bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating force-time characteristics of prone thoracic SMT and self-reported patient outcome measures: a feasibility study
Authors: Choi Grand , Giuliano Dominic , Tibbles Anthony , Howarth Samuel J. , Tran Steve , Lee Joyce , Funabashi Martha 
Published: July 2023

Abstract
Background
Spinal manipulative therapy (SMT) is commonly used to treat musculoskeletal conditions, including thoracic spine pain. Applying patient-specific force-time characteristics are believed to be important to improve SMT’s effectiveness. Investigating SMT as part of a multimodal approach is fundamental to account for the complexity of chiropractic clinical practice. Therefore, pragmatic investigations balancing minimal disruptions to the clinical encounter at the same time as ensuring a robust data quality with rigorous protocols are needed. Consequently, preliminary studies are required to assess the study protocol, quality of data recorded and the sustainability of such investigation. Therefore, this study examined the feasibility of investigating SMT force-time characteristics and clinical outcome measures in a clinical setting.

Methods
In this mixed-methods study, providers recorded thoracic SMT force-time characteristics delivered to patients with thoracic spinal pain during regular clinical encounters. Self-reported clinical outcomes of pain, stiffness, comfort during the SMT (using an electronic visual analogue scale), and global rating of change scale were measured before and after each SMT application. Feasibility was quantitatively assessed for participant recruitment, data collection and data quality. Qualitative data assessed participants’ perceptions on the impact of data collection on patient management and clinical flow.

Results
Twelve providers (58% female, 27.3 ± 5.0 years old) and twelve patients (58% female, 37.2 ± 14.0 years old) participated in the study. Enrolment rate was greater than 40%, data collection rate was 49% and erroneous data was less than 5%. Participant acceptance was good with both providers and patients reporting positive experience with the study.

Conclusions
Recording SMT force-time characteristics and self-reported clinical outcome measures during a clinical encounter may be feasible with specific modification to the current protocol. The study protocol did not negatively impact patient management. Specific strategies to optimize the data collection protocol for the development of a large clinical database are being developed.
Association between toxic drug events and encephalopathy in British Columbia, Canada: a cross-sectional analysis
Authors: Xavier Chloé G. , Kuo Margot , Desai Roshni , Palis Heather , Regan Gemma , Zhao Bin , Moe Jessica , Scheuermeyer Frank X. , Gan Wen Qi , Sabeti Soha , Meilleur Louise , Buxton Jane A. , Slaunwhite Amanda K. 
Published: July 2023

Abstract
Background
Encephalopathy can occur from a non-fatal toxic drug event (overdose) which results in a partial or complete loss of oxygen to the brain, or due to long-term substance use issues. It can be categorized as a non-traumatic acquired brain injury or toxic encephalopathy. In the context of the drug toxicity crisis in British Columbia (BC), Canada, measuring the co-occurrence of encephalopathy and drug toxicity is challenging due to lack of standardized screening. We aimed to estimate the prevalence of encephalopathy among people who experienced a toxic drug event and examine the association between toxic drug events and encephalopathy.

Methods
Using a 20% random sample of BC residents from administrative health data, we conducted a cross-sectional analysis. Toxic drug events were identified using the BC Provincial Overdose Cohort definition and encephalopathy was identified using ICD codes from hospitalization, emergency department, and primary care records between January 1st 2015 and December 31st 2019. Unadjusted and adjusted log-binomial regression models were employed to estimate the risk of encephalopathy among people who had a toxic drug event compared to people who did not experience a toxic drug event.

Results
Among people with encephalopathy, 14.6% (n = 54) had one or more drug toxicity events between 2015 and 2019. After adjusting for sex, age, and mental illness, people who experienced drug toxicity were 15.3 times (95% CI = 11.3, 20.7) more likely to have encephalopathy compared to people who did not experience a drug toxicity event. People who were 40 years and older, male, and had a mental illness were at increased risk of encephalopathy.

Conclusions
There is a need for collaboration between community members, health care providers, and key stakeholders to develop a standardized approach to define, screen, and detect neurocognitive injury related to drug toxicity.
Predictive factors for recurrence after lower limb deformity correction in hypophosphatemic rickets
Authors: Suparatchatadej Chayut , Adulkasem Nath , Ariyawatkul Thanase , Eamsobhana Perajit , Chotigavanichaya Chatupon , Wongcharoenwatana Jidapa 
Published: July 2023

Abstract
Background
Surgical treatment for severe lower limb deformities in patients with hypophosphatemic rickets has shown satisfactory outcomes. However, the rates of recurrence of deformities after surgical correction were high, and studies on predictive factors of recurrence were limited. This study aimed to determine the predictive factors for the recurrence of lower limb deformities after surgical correction in patients with hypophosphatemic rickets, and the effects of each predictor on the recurrence of deformities.

Methods
We retrospectively reviewed the medical records of 16 patients with hypophosphatemic rickets aged 5–20 years and who had undergone corrective osteotomies between January 2005 and March 2019. Demographic data from the patients, biochemical profiles, and radiographic parameters were collected. Univariable Cox proportional hazard analyses of recurrence were performed. Kaplan–Meier failure estimation curves for deformity recurrences of potential predictors were created.

Results
A total of 38 bone segments were divided into 2 groups: 8 segments with recurrent deformities and 30 segments without recurrent. The average follow-up time was 5.5 ± 4.6 years. Univariable Cox proportional hazard analyses of recurrence found that an age < 10 years (hazard ratio [HR], 5.5; 95% CI, 1.1–27.1; p = 0.04), and gradual correction by hemiepiphysiodesis (HR, 7.0; 95% CI, 1.2–42.7; p = 0.03) were associated with recurrence after surgery. The Kaplan–Meier failure estimation for deformity recurrences by age at the time of surgery also achieved a statistically significant difference between ages < 10 years and those > 10 years (p = 0.02).

Conclusions
Identifying predictive factors for the recurrence of lower limb deformities after surgical correction in hypophosphatemic rickets can assist in early recognition, proper intervention, and prevention. We found that an age < 10 years at the time of surgery was associated with recurrence after deformity correction and gradual correction with hemiepiphysiodesis may also be a potential factor affecting the recurrence.
The leprosy reaction is associated with salivary anti-Porphyromonas gingivalis IgA antibodies
Authors: Falcão Michelle Miranda Lopes , Passos-Soares Johelle Santana , Machado Paulo Roberto Lima , Gomes-Filho Isaac Suzart , de Carvalho Lucas Pedreira , de Campos Elisangela Jesus , Calheira Mariana Costa , de Miranda Patrícia Mares , Santos Rebeca Pereira Bulhosa , Rocha Filho José Tadeu Raynal , de Farias Antonio Pedro Froes , Peixoto Taiana , Nascimento Roberto Meyer , Seymour Gregory John , Trindade Soraya Castro 
Published: July 2023

AbstractThe aim of the study was to evaluate the association between salivary anti-Porphyromonas gingivalis IgA antibodies and the leprosy reaction. The levels of salivary anti - P. gingivalis IgA antibodies, together with salivary flow and pH were measured in individuals diagnosed with leprosy and associated with the development of the leprosy reaction. Saliva was collected from 202 individuals diagnosed with leprosy at a reference leprosy treatment center, 106 cases with the leprosy reaction and 96 controls without the leprosy reaction. Anti - P. gingivalis IgA was evaluated by indirect immunoenzyme assay. Non-conditional logistic regression analysis was employed to estimate the association between antibody levels and the leprosy reaction. There was a positive statistically significant association between the levels of anti - P. gingivalis IgA and the presence of the leprosy reaction, controlling for confounders: age, sex, level of education and alcoholic beverage consumption: ORajusted: 2.55; IC 95%: 1.34–4.87. Individuals with leprosy who had high levels of salivary anti - P. gingivalis IgA had approximately twice as many chances of developing the leprosy reaction. The findings suggest a possible relationship between salivary anti - P. gingivalis IgA antibodies and the leprosy reaction.
RNA methylations in hepatic fibrosis, a gradually emerging new treatment strategy
Authors: Cheng Chenglong , Wu Yajie , Wang Xin , Xue Qiuyun , Huang Yurong , Liao Faxue , Wang Xiao , Duan Qiangjun , Miao Chenggui 
Published: July 2023

Abstract
Background
Hepatic fibrosis (HF) is a pathological process caused by excessive accumulation of extracellular matrix caused by a series of causes, leading to the formation of fiber scar. RNA methylation is a newly discovered epigenetic modification that exists widely in eukaryotes and prokaryotes and plays a crucial role in the pathogenesis of many diseases.

Results
The occurrence and development of HF are regulated by many factors, including excessive deposition of extracellular matrix, activation of hepatic stellate cells, inflammation, and oxidative stress. RNA methylations of different species have become a crucial regulatory mode of transcript expression, And participate in the pathogenesis of tumors, nervous system diseases, autoimmune diseases, and other diseases. In addition, there are five common types of RNA methylation, but only m6A plays a crucial regulatory role in HF. The pathophysiological regulation of m6A on HF is achieved by the combination of the methylated transferase, demethylated enzyme, and methylated reading protein.

Conclusions
RNA methylated methyltransferase, demethylase, and reading protein extensively affect the pathological mechanism of HF, which may be a new therapeutic and diagnostic target, representing a new class of therapeutic strategies.
Non-response bias in the analysis of the association between mental health and the urban environment: a cross-sectional study in Brussels, Belgium
Authors: Guyot Madeleine , Pelgrims Ingrid , Aerts Raf , Keune Hans , Remmen Roy , De Clercq Eva M. , Thomas Isabelle , Vanwambeke Sophie O. 
Published: July 2023

Abstract
Background
This paper aims at analysing the impact of partial non-response in the association between urban environment and mental health in Brussels. The potential threats of the partial non-response are biases in survey estimates and statistics. The effect of non-response on statistical associations is often overlooked and evidence in the research literature is lacking.

Methods
Data from the Belgian Health Interview Survey 2008 and 2013 were used. The association between non-response and potential determinants was explored through logistic regressions.

Results
Participants with low income, low educational levels, lower or higher age or in households with children were less likely to respond. When adjusting for socio-economic variables, non-response was higher in areas which are less vegetated, more polluted or more urbanised. Because the determinants of non-response and depressive disorders were similar, it is reasonable to assume that there will be more people with mental health problems among the non-respondents. And because more non-responses were found in low vegetation areas, the protective association between green spaces and mental health may be underestimated.

Conclusion
Our capacity to measure the association between the urban environment and health is affected by non-response in surveys. The non-random spatial and socio-economic distribution of this bias affects the research findings.
Monitoring SARS-CoV-2 variants in wastewater of Dhaka City, Bangladesh: approach to complement public health surveillance systems
Authors: Haque Rehnuma , Hossain Mohammad Enayet , Miah Mojnu , Rahman Mahbubur , Amin Nuhu , Rahman Ziaur , Islam Md. Shariful , Rahman Mohammed Ziaur 
Published: July 2023

Abstract
Background
Wastewater-based epidemiological surveillance has been considered a powerful tool for early detection and monitoring of the dynamics of SARS-CoV-2 and its lineages circulating in a community. This study is aimed to investigate the complexity of SARS-CoV-2 infection dynamics in Dhaka city by examining its genetic variants in wastewater. Also, the study seeks to determine a connection between the SARS-CoV-2 variations detected in clinical testing and those found in wastewater samples.

Results
Out of 504 samples tested in RT-qPCR, 185 (36.7%) tested positive for SARS-CoV-2 viral RNA. The median log10 concentration of SARS-CoV-2 N gene copies/Liter of wastewater (gc/L) was 5.2, and the median log10 concentration of ORF1ab was 4.9. To further reveal the genetic diversity of SARS-CoV-2, ten samples with ORF1ab real-time RT-PCR cycle threshold (Ct) values ranging from 28.78 to 32.13 were subjected to whole genome sequencing using nanopore technology. According to clade classification, sequences from wastewater samples were grouped into 4 clades: 20A, 20B, 21A, 21J, and the Pango lineage, B.1, B.1.1, B.1.1.25, and B.1.617.2, with coverage ranging from 94.2 to 99.8%. Of them, 70% belonged to clade 20B, followed by 10% to clade 20A, 21A, and 21J. Lineage B.1.1.25 was predominant in Bangladesh and phylogenetically related to the sequences from India, the USA, Canada, the UK, and Italy. The Delta variant (B.1.617.2) was first identified in clinical samples at the beginning of May 2021. In contrast, we found that it was circulating in the community and was detected in wastewater in September 2020.

Conclusion
Environmental surveillance is useful for monitoring temporal and spatial trends of existing and emerging infectious diseases and supports evidence-based public health measures. The findings of this study supported the use of wastewater-based epidemiology and provided the baseline data for the dynamics of SARS-CoV-2 variants in the wastewater environment in Dhaka, Bangladesh.
Effects of spatial configuration on the patient’s journey to the Emergency Department
Authors: Meka Bardha , Navakazi Vlora , Xërxa Beqiri Flaka 
Published: July 2023

AbstractReaching the destination, users often encounter complex interfaces created between hospital spaces and the urban tissue. The literature highlights the influence of spatial configuration on the performance of external and internal spaces of healthcare settings. In this regard, studies related to Emergency Department (ED), mostly focus on internal spaces, without specific research on the accessibility of the structures themselves. By extending the research area to the entire system of territory-hospital-ED relations, the study conducted at the University Clinical Center of Kosovo (UCCK) in the city of Prishtina aims to investigate the effects of spatial configuration on the performance of spaces in the patient's journey to ED. The paper attempts to understand the causes that have shaped the spatial configuration of the city and the hospital over the years and their impact on ED accessibility. Through configurational theory of architecture, the paper quantitatively examines the interactions between the levels of this relational system at various spatial scales and time intervals. A methodological framework of spatial requirements and corresponding indicators was developed. It was observed that the declined syntactic values of the city affected the degree of the hospital accessibility, deteriorating the continuity of movement from the city to the hospital, followed by a subsequent disruption due to the change in the spatial configuration of the hospital and the relative position of ED. The outcome shows that configurational changes affect the continuity of movement sequentially in each segment of the patient’s journey towards ED, with interrelated consequences at all levels.
Compensatory cross-talk between autophagy and glycolysis regulates senescence and stemness in heterogeneous glioblastoma tumor subpopulations
Authors: Martell Emma , Kuzmychova Helgi , Senthil Harshal , Kaul Esha , Chokshi Chirayu R. , Venugopal Chitra , Anderson Christopher M. , Singh Sheila K. , Sharif Tanveer 
Published: July 2023

AbstractDespite tremendous research efforts, successful targeting of aberrant tumor metabolism in clinical practice has remained elusive. Tumor heterogeneity and plasticity may play a role in the clinical failure of metabolism-targeting interventions for treating cancer patients. Moreover, compensatory growth-related processes and adaptive responses exhibited by heterogeneous tumor subpopulations to metabolic inhibitors are poorly understood. Here, by using clinically-relevant patient-derived glioblastoma (GBM) cell models, we explore the cross-talk between glycolysis, autophagy, and senescence in maintaining tumor stemness. We found that stem cell-like GBM tumor subpopulations possessed higher basal levels of glycolytic activity and increased expression of several glycolysis-related enzymes including, GLUT1/SLC2A1, PFKP, ALDOA, GAPDH, ENO1, PKM2, and LDH, compared to their non-stem-like counterparts. Importantly, bioinformatics analysis also revealed that the mRNA expression of glycolytic enzymes positively correlates with stemness markers (CD133/PROM1 and SOX2) in patient GBM tumors. While treatment with glycolysis inhibitors induced senescence in stem cell-like GBM tumor subpopulations, as evidenced by increased β-galactosidase staining and upregulation of the cell cycle regulators p21Waf1/Cip1/CDKN1A and p16INK4A/CDKN2A, these cells maintained their aggressive stemness features and failed to undergo apoptotic cell death. Using various techniques including autophagy flux and EGFP-MAP1LC3B+ puncta formation analysis, we determined that inhibition of glycolysis led to the induction of autophagy in stem cell-like GBM tumor subpopulations, but not in their non-stem-like counterparts. Similarly, blocking autophagy in stem cell-like GBM tumor subpopulations induced senescence-associated growth arrest without hampering stemness capacity or inducing apoptosis while reciprocally upregulating glycolytic activity. Combinatorial treatment of stem cell-like GBM tumor subpopulations with autophagy and glycolysis inhibitors blocked the induction of senescence while drastically impairing their stemness capacity which drove cells towards apoptotic cell death. These findings identify a novel and complex compensatory interplay between glycolysis, autophagy, and senescence that helps maintain stemness in heterogeneous GBM tumor subpopulations and provides a survival advantage during metabolic stress.
Multilevel multivariate modeling on the association between undernutrition indices of under-five children in East Africa countries: evidence from recent demographic health survey (DHS) data
Authors: Asmare Abebew Aklog , Agmas Yitateku Adugna 
Published: July 2023

Abstract
Background
Malnutrition is the main cause of illness and death in children under the age of five. It affects millions of children worldwide, putting their health and future in jeopardy. Therefore, this study aimed to identify and estimate the effects of important determinants of anthropometric indicators by taking into account their association and cluster effects.

Method
The study was carried out in 10 countries in East Africa: Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Zimbabwe, Kenya, Zambia, and Malawi. A weighted total sample of 53,322 children under the age of five was included. Given the impact of other predictors such as maternal, child, and socioeconomic variables, a multilevel multivariate binary logistic regression model was employed to analyze the relationship between stunting, wasting, and underweight.

Result
The study included 53,322 children, and 34.7%, 14.8%, and 5.1% were stunted, underweight, and wasted, respectively. Almost half of the children (49.8%) were female, and 22.0% lived in urban areas. The estimated odds of children from secondary and higher education mothers being stunted and wasted were 0.987; 95% CI: 0.979 – 0.994 and 0.999; 95% CI: 0.995 – 0.999, respectively, times the estimated odds of children from no education mothers. Children from middle-class families were less likely to be underweight than children from poorer families.

Conclusion
The prevalence of stunting was higher than in the sub-Saharan Africa region, but the prevalence of wasting and underweight was lower. According to the study's findings, undernourishment among young children under the age of five continues to be a significant public health issue in the East African region. Governmental and non-governmental organizations should therefore plan public health participation focusing on paternal education and the poorest households in order to improve the undernutrition status of children under five. Additionally, improving the delivery of healthcare at health facilities, places of residence, children's health education, and drinking water sources are essential for lowering child undernutrition indicators.