bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of road traffic accidents and its associated factors among public transportation in Africa: systematic review and meta-analysis
Authors: Atalay Yibeltal Assefa , Alemie Bersufekad Wubie , Gelaw Belete , Gelaw Kelemu Abebe 
Published: February 2025

IntroductionNowadays, Injuries, disabilities, and deaths due to road traffic accidents pose a major threat to public health worldwide. There was no meta-analysis study conducted in this area in Africa, hence the need for the study.ObjectivesThis review aimed to assess the pooled prevalence and associated factors of road traffic accidents among public transportation in Africa.MethodsThis systematic review and meta-analysis study was conducted in Africa according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using Boolean logic operators and targeted keywords, we searched for publications on several electronic databases (Web of Science, PubMed, Google Scholar, African Journals Online (AJOL), and Science Direct). The degree of heterogeneity among the included studies, the 95% confidence interval, and the pooled prevalence were estimated using a random effects model.ResultsThis review included 45 studies with 15,968 participants. The overall estimated pooled prevalence of road traffic accident among public transportation in Africa was found to be 38.83% (95% CI: 33.54, 44.12). Meta-regression analysis indicated that sample size, publication year, country, study design, and sub-region had no significant impact on RTA prevalence. Based on a sub-group analysis by countries where the studies were conducted, the higher pooled prevalence of road traffic accidents was found in Congo at 67.90% (95% CI: 59.99, 75.81), while the lower pooled prevalence of road traffic accidents was in Libya at 15.80% (95% CI: 10.99, 20.61). Driving experience (AOR: 2.64, 95% CI: 1.70, 3.34), chewing Khat while driving (AOR = 4.69, CI: 2.80, 7.85), alcohol use (AOR = 2.72, CI: 1.49, 4.97), and receiving mobile phone calls while driving (AOR = 2.37, CI: 1.42, 3.95) were factors significantly associated with road traffic accidents.ConclusionIn conclusion, the pooled prevalence of road traffic accidents in Africa was found to be high. Therefore, we recommend that drivers have to strictly adhere to traffic regulations Moreover, It is recommended that policymakers and administrators ought to gain awareness of road traffic accidents and its risk factors to put existing road traffic accidents preventive and control measures into action.
Systematic review of the epidemiological evidence of associations between quantified occupational exposure to respirable crystalline silica and the risk of silicosis and lung cancer
Authors: Mundt Kenneth A. , Thompson William J. , Dhawan Gaurav , Checkoway Harvey , Boffetta Paolo 
Published: February 2025

IntroductionOccupational exposure to respirable crystalline silica (RCS) has been associated with both silicosis and lung cancer, but no systematic review (SR) specifically focused on exposure-response relationships has been published for these diseases.MethodsWe conducted this SR in compliance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed searches, supplemented with Web of Science and Google Scholar searches, identified 1,007 potentially relevant articles. After applying selection criteria and removing duplicates, 65 publications were reviewed and evaluated, 20 of which presented at least semi-quantitative exposure-response results for lung cancer (n = 12) and/or silicosis (n = 10).ResultsCumulative RCS exposure was most commonly reported. Increasing silicosis risk with increasing cumulative RCS exposure was reported in all studies, with exposure thresholds indicated, but at different cumulative exposures. For most studies defining silicosis as International Labor Organization (ILO) score ≥ 1/0, substantially increased risks were clear at or above 1 mg-/m3-yr. For lung cancer, exposure-response estimates were mixed with 4 studies reporting no statistically significantly increased relative risk of lung cancer at any cumulative RCS exposure. Three studies reported statistically significant increased risks but only for high cumulative RCS exposures. Residual confounding by smoking was not explicitly discussed in most studies. One case–control study presented an exposure-response analysis for silica and lung cancer limited to never-smokers with substantial silica exposure; risk was increased only among those in the highest RCS exposure category. Studies with more detailed smoking information generally reported risks close to background levels except at the highest cumulative RCS exposure categories.ConclusionSilicosis risk clearly and consistently was increased above cumulative exposure thresholds of roughly 1 mg/m3-years across most studies. However, for lung cancer, results were heterogeneous with potential residual confounding by smoking complicating interpretation. Results suggest that lung cancer risk may not be increased at cumulative RCS exposures below the reported exposure thresholds for silicosis risk.
OpenSEA: a 3D printed planetary gear series elastic actuator for a compliant elbow joint exoskeleton
Authors: Jenks Benjamin , Levan Hailey , Stefanovic Filip 
Published: February 2025

IntroductionNext-generation assistive robotics rely on series elastic actuators (SEA) that enable compliant human-robot interaction. However, currently there is a deficiency of openly available SEA systems to support this development. To address this, we propose a novel design of a compliant 3D-printed SEA device for elbow movement rehabilitation exoskeletons that we make openly available.MethodsWe designed a 3D-printed SEA to incorporate a planetary gear system and torsional spring, offering compliance, adaptability, and cost-effectiveness. The design provides a high-power density, that can address torque limitations in 3D printed SEA systems. Our design utilizes a 4.12 Nm motor operating at 26 RPM based on assessment of functional performance differences across healthy and post-stroke individuals. Moreover, the design of this SEA allows for easily adjustable parameters to fit different joints, or various torque output configurations, in low-cost exoskeleton applications in rehabilitation.ResultsTesting demonstrated an average compliance contribution of the planetary gear and the average total system compliance of 14.80° and 22.22°, respectively. This range conforms to those expected in human-exoskeleton interaction. Similarly, an FEA analysis of the 3D printed system shows stress ranges of the SEA gears to be between 50 and 60.2 MPa, which causes a displacement of approximately 0.14 mm. This is within the operational flexural range of standard 3D printed materials such as PLA, which is 175 MPa.DiscussionThe study demonstrates an openly available SEA design for 3D printed exoskeletons. This work provides an entry point for accessible exoskeleton design, specifically for rehabilitation. Future work will explore the role of segment vs joint rigidity in developing next-generation compliant exoskeletons, and improving accessibility for personalizable assistive exoskeletons. All designs presented herein are publicly available.
Does gender equality in sports matter? examining the socio-economic impact on public perceptions
Authors: Indelicato Alessandro 
Published: February 2025

IntroductionGender equality (GE) is increasingly becoming a key point on modern political agendas. While governments and civil societies strive to achieve this goal, we may be far from “perfect” equality between women and men. Sport is a good example of some of the inequalities that men and women face, such as pay, discrimination, and unequal opportunities.MethodsThe study uses data from the Special Eurobarometer 525 (April–May 2022) to understand attitudes towards GE in sports (ATGEQS). By applying Fuzzy-Hybrid TOPSIS approach, and other methods like Latent Profile Analysis and Multinomial Logistic Regression, I investigate how gender, age, income, education, political beliefs and nationality affect these attitudes.Results and DiscussionThe Nordic countries have the highest ATGEQS, while support for EU GE policies, left-wing views, and life satisfaction is positively related to favourable attitudes. The findings highlight the need for awareness and policies for sports participation to be created, with greater emphasis on disadvantaged groups.
Development of a Clinical Decision Support System for Evidence-Based Management of Hypertension in Older Patients Using a No-code Platform
Authors: Kudabaeva Venera Zh. , Mansharipova Almagul T. , Shulzhenko Larisa V. , Krasnov Gleb S. , Pershukov Igor V. 
Published: February 2025

Hypertension is common among older people and often accompanied by frailty. Physicians are in need of comprehensive assessment tools to effectively manage hypertension in older patients.We conducted a literature search and evaluated current studies, systematic reviews and meta-analyses, exploring the relationship between hypertension and frailty. Based on the analysis findings, we developed an IT solution with hypertension management elements for geriatric physicians. This article exemplifies the work with the literature and a no-code platform (IT system for developing medical solutions without programming knowledge) to create a clinical decision support system for geriatric physicians. This system will be used in subsequent studies using real-world data.
Intensive Care Management of Pediatric Status Asthmaticus
Authors: Bykov Yuri V. , Obedin Alexander N. , Muravyova Alla A. , Zinchenko Oleg V. 
Published: February 2025

Background: Status asthmaticus (SA) in children and adolescents is a medical emergency that requires immediate specialized care in an intensive care unit.Objective: To determine the current state of the problem regarding etiopathogenesis, diagnosis, and intensive care management of pediatric SA.Materials and methods: We searched keywords (status asthmaticus, children and adolescents, glucocorticoids, intensive care, mechanical ventilation) in the Cochrane Library, PubMed, and Medscape and analyzed the found papers. We selected 42 sources for the review. The inclusion criterion was the description of the pathogenesis, clinical manifestations, and intensive care features in children and adolescents with SA. The exclusion criterion was the information on etiopathogenesis, clinical manifestations, and emergency care in adults and older adults with SA.Results: Glucocorticoids and β2-agonists are the first line of therapy in SA. Oxygen therapy, including high-flow oxygen delivery and noninvasive positive pressure ventilation, is critical in pediatric cases. The second-line treatment includes methylxanthines, anticholinergic drugs, and magnesium sulfate. In case of drug treatment failure, children are intubated and placed on mechanical ventilation.Conclusions: Pediatric SA is a medical emergency with a high mortality risk, requiring competent emergency care. Knowledge of step-by-step intensive therapy will improve the management of this condition in children and adolescents.
Therapeutic Apheresis in Early-Onset Preeclampsia: Literature Review
Authors: Plakhotina Elena N. , Belousova Tamara N. , Bryancev Evgenii V. , Chaplygina Oksana V. 
Published: February 2025

Preeclampsia is a multisystem disorder that manifests after 20 weeks’ gestation. It is a leading cause of maternal and fetal morbidity and mortality. Approximately 25% of early-onset preeclampsia cases are severe, and 85% of pregnant women with severe preeclampsia develop multiple organ failure. Stillbirth and early neonatal mortality in women with early-onset preeclampsia are 3%-5% higher than those in cases of late-onset preeclampsia. Birth asphyxia is diagnosed in 100% of newborns. Invasive respiratory support is required in 80% of cases. Every fourth newborn has cardiovascular and central nervous system issues.The analyzed literature demonstrated a possibility of pregnancy prolongation in early-onset preeclampsia using different therapeutic apheresis techniques, which can reduce negative consequences for newborns and mothers.
Cellular Immunity in Patients With Small Cell Lung Cancer in Presence and Absence of Circulating Tumor Cells
Authors: Khomidov Mekhrullokhodzha A. , Zlatnik Elena Y. , Novikova Inna A. , Haragezov Dmitriy A. , Lejman Igor A. , Ayrapetova Tamara G. , Stateshnyy Oleg N. , Milakin Anton G. , Mirzoyan Ellada A. , Yozef Kristian D. , Antonyan Arthur A. , Alekseev Eduard K. 
Published: February 2025

Background: Circulating tumor cells (CTCs) play an important role in hematogenous metastasis of malignant tumors. Small cell lung cancer (SCLC) is the most aggressive form of lung cancer with the highest number of detected CTCs.Objective: To evaluate the presence and number of CTCs as an immunosuppression factor in SCLC.Materials and methods: In 30 patients with stage III-IV SCLC, CTCs were detected using the CellSearch system (Veridex LLC, Belgium) before treatment. The participants were divided into groups based on presence of CTCs. Flow cytometry was used to assess T- and natural killer (NK)-cellular components of the immune system and revealed that the CTC presence in patients with SCLCwas accompanied by low levels of NK cells expressing CD335+, granzyme B, and perforin and lower levels of helper T cells with markers of early activation (CD38 and CD69). Lower levels of CD8+CD69+ activated cytotoxic T cells were observed with the highest level of CTCs (>50). Thus, a decrease in the quantitative and functional parameters of T and NK cells in presence of CTCs can be regarded as one of the immunosuppression factors in patients with SCLC.Results: The presence of CTCs, regardless of their number in the blood of patients with SCLC, is characterized by suppression of the innate immune system: decreased functional activity of NK cells, which, even with the preservedtotal number of NK cells, leads to a decrease in their antitumor potential and is often observed in case of widespread metastases. A similar pattern was noted in the analysis of the adaptive immune system, namely, the T cells.Conclusions: As with other malignant tumors, the presence of CTCs in patients with SCLC can be regarded as one of the immunosuppression factors.
Features of Ultrasonographic Anatomy and Manifestations of Local Complications in Acute Necrotizing Pancreatitis
Authors: Tseneva Olga A. , Moiseenkova Elena V. , Doroshenko Dmitriy A. , Mikhailusov Sergei V. , Anosov Viktor D. , Hokonov Muhamed A. , Koroshvili Vadim T. 
Published: February 2025

Relevance: Diagnosing pancreatic necrosis and its complications is challenging despite the widespread use of state-of-the-art highprecision imaging methods in routine practice.Objective: To determine topographic features of local complications of pancreatic necrosis using ultrasonography and their effect on the disease outcome.Materials and methods: We examined 92 patients (mean age, 42.8±4.6 years) with moderate and severe pancreatic necrosis. There were 4 types (models) of pancreatic necrosis according to the spread of local complications: central, 25 cases (27.2%); left, 32 (34.8%); right, 16 (17.4%), and mixed, 19 (20.6%). We used ultrasound machines: LOGIQe (GE HealthCare, USA), MyLab 70 (Esaote, Italy), Voluson S10 (GE HealthCare, USA), with convex and linear transducers (5.0 and 7.5 MHz). Analyses were conducted with Microsoft Excel 2017 (Microsoft Corp, USA) using mean values, 95% CI, the χ2 test, and the P value.Results: We determined a diagnostic ultrasonographic algorithm, topographic relationship of local complications and abdominal organs, and ways of inflammation and necrosis spread, and compared disease outcomes for different configurations of foci. Discussion: The most popular landmark was the parapancreatic fiber and omental bursa (93.4%); the least, the paranephrium (28.3%) (χ2=135.674; P <.001) Leakage along Gerota and Toldt fascias showed no differences between the left and right sides (χ2=0.028; P=.867 and χ2=0.001; P=.977). Among the isolated foci, “stripes” (41.4%) (χ2=26.561; P <.001), “ovals” (20.7%) (χ2=75.625; P <.001) ), and “drops” (17.2%) (χ2=47.207; P <.001) were more common findings than complex configurations (“horseshoes” and “butterflies”).Conclusions: The refined diagnosis of local complications of pancreatic necrosis, ultrasonographic manifestations, and syntopy enable to predict the effectiveness of ultrasonography-guided percutaneous drainage and choose an optimal surgical approach.
Optimizing Mitral Valve Replacement Outcomes: The Role of Goal-Directed Hemodynamic and Fluid Therapy in the Perioperative Period
Authors: Ibadov Ravshan A. , Aliev Sherzod M. , Ibragimov Sardor Kh. , Ergashev Suhrob P. 
Published: February 2025

Background: There is no doubt that hemodynamic monitoring plays a crucial role in cardiac surgery. Research is generally aimed to identify optimal strategies for maintaining hemodynamic stability, reducing complications, and minimizing recovery time after surgery.Objective: To study the effect of echocardiography-guided goal-directed hemodynamic and fluid therapy on perioperative outcomes of mitral valve replacement (MVR).Material and methods: We analyzed data from 146 patients with mitral regurgitation who underwent MVR. The patients were grouped by standard hemodynamic therapy (comparison group, n=74) and goal-directed therapy (main group, n=72). The study groups were representative, and preoperative clinical, laboratory, and imaging data did not differ significantly between the groups. The study period began with the induction of general anesthesia and ended with hemodynamic stabilization achieved. This point of clinical recovery was defined as the successful extubation and absence of vasoactive support; the dose of inotropes and/or vasopressors was either completely weaned off or remained unchanged for >8 hours.Results: The study groups differed in several key parameters. The anesthesia time decreased from 255 to 223 minutes (P=.02), and the cardiopulmonary bypass time from 94 to 82 minutes (P<.001). The volume of fluids until hemodynamic stabilization was achieved was higher in the comparison group (P=.002). Inotropes were used more often in the comparison group (P><.05). The mechanical ventilation time in the main group and the comparison group was 7.33 and 13 hours, respectively (P><.001); the intensive care unit length of stay was 1.1 and 1.8 hours (P=.014), respectively. The incidence of acute myocardial ischemia was lower in the main group (2.8% vs 12.2%, P=.026). Conclusions: Goal-directed hemodynamic and fluid therapy significantly improves MVR outcomes and reduces the risk of postoperative complications and long-term use of cardiovascular drugs.> <.001) . The volume of fluids until hemodynamic stabilization was achieved was higher in the comparison group (P=.002). Inotropes were used more often in the comparison group (P <.05) ). The mechanical ventilation time in the main group and the comparison group was 7.33 and 13 hours, respectively (P <.001) ; the intensive care unit length of stay was 1.1 and 1.8 hours (P=.014), respectively. The incidence of acute myocardial ischemia was lower in the main group (2.8% vs 12.2%, P=.026).Conclusions: Goal-directed hemodynamic and fluid therapy significantly improves MVR outcomes and reduces the risk of postoperative complications and long-term use of cardiovascular drugs.
Analysis Of Students Higher Order Thinking Skills Reviewed From The Speed Of Answering Science Questions
Authors: Rifda Nur Hikmahwati Arif  , Sitti Saenab  , Sulastri  , Salma Samputri  , M. Arifuddin Jamal  , Rifda Mardian Arif  
Published: February 2025

This study aims to analyze 1) The Score of Higher-Order Thinking Skills (HOTS) of International Class Program (ICP) students of Science Education Study Program FMIPA UNM, 2) The Score of Higher-Order Thinking Skills (HOTS) of International Class Program (ICP) students in relation to the speed of answering questions. This is a descriptive quantitative research involved 18 students, with an instrument in the form of a Quizizz application-based test. Data were analyzed descriptive statistic based on the distribution of correct answer values and also the time to answer the science questions. The results of the research showed that: (1) The average score of higher order thinking skills of IPA ICP FMIPA UNM students was 42,8 in a medium category. The frequency of students were in the categories Very high was 0% , high was 17%, medium was 33%, low was 44% and Very low was 16%. (2) Students who answered at a moderate speed (21-30 seconds) had the highest average score of 66.67, indicating that moderate time management provides better results than a very fast speed (0-10 seconds) or very slow (≥41 seconds), with scores of 36.67% and 44.17% respectively. This research confirms that moderate management of answering time supports better learning outcomes. To improve HOTS abilities, it is recommended to implement problem-based learning and regular practice of HOTS questions.
The Language of Inclusion and its Impact on the Leadership of Equity within Scottish Secondary Schools
Authors: McConachie Ruth 
Published: February 2025

Language and power are inextricably linked, and our use of language influences our attitudes, beliefs and values as human beings. This study focuses on how representations of inclusion frame our collective understanding of the term. It uses Critical Discourse Analysis to analyse how inclusion is represented in key Scottish policies, media headline representations and through professional association discourse. These different representations contribute to a variance in understanding and the narrative within education about inclusion. Empirical research was undertaken with head teachers in a case study local authority to consider how these representations feature within their settings, and examine any impact on the leadership of equity.
Ultimately, language impacts on our attitudes and collective understanding about inclusion. This paper considers how varying attitudes potentially undermine the leadership of equity within secondary schools.