bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Struggling to participate in everyday life’: emerging adults’ experiences of living with long-term health challenges
Authors: Rasalingam Anurajee , Brekke Idunn , Stenberg Una , Haaland-Øverby Mette , Helseth Sølvi 
Published: July 2023

Abstract
Aim
To gain a deeper understanding of the experiences of participation in the everyday life of emerging adults living with long-term health challenges and how this influences their own quality of life.

Methods
Using an explorative study design, data were collected through in-depth interviews with a sample of 12 young people aged 18–29 years living with long-term health challenges in Norway.

Findings
The analysis identified one overarching theme of struggling to participate in everyday life, and four subthemes: the notion of being independent but also dependent, experiencing mismatch between needs and support, experiencing deprivation of spontaneity and feeling uncertain about the future. The emerging adults experienced difficulties with participation in key areas of life such as education, employment and leisure activities. Associated symptoms of their diagnosis, limited physical abilities and lack of sufficient support made it hard to participate in everyday life the way they aspired to.

Conclusion
The challenges of living with a long-term health challenge as an emerging adult contributed to limitations in participation in different areas of life that was perceived as important for their quality of life.
Human papillomavirus vaccine acceptance among adolescent girls in Ethiopia: a systematic review and meta-analysis
Authors: Zewdie Amare , Kasahun Abebaw Wasie , Habtie Adane , Gashaw Anteneh , Ayele Mulat 
Published: July 2023

AbstractBackgroundCervical cancer is the fourth most common cancer affecting females. Human papillomavirus vaccination of adolescent girls is the primary strategy for cervical cancer prevention but in Ethiopia, it lacks emphasis. Despite different studies done and found a highly variable level of vaccine acceptance; however, there was no summarized evidence on the issues as a nation. Thus this systematic review and meta-analysis aimed to assess the pooled prevalence of human papillomavirus vaccine acceptance by adolescent girls and its associated factors in Ethiopia.MethodA systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Google Scholar, and African Online Journal databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify factors associated with vaccine acceptance.ResultOverall, 157 articles were retrieved and finally 7 articles were included in this review. The pooled prevalence of adolescent human papillomavirus vaccine acceptance was 46.52% (95%CI; 30.47-62.57%). Subgroup analysis showed that adolescent vaccine acceptance was highest in the Oromia region and lowest in Addis Ababa. Knowledge about human papillomavirus vaccination (AOR = 3.89, 95% CI: (2.85–5.32)) and attitude (AOR = 2.65, 95% CI: (2.03– 3.44)) were significantly associated with adolescent’s vaccine acceptance.ConclusionHuman papillomavirus vaccine acceptance of adolescent girls in Ethiopia was low. Knowledge about the vaccine and attitude to vaccination were positively associated with their vaccine acceptance. Therefore, policymakers and program planners should target school-aged adolescents in increasing their awareness and changing their attitudes to enhance their vaccine acceptance in order to prevent and control cervical cancer.
Prognostic value of the post-exercise heart rate recovery and BHDE-index in chronic obstructive pulmonary disease
Authors: Chen Shih-Yu , Huang Chun-Kai , Wu Chia-Ling , Peng Hui-Chuan , Yu Chong-Jen , Chien Jung-Yien 
Published: July 2023

Abstract
Background
The BODE index, consisting of body mass index (B), airflow obstruction (O), dyspnea score (D), and exercise capacity (E), can predict outcomes in COPD. However, when spirometry was restricted to prevent cross-infection such as COVID-19 pandemic, a modified index would be needed. Because cardiovascular dysfunction is associated with poor clinical outcomes in COPD, we conducted a novel BHDE-index by replacing spirometry with post-exercise heart rate recovery (HRR, H) and evaluated its predictive performance in this observational study.

Methods
From January 2019 to December 2019, enrolled patients were analyzed as a derivation cohort for the setup of the model. This model was verified in another group of patients generated between January 2020 and December 2020, as the validation cohort. The post exercise HRR was defined as the difference of heart rate immediately after and 1 min after test cessation.

Results
A total of 447 patients with COPD were enrolled. Patients with abnormal HRR were older, with more severe airway obstruction, severe airway symptoms, faster resting heart rate, shorter 6-min walk distance and higher frequency of severe acute exacerbation in previous one year. The prediction performance of the BHDE-index for one-year severe COPD exacerbation was similar to that of the BODE-index in both the derivation and validation groups [area under the receiver operating characteristic curve (AUROC) 0.76 vs. 0.75, p = 0.369; AUROC 0.74 vs. 0.79, p = 0.05]. The prediction performance for 1 year mortality was also similar between BHDE-index and BODE-index in both cohorts [AUROC 0.80 vs. 0.77, p = 0.564; 0.76 vs. 0.70, p = 0.234]. Univariate and multivariate analyses also showed that the BHDE-index was an independent and important predictor of annual severe COPD exacerbation in the derivation and validation cohorts.

Conclusions
The BHDE-index is a good and easy-to-perform prediction model for the risk of severe acute exacerbation and 1-year mortality in COPD wherever spirometry results are unavailable.
Treatment of humeral shaft fractures with different treatment methods: a network meta-analysis of randomized controlled trials
Authors: Qiu Hao , Liu Yuting , Chen Yu , Weng Zheng , Liu Dun , Dong Jing , Lu Minpeng 
Published: July 2023

Abstract
Purpose
Humeral shaft fractures (HSFs) can be treated non-operatively (Non-OP), with open reduction and plate osteosynthesis (ORPO), minimally invasive plate osteosynthesis (MIPO), or with intramedullary nails (IMN). However, the best treatment for HSFs still remains controversial.We performed a network meta-analysis to explore which should be the best method for HSFs.

Methods
The computerized search had been conducted on electronic databases PubMed, EMBASE, Cochrane Library, and Medline from the establishment of the database to the end of December 2022. The quality evaluation of the included literature had been completed by Review Manager (version 5.4.1). Stata 17.0 software (Stata Corporation, College Station, Texas, USA)was used for network meta-analysis.We included randomized controlled trials (RCTs) comparing different treatments to treating HSFs.

Results
The pairwise comparison results demonstrated that there was no statistical difference between IMN, MIPO, Non-OP, and ORPO in terms of radial nerve injury and infection, and Non-OP presented significantly more nonunion than ORPO, IMN, and MIPO. However, no statistically significant difference between ORPO, IMN, and MIPO was discovered. The results of the network meta-analysis displayed that surface under the cumulative ranking curve (SUCRA) probabilities of IMN, MIPO, Non-OP, and ORPO in radial nerve injury were 46.5%, 66.9%, 77.3%, and 9.3%, respectively, in contrast, that in infection were 68.6%, 53.3%, 62.4%, and 15.4%, respectively, and that in nonunion were 51.7%, 93.1%, 0.7%, and 54.5%, respectively.

Conclusion
We came to the conclusion that MIPO is currently the most effective way to treat HSFs.

Trial registration
Name of the registry: Prospero, 2. Unique Identifying number or registration ID: CRD42023411293.
Effects of UBE3A on the insulin resistance in polycystic ovary syndrome through the ubiquitination of AMPK
Authors: Ma Ning , Zhou Jing , Zhou Zhi , Wan Bangbei , Lu Weiying 
Published: July 2023

Abstract
Background
Polycystic ovary syndrome (PCOS) is a reproductive hormonal abnormality and a metabolic disorder, which is frequently associated with insulin resistance (IR). We aim to investigate the potential therapeutic effects of Ubiquitin-protein ligase E3A (UBE3A) on IR in the PCOS rats via Adenosine 5‘-monophosphate (AMP)-activated protein kinase (AMPK) activation.

Methods
The PCOS and IR rats model was established by dehydroepiandrosterone (DHEA) and high fat diet (HFD) treatment, and the fat rate, glucose tolerance and insulin tolerance were measured. The IR rats numbers were calculated. Besides, the mRNA levels of glucose transporter 4 (GLUT4) and UBE3A were detected by RT-qPCR. Furthermore, the relationship between was demonstrated by co-IP assay. The phosphorylation and ubiquitination of AMPK were analyzed by western blot.

Results
UBE3A was up-regulated in the PCOS rats. UBE3A knockdown significantly decreased the fat rate, glucose tolerance and insulin tolerance in the PCOS and IR rats. Additionally, the GLUT4 levels were significantly increased in PCOS + IR rats. Besides, after UBE3A knockdown, the IR rats were decreased, the p-IRS1 and p-AKT levels were significantly up-regulated. Furthermore, UBE3A knockdown enhanced phosphorylation of AMPK through decreasing the ubiquitination of AMPK. AMPK knockdown reversed the role of UBE3A knockdown in the PCOS + IR rats.

Conclusions
UBE3A knockdown inhibited the IR in PCOS rats through targeting AMPK. Our study indicated that UBE3A might become a potential biological target for the clinical treatment of PCOS.
Forces and moments generated during extrusion of a maxillary central incisor with clear aligners: an in vitro study
Authors: McKay Abraham , McCray Julie , Bankhead Brent , Lee Michael M. , Miranda Gabriel , Adel Samar M. , Kim Ki Beom 
Published: July 2023

Abstract
Objective
To assess the possibility of extrusion of a maxillary central incisor with the use of buccal and lingual pressure columns in the absence of attachments, and to evaluate the forces and moments experienced by the teeth using both thermoformed and 3D-printed clear aligners.

Materials and methods
A three-axis force and moment sensor (Aidin Robotics, Anyang, South Korea) was used to measure the forces and moments during extrusion of an upper left central incisor (UL1) and any forces experienced by the upper right central incisor (UR1) using thermoformed aligners and 3D-printed aligners. For the thermoformed aligners, the materials used were ATMOS® (American Orthodontics, Sheboygan, WI) and Zendura FLX® (Bay Materials LLC, Fremont, CA). 3D-printed aligners were fabricated using TC-85 clear photocurable resin (Graphy Inc., Seoul, South Korea). For each material type, three conditions were tested: Group 1: No attachment or pressure columns (control); Group 2: Attachment only; and Group 3: Pressure columns only. Each group was planned for 0.5 mm of extrusion on the UL1.

Results
All force readings collected demonstrated statistically significant differences when compared by materials and when compared by groups, with a P value of < 0.001. In the absence of attachment or pressure columns (Group 1), ATMOS® and TC-85 groups exerted extrusive force on the UL1. However, significantly lower forces and moments were exerted by the TC-85 group in comparison to the ATMOS® and Zendura FLX® groups. In the presence of attachment (Group 2), all three ATMOS®, Zendura FLX® and TC-85 groups exerted extrusive force on the UL1, with the TA group showing different directions of faciolingual force, mesiodistal force and faciolingual inclination on the UR1 when compared to the other two thermoformed groups. Whereas in the presence of pressure columns (Group 3), only the TC-85 3D-printed aligner group exerted extrusive force. Thermoformed aligners generated significantly higher mean forces and moments than 3D-printed aligners. Significant levels of unintended forces and moments were present in all groups.

Conclusions
Force levels generated during extrusion with clear aligners are significantly lower with those 3D-printed using TC-85 than with those thermoformed using ATMOS® or Zendura FLX®. Attachments consistently generated extrusive forces, and may be an effective adjunct in achieving extrusion of incisors. Extrusion may be achieved without the use of attachments by utilizing pressure columns in 3D-printed aligners using TC-85. While different strategies can generate extrusive forces, there are significant unintended forces and moments.
A randomized controlled trial on the effects and acceptability of individual mindfulness techniques – meditation and yoga – on anxiety and depression in people with Parkinson’s disease: a study protocol
Authors: Kwok Jojo Yan Yan , Auyeung Man , Pang Shirley Yin Yu , Ho Philip Wing Lok , Yu Doris Sau Fung , Fong Daniel Yee Tak , Lin Chia-chin , Walker Richard , Wong Samuel Yeung-shan , Ho Rainbow Tin Hung 
Published: July 2023

Abstract
Background
Between 40 and 50% of patients with Parkinson’s disease (PD) experience anxiety and depression, associated with impaired physical function, high care dependency and mortality. Recently, the United States National Institutes of Health has urged the implementation of mindfulness practices in chronic illness care. Most research to date has examined the effects on chronically ill patients of complex interventions using a combination of mindfulness techniques. In PD patients, however, such complex modalities appear to hinder the technique mastery. Hence, the aim of this trial is to investigate the effects and underlying mechanism of individual mindfulness techniques among PD patients, as well as exploring participants’ experience in using individual mindfulness techniques as a lifestyle intervention for stress and symptom management.

Methods
We will conduct an assessor-blind three-arm randomized waitlist-controlled trial with a descriptive qualitative evaluation. Up to 168 PD patients will be recruited from community settings and out-patient clinics, and randomized to meditation, yoga, or usual care group. Meditation and yoga sessions of 90-minute are held weekly for 8 weeks. Primary outcomes include anxiety and depression. Secondary outcomes include PD-related motor and non-motor symptoms and quality-of-life; and level of mindfulness and biomarkers of stress and inflammatory responses will be measured as mediating variables. All outcome evaluations will be assessed at baseline, 8 weeks, and 24 weeks. Following the intention-to-treat principle, generalized estimating equation models and path analysis will be used to identify the treatment effects and the mediating mechanisms. A subsample of 30 participants from each intervention group will be invited for qualitative interviews.

Discussion
The study would also generate important insights to enhance the patients’ adaptation to debilitating disease. More specifically, symptom management and stress adaptation are highly prioritized healthcare agenda in managing PD. The research evidence will further inform the development of community-based, nurse-led compassionate care models for neurodegenerative conditions, which is complementary to existing health services.

Trial registration
WHO Primary Registry – Chinese Clinical Trials Registry number: ChiCTR2100045939; registered on 2021/04/29 (https://www.chictr.org.cn/showproj.html?proj=125878).
Isolation and identification of active ingredients and biological activity of Dioscorea nipponica Makino
Authors: Xia Guangqing , Zhao Guanshu , Pei Shichun , Zheng Yanping , Zang Hao , Li Li 
Published: July 2023

AbstractThis study reported the isolation and identification of bioactive compounds from Dioscorea nipponica Makino, a plant used in traditional medicine for various ailments. Nine compounds were isolated, including a new compound named as diosniposide E, which was elucidated by analyzing its 1H-NMR, 13C-NMR, DEPT, COSY, HMBC and MS data and comparing them with data available in literature. The other eight compounds were identified as known compounds. Theoretical calculations of energy and the generation of a molecular electrostatic potential surface map were employed to assess the antioxidant capacity of nine compounds, the calculation results exhibited that compounds 5 and 6 had strong antioxidant capacities. To further evaluate the antioxidant activities of the investigated compounds, the DPPH and ABTS assays were conducted. The results from the DPPH scavenging activity test revealed that compounds 4–6 exhibited enhanced scavenging activities compared to L-ascorbic acid, while displaying similar efficacy to trolox. Moreover, the ABTS scavenging activities of compounds 4–6 were found to surpass those of L-ascorbic acid and trolox. In terms of α-glucosidase inhibition, compounds 3 and 4 displayed remarkable inhibitory activities that surpassed the effects of acarbose. Additionally, compound 2 exhibited potent anticholinesterase activities, outperforming donepezil. This research provides insights into the potential bioactive compounds present in Dioscoreanipponica Makino and may contribute to its use in traditional medicine.
Perception and knowledge of learners about the use of 3D technologies in manual therapy education – a qualitative study
Authors: Kovanur Sampath Kesava , Arumugam Ashokan , Yaghi Esra , Fairs Emma , Andersen Patrea 
Published: July 2023

Abstract
Objectives
Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional ‘See one, do one, teach one’ approach. However, this ‘teacher centred’ approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education.

Methods
An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis.

Results
Six factors were identified which appeared to influence participants’ perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants’ perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions (‘no role’ (techstatic) versus a ‘complete role’ (techsavvy)).

Conclusion
Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.
Enhancing medical education in respiratory diseases: efficacy of a 3D printing, problem-based, and case-based learning approach
Authors: Yan Xuebo , Zhu Yingying , Fang Lei , Ding Peishan , Fang Shu , Zhou Jinhua , Wang Jiong 
Published: July 2023

Abstract
Objectives
The present study aims to investigate the efficacy of utilizing three-dimensional (3D) printing technology in concert with Problem-Based Learning (PBL) and Case-Based Learning (CBL) pedagogical approaches in educating senior undergraduate clinical medical students on respiratory diseases.

Methods
A cohort of 422 fourth-year clinical medicical students of from Anhui Medical University, pursuing a five-year program, were arbitrarily segregated into two distinct groups. The experimental group was subjected to a combined pedagogical approach, which included 3D printing technology, PBL and CBL (referred to as DPC). Conversely, the control group was exposed to conventional teaching methodologies for respiratory disease education. The effectiveness of the teaching methods was subsequently appraised using both theoretical test scores and custom questionnaires.

Results
Post-quiz scores indicated a statistically significant improvement in the DPC group as compared to the traditional group (P < 0.01). Self-evaluation and satisfaction questionnaires revealed that the DPC group’s self-assessment scores outperformed the traditional group in several aspects, including clinical thinking ability, learning initiative, self-study ability, anatomical knowledge mastery, confidence in learning, ability to analyze and solve problems, comprehension of the knowledge, help to clinical thinking and level of satisfaction on the teaching methods (P < 0.01). However, within the unsatisfied DPC sub-group, none of these self-assessment aspects, except for comprehension of the knowledge, impacted the learning efficacy (P > 0.05).

Conclusion
The deployment of the DPC pedagogical approach may confer unique experiential learning opportunities for students, potentially enhancing theoretical test scores and promoting self-evaluation and satisfaction in the context of respiratory disease education. Hence, it may be instrumental in augmenting the overall teaching efficacy.