bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of anticoagulation in patients with brain metastasis
Authors: Hamulyák Eva. N. , Yust-Katz Shlomit , Leader Avi 
Published: December 2024

Abstract
Venous thromboembolism (VTE) is a prevalent and serious complication among cancer patients, necessitating therapeutic anticoagulation for many individuals with brain metastases. Simultaneously, patients with brain metastases, particularly those with high-risk primary tumors, have an increased risk of intracranial hemorrhage (ICH). Managing anticoagulation in these patients presents a dual challenge: preventing thromboembolism while avoiding hemorrhagic events. Here, we present our approach to anticoagulation for acute VTE in patients with brain metastases, based on the available evidence. We review potential risk factors for anticoagulation-associated ICH in this population and discuss strategies for managing acute VTE in patients with and without ICH.
Givosiran: a targeted treatment for acute intermittent porphyria
Authors: Dickey Amy K. , Leaf Rebecca K. 
Published: December 2024

Abstract
The acute hepatic porphyrias (AHPs) are a family of rare genetic diseases associated with attacks of abdominal pain, vomiting, weakness, neuropathy, and other neurovisceral symptoms. Pathogenic variants in 1 of 4 enzymes of heme synthesis are necessary for the development of AHP, and the onset of acute attacks also requires the induction of δ-aminolevulinic acid synthase 1 (ALAS1), the first and rate-limiting step of heme synthesis in the liver. Givosiran is an RNA interference medication that inhibits hepatic ALAS1 and was designed to treat AHP. In 2019 the US Food and Drug Administration approved givosiran for AHP based on positive results from a phase 3 clinical trial of 94 patients with AHP who demonstrated a marked improvement in AHP attacks and a substantial decrease in δ-aminolevulinic acid and porphobilinogen, the primary disease markers of AHP. A long-term follow-up study demonstrated continued improvement in AHP attack rates, biochemical measures of disease, and quality of life. Real-world studies have also confirmed these results. Common side effects include injection site reactions, hyperhomocysteinemia, and abnormalities of liver and renal biochemistries. This article reviews the studies that led to givosiran approval, discusses real-world clinical data, and highlights remaining questions in the treatment of AHP.
Porphyria cutanea tarda: a unique iron-related disorder
Authors: Leaf Rebecca K. , Dickey Amy K. 
Published: December 2024

Abstract
The porphyrias are a group of disorders of heme biosynthesis, each characterized by an enzymatic defect in the heme biosynthetic pathway. Porphyria cutanea tarda (PCT) arises due to the inhibition of uroporphyrinogen decarboxylase (UROD) in the presence of hepatic iron and oxidative stress. Most patients with PCT have evidence of siderosis on liver biopsy, and the disease resolves with iron depletion. PCT manifests as skin fragility, blistering cutaneous lesions on sun-exposed areas, dark urine, and elevated plasma and urine porphyrins. Factors contributing to the development of PCT include alcohol use, hepatitis C virus infection, human immunodeficiency virus, estrogen use, UROD pathogenic variants, and hereditary hemochromatosis. Treatment includes therapeutic phlebotomy to decrease total body iron levels and low-dose hydroxychloroquine, which reduces hepatic porphyrin content. The following review explores the biology of PCT, the critical role of iron in disease pathogenesis, and our approach to the management of these patients.
DOACs: role of anti-Xa and drug level monitoring
Authors: Mithoowani Siraj , Siegal Deborah 
Published: December 2024

Abstract
Direct oral anticoagulants (DOACs) do not require routine monitoring of anticoagulant effect, but measuring DOAC activity may be desirable in specific circumstances to detect whether clinically significant DOAC levels are present (eg, prior to urgent surgery) or to assess whether drug levels are excessively high or excessively low in at-risk patients (eg, after malabsorptive gastrointestinal surgery). Routine coagulation tests, including the international normalized ratio (INR) or activated partial thromboplastin time (aPTT), cannot accurately quantify drug levels but may provide a qualitative assessment of DOAC activity when considering the estimated time to drug clearance based on timing of last drug ingestion and renal and hepatic function. Drug-specific chromogenic and clot-based assays can quantify drug levels but they are not universally available and do not have established therapeutic ranges. In this review, we discuss our approach to measuring DOAC drug levels, including patient selection, interpretation of coagulation testing, and how measurement may inform clinical decision-making in specific scenarios.
Effects of a SWELE program for improving mental wellbeing in children and adolescents with special educational needs: protocol of a quasi-experimental study
Authors: Lee Regina Lai Tong , Chan Sally Wai Chi , Chong Yuen Yu , Chau Steven Wai Ho , Choi Kai Chow , Chien Wai Tong 
Published: December 2024

Abstract
Background
Unstructured play has also been found effective on promoting positive emotions and emotional competence among children and adolescents with special educational needs (SEN). Unstructured Outdoor Play coupled with Mindfulness-based Interventions via ‘Supporting Wellness in E-Child Learning Environments’ (SWELE) program can foster the mental health and wellbeing of children and adolescents with SEN. Currently there is a lack of the unstructured play with mindfulness-based interventions in the special schools in Hong Kong. Thus, aim of the SWELE program is to examine the effects of unstructured play with mindfulness-based interventions—(SWELE) program combining unstructured outdoor play activities with mindfulness-based interventions to promote mental wellbeing among SEN children and adolescents.

Methods
This 16-week SWELE program focuses on combining unstructured outdoor play activities with mindfulness-based interventions to promote mental wellbeing among children and adolescents with SEN. Training workshops for schoolteachers, school principals, parents and student mental health ambassadors in each special school together with a 16-week SWELE program and each last 45–60 min. Unstructured play allows students the freedom to explore, create and discover without predetermined rules or guidelines. Outdoor unstructured play activities include naturally run, jump and move on a playground, riding a bike, climbing trees, playing tag, playing with blocks, colour, water play, and boxes. A convergent parallel mixed-methods design both with a quantitative measure using a single group pre- and post-tests quasi-experiment behavioural observational method to preliminarily evaluate the impact of SWELE Program on SEN children’s and adolescents’ mental wellbeing; and with a qualitative design to conduct eight focus group discussions including schoolteachers, school principals, parents, SEN students, school nurses from six selected special groups and to explore their perceptions and experiences after participated the SWELE program.

Discussion
The purpose of this protocol is to examine the effects of a 16-week SWELE program on the mood, anxiety level, social skills and playfulness behaviours among children and adolescents with SEN in the special schools in Hong Kong. From the evaluation and observation, the pre-set aim and objectives on the improvement of mental wellbeing in children and adolescents with SEN can be confirmed.

Trial registration
ClinicalTrial.gov, NCT06112483. Registered on 31 October 2023.
Technology frustration in healthcare – does it matter in staff ratings of stress, emotional exhaustion, and satisfaction with care? A cross-sectional correlational study using the job demands-resources theory
Authors: Wirkkala Maarit , Wijk Katarina , Larsson Agneta C. , Engström Maria 
Published: December 2024

Abstract
Background
Health information technology has developed into a cornerstone of modern healthcare. It has changed workflows and enhanced communication, efficiency, and patient safety. However, technological development has progressed faster than research on its potential effects on care quality and the healthcare work environment. Using the Job Demand-Resources theory, this study investigated the associations between "frustration with technology" and three outcomes: stress, emotional exhaustion, and staff satisfaction with care, holding job resources and the demand workload constant.

Method
A cross-sectional correlational study was conducted between January and April 2022. Healthcare staff from different professions (e.g., physicians, registered nurses, physiotherapists, licensed practical nurses) and workplaces (n = 417, response rate 31%) answered a survey regarding job demands and resources in the workplace, frustration with technology, stress, emotional exhaustion, and satisfaction with care. Data were analyzed with Spearman’s rank correlation coefficient, the Mann–Whitney U test, and the Kruskal–Wallis test, and multiple variables, one for each outcome, were tested with Generalized Estimated Equations models in SPSS.

Results
The bivariate correlation analyses confirmed statistically significant associations between all the independent variables and the outcomes, except for the independent variable high workload. A high workload was associated with stress and emotional exhaustion but not with staff satisfaction with care. In the three GEE models, one for each outcome, higher stress was statistically significantly associated with more frustration with technology and lower scores for the variables participation in decision-making, sense of community at work, and higher workload. Higher emotional exhaustion was associated with more frustration with technology, higher workload, a lower teamwork climate, and lower growth opportunities. Lower staff satisfaction with care was associated with lower scores for the variable participation in decision-making.

Conclusions
Taking other variables into account, technology frustration matters in staff ratings of stress and emotional exhaustion, but not with the satisfaction of given care. Future studies should aim to further investigate what causes technology frustration and how to mitigate it.
Extracellular vesicles: biological mechanisms and emerging therapeutic opportunities in neurodegenerative diseases
Authors: Wang Ling , Zhang Xiaoyan , Yang Ziyi , Wang Binquan , Gong Hongyang , Zhang Ke , Lin Yi , Sun Mingkuan 
Published: December 2024

AbstractExtracellular vesicles (EVs) are membrane vesicles originating from different cells within the brain. The pathophysiological role of EVs in neurodegenerative diseases is progressively acknowledged. This field has advanced from basic biological research to essential clinical significance. The capacity to selectively enrich specific subsets of EVs from biofluids via distinctive surface markers has opened new avenues for molecular understandings across various tissues and organs, notably in the brain. In recent years, brain-derived EVs have been extensively investigated as biomarkers, therapeutic targets, and drug-delivery vehicles for neurodegenerative diseases. This review provides a brief overview of the characteristics and physiological functions of the various classes of EVs, focusing on the biological mechanisms by which various types of brain-derived EVs mediate the occurrence and development of neurodegenerative diseases. Concurrently, novel therapeutic approaches and challenges for the use of EVs as delivery vehicles are delineated.
Elemental stoichiometry and insect chill tolerance: evolved and plastic changes in organismal Na+ and K+ content in Drosophila
Authors: Chalmer Sarah C. , Rudman Seth M. , Andersen Mads K. , Schmidt Paul , MacMillan Heath A. 
Published: December 2024

ABSTRACT
Acclimation and evolutionary adaptation can produce phenotypic changes that allow organisms to cope with challenges. Determining the relative contributions and the underlying mechanisms driving phenotypic shifts from acclimation and adaptation is of central importance to understanding animal responses to change. Rates of evolution have traditionally been considered slow relative to ecological processes that shape biodiversity. Many organisms nonetheless show patterns of genetic variation that suggest that adaptation may act sufficiently fast to allow continuous change in phenotypes in response to environmental change (called ‘adaptive tracking’). In Drosophila, both plastic and evolved differences in chill tolerance are associated with ionoregulation. Here, we combine an acclimation experiment, field collections along a well-characterized latitudinal cline, and a replicated field experiment to assess the concordance in the direction, magnitude, and potential mechanisms of acclimation and adaptation on chill coma recovery and elemental (Na and K) stoichiometry in both sexes of Drosophila melanogaster. Acclimation strongly shaped chill coma recovery, spatial adaptation produced comparatively modest effects, and temporal adaptation had no significant effect. Leveraging knowledge on the mechanisms underlying variation in chill tolerance traits, we find that relationships between elemental stoichiometry and chill coma recovery in the context of acclimation may differ from those that are associated with spatial adaptive change.
Extracellular vesicles and nanoparticles at a glance
Authors: Jeppesen Dennis K. , Zhang Qin , Coffey Robert J. 
Published: December 2024

ABSTRACT
Cells can communicate with neighboring and more distant cells by secretion of extracellular vesicles (EVs). EVs are lipid bilayer membrane-bound structures that can be packaged with proteins, nucleic acids and lipids that mediate cell–cell signaling. EVs are increasingly recognized to play numerous important roles in both normal physiological processes and pathological conditions. Steady progress in the field has uncovered a great diversity and heterogeneity of distinct vesicle types that appear to be secreted from most, if not all, cell types. Recently, it has become apparent that cells also release non-vesicular extracellular nanoparticles (NVEPs), including the newly discovered exomeres and supermeres. In this Cell Science at a Glance article and the accompanying poster, we provide an overview of the diversity of EVs and nanoparticles that are released from cells into the extracellular space, highlighting recent advances in the field.
Low-grade systemic inflammation, but not neuroinflammation, is associated with 12-month postoperative outcome after total hip arthroplasty in patients with painful osteoarthritis
Authors: Blichfeldt-Eckhardt Morten R. , Varnum Claus , Lauridsen Jørgen T. , Rasmussen Lasse E. , Mortensen Winnie C. P. , Jensen Hanne I. , Vaegter Henrik B. , Lambertsen Kate L. 
Published: December 2024

AimsBetter prediction of outcome after total hip arthroplasty (THA) is warranted. Systemic inflammation and central neuroinflammation are possibly involved in progression of osteoarthritis and pain. We explored whether inflammatory biomarkers in blood and cerebrospinal fluid (CSF) were associated with clinical outcome, and baseline pain or disability, 12 months after THA.MethodsA total of 50 patients from the Danish Pain Research Biobank (DANPAIN-Biobank) between January and June 2018 were included. Postoperative outcome was assessed as change in Oxford Hip Score (OHS) from baseline to 12 months after THA, pain was assessed on a numerical rating scale, and disability using the Pain Disability Index. Multiple regression models for each clinical outcome were included for biomarkers in blood and CSF, respectively, including age, sex, BMI, and Kellgren-Lawrence score.ResultsChange in OHS was associated with blood concentrations of tumour necrosis factor (TNF), interleukin-8 (IL-8), interleukin-6 receptor (IL-6R), glycoprotein 130 (gp130), and IL-1β (R2 = 0.28, p = 0.006), but not with CSF biomarkers. Baseline pain was associated with blood concentrations of lymphotoxin alpha (LTα), TNFR1, TNFR2, and IL-6R (R2 = 0.37, p < 0.001) and CSF concentrations of TNFR1, TNFR2, IL-6, IL-6R, and IL-1Ra (R2 = 0.40, p = 0.001). Baseline disability was associated with blood concentrations of TNF, LTα, IL-8, IL-6, and IL-1α (R2 = 0.53, p < 0.001) and CSF concentrations of gp130, TNF, and IL-1β (R2 = 0.26, p = 0.002). Thus, preoperative systemic low-grade inflammation predicted 12-month postoperative outcome after THA, and was associated with preoperative pain and disability.ConclusionThis study highlights the importance of systemic inflammation in osteoarthritis, and presents a possible path for better patient selection for THA in the future. Preoperative central neuroinflammation was associated with preoperative pain and disability, but not change in OHS after THA.Cite this article: Bone Joint Res 2024;13(12):741–749.
When Trans met Discipline: scenes from an arranged marriage
Authors: Sitas Rike , bhagat heeten 
Published: December 2024

Transdisciplinarity is all the rage!
This spirited statement, or announcement even, rings true of the contemporary intellectual landscape. The amalgamated term/concept proposes a means to breakdown traditional boundaries, encourage collaboration outside of staid academic spaces and in doing so become a key driver for innovation. Many have bought into this promise. However, amidst the fervour for the promise of fluidity of knowledge and interdisciplinary exchange lies a productive tension between the principles of transness and the inherent fixity of traditional disciplinary structures. Etymologically, they sit on opposites ends of a spectrum indicating flux and fixity. What kind of union does this term portend? What is liminal, or overlooked in the composition these opposing forces?
Our provocation aims to take on a playful troubling in what observe as a limitation of the scope of transdisciplinary work. Drawing on critical perspectives from trans and queer studies, discipline-making and un-disciplining and the energies that heralded the birth of transdisciplinarity, our provocation plays with the tacit ways in which power structures, historical legacies, and implicit biases continue to operate spaces that claim transdisciplinarity. We aim to argue for a more thorough understanding of the interplay between fixity and fluidity, highlighting how acknowledging these dynamics can lead to an expanded palette of work that can leap beyond the current practices of engaged scholarship towards the speculative and outrageous. Through a series of conversations with texts, theorists and activists, our contribution will work to make productive mischief from the periphery.
Nearly collimated 940-nm buried-photonic-crystal surface-emitting laser for lens-free discrete multitone transmission at 22  Gbit/s over 20  m
Authors: Lin Gong-Ru , Miao Wen-Chien , Chen Po-Lun , Ho Pin-Wei , Hong Yu-Heng , Chang Shu-Wei , Wu Chao-Hsin , Kuo Hao-Chung 
Published: December 2024

By using a high-power surface-emitting laser configured with a buried two-dimensional hollow pyramid photonic-crystal layer (referred to as PhCSEL) with a low-divergent-angle (0.25 deg) and large-emission-aperture beam at 940 nm, a lensless free-space-optical point-to-point link with either NRZ-OOK or QAM-DMT data format carried by the nearly collimated beam is demonstrated over 0.3-m short-reach and 20-m long-reach schemes. The buried 2D hollow pyramid photonic-crystal layer configures the band-edge lasing effect to induce zero group velocity for all coupled light waves and provide an almost collimated beam across a broad aperture. Under directly encoded back-to-back transmission, the PhCSEL offers a
−3  dB
bandwidth of 3.25 GHz to enable either the NRZ-OOK data rate up to 5.75 Gbit/s or the 3-GBaud 64-ary QAM DMT data rate of 18 Gbit/s over 0.3 m in free space. When using the bit-loading DMT algorithm for spectral usage efficiency optimization within 4.09-GBaud bandwidth, the multiband bit-loaded QAM-DMT format can elevate the total data rate up to 22 Gbit/s. Lengthening the free-space distance to 20 m slightly degrades the received signal-to-noise ratio by the inevitable diverged beam spot. Nevertheless, the PhCSEL still performs 1-GBaud broadband DMT streaming with allowable 16-QAM at 4-Gbit/s or 64-QAM at 6-Gbit/s over the 20-m lensless free-space link.
Real structures on primary Hopf surfaces
Authors: Khaled Zahraa 
Published: December 2024

Abstract
The first goal of this article is to give a complete classification (up to Real biholomorphisms) of Real primary Hopf surfaces

(

H
,
s

)

\left(H,s)

, and, for any such pair, to describe in detail the following naturally associated objects : the group

Aut

h

(

H
,
s

)

{{\rm{Aut}}}_{h}\left(H,s)

of Real automorphisms, the Real Picard group

(

Pic

(

H

)

,

s

ˆ

*

)

\left({\rm{Pic}}\left(H),{\hat{s}}^{* })

, and the Picard group of Real holomorphic line bundles

Pic

R

(

H

)

{{\rm{Pic}}}_{{\mathbb{R}}}\left(H)

. Our second goal is the classification of Real primary Hopf surfaces up to equivariant diffeomorphisms, which will allow us to describe explicitly in each case the real locus

H

(

R

)

=

H

s

H\left({\mathbb{R}})={H}^{s}

and the quotient

H
⁄

⟨

s

⟩

H/\langle s\rangle

.
Gendered Virginity in Pakistan: Rituals, Trials, and Punishment for a Girl in a Bāgārrī Community of Sindh
Authors: Sadique Salma , Ali Inayat , Ali Shahbaz 
Published: December 2024

Abstract
The human body has long been a focal point within sociocultural and political contexts, with particular emphasis on the female body and its multifaceted meanings, encompassing both visible and invisible boundaries. This is evident in the contemporary practice of virginity testing within the Bāgārrī community in the Sindh Province of Pakistan. In this community, the female body becomes a negotiating terrain, exemplified by the virginity ritual known as Pōthī, conducted by a Bhōpā (priest). This ritual serves as a conduit for communication between the human realm and the divine, facilitated through the symbolism of wheat grains. The outcomes of this ritual have significant consequences: a verified virgin is rewarded with various gifts, whereas a failed test subjects the individual to penalties enforced by the local political system, the Pānchāyāt. Thus, the female body not only becomes a site of sociocultural significance but also is entangled in the dynamics of local governance.
On high power sums of a hybrid arithmetic function
Authors: Lao Huixue , Liu Huafeng , Yu Ruotong 
Published: December 2024

Abstract
Let λ
f
(n), σ(n) and ϕ(n) denote nth Fourier coefficient of the primitive holomorphic cusp form f, the sum-of-divisors function, and the Euler totient function, respectively. In this paper, we first refine related previous results on the power sum

∑

n
≤
x

λ

f

j

(
n
)

σ

b

(
n
)

ϕ

c

(
n
)

$\begin{array}{}
\displaystyle
\sum\limits_{n\leq x} \lambda_{f}^{j}(n)\sigma^{b}(n)\phi^{c}(n)
\end{array}$

and then investigate the average behavior of the power sum

∑

n
=

a
2

+

b
2

+

c
2

+

d
2

≤
x
,

(
a
,
b
,
c
,
d
)
∈

Z

4

λ

f

j

(
n
)

σ

b

(
n
)

ϕ

c

(
n
)
.

$\begin{array}{}
\displaystyle
\sum\limits_{\substack{n=a^2+b^2+c^2+d^2\leq x, \\
(a,b,c,d)\in {\mathbb{Z}}^4}} \lambda_{f}^{j}(n)\sigma^{b}(n)\phi^{c}(n).
\end{array}$
Periodic Solutions for Conformable Non-autonomous Non-instantaneous Impulsive Differential Equations
Authors: Ding Yuanlin , Liu Kui 
Published: December 2024

Abstract
This paper studies a new type of conformable non-autonomous non-instantaneous impulsive differential equations. We present the solution by a new kinds of conformable Cauchy matrix. Also, we present its some properties. Next, we respectively discuss about the existence and uniqueness of 𝓒-periodic solutions of linear homogeneous and nonhomogeneous problems. Further, we study the nonlinear problem via fixed point theorem. Examples are also given to verify theory results.