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Objective: To investigate in vivo 6-degree-of-freedom (DOF) vertebral motion in patients with isthmic spondylolisthesis (IS) during various functional weight-bearing activities. Methods: Fifteen asymptomatic volunteers (mean age 54.8 years) and fourteen patients with IS at L4-5 (mean age 53.4 years) were recruited. The positions of the vertebrae (L4-L5) in the supine, standing, flexion–extension, left–right twisting and left–right bending positions were determined using previously described CT-based models and dual fluoroscopic imaging techniques. Local coordinate systems were established at the center of the anterior vertebra of L4 isthmic spondylolisthesis (AIS), the posterior lamina of L4 isthmic spondylolisthesis (PIS) and the center of the L5 vertebra to obtain the 6DOF range of motion (ROM) at L4-L5 and the range of motion (ROM) between the AIS and the PIS. Results: The translation along the anteroposterior axis at L4-L5 during flexion–extension, left–right bending and left–right twisting was significantly greater than that of the healthy participants. However, the translation along the mediolateral axis at L4-L5 presented paradoxical motion under different positions: the ROM increased in the supine-standing and flexion–extension positions but decreased in the left–right bending and left–right twisting positions. The separation along the anteroposterior axis during flexion was significantly greater than that during standing, on average, reaching more than 1 mm. The separation along the mediolateral axis during standing, flexion and extension was significantly greater than that in the supine position. Conclusions: This study revealed the occurrence of displacement between the AIS and PIS, primarily in the form of separation during flexion. Symptomatic patients with isthmic spondylolisthesis exhibit intervertebral instability, which might be underestimated by flexion–extension radiographs. [ABSTRACT FROM AUTHOR]

Background and aims: Long pre-hospital delay substantially increases the likelihood of perforated appendicitis. This study aimed to find patient-related factors affecting this delay. Methods: A survey was conducted for patients with acute appendicitis after appendectomy. The participants were asked about their path to the surgical center and socioeconomic status. Variables affecting delays and the rate of complicated appendicitis were analyzed. Results: The study included 510 patients; 157 (31%) had complicated appendicitis with a median prehospital delay of 42 h. In patients with uncomplicated appendicitis, the delay was 21 h, p <.001. Forty-six (29%) patients with complicated appendicitis were not referred to the hospital after the first doctor's visit. The multivariate analysis discovered factors associated with long pre-hospital delay: age 40–64 years (OR 1.63 (95% CI 1.06–2.52); compared to age 18–39), age more than 64 years (OR 2.84 (95% CI 1.18–6.80); compared to age 18–39), loss of appetite (OR 2.86 (95% CI 1.64–4.98)), fever (OR 1.66 (95% CI 1.08–2.57)), non-referral by helpline nurse (OR 2.02 (95% CI 1.15–3.53)) and non-referral at first doctors visit (OR 2.16 (95% CI 1.32–3.53)). Age 40–64 years (OR 2.41 (95% CI 1.50–3.88)), age more than 64 years (OR 8.79 (95% CI 2.19–35.36)), fever (OR 1.83 (95% CI 1.15–2.89)) and non-referral at first doctors visit (OR 1.90 (95% CI 1.14–3.14)) were also risk factors for complicated appendicitis. Conclusions: Advanced age, fever and failure to suspect acute appendicitis in primary care are associated with prolonged pre-hospital delay and complicated appendicitis. [ABSTRACT FROM AUTHOR]

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Background: Understanding the relationship of social network use and addictive behaviors with adolescent psychosocial health is crucial in today's digital age. Aim: To verify the associations between social network use, messaging applications, and the addictive behaviors to social network with psychosocial health in Spanish adolescents. Methods: A cross-sectional study was developed with 632 adolescents, aged 12 to 17 years from the Region of Murcia, Spain. The assessment of social network use (Facebook, Twitter, Instagram, Snapchat, and TikTok) involved evaluating the frequency of use of each social network individually using a single-item scale with five response options. WhatsApp use (i.e., a messaging application) was evaluated in the same manner. The Short Social Networks Addiction Scale-6 Symptoms was employed to assess potential addictive behaviors to social network use. The psychosocial health was assessed using the Strengths and Difficulties Questionnaire. Generalized linear regression models were conducted, and predictive probabilities of having psychosocial health problems were calculated. Results: The predicted probability of presenting psychosocial health problems in the medium users and high users of social networks was 19.3% (95% confidence interval [CI] 13.0 to 27.7), and 16.2% (95% CI 10.2 to 24.6) higher compared to low users, respectively. High usage of Instagram, TikTok, Snapchat, and Facebook was associated with increased probabilities of psychosocial health problems, with Facebook showing the highest probabilities, at 31.3% (95% CI 14.8 to 54.2) for medium users and 51.9% (95% CI 26.5 to 76.3) for high users. Additionally, adolescents with addictive behaviors to social network use had from 19.0 to 25.2% probabilities of experiencing psychosocial health problems. Finally, the highest probabilities of having psychosocial health problems were identified in adolescents with high addictive behaviors when using social networks (28.9%; 95% CI 19.3 to 40.8%) and the lowest in those with low addictive behaviors (6.8%; 95% CI 3.3 to 13.6%). Conclusion: Adolescents who use social networks more frequently and exhibit more addictive behaviors related to their use are more likely to experience psychosocial health problems compared to those who do not. Facebook showed the strongest association, followed by Snapchat, Instagram, and TikTok. Our data also revealed that adolescents exhibit various signs of addictive behaviors to social network use. [ABSTRACT FROM AUTHOR]

Simple Summary: Inflammation-based prognostic markers have been recognized as useful in a range of oncologic conditions. Given the high mortality rate associated with pancreatic ductal adenocarcinoma (PDAC), the demand for accurate prognostic tools is significant. Nonetheless, the literature still shows conflicting results regarding the effectiveness of the various available scoring systems. Our data confirm that NLR and PNI are useful biomarkers regarding overall survival in PDAC. Especially in advanced disease stages, they seem to be of considerable benefit as easily accessible tools for prognosis prediction. Purpose: Prognostic inflammation-based parameters have been reported as useful tools in various oncologic diseases. Pancreatic ductal adenocarcinoma (PDAC) is characterized by a high mortality rate, making reliable prognostic markers highly desirable. However, there is still inconsistency in the literature regarding the efficacy of the different available scores. Methods: A total of 207 patients, who underwent primary resection of PDAC from January 2000 to December 2018 at the University Hospital of Erlangen, were included in this retrospective single-center study. Different biomarkers, including the preoperative neutrophil–lymphocyte ratio (NLR), the platelet–lymphocyte ratio (PLR), the c-reactive protein (CRP)–albumin ratio (CAR), the lymphocyte–CRP ratio (LCR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGPS) were analyzed for their ability to predict overall survival (OS). Results: In our cohort, the median overall survival was 20.7 months. Among the investigated biomarkers, NLR and PNI were identified as independent prognostic markers (Hazard Ratio (HR) 1.6 (1.0–2.5), p = 0.048 and HR 0.6 (0.4–0.9), p = 0.018), whereas PLR, CAR, LCR and mGPS did not reach significance in the multivariate analysis. Subgroup analysis revealed that the prognostic value of NLR and PNI is particularly evident in locally advanced tumor stages (pT3/4 and pN+). Conclusions: The NLR and PNI could serve as valuable tools for estimating prognosis in patients with PDAC undergoing pancreatic resection in curative intention, especially in locally advanced tumor stages. However, conflicting results in the current literature highlight the need for further prospective studies to validate these findings. [ABSTRACT FROM AUTHOR]

Simple Summary: Relapse and treatment-related side effects pose significant challenges for older patients with high-risk blood cancers (myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML)) undergoing hematopoietic stem cell transplants from HLA-haploidentical donors. We compared two preparative treatment regimens to identify the most tolerable and effective approach: one using fludarabine, cyclophosphamide, and melphalan, and the other using fludarabine, cyclophosphamide, and treosulfan. Our goal was to determine which treatment offers better survival rates and fewer side effects. We found that both regimens resulted in similar survival outcomes. However, the melphalan regimen was associated with fewer relapses but more treatment-related deaths, while the treosulfan regimen had fewer side effects but exhibited poorer disease control. These findings suggest that treosulfan may be safer, though higher doses might improve disease control, providing valuable insights for future treatments. Relapse and regimen-related toxicities remain major challenges in achieving long-term survival, particularly among older patients with high-risk myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Previous studies have demonstrated the feasibility of treosulfan-based conditioning, noting stable engraftment and low non-relapse mortality (NRM) in patients undergoing HLA-matched allo-HSCT. However, data on treosulfan-based conditioning in the HLA-haploidentical transplantation (HaploT) setting are limited. We retrospectively compared conditioning with fludarabine–cyclophosphamide (FC)–melphalan (110 mg/m2) and FC-treosulfan (30 g/m2) prior to HaploT using post-transplantation cyclophosphamide (PTCy) in patients with high-risk MDS/AML patients ≥ 50 years, transplanted from 2009–2021 at our institution (n = 80). After balancing patient characteristics by a matched-pair analysis, we identified twenty-one matched pairs. Two-year OS and LFS were similar among the groups (OS 66% and LFS 66%, p = 0.8 and p = 0.57). However, FC-melphalan was associated with a significantly lower probability of relapse compared to FC-treosulfan (0% vs. 24%, p = 0.006), counterbalanced by a higher NRM (33% vs. 10%, p = 0.05). Time to engraftment and incidences of acute and chronic graft-versus-host disease (GvHD) did not differ significantly. In conclusion, HaploT using FC-treosulfan in combination with PTCy in patients aged ≥50 years with MDS/AML appears safe and effective, particularly in advanced disease stages. We confirm the favorable extramedullary toxicity profile, allowing for potential dose intensification to enhance antileukemic activity. [ABSTRACT FROM AUTHOR]

Simple Summary: Tyrosine kinase inhibitors (TKIs), particularly imatinib, have afforded Chronic Myeloid Leukemia (CML) patients long-term remission. This revolution in leukemia treatment is unfortunately accompanied by the fact that treatment interruption, in most cases, leads to the re-emergence of BCR-ABL-leukemia cells, caused by leukemia stem cells, that are insensitive to TKI treatment. Moreover, TKIs paradoxically induce a quiescent state in leukemia stem and progenitor cells. Current CML studies focus on these quiescent leukemia stem cells in order to reactivate them and restore TKI sensitivity. We show here that under TKI treatment, leukemia stem cells retrieve motility in a reconstituted niche when incubated with SKF96365, a calcium channel inhibitor, and that this effect is dependent on RhoA activation by BCR-ABL independently of its tyrosine kinase activity. Altogether, these results suggest that SKF-96365 or its derived molecules could be interesting compounds for targeting quiescent CML stem and progenitor cells under TKI treatment. Background: A major issue in Chronic Myeloid Leukemia (CML) is the persistence of quiescent leukemia stem cells (LSCs) in the hematopoietic niche under tyrosine kinase inhibitor (TKI) treatment. Results: Here, using CFSE sorting, we show that low-proliferating CD34+ cells from CML patients in 3D co-culture hide under HS27A stromal cells during TKI treatment—a behavior less observed in untreated cells. Under the same conditions, Ba/F3p210 cells lose their spontaneous motility. In CML CD34+ and Ba/F3p210 cells, while Rac1 is completely inhibited by TKI, RhoA remains activated but is unable to signal to ROCK. Co-incubation of Ba/F3p210 cells with TKI, SKF-96365 (a calcium channel inhibitor), and EGF restores myosin II activation and amoeboid motility to levels comparable to untreated cells, sustaining the activation of ROCK. In CFSE+ CD34+ cells containing quiescent leukemic stem cells, co-incubation of TKI with SKF-96365 induced the expulsion of these cells from the HS27A niche. Conclusions: This study underscores the role of RhoA in LSC behavior under TKI treatment and suggests that SKF-96365 could remobilize quiescent CML LSCs through reactivation of the RhoA/ROCK pathway. [ABSTRACT FROM AUTHOR]

Background: Thyroid storm (TS), a life-threatening condition that can damage multiple organs, has limited therapeutic options. Hypercytokinemia is a suggested background, but the pathological condition is unclear and there are no appropriate animal models. We aimed to develop a TS mouse model by administration of triiodothyronine and lipopolysaccharide, and then to examine the effects of ghrelin on this model. Methods: We evaluated the use of serum IL-6 levels as a representative marker of hypercytokinemia in patients with TS. To establish the mouse model, preliminary experiments were conducted to determine the non-lethal doses of triiodothyronine and lipopolysaccharide when administered individually. As a TS model, C57BL/6 mice were administered with triiodothyronine 1.0 mg/kg (subcutaneously, once daily for seven consecutive days) and lipopolysaccharide 0.5 mg/kg (intraperitoneally, on day 7) to develop a lethal model with approximately 30% survival on day 8. We assessed the survival ratio, mouse sepsis scores and blood biomarkers (IL-6, metanephrine, alanine aminotransferase) and evaluated the effects of ghrelin 300 µg/kg on these parameters in TS model. Results: Serum IL-6 was increased in patients with TS compared with those with Graves' disease as the diseased control (18.2 vs. 2.85 pg/mL, P <.05, n = 4 each). The dosage for the murine TS model was triiodothyronine 1.0 mg/kg and lipopolysaccharide 0.5 mg/kg. The TS model group had increased mouse sepsis score, serum IL-6, metanephrine and alanine aminotransferase. In this model, the ghrelin improved the survival rate to 66.7% (P <.01, vs. 0% [saline-treated group]) as well as the mouse sepsis score, and it decreased the serum IL-6 and metanephrine. Conclusion: We established an animal model of TS that exhibits pathophysiological states similar to human TS with induction of serum IL-6 and other biomarkers by administration of T3 and LPS. The results suggest the potential effectiveness of ghrelin for TS in humans. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the perspectives, preferences, and clinical experiences regarding using electronic apex locator and apex locator integrated instrumentation of dentists and endodontists. Methods: A web-based questionnaire consisting of 3 parts and 23 closed-ended questions to achieve the objective of the study was carried out in ethical conditions between August and October 2023. The first part of survey included demographic information, while the second part was about evaluating electronic apex locator usage. In the last part, only participants' use of apex locator-integrated instrumentation was evaluated. Data were analyzed at a significance level of p < 0.05. Results: A total of 297 clinicians, including 59 endodontists and 34 endodontic residents/Ph.D. students participated in the questionnaire. Endodontists and endodontic residents/Ph.D. students perform statistically significantly more root canal treatments per week on average (p = 0.001). For the working length determination method (multiple option question), 78.5% of participants use an electronic apex locator and 39.7% apex locator-integrated engines. However, the preference rate for electronic apex determination technique was generally 95.6%, with the full rate confirmation of endodontists and endodontic residents/Ph.D. students (100%). A total of 21 endodontists out of 59 prefer apex locator integrated engine-driven instrumentation. Although many of these specialized clinicians use this technique, they stated that they measure electronic working length passively for confirmation of the working length before (90.5%) and after the preparation (66.7%). Conclusions: Dentists, as well as endodontists, are skeptical about apex locator-integrated engine-driven instrumentation. Using this technique as a supporter rather than a primary way for preparation within safe limits may give safer results in terms of treatment outcomes. [ABSTRACT FROM AUTHOR]

This study explored the relationship between depressive symptoms and suicidality among community-dwelling adolescents aged 10–18 years, examining whether self-esteem, somatic symptoms, and self-harm mediate this relationship. Utilizing a pre-existing dataset from a nationwide adolescent mental health survey conducted in Korea in 2021, data were collected using several standardized self-administered instruments: the Korean version of Rosenberg's self-esteem scale, Korean Children's Somatization Inventory, Korean version of the Self-Harm Inventory, Mental Health Screening for Depressive Disorders, and Mental Health Screening for Suicide Risk. A path model was constructed and validated, followed by path analysis to assess the effects. Data from 6689 adolescents, including 5937 students and 752 out-of-school adolescents, revealed that 18.7% were in the suicidality group, 11.8% experienced depressive symptoms, 57.9% exhibited somatic symptoms, and 27.4% engaged in self-harm. Depressive symptoms had a positive direct effect on suicidality (β = 0.166, p < 0.001, 95% confidence interval = 0.159–0.172). Bootstrapping tests showed a statistically significant indirect effect of self-esteem, somatic symptoms, and self-harm on the relationship between depressive symptoms and suicidality (β = 0.021, 95% confidence interval = 0.013–0.029). Our findings suggest that self-esteem, somatic symptoms, and self-harm mediate the relationship between depressive symptoms and suicidality, and comprehensive mental health management strategies addressing these factors are recommended. [ABSTRACT FROM AUTHOR]

Background: Methamphetamine use disorder (MUD) is a global health problem. Studies have shown Tai Chi is a potential treatment for MUD. We aimed to explore the effectiveness of Tai Chi in improving drug cravings, attention bias, and physical fitness in men with MUD compared with aerobic exercise. Methods: A total of forty-eight participants (mean age 39.1 ± 8.7 years) were randomly assigned to either the Tai Chi group (TC) or the running group (RG). The TC performed 60 min of moderate-intensity (65–75% HRmax) Tai Chi exercise three times a week. The RG performed 60 min of moderate-intensity (65–75% HRmax) running on a treadmill three times a week. Before and after the intervention, drug cravings, attention bias, and physical fitness were evaluated. Results: After 12 weeks, we found the TC significantly improved in attention bias (F (1, 43) = 6.023, p = 0.019, d = −0.42) and reaction time (F (1, 43) = 6.181, p = 0.017, d = −0.72). No significant improvement was found in other variables in the TC, compared to the RG (p > 0.05). Conclusions: The 12-week Tai Chi intervention improved attention bias and reaction time, compared to RG. Tai Chi exercise might be a potential auxiliary method for the rehabilitation for men with MUD. [ABSTRACT FROM AUTHOR]

(1) Background: Physical activity is known to promote health and psychological well-being in older adults, yet global inactivity rates in this population remain high. Among the factors associated with physical activity, self-efficacy for exercise represents a key predictor for developing effective interventions in older adults. This study aimed to validate the Self-Efficacy for Exercise Scale (SEE) in individuals over 65. (2) Methods: A sample of 726 older adults from the USA and Italy (51.1% females; age range = 65–95 years; Mage = 72.57, SDage = 6.49) completed the SEE, along with the Godin–Shepard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), the Big Five Inventory 2—Extra Short Form (BFI-2-XS), and the 12-item Short Form Health Survey (SF-12). (3) Results: The SEE showed a Cronbach's Alpha of 0.88 and a Composite Reliability of 0.89. Moreover, it demonstrated a unidimensional factor structure and good fit indices. Full measurement invariance was achieved across gender and age, while partial scalar invariance was found across countries, suggesting minor cultural differences. Correlation with the GSLTPAQ, the BFI-2-XS, and the SF-12 support the convergent and nomological validity of the SEE. (4) Conclusions: These findings provide evidence that the SEE is a reliable and valid measure of self-efficacy for exercise among older adults and that the items are interpreted similarly across different ages, genders, and cultures. [ABSTRACT FROM AUTHOR]

This study aimed to develop and establish psychometric properties of the End-of-Life Nursing Competency Scale for Clinical Nurses. The initial items were derived from an in-depth literature review and field interviews. The content validation of these items was assessed over three rounds by experts in end-of-life nursing care. The study included 437 clinical nurses from four hospitals in S, E, and D cities in South Korea. The final exploratory factor analysis resulted in a scale consisting of 21 items with the following five factors that explained 68.44% of the total variance: Physical care—imminent end-of-life, legal and administrative processes, psychological care—patient and family, psychological care—nurses' self, and ethical nursing. The final model with these five subscales was validated through confirmatory factor analysis. Both item convergent-discriminant validity and known-group validity, which compared two groups based on clinical experience (p < 0.008) and working department (p < 0.008), were satisfactory. The internal consistency, as measured by Cronbach's α, ranged from 0.62 to 0.89 for the subscales and was 0.91 for the total scale. This scale has been validated as a reliable and effective instrument for clinical nurses to self-assess their end-of-life nursing competencies in a clinical setting. [ABSTRACT FROM AUTHOR]

Background: Long-lasting symptoms with a possible relation to psychosomatic comorbidity have been described following COVID-19. However, data is sparse in general practice. The trial's objective was to investigate the time-dependent frequency of disease symptoms and relation to psychosomatic comorbidity and daily life impairment (DLI). Methods: Comparative cohort study of patients reporting a previous SARS-CoV-2 infection and uninfected controls in general practice. Participants were recruited in 14 general practices in the greater Munich area. Data collection was questionnaire based with a 12 months follow-up. Descriptive statistics, multivariable regression and bivariate correlations were used for analysis. Results: A total of n = 204 cases infected up to 42 months ago (n = 141 Omicron, n = 63 earlier variants), and n = 119 controls were included. Disease symptoms were substantially more prevalent in cases (55–79% vs. 43% within one year of infection). This difference also appeared in the multivariable analysis adjusting for socio-demographics and psychosomatic comorbidity with odds ratios (OR) of 4.15 (p < 0.001) and 3.51 (p = 0.054) for the cohorts with Omicron or earlier variants infection (vs. controls), respectively. It was persistent with earlier variants (OR 1.00 per month, p = 0.903), while a decreasing trend was observed for Omicron (OR 0.89 per month, p < 0.001). DLI was especially correlated with fatigue (r = 0.628). Conclusion: DLI, psychosomatic comorbidity and independently increased disease symptoms require holistic treatment of the patient in general practice according to the bio-psycho-social model. A key role in restoring the daily life capability may be attributed to the symptom fatigue. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7–10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy. We conducted a randomized controlled trial at a tertiary care academic medical center in the southeastern US with 100 postpartum individuals (50 per arm) from 2018 to 2019. Among 100 trial participants, blood pressure follow-up within 7–10 days postpartum was higher albeit not statistically significant between postpartum individuals randomized to the remote assessment intervention versus office-based standard care (absolute risk difference 18.0%, 95% CI −0.1 to 36.1%, p = 0.06). Patient-reported facilitators for remote blood pressure monitoring were maternal convenience, clarity of instructions, and reassurance from the health assessments. These positive aspects occurred alongside barriers, which included constraints due to newborn needs and the realities of daily postpartum life. [ABSTRACT FROM AUTHOR]

The hypothalamic‐pituitary‐somatotropic (HPS) axis controls many physiological and pathophysiological processes. The phenomenon of insensitivity to growth hormone resistance (GHres) was previously reported to be due to the development of inflammation. Therefore, the primary aim of the study was to determine the impact of inflammation caused by lipopolysaccharides (LPS) on the secretory activity of the HPS axis in sheep. The further goal was to determine the effect of inflammatory factors on individual components involved in intracellular signal transduction to GH via the GH receptor (GHR). The research was carried out on 24 seasonal sheep kept under a short‐day photoperiod, randomly divided into two groups. Before the experiment, the sheep estrous cycles were synchronized. The results of the current study in a sheep model showed that inflammation impairs the activity of the somatotropic axis. On the one hand, LPS injection stimulated (p < 0.01) GH secretion, and on the other hand, it reduced the liver's sensitivity to this hormone by directly reducing (p < 0.01) GHR expression and activating the GHR inhibitory signal transduction mechanism. A symptom of such an inhibitory postreceptor signaling pathway may be due to an increase in SOCS3 expression (p < 0.01). The effect of various inhibition pathways is a significant reduction in the expression of the main transcription activator IGF1‐STAT5B (p < 0.05). The action of GHres in the liver resulted in the inhibition of IGF1 secretion, which in the long term may have negative consequences for growth and development. Our study suggests that disruption of the GH cell signaling pathway may be one of the important elements of the pathophysiology of inflammation. It can suppress growth and hepatic metabolism to spare energy expenditure. [ABSTRACT FROM AUTHOR]

Background: No research report has been conducted to investigate the impact of oxidation balance score (OBS) on the estimated pulse wave velocity(ePWV).We aimed to examine the association between OBS and ePWV. Method: We evaluated data for 13,073 patients from the National Health and Nutrition Examination Survey (NHANES). The exposure variable was OBS. The outcome variables was combination of ePWV and arterial stiffness. Results: We observed a significant negative correlation between OBS (Per 1SD increase) and ePWV in the gradually adjusted models. Based on the aforementioned results, a two-piecewise logistic regression adjusted model was subsequently employed to establish the association between OBS and elevated ePWV, and the inflection point was determined as 5. The increased risk of elevated ePWV (OR:0.70; 95%CI:0.51–0.94) gradually decreases with the increase of OBS on the left side of the inflection point; however, when OBS exceeds 5, this decrease in risk of elevated ePWV(OR:1.00; 95%CI:0.96–1.04) is no longer observed (P for log likelihood ratio test = 0.028). Conclusions: There exists a significant association between OBS and ePWV in the context of American adults. Specifically, OBS exhibits a negative correlation with ePWV; however, when considering an elevated ePWV, a saturation effect is observed in relation to OBS. [ABSTRACT FROM AUTHOR]

This study aims to identify the determinants associated with physical activity (PA) behavior in newly diagnosed obstructive sleep apnea (OSA) patients by applying the Health Action Process Approach (HAPA) with a longitudinal design. Anthropometric and clinical (OSA severity, subjective somnolence, use of continuous positive airway pressure (CPAP)) variables, the determinants of physical activity specified in the HAPA (motivational self-efficacy, outcome expectancies, risk perception, intention, maintenance self-efficacy, action planning, coping planning, social support), as well as physical activity behavior were assessed using a longitudinal (T1 and T2) design in a sample of 57 OSA patients in routine care. Applying regression analyses, regarding the motivation phase, the amount of explained variance in intention was 77% and 39% of the variance in physical activity. In the motivational phase, motivational self-efficacy, risk perception and outcome expectancies were associated with intention. In the volitional phase, physical activity at T1 and social support (family) were related with physical activity at T2. In conclusion, the assumptions of HAPA were partially found in the context of newly diagnosed OSA patients. This study provided additional evidence regarding the role of motivational self-efficacy, outcome expectancies and risk perception during motivational phase, and highlighted the important role of social support from the family in the PA in this population. [ABSTRACT FROM AUTHOR]

Individuals with inherited cancer syndromes, such as Li-Fraumeni syndrome (LFS), may be motivated to adopt health-protective behaviors, such as eating more fruits and vegetables and increasing physical activity. Examining these health behaviors among young people with high lifetime genetic cancer risk may provide important insights to guide future behavioral interventions that aim to improve health-related quality of life (HRQOL). We used a self-regulatory framework to investigate relationships among diet and physical activity behaviors and psychosocial constructs (e.g., illness perceptions, coping, HRQOL) in adolescents and young adults (AYAs; aged 15–39 years) with LFS. This longitudinal mixed-methods study included 57 AYAs aged 16–39 years at enrollment), 32 (56%) of whom had a history of one or more cancers. Participants completed one or two telephone interviews and/or an online survey. We thematically analyzed interview data and conducted regression analyses to evaluate relationships among variables. AYAs described adopting healthy diet and physical activity behaviors to assert some control over health and to protect HRQOL. More frequent use of active coping strategies was associated with greater reported daily fruit and vegetable intake. Greater reported physical activity was associated with better quality of psychological health. Healthy diet and physical activity behaviors may function as LFS coping strategies that confer mental health benefits. Clinicians might emphasize these potential benefits and support AYAs in adopting health behaviors that protect multiple domains of health. Future research could use these findings to develop behavioral interventions tailored to AYAs with high genetic cancer risk. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy (DR) is one of the most common complications of diabetes worldwide. The aim of this study was to assess the prevalence of DR in hospitalized patients with type 2 diabetes (T2DM) in Tibet and to identify risk factors that may influence the occurrence of DR. Methods: This was a cross-sectional study conducted in a third-class hospital in the Tibet Autonomous Region. The prevalence of DR in hospitalized patients with T2DM was measured. Univariate and multivariate logistic regression, restricted cubic spline (RCS) analysis and receiver-operating characteristic curve analysis were used to investigate the risk factors for DR. Results: The prevalence of DR was 29.3%. The duration of diabetes; concentrations of 25-OH-VitD3, hemoglobin, fasting insulin, alanine aminotransferase, total bilirubin, and creatinine; and HOMA-IR were significantly different between DR patients and non-DR patients (all P < 0.05). Univariate and multivariate logistic regression revealed that a longer duration of diabetes and lower 25-OH-VitD3 levels were associated with increased DR risk. RCS analysis suggested overall positive associations of the duration of diabetes and 25-OH-VitD3 concentrations with DR risk (P nonlinearity < 0.05). The turning points for the duration of diabetes and 25-OH-VitD3 concentrations were 5.1 years and 10.6 ng/mL, respectively. The sensitivity, specificity, and area under the receiver-operating characteristic curve for the combination of the duration of diabetes and 25-OH-VitD3 levels were 79.4%, 69.4% and 0.764, respectively. Conclusions: Given the high prevalence of DR in hospitalized patients with T2DM in Tibet, vitamin D supplementation seems to be important in the prevention of DR to some degree. [ABSTRACT FROM AUTHOR]

Introduction: Anti-inflammatory and anti-fibrotic properties maximize the therapeutic potential of bone marrow aspiration concentrate (BMAC) in osteoarthritis (OA) knee. There is a lack of studies to standardize the treatment procedure to make the studies done across various centers comparable to understand the lacunae better and develop further the deficiency in our understanding of BMAC for OA knee. We aimed to assess the degree of pain relief, functional outcome, and cartilage thickness with different doses of BMAC in primary OA knee. Materials and Methods: A single-centered prospective observational study was conducted with 80 patients of OA knee who were divided into 4 groups where group A (n = 20), group B (n = 20), group C (n = 20), and group D (n = 20) received intra-articular 1, 2, 5 million BMAC cells per kg body weight, and intra-articular saline, respectively. All patients were followed up with Visual Analog Scale (VAS), knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC) scores both pre and post-procedurally at 1, 3, 6, and 12 months follow-up. Results: The study found no significant differences in demographics or co-morbidities across four participant groups (A, B, C, D). However, clinical outcomes varied markedly: Groups B and C showed significant improvements in pain perception (VAS scores), knee function, and quality of life (KOOS and WOMAC scores), while Group A showed marginal or non-significant changes, and Group D exhibited no significant improvements. These findings suggest that treatments in Groups B and C reached the Minimal Clinically Important Difference, significantly enhancing patient-reported outcomes. Conclusion: A dose of 2 million BMAC cells per kg body weight for knee OA serves as the better regenerative modality of choice in cartilage regeneration. With our dose-escalation study, we would be able to standardize the treatment procedure and enable global comparison of the treatment method across various regions of the world. [ABSTRACT FROM AUTHOR]

Moral distress is recognized as a serious problem not only among healthcare providers, but also in the healthcare system in general. It is considered that moral distress in health care is defined as a phenomenon in which nurses know how to proceed ethically in certain situations but are constrained from acting. There are currently no studies conducted on moral distress among anesthesia and intensive care nurses in Latvia, but the moral distress scale has been adapted since beginning the research. Additionally, there have been no studies conducted in Latvia to analyze the correlations between the level of moral distress and burnout syndrome. The results of the conducted research confirmed H0 (null hypothesis), which suggests that there is no association between moral distress and burnout rates in nursing practitioners in anesthesiology and intensive care. The results of the study and a review of the existing literature suggest that there is a statistically significant relationship between moral distress rates and the rates of emotional exhaustion, as well as the rates of depersonalization. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients diagnosed with gynecological and breast cancer undergo multimodal treatments leading to estrogen deprivation and vaginal damage in case of radiotherapy, resulting in significant impairments of vulvo-vaginal function. Non-ablative intravaginal CO2 laser is a promising technique for VVA (vulvo-vaginal atrophy) in breast cancer, gynecological and other pelvic cancer survivors. In this study we explored the effectiveness and the long-term effects of repeated cycles of laser therapy. This therapeutic regimen could represent an effective treatment option for patients with limited therapeutic alternatives due to the hormone-sensitivity frequently showed by these cancers. This study aimed to investigate the efficacy and duration of multiple non-ablative intravaginal CO2 laser (V-lase®) cycles in breast cancer patients, gynecological and other pelvic cancers previously subjected to multiple oncological treatments. This prospective study enrolled women under the age of 65 years who reported vaginal symptoms. Data on the Vaginal Health Index (VHI), vaginal length (VL), vaginal pain measured using a Visual Analog Scale (VAS), and the Female Sexual Function Index (FSFI) were collected at baseline and before each laser application, and at subsequent follow-up visits. A total of 170 laser applications were performed on 113 women with various types of cancer. Most patients (57.5%) had received radiotherapy-based treatments before receiving laser treatment. Vaginal health parameters and sexual function improved significantly with each laser application. However, a temporary decline in these improvements occurred during the intervals between cycles. Such worsening was reversed with the subsequent cycle in all groups of patients, irrespective of the type of oncological treatments they had undergone. Multiple course vaginal laser therapy showed promising results as a potential treatment for vaginal atrophy in heavily treated gynecological and breast cancer patients, necessitating further research to determine the optimal time interval between cycles to ensure sustained positive effects. [ABSTRACT FROM AUTHOR]

Background The increased prevalence of overweight and obesity in the Czech Republic and Slovakia has led to heightened emphasis on weight control, particularly among women. Our aim is to explore body image perceptions among women in both countries and compare their attitudes, focusing on the relationship between body image and body mass index (BMI), height, weight, body fat and the weight control. Methods The cross-sectional study involved 358 female students from the University of Pardubice and Constantine the Philosopher University in Nitra, with equal representation from the Czech Republic and Slovakia. Body parameters were assessed using anthropometric methods and the InBody 230 diagnostic device, while participants' perceptions of their bodies were evaluated using the Body Shape Questionnaire. Results The results confirmed that BMI did not significantly influence self-perception among Slovak students, while Czech participants with increasing obesity tended to perceive themselves more negatively. Significantly higher median values for BMI (p  = 0.0509), weight (p  = 0.0507), height (p  = 0.05) and body image (p  = 0.002) were observed in the Czech Republic compared with Slovakia. No significant difference was found in weight control and fat between participants from both countries. Conclusions Although obesity was demonstrated in both nations, body satisfaction was different for participants from the Czech Republic and Slovakia. [ABSTRACT FROM AUTHOR]

Background: The risk factors for acute skin failure (ASF), a serious complication of the skin, are not fully understood. Purpose: This study was designed to explore the risk factors for ASF in critically ill patients and construct a clinical prediction model. Methods: Intensive care unit patients were prospectively observed and assigned into two groups: with and without ASF. A logistic regression model was constructed, and its predictive power and clinical utility were evaluated. Results: Of the 204 eligible patients enrolled as participants, 58 (28.43%) developed ASF. Sepsis, vasoactive drugs, and age were shown to be risk factors for ASF, whereas peripheral perfusion index ratio and albumin level were shown to be protective factors. The area under the receiver operating characteristic curve was 0.83. The maximum Youden index of the model was 0.39 (specificity: 0.87, sensitivity: 0.77). The Hosmer– Lemeshow test (p = .20) and calibration curve showed good fitness and predictive utility with respect to the model. Conclusions: The developed model effectively predicts ASF risk, allowing for the early identification of high-risk patients. Identifying risk factors such as sepsis, vasoactive drugs, and age and considering protective factors such as peripheral perfusion index and albumin levels may help optimize care plans. Clinical staff should pay special attention to these factors and their impact on skin health in critically ill patients. [ABSTRACT FROM AUTHOR]

BACKGROUND The prevention of coronary artery disease (CAD) faces dual challenges: the aspirin-induced gastrointestinal injury, and the residual cardiovascular risk after statin treatment. Geraniol acetate (Gefarnate) is an anti-ulcer drug. It was reported that geraniol might participate in lipid metabolism through a variety of pathways. The aim of this study was to assess the lipidlowering effects of gefarnate in statin-treated CAD patients with residual hypertriglyceridemia. METHODS In this prospective, open-label, randomized, controlled trial, 69 statin-treated CAD patients with residual hypertriglyceridemia were randomly assigned to gefarnate group and control group, received gefarnate (100 mg/3 times a day) combined with statin and statin alone, respectively. At baseline and after one-month treatment, the levels of plasma triglyceride, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol were tested. RESULTS After one-month gefarnate treatment, triglyceride level was significantly lowered from 2.64 mmol/L to 2.12 mmol/L (P = 0.0018), LDL-C level lowered from 2.7 mmol/L to 2.37 mmol/L (P = 0.0004), HDL-C level increased from 0.97 mmol/L to 1.17 mmol/L (P = 0.0228). Based on statin therapy, gefarnate could significantly reduce the plasma triglyceride level (P = 0.0148) and increase the plasma HDL-C level (P = 0.0307). Although the LDL-C and total cholesterol levels tended to decrease, there was no statistically significant difference. CONCLUSIONS The addition of gefarnate to statin reduced triglyceride level and increased HDL-C level to a significant extent compared to statin alone in CAD patients with residual hypertriglyceridemia. This suggested that gefarnate might provide the dual benefits of preventing gastrointestinal injury and lipid lowering in CAD patients. [ABSTRACT FROM AUTHOR]

Background: Psoriasis, a chronic autoimmune condition, imposes significant burdens on patients' well-being. While corticosteroid medications are commonly used, their prolonged use presents risks. Statins, known for their immunoregulatory and anti-inflammatory properties, have emerged as potential alternatives. Previous reviews indicated that statins might improve psoriasis symptoms but showed inconsistent results and lacked meta-analyses that generated pooled effect estimates. Therefore, this study addresses this gap by providing a comprehensive overview of the impact of statins on psoriasis severity and quality of life (QoL) for patients with psoriasis. Methods: A thorough search of four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Science Direct) was conducted for relevant studies published before April 2024. Results: Seven studies involving 369 patients were included. This meta-analysis showed a statistically significant reduction in PASI scores at week 8 with statin treatment (MD = −1.96, 95% CI [−3.14, −0.77], p = 0.001). However, no statistically significant difference was found between statins and placebo at week 12 (MD = 0.19, 95% CI [−0.18, 0.55]). Additionally, DLQI scores indicated a significant improvement in quality of life with statins compared to placebo (MD = −3.16, 95% CI [−5.55, −0.77]). Conclusions: Statins can improve disease severity and quality of life in psoriasis patients, suggesting the potential benefits of statin therapy. However, further research is needed to determine the optimal treatment duration, address outcome heterogeneity, and explore additional benefits such as cholesterol and triglyceride reduction. [ABSTRACT FROM AUTHOR]

Infectious disease outbreaks present ongoing and substantial challenges to health systems at local, national, and global levels, testing their preparedness, response capabilities, and resilience. This study aimed to identify and analyze critical health system-level factors that influence infection outbreaks, focusing on the experience of the COVID-19 pandemic in Korea. Conducted as a secondary data analysis, this study utilized national datasets from Korea. Given the inherent spatial dependencies in the spread of infectious diseases, we employed a spatial lag model to analyze data. While city-specific characteristics did not emerge as significant factors, health system variables, particularly the number of community health centers and health budgets, showed significant influence on the course of the COVID-19 outbreak, along with spatial autocorrelation coefficients. Our findings underscore the importance of enhancing public healthcare infrastructure, considering regional specificities, and promoting collaboration among local governments to bolster preparedness for future outbreaks. These insights are crucial for policymakers and healthcare professionals in formulating effective strategies to prevent, manage, and mitigate the impact of infectious disease outbreaks. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis, characterized by reduced bone mass and increased fracture risk, presents a significant public health challenge. Dual-energy X-ray Absorptiometry (DEXA) scans offer a reliable means of assessing bone mineral density (BMD) and detecting osteoporosis. The aim of this study is to assess awareness, attitude, and practice of women in the Jazan region toward DEXA scan. Methods: Data were collected through a self-administered online questionnaire. Statistical analysis was conducted using SPSS version 29.0. The total knowledge scores of participants were calculated to assess potential associations with sociodemographic data. A p-value of less than 0.05 was considered statistically significant. Results: Among 400 women, 230 (57.5%) had low knowledge scores primarily due to poor knowledge of the DEXA scan procedure. Merely 39 women had undergone a DEXA scan mainly due to medical prescription (n = 22, 56.4%). Total knowledge scores were significantly higher among women with high monthly incomes (p = 0.019) and those working in medical-related jobs (p = 0.017). Conclusions: This study underscores the need for targeted interventions to improve awareness of DEXA scans among women in Jazan City. Additionally, the findings suggest that socioeconomic factors may influence awareness levels, emphasizing the importance of tailored educational strategies to reach diverse demographics. [ABSTRACT FROM AUTHOR]

Background: The reported outcomes of pediatric dilated cardiomyopathy (DCM) have varied across studies. There are few outcome data concerning DCM in Chinese children. Therefore, we conducted a retrospective study to describe clinical features and determine risk factors for poor outcomes in children with DCM. Methods: We enrolled 121 children with DCM in our hospital from 2003 to 2021. General information and laboratory and echocardiographic data were collected and analyzed. Cox regression analysis was performed to determine risk factors for poor outcomes. Results: This study included 121 patients (69 males and 52 females). The median age at diagnosis was 10.8 years, and the follow-up time was 10.0 months. Eighty-two patients (67.8%) exhibited cardiac function classes III–IV at the time of diagnosis. Tachypnea was the most common symptom (78.5%). In echocardiography, the mean left ventricular end-diastolic dimension z score was 7.36 ± 2.73, and the left ventricular ejection fraction z score was −6.58 ± 2.17. The 1-, 2-, and 5-year survival rates were 51.2%, 43.8%, and 32.2%, respectively. Cox analysis revealed that cardiac function classes III–IV (hazard ratio [HR] = 1.801, 95% confidence interval [95% CI] = 1.030–3.149, p = 0.039) and calcium levels (HR = 0.219, 95% CI = 0.084–0.576, p = 0.002) were predictors of poor outcomes in children with DCM. Conclusions: Children with DCM are at high risk of death. Cardiac function class III–IV and calcium levels were related to the prognosis of pediatric DCM patients. [ABSTRACT FROM AUTHOR]

Background This study aimed to compare the survival outcomes of patients with initially unresectable hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) who underwent or did not undergo salvage surgery followed by a triple combination conversion treatment consisted of locoregional treatment (LRT), tyrosine kinase inhibitors (TKIs), and anti-PD-1 antibodies. Methods The data from 93 consecutive patients with initially unresectable HCC and PVTT across 4 medical centers were retrospectively reviewed. They were converted successfully by the triple combination treatment and underwent or did not undergo salvage resection. The baseline characteristics, conversion schemes, conversion treatment-related adverse events (CTRAEs), overall survival (OS), and progression-free survival (PFS) of the salvage surgery and non-surgery groups were compared. Multivariate Cox regression analysis was performed to identify independent risk factors for OS and PFS. Additionally, subgroup survival analysis was conducted by stratification of degree of tumor response and type of PVTT. Results Of the 93 patients, 44 underwent salvage surgery, and 49 did not undergo salvage surgery. The OS and PFS of the salvage surgery and non-surgery groups were not significantly different (P  = .370 and.334, respectively). The incidence and severity of CTRAEs of the 2 groups were also comparable. Subgroup analyses revealed that for patients with complete response (CR) or types III-IV PVTT, there was a trend toward better survival in patients who did not undergo salvage surgery. Multivariate analysis showed that baseline α-fetoprotein and best tumor response per mRECIST criteria were independent prognostic factors for OS and PFS. Conclusions For patients with initially unresectable HCC and PVTT who were successfully converted by the triple combination therapy, salvage liver resection may not be necessary, especially for the patients with CR or types III-IV PVTT. [ABSTRACT FROM AUTHOR]

Background: Chronic low-grade inflammation may mediate the relationship between obesity and diabetes, yet clinical research in this area remains scarce. Thus, this study aimed to explore the mediating role of chronic low-grade inflammation in this relationship using the National Health and Nutrition Examination Survey (NHANES). Methods: This study involved 2,482 participants enrolled in the NHANES between 2005 and 2016. Based on the complex sampling survey weights of NHANES, logistic regression models were fitted, adjusting for various covariates to investigate the relationship between BMI, INFLA score, and diabetes. Moreover, weighted quantile sum (WQS) regression models were fitted to analyze the proportional contribution of individual components within the INFLA score. Finally, mediation analysis was conducted to quantitatively assess the magnitude of the mediating effect of the INFLA score on the relationship between BMI and diabetes. Results: After adjusting for all potential confounding factors, a significant positive correlation was noted between INFLA score and diabetes [OR (95% CI), 1.038(1.003–1.075), p = 0.035]. Additionally, a significant positive correlation was observed between the high INFLA group and diabetes compared to the low INFLA group [OR (95% CI), 1.599(1.031–2.481), p = 0.037]. WQS regression models revealed that the proportional contributions of C-reactive protein, white blood cell count, platelet count, and neutrophil-to-lymphocyte ratio (NLR) were 55.5%, 34.8%, 8.46%, and 1.19%, respectively. Finally, the results of the mediation analysis indicated that the indirect effect of the INFLA score accounted for 10.20%. Conclusions: Chronic low-grade inflammation was associated with diabetes and partially mediates the relationship between obesity and diabetes. [ABSTRACT FROM AUTHOR]

Background: The global rise in the elderly population has increased the prevalence of root caries. Streptococcus mutans, Lactobacilli and Actinomyces are considered the primary pathogens of dental caries in culture-based studies. This study aimed to investigate bacterial profiles in coronal and root caries lesions and determine the association of specific bacterial genera at each site. Methods: Dentine samples from carious lesions were collected from 22 extracted teeth using an excavator. Microbial DNA was extracted from the samples using a protocol developed for this study. 16S rRNA gene amplicon sequencing was employed for microbial analysis. PCR amplification targeted the V3-V4 region of the bacterial 16S rRNA, and the amplicon sequencing used an Illumina MiSeq system (2 × 300 bp paired-end reads). Statistical analysis was performed by the Phyloseq and DESeq2 packages in R. Results: In coronal caries, Olsenella, Lactobacillus and Prevotella were the most prevalent genera, comprising approximately 70% of the microbiome community. In the root caries, however, although Olsenella, Prevotella and Lactobacillus remained the dominant genera, they accounted for only half of the microbiome community. This study identified significant differences in alpha diversity indices between the coronal and root caries. LEfSE analysis revealed several unique genera in each caries lesion. Conclusion: The microbiome of root caries lesions was richer and more complex than the coronal caries microbiota. The results suggest that lesion-related variations in the oral microflora may be detected in carious dentine. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of diabetic cardiomyopathy is closely linked to abnormal glycosylation modifications. N-acetylglucosaminyltransferase V (GnT-V), which catalyzes the production of N-linked -1–6 branching of oligosaccharides, is involved in several pathophysiological mechanisms of many disorders, including cardiac hypertrophy and heart failure. However, the mechanism by which GnT-V regulates cardiac hypertrophy in diabetic cardiomyopathy is currently poorly understood. In this study, we investigated the role of GnT-V on myocardial hypertrophy in diabetic cardiomyopathy and elucidated the underlying mechanisms. Material and methods: Streptozotocin (STZ) was intraperitoneally injected into mice to induce diabetic cardiomyopathy. An adeno-associated virus (AAV) carrying negative control small hairpin RNA (shNC) or GnT-V-specifc small hairpin RNA (shGnT-V) was used to manipulate GnT-V expression. In our study, forty male C57BL/6J mice were randomly divided into four groups (10 mice per group): control mice with AAV-shNC, diabetic cardiomyopathy mice with AAV-shNC, control mice with AAV-shGnT-V, and diabetic cardiomyopathy mice with AAV-shGnT-V. In addition, H9C2 cells and primary neonatal cardiac fibroblasts treated with high glucose were used as a cell model of diabetes. Analysis of cardiac hypertrophy and fibrosis, as well as functional studies, were used to investigate the underlying molecular pathways. Results: AAV-mediated GnT-V silencing dramatically improved cardiac function and alleviated myocardial hypertrophy and fibrosis in diabetic mice. In vitro experiments demonstrated that GnT-V was elevated in cardiomyocytes and induced cardiomyocyte hypertrophy in response to high glucose stimulation. GnT-V knockdown significantly reduced the expression of the integrinβ1 signaling pathway, as evidenced by decreased downstream ERK1/2 activity, which inhibited cardiomyocyte hypertrophy accompanied by reduced ANP, BNP, and β-MHC expression. Furthermore, knocking down GnT-V expression lowered the TGF-β1-Smads signaling pathway, which reduced the expression of α-SMA, collagen I, and collagen III. Conclusions: Overall, our research indicated that GnT-V may be a useful therapeutic target to treat diabetic cardiomyopathy, primarily in the inhibition of myocardial hypertrophy and fibrosis. [ABSTRACT FROM AUTHOR]

Background: The turnover of newly graduated nurses is a severe challenge for healthcare systems, and so it is essential to identify its predictive factors. This study investigates whether professional commitment, career adaptability, career self-efficacy, anxiety, and depression levels before and after internship can predict the turnover intention of newly graduated nurses after one year of employment. Methods: In a longitudinal study, 271 undergraduate nursing students recruited by convenience sampling were surveyed before internship (T1), after internship (T2), and after one year of employment (T3), with all surveys conducted on the Wenjuanxing survey platform (www.wjx.cn). Generalized linear models and restricted cubic spline models were used to explore possible linear and nonlinear relationships between turnover intention and the variables of interest. Results: Professional commitment both pre-internship (β = −0.060, p = 0.007, 95% CI [− 0.104, − 0.016]) and post-internship (β = −0.053, p = 0.015, 95% CI [− 0.096, − 0.010]) can negatively predict turnover intention. There is also a negative linear relationship between post-internship career self-efficacy and turnover intention (β = −0.308, p < 0.001, 95% CI [− 0.436, − 0.180]). In addition, professional commitment both pre-internship (adjusted R2 = 0.046, p = 0.004) and post-internship (adjusted R2 = 0.068, p < 0.001), career self-efficacy both pre-internship (adjusted R2 = 0.039, p = 0.008) and post-internship (adjusted R2 = 0.116, p < 0.001), career adaptability both pre-internship (adjusted R2 = 0.057, p < 0.001) and post-internship (adjusted R2 = 0.039, p = 0.008), anxiety both pre-internship (adjusted R2 = 0.035, p = 0.014) and post-internship (adjusted R2 = 0.048, p = 0.003), and depression levels both pre-internship (adjusted R2 = 0.031, P nonlinear = 0.021) and post-internship (adjusted R2 = 0.053, p = 0.002) are nonlinearly associated with turnover intention. Conclusions: Nursing educators and clinical care administrators must take action to enhance the professional commitment and career self-efficacy of nursing students during their internship. It is also important to pay attention to their career adaptability, as well as to any anxiety or depression that they may experience during clinical practice. This can help to reduce the turnover intention during the first year of their nursing career. [ABSTRACT FROM AUTHOR]

Older people with food insecurity in Ghana are often exposed to poor health conditions, highlighting the importance of the National health Insurance Scheme (NHIS) enrolment for ensuring they receive necessary medical attention through access to health care services. However, we know very little about the association between food insecurity and National Health Insurance Scheme enrolment among older people in Ghana. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana (i.e., Upper West, Bono, and Greater Accra regions (n = 1,073)). We find that 77% of older adults reported not being enrolled into the NHIS. Results from logistic regression analysis show that older people who experienced severe household food insecurity were less likely to enroll in the National Health Insurance Scheme than those who did not experience any food insecurity (OR = 0.48 p < 0.001). Based on these findings, we argue that in addition to the traditional socioeconomic factors, addressing severe food insecurity may improve health insurance enrolment among older adults. Additionally, policymakers should also consider older people's socioeconomic circumstances when formulating policies for them to enrol in health insurance. [ABSTRACT FROM AUTHOR]

Background: Osteonecrosis of the femoral head (ONFH) often leads to the collapse of the femoral head, ultimately resulting in patients undergoing premature total hip arthroplasty (THA). The surgical hip dislocation (SHD) technique is a type of hip-preserving surgery aimed at delaying or avoiding THA. This study aims to evaluate the clinical efficacy of SHD techniques through femoral head fovea fenestration and impaction bone grafting for the treatment of non-traumatic ONFH. Methods: A retrospective analysis was conducted on the clinical data of 39 patients (39 hips) with non-traumatic ONFH who underwent SHD for treatment from 2016 to 2017. The Harris hip score (HHS) and the minimum clinically important difference (MCID) are used to evaluate clinical outcomes, while radiographic evaluations are conducted using X-rays. Kaplan-Meier survival analysis defined clinical failure as further THA, and conducted univariate survival analysis and Cox regression analysis. Any complications were recorded. Results: All patients were followed up for 24–72 months, with an average of (60 ± 13.0) months. At the last follow-up, based on the HHS, 25 patients (64.1%) reported excellent and good clinical outcomes. 29 patients (74.3%) achieved MCID. Imaging evaluation of the postoperative femoral head status showed that 6 cases improved, 20 cases remained stable, and 13 cases showed progressed. Out of 39 hips, 12 hips had postoperative clinical failure, resulting in a clinical success rate of 69.2%. Association Research Circulation Osseous (ARCO) stage, China-Japan Friendship Hospital (CJFH) classification, and postoperative crutch-bearing time are risk factors for clinical failure. Postoperative crutch-bearing time of less than 3 months is an independent risk factor for clinical failure. After surgery, there was one case of sciatic nerve injury and one case of heterotopic ossification. There were no infections or non-union of the greater trochanter osteotomy. Conclusion: The SHD technique through the femoral head fovea fenestration and impaction bone grafting provides a safe and effective method for treating non-traumatic ONFH, with good mid-term clinical outcomes. ARCO staging, CJFH classification, and postoperative crutch-bearing time are risk factors that affect clinical outcomes after surgery and lead to further THA. Insufficient postoperative crutch-bearing time is an independent risk factor for clinical failure. [ABSTRACT FROM AUTHOR]

Background: Pericoronitis, an inflammation near wisdom teeth, often occurs when they are partially emerged, especially in the lower jaw. Commonly, the gingiva partially envelops the tooth. Treatments vary from gingival surgery to extraction. This study assessed the efficacy of a mouthwash with Chlorhexidine, Benzydamine, Nanosilver, Amoxicillin, and Metronidazole for pain reduction and enhancement of maximum mouth opening in acute pericoronitis cases. Materials and methods: In this randomized controlled clinical trial conducted at the Gorgan Dental Faculty, 48 pericoronitis patients were randomized into two groups. The control group used a 0.12% chlorhexidine mouthwash, while the case group used a mouthwash containing Chlorhexidine, Benzydamine, Nanosilver, Amoxicillin, and Metronidazole. The study recorded Visual Analog Scale (VAS) scores for 7 days, and Maximum mouth opening (MMO) was measured at the start and after 7 days. The analysis was performed using SPSS v20. Results: In this study, we compared the effects of a combined mouthwash with those of a chlorhexidine mouthwash on pericoronitis in 48 patients, with an average age of 21.56 years. No significant difference in pain reduction was observed between the groups; however, both groups exhibited decreased pain and improved MMO post-treatment. The gender distribution was balanced across both groups. Conclusion: The results indicate that both chlorhexidine mouthwash and combined mouthwash significantly improved maximum mouth opening. Nonetheless, there were no notable differences in efficacy between the two groups. These findings suggest that these mouthwashes may be beneficial for oral hygiene, warranting further in-depth research. Trial registration: Registered on 12/03/2023, registration number IRCT20230104057046N1. [ABSTRACT FROM AUTHOR]

Introduction: For older adults, maintaining muscle strength and balance is crucial to preserve an upright posture and independently manage their basic activities of daily living (ADL). This study aimed to examine whether muscle strength and balance mediate the relationship between frailty syndrome (FS) and osteoporosis in a large sample of community-dwelling older adults. Material and Methods: This cross-sectional study is part of the second phase (2016-2017) of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. Data from 2018 older adults were collected by a trained person using bone mineral density (BMD), frailty index, activities of daily living (ADL), instrumental activities of daily living (IADL), handgrip strength (HGS), quadriceps muscle strength (QMS), Berg Balance Scale (BBS), and Timed Up and Go test (TUG test) and analyzed using analysis of variance, chi-square, and path analysis tests. Results: The mean indices of femoral neck BMD and lumbar spine BMD, HGS, QMS, BBS, ADL, and IADL were lower in the frail older adults than in the pre-frail and non-frail older adults. In addition, the mean TUG test level was higher in the frail older adults than in the non-frail and pre-frail older adults. The results of the present study have indicated that frailty is significantly related to osteoporosis, and that balance and muscle strength can predict osteoporosis; these variables play a mediating role in the relationship between frailty and osteoporosis. Conclusion: From the results of the present study, it can be concluded that frailty may increase the odds of osteoporosis. The results of the current study have indicated that balance (BBS and TUG test) and muscle strength (HGS and QMS) are associated with osteoporosis and these variables play a mediating role in the relationship between frailty and osteoporosis. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B infection has been associated with the development of gestational diabetes but the underlying mechanism is not known. Objective: To examine associations between viral activity, gestational diabetes mellitus (GDM), and insulin resistance in pregnant people with chronic hepatitis B infection (HBV). Design: Prospective cohort study across three tertiary maternity centres in Melbourne, Australia, between May 2021 and April 2023. Methods: Participants were followed prospectively through pregnancy to evaluate subsequent GDM diagnosis. Demographics, pregnancy outcomes, and markers of viral activity were compared between those with GDM versus those without. Logistic regression analysis was performed pre- and post-adjustment for known confounders. Sub-group analysis of participants from South East Asia (SEA) was performed. Outcome measures included GDM diagnosis, insulin resistance (Homeostatic Model Assessment Insulin Resistance score (HOMA-IR) score), HBV activity as measured by liver function tests, HBV viral load, hepatitis B e antigen, and quantitative hepatitis B surface antigen (quantHBsAg). Results: A total of 113 women were recruited. One third (38/112, 33.9%) developed GDM, mostly diagnosed on isolated postprandial hyperglycaemia (25/38, 65.8%). Over half were born in SEA (66/113, 58.4%). Mean quantHBsAg was significantly lower in those with GDM (p = 0.044). No other associations were identified between GDM or HOMA-IR and markers of hepatic activity on multivariate logistic regression analysis and on sub-group analysis of those born in SEA. Conclusions: QuantHBsAg was significantly lower in those with GDM; otherwise, no association between GDM and measures of HBV viral activity was found. QuantHBsAg may be useful as an early pregnancy marker for GDM risk and warrants further research. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is a common problem worldwide with a global prevalence of 20%. There is no local relevant study from Iraq about the prevalence of hearing loss. Objective: To assess the prevalence of hearing loss among patients attending the otolaryngology clinic, Ramadi city, Iraq. Method: This retrospective study was conducted at the otolaryngology clinic, Ramadi city, Anbar government, Iraq. Patients with hearing loss were enrolled in the current study. Data were gathered from patients record regarding the age, sex, type, side, and severity of hearing loss. Additionally, the number of cases were registered for each month during the study period. Results: Out of 8497, there were 2165 (25.48%) patients with hearing loss. The highest number of cases was registered in April (n = 246, 11.4%). The highest age group affected was 18–60 years (n = 1125) with slight male predominance (51.64%). The main cause of hearing loss was secretary otitis media (n = 762, 35.19/5). The vast majority of cases were with conductive hearing impairment (n = 2051, 94.73%). Unilateral hearing loss (50.76%) was slightly more than bilateral one. Mild hearing loss has outnumbered (n = 1905, 88%) the other severities. Conclusion: The prevalence of hearing loss was 25.48%. Hearing loss could affect any age with slight male predominance. The majority of the cases were with conductive type and mild severity. [ABSTRACT FROM AUTHOR]

Background: Observational studies have shown that oxidative stress (OS) is associated with Parkinson's disease (PD). However, whether such observations reflect cause-effect remains largely unknown. To test this, we performed a two-sample bidirectional Mendelian randomization (MR) analysis to investigate the causal-effects between OS biomarkers and PD. Methods: We selected summary statistics data for single-nucleotide polymorphisms (SNPs) associated with catalase (n = 13), glutathione peroxidases (n = 12), superoxide dismutase (n = 13), vitamin A (n = 7), vitamin C (n = 10), vitamin E (n = 12), vitamin B12 (n = 8), folate (n = 14), copper (n = 6), Zinc (n = 7), and iron (n = 23) levels, and the corresponding data for PD from the International Parkinson Disease Genomics Consortium (IPDGC, 33,674 cases and 449,056 controls). Inverse-variance weighted (IVW) MR analyses were conducted to estimate associations of OS with PD. Reverse MR analysis was further performed to predict the causal effects of PD on the above OS biomarkers. Results: As for PD, the IVW method suggested that the Zinc (Zn) levels was significantly associated with PD (OR = 1.107, 95% CI 1.013-1.211; p = 0.025), which is consistent with results from the weighted median analyses. Moreover, the results remained consistent and robust in the sensitivity analysis. However, there were no significant associations of catalase, glutathione peroxidases, superoxide dismutase, vitamin A, vitamin C, vitamin E, vitamin B12, folate, copper, or iron with PD. As for OS, our reverse MR analysis also did not support a causal effect of liability to PD on OS. Conclusion: The MR study supported the causal effect of Zn on PD. These findings may inform prevention strategies and interventions directed toward OS and PD. [ABSTRACT FROM AUTHOR]

Background: Self-efficacy is the ability to execute, and it is a critical predictor of health-related outcomes among people living with human immunodeficiency virus (PLHIV). Self-efficacy directly determines treatment outcome. However, there is no evidence on the self-efficacy of PLHIV for self-management in Ethiopia. Currently, HIV is considered a manageable chronic disease. However, the burden remains high despite all the taken measures. Objectives: This study aimed to assess the self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), northwest Ethiopia, 2022. Methods: A cross-sectional study was conducted on PLHIV selected by a systematic random sampling technique using an interviewer-administered questionnaire at the UOGCSH from August 10 to September 30, 2022. The data was entered and analyzed using the Statically Package for Social Science version 25.0. Categorical variables were summarized as frequency (percentage) of the total. Both descriptive and inferential statistics, such as the Kruskal-Wallis H test and Mann-Whitney U test were performed to detect difference. P-value < 0.05 was considered to indicate statistically significance. Results: Overall, 405 PLHIV participated in the study, giving a 96% response rate. The overall median (Interquartile range) self-efficacy score of PLHIV for self-management was 22 (4) and 67.4% of the PLHIV self-efficacy score was above the median. A statistically significant difference was detected between the social support groups (χ2 (2) = 37.17, p < 0.0001), education background (U = 10,347, Z = 2.279, P = 0.023, r = 0.113), living conditions (U = 12,338, Z = 2.457, P = 0.014, r = 0.122) and medication adherence (U = 9516.5, Z = 3.699, P < 0.0001, r = 0.184). Conclusion: Most participants' self-efficacy score was above the median. Statistically significant differences in self-efficacy were observed based on individual, environmental, and clinical factors. We suggest training and workshops for healthcare workers and the hospital and adherence support groups should work to improve the self-efficacy of PLHIV. [ABSTRACT FROM AUTHOR]

Background: Changing the food environment is an important public health lever for encouraging sustainable food choices. Targeting the availability of vegetarian main meals served in cafeterias substantially affects food choice, but acceptability has never been assessed. We examined the effects of an availability intervention at a French university cafeteria on students' main meal choices, meal offer satisfaction and liking. Methods: A four-week controlled trial was conducted in a university cafeteria in Dijon, France. During the two-week control period, vegetarian main meals constituted 24% of the offer. In the subsequent two-week intervention period, this proportion increased to 48%, while all the other menu items remained unchanged. Students were not informed of the change. Student choices were tracked using production data, and daily paper ballots were used to assess student satisfaction with the meal offer and liking of the main meal they chose (score range [1;5]). Nutritional quality, environmental impact, and cost of production of meal choices were calculated for each lunchtime. Food waste was measured over 4 lunchtimes during control and intervention periods. An online questionnaire collected student feedback at the end of the study. Results: Doubling availability of vegetarian main meals significantly increased the likelihood of choosing vegetarian options (OR = 2.57, 95% CI = [2.41; 2.74]). Responses of the paper ballots (n = 18,342) indicated slight improvements in meal offer satisfaction from 4.05 ± 0.92 to 4.07 ± 0.93 (p = 0.028) and in liking from 4.09 ± 0.90 to 4.13 ± 0.92 (p < 0.001) during control and intervention periods, respectively. The end-of-study questionnaire (n = 510) revealed that only 6% of students noticed a change the availability of vegetarian main meals. The intervention led to a decrease in the environmental impact of the main meals chosen, a slight decrease in nutritional quality, a slight increase in meal costs and no change in food waste. Conclusions: Doubling availability of vegetarian main meals in a university cafeteria resulted in a twofold increase in their selection, with students reporting being more satisfied and liking the main meals more during the intervention period. These results suggest that serving an equal proportion of vegetarian and nonvegetarian main meals could be considered in French university cafeterias to tackle environmental issues. Trial registration: Study protocol and analysis plan were pre-registered on the Open Science Framework (https://osf.io/pf3x7/). [ABSTRACT FROM AUTHOR]

Simple Summary: Quality of life significantly affects health outcomes in cancer patients. However, evidence of an association between diet quality and quality of life in cancer survivors is sparse in Mediterranean countries. The aim of this study was to evaluate the associations between an a priori diet quality index, the Healthy Eating Index-2015 (HEI-2015), and quality of life, assessed through a validated questionnaire targeted at women with a breast cancer diagnosis. A higher HEI-2015 score was positively associated with summary quality of life score and inversely associated with symptom scores. Health-related quality of life (HRQoL) represents one of the most concerning aspects for cancer patients. The Healthy Eating Index (HEI) is an a priori diet quality index directly associated with health outcomes and HRQoL in cancer survivors in North American populations. We evaluated, in a Mediterranean population, the baseline associations between HEI-2015 and HRQoL in 492 women with breast cancer recruited in a DEDiCa lifestyle trial. Dietary data were obtained from 7-day food records; HRQoL was assessed through the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30) and the C30 Summary Score (SumSc). Analysis of variance and multivariable linear and log-gamma regression models were performed. Mean and standard deviation for HEI-2015 score was 68.8 ± 11.2; SumSc was 81.5 ± 12.9. Women with lower HEI-2015 score had higher BMI, were more frequently exposed to tobacco smoke and had fewer years of education. Patients with a HEI-2015 score greater than 68.7 (median value) showed a significant increase in SumSc of 4% (p = 0.02). HEI-2015 components also associated with SumSc were beans and greens (β = 1.04; p = 0.02). Weak associations were found for total vegetables and saturated fats. Higher diet quality in breast cancer survivors was associated with higher overall HRQoL in this cross-sectional analysis. [ABSTRACT FROM AUTHOR]

Simple Summary: Conventional intravenous platinum(II) chemotherapy medications, including carboplatin, oxaliplatin and cisplatin, have demonstrated remarkable efficacy in treating several forms of cancer. Also, this therapy is frequently accompanied by toxicity and development of resistance. More potent platinum complexes with fewer side effects may be of benefit. This study compares the in vitro anticancer effect of novel platinum(II) complexes and their platinum(IV)-dihydroxy derivatives with cisplatin to understand the influence of different mechanisms of action on potency. The investigation of these complexes is expected to advance our understanding to support further research into their application as cancer therapeutics. Development of resistance to cisplatin, oxaliplatin and carboplatin remains a challenge for their use as chemotherapies, particularly in breast and colorectal cancer. Here, we compare the anticancer effect of novel complexes [Pt(1,10-phenanthroline)(1S,2S-diaminocyclohexane)](NO3)2 (PtIIPHENSS), [Pt(5-methyl-1,10-phenanthroline)(1S,2S-diaminocyclohexane)](NO3)2 (PtII5MESS) and [Pt(5,6-dimethyl-1,10-phenanthroline)(1S,2S-diaminocyclohexane)](NO3)2 (PtII56MESS) and their platinum(IV)-dihydroxy derivatives with cisplatin. Complexes are greater than 11-fold more potent than cisplatin in both 2D and 3D cell line cultures with increased selectivity for cancer cells over genetically stable cells. ICP-MS studies showed cellular uptake occurred through an active transport mechanism with considerably altered platinum concentrations found in the cytoskeleton across all complexes after 24 h. Significant reactive oxygen species generation was observed, with reduced mitochondrial membrane potential at 72 h of treatment. Late apoptosis/necrosis was shown by Annexin V-FITC/PI flow cytometry assay, accompanied by increased sub-G0/G1 cells compared with untreated cells. An increase in S and G2+M cells was seen with all complexes. Treatment resulted in significant changes in actin and tubulin staining. Intrinsic and extrinsic apoptosis markers, MAPK/ERK and PI3K/AKT activation markers, together with autophagy markers showed significant activation of these pathways by Western blot. The proteomic profile investigated post-72 h of treatment identified 1597 MDA−MB−231 and 1859 HT29 proteins quantified by mass spectroscopy, with several differentially expressed proteins relative to no treatment. GO enrichment analysis revealed a statistically significant enrichment of RNA/DNA-associated proteins in both the cell lines and specific additional processes for individual drugs. This study shows that these novel agents function as multi-mechanistic chemotherapeutics, offering promising anticancer potential, and thereby supporting further research into their application as cancer therapeutics. [ABSTRACT FROM AUTHOR]

Simple Summary: Based on this study, we define a new biomarker termed lymphocyte-to-albumin ratio (LAR) that may predict the prognosis for patients with metastatic NSCLC treated with immunotherapy. This study aims to determine the relationship of the LA index with patients' survival rate through studying the records of 227 patients who were treated with nivolumab after one or multiple cycles of chemotherapy. Therefore, the results showed that a higher LA index is significantly related to better overall survival (OS) and progression-free survival (PFS). Overall, the LA index deserves its merit of being a simple, cost-effective, noninvasive method applicable in NSCLC immunotherapy as a clinically practical tool for predicting treatment outcomes. Objective: Immunotherapies are commonly employed for the treatment of non-small-cell lung cancer (NSCLC). However, predictive biomarkers still need to be improved to predict responses to these agents. The lymphocyte–albumin (LA) laboratory index has not been evaluated before in this patient group. The aim of this study was to analyze the relation between the LA index and the survival rate of metastatic NSCLC patients who had immunotherapy after at least one round of chemotherapy. Methods: The research included 227 patients diagnosed with metastatic NSCLC, who were administered nivolumab after at least one round of chemotherapy. The LA index was calculated by multiplying lymphocyte count and albumin concentration. The optimal threshold values for the index were established by the examination of the ROC curve for both overall survival (OS) and progression-free survival (PFS). Oncological data were obtained retrospectively from patient files, and survival analyses were performed. Results: The median follow-up was 7.9 months. Progression was observed in 129 (56.9%) patients. A total of 97 (42.7%) patients died during the follow-up. The cutoff values of the LA index to predict OS and PFS were determined as 52.87 and 57.67, respectively. The low-LA group had significantly lowered OS and PFS compared to the high-LA group. LA was found to be an independent prognostic factor for PFS (hazard ratio 4.47; 95% confidence interval, 2.73–7.34; p < 0.001) and OS (hazard ratio 6.24; 95% confidence interval, 3.46–11.25; p < 0.001) in the multivariate regression analysis. Conclusions: In this study, we observed that the LA index independently predicts OS and PFS in immunotherapy-treated metastatic NSCLC patients. Its ease of application, low cost, and noninvasive nature make it a potential guide for clinicians in predicting treatment responses and survival. [ABSTRACT FROM AUTHOR]

Background: Emergence agitation is a transient confusional state of a child associated with consciousness from general anaesthesia, commonly occurs in the postoperative setting which delays their recovery and exposes them to traumas. The main objective of the current study was to investigate the magnitude of emergence agitation, its interventions and associated factors among paediatric surgical patients at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: Hospital based cross-sectional study with prospective follow-up framework was conducted on a paediatric surgical patients aged 2-14 years who underwent surgery under general anaesthesia between June 1 - October 30 2022. Stratified sampling method followed by simple random sampling technique was employed to reach study participants. Magnitude of emergence agitation and its interventions done at post-anaesthetic care units were recorded. Data analysis was carried out using a descriptive statistics method and the results were summarized using tables and diagrams. Bivariate analysis was done to identify causal relationship and multivariable analysis to assess the confounding effects of factors associated with emergence agitation. A p-value of less than 0.05 was considered statistically significant factor. Results: A total of 150 participants were included in the current study, where 107 (71.3%) were male and 97 (64.7%) were preschool aged. About 81 (54%) of care givers were female and majority of them have completed primary school. The mean (standard deviation) age of the participants was 6.4 (3.57) years. Around 42.7% of them developed emergence agitation with an average duration of 8.39 ± 4.45 minutes. Factors such as propofol administration at the end of procedure (OR of 0.104 with 95% CI [0.035, 0305]), Ear, nose, throat surgery and oral maxillofacial surgery (OR of 2.341 with 95% CI [1.051, 5.211]) and arrival of patient to recovery awake (OR of 0.456 95% CI [0.209, 0.994]) showed statistically significant association with emergence agitation. Conclusion: Almost half of the study participants experienced emergence agitation which is high magnitude. Ear, nose, throat surgery and oral maxillofacial surgeries were predictive factors of emergence agitation while propofol administration at the end of procedure and arrival of patient to recovery awake significantly decreased risk of emergence agitation. Therefore, anaesthesia personnel should have essential skills and knowledge to effectively care for children perioperatively including to minimize and treat emergence agitation. [ABSTRACT FROM AUTHOR]

(1) Background: Adolescence is a critical period when dietary choices are a major concern. It is therefore important to understand the psychological factors that explain these choices. The objective of this study was to assess the predictive role of perceived self-efficacy for healthy eating and weight regulation on healthy and unhealthy eating behavior through the mediation of autonomous motivation, controlled motivation, amotivation, and perceived barriers to daily mechanisms affecting healthy consumption. (2) Methods: A total of 994 adolescents between 15 and 19 years old from Mexico and Spain participated in the study. The Spanish versions of the healthy eating and weight self-efficacy questionnaire, the behavioral regulation in exercise questionnaire, the barriers to healthy eating scale, and the weight-related behaviors scale questionnaire were used to measure the variables of interest. (3) Results: Mediated serial regression analysis showed that barriers to healthy eating (the daily mechanism of food consumption) reduced healthy eating choices. Healthy eating and weight self-efficacy also showed a positive significant relationship with autonomous motivation and a negative relationship with controlled motivation and amotivation. All the types of motivation showed a positive relationship with barriers to healthy eating. (4) Conclusions: The results point out the need to enhance self-efficacy, promote autonomous motivation, and reduce perceived barriers in young people with respect to healthy eating. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study aimed to assess the correlation between subjective oral health status and mental health in a group of university students in Serbia. Methods: The study included 948 students, aged between 18 and 27, from the Faculty of Medical Sciences, University of Kragujevac, Serbia, and was conducted in 2020. The World Health Organization's Oral Health Questionnaire for Adults was utilized to evaluate the respondents' self-perceived oral health and oral hygiene practices. The existence of depressive symptoms was evaluated using the Beck Depression Inventory-II (BDI-II), and the Zung self-rating anxiety scale (SAS) was used for determining anxiety symptoms. Results: It is observed that 28.9% of respondents exhibit symptoms of depression and 42.3% showed symptoms of anxiety. Results show that students with severe depression and anxiety symptoms very often reported lower self-perceived oral health and oral health problems. Although the nature of this relationship has not been thoroughly evaluated, several studies have shown a mutually dependent connection between oral health and mental health. Conclusions: The results suggest that some aspects of oral health are associated with higher risks of developing symptoms of depression or anxiety, and vice versa. [ABSTRACT FROM AUTHOR]