bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of the determinants of alcohol use among women in Oshikoto region, Namibia
Authors: Netope Rebekka N. , Nghitanwa Emma M. , Endjala Tuwilika 
Published: April 2023

Background: Alcohol abuse is one of the world’s main public health issues. Alcohol use is growing among African women, and it has become an underlying factor in women’s health risk profiles. Objective: The purpose of this study is to investigate the factors that influence women’s alcohol consumption in the Oshikoto Region.Materials and Methods: The study used a quantitative research method with a cross-sectional, analytical design. Data were gathered using interview-led questionnaires from 121 women aged 18-49 years at two state hospitals in the Oshikoto region’s two selected constituencies. The Statistical Package for the Social Sciences, version 26, was used to evaluate the data.Results: The subjects’ median age was 33 years old. The bulk of the participants, 84 (69.4%), resided in rural areas. 49 (40.5%) of the participants were unmarried, and the majority (62%) had children. According to the results, 64 (52.89%) of respondents use alcohol to cope with their problems on occasion. When they are anxious, approximately 56 (46.28%) of the respondents use alcohol to relax and ignore their problems. In the univariable log-binomial regression analysis, a family history of alcohol use (p-value 0.019), peer pressure (p-value 0.004), and spending the majority of time at Cuca shops (p-value 0.000) were all linked with an increased risk of harmful alcohol use.Conclusion: Identifying the determinants of alcohol use may aid in the creation of recommendations for preventative measures and alcohol awareness programs.
Barriers to and Facilitators of Collegiate Athletes Seeking Mental Health Services
Authors: Yoon Julian Jehoon , Petrie Trent 
Published: April 2023

Context
Approximately 1 in 5 student-athletes experience some type of mental health concern. However, fewer than half of student-athletes who report mental health concerns seek mental health treatment (ie, psychotherapy or medication). Data concerning barriers to student-athletes seeking mental health care are limited but suggest that stigma is the primary reason. Further, whether having shared identities with their sport psychologists (eg, race and gender) encourages student-athletes to seek help has been minimally explored.

Objectives
To determine the frequency of internal and external barriers to athletes seeking mental health care and examine the importance of athletes and sport psychologists sharing identities as a facilitator of seeking help.

Design
Cross-sectional study.

Setting
Collegiate athletics.

Patients or Other Participants
A total of 266 student-athletes (53.8% women, 42.5% White) from a National Collegiate Athletic Association Division I university.

Main Outcome Measures
Student-athletes responded to 9 binary (yes or no) prompts related to internal barriers (eg, beliefs and attitudes about mental health) and 7 reflecting external barriers (ie, different stakeholders, such as the head coach). Regarding facilitators of mental health help-seeking, student-athletes rated how important it was for them to share each of 10 identities with their sport psychologist from 1 (not at all important) to 5 (extremely important). All identified barriers and facilitators were derived from existing research.

Results
Differences were found in athletes’ ratings of internal and external barriers. For example, a belief in one’s own reliance and not having enough time were significant barriers, as was their head coach having a negative attitude about the importance of mental health. Female student-athletes rated sharing a gender identity with their sport psychologist as more important than did male student-athletes.

Conclusions
Despite efforts by the National Collegiate Athletic Association to reduce the stigma surrounding mental health, persisting barriers within collegiate sports may keep athletes from seeking help.
Maximal Lower Limb Strength in Patellar Tendinopathy: A Systematic Review With Meta-Analysis
Authors: Obst Steven J. , Peterson Benjamin , Heales Luke J. 
Published: April 2023

Objective
To investigate whether lower limb strength is reduced in people with patellar tendinopathy (PT) compared with asymptomatic control individuals or the asymptomatic contralateral limb.

Data Sources
MEDLINE, PubMed, Scopus, and Web of Science.

Study Selection
To be included in the systematic review and meta-analysis, studies were required to be peer reviewed, published in the English language, and case control investigations; include participants with a clinical diagnosis of PT and an asymptomatic control or contralateral limb group; and include an objective measure of lower limb maximal strength.

Data Extraction
We extracted descriptive statistics for maximal strength for the symptomatic and asymptomatic limbs of individuals with PT and the limb(s) of the asymptomatic control group, inferential statistics for between-groups differences, participant characteristics, and details of the strength-testing protocol. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies.

Data Synthesis
Of the 23 included studies, 21 reported knee strength, 3 reported hip strength, and 1 reported ankle strength. Random-effects models (Hedges g) were used to calculate the pooled effect sizes (ESs) of muscle strength according to the direction of joint movement and type of contraction. The pooled ESs (95% CI) for maximal voluntary isometric contraction knee-extension strength, concentric knee-extension strength, and concentric knee-flexion strength were 0.54 (0.27, 0.80), 0.78 (0.30, 1.33), and 0.41 (0.04, 0.78), respectively, with all favoring greater strength in the asymptomatic control group. Researchers of 2 studies described maximal eccentric knee-extensor strength with no differences between the PT and asymptomatic control groups. In 3 studies, researchers measured maximal hip strength (abduction, extension, and external rotation), and all within-study ESs favored greater strength in the asymptomatic control group.

Conclusions
Isometric and concentric knee-extensor strength are reduced in people with PT compared with asymptomatic control individuals. In contrast, evidence for reduced eccentric knee-extension strength in people with PT compared with asymptomatic control individuals is limited and inconsistent. Although evidence is emerging that both knee-flexion and hip strength may be reduced in people with PT, more examination is needed to confirm this observation.
Impact of Dosimetric Parameters on Interplay Effects in 6 MV Flattening Filter-Free Photon Beams to Treat Lung Cancer
Authors: Poolnapol Vanida , Sanghangthum Taweap , Keawsamur Mintra 
Published: April 2023

Context:
Interplay effects have become the significant problem in lung cancer radiotherapy. Since these effects yield dose variation within the target and surrounding tissues.

Aim:
The aim of this study is to investigate the effect of the dosimetric parameters of interplay effects in 6 MV flattening filter-free (FFF) photon beams for lung cancer.

Settings and Design:
This study performed planning, measurement, and data analysis sections for examining different breathing amplitudes and phases, doses, dose rates, field sizes, and fractionations.

Subjects and Methods:
Standard and clinical plans were created on the eclipse treatment planning system. The static and dynamic measurements were performed using a robotic platform and two-dimensional (2D) diode array. The gamma passing rates were defined as the percent of dose variation caused by the interplay effects.

Statistical Analysis Used:
Unpaired t-test.

Results:
The outcomes showed three trends between gamma passing rates (γ) and dosimetric parameters. First, a decreasing trend was breathing amplitudes. The lowest γ of maximum amplitudes (2 cm) in both one dimensional and 2D were <25%. Second, an increasing trend was field sizes. The lowest γ of minimum field size (4 cm × 4 cm2) was <55%. Third, constant outcomes were breathing phases, doses, dose rates, and a number of fractions. The γ values of these factors were 53.1%, 55.1%, 34.7%, and 36.7%, respectively.

Conclusions:
Lung tumor motion-induced interplay effects in 6 MV FFF photon beams are more pronounced for higher breathing amplitudes and smaller field sizes.
Calculation of Attenuation Parameter for Ir-192 Gamma Source in Shielding Materials
Authors: Sabri Adila Hanim Aminordin , Abdul Aziz M. Z. , Olukotun S. F. , Tajudin S. M. 
Published: April 2023

Purpose:
Calculation of photon attenuation is necessary for the selection of shielding materials for an irradiation facility.

Methods and Materials:
In this work, a Monte Carlo simulation was utilized to assess the effectiveness of clay-polyethylene mixture and clay as the radiation shielding materials for high-energy gamma sources (Ir-192). Ordinary concrete was also studied as the benchmark.

Results:
The calculated linear attenuation values for ordinary concrete are within 0.44% of the standard XCOM value for 380 keV photon. In the case of a multienergy Ir-192 gamma source, the calculated linear attenuation coefficient (μ) for ordinary concrete is 15.5% and 7.25% higher than clay and fabricated clay-polyethylene, respectively. Meanwhile, the μ value for fabricated clay-polyethylene is 8.3% higher than that of clay.

Conclusion:
In conclusion, a 10 cm thickness of clay and clay-polyethylene mixture is sufficient to attenuate 87% and 89% of photons from Ir-192 source. The calculated linear attenuation coefficients for the three shielding materials are also consistently higher, about 7.5%, than that of the XCOM value for 380 keV photon.
Segmentation of Organs and Tumor within Brain Magnetic Resonance Images Using K-Nearest Neighbor Classification
Authors: Yoganathan S. A. , Zhang Rui 
Published: April 2023

Purpose:
To fully exploit the benefits of magnetic resonance imaging (MRI) for radiotherapy, it is desirable to develop segmentation methods to delineate patients' MRI images fast and accurately. The purpose of this work is to develop a semi-automatic method to segment organs and tumor within the brain on standard T1- and T2-weighted MRI images.

Methods and Materials:
Twelve brain cancer patients were retrospectively included in this study, and a simple rigid registration was used to align all the images to the same spatial coordinates. Regions of interest were created for organs and tumor segmentations. The K-nearest neighbor (KNN) classification algorithm was used to characterize the knowledge of previous segmentations using 15 image features (T1 and T2 image intensity, 4 Gabor filtered images, 6 image gradients, and 3 Cartesian coordinates), and the trained models were used to predict organ and tumor contours. Dice similarity coefficient (DSC), normalized surface dice, sensitivity, specificity, and Hausdorff distance were used to evaluate the performance of segmentations.

Results:
Our semi-automatic segmentations matched with the ground truths closely. The mean DSC value was between 0.49 (optical chiasm) and 0.89 (right eye) for organ segmentations and was 0.87 for tumor segmentation. Overall performance of our method is comparable or superior to the previous work, and the accuracy of our semi-automatic segmentation is generally better for large volume objects.

Conclusion:
The proposed KNN method can accurately segment organs and tumor using standard brain MRI images, provides fast and accurate image processing and planning tools, and paves the way for clinical implementation of MRI-guided radiotherapy and adaptive radiotherapy.
Effect of troxerutin on the expression of genes regulating mitochondrial biogenesis and microRNA-140 in doxorubicin-induced testicular toxicity
Authors: Mokhtari Behnaz , Abdi Arezou , Athari Seyed Zanyar , Nozad-Charoudeh Hojjatollah , Alihemmati Alireza , Badalzadeh Reza 
Published: April 2023

Background:
Application of doxorubicin (DOX) in cancer patients is limited due to its dose-dependent toxicity to nontarget tissues such as testis and subsequent infertility. Due to limitation of our knowledge about the mechanisms of DOX toxicity in the reproductive system, reduction of DOX-induced testicular toxicity remains an actual and primary clinical challenge. Considering the potentials of troxerutin (TXR) in generating a protective phenotype in many tissues, we aimed to examine the effect of TXR on DOX-induced testicular toxicity by evaluating the histological changes and the expression of mitochondrial biogenesis genes and microRNA-140 (miR-140).

Materials and Methods:
Twenty-four adult male Wistar rats (250–300 g) were divided in groups with/without DOX and/or TXR. DOX was injected intraperitoneally at 6 consecutive doses over 12 days (cumulative dose: 12 mg/kg). TXR (150 mg/kg/day; orally) was administered for 4 weeks before DOX challenge. One week after the last injection of DOX, testicular histopathological changes, spermatogenesis activity, and expression of mitochondrial biogenesis genes and miR-140 were determined.

Results:
DOX challenge significantly increased testicular histopathological changes, decreased testicular expression profiles of sirtuin 1 (SIRT-1) and nuclear respiratory factor-2 (NRF-2), and increased expression of miR-140 (P < 0.05 to P < 0.01). Pretreatment of DOX-received rats with TXR significantly reversed testicular histopathological changes, spermatogenesis activity index, and the expression levels of SIRT-1, peroxisome proliferator-activated receptor-γ coactivator 1-alpha (PGC-1α), NRF-2, and miR-140 (P < 0.05 to P < 0.01).

Conclusion:
Reduction of DOX-induced testicular toxicity following TXR pretreatment was associated with upregulation of SIRT-1/PGC-1α/NRF-2 profiles and better regulation of miR-140 expression. It seems that improving microRNA-mitochondrial biogenesis network can play a role in the beneficial effect of TXR on DOX-induced testicular toxicity.
Differentiation between alcohol-associated cirrhosis and hepatitis B-associated cirrhosis based on hepatic complications and psychological symptoms
Authors: Liang Yun-Fang , Wang Si-Qi , Pan Zhao-Yu , Deng Zhi-He , Xie Wen-Rui 
Published: April 2023

Background:
The prognosis of and occurrence of complications in patients with different clinical features of cirrhosis differ, and cirrhosis with different etiologies has varying clinical characteristics. The aim of this study was to describe the liver function markers, hepatic complications, and psychological features differentiating patients with hepatitis B virus (HBV) infection-related and alcohol-related cirrhosis.

Materials and Methods:
This was a retrospective and observational study that analyzed the medical data of inpatients with alcohol-related or HBV infection-related cirrhosis from May 2014 to May 2020. Markers of liver function, portal hypertension, and psychological symptoms were compared between the two groups.

Results:
Patients with alcohol-related cirrhosis showed higher Self-Rating Anxiety Scale scores and prevalence of hypoproteinemia, fatty liver, and depression than those with HBV infection-related cirrhosis (all P < 0.05). After adjustment for potential confounders, patients with alcohol-related cirrhosis also showed higher risks of increased total cholesterol (odds ratio [OR] =2.671, 95% confidence interval [CI]: 1.160–6.151, P = 0.021), increased high-density lipoprotein-cholesterol (OR = 2.714, 95% CI: 1.009–7.299, P = 0.048), and fatty liver (OR = 2.713, 95% CI: 1.002–7.215, P = 0.048); however, splenomegaly and splenectomy were significantly associated with HBV infection-related cirrhosis (OR = 2.320, 95% CI: 1.066–5.050, P = 0.034).

Conclusion:
Patients with alcohol-related cirrhosis were more likely to develop hyperlipidemia, fatty liver, and psychological symptoms, whereas those with HBV-related cirrhosis had a higher risk of splenomegaly.
Comparison of the effect of ursodeoxycholic acid and multistrain synbiotic on indirect hyperbilirubinemia among neonates treated with phototherapy: A double-blind, randomized, placebo-controlled clinical trial study
Authors: Babaie Elahe , Hassanpour Kazem , Aldaghi Mitra , Sahebkar Mohammad 
Published: April 2023

Background:
This study was aimed at evaluating the effect of ursodeoxycholic acid (UDCA) and multistrain synbiotic on indirect hyperbilirubinemia among neonates treated with phototherapy.

Materials and Methods:
This double-blind, randomized clinical trial was conducted on 120 subjects presenting with indirect hyperbilirubinemia in 2019. Subjects were randomly divided into three groups of synbiotic, UDCA, and control. The synbiotic group received five drops/day of synbiotic in addition to phototherapy. UDCA group received 10 mg/kg/day of Ursobil divided every 12 h in addition to phototherapy. The Control group received a placebo (water) in addition to phototherapy. Phototherapy was discontinued when the bilirubin levels reached <10 mg/dL. Total bilirubin levels were measured using the diazo method at 12, 24, and 36 h after hospitalization. This study used repeated measure analysis of variance and post hoc tests.

Results:
The mean total of bilirubin was substantially decreased in both synbiotic and UDCA groups as compared to the control group at 24 h after hospitalization (P < 0.001). Moreover, the Bonferroni post hoc test showed significant differences regarding the mean total of bilirubin between the three groups (P < 0.05) except for the association between UDCA and synbiotic at 24 h after hospitalization (P > 0.99).

Conclusion:
Findings suggest that UDCA and synbiotic administration alongside phototherapy are more effective in reducing bilirubin levels as compared to phototherapy alone.
Comparison of intrathecal bupivacaine with different doses of clonidine for spinal anesthesia in adults
Authors: Dattatri Sangeetha , Hareesh S. B. , Ashokanand Devanahalli V. 
Published: April 2023

Background:
Evaluating the optimal dose of intrathecal clonidine adjuvant has a great impact on day-to-day practice of anesthesia, as spinal anesthesia is one of the most commonly performed anesthetic procedure.

Objectives:
Evaluate for the minimal dose of intrathecal clonidine as an adjunct to bupivacaine heavy for spinal anesthesia that can produce optimal sensory and motor blockade with minimal hemodynamic effects.

Methods:
Randomized control trials carried out on adult patients, of both genders undergoing elective infraumbilical surgeries under spinal anesthesia with bupivacaine heavy and different doses of clonidine having ethical committee approval were included and articles published in non-English languages were excluded. Databases (PubMed and Google Scholar) and websites of the Indian Journal of Anaesthesia and anesthesia essays and researches journals were systematically searched and interpreted in accordance with the PRISMA guidelines. Quality assessment was done using the Risk of Bias assessment 2.O tool. The mean time taken for the onset of sensory and motor blockade, mean duration of sensory and motor blockade and significant adverse effects were the key outcome variables. Nonstatistical synthesis of quantitative data of the selected articles was done.

Results:
The efficacy in terms of sensory and motor blockade was comparatively more with 1 μg/kg of intrathecal clonidine than with lower doses, however, cardiovascular adverse effects were dose-dependent, with 15 μg intrathecal clonidine causing least cardiovascular disturbance.

Conclusion:
15–30 μg intrathecal clonidine as an adjunct to bupivacaine heavy would produce optimal sensory and motor block with minimal hemodynamic disturbances.
Evaluation of sub-brow approach to the frontozygomatic suture for Open Reduction and Internal Fixation (ORIF) of Zygomatico maxillary complex (ZMC) fractures: A prospective cohort study
Authors: Pandya Avadh R. , Panneerselvam Elavenil , Vignesh Arun , Krishnakumar V B Raja 
Published: April 2023

ABSTRACT

Introduction:
Contemporary incisions used to access the frontozygomatic (FZ) sutures are the lateral brow and upper blepharoplasty incisions which are associated with specific limitations and complications. The authors describe the use of sub-brow incision as an alternate approach for exposure of the FZ region.

Methods:
This is a prospective cohort study involving patients requiring surgical management of zygomatico maxillary complex (ZMC) fractures with fixation at FZ suture alone or along with fixation at infra-orbital rim and/or zygomaticomaxillary buttress. A sub-brow incision was used to expose the fracture and fixation was done with a 4-hole miniplate. The parameters evaluated were specific to the FZ region (sub-brow incision), namely surgical access, bleeding, fracture exposure time, post-operative scar, and pain. Each patient was reviewed on 1st, 5th, 7th, 10th, 30th, and 90th day.

Results:
The study sample included eight male patients. The mean age was 30 years. The sub-brow incision demonstrated favorable postoperative outcomes; adequate exposure was achieved in all 8 patients. The scar formation was found to be higher on the 7th day and the least scar formation was seen by the third month. The mean pain score was found to be high on first post-operative day and the least pain was seen by the 10th day. The mean score of surgical field bleeding was found to be 1.75 which signified mild bleeding according to Fromme’s scale. The mean time taken for adequate exposure of the fracture was 6.62 min. All the assessment parameters were statistically significant (P value <0.01).

Conclusion:
Sub-brow incision is an effective approach for ORIF of zygomatic fractures at FZ suture. The technique is quick, simple, and associated with minimal complications.
Effects of curcumin on oral cancer at molecular level: A systematic review
Authors: Singh Akhilesh Kumar , Sharma Naresh Kumar , Mishra Nitesh , Mahajan Arjun , Krishnan Aswathi , Rajpoot Ravina , Kumar Janani Anand , Pandey Arun 
Published: April 2023

ABSTRACT
This systematic review mainly focuses on the effects of curcumin on oral cancer cells at the molecular level and summarizes the results of the studies. We searched and analyzed various databases such as Pub Med, ProQuest, Google Scholar, Science Direct, and Scopus. Searches were conducted from 2006 to 2021. This systematic review evaluated various effects of curcumin on oral cancer at the molecular level. All the studies related to the effects of curcumin on oral cancer, both in-vivo and in-vitro, were included. After abstract and text screening a total of 13 articles were finally selected for the study based on the inclusion and exclusion criteria. All most all the included studies reported that after treating the cell lines with curcumin there is a reduction in cell proliferation and cell growth, analyzed using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. Curcumin also induces S phase cell cycle arrest and also prevents Tregs migration. The curcumin reverses the process of epithelial mesenchymal transition (EMT) back to mesenchymal epithelial transition (MET). From this review, it is concluded that curcumin inhibited proliferation, migration, invasion, and metastasis, and induced apoptosis via modulating multiple signaling pathways in oral cancer cell lines. But further clinical trials are needed for a detailed evaluation of the effects of curcumin on patients with oral cancer.