bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanical performance and durability attributes of biodegradable natural fibre-reinforced composites—a review
Authors: Ramful Raviduth 
Published: December 2024

AbstractWith the rising awareness about the impact of excessive urbanization on the environment, alternative and more eco-friendly materials such as natural fibre-reinforced composites (NFRCs), which have lower embodied energy, can be considered in modern application ranging from construction housing to urban infrastructures in order to promote the concept of sustainable development. One of the current challenges faced by material engineers is to develop NFRCs with optimized durability performance which correspond to high mechanical attributes during their service lifetime while possessing satisfactory degradability trait in the disposal phase. This proposed review study principally covered the state-of-the-art progress made in the development of sustainable composite material such as advanced and biodegradable NFRC. In the first section, the review covered key aspects of NFRC fabrication including fibres and matrix selection, property-enhancing treatment for fibres and influence of nanostructures in biodegradable composites. In the second phase of this review, the fibre-matrix interaction and their corresponding physical and mechanical performance were discussed. The typical failure modes observed in NFRCs were outlined and means to improve their facture toughness were proposed. Finally, the third section comprised the durability and degradation assessment of key components of the biodegradable NFRCs, namely the fibre reinforcement, matrix and interface sections. Additionally, the impact of disposing of similar composite materials in the environment was assessed, and present-day recycling techniques were discussed. Further research on the mechanical performance, durability traits and degradability aspects of NFRCs as enumerated in this study will unquestionably promote their use and integration into a wider range of engineering applications in our modern society.
Nonadjustable state of programmable shunt valve: obstruction of middle cranial fossa arachnoid cyst-peritoneal shunt
Authors: Cao Hongbin , Guo Genrui , Wu Wenjing , Cheng Zhenghai 
Published: December 2024

Abstract
Background
A nonadjustable state of the programmable shunt valve is a rare phenomenon. This case report aims to explore the cause of pressure adjustment dysfunction in a programmable shunt valve in a middle cranial fossa arachnoid cyst-peritoneal shunt patient and to underscore this dysfunction as an indicator of shunt valve obstruction.

Case presentation
A child with a ruptured giant arachnoid cyst in the left middle cranial fossa presented with acute intracranial hypertension following head trauma. The initial cysto-peritoneal shunt surgery rapidly alleviated symptoms, including headaches, vomiting, and left cranial nerve palsy, stabilizing the clinical condition. However, between 20 and 24 months after the initial shunt surgery, the patient developed intermittent shunt dysfunction, experiencing recurrent headaches and vomiting, during which the programmable valve’s pressure setting had become fixed and was no longer adjustable. A second surgery was then performed to remove the existing shunt, excise the fibrotic cyst wall, fenestrate the basal cistern, and establish temporary subdural drainage. During this operation, extensive fibrosis of the cyst wall in the subdural space was discovered, forming a tough and hypertrophic fibrotic membrane that encased the cerebral hemispheres. This fibrotic material nearly filled the shunt valve chamber, causing valve obstruction and immobilizing the pressure control rod, resulting in pressure adjustment dysfunction. As the patient could not maintain stability without continuous drainage, a third surgery was ultimately necessary to place a subdural-peritoneal shunt. Five years of follow-up revealed no significant clinical symptoms, and the patient has maintained a normal life.

Conclusion
Shunt valve obstruction is an underestimated cause of shunt system failure, with no current definitive method for early diagnosis. Fibrotic deposition is a primary mechanism underlying shunt valve obstruction. Pressure adjustment dysfunction in a programmable shunt valve serves as a reliable indicator of shunt valve obstruction. Further research should prioritize the treatment and prevention of shunt valve obstructions to improve outcomes in neurosurgical practice.
Ventilatory functions in response to bicycle ergometry training in boys with Duchenne muscular dystrophy
Authors: Wagdy Eman , Mohamed Marwa Taher , Ahmed Angham Mohamed Adel , Fayez Marian Mamdouh 
Published: December 2024

Abstract
Background
Duchenne muscular dystrophy (DMD) is the popular kind of muscular dystrophy in childhood characterized by gradual motor decline and respiratory failure which ultimately results in death.

Purpose
This research sought to determine the impact of bicycle ergometer on ventilatory functions and motor ability in boys with DMD.

Design
Single-blind, randomized controlled experiment.

Methods
Thirty boys with DMD were randomly split into two similar groups. A selected physical therapy regimen was implemented for the control and ergometer groups, while a bicycle ergometer was implemented only for the ergometer group. All boys were assessed for respiratory functions covering forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) using spirometry, and motor ability using the North Star Ambulatory Assessment (NSAA). The rehabilitation session was conducted three times a week for 12 successive weeks.

Results
Post-rehabilitation findings in the two groups detected a notable rise in every evaluated variable. However, the ergometer group revealed a notable rise in all assessed variables in relation to that of the control group.

Conclusion
Bicycle ergometer as an aerobic exercise could promote ventilatory functions and motor ability in boys with DMD.

Trial registration
Clinicaltrials.gov (No. NCT05849688).
Effect of improving food security on parenting practices and caregiver–adolescent relationships: qualitative findings of an income-generating agricultural intervention in rural Kenya
Authors: Onono Maricianah A. , Sheira Lila , Frongilio Edward A. , Odhiambo Gladys , Wekesa Pauline , Conroy Amy , Bukusi Elizabeth A. , Cohen Craig R. , Weiser Sheri D. 
Published: December 2024

Background
Despite the recognised links between food insecurity and parenting, few studies have evaluated the perceived impacts of livelihood or food security interventions on parental practices, intra-household functioning, adolescent behaviour and psychosocial outcomes in HIV-affected households in sub-Saharan Africa.

Aims
The study aimed to understand the perceived effects of food security on parenting practices and how this was experienced by both adolescent girls (aged 13–19 years) and their caregivers in rural Kenya.

Method
We conducted semi-structured, individual interviews with 62 caregiver–adolescent dyads who were participants in the adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in the Shamba Maisha agricultural and finance intervention trial (NCT01548599). Data were analysed following the principles of thematic analysis.

Results
Compared to control households, the Shamba Maisha intervention households had improved food security and strengthened economic security, which, in turn, improved parenting practices. Intervention households described changes in parenting experiences, including decreased parental stress, reduced absenteeism and harsh parenting and improved caregiver– adolescent relationships. These positive caregiving practices, in turn, contributed to improved mental health and fewer behavioural problems among adolescent girls. Changes in the control households were less noticeable.

Conclusion
These findings demonstrate how an income-generating agricultural intervention may improve food security and positively affect parenting practices, intra-household dynamics and adolescent psychosocial well-being and behaviour. Further research is needed to explore how to harness the social benefits of agricultural interventions to best address the critical intersections among food insecurity, parenting practices and adolescent mental health.
Adrenal Venous Sampling Using Metanephrine in Primary Aldosteronism With or Without Cortisol Cosecretion
Authors: Kawahara Eduardo Z , Okubo Jessica , Cavalcante Aline C B S , Pilan Bruna , Frudit Paula , Pereira Caio A A , Basmage Larissa , Viel Jacqueline M , Maciel Ana Alice W , Freitas Thais C , Fagundes Gustavo F C , Goldbaum Tatiana S , Brito Luciana P , Gomes Nathalia L , Pereira Maria Adelaide A , Coelho Fernando M A , Ledesma Felipe L , Chambo Jose L , Bortolotto Luiz A , Pio-Abreu Andrea , Silva Giovanio V , Drager Luciano F , Fragoso Maria Candida B V , Nahas William C , Carnevale Francisco C , Latronico Ana Claudia , Mendonca Berenice B , Almeida Madson Q 
Published: December 2024

Abstract

Context
The role of plasma metanephrine in adrenal venous sampling (AVS) for assessing lateralization in primary aldosteronism (PA) requires further clarification.

Objective
To evaluate the performance of plasma metanephrine in AVS for determining aldosterone lateralization in PA, with or without mild autonomous cortisol secretion (MACS).

Methods
Sequential AVS under cosyntropin stimulation was conducted in 58 consecutive patients with PA and indication for AVS. The selectivity index (SI) was assessed using plasma metanephrine (SIMN) and cortisol (SIC). The lateralization index (LI) for aldosterone was calculated using metanephrine (LIA/MN) and cortisol (LIA/C).

Results
Right SIMN was significantly higher than left SIMN (127.91 nmol/L [78.12, 239.12] vs 46.16 nmol/L [26, 73.87]; P &lt; .001). SIMN and SIC were strongly correlated in both the right adrenal vein (r = 0.518, P &lt; .001) and the left adrenal vein (r = 0.435, P &lt; .001). A SIMN &gt; 6.45 demonstrated a sensitivity and specificity of 100%, outperforming the cut-off of 12 for identifying successful catheterization. Six cases with SIMN &gt; 12 and SIC between 3 and 5 indicated that a SIC &gt; 3 is sufficient for 4-confirming successful cannulation. LIA/MN and LIA/C were significantly correlated (r = 0.752, P &lt; .001), with PA lateralization concordant in 93.1% of cases. Two discordant cases (unilateral PA by cortisol, bilateral by metanephrine) exhibited nonclassical histology, which is associated with a higher risk of PA recurrence. MACS was identified in 15 out of 58 patients (25.86%) and generally did not influence AVS lateralization, except when aldosterone and cortisol were secreted by different adrenal lesions.

Conclusion
Metanephrine was superior to cortisol after cosyntropin for assessing selectivity and equivalent to cortisol for lateralization. Moreover, MACS did not impact lateralization in AVS under cosyntropin in most cases.
Sub-toxic cisplatin concentrations induce extensive chromosomal, nuclear and nucleolar abnormalities associated with high malignancy before acquired resistance develops: Implications for clinical caution
Authors: Delinassios John G. , Hoffman Robert M. , Koumakis George , Palitskaris Dimitrios , Poulatsidou Kyriaki-Nefelli , Delinasios George J. 
Published: December 2024

Aim
This study investigates the impact of sub-toxic cisplatin levels on nuclear and nucleolar abnormalities and chromosome instability in HeLa cells since our current knowledge of cisplatin effects on these parameters is based on studies with high concentrations of cisplatin.

Materials and methods
HeLa cells were exposed to gradually increasing sub-toxic doses of cisplatin (0.01 to 0.2 μg/ml). Cells treated with 0.1 and 0.2 μg/ml, termed HeLaC0.1 and HeLaC0.2, were not cisplatin-resistant, only exhibiting a slightly reduced viability, and were termed “cisplatin-sensitized cells.” Giemsa and silver staining were used to detect nuclear and nucleolar abnormalities and chromosomal alterations.

Results
Notable abnormalities were observed in HeLaC0.1 and HeLaC0.2 cells after treatment with sub-toxic concentrations of cisplatin: nuclei showed abnormal shapes, blebs, micronuclei, fragmentation, pulverization, and multinucleation; nucleoli exhibited irregular shapes and increased numbers; anaphase cells showed more nucleolar organizing regions. Abnormal chromosome segregation, heightened aneuploidy (81–140 chromosomes), polyploidy, double minutes, dicentrics, chromatid exchanges, chromatid separations, pulverization, and chromosome markers were prominently noted. These abnormalities were intensified in cells pre-sensitized to 0.02 or 0.08 μg/ml cisplatin for seven days, then exposed to 0.03 or 0.1 μg/ml cisplatin for 24 hours, and finally cultured in cisplatin-free medium for 24 hours before chromosome analysis.

Conclusion
HeLa cells subjected to increasing concentrations of sub-toxic cisplatin exhibited large-scale, multiple-type abnormalities in nuclei, nucleoli, chromosomes, and chromosomal numbers, indicating genetic/chromosomal instability associated with high malignancy, before the development of cisplatin resistance. These results suggest that low doses of cisplatin administration in the clinical setting may promote malignancy and caution should be used with this type of treatment.
Effect of concentric exercise-induced fatigue on proprioception, motor control and performance of the upper limb in handball players
Authors: Hadjisavvas Stelios , Efstathiou Michalis A. , Themistocleous Irene-Chrysovalanto , Daskalaki Katerina , Malliou Paraskevi , Giannaki Christoforos D. , Lewis Jeremy , Stefanakis Manos 
Published: December 2024

Background
The last phases of a competitive game are when shoulder injuries most commonly happen, and fatigue is thought to be a major contributing factor, perhaps because of reduced proprioception and motor control. The purpose of this study was to investigate the effect of concentric fatigue on proprioception, motor control, and performance of the upper limb in handball players.

Methods
Forty-six right-handed handball players (all males, age 26.1 ± 5.54 years) were included in this test-retest laboratory experiment. Proprioception was assessed using joint reposition sense (JRS), threshold to detection of passive movement (TTDPM), muscle onset latency (MOL), motor control using Y balance test upper quarter (YBT-UQ) and performance using the athletic shoulder test (ASH) before and immediately after fatigue intervention. The fatigue protocol consisted of concentric, maximal effort, isokinetic contractions at 900/sec with sets of 30 repetitions of the shoulder external and internal rotator muscles. Fatigue was determined by a 40% decline in the peak torque over three consecutive contractions despite reinforcing feedback and encouragement.

Results
A significant increase in absolute angular error (AAE) was observed in all target angles in both external rotation (ER) and internal rotation (IR) directions (p < 0.01). In addition, there was a significant increase in TTDPM in internal rotation after fatigue intervention (p = 0.020. Variable changes were found in YBT-UQ and ASH tests. Specifically, statistically significant differences were found in anteromedial (AM) (p = 0.041), superolateral (SL) reach directions (p = 0.005), composite score (p = 0.009) in the right hand and inferolateral (IL) reach direction in the left hand (p = 0.020) in the YBT-UQ. In addition, there was a significant reduction in isometric strength (ASH test) in the I position of the right hand (p = 0.010) and all positions of the left hand (p<0.05). Furthermore, there was an increase in MOL scores after fatigue but the increase was not significant (p > 0.05).

Conclusions
Concentric fatigue of the rotator cuff muscles induces notable deficits in joint position awareness, kinesthesia, motor control, and performance of the upper extremity in elite male handball players. Although fatigue reduces reflex reaction time the effect is only marginal.
Association between serum endocan levels and organ failure in hospitalized patients with cirrhosis
Authors: Wejnaruemarn Salisa , Suksawatamnuay Sirinporn , Vanichanan Jakapat , Komolmit Piyawat , Treeprasertsuk Sombat , Thanapirom Kessarin 
Published: December 2024

Background & aims
Acute-on-chronic liver failure is a syndrome characterized by organ failure and high short-term mortality. The lack of reliable biomarkers for the early detection of acute-on-chronic liver failure is a significant challenge. Endothelial dysfunction plays a key role in the development of organ failure. Serum endocan is a potential new biomarker for endothelial dysfunction. Therefore, this study aimed to assess the association between endocan and organ failure and 28-day mortality in patients with cirrhosis.

Methods
Hospitalized patients with cirrhosis with and without organ failure were prospectively enrolled according to the criteria of the European Association for the Study of Liver-Chronic Liver Failure consortium. The comparative performances of serum endocan, procalcitonin, and interleukin-6 for diagnosing organ failure and predicting mortality were studied.

Results
The study included 116 hospitalized patients with cirrhosis, 55 of whom had organ failure on admission. Patients with organ failure had significantly higher endocan, procalcitonin, and interleukin-6 levels than those without it. At a cut-off value of 15.8 ng/mL, endocan showed a sensitivity of 63.6% and specificity of 67.2% for the diagnosis of organ failure, with an area under the receiver operating characteristic curve of 0.65, which is comparable to procalcitonin and interleukin-6. Multivariate analysis identified serum endocan, creatinine, and total bilirubin as independent factors for organ failure in hospitalized patients with cirrhosis. Patients who died within 28 days had significantly higher baseline biomarker levels than those who survived. Liver failure, hospital-acquired infection, mechanical ventilator use, and interleukin-6 ≥37 pg/mL were independent predictors of 28-day mortality.

Conclusion
Serum endocan is associated with organ failure and is an independent risk factor of organ failure in hospitalized patients with cirrhosis.
Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China
Authors: Lin Guodong , Peng Hailun , Yin Bingling , Xu Chongxiao , Zhao Yueli , Liu Anwei , Guo Haiyang , Pan Zhiguo 
Published: December 2024

Objective
In this retrospective analysis, we explored the clinical characteristics and risk factors of secondary infections in patients with severe heatstroke with the aim to gain epidemiological insights and identify risk factors for secondary infections.

Method
The study included 129 patients with severe heatstroke admitted to the General Hospital of the Southern Theater Command of the PLA between January 1, 2011, and December 31, 2021. Patients were divided into an infection group (n = 24) and a non-infection group (n = 105) based on infection occurrence within 48 h of intensive care unit (ICU) admission. Clinical indicators, infection indicators, and clinical outcomes within 24 h of ICU admission were collected and compared between the groups. Independent risk factors for infection in patients with severe heatstroke were analyzed using univariate and multivariate analyses. A nomogram model was constructed, evaluated, and validated.

Result
Among the 129 patients with heatstroke, 24 developed secondary infections. Infections occurred between days 3 and 10 post-ICU admission, primarily affecting the lungs. Multivariate analysis identified vasopressor use, serum creatinine level, and gastrointestinal dysfunction at admission as independent risk factors, while elevated lymphocyte count (odds ratio [OR] = 0.167; 95% confidence interval [CI] 0.049–0.572; P = 0.004) was protective against severe heatstroke. Infected patients required longer durations of mechanical ventilation (OR = 2.764; 95% CI, 1.735–4.405; P = 0.044) and total hospital stay than those in the non-infection group. The nomogram model demonstrated clinical feasibility.

Conclusion
Increased lymphocyte count is an independent protective factor against infections in patients with severe heatstroke. Vasopressor use, gastrointestinal dysfunction, and elevated serum creatinine levels are independent risk factors. These indicators can aid clinicians in assessing infection risk in patients with severe heatstroke.
Survey of Geriatric Competencies and Curricular Models in Entry-Level DPT Programs in the United States
Authors: Mierzwicki Justin T. , Blood Karen M. 
Published: December 2024

Background and Purpose:
Nearly 2 decades have elapsed since the last national survey examining entry-level PT geriatric content. Furthermore, no survey has been completed investigating the extent to which the “Essential Competencies in the Care of Older Adults at the Completion of Entry-level Physical Therapist Professional Program of Study” were incorporated into DPT programs. The purpose of this study is to identify the extent to which DPT programs include geriatric topics and the Essential Competencies within curricula and determine geriatric content requiring proficiency for entry-level practice.

Methods:
A survey was developed in Qualtrics™ and distributed via email 4 times over 2 months in 2023 to DPT program chairs and APTA social media platforms. The survey contained sections on geriatric curriculum models, environment of content coverage, incorporation of Essential Competencies, and skills requiring entry-level proficiency. Data analysis was completed using descriptive statistics.

Results and Discussion:
Responses were received from 134/276 programs. Seventy-nine and nine tenths percent of responding programs have a dedicated geriatric course, 93.4% of which require 1 geriatric course, with a mean of 2.6 credits (SD 1.02). In programs without dedicated geriatric courses, a mean of 2.7 credit hours (SD 2.88) of geriatric content was reported. Eighty-nine percent of programs cover age-related changes to major body systems and balance and fall screening, with <60% addressing interventions for cognition and social isolation. Of the surveyed Essential Competencies, 80.4% were incorporated into >70% of programs. A total of 31.6% of the tests and measures were taught, 15.8% were practiced, and 10.5% were identified by >70% of programs as requiring proficiency for entry-level practice.

Conclusions:
There is variation in geriatric content incorporated into entry-level DPT programs and moderately robust uptake of Essential Competencies. Entry-level education may not meet APTA-Geriatrics Best Practice guidelines with relatively few tests, measures, and interventions recommended with consensus to be proficient prior to entry-level practice. Improved knowledge translation and curricular guidance may help reduce practice variation and enhance entry-level education in geriatric physical therapy.