bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Efficacy of Ezetimibe Combined with Rosuvastatin in the Treatment of Patients with Primary Hypercholesterolemia Inadequately Controlled by Statin Therapy
Authors: Wei Zhifeng , Wang Fang , Zhang Lina , Dai Weixin 
Published: December 2024

Aims/Background Primary hypercholesterolemia (PHC) is a major risk factor for atherosclerotic cardiovascular disease (ASCVD). Although the fact that statins effectively lower low-density lipoprotein cholesterol (LDL-C) levels, some patients fail to achieve target LDL-C levels and continue to have a high risk of cardiovascular disease. This study aims to evaluate the clinical efficacy and safety of ezetimibe combined with rosuvastatin in patients with PHC. Methods This study retrospectively examined 101 patients with PHC who received statins at the cardiology department of Jilin Province FAW General Hospital, between 2021 and 2024. Patients were divided into the observation (ezetimibe combined with rosuvastatin, n = 45) and control (rosuvastatin, n = 66) groups in accordance with their treatment regimens. Data were sourced from the hospital's electronic health records system, and statistical analysis was performed by using SPSS 25.0 software (IBM Corporation, Armonk, NY, USA). Results Baseline characteristics were similar between the two groups. After 12 weeks of treatment, the reduction in LDL-C levels in the observation group (–0.373 [–0.427, –0.348]) was greater than that in the control group (–0.240 [–0.318, –0.222], p < 0.001). The percentage changes in total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels were significantly better in the observation group (TC: –0.230 [–0.302, –0.144], TG: –0.292 [–0.333, –0.237], and HDL-C: 0.081 [0.067, 0.111]) than in the control group (TC: –0.127 [–0.158, –0.119], TG: –0.082 [–0.101, –0.067], and HDL-C: 0.000 [–0.163, 0.133] with p < 0.001, p < 0.001, and p = 0.011, respectively). Regarding drug safety, the incidence of adverse events was comparable between the two groups (11.10% vs. 12.10%, p = 0.871). Conclusion The combination of ezetimibe and rosuvastatin demonstrates superior lipid-lowering efficacy and good safety in patients with PHC inadequately controlled by statin therapy, providing an effective alternative treatment option. Further large-scale, multicenter randomized controlled trials are warranted to confirm its long-term efficacy and safety.
A High-Resolution and High-Bandwidth Nano-Optomechanical MEMS Accelerometer with Ultra-Wide Optical and Temperature Ranges
Authors: Ge Chang , Dominguez Daniel , Miller Michael , Eichenfield Matt 
Published: December 2024

We demonstrate a > 10 milligram, fiber-packaged, ultra-high-sensitivity nano-optomechanical MEMS accelerometer using an intrinsically differential Mach-Zehnder strain-sensing interferometer with
10μ g/Hz resolution up to 100 kHz. The differential readout is insensitive to wavelength and temperature over ~40 nm and ~30 degree ranges, respectively.
Antioxidant, anti-prostate cancer potential, and phytochemical composition of the ethyl acetate stem bark extract of Boascia coriacea (Pax.)
Authors: Moriasi Gervason , Ngugi Mathew , Mwitari Peter , Omwenga George 
Published: December 2024

Background
The antioxidant and anticancer potential of natural compounds, particularly from medicinal plants, is increasingly being explored as alternatives to synthetic antioxidants and chemotherapeutics. Boascia coriacea (Pax) has been traditionally used for treating various ailments, including oxidative stress-related diseases and prostate cancer. However, there is a paucity of empirical evidence to validate the ethnomedicinal claims, hence this study.

Methods
The antioxidant capacity of the extract was assessed using 1,1-Diphenyl-2-picryl Hydrazyl radical (DPPH) radical scavenging and hydrogen peroxide scavenging assays, alongside total antioxidant capacity. In vitro cytotoxicity was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay on Vero CCL-81 normal cells and DU-145 prostate cancer cells. Gene expression levels of ar, bcl-2, caspase 3, cdk1, and p53 were quantified using qPCR to elucidate the mechanisms of action. Phytochemical analysis was conducted using gas chromatography-mass spectrometry.

Results
The studied plant extract exhibited significant DPPH radical scavenging activity, with an EC50 of 0.008 μg/ml, 10-fold lower than that of L-ascorbic acid (0.08 μg/ml), indicating potent antioxidant capacity. Similarly, the extract demonstrated substantial hydrogen peroxide scavenging activity, albeit with lower efficacy (EC50 of 1039.10 μg/ml) compared to L-ascorbic acid, and a total antioxidant capacity of 454.39±25.26 μg AAE/mg dw. In vitro cytotoxicity assay revealed a CC50 of 68.61 μg/ml against Vero CCL-81 cells and an IC50 of 32.16 μg/ml against DU-145 cells, with a superior selectivity index of 2.13, compared to doxorubicin’s 1.46. The extract significantly downregulated the expression of ar, bcl-2, normalised caspase 3, cdk1 genes while upregulating p53 in DU-145 cells, suggesting its role in inducing apoptosis and inhibiting cancer cell proliferation. Phytochemical analysis identified 19 compounds, including lup-20(29)-en-3-one (7.99%) and lupeol (59.49%), which are associated with anticancer activity.

Conclusion
The ethyl acetate stem bark extract of B. coriacea demonstrates significant antioxidant and anticancer activities, potentially through modulation of apoptosis and cell cycle pathways. The presence of bioactive compounds supports its potential as a therapeutic agent, warranting further investigation for developing novel treatments for prostate cancer and oxidative stress-related conditions.
The nature, sequence and duration of professional activities of Emergency Medical Service providers: An observational study to evaluate quality of care using the steps in the EMS care process as described by the SPART model
Authors: Dercksen Bert , Struys Michel M. R. F. , Paans Wolter , Cnossen Fokie 
Published: December 2024

Background
The quality of care given by EMS staff is in part monitored by routine review of deployment reports that the providers must complete after each deployment. The assessment consists of determining whether a deployment was performed in a medically correct manner and thus whether the clinical reasoning process was appropriate. The time used during the deployment is also measured, as there are often time limits for performing different parts of the deployment and these must be adhered to. One might question whether measuring the time spent really gives insight into the quality of care, and if it might not be more useful to see how that time was spent. We therefore conceived a study to map the EMS care process and evaluate this process in relation to the time used.

Methods
We used a focused ethnographic study design. Video recordings of EMS deployments in combination with semi-structured interviews of the EMS providers involved, were thematically analysed. This led to insights into the EMS care process and the embedded clinical reasoning. By categorising the professional activities we identified we were able to define a model that describes in general the EMS care process. We reported the first part of this study in which we developed this so called SPART model in a separate paper. In this second part of the study we determined the execution time within a deployment and measured the frequency of occurrence and the duration of the identified activities. We interpreted the operational content and the time variables both qualitatively and quantitatively. We also determined the distribution of activities over the three deployment operational periods (response, on-scene and transport period).

Results
Using the SPART model, we gained insight into the different activities’ nature, order, and duration. We could qualitatively judge the effectiveness of the clinical reasoning process, i.e., the quality of care delivered. Generally, the studied cases were followable, and the clinical reasoning process was medically logical. The diagnostic process sometimes continued after the clinical decision, which was not medically logical. Remarkably, this never changed the clinical decision. Although this could negatively affect the quality of care, we found no clinical evidence that this was the case.

Conclusion
Our findings demonstrated that the quality of care in EMS can be measured by using the SPART model to evaluate EMS deployments. We concluded that qualitative judgment was more important than quantitative evaluation. Interpreting the order of different activities led to the clearest understanding of the clinical reasoning process. It was concluded that knowledge of the exact time used per activity and, in total, had the least impact on understanding the clinical reasoning process.
Photobiomodulation in post menopause genitourinary syndrome—Study protocol for a randomized, double-blind, controlled clinical protocol
Authors: Pereira Silvia Regina dos Santos , Mesquita-Ferrari Raquel Agnelli , Salviatto Luciana Toledo Costa , Bezerra Cícero Dayves da Silva , Dalapria Vanessa , Mello Erika da Silva , Almeida-Lopes Luciana , Bossini Paulo Sérgio , Gonçalves Marcela Leticia Leal , Deana Alessandro Melo 
Published: December 2024

Introduction
Genitourinary Syndrome of Menopause (GSM) defines a set of symptoms associated with an estrogen deficit involving alterations in organs genitourinary and that results in several urinary, genital, and sexual alterations. Brazilian women live about a third of their life after menopause, where hormonal changes occur along with clinical manifestations, characterized by vaginal and vulvar dryness, burning sensation, discomfort, vulvovaginal irritation, lack of lubrication, dyspareunia and urinary incontinence. Fractionated photothermolysis and radiofrequency systems, alone or in combination were tested to improve GSM.

Objective
The goal of this study is to elaborate a protocol to evaluate the clinical response of patients with symptoms of GSM after the application of photobiomodulation in the vulvar region.

Method
In this randomized, double-blind, placebo-controlled study protocol, women over 50 years of age who are in the postmenopausal period (amenorrhea for at least 12 months, with no pathology involved) with one or more symptoms of GSM will be randomly divided into two groups. The treatment group (n = 30) will receive four consecutive applications, weekly, using DMC laser diode (λ = 808 nm), 4J per point, 100mW of power, 1,016W/cm2, 8 sites in the vulvar region, The Placebo Group (n = 30) will be handled as treated, but with the laser turned off. The quality of life will be assessed using female sexual functioning index (FSFI-6), urinary incontinence questionnaire (ICIQ-SF), Quality of life will be analyzed using the female sexual functioning index (FSFI-6). The intensity of menopausal symptoms will be evaluated using a visual analogue scale (VAS), the vulvo vaginal atrophy will be measured by the Vaginal Health Index (VHI). Also, the vaginal temperature will be measured using a thermal camera, the pressure of the pelvic floor force (vaginal dynamometer) and a 1-hour Pad Test will be performed to quantify the urinary loss. With this procedure, we intend to obtain an overall better life quality and diminished symptoms in women with GSM. All assessments will be performed prior to the first irradiation and after the last one.

Trial registration
This protocol is registered at ClinicalTrials.gov under the number NCT05557799.
Exploring access to health and social supports for intimate partner violence (IPV) survivors during stressful life events (SLEs)—A scoping review
Authors: Idriss-Wheeler Dina , Bancroft Xaand , Bouraleh Saredo , Buy Marie , Yaya Sanni , El-Khatib Ziad 
Published: December 2024

Background
Survivors of intimate partner violence (IPV) often face increased incidents of violence during stressful life events (SLEs) such as economic recessions, environmental disasters, and pandemics. These events can diminish the effectiveness of both formal (e.g., health, social, justice, labor, community) and informal (e.g., friends, family, neighbors) support systems. Additionally, SLEs exacerbate existing health and social inequities, making it necessary to understand the accessibility of support services during these times. This scoping review investigates access to services by individuals experiencing IPV during SLEs in high-income countries.

Approach
A comprehensive search was conducted across several electronic databases including MEDLINE (OVID), Embase (OVID), PsychInfo (OVID), CINAHL (EBSCO), Global Health (EBSCO), Gender Watch (ProQuest), Web of Science, and Applied Social Sciences Index & Abstracts (ProQuest), along with the search engine Google Scholar. This search, which imposed no date restrictions, was extended through May 22nd, 2024. Key search terms were developed from prior literature and in consultation with an expert librarian, focusing on ‘stressful life events,’ ‘intimate partner violence,’ and ‘access to services.’. Each study was screened and extracted by two reviewers and conflicts were resolved through discussion or a third reviewer.

Results
The search across eight databases and citation searching resulted in a total of 7396 potentially relevant articles. After removing 1968 duplicates and screening 5428 based on titles and abstracts, 200 articles underwent full abstract review. Ultimately, 74 articles satisfied the inclusion criteria and were selected for further analysis. The analysis focused on barriers and facilitators to access, identifying challenges within Survivors’ support systems, redirected resources during crises, and complex control dynamics and marginalization. Over 90% of the literature included covered the recent COVID-19 pandemic. Addressing these challenges requires innovative strategies, sustained funding, and targeted interventions for high-risk subgroups.

Conclusion
This scoping review systematically outlined the challenges and enabling factors influencing the availability of support services for Survivors of IPV during SLEs. It underscores the need for robust, culturally sensitive health and social support mechanisms, and policies. Such measures are essential to better protect and assist IPV Survivors and their service providers during these critical times. Furthermore, it is imperative to integrate the insights and expertise of the violence against women (VAW) sector into emergency planning and policy-making to ensure comprehensive and effective responses that address the unique needs of Survivors in crises.
The effect of problem-based learning on improving problem-solving, self-directed learning, and critical thinking ability for the pharmacy students: A randomized controlled trial and meta-analysis
Authors: Chen Tu , Zhao Yi-Jing , Huang Feng-Qing , Liu Qun , Li Ying , Alolga Raphael N. , Zhang Lei , Ma Gaoxiang 
Published: December 2024

Objective
This study aimed to comprehensively evaluate the effect of PBL on problem-solving, self-directed learning, and critical thinking ability of pharmaceutical students through a randomized controlled trial (RCT) and meta-analysis of RCTs.

Methods
In 2021, 57 third-year pharmacy students from China Pharmaceutical University were randomly divided into a PBL group and a lecture-based learning (LBL) group. Mean scores were compared between the two groups for problem-solving, self-directed learning, communication skills, critical thinking, and final exam grades. Students’ feedback on the implementation of PBL was also collected. A meta-analysis was subsequently performed. Two authors independently conducted a comprehensive search of two databases (PubMed and CNKI). Eligible studies with effective data were included and the valuable data were extracted for analysis. Quality of involved studies was assessed by the Cochrane Collaboration’s tool. All analyses of statistics were conducted using the ‘metafor’ package in R software.

Results
The PBL group had significantly higher mean scores for problem-solving (8.43±1.56) and self-directed learning (7.39±1.19) than the LBL group (7.02±1.72 and 6.41±1.28, respectively). The PBL group also showed better communication skills (8.86±1.47) than the LBL group (7.68±1.89). The mean level of critical thinking was significantly higher in the PBL group than the LBL group (p = 0.02). The PBL group also had better final exam grades (79.86±1.38) compared to the LBL group (68.1±1.76). Student feedback on PBL implementation was positive. The outcome of subsequent meta-analysis including 8 eligible studies involved 1819 participants showed that the use of PBL significantly improved problem-solving ability (SMD = 1.12, 95% CI = 0.25–1.99) and PBL was also associated with better performance in self-directed learning (SMD = 1.55, 95% CI = 0.64–2.45). However, there was no significant difference in the final exam score in the PBL group compared to the LBL control group (SMD = 0.23, 95% CI = -0.08–0.53).

Conclusion
This study found that PBL is an effective teaching method for pharmacy students.
Memories of Dress: Recollections of Material Identities, Alison Slater, Susan Atkin and Elizabeth Kealy-Morris (eds) (2023)
Authors: Amit Tal Granovsky 
Published: December 2024

Review of: Memories of Dress: Recollections of Material Identities, Alison Slater, Susan Atkin and Elizabeth Kealy-Morris (eds) (2023)
London: Bloomsbury Visual Arts, 258 pp.,
ISBN 978-1-35015-379-0, h/bk, £85.00
Filling gaps in the distribution of the Guianan broad-nosed bat (Platyrrhinus guianensis): an extension in distribution beyond the Guiana Shield
Authors: Ferreira Gilmax Gonçalves , Trevelin Leonardo C. , Tavares Valéria da C. , de Castro Isai J. , Nagamachi Cleusa Y. , Rossi Rogério V. , Pieczarka Julio C. , Melo Benathar Thayse C. 
Published: December 2024

Abstract
The distribution of Platyrrhinus guianensis, a species originally considered endemic to the Guiana subregion, has recently been extended to a southernmost Brazilian Amazon point, yet included within the Guiana Shield. Based on comprehensive revisionary work, we extend this species occurrence eastwards and southwards, encompassing 11 localities, including Eastern Amazonia forests. These records correspond to primary and secondary floodplain forest habitats in the Brazilian states of Amapá, Maranhão, Mato Grosso, and Pará.
Gerechter Friede – eine pfingstliche Perspektive
Authors: Wenk Matthias 
Published: December 2024

Zusammenfassung
Als Beitrag zu einem gerechten Frieden stehen den Pfingstkirchen zwei Ressourcen zur Verfügung, die sie jedoch unterschiedlich nutzen: (1) Apg 2, ihr identitätsstiftendes Narrativ, mit den „vielen Zungen“ als linguistisches Symbol des Friedens, und (2) ihre Geschichte, die ihre Anfänge in einem von Ungerechtigkeit und Gewalt geprägten Umfeld nahm, in welchem die Opfer der Gewalt ihren Feinden die versöhnende Hand entgegenstreckten.
NRXN1-related disorders, attempt to better define clinical assessment
Authors: Pavone Piero , Pappalardo Xena Giada , Parano Claudia , Falsaperla Raffaele , Corsello Antonio , Parano Enrico , Polizzi Agata , Ruggieri Martino 
Published: December 2024

Abstract

Background

NRXN1-related disorders are uncommonly reported. The clinical features of the disorders are wide and heterogeneous mainly consisting of undistinctive facial dysmorphism, mild to severe intellectual and speech delay, epileptic seizures, and motor dysfunction. Defects in NRXN1 gene have been identified in cases diagnosed as Pitt-Hopkins-like-syndrome 2 (PTHLS2; OMIM#614325).

Methods
Literature review of NRXN1-related disorders was conducted and main clinical features of individuals affected by these disorders were analyzed. In addition, clinical features of individuals labelled with PTHSL2 diagnosis were reported. A comparison between international consensus diagnostic criteria for Pitt-Hopkins syndrome (PTHS) and twins presenting with NRXN1-related disorder and followed by this institution were also presented.

Results
Our data confirmed that NRXN1-related disorders mainly manifest with undistinctive dysmorphic features and neurological involvement consisting of more or less severe developmental delay/intellectual disability, autistic spectrum disorder, and epilepsy. Relationship between PTHSL2 and NRXN1 remains to be established.

Conclusions
Our present analysis denoted a heterogeneous and unspecific clinical framework of the NRXN1-related disorders mainly affecting the nervous system for which the clinical diagnosis remains inconclusive without the support of genetic analysis. Further contributions are necessary to better clarify the clinical assessment of PTHSL2.
Genetic diagnosis of the Ehlers-Danlos syndromes
Authors: Zschocke Johannes , Demirdas Serwet , van Dijk Fleur S. 
Published: December 2024

Abstract
The Ehlers-Danlos syndromes (EDS) represent a group of genetically diverse disorders characterized by the variable combination of joint hypermobility, hyperextensibility of the skin, and connective tissue fragility affecting the skin and other organs. Based on clinical features, 13 different types of EDS have been delineated, 12 of which represent monogenic conditions caused by pathogenic variants in 21 confirmed genes. Pathogenesis is related to disturbances of collagen formation and/or stability. No monogenic cause has been identified for hypermobile EDS (hEDS), a more common EDS type, which is unlikely to represent a single gene disorder in the majority of affected individuals and at present cannot be diagnosed by genetic investigations. Here we summarize the clinical features and the molecular bases of the monogenic EDS types, highlight diagnostic challenges, and provide guidance for the molecular work-up of affected individuals. In general, genetic tests are indicated if clinical features suggest a monogenic EDS type but are usually unrewarding for other cases of hypermobility.
Non-genetic diagnostic investigations in monogenic Ehlers-Danlos syndromes
Authors: Dijk Fleur S. van , Angwin Chloe , Ghali Neeti , Zschocke Johannes , Wagner Bart 
Published: December 2024

Abstract
With increased application of Next Generation Sequencing (NGS) in the diagnosis of monogenic Ehlers-Danlos syndromes, there is an increased probability to identify variants of unknown significance. Additionally, in some cases no genetic alteration may be identified whilst there is a strong clinical suspicion on a monogenic EDS type. The diagnostic value of non-genetic investigations, which prior to NGS were quite commonly used to support the clinical diagnosis of monogenic EDS types, is explored. In addition, new structural/functional investigations that could deliver evidence towards pathogenicity are discussed. It appears that certain functional and/or structural investigations used frequently in the past can remain helpful and can provide additional evidence that may confirm a clinical diagnosis of a monogenic EDS type. However, there is a need for the development of novel structural/functional studies for monogenic types of EDS. The level of evidence of such studies for application in the established diagnostic DNA variant classification criteria remains to be determined.