bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of health education interventions on oral health promotion among older people: a systematic review
Authors: Bashirian Saeid , Khoshravesh Sahar , Ayubi Erfan , Karimi-Shahanjarini Akram , Shirahmadi Samane , Solaymani Parshang Faghih 
Published: September 2023

Abstract
Background
One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people.

Methods
Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP).

Results
In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality.

Conclusion
This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field.
Can vitamin B6 alleviate the adverse reactions of quadruple anti-Helicobacter pylori regimen? : randomized controlled trial
Authors: Cui Meng-Yan , Zhang Meng-Jie , Jiang Qiao-Li , Pei Zhong-Mei , Cui Zhen-Yu , Kang Mei , Lu Lun-Gen , Lu Ying-Ying 
Published: September 2023

Abstract
Background
Vitamin B6 is an essential water-soluble vitamin for humans. It is often used to prevent a variety of neuropathies, relieve vomiting, and relieve symptoms such as hand and foot neuritis.

Aim
To evaluate whether vitamin B6 can alleviate the adverse reactions caused by the quadruple anti-Helicobacter pylori treatment regimen containing minocycline and metronidazole.

Methods
In this randomized controlled trial, 280 patients with H. pylori infection were randomly placed into one of two treatment groups—the conventional treatment group and the vitamin B6 supplement treatment group—for 2 weeks. The primary endpoint was the total incidence of adverse reactions up to 2 weeks after treatment initiation. The study was designed according to CONSORT Medicinal Interventions. And it was registered with Chinese Clinical Trial Registry under the number ChiCTR2100053833.

Results
In terms of efficacy, vitamin B6 does not affect the efficacy of conventional regimen. In the vitamin B6 supplement treatment group, the incidence of adverse reactions was 56.92%, which was significantly lower than the 74.62% observed in the conventional treatment group. In addition, the severity of adverse reactions was also significantly reduced. The proportion of moderate to severe central nervous system symptoms decreased from 58.7 to 14.63%. And, the proportion of moderate to severe gastrointestinal reactions decreased from 33.33 to 0%. We speculate that the mechanism of vitamin B6 of reducing adverse reaction may be related to the production of GABA in the brain.

Conclusions
Vitamin B6 can alleviate adverse reactions of the quadruple anti-H. pylori regimen containing minocycline and metronidazole.
Analysis of risk factors of precocious puberty in children
Authors: Dong Yan , Dai Lili , Dong Yang , Wang Na , Zhang Jing , Liu Chao , Li Zhifang , Chu Limin , Chen Sisi 
Published: September 2023

Abstract
Background
The purpose of this study is to explore the related factors of precocious puberty in children.

Methods
1239 children who underwent physical examination in our hospital from January 2020 to December 2022 were analyzed, including 198 precocious children and 1041 normal children. According to the age of 198 precocious children and 1041 normal children, 205 normal children were selected, and the remaining 836 normal children were excluded. They were divided into precocious group and normal group. The general data of the two groups were recorded. Logistic regression was used to analyze the influencing factors of precocious puberty in children.

Results
There were statistically significant differences (P < 0.05) between the two groups in sex, bone age, daily exercise time, E2, FSH, LH, leptin, mother’s menarche time, living environment, consumption of nutritional supplements, consumption of foods containing pigments and preservatives, consumption of high-protein foods, and sleeping time. The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (> 10 years old), and daily exercise time (< 0.9 h), E2 (≥ 66.00pmol/L), FSH (≥ 6.00U/L), LH (≥ 3.50U/L), leptin (≥ 8.00 µ G/L), mother’s menarche time (< 12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (< 10 h).

Conclusion
In conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mother’s menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. Reminding parents to actively prevent related factors in clinical work is helpful to prevent the occurrence of precocious puberty in children.
Association between physicians’ characteristics and their knowledge, attitudes, and practices regarding advance care planning: a cross-sectional study
Authors: Sakamoto Ayaka , Inokuchi Ryota , Iwagami Masao , Hanari Kyoko , Tamiya Nanako 
Published: September 2023

Abstract
Background
Despite physicians’ vital role in advance care planning, a limited number of physicians practice it. This study assessed factors associated with physicians’ knowledge, attitudes, and practices regarding advance care planning.

Methods
This cross-sectional study used data from an anonymous survey conducted by the Japanese Ministry of Health, Labour and Welfare.
Questionnaires were mailed to 4500 physicians in November and December 2022. Data from 1260 respondents were analyzed.

Results
Of the respondents, 46.4%, 77.0%, and 82.0% reported good knowledge of advance care planning, agreed with promoting it, and with its provision by medical/care staff, respectively. Male physicians were significantly less likely to support advance care planning (odds ratio: 0.54, 95% confidence interval: 0.35–0.84) or agree to its provision by medical/care staff (odds ratio: 0.47, 95% confidence interval: 0.29–0.78) but significantly more likely to practice it (odds ratio: 1.58, 95% confidence interval: 1.05–2.36). Physicians specialized in surgery or internal/general/palliative medicine were more knowledgeable about advance care planning and more likely to practice it. Physicians working in clinics were significantly less knowledgeable (odds ratio: 0.33, 95% confidence interval: 0.25–0.44) about advance care planning and less likely to support it (odds ratio: 0.37, 95% confidence interval: 0.27–0.50), agree with its provision by medical/care staff (odds ratio: 0.54, 95% confidence interval: 0.39–0.75), or to practice it (odds ratio: 0.16, 95% confidence interval: 0.12–0.22).

Conclusions
Physicians working in clinics had less knowledge of advance care planning, less supportive attitudes, and less likely to practice it. Knowledge, attitudes and practice also varied by gender and specialty. Interventions should target physicians working in clinics.
Hesperetin attenuates the expression of markers of adipose tissue fibrosis in pre-adipocytes
Authors: Taheri Alemeh , Mobaser Samira Ezzati , Golpour Pegah , Nourbakhsh Mona , Tavakoli-Yaraki Masoumeh , Yarahmadi Sahar , Nourbakhsh Mitra 
Published: September 2023

Abstract
Background
Excessive extracellular matrix (ECM) deposition in adipose tissue is a hallmark of fibrosis, leading to disrupted adipose tissue homeostasis and metabolic dysfunction. Hesperetin, a flavonoid compound, has shown promising anti-inflammatory, anti-obesity and anti-diabetic properties. Therefore, we investigated the anti-fibrotic effects of hesperetin, through targeting ECM components and matrix metalloproteinase enzymes.

Methods
3T3-L1 cells were cultured in DMEM, containing 10% FBS and 1% penicillin/streptomycin. Cells were treated with a range of hesperetin concentrations, and the cell viability was determined using MTT assay. Subsequently, the expression of genes encoding collagen VI, osteopontin, matrix metalloproteinase-2 (Mmp-2) and Mmp-9 was analyzed using specific primers and real-time PCR technique. To evaluate protein levels of collagen VI and osteopontin, Western blotting was performed.

Results
Hesperetin affected the viability of 3T3-L1 adipocytes with IC50 of 447.4 µM, 339.2 µM and 258.8 µM (24 h, 48 and 72 h, respectively). Hesperetin significantly reduced the gene and protein expression of both collagen VI and osteopontin in 3T3-L1 pre-adipocytes, in a time- and dose-dependent manner. Hesperetin was also able to cause a remarkable decline in gene expression of Mmp2 and Mmp9.

Conclusion
Hesperetin could potently reduce the production of markers of adipose tissue fibrosis and might be considered a potential anti-fibrotic compound in obesity. Thus, hesperetin has the potency to be used for the treatment of obesity-associated fibrosis.
Block-based teaching method based on cybernetics: a trial with 115 Chinese undergraduate medical students
Authors: Liu Zhi-Ping , Liu Si-Han , Dai Xin , Chen Jie , Guo Qing-Feng , Zhang Da-Xin 
Published: September 2023

AbstractBackgroundClass attendance is important for academic performance. Personal interactions between teachers and students are difficult in large classes; the number of medical undergraduate students in China ranges from dozens to over 100. It is important for teachers to control the teaching process to improve student attendance and participation.MethodsTwo classes of fourth-year undergraduate medical students, with each class comprising 115 students, participated in the study. One class, the trial group, was taught by the block-based teaching method based on cybernetics. This study was conducted with three of the courses in the Introduction to Oncology subject, and the trial group’s courses included several blocks. Each block had a test paper that the students responded to immediately in class using the Internet. The teacher obtained feedback from the students when the rate of correct responses to block-test questions was less than 90%. The teacher adjusted the teaching in the following blocks according to the feedback information. The other class, the control group, was taught using the traditional lecture-based teaching method.ResultsThe average attendance in the trial group was 104/115 (90.43%), and that in the control group was 83/115 (72.17%) (p = 0.0003). The teacher adjusted the teaching three times in the radiotherapy course owing to the complex ideas. After feedback, information on chemotherapy for the upper body was adjusted once, as was that on chemotherapy for the lower body, owing to students’ attitudes. The average total score of the trial group was 86.06 ± 17.46 and that of the control group was 80.38 ± 6.97 (p = 0.041). Questionnaire I showed that the trial group students’ attendance and participation were better than in the control group. Questionnaire II showed that the block-based teaching method based on cybernetics was approved by the students.ConclusionsThe block-based teaching method based on cybernetics used in medical classes with large numbers of Chinese undergraduate students had positive effects.
Body landmarks and genetic algorithm-based approach for non-contact detection of head forward posture among Chinese adolescents: revitalizing machine learning in medicine
Authors: Yang Guang , He Shichun , Meng Deyu , Wei Meiqi , Cao Jianwei , Guo Hongzhi , Ren He , Wang Ziheng 
Published: September 2023

AbstractAddressing the current complexities, costs, and adherence issues in the detection of forward head posture (FHP), our study conducted an exhaustive epidemiologic investigation, incorporating a comprehensive posture screening process for each participant in China. This research introduces an avant-garde, machine learning-based non-contact method for the accurate discernment of FHP. Our approach elevates detection accuracy by leveraging body landmarks identified from human images, followed by the application of a genetic algorithm for precise feature identification and posture estimation. Observational data corroborates the superior efficacy of the Extra Tree Classifier technique in FHP detection, attaining an accuracy of 82.4%, a specificity of 85.5%, and a positive predictive value of 90.2%. Our model affords a rapid, effective solution for FHP identification, spotlighting the transformative potential of the convergence of feature point recognition and genetic algorithms in non-contact posture detection. The expansive potential and paramount importance of these applications in this niche field are therefore underscored.
Barriers and facilitators to the participation and engagement of primary care in shared-care arrangements with community mental health services for preventive care of people with serious mental illness: a scoping review
Authors: Parker Sharon M. , Paine Katrina , Spooner Catherine , Harris Mark 
Published: September 2023

Abstract
Background
People with serious mental illness die about 20 years earlier than the general population from preventable diseases. Shared-care arrangements between general practitioners and mental health services can improve consumers’ access to preventive care, but implementing shared care is challenging. This scoping review sought to describe current evidence on the barriers and facilitators to the participation and engagement of primary care (specifically general practitioners) in shared-care arrangements with community mental health services for preventive health care of this population.

Methods
We searched Medline, Embase, CINAHL, Scopus, APA PsychINFO and EBM Reviews from 2010 to 2022. Data was extracted against a Microsoft Excel template developed for the review. Data was synthesised through tabulation and narrative methods.

Results
We identified 295 records. After eligibility screening and full-text review, seven studies were included. Facilitators of engagement included a good fit with organisation and practice and opportunities to increase collaboration, specific roles to promote communication and coordination and help patients to navigate appointments, multidisciplinary teams and teamwork, and access to shared medical/health records. Barriers included a lack of willingness and motivation on the part of providers and low levels of confidence with tasks, lack of physical structures to produce capacity, poor alignment of funding/incentives, inability to share patient information and challenges engaging people with severe mental illness in the service and with their care.

Conclusion
Our results were consistent with other research on shared care and suggests that the broader literature is likely to be applicable to the context of general practitioner/mental health services shared care. Specific challenges relating to this cohort present difficulties for recruitment and retention in shared care programs. Sharing “goals and knowledge, mutual respect” and engaging in “frequent, timely, accurate, problem-solving communication”, supported by structures such as shared information systems are likely to engage primary care in shared care arrangements more than the traditional focus on incentives, education, and guidelines.
Unlocking the potential of microRNAs: machine learning identifies key biomarkers for myocardial infarction diagnosis
Authors: Samadishadlou Mehrdad , Rahbarghazi Reza , Piryaei Zeynab , Esmaeili Mahdad , Avcı Çığır Biray , Bani Farhad , Kavousi Kaveh 
Published: September 2023

Abstract
Background
MicroRNAs (miRNAs) play a crucial role in regulating adaptive and maladaptive responses in cardiovascular diseases, making them attractive targets for potential biomarkers. However, their potential as novel biomarkers for diagnosing cardiovascular diseases requires systematic evaluation.

Methods
In this study, we aimed to identify a key set of miRNA biomarkers using integrated bioinformatics and machine learning analysis. We combined and analyzed three gene expression datasets from the Gene Expression Omnibus (GEO) database, which contains peripheral blood mononuclear cell (PBMC) samples from individuals with myocardial infarction (MI), stable coronary artery disease (CAD), and healthy individuals. Additionally, we selected a set of miRNAs based on their area under the receiver operating characteristic curve (AUC-ROC) for separating the CAD and MI samples. We designed a two-layer architecture for sample classification, in which the first layer isolates healthy samples from unhealthy samples, and the second layer classifies stable CAD and MI samples. We trained different machine learning models using both biomarker sets and evaluated their performance on a test set.

Results
We identified hsa-miR-21-3p, hsa-miR-186-5p, and hsa-miR-32-3p as the differentially expressed miRNAs, and a set including hsa-miR-186-5p, hsa-miR-21-3p, hsa-miR-197-5p, hsa-miR-29a-5p, and hsa-miR-296-5p as the optimum set of miRNAs selected by their AUC-ROC. Both biomarker sets could distinguish healthy from not-healthy samples with complete accuracy. The best performance for the classification of CAD and MI was achieved with an SVM model trained using the biomarker set selected by AUC-ROC, with an AUC-ROC of 0.96 and an accuracy of 0.94 on the test data.

Conclusions
Our study demonstrated that miRNA signatures derived from PBMCs could serve as valuable novel biomarkers for cardiovascular diseases.
Effect of dietary intervention on the prevalence of asymptomatic malaria among 6–18-month-old children in rural Malawi
Authors: Sady Hany , Chaima David , Hallamaa Lotta , Kortekangas Emma , Ashorn Ulla , Banda Jomo , Mangani Charles , Maleta Kenneth , Ashorn Per , Fan Yue-Mei 
Published: September 2023

Abstract
Background
The complex interaction between malaria and undernutrition leads to increased mortality and morbidity rate among young children in malaria-endemic regions. Results from previous interventions suggest that improving nutritional status of young children may reduce the burden of malaria. This study tested a hypothesis that provision of lipid-based nutrient supplements (LNS) or corn-soy blend (CSB) supplementation to 6–18-month-old children in Malawi would reduce the prevalence of asymptomatic malaria among them.

Methods
A total of 840 6-month-old children were enrolled in a randomized trial. The participants received 12-month supplementation with three different daily dietary supplementations: CSB, soy-LNS, or milk-LNS, and one control group without supplementation. The prevalence rate of asymptomatic Plasmodium falciparum was determined by real-time PCR from the participant’s dried blood spots (DBS) collected at the baseline and every 3 months. The global null hypothesis was tested using modified Poisson regression to estimate the prevalence ratio (PR) between the control group and three intervention groups at all ages combined. All the models were adjusted for malaria at baseline, season of DBS sample collection, site of enrolment, and household asset Z-score.

Results
All children combined, the prevalence of P. falciparum was 14.1% at enrollment, 8.7% at 9 months, 11.2% at 12 months, 13.0% at 15 months and 22.4% at 18 months of age. Among all samples that were taken after enrolment, the prevalence was 12.1% in control group, 12.2% in milk-LNS, 14.0% in soy-LNS, and 17.2% in CSB group. Compared to children in the control group the prevalence ratio of positive malaria tests was 1.19 (95% CI 0.81–1.74; P = 0.372) in the milk-LNS group, 1.32 (95% CI 0.88–1.96; P = 0.177) in the soy-LNS group and 1.72 (95% CI 1.19–2.49; P = 0.004) in the CSB group.

Conclusion
The study findings do not support a hypothesis that LNS or CSB supplementation would reduce the prevalence of asymptomatic malaria among Malawian children. In contrast, there was a signal of a possible increase in malaria prevalence among children supplemented with CSB.
Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes
Authors: Litchfield Ian , Barrett Tim , Hamilton-Shield Julian , Moore Theresa , Narendran Parth , Redwood Sabi , Searle Aidan , Uday Suma , Wheeler Jess , Greenfield Sheila 
Published: September 2023

Abstract
Aims
With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, its important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes.

Methods
We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context – the influence and mitigation of a range of individual, socio-cultural, and environmental factors.

Results
We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities.

Conclusions
A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.