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Background: Reflux symptom index(RSI) and reflux finding score (RFS) are widely used scoring systems used to diagnose laryngopharyngeal reflux disease(LPRD). However many patients do visit the outpatient department with minimal symptoms not sufficient to fit the criteria described by Belafsky et al. for diagnosing LPRD. Most of these patients are provisionally diagnosed and treated for LPRD. Reflux symptom index(RSI) and reflux finding score (RFS) are widely used scoring systems used to diagnose(LPRD) (Belafsky PC et al., J Voice 16(2):274–7, 2002, Belafsky PC et al, Laryngoscope 111(8):1313–7, 2001). RSI has nine questions that the patient must grade from 0 to 5. An abnormal score is greater than 13. Laryngopharyngeal reflux (LPR) may or may not be diagnosed using the RSI and RFS especially when patients present with minimum symptoms not sufficient to score more than 13 and 7 respectively. These patients may miss the diagnosis and have to be treated empirically. Pepsin's presence in the saliva is indicative of reflux as pepsin is a gastric enzyme (NICE advice on Peptest for diagnosing gastro-oesophageal reflux, 2015, Wood JM et al., J Laryngol Otol 125(12):1218–24, 2011). Patients with minimum symptoms may be missed if diagnosis relies only on RSI AND RFS. The present study aims to see the correlation of pepsin-proven LPRD and RSI and RFS. Methods: This is a prospective study, 49 patients with symptoms suggestive of LPRD who tested positive for the pepsin test were further analysed for RSI and RFS. A cut-off value of > 25 ng/mL was considered diagnostic of LPRD (Dhillon VK et al., Curr Gastroenterol Rep 18(8):44, 2016). Result: The average RSI and RFS were respectively 10 and 4. The mean age of the patients in the study was 39 years and the mean weight was 60 kg. The association between RSI and PEPSIN detection is considered to be not statistically significant. Chi-squared equals 0.086 with 1 degree of freedom. The two-tailed P value equals 0.7698. Chi-squared equals 0.233 with 1 degree of freedom. The two-tailed P value equals 0.6295. The association between RFS and PEPSIN detection is considered to be not statistically significant. In terms of correlation analysis, neither the RSI nor the RFS had Pearson's correlation coefficient that was statistically significant. Conclusion: Since salivary pepsin detection and the RSI do not have any significant correlation, the RSI is not a valid diagnostic method for LPR and should not be used exclusively. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

The supplementary motor area (SMA) is involved in the functional deficits of chronic ankle instability (CAI), but the structural basis of its abnormalities remains unclear. To determine the differences in volume- and surface-based morphologic features of the SMA between patients with CAI and healthy controls and the relationship between these features and the clinical features of CAI. Cross-sectional study. Sports medicine laboratory. A total of 32 patients with CAI (10 women, 22 men; age = 32.46 ± 7.51 years) and 31 healthy controls (12 women, 19 men; age = 29.70 ± 8.07 years) participated. We performed T1-weighted structural magnetic resonance imaging of participants and calculated volume- and surface-based morphologic features of SMA subregions. These subregions included anterior and posterior subdivisions of the medial portion of Brodmann area 6 (6 ma and 6 mp, respectively) and supplementary and cingulate eye fields. Between-group comparisons and correlation analysis with clinical features of CAI were performed. Moderately thinner 6 mp (motor-output site; Cohen d = −0.61; 95% CI = −1.11, −0.10; P =.02) and moderately plainer 6 ma (motor-planning site; Cohen d = −0.70; 95% CI = −1.20, −0.19; P =.01) were observed in the CAI than the control group. A thinner 6 mp was correlated with lower Foot and Ankle Ability Measure Activities of Daily Living subscale scores before (r = 0.400, P =.02) and after (r = 0.449, P =.01) controlling for covariates. Patients with CAI had a thinner 6 mp and a plainer 6 ma in the SMA compared with controls. The thin motor-output site of the SMA was associated with ankle dysfunction in patients. This morphologic evidence of maladaptive neuroplasticity in the SMA might promote more targeted rehabilitation of CAI. [ABSTRACT FROM AUTHOR]

Background: Diabetes complications are prevalent in people with diabetes, causing considerable individual suffering and increased health costs. However, the relationships of multidimensional, modifiable, and nonmodifiable factors to diabetes complications and the role of diabetes distress have been rarely examined. Objective: The aims of this study were to examine the associations of age, sex, knowledge, self-efficacy, self-compassion, resilience, self-esteem, depressive symptoms, diabetes distress, social support, and body mass index with diabetes complications and to investigate the mediating role of diabetes distress. Methods: In this cross-sectional, correlational study, data on all study variables were collected from 148 people with diabetes through REDCap in 2023. Multiple regression analysis and the PROCESS macro for SPSS were used to address the aims. Results: Older age and higher levels of diabetes distress were associated with more diabetes complications. Depressive symptoms were associated with diabetes distress; and diabetes distress, but not depressive symptoms, was associated with diabetes complications, controlling for all other variables. Conclusions: Depressive symptoms and diabetes distress were directly or indirectly associated with diabetes complications, and diabetes distress was a mediator in the relationship between depressive symptoms and diabetes complications. Health care providers can target reduction of depressive symptoms and diabetes distress to reduce diabetes complications. [ABSTRACT FROM AUTHOR]

Background: Frailty is a multidimensional geriatric syndrome associated with physical, psychological and social changes. There is a paucity of research on frailty in Sub‐Saharan African (SSA) countries, especially Ethiopia. Objectives: To assess the initial correlations among frailty, nutritional status, depression and QOL (quality of life) in a group of older people in Ethiopia who are later enrolled in a study examining the effects of a nurse‐led community intervention on frailty and related health outcomes. Methods: Data from 68 community‐dwelling individuals 60 years of age, or over, were collected. Frailty was measured using the Amharic version of the Tilburg Frailty Indicator. The statistical analysis included Spearman's rank correlation coefficient for degrees of association, Mann–Whitney U‐test for variables with two categories and Kruskal–Wallis for variables with three or more categories. Results: The mean frailty score for participants was 7.3 (±1.9). Participants with higher frailty scores had lower nutritional status (rs = −0.46, p < 0.01). There was a statistically significant relationship (positive) between frailty scores and depression (rs = 0.39, p < 0.01). Depressed (Md = 9, n = 23) and non‐depressed frail older people (Md = 7, n = 45) showed a significant difference in their overall frailty score, U = 330.50, z = −2.49, p = 0.01, r = 0.30. There was an inverse significant association between the level of frailty across different domains in the QOL: physical (rs = −0.44, p < 0.01), psychological (rs = −0.45, p < 0.01), social relations (rs = −0.29, p < 0.05) and environmental (rs = −0.47, p < 0.01). Conclusion: The findings from this study were consistent with those from across middle‐income and high‐income countries. Implications for Practice: This research indicates that older people living in communities who are identified as frail often suffer from a poor nutritional status, depression and reduced QOL. It suggests that healthcare professionals in Sub‐Saharan countries would benefit from recognising the frailty in this population, and developing interventions aimed at enhancing nutrition, mental health and overall well‐being. [ABSTRACT FROM AUTHOR]

Dolutegravir, an integrase strand inhibitor, has been linked to an increase in body mass index among adults. However, little is known about its effect on adolescents. The study assessed the effect of a dolutegravir-based regimen on adolescents' body weight and emphasized the gender-specific differences in weight gain, if any. This prospective cohort study was conducted among 182 treatment-experienced adolescents living with HIV at a tertiary hospital in Southeast Nigeria. The body mass index measurements were calculated before transitioning to dolutegravir and after six months of being on the dolutegravir regimen. A comparison of the difference in mean body mass index before and after dolutegravir-based therapy was determined using a paired t-test. At the end of the six-month follow-up, there was a significant increase in the respondents' overall body mass index z-score (t = −10.00, p < 0.001). There was a significant increase in the body mass index z-score of both genders (male; t = −7.49, p < 0.001, female; t = −6.91, p < 0.001). The dolutegravir-based therapy (β-coefficient = −0.17, t = − 2.09, p < 0.001) and baseline body mass index z-score (β-coefficient = 0.76, t = 15.86, p < 0.001) were significant predictors of body mass index z-score at six months. In adolescents living with HIV, the transition to dolutegravir is associated with increased body weight. Female adolescents tend to gain more weight compared to males. Therefore, there is a need for regular monitoring of body weight for early detection of obesity and prompt intervention. [ABSTRACT FROM AUTHOR]

Background: Evidence from animal and human studies suggests glutamatergic dysfunction in posttraumatic stress disorder (PTSD). The purpose of this study was to investigate glutamate abnormalities in the dorsolateral prefrontal cortex (DLFPC) of individuals with PTSD using 7T MRS, which has better spectral resolution and signal-to-noise ratio than lower field strengths, thus allowing for better spectral quality and higher sensitivity. We hypothesized that individuals with PTSD would have lower glutamate levels compared to trauma-exposed individuals without PTSD and individuals without trauma exposure. Additionally, we explored potential alterations in other neurometabolites and the relationship between glutamate and psychiatric symptoms. Methods: Individuals with PTSD (n = 27), trauma-exposed individuals without PTSD (n = 27), and individuals without trauma exposure (n = 26) underwent 7T MRS to measure glutamate and other neurometabolites in the left DLPFC. The severities of PTSD, depression, anxiety, and dissociation symptoms were assessed. Results: We found that glutamate was lower in the PTSD and trauma-exposed groups compared to the group without trauma exposure. Furthermore, N -acetylaspartate (NAA) was lower and lactate was higher in the PTSD group compared to the group without trauma exposure. Glutamate was negatively correlated with depression symptom severity in the PTSD group. Glutamate was not correlated with PTSD symptom severity. Conclusion: In this first 7T MRS study of PTSD, we observed altered concentrations of glutamate, NAA, and lactate. Our findings provide evidence for multiple possible pathological processes in individuals with PTSD. High-field MRS offers insight into the neurometabolic alterations associated with PTSD and is a powerful tool to probe trauma- and stress-related neurotransmission and metabolism in vivo. [ABSTRACT FROM AUTHOR]

Aim: Digital platforms such as YouTube are popular sources of health-related information. Although there are studies evaluating the quality of different online medical content, studies focusing on the quality of dementia-related content are limited. This study aimed to investigate the quality of YouTube videos related to dementia patient care. Material and Methods: Using the term "Dementia care" on the YouTube platform, 100 English videos that met the inclusion criteria were identified and analyzed. In addition to video popularity measurements, to evaluate content quality, the global quality scale (GQS), modified DISCERN scale, Journal of the American Medical Association (JAMA) quality scale, and the patient education materials assessment tool for audio/visual materials (PEMAT-A/V) are used. Results: It was observed that most of the videos were uploaded by non-academic health institutions (36%) and health professionals (23%). When the content of the videos was evaluated, it was determined that general care strategies were the most common content with 52%. Scores indicating high levels of reliability and accuracy were determined on all applied content quality scales. Videos sourced from academic healthcare institutions were found to have the highest scores on content quality scales. In correlation analyses, video metrics such as duration, view ratio, number of comments, and video power index values were positively correlated with content quality scores. Conclusion: Videos about dementia patient care on YouTube generally exhibit high popularity and content quality. Individuals seeking information about dementia care on online platforms should be directed to videos uploaded by healthcare institutions. [ABSTRACT FROM AUTHOR]

Introduction: People with Parkinson's Disease (PD) often show reduced anticipatory postural adjustments (APAs) before voluntary steps, impacting their stability. The specific subphase within the APA stage contributing significantly to fall risk remains unclear. Methods: We analyzed center of pressure (CoP) trajectory parameters, including duration, length, and velocity, throughout gait initiation. This examination encompassed both the postural phase, referred to as anticipatory postural adjustment (APA) (APA1, APA2a, APA2b), and the subsequent locomotor phases (LOC). Participants were instructed to initiate a step and then stop (initiating a single step). Furthermore, we conducted assessments of clinical disease severity using the Unified Parkinson's Disease Rating Scale (UPDRS) and evaluated fall risk using Tinetti gait and balance scores during off-medication periods. Results: Freezing of gait (FOG) was observed in 18 out of 110 participants during the measurement of CoP trajectories. The Ramer-Douglas-Peucker algorithm successfully identified CoP displacement trajectories in 105 participants (95.5%), while the remaining 5 cases could not be identified due to FOG. Tinetti balance and gait score showed significant associations with levodopa equivalent daily dose, UPDRS total score, disease duration, duration (s) in APA2a (s) and LOC (s), length in APA1 (cm) and APA2b (cm), mediolateral velocity in APA1 (X) (cm/s), APA2a (X) (cm/s), APA2b (X) (cm/s) and LOC (X) (cm/s), and anterior-posterior velocity in APA2a (Z) (cm/s) and APA2b (Z) (cm/s). Multiple linear regression revealed that only duration (s) in APA2a and UPDRS total score was independently associated with Tinetti gait and balance score. Further mediation analysis showed that the duration (s) in APA2a served as a mediator between UPDRS total score and Tinetti balance and gait score (Sobel test, p = 0.047). Conclusion: APA2 subphase duration mediates the link between disease severity and fall risk in PD, suggesting that longer APA2a duration may indicate reduced control during gait initiation, thereby increasing fall risk. [ABSTRACT FROM AUTHOR]

Background & Objective: The viruses are considered as one of the most prevalent factors that cause infertility because they represent a significant role in sexual transmission disease. The purpose of this study was to evaluate the correlations between viruses (HSV) viral load and semen parameters in groups of fertile and infertile Iraqi men. Materials & Methods: This study comprised fifty infertile males and fifty fertile healthy males. Seminal fluid analysis was conducted on all participants to detect the presence of HSV using the HSV1, 2 quantification kits. Results: There was a high significant correlation between sperm concentration and percentage of rapid linear progression motility (r= 0.478**) of infertile men. A strong meaningful connection was seen between the percentage of sperm concentration and both the percentage of sluggish linear or nonlinear motility (r = 0.681**) and the percentage of non-progressive motility (r = 0.604**). There was a strong negative connection (r = -0.725**) between the concentration of sperm and the number of immotile spermatozoa. On the others hand, there was a high significant correlation between rapid linear progression and slow linear or nonlinear (r =0 .413**) non-progressive motility (r = 0.704**) respectively, and high negative significant between rapid linear progression and immotile spermatozoa. The correlation between slow linear or nonlinear and non-progressive motility was highly significant (r= 0.555**) and negative significant between slow linear or nonlinear and immotile spermatozoa. Finally, A strong negative correlation (-0.813**) was observed between non-progressive motility and immotile spermatozoa. Conclusion: The study found that HSV infection had an effect on semen parameters and will cause male infertility. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals appear to play a key role in shaping pregnant women's views and attitudes towards lifestyle issues, such as exercise. The aim of this study is to investigate the views and beliefs of Greek midwives and obstetricians regarding exercise during pregnancy. Methods: This is a cross-sectional study conducted during the period of January 2022–March 2023. For this study, 237 Greek midwives and obstetricians employed in healthcare settings in Attica, Greece completed an anonymous and self-report questionnaire. Four different/independent models of multivariate analyses of variance were conducted. Results: The vast majority of these healthcare professionals (88.6%) believed that exercise during pregnancy is generally beneficial. According to the multivariate analyses, healthcare professionals with postgraduate/doctoral studies were more likely to believe that (a) exercise is generally beneficial (p = 0.03), (b) pregnant women should be informed about it (p = 0.028), (c) informing pregnant women is necessary/useful (p = 0.023), and (d) pregnant women showed interest in it (p = 0.034). Also, freelance midwives were more likely to believe that pregnant women should be informed about exercise (p = 0.006), and that they showed interest in it (p = 0.034). In addition, (a) freelance midwives (p = 0.050), and those who had experience in antenatal counselling (p = 0.037), as well as (b) obstetricians who were largely experienced in monitoring normal pregnancies (p = 0.001), were less likely to associate exercise during pregnancy with the occurrence of placental abruption. Conclusion: Alongside healthcare professionals' educational level, their professional setting and professional experience emerge as key factors and need to be considered when designing innovative interventions to support exercise during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Parents of children suffering from congenital heart disease experience high levels of stress and negative emotions. Therefore, recognition of parents' emotional states and their ways of coping with it is becoming more and more important. Methods: The study group consisted of 154 parents of newborns and infants with cyanotic congenital heart disease, before and after cardiac surgery (partial or full). To assess parental negative emotions, the level of stress, and strategies of coping with it, standardized questionnaires, such as HADS-M, PSS-10, and COPE, were used. Results: Stress levels in parents were high and associated with negative emotions (anxiety, depression, irritability), as well as the choice of non-constructive coping strategies, which was observed especially in younger parents. Conclusions: Assessing parents' stress levels and ways of coping with stress can improve family functioning and provide better development conditions for the child. [ABSTRACT FROM AUTHOR]

Reports have highlighted the role of supportive work environments in several nurse outcome measures, indicating a need for effective leadership styles that improve the nurse working environment. Authentic leadership is a relatively new concept in Arab work culture. The purpose of this study was to examine the relationship between authentic leadership demonstrated by nurse managers and work engagement among Jordanian registered nurses. A cross-sectional correlational design was employed. A sample of 238 registered nurses working in a public hospital in Jordan was collected. Data collection was performed by using the staff demographics questionnaire, the authentic leadership questionnaire (ALQ), and the Utrecht Work Engagement Scale (UWES)-17 items. Descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation, and hierarchical multiple regression analysis were employed to analyze the data. The results showed a statistically significant positive correlation between authentic leadership and work engagement in the hierarchical regression analysis (B = 0.34, t = 5.54, p < 0.001). After controlling demographic variables, authentic leadership accounted for 11% of the additional variance above and beyond the 5% accounted for age, educational level, and work experience (change of R 2 = 0.11, p < 0.01). Nurses whose managers demonstrate higher levels of authentic leadership report more work engagement (r = 0.37, p < 0.001). Considering the role of authentic leadership in promoting nurses' work engagement, it would be beneficial to develop authentic leadership behaviors for nurse managers. [ABSTRACT FROM AUTHOR]

The research aimed to find the relationship between Internet Vigilance, emotional creativity, and self-sufficiency. The current research sample consisted of (898) male and female students at Damietta University in the faculties of (Specific Education - Education - Physical Education - Applied Arts - Commerce - Science - Engineering - Literature – Computers and information) in the first and fourth academic year, with an average age of 20.09 and a standard deviation of 2.56 in the first university semester of the academic year 2022/2023. With the aim of revealing their levels in the Internet Vigilance variable, the level of the emotional creativity and self-efficacy variables, and the extent of the differences between them due to gender, academic stage, and specialization, and the nature of the relationship between each of the electronic alertness variable, the emotional creativity variable, and self-efficacy among male and female university students. Damietta, in the colleges of (Specific Education - Education - Physical Education - Applied Arts - Commerce - Science - Engineering - Literature - Computers and Information), Regarding the extent to which it is possible to predict each of the variables of emotional creativity and self-efficacy through the dimensions of the Internet Vigilance variable, the researcher here relied on two tools to measure the variable dimensions of Internet Vigilance, the (Reince et al., 2018) scale to measure the trait, and the (Johannes et al., 2020) scale to measure the situation, as the researcher Arabized it, codified it, and verified the extent of its psychometric properties, and two tools to measure the variables of emotional creativity and self-efficacy among male and female students at Damietta University in the faculties of (Specific Education - Education - Physical Education - Applied Arts - Commerce - Sciences - Engineering - Literature - Computers and Information) prepared by the researcher. To identify the results of the research, the following statistical treatments were used: T-test for independent samples, Cronbach's Alpha test, One-Way ANOVA, frequencies, arithmetic means, standard deviations, and correlation analysis. Pearson correlation coefficients, multiple regression analysis, and the bootstrap method to test confidence interval (CI) estimates, using version 23.0 of the statistical program SPSS. The research showed several results, the most important of which are: the existence of a significant correlation between Internet Vigilance and emotional creativity, and that the Internet Vigilance variable predicted emotional creativity, while The results related to self-efficacy showed its mediation in the relationship between each of the variables (Internet Vigilance and emotional creativity).The results also showed that the effect of self-efficacy on Internet Vigilance among university students varies according to the students’ academic stage. The results also showed that there are statistically significant differences in the relationship between self-efficacy and emotional creativity among university students depending on the variable of type (sex), as well as specialization (scientific/ literary). [ABSTRACT FROM AUTHOR]

In Pakistan, like other developing countries, utilization of family planning methods is a serious public health concern among married women. Researchers in the study focused on utilization of family planning methods among married women and their exposure to media messages. The researchers used retrospective analysis of secondary data of 3334 married women. Our research findings reveal that married women have a very limited access to media service messages promoting utilization of family planning methods. It is discussed that women with exposure to media messages about the utilization of family planning significantly utilized birth control behavior than women who had not heard and seen any media message. The authors concluded that married women in the country particularly in rural areas have a very limited access to media messages promoting family planning which causes non-utilization of family planning methods. It is recommended that different programs and awareness messages on media should be started to promote family planning and married women's access to media programs should be ensured. [ABSTRACT FROM AUTHOR]