bluuebunny/crossref_metadata_2025 huggingface dataset:
Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care
Authors: Fasugba Oyebola , Cheng Heilok , Dale Simeon , Coughlan Kelly , McInnes Elizabeth , Cadilhac Dominique A. , Cheung Ngai W. , Hill Kelvin , Page Kirsty , Menendez Estela Sanjuan , Neal Emily , Pollnow Vivien , Slark Julia , Gilder Eileen , Ranta Anna , Levi Christopher , Grimshaw Jeremy M. , Middleton Sandy
Published: January 2025

Background

Despite evidence supporting interventions that improve outcomes for patients with stroke, their implementation remains suboptimal. Facilitation can support implementation of research into clinical practice by helping people develop the strategies to implement change. However, variability in the amount (dose) and type of facilitation activities/facilitator roles that make up the facilitation strategies (content), may affect the effectiveness of facilitation. This review aimed to determine if, and how, facilitation dose is measured or reported and the type of facilitation strategies used to support adoption of stroke interventions in hospitals and subacute settings. We also assessed whether the included studies had reporting checklists or guidelines.

Methods

The scoping review was based on Arksey and O’Malley’s framework. Cochrane, CINAHL and MEDLINE databases were searched to identify randomised trials and quasi-experimental studies of stroke interventions published between January 2017 and July 2023. Accompanying publications (quantitative, qualitative, mixed methods or process evaluation papers) from eligible studies were also included. Narrative data synthesis was undertaken.

Results

Ten studies (23 papers) from 649 full-text papers met the inclusion criteria. Only two studies reported the total facilitation dose, measured as the frequency and duration of facilitation encounters. Authors of the remaining eight studies reported only the frequency and/or duration of varying facilitation activities but not the total dose. The facilitation activities included remote external facilitator support via ongoing telecommunication (phone calls, emails, teleconferences), continuous engagement from on-site internal facilitators, face-to-face workshops and/or education sessions from external or internal facilitators. Facilitator roles were broad: site-specific briefing, action planning and/or goal setting; identifying enablers and barriers to change; coaching, training, education or feedback; and network support. Only two studies included reporting checklists/guidelines to support researchers to describe interventions and implementation studies in sufficient detail to enable replication.

Conclusions

There is a paucity of information on the measurement of facilitation dose and reporting on specific details of facilitation activities in stroke implementation studies. Detailed reporting of dose and content is needed to improve the scientific basis of facilitation as strategic support to enable improvements to stroke care. Development of a standardised measurement approach for facilitation dose would inform future research and translation of findings.
Electroacupuncture alleviates paclitaxel-induced peripheral neuropathy by reducing CCL2-mediated macrophage infiltration in sensory ganglia and sciatic nerve
Authors: Li Yuanyuan , Xu Ruoyao , Chen Muyan , Zheng Kaige , Nie Huimin , Yin Chengyu , Liu Boyu , Tai Yan , Du Junying , Wang Jie , Fang Jianqiao , Liu Boyi
Published: January 2025

Background

Paclitaxel-induced peripheral neuropathy (PIPN) is prevalent among patients receiving paclitaxel chemotherapy, which results in sensory abnormality as well as neuropathic pain. Conventional medications lack effectiveness on PIPN. Clinical trials identified beneficial effects of acupuncture on PIPN among patients receiving chemotherapy. Here we explored the mechanisms underlying how acupuncture might alleviate PIPN.

Methods

A mouse model of PIPN was established by repeated paclitaxel application. Electroacupuncture (EA) was applied at ST36 and BL60 acupoints of model mice. Immunostaining, flow cytometry, behavioral assay, in vivo imaging were utilized for effects determination and mechanism exploration.

Results

EA ameliorated mechanical and cold pain hypersensitivities, reduced sensory neuron damage and improved loss in intra-epidermal nerve fibers (IENFs) in model mice. Macrophages infiltration were detected in DRG and sciatic nerve of model mice, which was reduced by EA. EA affected M1-like pro-inflammatory macrophage infiltration in DRG, whereas it did not affect M2-like macrophages. DRG neurons released chemoattractant CCL2 that recruited macrophages via CCR2 to DRG. EA reduced CCL2 overproduction by DRG neurons and reduced macrophage infiltration. Blocking CCR2 mimicked EA’s anti-allodynic effect, whereas exogenously applying recombinant CCL2 reversed the ameliorative effect of EA on macrophage infiltration and abolished EA’s anti-allodynia on model mice. EA ameliorated other signs of PIPN, including sensory neuron damage, sciatic nerve morphology impairment and IENFs loss. In mice inoculated with breast cancer cells, EA didn’t affect paclitaxel-induced antitumor effect.

Conclusions

These findings suggest EA alleviates PIPN by reducing CCL2/CCR2 mediated-pro-inflammatory macrophage infiltration into sensory ganglia as well as the sciatic nerve. Our study supports EA could be used as a potential non-pharmacological therapy for PIPN.
Management of female para-urethral cyst with dyspareunia: a case report
Authors: Deepak Manoj Kumar , Meyyappan R. M. , Kumar T. Senthil , Saravanan J.
Published: January 2025

Background

The diagnosis and management of female genital conditions (Rodriguez et al. in Clin Anat 34(1):103–107, 2020. https://doi.org/10.1002/ca.23654) are often challenging. The atypical presentations, combined with patient hesitancy to be subjected to an examination by a male urologist, are factors that limit a timely diagnosis. Para-urethral cysts (Pastor and Chmel in Int Urogynecol J 29(5):621–629, 2018. https://doi.org/10.1007/s00192-017-3527-9) are often incidentally detected by gynecologists during pelvic examination for other reasons. Patients rarely present with complaints of lower urinary tract symptoms and dyspareunia affecting sexual life. Diagnosis in most instances can be made by physical examination but often a detailed evaluation with ultrasonography, voiding cystourethrogram, computed tomography, or magnetic resonance imaging is needed. The definitive management of symptomatic para-urethral cysts is through surgical excision.

Objective

This report aims to reflect clinically upon a rare pathology of the female genital system.

Case presentation

We present the case of a 36-year-old, sexually active, Indian (Asian) woman with a 6-month history of progressively worsening lower urinary tract symptoms, consisting of dysuria, post-micturition dribble, increased urination frequency, and significant dyspareunia. Physical examination in the lithotomy position revealed a cystic lesion located in the midline slightly to the left of the anterior vaginal wall. Magnetic resonance imaging also revealed a T2/T1 hyperintense lesion located below the level of the pubic symphysis. The patient was posted for exploration under anesthesia and the cyst was excised completely. The histopathology findings were consistent with para-urethral gland cyst with ulceration and squamous metaplasia.

Conclusion

Any lower urinary tract symptoms in a woman needs thorough clinical examination. Association of para-urethral cyst with lower urinary tract symptoms and dyspareunia is rare, and if present, always warrants surgical excision.
Observational study: effect of varying transport durations and feed withdrawal on the physiological status and health of dairy calves
Authors: van Dijk Luca L. , Siegmann Susanne , Field Niamh L. , Sugrue Katie , van Reenen Cornelis G. , Bokkers Eddie A. M. , Conneely Muireann , Sayers Gearoid
Published: January 2025

Long-distance transport and associated fasting of unweaned calves have the potential to compromise the animals’ welfare. This observational study aimed to determine how transport and fasting durations impacted the physiology and health of 115 transported calves in three transport groups; IRE (n = 20, mean age 29.8d; short road transport (~ 29 h incl. resting time) and short feed deprivation (~ 11 h)), INT (n = 65, mean age 24.9d; long road/ferry transport (~ 79 h incl. resting times) and long feed deprivation (~ 28 h and 25 h)), and NLD (n = 30, mean age 17.7d; short road transport (~ 28 h incl. resting time) and long feed deprivation (> 18 h)). All calves travelled through an assembly centre. Each calf was blood sampled (arrival at destination farm, 1-week and 3-weeks post-arrival), health scored (arrival, 1, 3, 7, 8, 20d post-arrival) and weighed (farm/mart of origin [IRE and INT only], arrival, and 3-weeks post-arrival). (Generalised) linear mixed models were used to analyse differences in blood variables, weight, and health scores on arrival and during recovery (all other timepoints). Despite differing transport durations, both INT and NLD calves exhibited glucose, beta-hydroxy-butyrate, non-esterified-fatty-acids and sodium levels outside reference limits upon arrival, which were different from values observed in IRE calves (p < 0.05). Lactate and potassium were above reference range for INT calves on arrival, and higher than in IRE and NLD groups (p < 0.05). One- and three-weeks post arrival, most variables returned to within reference ranges, and differences between groups were minimal and not clearly associated with either transport duration or fasting during transport. Health scores did not differ between transport groups at arrival, and differences were minimal during the three-week recovery period. INT calves lost more weight during the journey than IRE calves (p < 0.01), while INT and NLD calves gained similar weight in the 3-weeks post-arrival, but less than IRE calves (both p < 0.01). Overall, changes in the physiological status of calves post transport appeared to relate more to the duration of feed deprivation than to the duration of transport, except for potassium and lactate (muscle fatigue), which were impacted more for INT calves. Most variables showed clear signs of recovery to within reference levels for all groups within three weeks. Minimizing the duration of feed deprivation during transport should be a key consideration for the dairy industry to reduce the impact of transport on calf welfare.
In vivo antidiabetic and ex-vivo antioxidant activities of dichloromethane extract of Xerophyta spekei
Authors: Ndile Michael Musila , Makori Wycliffe Arika , Kibiti Cromwell Mwiti , Ngugi Mathew Piero
Published: January 2025

Background

The medicinal plant Xerophyta spekei is used among Embu and Mbeere communities to manage diabetes mellitus. However, its efficacy has never been evaluated in vivo. The purpose of this study was to investigate its quantitative phytochemical and antidiabetic potential. Extraction was done using Dichloromethane (DCM). Quantitative phytochemical analysis was conducted using GC-MS. To evaluate antidiabetic activity, groups of mice which included normal control, diabetic control, positive control, and extract-administered groups (50, 100, 150, and 200 mg/kg body weight) were used. Alloxan monohydrate was used to induce diabetes. Blood glucose of the mice was determined hourly for the first six hours, and once after 12 and 24 h on the first day. Thereafter, the blood glucose in mice was determined once a week for three weeks. During the experimental period of three weeks, body weights were determined. After 21 days, lipid profiles, kidney and liver function tests as well as ex vivo antioxidant assays were carried out.

Results

The phytochemicals classes identified included flavonoids, phenolic compounds, phytosterols, terpenoids, fatty acids, tocopherols and alkaloids. Stigmasterol had the highest concentration (12.99 ± 2.56 mg/g). The extract decreased blood glucose dose-dependently, with 200 mg/kg bw dose resulting in the highest % mean change (40.10 ± 0.95). The extract gradually decreased blood glucose during 21 days of treatment. It attenuated loss of body weight and aberrant biochemical parameters including liver and renal function tests as well as lipid profiles in diabetic mice. Furthermore, it reduced levels of malondialdehyde and enhanced enzymatic antioxidant activities in diabetic mice.

Conclusions

The study confirms that DCM extract X. spekei contains phytochemicals with antioxidant and antidiabetic properties. The findings authenticate the folkloric use of X. spekei in managing diabetes mellitus. The medicinal plant also serves as a potential source for developing antidiabetic agents.
The impact of the cognitive-emotive dialectic on L2 development of English majors in the free teacher education program in China: a perezhivanie perspective
Authors: Li Wei
Published: January 2025

The field of second language acquisition (SLA) research had long been governed by a paradigm that prioritized cognition over emotion. Recently, increased attention has been drawn to the role of perezhivanie in language development as Vygotsky’s sociocultural theory (SCT) brought together emotion and cognition, thereby offering an analytical tool to explore the interplay of emotion and cognition in a holistic way. The present study seeks to explore and capture the notion of perezhivanie in three Chinese learners of L2 English in the free teacher education program and its link for their language development. Utilizing multiple sources of data, including questionnaires, narrative frames and interviews, this study conducts a thematic analysis of the cognitive and emotive elements in the data. The study reveals that the three participants shared the same purpose in learning English: to become English teachers in either primary or high schools. It also demonstrates that during the language learning process, predominantly negative emotions, while not inevitably hindering progress, can slow down the pace of language development, whereas positive emotions consistently foster language development.
A combination of low-temperature radiofrequency thermocoagulation and pulsed radiofrequency of the bilateral Gasserian ganglion for bilateral trigeminal neuralgia due to multiple sclerosis: a case report
Authors: Tamura Mihoko , Nakagawa Masayuki , Abe Yoichiro
Published: January 2025

Background

Bilateral trigeminal neuralgia secondary to multiple sclerosis is an extremely rare condition. When Gasserian ganglion block is performed, it is necessary to achieve reliable long-term analgesic effects while avoiding treatment-related complications.

Case presentation

A 49-year-old male with multiple sclerosis exhibited persistent dull pain and paroxysmal electric shock-like pain in his bilateral maxillary molars and mandible. He was diagnosed with trigeminal neuralgia due to multiple sclerosis. Due to severe side effects, it was difficult to achieve adequate pain control with medication alone. By performing low-temperature radiofrequency thermocoagulation and pulsed radiofrequency of the Gasserian ganglion while monitoring masseter muscle contraction, a satisfactory and rapid analgesic effect was obtained without masticatory atonia.

Conclusions

To the best of our knowledge, this is the first case of bilateral trigeminal neuralgia due to multiple sclerosis in which low-temperature radiofrequency thermocoagulation combined with pulsed radiofrequency was successfully performed for pain relief without masticatory atonia.
The internal conflicts and contemporary dilemmas of America’s national characteristics
Authors: Zhou Shaoqing
Published: January 2025

Since the twenty-first century, the political landscape of the United States has undergone dramatic changes. One of the key manifestations is the rise of evangelical Christian nationalism and its significant internal and external political consequences. While the causes behind the rise of evangelical Christian nationalism in the United States and its resulting political effects are multifaceted, fundamentally, these developments are closely linked to issues that have existed throughout the history of the American nation-building process, such as the ambiguity of national objectives and the conflict of value systems. The root cause lies in the instability and multifaceted nature of the American national characteristics. Since its founding, the U.S. has consistently wavered in its national characteristics, presenting three competing models of the modern American state: the empire of liberty, the liberal civic state, and the Anglo-Saxon Protestant nation. The positioning of these three national characteristics, which are seemingly contradictory yet often coexisting, has, on the one hand, shaped the unique character of the United States, while on the other hand, it has exposed the U.S. to periodic conflicts and crises. It is important to note that the rise of evangelical Christian nationalism in the twenty-first century, coupled with the increasing polarization of American politics, may disrupt the previously existing balance of conflicting yet coexisting national identities. With the continuous decline in the population of the white majority, this balance is likely to break down further, potentially resulting in prolonged internal strife within the U.S.
Nedl1 knockout ameliorates cognitive impairment and improves epilepsy threshold in pilocarpine-induced epileptic mice
Authors: Lu Qian , Liu Mengjia , Guo Shufang , Wang Yangyang , Zou Liping
Published: January 2025

Background

Epilepsy is a common neurological disorder. The homologous to E6-AP carboxy terminus (HECT) E3 ligase is associated with epilepsy. NEDD4-like ubiquitin protein ligase-1 (NEDL1) is a HECT E3 ligase that is highly expressed in the brain. This study aimed to investigate the involvement of NEDL1 in epilepsy and the potential effect of NEDL1 on the cognitive ability.

Methods

The pilocarpine-induced epileptic mouse model was used to assess cognitive functions in Barnes maze, the pathological changes, and the activation of astrocytes and microglia in wild-type (Nedl1
+/+) and Nedl1 knockout (Nedl1

−/−
) mice. The RNA-seq method was used to analyze differentially expressed genes and explore the brain pathophysiology after epilepsy development.

Results

Nedl1 knockout resulted in a protective effect against epilepsy. The Nedl1

−/−
mice showed improved spatial learning and memory, alleviation of pathological damage in the hippocampus induced by epilepsy, and reduced microglial activation in the hippocampus. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of differentially expressed genes also revealed several prominently enriched T-cell-related pathways.

Conclusions

Nedl1 knockout reduces seizures and alleviates neuroinflammation. The potential functional link between NEDL1 and epilepsy provides a new approach to the treatment and intervention of epilepsy.
Comparing prediction accuracy for 30-day readmission following primary total knee arthroplasty: the ACS-NSQIP risk calculator versus a novel artificial neural network model
Authors: Buddhiraju Anirudh , Shimizu Michelle Riyo , Chen Tony Lin-Wei , Seo Henry Hojoon , Bacevich Blake M. , Xiao Pengwei , Kwon Young-Min
Published: January 2025

Background

Unplanned readmission, a measure of surgical quality, occurs after 4.8% of primary total knee arthroplasties (TKA). Although the prediction of individualized readmission risk may inform appropriate preoperative interventions, current predictive models, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator (SRC), have limited utility. This study aims to compare the predictive accuracy of the SRC with a novel artificial neural network (ANN) algorithm for 30-day readmission after primary TKA, using the same set of clinical variables from a large national database.

Methods

Patients undergoing primary TKA between 2013 and 2020 were identified from the ACS-NSQIP database and randomly stratified into training and validation cohorts. The ANN was developed using data from the training cohort with fivefold cross-validation performed five times. ANN and SRC performance were subsequently evaluated in the distinct validation cohort, and predictive performance was compared on the basis of discrimination, calibration, accuracy, and clinical utility.

Results

The overall cohort consisted of 365,394 patients (trainingN = 362,559; validationN = 2835), with 11,392 (3.1%) readmitted within 30 days. While the ANN demonstrated good discrimination and calibration (area under the curve (AUC)ANN = 0.72, slope = 1.32, intercept = −0.09) in the validation cohort, the SRC demonstrated poor discrimination (AUCSRC = 0.55) and underestimated readmission risk (slope = −0.21, intercept = 0.04). Although both models possessed similar accuracy (Brier score: ANN = 0.03; SRC = 0.02), only the ANN demonstrated a higher net benefit than intervening in all or no patients on the decision curve analysis. The strongest predictors of readmission were body mass index (> 33.5 kg/m2), age (> 69 years), and male sex.

Conclusions

This study demonstrates the superior predictive ability and potential clinical utility of the ANN over the conventional SRC when constrained to the same variables. By identifying the most important predictors of readmission following TKA, our findings may assist in the development of novel clinical decision support tools, potentially improving preoperative counseling and postoperative monitoring practices in at-risk patients.
Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study
Authors: Soerarso Rarsari , Yonas Emir , Sirait Silfi Pauline , Hasanah Dian Yaniarti , Raharjo Sunu Budhi , Siswanto Bambang Budi , Cramer Maarten J. , van der Harst Pim , Oerlemans Marish I. F. J.
Published: January 2025

Background

Hyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin–angiotensin–aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fluid-overloaded heart failure patients are commonly treated with loop diuretics, acutely decompensated heart failure patients tend to be less responsive to conventional oral doses of a loop diuretic, while other different diuretics could work in different part of nephron circulation system. In this study, we aim to further examine the role of tolvaptan, a vasopressin receptor antagonist, in the treatment of hyponatremia secondary to acutely decompensated heart failure.

Results

A total of 71 patients with hyponatremia secondary to ADHF were included, and all patients were given tolvaptan. 37 patients were administered tolvaptan early (up until 5 th day of admission). 34 patients received tolvaptan after 5 th day of admission mean administration as 6.86 th day, and median administration was 5 th day. Analysis showed lower length of stay in patients receiving early administration of tolvaptan compared to late administration (8.86 ± 5.06 vs 18.5 ± 9.05 p0.001, respectively). Patients with early initiation of tolvaptan also achieved a larger net increase in sodium levels at discharge compared to admission (6.46 ± 6.69 vs 3.68 ± 4.70 p0.048, respectively).

Conclusions

Early administration of tolvaptan in treating hyponatremia in acutely decompensated heart failure patients is associated with a lower length of hospitalization and a higher increase in serum sodium of patients in hyponatremic ADHF patients.
Risk factors for the recurrence of atrial fibrillation after catheter ablation: a meta-analysis
Authors: Li Gonghao , Zhao Yanli , Peng Zhongxing , Zhao Yunfeng
Published: January 2025

Background

The rate at which atrial fibrillation (AF) patients experience a return of symptoms after catheter ablation is significant, and there are multiple risk factors involved. This research intends to perform a meta-analysis to explore the risk factors connected to the recurrence of AF in patients following catheter ablation.

Methods

The PubMed, Cochrane Library, WOS, Embase, SinoMed, CNKI, Wanfang, and VIP databases were explored for studies from January 1, 2000 to August 10, 2021, and research meeting the established inclusion requirements was chosen. Two authors separately gathered details regarding the study structure. The strength of the link between various risk factors and AF returning after CA was evaluated using odds ratios. All statistical evaluations were conducted with RevMan5.3 software.

Results

In total, 44 articles and 62,674 patients were included. The OR for AF recurrence in patients with diabetes was 2.04 compared with the reference group (95% CI 1.51–2.76, p < 0.00001); that of lower left ventricular ejection fraction was 1.38 (95% CI 1.25–1.52, p < 0.00001); that of female was 1.34 (95% CI 1.18–1.52, p < 0.00001); that of increased age was 1.03 (95% CI 1.02–1.04, p < 0.00001); that of persistent AF was 1.72 (95% CI 1.58–1.87, p < 0.00001); that of AF duration over 2 years was 1.17 (95% CI 1.08–1.26, p < 0.00001); that of increased left atrial diameter (LAD) was 1.12 (95% CI 1.08–1.17, p < 0.00001); that of larger left atrial volume index (LAVi) was 1.02 (95% CI 1.01–1.03, p < 0.00001); that of higher hs-CRP was 1.19 (95% CI 1.04–1.36, p = 0.04); that of early recurrence (ER) was 3.22 (95% CI 2.74–3.77, p < 0.00001); and that of long ablation duration was 1.00 (95% CI 0.98–1.02, p = 0.72). Heterogeneity and slight publication bias were observed for each factor.

Conclusions

Evidence indicates that diabetes, low left ventricular ejection fraction, being female, older age, longer duration of atrial fibrillation, elevated high-sensitivity C-reactive protein levels, large left atrial dimension, large left atrial volume index, persistent atrial fibrillation, and exercise rehabilitation are factors that increase the chances of getting atrial fibrillation again after catheter ablation. However, the length of the ablation procedure does not relate to the recurrence of AF.
Seismic evaluation and retrofit of reinforced concrete structures
Authors: Shendkar Mangeshkumar R. , Tantri Adithya , Rao Asha Udaya
Published: January 2025

The destructive earthquakes in the world clearly reveal the importance of the seismic behavior of the structures. The current study proposes and numerically investigates a systematic technique for the seismic assessment and retrofit of reinforced-concrete buildings according to both material strain limit approach and Quadrants assessment method. In this study numerical analysis were made for two three-dimensional building models, namely a single-storey 30 years old existing RC building in Koyna-Warna area (Zone-IV) in India, and an earthquake-resistant designed 4-story RC building. The structural analyses were performed for two 3-D models of the selected buildings are analysed. Nonlinear static adaptive pushover analysis method was used in Seismostruct software program for two different buildings. While one of the buildings is an existing building, the other is chosen as a new building. Structural characteristics and deficiencies of the investigated single-storey existing reinforced-concrete structure necessitated seismic evaluation. The deficiencies include pitched roofs, re-entrant corners, and structural distress such as structural element cracking and cover concrete spalling, among others. The single-story RC building is retrofitted with RC jacketing and fiber-reinforced polymer sheet wrapping, while the four-storey RC building does not need to be retrofitted based on the Quadrants assessment method. Also, the significant seismic design parameters are evaluated before and after the retrofit. The results show that the material strain limit technique when combined with the Quadrants assessment method makes a more efficient technique for seismic assessment and retrofit purpose. Also, the ultimate capacity and over strength factor of the retrofitted single-storey RC existing building are found 2.04 times and 1.82 times increased in X and Y direction as compared to the building without retrofit, because of the RC jacketing and FRP sheet wrapping.
The influence of adding B. subtilis bacteria on the mechanical and chemical properties of cement mortar
Authors: Ibrahim Osama Ahmed , Mohamed Ahmed Ibrahim Hassanin , Ibrahim Wael , Abd-Al Ftah Raghda Osama , Hamed Shimaa R. , Abd-Elnaby Sherif Fakhry M.
Published: January 2025

Background

This study investigated the effect of B. Subtilis bacteria on the properties of cement mortar. This was done by using soil samples from Sharkia, Egypt, to isolate 48 bacterial strains, after which they were cultured using the Johnson method and various media. Bacteria were then added to the cement mortar in amounts of 5% and 10% by weight to evaluate their effect on the mechanical and chemical properties of the modified mortar.

Results

The study examined the compressive and flexural strength of the modified mortar over time, as well as its microscopic properties and chemical composition after 28 days. The results indicated that bacterial additions of 5% and 10% increased the compressive strength of the mortar after 28 and 56 days compared to the control. A 5% bacteria concentration resulted in significant improvements in strength, showing the best concentration for increasing mortar strength. The addition of 5% bacteria significantly enhanced the early flexure strength, while the 10% showed superior long-term strength after 56 days. Scanning electron microscopy (SEM) revealed high CaCO3 deposits in the bacterial samples, indicating microbial-induced calcite precipitation that filled the small cracks and increased strength. Fourier-transform infrared spectroscopy (FTIR) confirmed the presence of hydroxyl, carbonate, and silicate groups, with bacterial samples having a higher carbonate content, indicating an increase in calcium carbonate formation and microstructure.

Conclusions

The ideal bacterial concentration was 5% as it improved the compressive and flexural strength while also promoting a more flexible microstructure. This study supports the employment of microorganisms in the production of more durable and environmentally friendly building materials, enhancing the sustainability of building practices.
Predictive accuracy of the Violence Risk Assessment Checklist for Youth in acute institutions: A prospective naturalistic multicenter study
Authors: Laake Anniken Lucia Willumsen , Roaldset John Olav , Husum Tonje Lossius , Bjørkly Stål Kapstø , Chudiakow Gustavsen Carina , Grenabo Sara Teresia , Lockertsen Øyvind
Published: January 2025

Background

Acute health and social services for children and adolescents often struggle with youth aggression and violence. Early identification of violence risk during institutional stay can help prevent violent incidents. As such, this study assessed the predictive accuracy of the Violence Risk Assessment Checklist for Youth (V-RISK-Y) aged 12–18 in two different juvenile settings providing 24-hour services for youth. Institutions were included from child and adolescent inpatient psychiatry and residential youth care under child protective services.

Methods

A prospective, naturalistic observational study design was employed. V-RISK-Y was administered for youth admitted to four acute inpatient psychiatric units and four acute residential youth care institutions. Incidents of violence and threats during the youth’s stay were registered by institutional staff. In total, 517 youth were included in analyses, 59 of whom were registered with at least one incident of violence or threats during their stay. Area under curve (AUC) and logistic regression analyses were used to assess predictive accuracy and validity of V-RISK-Y.

Results

For the overall sample, V-RISK-Y had good predictive accuracy, and the sum score of V-RISK-Y significantly predicted registered violent incidents. Stratified analyses indicated good predictive accuracy of V-RISK-Y for the inpatient units, but not for the residential youth care institutions.

Conclusions

Findings imply that V-RISK-Y is accurate in identifying violence risk for youth admitted to inpatient psychiatric units but has limited predictive accuracy in residential youth care institutions. Future research should explore approaches to correctly identify violence risk in residential care settings.
IGF-1 Assessment During Weekly Somatrogon Treatment in Pediatric Patients With GH Deficiency
Authors: Nayak Satyaprakash , Wajnrajch Michael P , Korth-Bradley Joan , Taylor Carrie Turich , Thomas Marc , Maniatis Aristides , Deal Cheri L , Rosenfeld Ron G , Cara José F , Ravva Patanjali
Published: January 2025

Context

In patients with GH deficiency (GHD) receiving GH treatment, IGF-1 concentrations are used by physicians to monitor treatment safety and efficacy and guide dosing decisions. Somatrogon is a long-acting GH approved as a once-weekly treatment for pediatric GHD. Somatrogon administration results in characteristic changes in the IGF-1 profile, with values measured at 96 hours postdose representing mean IGF-1 concentrations that best reflect overall somatrogon exposure.

Objective

To develop a simple method to enable physicians to predict mean IGF-1 concentrations following somatrogon dosing, based on a single IGF-1 measurement taken at any point during the 7-day dosing interval.

Methods

Data from phase 2 and phase 3 somatrogon studies were used to develop a 2-compartment pharmacokinetic model with delayed first-order absorption. An indirect-response pharmacokinetic/pharmacodynamic model was applied to the predicted somatrogon concentrations, and model simulations were used to predict IGF-1 and IGF-1 SD score (SDS) levels for participants in both studies.

Results

A total of 16,213 dosing records (from 42 and 109 participants in the phase 2 and 3 studies, respectively) were used for the simulations, generating predicted values for IGF-1 and IGF-1 SDS. Predicted values were scaled against the respective values at 96 hours (day 4). These values were used to create a table showing the adjustments required to predict mean IGF-1 and IGF-1 SDS values depending on time after dose.

Conclusion

We developed a simple method enabling physicians to predict mean weekly IGF-1 values using IGF-1 values measured at any point in the dosing interval.
Real-World Evaluation of i-gel Introduction on Intraoperative Airway-Related Safety Events: A Retrospective Cohort Study From a New England Hospital Network
Authors: Obeidat Salameh S. , Suleiman Aiman , Ahrens Elena , Needham Matthew J. , Stewart Catriona , Khany Mitra , Tartler Tim M. , Zucco Liana , Pandit Jaideep. J. , Schaefer Maximilian S. , Ramachandran Satya Krishna
Published: January 2025

BACKGROUND:

Several health care networks have fully adopted second-generation supraglottic airway (SGA) i-gel. Real-world evidence of enhanced patient safety after such practice change is lacking. We hypothesized that the implementation of i-gel compared to the previous LMA®-Unique™ would be associated with a lower risk of airway-related safety events.

METHODS:

Adult patients undergoing general anesthesia with LMA-Unique or i-gel between January 2013 and June 2020 at an academic health care network were included. We assessed the influence of i-gel implementation on the trends of intraoperative airway-related safety events, a composite outcome of respiratory disturbances including intraoperative desaturation (<90%), hypo- or hypercapnia (<25 or >50 mm Hg), high driving pressures (>30 cmH2O), low tidal volumes (<4 mL/kg), multiple attempts of SGA placement, or emergency replacement with a tracheal tube, using adjusted ordinary least-squares regression interrupted time series analysis.

RESULTS:

A total of 21,417 patients were included, and 5193 experienced airway-related safety events (24.2%). After the wider uptake of i-gel in January 2018, the reduction in the monthly trend of airway-related safety events was magnified to −0.3% per month (95% confidence interval [CI], −0.1% to −0.4%, P < .001), compared to the LMA-Unique period (−0.2% per month, 95% CI, −0.1% to −0.3%; P = .002).

CONCLUSIONS:

We found a significant decline in the monthly trend of airway-related safety events after the full implementation of i-gel in our health care network. This study provides real-world patient safety and clinical effectiveness information to clinicians and decision-makers.
Counterregulatory roles of GLI2 and GLI3 in osteogenic differentiation via Gli1 expression
Authors: Takahashi Yuto , Ishida Yamato , Yoshida Saishu , Shin Hye-Won , Katoh Yohei , Nakayama Kazuhisa
Published: January 2025

The GLI1, GLI2 and GLI3 transcription factors mediate Hedgehog (Hh) signaling, which is crucial for bone development. During intramembranous ossification, mesenchymal stem cells (MSCs) are directly differentiated into osteoblasts. Under basal and Hh pathway-stimulated conditions, primary cilia play essential roles in proteolytic processing of GLI3 to its repressor form (GLI3R) and in activation of GLI2. Although previous studies in mice have suggested that Gli1 expression depends on GLI2 and GLI3, coordinated roles of GLI1, GLI2 and GLI3 in osteogenic differentiation are not fully understood at the cellular level. From the MSC line C3H10T1/2, we established Gli2-knockout (KO) and Gli3-KO cells, as well as constitutively GLI3R-producing (cGLI3R) cells, and expressed GLI1, GLI2 and GLI3 constructs in these cell lines. The results demonstrate at the cellular level that GLI2 and GLI3R counterregulate osteogenic differentiation via activation and repression of Gli1 expression, respectively; GLI3R, which results from GLI3 processing requiring protein kinase A-mediated phosphorylation, downregulates expression of Gli2 as well as Gli1; and GLI1 upregulates expression of Gli1 itself and Gli2, constituting a GLI1–GLI2 positive feedback loop.
Republican debates in Restoration drama
Authors: Γαβαλά Δικαία
Published: January 2025

Αυτή η διατριβή υποστηρίζει ότι οι τραγωδίες της Παλινόρθωσης (1660-1688) χρησιμοποίησαν τον ρεπουμπλικανικό λόγο της δεκαετίας του 1650 καθώς και τα ρεπουμπλικανικά θέματα της κλασικής αρχαιότητας για να αντιπαραθέσουν επι σκηνής τις ρεπουμπλικανικές ιδέες της πρώιμης μοντέρνας Αγγλίας. Οι επεξεργασίες της έννοιας του πολίτη στη σκηνή από τη δεκαετία του 1660 έως τη δεκαετία του 1690 διατήρησαν το πνεύμα του ρεπουμπλικανισμού παρά τη λογοκρισία στον εντύπο λόγο και τις πιθανές διώξεις για τη δημόσια έκφραση των πρωτο-δημοκρατικών ιδεών. Το αφήγημα ότι οι ρεπουμπλικανικές αξίες αναδύονται στον πολιτικό λόγο με τη μορφή του Αγγλικού φιλελευθερισμού μόνο μετά την εποχή της Glorious Revolution (1688-1689) είναι εδώ, σε αυτή τη διατριβή, αλλαγμένο σε μια άλλη ιστορία, σύμφωνα με την οποία αυτές οι αξίες παρέμειναν στην επιφάνεια και δοκιμάστηκαν στο δημόσιο έδαφος του θεάτρου καθ'όλη τη διάρκεια της διακυβέρνησης του παλινορθωμένου Βασιλιά Charles II. Για να το αποδείξει αυτό, η διατριβή επιχειρεί να συλλάβει όσο το δυνατόν περισσότερες από τις «εξισώσεις» νοήματος που έφερε η ρεπουμπλικανική ιδεολογία εκείνη την εποχή, διαβάζοντας και χρησιμοποιώντας την έρευνα μελετητών από τους κλάδους της ιστορίας, της λογοτεχνίας, της πολιτικής θεωρίας, και των σπουδών φύλου. Εξετάζοντας αυτά τα νοήματα μπορούμε να καθορίσουμε αν τα έργα τα μετέφεραν τις ρεπουμπλικανικές ιδέες– ακόμη και ασυνείδητα – και μπορούμε να καταλάβουμε πώς οι πρωτοδημοκρατικές ιδέες έγιναν αντιληπτές, διαδόθηκαν και δραματοποιήθηκαν. Είναι πιθανό τα ζητήματα της ελευθερίας και της νομιμότητας της εξουσίας με τα οποία ασχολείται τόσο πολύ η δραματουργία της περιόδου του Exclusion Crisis (1679-1681) να μην ανήκαν ούτε στα «στρατόπεδα» των Τόρις ούτε των Ουίγων, αλλά να προϋπήρχαν, να ενέπνευαν ακροατήρια και πολιτικούς παράγοντες και να μεταφράζονταν στην τελετουργική δημόσια ρητορική που συναντάται σε θεατρικά έργα και, πιο συγκεκριμένα, σε τραγωδίες. Αυτός ο ισχυρισμός, με τη σειρά του, θα μας προσφέρει μια νέα κατανόηση της σχέσης των πολιτών της πρώιμης μοντέρνας περιόδου με τις πολιτικές ιδέες ως πολύπλευρη και ως άρρηκτα συνδεδεμένη με τα καταλυτικά πολιτικά γεγονότα του Commonwealth period (1649-1660) και της Παλινόρθωσης. Συμπερασματικά, το θέατρο ήταν ένας κύριος χώρος για την επιβίωση της ιδεολογίας του ρεπουμπλικανισμού μετά την Παλινόρθωση.
Injury incidence and associated factors among soccer players during the 2021 African Cup of Nations competition
Authors: Chaabeni Amr , Kalai Amine , Ben Saad Helmi , Zerguini Yacine , Tabben Montassar , Chamari Karim , Jellad Anis
Published: January 2025

Background Understanding the epidemiology of soccer injuries during specific international competitions is essential for customizing preventive strategies. Several studies have reported outcomes related to international competitions but, to the best of our knowledge, there has been no investigation into the injury patterns during any African Cup of Nations (AFCON) tournaments. This study aimed to analyse the incidence and the characteristics of soccer injuries during the 2021 African Cup of Nations (AFCON), which took place in Cameroon from January 9 to February 6, 2022. Methods A video-based analysis covering 52 matches was conducted by two independent consultant physicians. They reviewed injury replays to determine incidence and characteristics ( i.e. ; mechanisms, body location, match moment, player substitution, absence in the next match, and referee decisions). Results The tournament involved 519 male players, comprising 275 African (ALP) and 244 Non-African (NALP) league players. Eighty-seven injuries occurred, with incidences of 1.7 and 48.8 injuries per match and per 1000 match hours, respectively. Injury incidence rose with competition stages, particularly contact mechanism injuries. Non-contact injuries (23/87) predominantly occurred after 60 minutes of play (19/23), with the thigh being the most frequently affected body part (18/87). Older age and playing time significantly correlated with injury occurrence (p=0.032 and p<0.001, respectively). NALP midfielders and forwards were notably injured by contact mechanisms (36/45) in the attacking zone. Although non-contact mechanisms were more common in ALP than NALP (13/42 vs. 9/45), the difference lacked statistical significance (p=0.240), with a higher rate of muscle injuries (13/42 vs. 10/45, p=0.001). Conclusion Muscle injuries prevailed among professional soccer players in the 2021 AFCON, with older age and playing time identified as key associated factors. Muscle injuries were more prevalent in ALP compared to NALP.
Novel Method for Routine Ultrasound-Guided Serum Collection for Biomarker Analysis Around the Knee Joint
Authors: Kluzek Stefan , O'Sullivan Oliver
Published: January 2025

Background Biomarkers are essential tools in modern medicine, allowing stratification and monitoring of clinical care and treatment response. While systemic blood biomarkers, typically collected from the antecubital vein (AV), are widely used, their sensitivity for joint-specific pathologies such as osteoarthritis (OA) may be limited due to systemic dilution. At present, no serum biomarker reliably reflects the microenvironment of an affected joint in clinical practice. Although synovial fluid (SF) assessment can provide insights into localised pathology and are clinically used for diagnosis in crystal arthropathies and joint infections, their collection is invasive, painful, and carries risks, including infection, making repeated sampling impractical, limiting utility for monitoring treatment responses. This study introduces a novel ultrasound-guided venous sampling technique targeting the saphenous vein (SV) proximal to the knee joint as a less invasive alternative to SF aspiration, hypothesising that it may better reflect the joint-specific microenvironment. Methods A standardised gel model was used to train medically qualified researchers in ultrasound-guided venepuncture of vescles around 2-15 mm in diameter. Subsequently, 32 participants consented to blood sampling from the SV above the knee, with a proximally applied tourniquet to dilate vein diameter for easier venepuncture collection. Results The technique achieved serum collection in over 80% of consented individuals with minimal adverse effects (including n=2 minor bruising and n=1 transient nerve irritation). Key procedural insights included optimal site selection, appropriate pressure application, and effective tourniquet use. Discussion This method demonstrates feasibility, acceptability, and the potential for more localised sample collection, advancing biomarker research. Further validation, including paired SF comparisons, is required to confirm diagnostic utility and develop therapeutic strategies for joint-specific conditions.
Critical care services in Bagmati province of Nepal: A cross sectional survey
Authors: Aryal Diptesh , Luitel Subekshya , Paudel Sushila , Shakya Roshni , Pandey Janaki , Amatya Isha , Acharya Prashant , Pant Suman , Paneru Hem Raj , Beane Abi , Haniffa Rashan , Gyanwali Pradip
Published: January 2025

Background This study aimed to assess the current status of critical care services in 13 districts of Bagmati Province in Nepal, with a focus on access, infrastructure, human resources, and intensive care unit (ICU) services. Methods A cross-sectional survey was conducted among healthcare workers employed in 87 hospitals having medical/surgical ICUs across Bagmati Province. Data were collected through structured questionnaires administered via face-to-face and telephone survey. Descriptive analysis was used for data analysis, involving frequencies and percentages. Results From 87 hospitals, a total of 123 ICUs were identified in the province, providing 1167 beds and 615 functioning ventilators. The average ICU bed availability per 100,000 population was 19, ranging from 3.6 in Makwanpur to 33.9 in Kathmandu. Out of 13 districts, 95% of beds were concentrated in just four districts, while six had no ICU facilities. Of the available facilities, 69.9% were owned by private entities. One-to-one nurse-to-ventilated bed ratio was maintained by 63.4% of ICUs during daytime, and 62.6% at nighttime. Furthermore, 74.8% of ICUs had consultants trained in critical care medicine. While essential equipment availability was higher in Bagmati province, gaps existed in the availability of oxygen plants and isolation rooms. Similarly, many ICUs offered continuous medical education and cardiopulmonary resuscitation (CPR) training, but improvements were necessary in clinical audits, antibiotic stewardship programs, and research engagement. Conclusions Disparities in critical care resources were evident across districts in Bagmati Province, highlighting the need for a balanced and decentralized approach to ensure equitable access to care. Although there were disparities, numerous ICUs were effectively carrying out multiple critical care procedures. This study suggests conducting a nationwide mapping of ICU resources, prioritizing infrastructure development, optimizing resource allocation, and establishing national protocols.