Statistically Significant Research Articles

Comparison of balloon catheter and oral misoprostol for cervical ripening in women with pre-labor rupture of membranes: A Finnish randomized controlled trial.

Pre-labor rupture of membranes (PROM) occurs in about 8% of term pregnancies with over 70% delivering spontaneously within 24 h. However, prolonged PROM increases the risk of chorioamnionitis and neonatal sepsis. While misoprostol and oxytocin are considered safe and effective methods of labor induction, most guidelines do not encourage balloon catheter (BC) use following PROM given concerns about increased risk of chorioamnionitis. However, lack of robust evidence exists. This study aimed to compare BC and low-dose oral misoprostol (OM) regarding infectious morbidity and assess the impact of routine antibiotic prophylaxis during BC use on infection prevention. A randomized controlled trial comparing BC and low-dose 25 μg OM for pre-induction cervical ripening in an inpatient setting and assessing the preventive effect of prophylactic antibiotics during BC use in 175 women with PROM was carried out between 1.2.2021 and 31.12.2023 in Helsinki University Hospital. The study protocol was registered in the ISCTN registry (ISRCTN10972090). The primary outcome measures of the study were the mode of delivery, and maternal and neonatal infections. Eighty-nine women (50.9%) were allocated in the BC arm and 86 women (49.1%) in the OM arm. The cesarean delivery rates were comparable (BC 19.1% [n = 17] vs. OM 11.6% [n = 10]; p = 0.17). The rate of chorioamnionitis (BC 9.1% [n = 8] vs. OM 3.5% [n = 3]; p = 0.21) or neonatal infection (BC 4.5% [n = 4] vs. OM 2.3% [n = 2]; p = 0.68) were not statistically significantly different between the groups, although there was a trend towards higher frequency of infections in the BC arm. There were no differences in the incidence of chorioamnionitis or neonatal infections when routine antibiotic prophylaxis was administered during the BC use compared to those who did not receive antibiotics (chorioamnionitis 10.9% with antibiotics vs. 8.0% without antibiotics; p = 0.68, and neonatal infection 5.3% vs. 3.9%; p = 1.00). Maternal childbirth satisfaction was similar in the BC and OM groups. Our results showed almost threefold frequency of chorioamnionitis and twofold frequency of neonatal infections following the use of BC compared to OM, although the study was underpowered for reaching statistical significance. The use of prophylactic antibiotics during BC retention did not reduce the incidence of infections.

Racial preferences in sports NFTs? Empirical evidence from NBA Top Shots

Purpose The purpose of this paper is to analyse a large data set of over 2.4 million Top Shot NFT transactions to determine whether there is evidence of revealed racial preferences in the Top Shot market.Design/methodology/approach This study examines a data set of 2.43 million transactions from 28 July 2020 to 20 March 2021 using Ordinary Least Squares, Weighted Least Squares and Inverse Probability Weighting. Our models include indicator variables for the race of depicted players and examine estimated race coefficients for statistical significance and effect size.Findings Our results indicate that the National Basketball Association (NBA) Top Shot NFTs depicting Black players or Black/Mixed players trade for higher prices than those depicting White players, after controlling for other factors including on-court performance. While highly statistically significant, the effect sizes are below conventional thresholds for small effects.Practical implicationsRecent empirical studies present evidence suggesting that Black players may earn less than comparable White players. Our findings challenge implicit justifications for observed earning disparities based on consumer preference.Originality/value This study provides empirical analysis into revealed racial preference of consumers for sports memorabilia. It is the first to examine racial preference in NBA NFTs.

Smartphone addiction and depression among health sciences students during COVID-19 pandemic

BackgroundPrevious studies indicate an increasing prevalence of depression among university students worldwide. Besides, university students are more likely to excessively use smartphones, making them more susceptible to smartphone addiction. Pandemic conditions can also have negative effects on mental health. Thus, this study aims to investigate the frequency of depression among university students during COVID-19 pandemic.MethodsThe study population for this mixed-method research, which includes both qualitative and quantitative components, consists of students studying health sciences at a state university in Istanbul, Türkiye. No sample was selected for the quantitative data collection; instead, it was aimed to reach the entire population. Sociodemographic characteristics, the 10-item Smartphone Addiction Scale-Short Version (SAS-SV), and the 21-item Beck Depression Inventory (BDI) were used. In the qualitative part of our study, semi-structured online interviews were conducted with 12 students. Statistical significance level was set at p < 0.05.ResultsThe study, involving 819 students, found that 25.2% had moderate depression and 5.7% had severe depression. A statistically significant relationship was found between self-perceived smartphone addiction and the presence of moderate-severe depression (p < 0.001). Participants who spent more than 4 h a day on their smartphones, those who checked their smartphones more than 30 times a day, those who perceived themselves as smartphone addicts, and those who experienced smartphone-related sleep problems obtained statistically significantly higher scores from BDI compared to others (p < 0.05). According to our qualitative results, some participants thought that smartphone use could cause a depressive mood by isolating people, while others believed it could do so through the negative effects of social media. All participants reported that the quarantine period increased their smartphone usage.ConclusionOur results suggest a potential interaction between smartphone addiction and depression. This indicates the potential benefit of assessing and addressing both conditions simultaneously.

Effects of Jintiange on the healing of osteoporotic fractures in aged rats

ObjectiveTo examine the effects of Jintiange on enhancing the healing of osteoporotic fractures in aged rats.MethodsAn osteoporotic fracture model of femur was established using 70 SD rats (aged > 12 months), which were randomly numbered and divided into an experimental group and a control group, each with an equal sample size (n = 35). The experimental group received Jintiange capsule ingredients via intragastric administration, while the control group received an equal volume of saline via the same method. X-ray examinations were conducted at the 4th and 12th weeks to evaluate fracture healing in the rats. After 12 weeks, micro-CT scanning was employed to assess the microstructure of the healthy femurs, and the parameters of the experimental and control groups were compared.ResultsAfter 4 weeks, the mean fracture healing scores were 0.78 ± 0.43 in the experimental group and 0.56 ± 0.51 in the control group. After 12 weeks, the mean scores were 1.50 ± 0.71 in the experimental group and 0.96 ± 0.68 in the control group. The scores in the experimental group were higher than those in the control group (P < 0.05). Micro-CT examination of the femurs showed an improvement trend in bone microarchitecture in the experimental group, indicated by increased bone volume fraction (BV/TV), trabecular number (Tb. N), and trabecular thickness (Tb. Th). However, these improvements were not statistically significant. A negative correlation with statistical significance was observed between trabecular separation (Tb. Sp) and fracture healing scores.Conclusions Jintiange may promote osteoporotic fracture healing in aged rats by enhancing bone microstructure.

Cumulative incidence and treatment effectiveness of low bone mineral density among people living with HIV in Iran (2021–2023)

BackgroundThe introduction of antiretroviral therapy (ART) has significantly improved the life expectancy of people living with HIV (PLHIV), leading to an increased prevalence of age-related comorbidities such as osteoporosis. This study investigates the incidence and characteristics of low bone mineral density (BMD) and the treatment effectiveness of low BMD participants among PLHIV in Kerman, Iran.MethodsA longitudinal study utilized dual-energy X-ray absorptiometry (DEXA) to screen 94 PLHIV in Kerman, Iran, for low BMD. Participants were aged 30 or older and had received antiretroviral therapy (ART) for at least 12 months. Those with low BMD were entered into a single-arm clinical trial and received the appropriate treatment. These people were checked to assess the treatment effectiveness 11 months after completion of the treatment. Those with normal BMD entered a cohort study and were checked to determine the cumulative incidence of low BMD. Data on demographics, medical history, and laboratory tests were collected. A chi-square test was used to assess the association between the categorical variables. A t-test (for normally distributed variables), or Mann-Whitney U (for non-normally distributed variables) was used to assess the differences of BMD between the two groups. Statistical significance was set at p ≤ 0.05, with analyses conducted in Stata 17.ResultsAmong 94 PLHIV at baseline, 48 participants (51%) had low BMD. During the follow-up, 11 participants (11.7%) missed the follow-up visits. In the follow-up, 83 PLHIV (40 with low BMD and 43 with normal BMD at baseline) were available. Among 40 participants who received treatment, 5 had normal BMD (treatment effectiveness: 12.5%). However, among 43 PLHIV with normal BMD at baseline, 7 PLHIV had low BMD at the follow-up visit (cumulative Incidence 16.3%). Those with lower body mass index (BMI) had a higher prevalence of low BMD than those with normal BMI during the follow-up (p-value: 0.003). Lumbar spine BMD increased modestly (0.005 g/cm2), while femoral neck and total hip BMD declined in total participants (0.011, 0.007 g/cm2, respectively). Osteocalcin and β-isomerized C-terminal telopeptides (β-CTx) levels were higher in the low BMD group in the follow-up, indicating increased bone turnover.ConclusionsThe study highlights the high cumulative incidence of 16.3% and treatment effectiveness of 12.5% of low BMD among PLHIV in Kerman, Iran, with implications for fracture risk. Despite a steady state in spine BMD decline, the risk of fracture remains elevated due to continued femoral neck and total hip BMD reduction. Gender-specific factors and BMI may influence susceptibility to low BMD.

Post-transplant complications revealed by mycophenolate mofetil related transporters and metabolic enzymes gene polymorphisms in pediatric patients with hematological disorders

BackgroundHaploidentical hematopoietic stem cell transplantation (Haplo-HSCT) serves as an important option for patients without an HLA matched donor in treating hematological disorders, while patients may experience various complications after transplantation. Mycophenolate mofetil (MMF), a cornerstone drug for graft-versus-host disease (GvHD) prophylaxis, effectively reduces the incidence of acute GvHD, and the efficacy of MMF varies among individuals associated with MMF-related transporters and metabolic enzymes single nucleotide polymorphisms (SNPs). However, limited studies have systematically reported the correlations between the MMF-related SNPs and post-transplant complications.MethodsHere, we conducted a retrospective study involving 90 pediatric patients with hematological disorders who underwent haplo-HSCT at a single center. All patients were subjected to MMF-related SNP testing, combined with common clinical characteristics, to be correlated with post-transplant complications.ResultsWe observed that all 15 MMF-related SNPs were in Hardy-Weinberg equilibrium. Based on multivariate Cox regression analysis of post-transplant complications, we discovered that SLCO1B1 (521T > C) variant genotype was an independent protective factor for chronic GvHD (HR = 0.25, 95% confidence interval (CI) (0.08–0.84)). For viral infection, CYP2C8 (1291 + 106T > C) variant genotype was an independent risk factor for cytomegalovirus infection (HR = 2.98, 95% CI (1.18–7.53)). As to hemorrhagic cystitis, SLCO1B1 (1865 + 4846T > C) variant genotype was an independent protective factor, while older age was considered as an independent risk factor (HR = 0.41, 95% CI (0.19–0.85); HR = 2.52, 95% CI (1.14–5.54), respectively). No statistical significance was discovered between common clinical characteristics and MMF-related SNPs with other complications, including grade II-IV/III-IV acute GvHD, Epstein-Barr virus infection, peri-engraftment syndrome, and capillary leak syndrome. We also discovered SLCO1B1 (597 C > T) and SLC29A1 (-162 + 228 A > C) variant genotypes are both independent factors for cumulative incidence of relapse after haplo-HSCT (HR = 4.02, 95% CI (1.42–11.44); HR = 0.18, 95% CI (0.07–0.43), respectively).ConclusionsOur findings highlight the significance of MMF-related transporters and metabolic enzymes SNPs in the development of post-transplant complications, contributing to facilitating personalized risk assessment and improving the clinical management in haplo-HSCT patients.

Stromal immune cells expression of Siglec-15 is associated with lower T stage and better prognosis of urinary bladder cancer

IntroductionSialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) is a novel immune checkpoint, similar to programmed death-ligand (PD-L1), and has emerged as a potential target for cancer immunotherapy. Until recently, little was known about the expression and role of Siglec-15 in bladder cancer (BC).MethodsIn this study, we used immunohistochemical staining to assess the expression of Siglec-15 and PD-L1 in 69 primary BC samples and analyzed their relationship with clinicopathologic characters and prognosis.ResultsThe expression rates of Siglec-15 in the tumor cells, stromal immune cells, and both the tumor and stromal cells were 84.1% (58/69), 50.7% (35/69), and 44.9% (31/69), respectively. The PD-L1 expression rate was 52.2% (36/69), with a positive rate of 17.4% (12/69). PD-L1 expression was inversely correlated with Siglec-15 expression, but the statistical significance was not achieved (P = 0.072). Low stromal Siglec-15 expression was associated with advanced tumor stage (P = 0.010). PD-L1 expression was associated with tumor stage (P = 0.008) and perineural invasion (PNI) (P = 0.048). Kaplan-Meier survival curves showed that stromal Siglec-15 expression was associated with a better prognosis (P = 0.012), although it was not an independent prognostic factor after multivariate analysis (P = 0.236) .DiscussionThis study revealed a high expression rate of Siglec-15 in BC and may provide valuable insights for patient selection in future clinical trials.

Risk factors for gastric mucosa lesion in critically ill patients undergoing endoscopy for percutaneous gastrostomy: a case-control study

BackgroundPharmacologic prophylaxis for gastric ulcer is commonly prescribed in patients hospitalized in the intensive care unit (ICU). The aim of the study was to assess the current prevalence and risk factors for gastric mucosa lesion in ICU patients receiving standard pharmacologic prophylaxis undergoing endoscopy for percutaneous gastrostomy implantation.MethodsPatients hospitalized in the mixed medical-surgical ICU undergoing percutaneous endoscopic gastrostomy (PEG) were analyzed. We excluded patients receiving either no or high doses of intravenous proton pump inhibitor (PPI), only patients receiving standard doses of PPI were included. Data retrieved from the electronic medical records included: demographics, risk factors for gastric mucosa lesion (use of stimulants, comorbidities, medications, treatment methods in the ICU, laboratory derangements) and endoscopic findings. The study compared a group of patients with gastric mucosa lesions (cases) vs. patients without gastric mucosa lesions (controls). Inter-group comparisons between cases and controls were performed. Depending on the type of distribution continuous variables were assessed using two-sample t-test or Mann-Whitney test, whereas categorical variables with Chi-squared or Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) were calculated. Statistical significance was assumed at p < 0.05.ResultsPatients with no prophylaxis (n = 8) or receiving high doses (> 40 mg per day) of proton pump inhibitor (n = 2) were excluded. There were 182 patients receiving standard intravenous dose of PPI, 63 (34.6%) women and 119 (65.4%) men, with median age 61.5 (interquartile range IQR 46.0–70.0) years. Majority of patients (n = 169, 92.9%) were receiving pharmacological prophylaxis for venous thromboembolism. There were 53 (29.1%) patients with gastric mucosa lesion. The only risk factor that was significantly different between cases and controls was history of gastric ulcer (p = 0.04) with OR 3.8 (95% CI 1.1–12.5; p = 0.03).ConclusionsMajority of various risk factors for gastric ulceration may not predict gastric mucosa lesion in ICU patients receiving standard pharmacological prophylaxis undergoing endoscopy for PEG implantation. We found that history of gastric ulcer may be a risk factor for gastric ulceration in the ICU patients. Patients with history of gastric ulcer might benefit from higher than standard doses of anti-ulcer medication when hospitalized in the ICU.

The effectiveness of postoperative delirium prevention, diagnosis, and intervention protocol in patients monitored in the intensive care unit after cardiac surgery: a quasi-experimental study

BackgroundThe incidence of delirium is high in the intensive care unit (ICU) after cardiac surgery. The development of evidence-based care protocols for delirium management and training of nurses in this regard can ensure effective management of delirium. This quasi-experimental study aimed to assess the effectiveness of a postoperative delirium prevention, diagnosis, and intervention protocol in patients undergoing monitoring in the ICU after cardiac surgery.MethodsThis study included 64 patients who underwent cardiac surgery and met the inclusion criteria, along with 14 nurses working in the ICU. Patients were divided into control (n = 32) and intervention (n = 32) groups. The study comprised three phases: determining the incidence of delirium in the control group and the delirium diagnosis status of the nurses; providing training to nurses on postoperative delirium prevention, diagnosis and intervention protocol; implementing a preliminary study of the protocol; and finally, implementing the protocol in the intervention group. Statistical significance was set at p < 0.05.ResultsWhile there was no significant agreement in delirium diagnosis between researcher and nurses in the control group (kappa: 0.207) (p > 0.05), significant agreement was observed in the intervention group (kappa: 1.00) (p < 0.001). The delirium diagnosis rate of the nurses was 14.3% in the control group and 100% in the intervention group, which was a significant difference. The incidence of delirium was 21.9% in the control group and 9.4% in the intervention group, although the difference was not significant.ConclusionPostoperative delirium prevention, diagnosis, and intervention protocol effectively enhance delirium diagnosis compliance among researchers and nurses and improve the accuracy of delirium diagnosis among postcardiac surgery ICU patients. The implementation of this protocol is recommended for delirium management in such patients.Trial registrationThis study was retrospectively registered at Clinicaltrials.gov on 19.02.2024 (Clinical Trials ID: NCT06268119).

Comparative Study of Dyslipidemia in Diabetic Patients with Diabetic Nephropathy and Diabetic Patients without Nephropathy

Background: Dyslipidemia is a significant risk factor for cardiovascular complications and renal damage in diabetic patients, particularly those with nephropathy. It exacerbates diabetic nephropathy (DN) progression through mechanisms such as oxidative stress and glomerulosclerosis. Objectives: This study aimed to compare lipid abnormalities between diabetic patients with nephropathy and those without, assess correlations with glycemic control and urinary microalbumin, and evaluate dyslipidemia’s impact on renal function. Methods: A cross-sectional study was conducted at Patna Medical College &amp; Hospital involving 60 diabetic patients aged 20–60 years, divided into two groups: diabetic patients with nephropathy (Group A, n=30) and without nephropathy (Group B, n=30). Demographics, lipid profiles, glycemic parameters, and renal function were analyzed. Dyslipidemia prevalence was assessed, and statistical significance was determined using SPSS (p&lt;0.05 considered significant). Results: Dyslipidemia was more prevalent in the nephropathy group (73.3% vs. 46.7%, p=0.03), with significantly elevated cholesterol, triglycerides, LDL-C, and reduced HDL-C levels. Mean fasting glucose, postprandial glucose, and HbA1c levels were also higher in the nephropathy group (p&lt;0.05). Conclusion: Dyslipidemia is significantly more severe in diabetic patients with nephropathy, linked to poor glycemic control and renal dysfunction. Targeted lipid management strategies are essential to mitigate cardiovascular and renal risks in these patients.

Mini-strokes within Broca-caudate connections during left insular glioma awake surgery cause transient severe naming deficits.

To provide an explanation for the intraoperative onset of severe naming deficits in the course of awake resection of left insular glioma. We retrospectively reviewed a series of 14 patients operated on in awake conditions for a left insular IDH-mutated glioma. Preoperative MRI included high-resolution diffusion sequences, to which constrained spherical deconvolution pipeline was applied, to obtain a whole brain tractogram. Whole brain T1 parcellation was obtained by Freesurfer, allowing to dissect the tractogram and identify the connections between the caudate nucleus and Broca's area. Postoperative MRI standard diffusion the day after surgery was performed, allowing to delineate and register to the preoperative MRI any area of hyperintense diffusion with low apparent diffusion coefficient. The pathway between pars triangularis (resp. opercularis) and Broca's area were considered as damaged whenever more than 50% of streamlines were passing through the mini-strokes. Patients' language abilities (including a picture naming task) were assessed and reported before, during and after surgery by certified speech therapists. Severe postoperative naming deficits were defined as a score lower than 40/80 items. Contingency tables were analyzed with Fisher exact test (statistical significance set at 0.05). Out the 14 patients, 8 patients had a mini-stroke on the immediate postoperative MRI. None of the 6 patients without any stroke had postoperative naming severe deficits. Five out the 8 patients with a mini-stroke had a severe postoperative naming deficit, characterized by strong verbal perseverations. This difference was statistically significant (exact Fisher test, p = 0.03). For the five patients with a deficit, the mini-stroke damaged either the pars triangularis - caudate pathway or the pars opercularis - caudate pathway, whenever the pars triangularis was resected after negative cortical mapping. For the three patients without severe postoperative naming deficit, the mini-stroke spared the Broca-caudate pathway. All patients recovered quasi-normal naming abilities at the 4-month postoperative evaluation. The occurrence of mini-strokes within the connections between Broca's area and the caudate nucleus explains the sudden naming deficits observed intraoperatively in some patients during awake resection of IDH-mutated insular glioma. Further studies are needed to better predict such event and to assess its impact on other cognitive functions.

The Influence of the Degree of Dental Implant Insertion Compression on Primary Stability Measured by Resonance Frequency and Progressive Insertion Torque: In Vitro Study

Background: This study aimed to evaluate the primary stability, according to the insertion torque value (ITV) and resonance frequency analysis (RFA), of dental implants placed in standardized blocks of bone quality equivalent to type II-A bone, using three surgical undersized protocols of 0.2 mm, 0.5 mm, and 0.8 mm, considering different dental implant diameters and lengths. Methods: One hundred and twenty dental implants (DIs) of different diameters (3.5, 3.8, 4.5, and 5.0 mm) and lengths (8.5, 10.0, 11.5, 13.0, and 15.0 mm) placed in polyurethane blocks equivalent to type II-A bone, according to the Lekholm and Zarb classification modified by Rosas et al., were examined with three surgical protocols of under-milling of 0.2, 0.5, and 0.8 mm. The ITV and the RFA were the determinants of primary stability, and their respective values were recorded as Ncm and the implant stability quotient (ISQ) immediately after the placement of the DIs. These were evaluated according to each surgical insertion protocol, length, and diameter of the DI under a multivariate analysis model (MANOVA). Statistical significance was set at p &lt; 0.05. Results: It was observed that the average of the ITV was significantly higher when a 0.8 mm under-milling protocol was used (63.2 ± 14.9 Ncm) (p &lt; 0.001). However, the ITV was significantly lower when a 0.2 mm under-milling protocol was used (25.1 ± 8.3 Ncm) (p &lt; 0.001). On the other hand, the ISQ did not present significant differences (p = 0.166) when comparing the 0.2 (67.6 ISQ ± 5.4 ISQ), 0.5 (65.8 ISQ ± 3.4 ISQ), and 0.8 (65.7 ISQ ± 4.0 ISQ) under-milling protocols in the evaluation of the primary stability of the dental implant. The multivariate effect size (ηp2 = 0.639) indicated that the variability detected in the insertion torque and the ISQ, at the same time, was explained by 63.9% (p &lt; 0.001) due only to the compression protocol, while the implant diameter explained this variability by 27.0% (ηp2 = 0.270) (p &lt; 0.001) and the implant length only significantly explained this variability by 12.1% (ηp2 = 0.121) (p = 0.030). Finally, any interaction between the compression protocol, implant diameter, and length did not influence insertion torque variability or the ISQ (p &gt; 0.05). Conclusions: It can be concluded that when the surgical protocol for subpreparation is optimal according to the prepared bone bed, regardless of the diameter or length of the dental implant used, primary stability was assured according to the ITV and the RFA in 63.9%. This finding allows us to recommend carrying out a correct analysis of bone quality in order to subsequently select the most appropriate surgical protocol for the subpreparation of the bone bed to achieve better primary stability of the dental implant.

Investigation of the Relationship Between ACTN3 rs1815739 Polymorphism and Openbite Cases: A Prospective Study.

The aim of this study was to examine whether ACTN3 rs1815739 polymorphism, which causes the deficiency of the alpha-actinin-3 muscle protein, is related to the formation of open bite malocclusion. Fifty-eight participants (18.5 ± 3.6 years old) with anterior open bite (n = 29) and normal overbite (n = 29) who presented to Marmara University, Department of Orthodontics for treatment were included in the study. Initial cephalometric radiographs were used for the diagnosis of malocclusion. The case group was divided into three subgroups according to degree of open bite. For DNA isolation, oral epithelial cells were collected with buccal swabs (Van Allen Way, Carlsbad, USA), and the real-time PCR method was used for the genotyping of all polymorphisms. The results were statistically analysed, and the threshold for statistical significance was set at p < 0.05. The frequencies of RR, RX and XX genotypes of ACTN3 rs1815739 polymorphism were found as 6 (20.7%), 14 (48.3%) and 9 (31.0%) in the control group and 8 (8%), 9 (31.0%) and 12 (41.4%) in the case group, respectively. There was no statistically significant difference between the groups in terms of the presence of the examined polymorphism (p > 0.05). However, the intra-group evaluation of case group revealed a significant difference in the prevalence of XX genotype (83.3%) for the subgroup with an open bite of -5 mm or above. Although no significant difference was observed between the case and control groups, a possible association was identified between ACTN3 rs1815739 polymorphism and an increased severity of open bite malocclusion.

One-Week Maternal Separation Caused Sex-Specific Changes in Behavior and Hippocampal Metabolomics of Offspring Rats

To investigate the effects of one-week maternal separation (MS) on anxiety- and depression-like behaviors in adolescent and adulthood as well as adult hippocampal metabolomics simultaneously in offspring female and male rats. In the MS group, newborn SD rats were separated from their mothers for 3 h per day from postnatal days (PND) 2 to 8. The open field test (OFT), elevated plus mazes (EPM), novelty suppressed feeding test (NSFT), and forced swimming test (FST) were conducted during adolescence and adulthood. Serum corticosterone, mRNA expression of hippocampal inflammatory cytokines, and hippocampal untargeted metabolomics of offspring adult rats were examined using an assay kit, qRT-PCR, and UPLC-Q-TOF/MS. Both MS female and male rats showed similar behaviors in OFT, EPM, NSFT, and SPT, except for the latency to feeding during adolescence and the open arm entries during adulthood, showed statistical significance only in MS female rats. Serum corticosterone and hippocampal pro-inflammatory cytokines IFN-γ were significantly elevated in both female and male rats, and IL-1β and TNF-α were significantly increased only in female rats. In hippocampal metabolism, the identification of differential metabolites displayed 53 and 37 in female rats and male rats, respectively (with 35 common metabolites), which were involved in 33 and 30 metabolic pathways with 28 common pathways. One-week MS induced sex-specific anxiety- and depression-like behaviors in female and male offspring rats during adolescence and adulthood, as well as sex-differentiated characteristics in the hippocampus inflammatory cytokines and metabolomics of adult MS rats. From the experimental data, the effects of MS on the female offspring rats were more severe than those of the male offspring rats.

A Meta-Analysis of Levofloxacin for Contacts of Multidrug-Resistant Tuberculosis.

Data from randomized trials evaluating the effectiveness of tuberculosis (TB) preventive treatment for contacts of multidrug-resistant (MDR)-TB are lacking. Two recently published randomized trials that did not achieve statistical significance provide the opportunity for a meta-analysis. We conducted combined analyses of two phase 3 trials of levofloxacin MDR-TB preventive treatment - Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis (VQUIN) trial and the Levofloxacin preventive treatment in children exposed to MDR-TB (TB-CHAMP) trial. Following MDR-TB household exposure, VQUIN enrolled mainly adults in Vietnam; TB-CHAMP enrolled mainly young children in South Africa. Random assignment in both trials was 1:1 at the household level to daily levofloxacin or placebo for 6 months. The primary outcome was incident TB by 54 weeks. We estimated the treatment effect overall using individual participant data meta-analysis. The VQUIN trial (n=2041) randomly assigned 1023 participants to levofloxacin and 1018 participants to placebo; TB-CHAMP (n=922) assigned 453 participants to levofloxacin and 469 participants to placebo. Median age was 40 years (interquartile range 28 to 52 years) in VQUIN and 2.8 years (interquartile range 1.3 to 4.2 years) in TB-CHAMP. Overall, 8 levofloxacin-group participants developed TB by 54 weeks versus 21 placebo-group participants; the relative difference in cumulative incidence was 0.41 (95% confidence interval [CI] 0.18 to 0.92; P=0.03). No association was observed between levofloxacin and grade 3 or above adverse events (risk ratio 1.07, 95% CI 0.70 to 1.65). Musculoskeletal events of any grade occurred more frequently in the levofloxacin group (risk ratio 6.36, 95% CI 4.30 to 9.42), but not among children under 10 years of age. Overall, four levofloxacin-group participants and three placebo-group participants had grade 3 events. In this meta-analysis of two randomized trials, levofloxacin was associated with a 60% relative reduction in TB incidence among adult and child household MDR-TB contacts, but with an increased risk of musculoskeletal adverse events. (Funded by the Australian National Health and Medical Research Council, UNITAID, and others.).

Disordered eating behaviors and associated factors among secondary school adolescents in Harar town, eastern Ethiopia: cross-sectional study

BackgroundAdolescent eating disorders impair physical and mental development and are associated with poor health outcomes in adulthood. However, there is little research on disordered eating in Ethiopia, particularly in the study area. As a result, the purpose of this study is to examine disordered eating behaviors and associated factors in secondary school adolescents in the study area.MethodsA school-based cross-sectional study was conducted among 1104 secondary school adolescents in Harar town from June 30 to July 15, 2022. Multistage cluster sampling was used, and data was collected using self-administered questionnaires. The eating attitude test-26 was used to assess disordered eating behaviors, and scores of 20 and above were considered to have disordered eating behaviors. A binary logistic regression analysis was done to identify factors associated with disordered eating behaviors and the statistical significance level was set at a p-value of 0.05.ResultIn this study, 28.37% [95% CI (25.73%, 31.16%)] of the adolescents had disordered eating behaviors. Being female [AOR = 1.81, 95% CI (1.29, 2.53)], being from a mother, attending technical school [AOR = 3.61, 95% CI: (1.85, 7.04)], and having a higher-educated father [AOR = 1.55, 95% CI: (1.02, 2.36)] were significantly associated with disordered eating behaviors. Furthermore, desire to lose weight [AOR = 2.09, 95% CI (1.49, 2.93)], smoking [AOR = 3.64, 95% CI (2.24, 5.91)], emotional problems [AOR = 1.7, 95% CI (1.14, 2.55)], and body image dissatisfaction [AOR = 0.96, 95% CI (0.94, 0.97)] were associated with disordered eating.ConclusionIn Harar, almost three out of ten secondary school adolescents had disordered eating behaviors. Personal, behavioral, and socio-demographic factors were associated with disordered eating. Since the prevalence of disordered eating is significant at the study site, all relevant stakeholders should have to develop appropriate interventions that target modifiable factors to reduce the burden.

Stigmatization and Psychosocial Burden in Acne Patients.

Acne vulgaris, a common dermatological condition, has physical manifestations and significant emotional and social implications for those affected. This study aims to assess the stigma experienced by acne vulgaris patients and identify relevant physical, social, and psychological factors. The research involved individuals aged 12-45 diagnosed with acne vulgaris. The authors recorded each patient's demographic information, global acne severity, and acne scar severity. Additionally, each patient completed the Dermatologic Life Quality Index, Beck Depression Inventory, Liebowitz Social Anxiety Scale, and 6-item stigmatization scale. Using the scale scores, the authors categorized the severity into subgroups and compared the results within these subgroups. The severity of acne was positively correlated with DLQI scores (r = 0.196, p = 0.004) and stigmatization scores (r = 0.156, p = 0.024). Higher stigmatization scores were associated with increased levels of depression (r = 0.461, p < 0.001) and anxiety (r = 0.336, p < 0.001), as well as a significant impact on quality of life (r = 0.472, p < 0.001). Upon stratification of patients into three age groups (adolescence, late adolescence, and adulthood), the comparisons between these groups did not reach statistical significance. The results of the current study reveal a clear connection between the severity of acne and psychosocial disturbances, irrespective of age. The authors advise incorporating psychosocial screening, especially for severe acne vulgaris patients of all ages.

Guideline-directed medical therapy for heart failure in arrhythmia-induced cardiomyopathy with improved left ventricular ejection fraction.

No study has analyzed the impact of guideline-directed medical therapy in preventing heart failure (HF) relapse in patients with arrhythmia-induced cardiomyopathy (AiCM) following left ventricular ejection fraction (LVEF) improvement. We analyzed data from a single-center cohort of 200 patients admitted for HF, LVEF <50% and cardiac arrhythmia considered by cardiologists to be the precipitating cause of the episode. The primary endpoint was time-to-HF relapse, defined as the composite of readmission for HF, Emergency Department (ED) visit for HF, or significant decline in LVEF. Changes in medication were recorded and a time-varying multivariate Cox regression was performed. After a median follow-up period of 6.14 years, diagnostic confirmation was achieved in 188 out of the initial 200 patients with suspected AiCM. A total of 89 patients (47.3%) met the primary endpoint. RAS inhibitors (adjusted hazard ratio (HR) 0.50 [0.31-0.81]; p = 0.005) and beta-blockers (adjusted HR 0.48 [0.28-0.81]; p = 0.006) were associated with a lower incidence of relapse. Mineralocorticoid receptor antagonists were associated with a significantly lower incidence of ED visits for HF (adjusted HR 0.38 [0.15-0.95]; p = 0.038), but did not achieve statistical significance for the combined primary endpoint. Antiarrhythmic drugs did not show a significant impact on the primary endpoint. Maintaining RAS inhibitors and beta-blockers was associated with a significantly lower incidence of relapse in the setting of AiCM with improved LVEF.

Effectiveness of Simulation Best Practices in Nurse Practitioner Education.

Nurse educators are challenged to implement simulation best practices (SBP) in advanced practice curricula. Prebriefing and debriefing were implemented in a nurse practitioner course using software-generated asynchronous virtual simulation. A pretest-posttest design was used to evaluate simulation scores and debriefing experience in a convenience sample of 36 students. Scores were statistically higher in the prebriefing group. Debriefing experience scale scores increased on the posttest with four items showing statistical significance. Results of the study provide support for implementation of SBP with prebriefing in online graduate-level nursing education.

Analysis of pregnancy and neonatal outcomes in 100 pregnant women with Rh-negative blood type

BackgroundThis study aimed to explore variations in prenatal care, delivery methods, influencing factors, and neonatal outcomes among Rh-negative pregnant women, so as to improve pregnancy healthcare for this demographic, raise the quality of maternal–fetal management, and safeguard the health of both mother and infant.MethodsThis study included 200 women who received routine prenatal care, exhibited no other pregnancy complications, and were admitted for delivery. They were divided into an observation group (100 Rh-negative blood type) and a control group (100 Rh-positive blood type). The study examined differences in pregnancy management, clinical characteristics and pregnancy outcomes between the two groups.ResultsThe results indicated that singleton pregnancies in Rh-negative mothers are associated with significantly higher rates of postpartum blood loss (305.1 ± 183.8 vs. 246.1 ± 84.9 mL, P = 0.004), neonatal hyperbilirubinemia (39% vs. 23%, P = 0.014), low birth weight (11% vs. 2%, P = 0.01), and NICU admission (30% vs. 18%, P = 0.046) compared to the control group. Among Rh-negative mothers, subgroup analysis by ethnicity revealed a higher incidence of fetal distress in the other ethnic groups compared to the Han and Zhuang groups (16.7%, 0, 6.5%, respectively, P = 0.025). Subgroup analysis based on ABO blood type within Rh-negative mothers did not show any statistical significance in various outcomes (all P > 0.05). Infants with neonatal hyperbilirubinemia born to Rh-negative mothers experienced a quicker resolution of hyperbilirubinemia compared to those whose mothers did not receive intramuscular anti-D immunoglobulin [1.0 (1.0, 1.5) vs. 5.0 (1.5, 10.0), P = 0.002].ConclusionsThe Rh-negative blood type is linked to higher risks of neonatal hyperbilirubinemia, low birth weight, and increased postpartum hemorrhage, resulting in detrimental pregnancy outcomes. Administering anti-D immunoglobulin speeds up the resolution of neonatal hyperbilirubinemia. Thus, prudent and efficient use of anti-D immunoglobulin can mitigate adverse outcomes for both mothers and newborns.