bluuebunny/crossref_metadata_2025_split huggingface dataset:
De-implementation strategy to reduce overtreatment of asymptomatic bacteriuria in the emergency department: a stepped-wedge cluster randomised trial
Authors: van Horrik Tessa M.Z.X.K. , Laan Bart J. , Stalenhoef Janneke E. , van Nieuwkoop Cees , Saanen Joppe B. , Schneeberger Caroline , Jong Eefje , Geerlings Suzanne E. 
Published: December 2024

Background: Asymptomatic bacteriuria (ASB) is the presence of bacteria in the urine of patients without symptoms of a urinary tract infection. Generally, treating ASB is not beneficial. Objective: We aimed to reduce overtreatment of ASB in the emergency department (ED) through a multifaceted de-implementation strategy. Design: A stepped-wedge cluster randomised trial. Methods: We performed our study in five EDs in the Netherlands from December 2020 to December 2021. Adult patients with urine cultures obtained during ED presentation were screened for inclusion and we excluded patients with indications for antibiotic therapy. The de-implementation strategy included education, reminders and competitive feedback on baseline results. The primary endpoint was patients with ASB treated with antibiotics. Secondary endpoints included the treatment duration and the number of urine tests ordered (urinalyses and urine cultures) in the ED per 1000 adult patients. Results: In total, 6837 urine cultures were screened. ASB was present in 224/3289 (7%) and 201/3548 (6%) patients, from whom 65/224 (29%) and 46/201 (23%) were inappropriately treated with antibiotics in the baseline and intervention period, respectively (adjusted odds ratio 1.20, 95% CI 0.56–2.62, p = 0.65). The number of urinalyses ordered decreased from 182 to 153 per 1000 patients (incidence rate difference −29.10, 95% CI −46.36 to −11.78, p < 0.001). Further, the treatment duration was shortened for patients with ASB in the intervention period (baseline period: 7.98 days (standard deviation (SD) 4.31) vs 5.79 days (SD 3.33), p = 0.006). Conclusion: Diagnostic stewardship by our de-implementation strategy reduced the number of urinalyses ordered and treatment duration in the ED, but we found no significant reduction in overtreatment of ASB. Trial registration: The trial was registered at https://onderzoekmetmensen.nl/en/trial/25918 , on 17-12-2019, registration number NL8242. The first participants were enrolled on 01-12-2020.
Microstructure and Mechanical Properties of TC4 Titanium Alloy Joint Fabricated By Vortex Flow-Based Friction Stir Welding
Authors: Liu Xiaochao , Zhang Pengyu , Li Wentao , Ye Tao , Xia Chuanchao , Zhang Tairui , Shi Junmiao , Xie Jilin , Ni Zhonghua 
Published: December 2024

AbstractTool wear is a critical challenge in titanium alloy friction stir welding (FSW). Vortex flow-based FSW (VFSW) is a potential solution for this issue because the VFSW process uses a similar material to the base metal as the tool. In this study, TC4 titanium alloy was welded by VFSW for the first time. Parameter optimization of the vortex flow formation is first done, and then the weld formation and the joints’ microstructure and mechanical performance are investigated at different traversing speeds. The results prove that the plunging velocity is the dominant factor in the vortex depth. A lower plunging speed is beneficial for the formation of a deeper vortex. Full penetration is achieved at traversing speeds of 50–120 mm/min at 300 r/min. At welding speed above 130 mm/min, insufficient penetration defects occur. In the heat affected zone, grain coarsening and β-phase volume fraction increase arise, whereas, in the weld nugget, an α+β lamellar structure emerges. Under the optimized parameters, the joint tensile strength is nearly 98% of the base material, but the elongation decreases significantly. The oxides drawn into the weld by the vortex at the junction between the vortex and the base material are the main reason for the small elongation. This study proves that the VFSW process is feasible for titanium alloys.
Enhancing external quantum efficiency in a sky-blue OLED by charge transfer via Si quantum dots
Authors: Pei Zingway , Wei Han Yun , Liu Yi Chun , Subramani Thiyagu , Fukata Naoki 
Published: December 2024

AbstractOrganic light-emitting diodes aim to achieve high efficiency by using excitons to achieve a 100% quantum efficiency (QE). However, developing functional organic materials for this purpose can be time-consuming. To address this challenge, a new method has been proposed to incorporate inorganic quantum dots into the organic luminescent layer to enable unlimited exciton formation and approach the 100% QE limit. Inorganic quantum dots are clusters of atoms that contain numerous thermally generated electrons and holes at conduction and valence bands. Immersed quantum dots act as charge generation centers, providing electrons and holes with unlimited amounts to form excitons. After radiative recombination, these excitons generate photons that cause internal QE to nearly 100%. This concept has been demonstrated using Silicon quantum dots (SiQDs) and phosphorescent materials. The average size of SiQDs is approximately 6 nm, and they are well-dispersed within the guest–host blue phosphorescent light-emitting materials. With only 5 × 10–3% (in weight) of SiQDs in the precursor, external QE increased from 2 to 17.7%, nearly a nine-fold enhancement. The prolonged decay time from 1.68 to 5.97 ns indicates that electrons are transferred from SiQDs to the luminescent materials. This universal method can be applied to green and red emissions with various inorganic quantum dots in different organic luminescent material systems.
Association between COVID-19 infection and new-onset dementia in older adults: a systematic review and meta-analysis
Authors: Shan Dan , Wang Congxiyu , Crawford Trevor , Holland Carol 
Published: December 2024

Abstract
Background
The relationship between COVID-19 infection and a possible increased likelihood of older adults developing new-onset dementia (NOD) remains elusive.

Methods
A thorough search was performed across several databases including MEDLINE/PubMed, PsycINFO, Scopus, medRxiv, and PQDT Global for studies published in English from January 2020 to December 2023. Only original investigations exploring the link between COVID-19 infection and NOD were selected for inclusion. We assessed the risk of developing NOD, using Risk Ratio (RR) for measurement. Control groups were categorized as: (i) a non-COVID cohort with other respiratory infections [control group (C1)]; and (ii) a non-COVID cohort with otherwise unspecified health status [control group (C2)]. Follow-up periods were divided into intervals of 3, 6, 12, and 24 months post-COVID.

Results
11 studies (involving 939,824 post-COVID-19 survivors and 6,765,117 controls) were included in the review. Across a median observation period of 12 months post-COVID, the overall incidence of NOD was about 1.82% in the COVID-infected group, compared to 0.35% in the non-COVID-infected group. The overall pooled meta-analysis showed a significantly increased NOD risk among COVID-19 older adult survivors compared to non-COVID-19 controls (RR = 1.58, 95% CI 1.21–2.08). Similar increased NOD risks were observed in subgroup analyses restricted to an observational period of 12 months (RR = 1.56, 95% CI 1.21–2.01), as well as in five studies that employed propensity score matching to sufficiently and effectively control for multiple confounding covariates (RR = 1.46, 95% CI 1.10–1.94). COVID-19 group and C1 group shared a comparably increased risk of developing NOD (overall RR = 1.13, 95% CI 0.92–1.38).

Discussion
Under normal circumstances, we believe that COVID-19 infection is likely to be a risk factor for developing NOD in older adults over time. While the increased NOD risk due to COVID-19 infection appears to be similar to that associated with other respiratory infections, it warrants and necessitates investigation with longer observations.
Declining trend of HTLV-1 among organ/ tissue donors in Iranian Tissue Bank between 2014–2021
Authors: Letafati Arash , Mozhgani Sayed Hamidreza , Norouzi Mehdi , Aboofazeli Amir , Taghiabadi Zahra , Zafarian Negar , Seyedi Saba , Jaberi Elnaz Mohammad , Poursaleh Sedigheh , Karami Maryam , Sarrafzadeh Sheida , Sadeghi Ahmadreza 
Published: December 2024

Abstract
Background
Human T-cell Lymphotropic Virus type-1 (HTLV-1) infection is associated with serious disorders, including Adult T-cell Leukemia/Lymphoma (ATLL) and HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP). In addition to sexual, vertical, parenteral, and blood transfusion, organ/tissue transplantation is considered as a transmission route of HTLV infection. Given the substantial risk of HTLV-1 transmission and the subsequent development of HAM/TSP (approximately 40%) in kidney transplant recipients, pre-transplant donor screening is crucial. The present study aimed to investigate the prevalence of HTLV-1 in potential organ/tissue donors referred to the Iranian Tissue Bank and Research Center (ITBRC).

Materials and methods
The study population was potential organ and/or tissue donors referred to ITBRC between 2014 and 2021, including two groups of brain death (potential donors of organs and/or tissues) and circulatory death donors (potential tissue donors from Iranian Legal Medicine Organization). Initial screening was performed using enzyme-linked immunosorbent assay (ELISA), and positive cases were confirmed for HTLV-1 infection with polymerase chain reaction (PCR).

Results
111 out of 3,814 donors were positive for HTLV-1 (3%). The rate of positive tests between 2014 and 2017 was 6%, which was significantly higher than the positive tests percentage between 2017 and 2021 with 0.5% (P-value < 0.001). The rate of test positivity in females was 4% compared to 2% in males (P-value = 0.001). Furthermore, individuals diagnosed with brain death exhibited a significantly lower likelihood of HTLV-1 infection (0.2%) compared to cases with circulatory death (4%) (P-value < 0.001).

Conclusion
Considering the contraindication of organ/tissue donation from donors with HTLV-1 positive test, these findings give an insight into the prevalence of HTLV-1 among potential organ/tissue donors in Iran. Moreover, the higher prevalence of HTLV-1 infection in circulatory death donors from Iranian Legal Medicine Organization urges for cautious evaluation in these donors.
Formulation, Development, and Characterization of AMB-Based Subcutaneous Implants using PCL and PLGA via Hot-Melt Extrusion
Authors: Chitnis Kshitij , Narala Nagarjuna , Vemula Sateesh Kumar , Narala Sagar , Munnangi Sivaram , Repka Michael A. 
Published: December 2024

Abstract
The hot-melt extrusion process is currently considered a prominent manufacturing technique in the pharmaceutical industry. The present study is intended to develop amlodipine besylate (AMB)-loaded subcutaneous implants to reduce the frequency of administration, thus improving patient compliance during hypertension management. AMB subcutaneous implants were prepared using continuous hot-melt extrusion technology using poly(caprolactone) and poly(lactic-co-glycolic acid) with dimensions of 3.70 cm (length) by 2.00 mm (diameter). The implants were characterized for thermal characteristics, drug-excipient incompatibilities, surface morphology, fracturability, in vitro drug release, and stability studies. Differential scanning calorimetry study confirmed the drug's crystalline state within the fabricated implants, while textural analysis demonstrated good fracturability in the lead formulation. Scanning electron microscopy revealed the smooth surface morphology of the lead subcutaneous implant. The lead formulation showed an extended drug release profile over 30 days (~ 2.25 mg per day) and followed zero-order release kinetics (R2 value to 0.9999) with a mean dissolution time of 14.96 days. The lead formulation remained stable for 30 days at accelerated stability conditions of 40°C and 75% relative humidity. In conclusion, developing hot-melt extruded implants could be an alternative to the conventional amlodipine besylate (AMB) formulation.

Graphical Abstract
Eco-friendly Nanostructured Liquid Crystals Loaded with Clove Oil as a Sustainable Approach for Managing Infected Burn Wounds
Authors: EL-Zahaby Sally A. , Wen Ming Ming , Abdelwahab Ibrahim A. , Shahine Yasmine M. , Abdelhady Sherien A. , Elbatouti Gihan A. 
Published: December 2024

Abstract
Infections are a leading complication in patients with burns. Effective antimicrobial treatment with regenerative tissue healing is required. Utilizing components derived from plant origin such as natural oils as a sustainable and eco-friendly approach for managing disease is highly required nowadays. The aim of the current study is to assess the antibacterial and wound-healing activity of clove oil and its novel eco-friendly nanostructured liquid crystals (Eco-friendly-NLCs) formulation in treating infected burn wounds. A 23 full factorial design was used to optimize the Eco-friendly-NLCs. Clove oil and its novel nano-formulation were characterized and subjected to in vitro and in vivo assessments for their efficacy. Twenty rats were used experimentally. The optimum Eco-friendly-NLCs had 189.2 ± 1.9 nm, -22.8 ± 0.7 mV and 0.308 as values for particle size, zeta potential and polydispersity index. Transmission electron microscope images showed discrete spherical shape NLCs with no aggregations. The microbiological and pharmacological results revealed a superior efficacy regarding clove loaded Eco-friendly-NLCs in inhibiting bacterial growth (inhibition zone of 38 mm), significantly reducing inflammatory biomarker levels (p < 0.001), promoting angiogenesis and prompt wound healing. The Eco-friendly-NLCs loaded with clove oil could be considered as a promising formulation providing anti-inflammatory, anti-bacterial and wound healing effects.

Graphical Abstract
Adult Height Following Prepubertal Treatment With Antiandrogen, Aromatase Inhibitor, and Reduced Hydrocortisone in CAH
Authors: Merke Deborah P , Mallappa Ashwini , Parker Megan , Sukin Charles , Kulkarni Sarah E , Keil Margaret F , Van Ryzin Carol , Hill Suvimol Chirathivat , Reynolds James C , Cutler Gordon B , Sinaii Ninet 
Published: December 2024

Abstract

Context
Height outcome in patients with classic congenital adrenal hyperplasia (CAH) is suboptimal due to glucocorticoid and androgen excess.

Methods
In an open, randomized, controlled trial, children with classic CAH were randomized to receive a combination regimen of antiandrogen, aromatase inhibitor, reduced hydrocortisone, and fludrocortisone prior to puberty or standard therapy (hydrocortisone, fludrocortisone). Females continued on antiandrogen during puberty. The primary endpoint was adult height.

Results
Of 62 children randomized, 45 completed the study. Adult height SDS did not differ between the investigational and control groups (−0.34 [0.93] vs −0.60 [0.89], respectively), mean difference 0.26 [95% CI −0.29, 0.82], P = .35), irrespective of midparental height, but was greater than the predicted adult height pretreatment in both groups (P &lt; .001). Growth rate and rate of bone maturation were reduced in the investigational group prior to puberty, despite lower hydrocortisone dose (7.6 [1.5] vs 15.0 [3.6] mg/m2/day, P &lt; .001), and improvement in predicted adult height appeared greater at pubertal onset (P = .049) compared to standard therapy. Antiandrogen treatment during puberty in girls allowed for lower-dose glucocorticoid, and improved height outcome (adult minus midparental height: −0.7 [4.6] vs −5.6 [5.2] cm, mean difference 4.9 [95% CI 0.09, 9.7], P = .046). Those who received GnRHa had lower growth rate (P = .023) and longer years of unchanged bone age (P = .017), regardless of treatment.

Conclusion
Prepubertal antiandrogen, aromatase inhibitor combination with reduced hydrocortisone improves short-term predicted height for children with CAH but does not result in taller adult stature than those treated with standard therapy, and is not recommended. Females may benefit from antiandrogen treatment during puberty.
Long-Acting Growth Hormone Therapy in Pediatric Growth Hormone Deficiency: A Consensus Statement
Authors: Maniatis Aristides , Cutfield Wayne , Dattani Mehul , Deal Cheri , Collett-Solberg Paulo Ferrez , Horikawa Reiko , Maghnie Mohamad , Miller Bradley S , Polak Michel , Sävendahl Lars , Woelfle Joachim 
Published: December 2024

Abstract

Context
Several long-acting growth hormone (LAGH) therapies have recently become available, but guidance on their usage in children with growth hormone (GH) deficiency is limited.

Methods
International experts in pediatric endocrinology were invited to join a consensus group based on their expertise in treating children with daily GH and LAGH. The group comprised 11 experts from 10 countries across the world. Online group meetings were held in February to March 2024 followed by a 1-day in-person meeting in May 2024 to finalize the consensus recommendations. A targeted literature search approach was used to identify and share evidence ahead of the meetings. Formulations considered were limited to those with international populations in phase III pivotal trials and regulatory approvals in multiple countries.

Evidence synthesis
Topics covered include patient selection and preference, dose adjustment, initiating and switching therapies, administration, adherence and missed doses, practical considerations, and knowledge gaps. LAGH formulations offer a potential advantage over daily GH injections for children with GH deficiency in terms of reduced injection frequency and treatment burden; this may also be associated with improved adherence and treatment outcomes over time. However, data on LAGH in pediatric GH deficiency are mostly limited to clinical trials, and long-term, real-world data are currently lacking.

Conclusion
This article provides an international consensus on the use of LAGH therapy in children with GH deficiency to guide practitioners when considering these new treatment options for their patients. Long-term data are needed to fill current data gaps and allow the creation of comprehensive evidence-based recommendations.
The Microbiota and Evolution of Obesity
Authors: Saad Mario J A , Santos Andrey 
Published: December 2024

Abstract
Obesity is a major global concern and is generally attributed to a combination of genetic and environmental factors. Several hypotheses have been proposed to explain the evolutionary origins of obesity epidemic, including thrifty and drifty genotypes, and changes in thermogenesis. Here, we put forward the hypothesis of metaflammation, which proposes that due to intense selection pressures exerted by environmental pathogens, specific genes that help develop a robust defense mechanism against infectious diseases have had evolutionary advantages and that this may contribute to obesity in modern times due to connections between the immune and energy storage systems. Indeed, incorporating the genetic variations of gut microbiota into the complex genetic framework of obesity makes it more polygenic than previously believed. Thus, uncovering the evolutionary origins of obesity requires a multifaceted approach that considers the complexity of human history, the unique genetic makeup of different populations, and the influence of gut microbiome on host genetics.
General Anaesthesia in Special Care Dentistry. Part 1: Justifying and Planning the Use of General Anaesthesia
Authors: Doshi Mili , Shehabi Zahra , Liu Sophie , Geddis-Regan Andrew 
Published: December 2024

General anaesthesia (GA) is sometimes necessary or appropriate to safely deliver comprehensive dental care for patients with disabilities and complex needs. GA may be indicated as a result of severe anxiety or cognitive dysfunction, where treatment with sedation or local anaesthesia has not been satisfactory or is contraindicated, or where a substantial amount of dental treatment is required. This article is the first of a three-part series that aims to expand upon some of the key practical considerations related to the planning and use of GA in dental care. CPD/Clinical Relevance: The use of general anaesthesia for patients with disabilities and complex needs requires careful consideration and planning.
Răzvan Bran: Las oraciones subordinadas y las construcciones sintácticas complejas en español. Consideraciones teóricas y ejercicios prácticos
Authors: Iosef Indra-Flavia-Elena 
Published: December 2024

Reseña del libro Las oraciones subordinadas y las construcciones sintácticas complejas en español. Consideraciones teóricas y ejercicios prácticos de Răzvan Bran.
Development of microsatellite markers for colony delineation of the invasive Asian subterranean termite (Blattodea: Rhinotermitidae) in South Florida and Taiwan
Authors: Tsai Cheng-Lung , Li Hou-Feng , Ching Yung-Hao , Lin Ming-Der , Chen Guan-Yu , Mullins Aaron , Scheffrahn Rudolf H. , Chouvenc Thomas , Su Nan-Yao 
Published: December 2024

Abstract
The Asian subterranean termite, Coptotermes gestroi (Wasmann) (Blattodea: Rhinotermitidae), is a major pest of wooden structures. Native to Southeast Asia, it has successfully invaded various regions worldwide. Developing a molecular technique for colony delineation is critical to evaluate the efficacy of subterranean termite baiting systems against C. gestroi. This study has assessed the robustness of 19 newly developed microsatellite loci for colony delineation of the invasive C. gestroi in both South Florida and Taiwan. Our results suggest that at least nine microsatellite markers, each with two alleles per locus, can accurately distinguish all C. gestroi colonies with little genetic variation in South Florida. Conversely, only five microsatellite loci are needed to delineate C. gestroi colonies in Taiwan. Additionally, differences in colony breeding systems may affect genetic differentiation among C. gestroi colonies. Our study provides a practical genetic method to accurately identify colony affiliation of foragers, which will help in the field evaluation of baiting systems in areas invaded by C. gestroi.
Isolation, structural characterization, and molecular docking studies on the bioactive compound from n-Hexane extract of Emilia sonchifolia (L.) DC against the pancreatic cancer target Aurora 2 Kinase
Authors: Prabhakaran Pratibha , Palanisamy Chella Perumal , Shanmugam Abirami , Damodharan Prabhu , Swaminathan Harshini , Devaraj Dhivya , Ahalliya Rathi Muthaiyan , Velliyur Kanniappan Gopalakrishnan 
Published: December 2024

Abstract

Objectives
Natural flora historically has played a substantial part in drug development since they serve as active ingredients in medications and templates for the synthesis of novel pharmaceuticals. Emilia sonchifolia is a conventionally utilised therapeutic flora in Indian pharmacopoeia. Therefore, the current study is intended to separate, structurally describe and analyse the anti-pancreatic cancer potential of isolated natural bio-constituents from E. sonchifolia (L.) DC.

Methods
n-Hexane extract using chromatographic techniques and structurally characterize them using spectroscopic techniques. Further, in silico molecular docking method was employed to investigate the bioactivity of the isolated compound against Aurora 2 Kinase (pancreatic cancer target protein).

Results
A mixture of stigmasterol with straight-chain monounsaturated alcohol (C49H86O) was isolated and identified from the aerial parts of E. sonchifolia using chromatographic techniques. The docking results showed that the isolated natural compound of stigmasterol with straight-chain monounsaturated alcohol has good docking results compared with Food and Drug Administration-permitted medicine.

Conclusions
Based on the outcomes, it can be concluded that the stigmasterol with straight-chain monounsaturated alcohol may act as a novel inhibitor for Aurora 2 Kinase. In the future, it may lead to the development of drugs targeting Aurora 2 Kinase for the effective treatment of pancreatic cancer.