bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of clinical outcome in post-thrombolysis among sample of Egyptian patients with acute ischemic stroke
Authors: Hussein AbdelRahman Mohamed , Bayoumy Iman Mohamed , Abdulghani Khaled Ossama , Eissa Mona Ali , Ahmed Ehab Mostafa , Abou Elmaaty Ali Ahmed
Published: January 2025

Background

Stroke stands as a major cause of morbidity and mortality worldwide. The recommended treatment for eligible patients within the initial 4.5-h window is intravenous recombinant tissue plasminogen activator (IV rt-PA). This study explored the factors influencing functional outcome following IV rt-PA treatment in a group of Egyptian patients with acute ischemic stroke (AIS). We included sixty patients diagnosed with AIS who met the criteria for IV rt-PA therapy. Data were collected and statistically analyzed, we established correlations with functional outcomes as measured by the modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS) 3-month post-treatment.

Results

Of the 60 patients, 40 (66.67%) exhibited a favorable functional outcome, while 20 (33.33%) experienced a less favorable outcome. Poor functional outcome was associated with atrial fibrillation [p value < 0.001, odds ratio (OR) 6.28], hypertension (p value = 0.001, OR 3.65), diabetes mellitus (p value 0.009, OR 2.805), and a higher NIHSS at admission (p value = 0.003, OR 8.03).

Conclusions

Certain factors may affect functional outcome in stroke patients treated with rt-PA therapy. There are strong associations between hypertension, diabetes, atrial fibrillation, post-rt-PA intracerebral hemorrhage (both asymptomatic and symptomatic), specific stroke subtypes, and less favorable functional outcome 3 months after rt-PA administration, as measured by the mRS.
A machine learning approach for wind turbine power forecasting for maintenance planning
Authors: Dhungana Hariom
Published: January 2025

Integrating power forecasting with wind turbine maintenance planning enables an innovative, data-driven approach that maximizes energy output by predicting periods low wind production and aligning them with maintenance schedules, improving operational efficiency. Recently, many countries have met renewable energy targets, primarily using wind and solar, to promote sustainable growth and reduce emissions. Forecasting wind turbine power production is crucial for maintaining a stable and reliable power grid. As renewable energy integration increases, precise electricity demand forecasting becomes essential at every power system level. This study presents and compares nine machine learning (ML) methods for forecasting, Interpretable ML, Explainable ML, and Blackbox model. The interpretable ML includes Linear Regression (LR), K-Nearest Neighbors (KNN), eXtreme Gradient Boosting (XGBoost), Random Forest (RF); the explainable ML consists of graphical Neural network (GNN); and the blackbox model includes Multi-layer Perceptron (MLP), Recurrent Neural Network (RNN), Gated Recurrent Unit (GRU), and Long Short-Term Memory (LSTM). These methods are applied to the EDP datasets using three causal variable types: including temporal information, metrological information, and power curtailment information. Computational results show that the GNN-based forecasting model outperforms other benchmark methods regarding power forecasting accuracy. However, when considering computational resources such as memory and processing time, the XGBoost model provides optimal results, offering faster processing and reduced memory usage. Furthermore, we present forecasting results for various time windows and horizons, ranging from 10 minutes to a day.
Comparison of mucosal microbiota populations across the gastrointestinal tract of healthy dogs
Authors: Lin Ching-Yen , Cross Tzu-Wen L. , Swanson Kelly S.
Published: January 2025

The gastrointestinal (GI) microbiota plays a crucial role in host health and disease in dogs, but the knowledge regarding the mucosal associated microbiota along the GI tract is limited in dogs. Therefore, the objective of this study was to characterize the phylogeny and predicted functional capacity of microbiota residing on the gut mucosa across five GI regions of healthy young adult and geriatric dogs fed different diets. Twelve weanling (8 weeks old) and 12 senior (11.1 years old) beagles were randomly assigned to be fed an animal product-based diet or plant product-based diet for 12 months. At that time, mucosal samples from the stomach, duodenum, jejunum, ileum, and mid-colon were collected. DNA was extracted and the hypervariable region 4 (V4) of the 16S rRNA gene was amplified to assess microbiota using Illumina MiSeq sequencing. Data were analyzed using QIIME 1.9.1. and Statistical Analyses of Metagenomic Profiles software 2.1.3. Gene predictions were made using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States. Taxonomic assessment revealed a greater (p < 0.05) species richness in the mid-colon compared with other segments. Principal coordinates analysis of weighted UniFrac distances demonstrated distinct clusters of stomach, ileum, and mid-colon samples, indicating the presence of unique microbial communities in these regions. The predominant phyla in all five segments were Proteobacteria, Firmicutes, Bacteroidetes, Actinobacteria and Fusobacteria, but their relative abundances varied between segments. Proteobacteria had a decreasing relative abundance from the stomach to mid-colon (q < 0.05). The ileum had the highest while the stomach had the lowest relative abundance of Firmicutes (q < 0.05). The duodenum had a higher abundance of Bacteroidetes than the stomach and ileum (q < 0.05). The mid-colon had a higher Fusobacteria relative abundance than other regions (q < 0.05). The predicted functional capacities of the microbiota in the stomach differed from those in the other segments. Age and diet of dog did not significantly impact the taxonomy or predicted functional capacities of the mucosal microbiota. In conclusion, our findings demonstrate distinct characteristics of the mucosal microbiota across various segments of canine GI tract.
Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome
Authors: Zidan Ahmed M. , Nafady Hytham Mohamed , Alkenawy Mohamed Abdelrahman , Ahmad Mohammad Abol Wafa , Eldeeb Ahmed Mohamed , Mohamed Mohamed Talaat , Fouda Mahmoud Mohamed Aboumandour , Soltan Hasan A. , Shabaan Nehal Elsayed , Mehany Ahmed B. M. , Ghoraba Yasser Fouad
Published: January 2025

Background

Most cases of entrapment neuropathy are due to median nerve compression, which manifests most commonly as carpal tunnel syndrome (CTS). There are several nonsurgical treatment options available for mild-to-moderate circumstances.

Aim

To assess the effect of ultrasound-guided percutaneous flexor retinaculum fenestration on the outcome of hydrostatic dissection of the median nerve in cases with CTS.

Methods

This randomized clinical research included a total of 54 individuals with CTS separated into two groups; group (A) included patients with hydrostatic dissection with adjuvant fenestration of transverse carpal ligament (n = 27), while group (B) involved patients with hydrostatic dissection alone (n = 27). Pain and disability through the visual analog scale (VAS), symptom severity (SS) score, modified Boston Carpal Tunnel Questionnaire (BCTQ), and functional disability (FD) score before injection and 3 months post-injection were assessed. Distal motor latency (DML) and sensory conduction velocity (SCV) were measured at baseline and 3 months after the procedure.

Results

SS and FD scores, were comparable in both groups before the procedure, while after three months of the procedure, the mean of SS and FD scores was significantly higher in group A (24.18 ± 3.62 and 17.52 ± 2.15, respectively) than in group B (16.55 ± 3.17and 11.39 ± 1.81, respectively) (p < 0.001). Also, there was a significant distinction between before and after the procedure in both groups (p < 0.001). Regarding electro physiologic outcomes, DML and SCV were comparable in both groups before the procedure, while after three months of the procedure, the mean of DML and SCV scores was significantly higher in group A (4.41 ± 0.41 and 39.27 ± 2.35, correspondingly) than group B (4.23 ± 0.37and 42.55 ± 2.75, respectively) (p = 0.011 and < 0.001, correspondingly). Also, there was significant variance between before & after the procedure in both groups (p = 0.010 and < 0.001, correspondingly).

Conclusion

Ultrasound-guided hydro-dissection and fenestration of the transvers carpal ligament is a simple, non-invasive treatment for CTS that has the potential to reduce symptoms for a long time and delay or perhaps prevent the need for open release.
Leveraging computational approaches in identifying novel HER-2 + breast cancer potential therapeutics: integrating virtual screening and molecular dynamics simulation
Authors: Bolaji Olawale Quadri , Adelusi Temitope Isaac , Ojo Taiwo Ooreoluwa , Boyenle Ibrahim Damilare , Oyedele Abdul-Quddus Kehinde , Ogunjobi Taiwo Temitope , Oyaronbi Adegboye Oyewole , Ayoola Sukurat Oluwatoyin , Ogunlana Abdeen Tunde
Published: January 2025

Background

Breast cancer, particularly the human epidermal growth factor receptor 2 positive subtype, presents a significant global health challenge due to its high prevalence and mortality rates. This study delves into the molecular intricacies of HER-2 positive breast cancer, with an emphasis on the role of the HER-2 oncoprotein and its associated signaling pathways in cell growth, differentiation, and survival. In our pursuit of overcoming the limitations of one of the leading therapeutic options, Lapatinib, such as its inhibition of hERG, we embarked on a comprehensive research journey.

Result

This study involved dual-stage molecular docking, initially with a library of PubChem-curated compounds, revealing Compound 90196902 as the best of the set. This was followed by the docking of DataWarrior-generated structural analogs of Compound 90196902, using various docking protocols such as standard precision, extra precision, and induced fit docking. Through this rigorous screening protocol, three promising drug candidates (Compound_56, Compound_81, and Compound_339) were identified, showing excellent interaction with the target. Additionally, binding free energy calculations, ADME and toxicity profiling, and molecular dynamics simulations presented these compounds as lead-like.

Conclusion

Compound_56 showed the most promising pharmacodynamic and pharmacokinetic properties, coupled with substantial structural stability. While immensely promising, further optimization and pre-clinical investigation are imperative to validate this compound as a viable alternative to existing therapies for HER-2 positive breast cancer.

Graphical abstract
Antibacterial efficacy and antibiotic sensitivity augmentation potential of selected traditional medicinal plant extracts against Vibrio cholerae O1 E1 Tor Ogawa
Authors: Chavan Pruthviraj , Naik Kamakshi , Ghosal Soumika , Charla Rajitha , Patil Rajalakshmi , Guruputranavar Jyoti N. , Patil Vishal S. , Harish Darasaguppe R. , Roy Subarna
Published: January 2025

Background

The leaves of Psidium guajava (PGAE), fruit peel of Punica granatum (PGRPE), and the bark of Careya arborea (CAE) are widely used traditional medicinal plants for treating diarrheal diseases across India. Our previous studies showed that the hydroalcoholic extracts of these plant parts inhibit the cholera toxin activity. Hence, this study is framed to investigate these extracts for anti-Vibrio cholerae activity and their ability to augment antibiotic sensitivity through a combination of in vitro and computational methods. The hydroalcoholic extracts of PGAE, PGRPE, and CAE were tested for antibacterial activity against Vibrio cholerae by minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and virulence gene expression studies by reverse transcriptase-polymerase chain reaction (RT-PCR). Further, antibacterial activity in combination with selected antibiotics was performed by disk diffusion method. The possible mode of action of these extracts was predicted using docking and molecular dynamics studies on selected virulence factors of Vibrio cholerae.

Results

All three plant extracts depicted antibacterial activity at different degrees. CAE showed MIC and MBC at 1.25 mg/mL and 10 mg/mL, PGAE at 1.25 mg/mL and 5 mg/mL; and PGRPE at 2.5 mg/mL and 10 mg/mL, respectively. RT-PCR confirmed these extracts significantly inhibited the expression of virulence genes like Flagellin A (FlaA), Vibrio polysaccharide synthesis transcription regulator (VpsT), and Lux Operon (LuxO). Further, the computational studies predicted that phytocompounds of these plants pose stable interaction with AphA, AphB, and ToxT playing the key role in inhibiting the expression of virulence factors.

Conclusion

The results emphasize that these plant extracts potentially inhibit the growth of Vibrio cholerae, decrease the expression of virulence gene, and enhance the sensitivity of certain conventional antibiotics.
Molecular mechanisms and enhanced functions of Hibiscus sabdariffa L—nanoliposomes as an emerging therapeutic strategy in UV and galactosamine skin aging-induced model
Authors: Nassar Eptehal , Rady Mai , Handousa Heba
Published: January 2025

Background

Skin aging is a multifactorial disorder that occurs due to extrinsic and intrinsic factors, where a decrease in natural antioxidant defenses and an imbalance between molecular biomarkers occur. The current study aims to develop nanoliposomes for the dermal delivery of Hs and to investigate their effects on skin biomarkers and skin aging.

Methods

Chemical profiling performed via high-performance liquid chromatography (HPLC)/ESI‒PDA‒MS revealed enrichment in phenolic metabolite contents. Hs-nanolopeosomes were characterized for their mean size, encapsulation efficiency of Hs and ability to penetrate the skin via confocal microscopy. An aged rat model generated via UV and galactosamine injection was evaluated for reduced glutathione (GSH) and malondialdehyde (MDA) levels, in addition to the levels of collagenase and elastase enzymes in the different study groups, which included a healthy control group, an aged group, a prophylactic group, an aged group treated with Hs-nanoliposomes, and a green tea extract-treated group (positive control). Moreover, the Bcl-2/Bax proteins were determined via ELISA, and MMP-1, MMP-2, MMP-9, and TIMP-1 expression was determined via RT‒qPCR in the study groups.

Results

Hs-nanoliposomes (~ 400 nm) proved deep skin localization in confocal images. Compared with the aged group and the green tea extract-treated group, the Hs-liposome-treated group presented elevated reduced glutathione and decreased malondialdehyde levels and inhibited collagenase and elastase enzymes. This treatment also decreased the Bcl-2/Bax ratio and downregulated the expression of MMP-1, MMP-2, and MMP-9. However, upregulation of TIMP-1 expression was detected. The outcomes were confirmed by histopathological assays, which revealed reduced saging and collagen damage in the Hs-nanolipid-treated group.

Conclusion

The present study proposed a potential antiaging nanobased formulation that can deliver Hs extract deep in the dermis layer to prevent the oxidative stress that leads to aging.
Synopsis of colorectal cancer: prevalence, symptoms, screening, staging, risk factors, and treatment
Authors: Balata Gehan F. , Azzam Hany N.
Published: January 2025

Colorectal cancer (CRC) impacts the colon and rectum, ranking as the fourth deadliest cancer worldwide, accounting for 10% of cancer cases and 9.4% of cancer-related deaths. CRC is frequently without symptoms until it reaches its later stages. Screening programs, including colonoscopies and tests on stool samples, have enhanced the chances of survival for people younger than fifty. The TNM staging system, which evaluates tumor size, lymph node involvement, and metastasis, is commonly utilized. Factors that increase the risk of developing colorectal cancer include exposure to chemicals, chronic inflammatory bowel disease, obesity, smoking, family history, genetic mutations, and specific diets. Diets high in fat, consumption of too much iron, sugary beverages, and meals with high sugar content can elevate the risk of CRC, whereas incorporating whole grains, fiber, calcium, vitamin D, dairy products, vegetables, fruits, and green tea into your diet can lower the risk. Management differs depending on stage: stages 0 and I are treated with endoscopy and local excision, whereas stages II, III, and IV necessitate systemic treatments like immunotherapy, targeted therapy, and chemotherapy.
Simultaneous gastroepiploic artery to right coronary artery bypass and trans-catheter aortic valve implantation: case series
Authors: Honda Kentaro , Wada Teruaki , Kunimoto Hideki , Nishimura Yoshiharu
Published: January 2025

Patients with coronary artery disease undergoing trans-catheter aortic valve implantation (TAVI) often receive TAVI alone. However, in cases of severe coronary lesions or anticipated difficulty in coronary access post-TAVI, percutaneous coronary intervention or coronary artery bypass grafting may be necessary. We performed simultaneous gastroepiploic artery to posterior descending artery bypass and TAVI in two patients with severe calcification of the right coronary artery ostium which is unsuitable for percutaneous intervention. The procedure was conducted through an upper median laparotomy, avoiding a full sternotomy. Patients were discharged on postoperative days 6 and 9, respectively. By combining minimally invasive techniques and avoiding median sternotomy, we achieved favorable outcomes without compromising the less invasive nature of TAVI. This approach demonstrates the potential for tailored, hybrid procedures in high-risk patients with concomitant aortic valve disease and complex coronary lesions.
Hierarchical transdimensional Bayesian inversion of 2D Magnetotelluric data
Authors: Bajpai Amit , Singh Arun , Varma Suraj
Published: January 2025

Uncertainty analysis in the estimated model parameters is an integral part of inverse solution. The traditional deterministic inversion algorithms provide a single inverse model with limited appraisal of the uncertainty in the model parameters. Transdimensional Bayesian inversion provides a solution to address this issue. We present a hierarchical transdimensional Bayesian inversion scheme for interpreting 2D magnetotelluric data. The subsurface resistivity model is represented using Voronoi cells, and the noise level in the data is treated as an unknown parameter and is estimated during the inversion process. The flexible parameterization and noise estimation make the scheme completely data-driven. To increase the efficiency of forward computation, a multi-resolution scheme is implemented. In this scheme, the grid is formed by stacking grids with different horizontal resolutions. The use of the multi-resolution approach enhances the efficiency of forward computations without any significant loss in the accuracy of the solutions. The transdimensional inversion was applied to two synthetic datasets to examine the resolution of complex model structures. Additionally, the algorithm was applied to the COPROD2 dataset. The results demonstrate that the transdimensional inversion effectively images complex subsurface structures and accounts for the unknown noise level in the data. The generated model ensemble provides valuable insights into the subsurface resistivity model through various statistical measures, with direct uncertainty quantification via standard deviation.
Refining Stereotaxic Deep Brain Stimulation Surgery Procedures for Parkinson Disease in Pursuit of Zero Pneumocephalus: 2-Dimensional Operative Video
Authors: Wang Ran , Liu Kaiyu , Yu Feng , Guo Liemei , Ma Junfeng , Chai Yi , Zhang Xiaohua , Zhou Hongyu
Published: January 2025

BACKGROUND AND OBJECTIVES:

Deep brain stimulation (DBS) is a well-established intervention for alleviating both motor and nonmotor symptoms of Parkinson disease. However, a common complication of stereotaxic DBS surgery is pneumocephalus, which can compromise electrode accuracy, complicate postoperative assessments, and negatively affect the long-term outcomes of DBS surgery. This report proposes a comprehensive and robust set of recommendations aimed at optimizing DBS surgical protocols to achieve zero pneumocephalus outcomes.

METHODS:

A retrospective analysis was undertaken on 138 patients with Parkinson disease who underwent simultaneous bilateral stereotaxic DBS targeting either the subthalamic nucleus or the globus pallidus internus at a single institution. The study compared the pneumocephalus volume and postsurgical electrode tip displacement between the original surgical technique and a refined procedure that incorporated modified supine position, dural puncture, and liquid sealing.

RESULTS:

With the implementation of the refined procedure, the volume of pneumocephalus significantly decreased from 14.40 ± 17.00 to 0.32 ± 1.02 mL, with 92.9% of patients showing no visible pneumocephalus or intracranial air less than 1 mL. In addition, the refined procedure was associated with less electrode tip displacement in the postoperative stage.

CONCLUSION:

The refined procedure effectively minimized the average pneumocephalus volume to approximately 0, and bilateral DBS electrodes exhibited enhanced stability during the postoperative stage.
Use of Supplemental Rod Constructs in Adult Spinal Deformity Surgery: A Review
Authors: Sardi Juan P. , Berlin Connor , Buell Thomas J. , Yen Chun-Po , Okonkwo David O. , Hamilton D. Kojo , Smith Justin S.
Published: January 2025

Adult spinal deformity comprises a heterogeneous group of disorders that primarily affects older patients and can have a significant negative affect on health-related quality of life. Operative treatment for adult spinal deformity typically entails posterior instrumented fusions that have demonstrated the potential to significantly improve health-related quality of life outcomes. However, until fusion is achieved, the instrumentation providing structural support is subject to repetitive cyclical loading that disproportionately fatigues high-stress areas and can result in instrumentation failure. Despite considerable advances in surgical fixation techniques and technology, pseudarthrosis with subsequent implant failure still poses a challenge for surgeons and continues to be 1 of the most common complications, leading to revision surgery. The addition of supplemental rods to primary constructs has gained widespread popularity to mitigate implant failure. Theoretically, more rods will add stiffness, stability, and decreased surface strain, which will provide longer instrumentation lifespan to allow for osseous fusion. There is significant heterogeneity in these constructs, and different types of supplemental rods (eg, satellite, accessory, delta rods, “kickstand rod,” and “iliac accessory rod”) can be used independently or in combination to further increase strength. However, the use of supplemental rods may increase the rate of proximal junctional kyphosis/failure and paradoxically diminish anterior column fusion rates. Hence, indications and optimal configurations are still a matter of debate. The aim of this narrative review is to provide an overview of the supplemental rod constructs described in the literature and focus on the current evidence supporting their indications and potential impact.
A Comparison of Decompression Size and Craniectomy Speed of Reverse Question Mark Versus Retroauricular Incisions for Decompressive Hemicraniectomy: A Cadaver Study
Authors: McIntyre Matthew K. , Ross Miner , Godil Jamila , Gerges Christina , Yamamoto Erin A. , Siler Dominic , Orina Josiah , Wright James
Published: January 2025

BACKGROUND AND OBJECTIVES:

Decompressive hemicraniectomy is a common emergent surgery for patients with stroke, hemorrhage, or trauma. The typical incision is a reverse question mark (RQM); however, a retroauricular (RA) incision has been proposed as an alternative. The widespread adoption ofthe RA incision has been slowed by lack of familiarity and concerns over decompression efficacy. Our goal is to compare the RA vs RQM incisions regarding decompression safety and to examine skill acquisition among resident neurosurgeons.

METHODS:

Six cadaveric heads were randomized to first receive either RQM or RA decompressive hemicraniectomy, which was followed by use of the other incision on the contralateral side. Primary endpoints were decompression circumference and time to bone flap removal. Resident neurosurgeon (postgraduate year 3 through 7) confidence and operative times were compared.

RESULTS:

All craniectomies yielded decompression diameters >13 cm (RQM: 13.5-15.5 cm; RA: 13.0-16.5 cm) and residual temporal bone heights <1.5 cm (RQM: 0.5-1.3 cm; RA: 0.5-1.5 cm). There were no differences between the RA and RQM groups in decompression circumference (P = .6605), residual temporal bone height (P = .7121), or time from incision until bone flap removal (P = .8452). There was a nonsignificant trend toward a shorter incision length with RA (RQM: 37.7 ± 0.7 cm vs RA: 35.1 ± 0.9; P = .0729). Regardless of which incision was performed first, operative time significantly improved from the first craniectomy to the second (−174.6 seconds, P = .0186). Surgeon confidence improved more with the RA incision, and there was a linear association with experience and time to bone flap removal in the RQM (P = .04) but not the RA (P = .95) groups.

CONCLUSION:

The RA incision may provide adequate operative exposure without significant changes in operative time. Cadaveric labs improve skill acquisition and should be considered during implementation of novel surgical approaches into practice.
The Company of Biologists: celebrating 100 years
Authors: Bray Sarah J. , Royle Stephen J. , Shiels Holly A. , St Johnston Daniel
Published: January 2025

Summary: As we begin celebrating our 100-year anniversary, we reflect on our extraordinary story so far, consider the Company's current support for our communities and prepare for some inspiring activities.
Association of intradialytic hypertension and antihypertensive medication use in patients undergoing maintenance hemodialysis: a prospective observational study
Authors: Sherif Mariam , Zachariah Seeba , Jagdale Rajaram
Published: January 2025

Background In patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis, intradialytic hypertension and intradialytic hypotension are the common complications. The study aimed to collect and assess intradialytic Blood Pressure (BP) complications and their association with BP medications. Methods This was a prospective observational study, conducted at the hemodialysis center in a teaching hospital in the UAE, that provide a specialist’s care for the patients receiving ongoing hemodialysis. Patient demographics, medications used, lab data and the peridialytic BP (pre-, intra-, and post-) dialytic BP were collected for a period of 6 months. SPSS Version 29, Armonk, NY was used for statistical analysis. Pearson Chi-square test and Fischer’s Exact test were used to compare the association between categorical variables to intradialytic hypertension and hypotension. Binary logistic regression was used to find the effect of predictive variables to the presence or absence of intradialytic complications. Results Blood pressure data was collected from 47 hemodialysis patients for a total of 2616 hemodialysis sessions during the 6 months study period. Non-dialysable antihypertensives were predominantly used. Beta-blockers (68%) and calcium channel blockers (66%) were the commonly used drug classes. Intradialytic hypertension events were diagnosed in 49 (1.9%) hemodialysis sessions and intradialytic hypotension was diagnosed in 23 (0.9%) hemodialysis sessions. Chi-square test showed association of antihypertensive medication use to the occurrence of intradialytic hypertension; especially ARBs, and alpha-1 blockers. Beta-blockers and calcium channel blockers use were associated with decreased number of intradialytic hypertension events (p-value <0.05). Regression showed broad confidence intervals. On the other hand, antihypertensive medication use showed no association with intradialytic hypotension. Conclusions Even though antihypertensive medications showed varying occurance of intradialytic hypertension, the results are inconclusive due to large confidence intervals that could be due to the presence of colliniarity between the variables. Future studies are required in larger populations.
Community perspectives on drug promotion on social media during the COVID-19 pandemic in KwaZulu-Natal, South Africa
Authors: Chimukuche Rujeko Samanthia , Ndlazi Julia , Seeley Janet
Published: January 2025

Background During the COVID-19 pandemic, social media and web-based platforms were widely used to promote medicinal substances. To assess community perspectives on drug promotions on social media, we conducted qualitative research using three workshops. The workshops aimed to highlight the public understanding of drug advertising focusing on community perceptions of social media drug promotions, their risks and benefits. Discussions were conducted on the importance of adhering to national drug regulation policies and the World Health Organisation ethical criteria for promotion, advertisement, and publicity of medicines. Methods Participants for the workshops were purposively sampled from local community youth groups and healthcare facilities. Two workshops included ten young adults aged 18-35, while the third workshop involved three healthcare professionals and one traditional healer. Results The study participants’ highlighted the value of honesty and trust in the drug promotions. Gaps in the ethical conduct of advertising were observed and concerns were raised about the reliability of social media information and the omission of valuable details on the drug advertisements. Conclusion Individuals have a right to informed choices that ensure their health safety. This study has highlighted the need for transparency and accountability in pharmaceutical and complementary medicine marketing on social media. Collaboration is needed between regulatory bodies, pharmaceutical companies, healthcare providers and community members, to make sure that drug advertising upholds ethical standards and public health.
Case Report : Successful live pregnancy following embryo transfer after isthmocele repair
Authors: Magray Dr. Shazia , Ali Dr. Jijisha , Puthiyidom Dr. Alphy , Gopalan Dr. Janaki , Maryum Dr. Rida
Published: January 2025

Abstract* Isthmocele, or uterine niche, is a defect in the anterior wall of the uterine isthmus, often following a cesarean section. It can lead to complications such as abnormal uterine bleeding, infertility, and pregnancy risks. This case report describes a successful live pregnancy after isthmocele repair and embryo transfer. A 28-year-old woman (para 1, living 1) presented with prolonged periods, dysmenorrhea, and secondary infertility. Transvaginal ultrasound revealed a large isthmocele and intra-cavitary uterine fluid. The patient underwent ovarian stimulation using an antagonist protocol twice, retrieving oocytes and freezing nine embryos. She later had laparoscopic isthmocele repair at another facility. Upon returning for frozen embryo transfer, irregular bleeding and dysmenorrhea persisted. Repeat ultrasound showed a small cesarean defect (4x3 mm), fluid in the endometrial cavity, and hyperechoic endometrium. Fluid aspiration was performed, followed by the transfer of a grade AA embryo. Although conception occurred, it was a biochemical pregnancy with a βhCG level of 12.43 mIU/ml. Due to a persistent scar defect and endometrial cavity fluid, the patient underwent hysteroscopy, endometrial biopsy, and minimal resection of the defect. Three months later, a frozen embryo transfer of a grade AB embryo was performed. This resulted in a viable pregnancy, confirmed by a βhCG level of 364 mIU/ml. The pregnancy progressed without complications, and at 36+3 weeks, the patient delivered a healthy baby via planned cesarean section. This case underscores the importance of diagnosing and managing isthmocele in infertility patients. Surgical repair can restore normal uterine anatomy and enhance the success of assisted reproductive techniques like embryo transfer.
Current status and needs of community-based practice in public healthcare institutions among Korean medical schools: a cross-sectional study
Authors: Kim Songrim , Cha Bongeun , Kyung Sun Young , Yune So Jung , Park Kyung Hye , Park Kwi Hwa
Published: January 2025

Background: This study analyzed the status of community-based practice in public healthcare institutions in Korean medical schools and identified related needs. Methods: We conducted an online cross-sectional survey in which 32 of 40 medical schools (80.0%) participated between March and April 2023. We developed questionnaire items aimed at ascertaining the status and perceptions of community-based practice and analyzed the response data using frequency analysis, the Mann-Whitney U test, and content analysis with word clouds.Results: Of the 32 medical schools analyzed, 23 (71.9%) offered practical courses, and of those, 12 (52.2%) implemented practice lessons within courses. Among 20 schools, 18 (90.0%) required students to complete practical courses and over 50% offered these courses in the third and fourth years of the clerkship phase. Perceptions of community practice showed no significant differences based on whether courses were offered. Many schools have proposed that practice should be a continuous curricular element from the premedical to medical years. The primary challenges facing community-based practice were identified as faculty development, collaboration, and compensation of practice institutions. The following words were extracted from the respondents’ comments: practice, community, institution, student, education, faculty, university, and public. Conclusion: This study identified the limitations of community-based education provided by Korean medical schools and we report findings that highlight areas of improvement. Notable among these is the need to continuously incorporate community-based practice into medical education while engaging in discussions and conducting research toward developing a comprehensive and systematic curriculum.
Impact of Gonadotropin-releasing Hormone Analogue and Gender-affirming Hormone Therapy on Bone Mineral Density in Transgender Adolescents
Authors: Chuncia-Ileczko Marta , Czyż Witold , Kacperczyk Julia , Arczewski Filip , Dziedzic Karol , Kulbacka Julia , Wojszczyk Maciej , Zys Damian , Pasek Piotr , Ryniecka Julia
Published: January 2025

Background: Sex hormones have a key impact on the development of the human body during puberty, including a significant influence on bone development - their shape, structure, length, and mineral density. Due to the growing number of transgender and gender diverse (TGD) adolescents and the increasing demand for gender-affirming hormone therapy (GAHT), there is rising curiosity about the impact of this therapy on the developing body of a young person. 
Purpose: This review aims to summarize the latest scientific reports on the impact of gonadotropin-releasing hormone analogues (GnRHas) and GAHT on the bone mineral density (BMD) of transgender adolescents undergoing gender-changing therapies. 
Findings: Low pretreatment BMD is more common among TGD adolescents than in the general population, and this is more prevalent in transgirls than in transboys. BMD Z-scores decline during treatment with GnRHas and respond differentially to GAHT. Regular follow-up and health advice are essential. Further long-term studies of the effects of these therapies on peak bone mass and future fracture risk are needed.
A Study on Factors Influencing the Inheritance Dilemma of Traditional Minority Sports Culture
Authors: Jiang Caixia
Published: January 2025

The inheritance dilemma of traditional minority sports culture in the New Era of Chinese Socialism was investigated using a field survey and literature review, and its influencing factors were explored. The results demonstrated that the inheritance of traditional minority sports culture is affected by various factors, such as a diversified ecological environment, socioecological trend, and a lack of cultural consciousness: (1) economization of natural ecological environment and homogenization of cultural inheritance space in the minority regions; (2) diversification of cultural, ecological environment, marginalization of traditional minority sports culture; (3) absence of successors to traditional culture; (4) imbalance in cultural inheritance methods. The traditional minority sports culture faces a severe identity crisis and a lack of cultural consciousness.
Research on the integration path of physical training and police practical skills in police academy
Authors: Chen Yun
Published: January 2025

With the increasingly complex social security environment, public security education is facing higher requirements, especially in training high-quality law enforcement personnel to adapt to the complex police environment, how to optimize the training system has become a key issue. The organic integration of physical training and actual police skills is an important way to improve the comprehensive quality of public security team. However, at present, there is a common separation between the two kinds of training, which fails to fully reflect the practical value of mutual cooperation, thus restricting the training effect and the practical application ability of the students. In this study, the status quo and problems of physical training and actual combat skills training in the police academy education system are deeply analyzed, focusing on the necessity of the integration of the two and the implementation path. Through systematic theoretical analysis and practical exploration, a series of optimization schemes including scenario-based training, scientific physical fitness improvement strategy and integrated curriculum design are proposed. This study not only provides an important theoretical basis for the improvement of the education quality of the police academy, but also provides practical guidance for promoting the all-round development of the students and enhancing the effectiveness of law enforcement.
Deep Policy Iteration with Integer Programming for Inventory Management
Authors: Harsha Pavithra , Jagmohan Ashish , Kalagnanam Jayant , Quanz Brian , Singhvi Divya
Published: January 2025

Problem definition: In this paper, we present a reinforcement learning (RL)-based framework for optimizing long-term discounted reward problems with large combinatorial action space and state dependent constraints. These characteristics are common to many operations management problems, for example, network inventory replenishment, where managers have to deal with uncertain demand, lost sales, and capacity constraints that results in more complex feasible action spaces. Our proposed programmable actor RL (PARL) uses a deep-policy iteration method that leverages neural networks to approximate the value function and combines it with mathematical programming and sample average approximation to solve the per-step-action optimally while accounting for combinatorial action spaces and state-dependent constraint sets. Methodology/results: We then show how the proposed methodology can be applied to complex inventory replenishment problems where analytical solutions are intractable. We also benchmark the proposed algorithm against state-of-the-art RL algorithms and commonly used replenishment heuristics and find that the proposed algorithm considerably outperforms existing methods by as much as 14.7% on average in various complex supply chain settings. Managerial implications: We find that this improvement in performance of PARL over benchmark algorithms can be directly attributed to better inventory cost management, especially in inventory constrained settings. Furthermore, in the simpler setting where optimal replenishment policy is tractable or known near optimal heuristics exist, we find that the RL-based policies can learn near optimal policies. Finally, to make RL algorithms more accessible for inventory management researchers, we also discuss the development of a modular Python library that can be used to test the performance of RL algorithms with various supply chain structures. This library can spur future research in developing practical and near-optimal algorithms for inventory management problems.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0617 .
Alternativas Jurídicas para o Custeio do Transporte Coletivo Urbano
Authors: Tavares Francisco Mata Machado
Published: January 2025

A mobilidade urbana traduz e produz uma gama de conflitos e de problemas sociais ao longo da história brasileira, desde as chamadas “Revoltas do Vintém” ao final do século XIX, até os protestos de junho de 2013. O tema, contudo, ainda não é suficientemente pesquisado sob um olhar jurídico constitucional. A partir da combinação entre a Nova Sociologia Fiscal e a Análise de Desenho de Políticas Públicas, tem-se como objetivo a elaboração de uma compreensão jurídica sobre o custeio do transporte coletivo urbano no Brasil. O método adotado se decompõe em dois planos. Primeiramente, com base em dados empíricos secundários e análises sócio-científicas presentes na recente literatura sobre o tema, identificam-se pobres, negros/as e mulheres como peculiarmente afligidos/as com a carga obrigacional e a precariedade da atuação governamental nessa seara. Em seguida, esta realidade é interpretada a partir do diagrama de Schneider e Ingram quanto à relação entre políticas públicas e os seus públicos-alvo. Assim, propõe-se uma proposta hermenêutica quanto ao regime tributário e orçamentário aplicável à questão e alcança-se a conclusão de que a política denominada tarifa zero é tão factível como imperativa no direito brasileiro. A contribuição apresentada compra um enquadramento jurídico apto à superação dos problemas fático-sociais apresentados.
Experiência urbana da mobilidade de mulheres: desafios ao planejamento urbano em Limeira (SP)
Authors: Marandola Júnior Eduardo José , Nogueira Fernanda de Faria Viana , Felizardo Ana Carolina Grilli
Published: January 2025

O presente trabalho busca se debruçar em algumas questões da mobilidade urbana a partir da experiência de mulheres no município Limeira (SP). Com as experiências cotidianas das participantes da pesquisa, investigar a experiência de mulheres no contexto das novas mobilidades urbanas nos permitiu compreender as transformações que são afetadas pela relações de gênero que dão sentido a mobilidade e, em uma perspectiva mais ampla, da própria cidade e das políticas públicas que pautam a construção de um planejamento urbano. Nos permitimos fazer o exercício de tensionamento do que é ser mulher em situação, tendo seu recorte a cidade de Limeira e as suas mobilidades urbanas. Aqui nos foi possível compreender como o deslocamento urbano no município de Limeira possui impacto nos corpos das mulheres e na sua experiência na cidade, tendo como destaque a criação do que nomeamos como táticas e estratégias para suas vivências urbanas. Consideramos latente, portanto, a urgência de se pensar uma administração pública que se paute nessas experiências para a construção de direito à uma cidade para todas e todos.
Um território em jornais
Authors: Silva Wanderson Vilton Nunes
Published: January 2025

Objetivo desse artigo é problematizar as relações entre memória social e território em narrativas de textos jornalísticos no ano de 2019, a partir de um contexto local do bairro da Várzea em Recife, capital pernambucana brasileira. Esta pesquisa é qualitativa com base em documentos públicos de mídias jornalísticas de Pernambuco encontradas em sites da internet. Procuramos matérias em sites de busca com os seguintes descritores: Várzea Recife, Várzea Recife Memória, Várzea Recife Imagens em 2019. Após essa busca encontramos e selecionamos 38 matérias relacionadas em sites de notícias, blogs, sites de acervos e instituições do/sobre o bairro da Várzea, zona oeste de Recife em Pernambuco. As notícias foram organizadas em três temas principais: a) anúncios de venda e aluguel de imóveis na Várzea, Recife-PE; b) memória, imagens e monumentos históricos; c) arquivos de memória e história. Por fim, dimensionamos como a construção midiática deste bairro da cidade de Recife em Pernambuco, está atravessada pela constituição de um espaço urbano marcado pelas temáticas da moradia, dos monumentos artísticos e culturais, bem como de elementos de uma memória atrelada aos movimentos negros e feministas no bairro.
Protocolos de aconselhamento em aleitamento materno: revisão de escopo
Authors: Coimbra Joyce Silva , Resende Cynthya Viana de , Cavalcanti Michele Curcino , Rodrigues Elisa da Conceição , Wernet Monika , Ruiz Mariana Torreglosa
Published: January 2025

Objetivo: mapear evidências disponíveis na literatura sobre protocolos utilizados no aconselhamento em aleitamento materno. Método: revisão de escopo com buscas realizadas em março de 2023, atualizadas em fevereiro de 2024, independentemente nas bases: PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science; CINAHL, Catálogo de Teses e Dissertações da CAPES e Cochrane Library, correlacionando os descritores Counseling, Breast Feeding, Education, Guideline e Protocol e sinônimos, sem delimitação de tempo e idioma. Resultados: a amostra final foi composta por 11 estudos, de 2003 a 2022, com predomínio do idioma inglês e do tipo ensaio clínico randomizado, aplicação mais frequente no puerpério e entre binômios com condições favoráveis ao aleitamento. Aplicados em sessões individuais ou grupais, com duração de 20-60 minutos e uso de material de apoio, sendo os enfermeiros, os profissionais mais citados. Conclusão: observou-se a escassez de pesquisas que detalham protocolos de aconselhamento em aleitamento materno, com predomínio da aplicação dos protocolos no puerpério.
criminoso que denuncia a si mesmo
Authors: Ormelesi Vinicius Fernandes
Published: January 2025

Este trabalho propõe uma discussão sobre a crítica de Nietzsche às instituições criminais. O tema é abordado a partir de uma passagem colhida do livro “Aurora” sobre uma conjectura na qual um criminoso denunciaria a si mesmo. Nesse sentido, o objetivo deste estudo é compreender se a subversão do conceito tradicional de justiça criminal, realizada por Nietzsche ao propugnar que a pena deve servir também como uma honra ao transgressor, pode ser relacionada às propostas da justiça restaurativa. O problema da pesquisa é verificar se há uma compatibilidade teórica entre a filosofia nietzschiana e os fundamentos da justiça restaurativa. Como método de abordagem, parte-se da interpretação conceitual dos textos do filósofo e de sua comparação analítica com as principais teses sustentadas pelo movimento da justiça restaurativa. A partir dessas premissas, discute-se a possibilidade de se visualizar no filósofo uma antecipação teórica de algumas ideias fundamentais da justiça restaurativa, como a ênfase na reparação do dano ao invés da punição. O estudo conclui que as visões de Nietzsche e da justiça restaurativa não são plenamente conciliáveis.