: Boshra Sylvia A. , Nazeam Jilan A. , Esmat Ahmed 
Published: January 2024

AbstractFlaxseed is an ancient commercial oil that historically has been used as a functional food to lower cholesterol levels. However, despite its longstanding treatment, there is currently a lack of scientific evidence to support its role in the management of cardiac remodeling. This study aimed to address this gap in knowledge by examining the molecular mechanism of standardized flaxseed oil in restoring cardiac remodeling in the heart toxicity vivo model. The oil fraction was purified, and the major components were standardized by qualitative and quantitative analysis. In vivo experimental design was conducted using isoproterenol ISO (85 mg/kg) twice subcutaneously within 24 h between each dose. The rats were treated with flaxseed oil fraction (100 mg/kg orally) and the same dose was used for omega 3 supplement as a positive control group. The GC-MS analysis revealed that α-linolenic acid (24.6%), oleic acid (10.5%), glycerol oleate (9.0%) and 2,3-dihydroxypropyl elaidate (7%) are the major components of oil fraction. Physicochemical analysis indicated that the acidity percentage, saponification, peroxide, and iodine values were 0.43, 188.57, 1.22, and 122.34 respectively. As compared with healthy control, ISO group-induced changes in functional cardiac parameters. After 28-day pretreatment with flaxseed oil, the results indicated an improvement in cardiac function, a decrease in apoptosis, and simultaneous prevention of myocardial fibrosis. The plasma levels of BNP, NT-pro-BNP, endothelin-1, Lp-PLA2, and MMP2, and cTnI and cTn were significantly diminished, while a higher plasma level of Topo 2B was observed. Additionally, miRNA − 1 and 29b were significantly downregulated. These findings provide novel insight into the mechanism of flaxseed oil in restoring cardiac remodeling and support its future application as a cardioprotective against heart diseases.
Machine learning algorithms for the prediction of adverse prognosis in patients undergoing peritoneal dialysis
Authors: Yang Jie , Wan Jingfang , Feng Lei , Hou Shihui , Yv Kaizhen , Xu Liang , Chen Kehong 
Published: January 2024

Abstract
Background
An appropriate prediction model for adverse prognosis before peritoneal dialysis (PD) is lacking. Thus, we retrospectively analysed patients who underwent PD to construct a predictive model for adverse prognoses using machine learning (ML).

Methods
A retrospective analysis was conducted on 873 patients who underwent PD from August 2007 to December 2020. A total of 824 patients who met the inclusion criteria were included in the analysis. Five commonly used ML algorithms were used for the initial model training. By using the area under the curve (AUC) and accuracy (ACC), we ranked the indicators with the highest impact and displayed them using the values of Shapley additive explanation (SHAP) version 0.41.0. The top 20 indicators were selected to build a compact model that is conducive to clinical application. All model-building steps were implemented in Python 3.8.3.

Results
At the end of follow-up, 353 patients withdrew from PD (converted to haemodialysis or died), and 471 patients continued receiving PD. In the complete model, the categorical boosting classifier (CatBoost) model exhibited the strongest performance (AUC = 0.80, 95% confidence interval [CI] = 0.76–0.83; ACC: 0.78, 95% CI = 0.72–0.83) and was selected for subsequent analysis. We reconstructed a compression model by extracting 20 key features ranked by the SHAP values, and the CatBoost model still showed the strongest performance (AUC = 0.79, ACC = 0.74).

Conclusions
The CatBoost model, which was built using the intelligent analysis technology of ML, demonstrated the best predictive performance. Therefore, our developed prediction model has potential value in patient screening before PD and hierarchical management after PD.
Influence of perceived parental child-rearing attitudes and ego identity on college adjustment among Korean nursing students
Authors: Choi Hye Seon , Lee Sona , Seo Eunju 
Published: January 2024

Abstract
Background
This study aimed to examine the relationship between nursing students’ perceived parental child-rearing attitude, ego identity, and college adjustment in Korea and explore factors that influence college adjustment.

Methods
This study surveyed 224 nursing students enrolled in universities located in two regions within South Korea. Data were collected from October 14 to November 31, 2019. Perceived parental child-rearing attitude (paternal emotional warmth, paternal rejection, paternal overprotection, maternal emotional warmth, maternal rejection, and maternal overprotection) and ego identity of nursing students were used as independent variables on college adjustment. Collected data were subjected to correlation analysis using SPSS version 26.0 for Windows. Further, regression analysis was performed on the influence of parental child-rearing attitude and ego identity on college adjustment.

Results
Among the parental child-rearing attitudes, paternal emotional warmth (r = .30, p < .001), maternal emotional warmth (r = .38, p < .001), and ego identity (r = .71, p < .001) were positively correlated with nursing students’ college adjustment, whereas maternal rejection was negatively correlated with ego identity (r = − .28, p < .001) and college adjustment (r = − .15, p = .025). Regression analysis of the effects of nursing students’ perceived parental child-rearing attitude and ego identity on college adjustment, with grade as a control variable, revealed that ego identity (p < .001) had a significant effect on college adjustment, and the higher the ego identity (β = 0.712), the higher the college adjustment. Further, the explanatory power of explaining college adjustment was high at 49.9%.

Conclusions
The nursing students’ perceived paternal emotional warmth, maternal emotional warmth, and ego identity were positively correlated with college adjustment. Additionally, ego identity was found as the influencing factor in Korean nursing students’ college adjustment. Therefore, programs to strengthen ego identity should be developed and implemented for college adjustment among nursing students.