bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Effects of HbA1c Reduction on Alleviating Chronic Nonspecific Low Back Pain in Prediabetic Non-obese Patients: A Non-Randomized Controlled Trial
Authors: Hasan Ghazwan Abdulla , Al-Obaidi Ahmed Dheyaa , Hashim Hashim Talib , Najah Al-Obaidi Mustafa , Al-Saady Yousif Ali , Othman Assalah , Khunda Sara S. , Saab Omar , Al-Obaidi Hasan , Merza Nooraldin 
Published: November 2024

Background: Pre-diabetes, characterized by elevated glycemic indices, poses a high risk of diabetes development, and is increasingly linked to non-specific low back pain. While mechanisms remain incompletely understood, metabolic, inflammatory, and neurological factors are implicated. Dietary interventions, including low-glycemic and anti-inflammatory diets, alongside weight management, may improve outcomes in this population. Objectives: In this non-randomized controlled trial, we aim to evaluate the influence of decreasing HbA1c levels on reducing chronic non-specific low back pain in pre-diabetic, non-obese individuals, as well as emphasizing the importance of such a study in supporting the literature. Methods: A non-randomized controlled single-blind clinical trial was conducted among 82 participants with chronic non-specific low back pain and pre-diabetes at an outpatient clinic in Baghdad from the 30th of January to the 22nd of September. The intervention methods aimed at reducing HbA1c levels to assess the reduction impact on alleviating chronic non-specific low back pain included dietary adjustments, sleep optimization, and correction of vitamins and minerals deficiencies. The follow-up process was conducted individually for each participant, with a monthly assessment over a period of six months. Results: At 12 weeks a significant decrease in chronic non-specific low back pain severity was observed in patients with lower HbA1C levels yielding a P-value of .021. Similarly, at 24 weeks there was a decline in the number of patients who reported chronic non-specific low back pain, and the association to lower HbA1C levels was significant with a p-value of .005. Conclusion: This study suggests the presence of a statistically significant association between reduction of HbA1C levels and ensuing improvement in chronic non-specific low back pain symptoms in non-obese prediabetic patients.
Mid-term effect of customized graduated elastic compression stockings for managing occupational edema: A randomized controlled trial
Authors: Wang Sheng-Xing , Yang Wen-Tao , Jin Zhen-Yi , Wen Jia-Hao , Ren Hua-Liang , Xiong Ying , Tao Xiao-Ming , Li Chun-Min 
Published: November 2024

Introduction: This study compared the effectiveness of customized graduated elastic compression stockings (c-GECS) based on individual lower-leg parameter models with standard graduated elastic compression stockings (s-GECS) in patients with occupational edema (OE). Methods: A single-blind, randomized controlled trial was conducted with 70 patients with OE, randomly assigned to the c-GECS or s-GECS group. Follow-up assessments were performed at 1 and 3 months. Primary outcomes comprised visual analog scale scores (1–10) for lower-limb symptoms and comfort level of GECS. Secondary outcomes included GECS usage duration, calf volume, and interface pressure at B and C points (B: minimal ankle circumference point; C: maximum calf circumference point). Results: Both groups exhibited significant improvements in pain, heaviness, and swelling symptoms at the 1- and 3-month follow up. At the 3-month follow up, the c-GECS group showed significantly superior improvement in symptoms. Comfort assessment revealed that c-GECS (16.2 ± 2.9) provided significantly greater comfort than s-GECS (13.6 ± 3.2) ( p < 0.001). However, the two groups showed no significant difference in GECS wear duration. At 3 months, the c-GECS group showed superior maintenance of stocking tension at point B ( p = 0.018). Both types of GECS significantly reduced calf volume at both time points, with no notable difference between the groups. Conclusion: c-GECS effectively alleviated pain, heaviness, and swelling symptoms in patients with OE. Although c-GECS did not exhibit a clear advantage in reducing calf volume as compared to s-GECS, it provided more stable and enduring pressure, enhanced the overall fit of GECS, and improved comfort during wear. Chinese Clinical Trial Registry No. ChiCTR2100042894.
Self-identification of autism: Why some autistic adults lack a clinical diagnosis and why this matters for inclusion
Authors: Ardeleanu Katherine , Steinberg Hillary , Garfield Tamara , Voltaire Samuelle , Shea Lindsay , Brown Maci , Chvasta Kyle , Tan Catherine Do 
Published: November 2024

Autism research and services have historically focused on individuals with a formal autism diagnosis. However, activists and self-advocates in the United States recognize that there are financial and clinical barriers impeding access to formal diagnostic evaluations for autism. Research also suggests that groups on the margins of autism, specifically those who are not White, young, or assigned male at birth, receive later diagnoses, if diagnosed at all. In particular, individuals who are autistic and LGTBQ+ are likely to not be afforded opportunities to be assessed and diagnosed. We conducted interviews with 65 queer and transgender autistic adults who either self-identified as autistic or had a formal autism diagnosis about their experiences with and perceptions of autism diagnosis. We found that participants derived a sense of meaning and affirmation from their autistic diagnosis and/or identity, faced significant barriers and deterrents to diagnosis, and experienced invalidation as both a barrier to and product of diagnosis. We argue that self-identified autistic individuals provide valuable context and data for many of the social processes and preferences reported by autistic people. We offer recommendations for research and services, specifically that many should not require formal autism diagnoses of participants. Lay abstract Most autism research and services focus on individuals with formal autism diagnoses. However, autism activists and self-advocates have raised awareness about the challenges that can prevent individuals from seeking or getting an autism diagnosis. We interviewed 65 queer and transgender adults who either self-identified as autistic without a formal diagnosis or who had a formal autism diagnosis. We found that participants made meaning of their autistic diagnosis and/or identity and found affirmation in this, faced significant barriers and deterrents to getting diagnosed, and experienced invalidation as both a barrier to and product of diagnosis. Due to the challenges that individuals face in getting a diagnosis, we recommend that researchers and advocates consider including self-identified autistic individuals in research and services.
Urgent Versus Elective Laparoscopic Cholecystectomy Following Percutaneous Transhepatic Gallbladder Drainage for Moderate Acute Cholecystitis: A Meta-Analysis
Authors: Yaermaimaiti Musa , Miersalijiang Abudukeremu , Wang Xue-Jun , Zhu Jian-Kang , Wang Hong-Cheng 
Published: November 2024

Background There is still controversy regarding the treatment strategy for moderate acute cholecystitis (AC). Percutaneous transhepatic gallbladder drainage (PTGBD) followed laparoscopic cholecystectomy (LC) has shown advantages compared to emergency LC (ELC). However, the results are controversial. Therefore, we conducted this updated meta-analysis to clarify this issue. Materials and Methods A comprehensive literature search for relevant studies comparing the PTGBD + LC and ELC for moderate AC was performed. The statistical analysis was conducted using Stata. Results A total of 14 studies were included. The pooled analysis revealed that PTGBD + LC group had a shorter operation time (SMD = −1.07, 95%CI = −1.19 to −0.95), lower amount of intraoperative bleeding (SMD = −0.93, 95%CI = −1.07 to −0.79), lower conversion rate (OR = 0.28, 95% CI = 0.17-0.44), lower postoperative complications (OR = 0.45, 95% CI = 0.23-0.88) shorter postoperative hospital stay (SMD = −1.20, 95%CI = −1.33 to −1.07), lower wound infection rate (OR = 0.41, 95%CI = 0.23-0.74) and higher hospitalization expenses (SMD = 1.13, 95%CI = 0.96 to 1.29) compared with ELC group. There was no significant difference in the incidence of bile leak, bile duct injury and total hospital stay. Conclusion This meta-analysis suggested that PTGBD + LC has significant advantages over ELC for moderate AC patients, including lower surgical difficulty, lower conversion rate, fewer postoperative complications, and shorter hospital stay.
Repair of palmar soft tissue defects of five digits in the same hand using a variety of free flaps
Authors: Li Muwei , Wu Gong , Zhang Zhe 
Published: November 2024

Palmar soft tissue defects of the digits are common. Severe multiple digit palmar soft tissue defects can lead to dysfunction and are difficult to treat. We report a case in which a variety of flaps were applied to repair the palmar soft tissue defects of five digits. Level of evidence: V
Quality assessment of medicines in selected resource-limited primary healthcare facilities using low- to medium-cost field testing digital technologies
Authors: Opuni Kwabena FM , Sunkwa-Mills Gifty , Antwi Maxwell A , Squire Antoinette , Afful George Y , Rinke de Wit Tobias F , Kretchy Irene A 
Published: November 2024

Background Digital technologies can assess the quality of medicines in resource-challenged health facilities in a timely manner and ensure effective healthcare. Objectives This study assessed the quality of some non-communicable disease medicines, antimalarials, antibiotics, non-steroidal anti-inflammatory drugs and hematinics in selected healthcare facilities as part of their (potential) participation in a digital pharmaceutical supply chain management system (Med4All). Methods All the sampled medicines were screened using TruScan analyzer and GPHF-minilab, that is , low-medium field technologies. The quality of a representative subset of the medicines (∼11%) was determined using pharmacopoeia gold standard methods. Results About 75% of the medicines were manufactured in Ghana, and 16% were imported from India, with the Ghana Food and Drugs Authority registering 72% of the medicines. There was over 90% availability of medicines in health facilities from the middle and southern sectors, while the northern sector had around 64%. Approximately 87% and 88% of the medicines passed TruScan™ Raman and GPHF-minilab analysis, respectively. There was no significant difference between the two screening methods for assessing the quality of the medicines ( p > 0.05). Of the 21 medicine samples, 5 (∼24%) failed, and 16 (76%) passed the pharmacopoeia test. The failed medicines were diclofenac, azithromycin and glibenclamide. Compared to the pharmacopoeia method, the performance of the TruScan™ Raman analyzer and the GPHF-minilab technologies were 71% and 63%, respectively. Conclusion The study provides insights into the quality of medicines in resource-limited primary healthcare facilities.
Evaluating the Impact of Biological Augmentation on Failure Rates and Complications in Acute Patellar Tendon Rupture Surgery Compared With Isolated Repair
Authors: Olivieri Rodrigo , Laso José Ignacio , Franulic Nicolás , Muñoz José T. , Ugarte Jaime , Innocenti Piero 
Published: November 2024

Background: Patellar tendon ruptures are infrequent but disabling injuries. Surgical treatment is the gold standard to obtain good outcomes, and numerous techniques have been described. Biomechanical studies report better results when augmented techniques are used. However, there is a lack of consensus regarding the best standard technique. Purpose/Hypothesis: The purpose of this study was to assess a cohort of patients with acute patellar tendon rupture that was surgically treated and to compare the clinical outcomes of 2 groups: isolated repair and biological augmentation techniques with autograft or allograft. It was hypothesized that the biological augmentation group would have better clinical outcomes than the isolated repair group. Study Design: Cohort study; Level of evidence, 3. Methods: All patients with acute patellar tendon rupture surgically treated in our center between 2016 and 2022 were retrospectively reviewed. Patient and rupture characteristics, surgical technique, clinical outcomes, and complications were recorded. The primary outcome was rerupture rate, and secondary outcomes were infection rate, stiffness >15° of knee flexion deficit, and extensor mechanism lag >5°. Results: The study included 34 patients with 36 operated knees (2 patients with bilateral rupture). The mean age was 44.9 years. Isolated repair was performed in 20 knees (55.6%), and 16 knees underwent repair and biological augmentation with autograft or allograft. Both groups were comparable in terms of their demographic characteristics. A statistically significant association was found between the type of surgery and tendon rerupture. Of the patients in the isolated repair group, 5 of 20 (25%) experienced a failure, whereas in the biological augmentation group, no reruptures were recorded ( P = .031). However, no statistically significant associations were found between the type of surgery and other complications, such as the development of stiffness ( P = .54), residual extension lag >5° ( P = .87), or the development of infection ( P = .25). Conclusion: In this cohort of patients, biological augmentation reduced the rate of surgical failure for acute patellar tendon rupture without being associated with a higher risk of complications such as stiffness, residual extension lag, or the development of infection.
Configuration Design and Size Optimization of a High-Precision Novel Parallel Pointing Mechanism Based on Interference Separation
Authors: Wang Sen , Li Shihua , Han Xueyan , Wei Jiahao , Gao Xueyuan , Xu Hongyu 
Published: November 2024

AbstractPointing mechanism is widely used in aerospace field, and its pointing accuracy and stability have high requirements. The pointing mechanism will be affected by external interference when it works. In order to eliminate the impact of interference forces on the output accuracy of the mechanism, firstly, this paper proposes a design method for high-precision pointing mechanisms based on interference separation, aiming at the high-precision pointing requirements of pointing mechanisms. Based on the screw theory, a synthesis method for inner compensation mechanisms has been proposed. And a new type of double-layer parallel mechanism has been designed to compensate for interference forces. Then, the kinematics and dynamics of the mechanism are carried out. An evaluation index for compensating external interference forces is proposed. The interference compensation analysis is conducted for the pointing mechanism. The correctness of the proposed interference force compensation coefficient is verified. Finally, in order to find the optimal solution for the workspace and interference force compensation coefficient of the pointing mechanism, multi-objective optimization design of the structural parameters of the mechanism was carried out based on the particle swarm optimization algorithm. This provides a theoretical basis for the prototype design of the subsequent double-layer parallel mechanism. This double-layer parallel mechanism combines the advantages of large load-bearing capacity, large workspace, and high output accuracy. It can be better applied in the aerospace field where high-precision pointing and force interference compensation are integrated.
Analysis of Water Film Distribution and Aerodynamic Performances of High-Speed Train Under Rainfall Environment
Authors: Li Meixiang , Yu Mengge , Liu Jiali , Sheng Xugao 
Published: November 2024

AbstractThe current research on the aerodynamic performance of the train running in rainy weather is primarily concerned with the trajectory of the raindrops and the aerodynamic variation of trains caused by raindrops. In fact, water film will generate on the train body when raindrops hit the train, which interacts with the flow field around the train, and would probably affect the aerodynamic performance of the train. In this paper, based on shear stress transport (SST) k-w turbulence model and Euler-Lagrange discrete phase model, the aerodynamic calculation model of a high-speed train under rainfall environment is established. The LWF (Lagrangian wall film) is used to simulate the water film distribution of the high-speed train under different rainfall intensities, and the aerodynamic performance of the train are studied. The calculation results show that raindrops will gather on the train surface and form water film under rainfall environment. With the extension of rainfall time, the thickness and coverage range of water film expand, and the maximum thickness of water film can reach 4.95 mm under the working conditions in this paper. The average thickness of water film on the train body increases with the rainfall intensity. When the rainfall intensity increases from 100 mm/h to 500 mm/h, the average water film thickness will increase by 3.26 times. The velocity of water film in the streamlined area of head car is larger than that in other areas, and the maximum velocity is 22.14 m/s. Compared with the rainless environment condition, the skin friction coefficient of the high-speed train increases and the average value will increase by 10.74% for a rainfall intensity of 500 mm/h. The positive pressure and resistance coefficient of the head car increase with the rainfall intensity. This research proposes a methodology to systematically analyze the generation of water film on the train surface and its influence on the train aerodynamic performance; the analysis can provide more practical results and can serve as a reference basis for the design and development of high-speed trains.
Experimental Investigation of the Micro-Milling of Additively Manufactured Titanium Alloys: Selective Laser Melting and Wrought Ti6Al4V
Authors: Rehan Muhammad , He Tao , Khalil Ahmed K. , Tahir Danish , Yip Wai Sze , To Sandy Suet 
Published: November 2024

AbstractIn recent years, additive manufacturing (AM) has gained popularity in the aerospace, automobile, and medical industries due to its ability to produce complex profiles with minimal tolerances. Micro-milling is recommended for machining AM-based parts to improve surface quality and form accuracy. Therefore, the machinability of a titanium alloy (Ti6Al4V) manufactured using selective laser melting (SLM) is explored and compared to that of wrought Ti6Al4V in micro-milling. The experimental results reveal the surface topology, chip morphology, burr formation, and tool wear characteristics of both samples. The micro-milling of AM-based Ti6Al4V generates a surface roughness of 19.2 nm, which is 13.9% lower than that of wrought workpieces, and this component exhibits less tool wear. SLM-based Ti6Al4V produces continuous chips, while wrought Ti6Al4V yields relatively short chips. Additionally, SLM-fabricated Ti6Al4V exhibits smaller burrs after micro-milling than wrought Ti6Al4V. Despite the higher hardness of SLM-based Ti6Al4V, it demonstrates better machinability than wrought Ti6Al4V, resulting in better surface quality with lower tool wear levels and shorter burr heights. This study provides valuable insights into future research on postprocessing AM-based titanium parts, especially using micro-milling.
Cognitive impact and brain structural changes in long COVID patients: a cross-sectional MRI study two years post infection in a cohort from Argentina
Authors: Cataldo Sol A. , Micciulli Andrea , Margulis Laura , Cibeyra Melina , Defeo Sabrina , Horovitz Silvina G. , Martino Analía , Melano Raul , Mena Milagros , Parisi Francisco , Santoro Diego , Sarmiento Florencia , Belzunce Martin A. 
Published: November 2024

AbstractObjectiveLong COVID is a condition characterised by persistent symptoms after a SARS-CoV-2 infection, with neurological manifestations being particularly frequent. Existing research suggests that long COVID patients not only report cognitive symptoms but also exhibit measurable cognitive impairment. Neuroimaging studies have identified structural alterations in brain regions linked to cognitive functions. However, most of these studies have focused on patients within months of their initial infection. This study aims to explore the longer-term cognitive effects and brain structural changes in long COVID patients, approximately two years post-infection, in a cohort from San Martín, Buenos Aires, Argentina.MethodsWe conducted a cross-sectional study involving 137 participants: 109 with long COVID symptoms and 28 healthy controls. The participants underwent an initial clinical assessment, completed a structured questionnaire and standardised scales, underwent a cognitive assessment, and had a brain MRI scan. Structural MRI images were processed via FreeSurfer and FSL to obtain volumetric measures for subcortical and cortical regions, along with regional cortical thickness. Differences between groups for these variables were analysed using ANCOVA, with permutation tests applied to correct for multiple comparisons.ResultsLong COVID patients reported persistent cognitive symptoms such as memory problems and brain fog, with higher levels of fatigue and reduced quality of life compared to controls. Despite subjective cognitive complaints, cognitive tests did not reveal significant differences between groups, except for the TMT-A (p = 0.05). MRI analysis revealed decreased volume in the cerebellum (p = 0.03), lingual gyrus (p = 0.04), and inferior parietal regions (p = 0.03), and reduced cortical thickness in several areas, including the left and right postcentral gyri (p = 0.02,p = 0.03) and precuneus (p = 0.01,p = 0.02).ConclusionsThis study highlights the enduring impact of long COVID on quality of life and physical activity, with specific brain structural changes identified two years post-infection. Although cognitive tests did not show clear impairment, the observed brain atrophy and significant reduction in quality of life emphasize the need for comprehensive interventions and further longitudinal studies to understand the long-term effects of long COVID on cognition and brain health.
Exploring what works well and less well in a community-based drop-in hub providing health and wellbeing services for people experiencing homelessness: a participatory action evaluation of service coordination
Authors: Adams Emma A. , Ramsay Sheena E. 
Published: November 2024

Abstract
Background
People experiencing homelessness often face obstacles accessing health and social care support. Challenges are further exacerbated when support provision for multiple unmet needs are not integrated or coordinated. To overcome these challenges, there has been growing attention on integrating and co-locating health and wellbeing services for people experiencing homelessness. In an urban area of North East England, a long-standing Hub or ‘drop-in centre’ offers a range of health and wellbeing support by bringing together the different health and care system agencies in one space. However, little is known about the perspectives of providers on what works well and less well in how the different services are coordinated.

Methods
Using a participatory action research approach, a qualitative service evaluation was undertaken between June and September 2023. Fourteen interviews were conducted with providers who work in a paid or voluntary capacity operating some of their service offerings or support in the Hub. Interview transcripts were analysed using inductive reflexive thematic analysis.

Results
Three themes were evident from the evaluation: 1) location and space matter, 2) co-location and relationships make a difference, and 3) service consistency and flexibility are paramount.

Conclusion
Co-locating support to cover the breadth of health and care needs has the potential to increase engagement and access for people experiencing homelessness, and to enhance trust with service users and between agencies. This model provides a unique example of co-location and integration of support, particularly with it being operated by a community housing organisation.