bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of early mobilisation on physical function in patients after heart valve surgery: a systematic review
Authors: Shawk Abdulrahman , Moffatt Fiona , ALaseem Aram 
Published: October 2024

Background/Aims Literature suggests that early mobilisation, defined as the initiation of physical activity within 48 hours following surgery, improves outcomes after cardiac surgery. This systematic review assessed the effectiveness of early mobilisation on physical function and other outcomes, including length of hospital stay and cost following heart valve surgery. Methods The Physiotherapy Evidence Database, MEDLINE, EMBASE, CINAHL and Cochrane Library were systematically searched from inception until May 2022 using relevant key words. Randomised controlled trials comparing early mobilisation and usual care for patients who had received heart valve surgery were included in the review. Methodological quality was assessed using the Physiotherapy Evidence Database scale and risk of bias using the Cochrane Risk of Bias 2 tool. The data were narratively synthesised. Results The search identified 210 articles, with 98 remaining after duplicates were removed. Upon screening for eligibility, nine articles were assessed in full and three randomised controlled trials involving 161 patients were included in the review. Early mobilisation protocols varied across trials. Two trials (n=124) reported significantly greater improvement in physical function with early mobilisation compared to usual care, including handgrip strength (P=0.001). One study (n=41) found early mobilisation significantly reduced the length of hospital stay (P=0.000), in-hospital care costs (P=0.000) and intensive care unit stay (P=0.000) compared to usual care. Methodological quality scores ranged from six to nine on the Physiotherapy Evidence Database scale. The risk of biased judgement was ‘low’ in one study and ‘some concerns’ in two studies. Conclusions Early mobilisation may improve physical function and reduce hospital and intensive care unit stays after heart valve surgery. However, differences in protocols and limited studies indicate further high-quality research is needed, particularly regarding cost-effectiveness. Establishing clear early mobilisation protocols could enhance recovery in this population. Implications for practice Early mobilisation may require the coordinated effort of a multidisciplinary team of physiotherapists, nurses and possibly other medical professionals. For its seamless and effective implementation, it is essential to understand whether this intervention falls under the domain of physiotherapists or requires broader team collaboration. Given these complexities, strategies targeting early mobilisation that balance both safety and resource considerations are advised to improve physical function after heart valve surgery, especially among patients who are frail.
MiRNA-200a and miRNA-200b expression, and vitamin-D level: Prognostic significance in obese non-diabetic and obese type 2 diabetes mellitus individuals
Authors: Alshahrani Abrar Fahad , Ashfaq Fauzia , Alsayegh Abdulrahman A , Bajahzer Mohammed , Khan Mohammad Idreesh , Beg Mirza Masroor Ali 
Published: October 2024

BACKGROUND
Obesity and type 2 diabetes mellitus (T2DM) are frequent co-occurring disorders that affect regular metabolic functions. Obesity has also been linked to an increased risk of developing diabetes. Obesity and diabetes are on the rise, increasing healthcare costs and raising mortality rates. Research has revealed that the expression profile of microRNAs (miRNAs) changes as diabetes progresses. Furthermore, vitamin D may have an anti-obesity effect and inverse association with body weight and body mass index (BMI). Low vitamin D levels do not solely cause obesity, which could be a factor in the etiology of T2DM.
AIM
To evaluate miRNA-200a and miRNA-200b expression, and vitamin-D levels in obese and obese T2DM individuals.
METHODS
This study included 210 participants, of which, 82 were obese (BMI > 30 kg/m2) without T2DM, 28 were obese with T2DM, and 100 were healthy controls. BMI was evaluated and both fasting and postprandial blood glucose were used to confirm T2DM. Exosomal miRNA-200a and miRNA-200b expression were analyzed using real-time PCR using Taqman probes, and vitamin-D levels were evaluated using an electrochemiluminescence-based immunoassay technique. All data analyses were performed using SPSS 20.0 and GraphPad Prism 5 software.
RESULTS
Overall, a 2.20- and 4.40-fold increase in miRNA-200a and miRNA-200b expression was observed among participants compared to healthy controls. MiRNA-200a and miRNA-200b expression among obese participants increased 2.40-fold and 3.93-fold, respectively, while in obese T2DM participants these values were 2.67-fold, and 5.78-fold, respectively, and these differences were found to be statistically significant (P = 0.02) (P < 0.0001). Obese participants showed a vitamin D level of 34.27 ng/mL, while in obese-T2DM participants vitamin D level was 22.21 ng/mL (P < 0.0001). Vitamin D was negatively correlated with miRNA-200a (r = -0.22, P = 0.01) and miRNA-200b (r = -0.19, P = 0.04). MiRNA-200a sensitivity was 75%, and specificity was 57%, with a cutoff value of 2.07-fold. MiRNA-200b sensitivity was 75%, and specificity was 71% with a cutoff value of 4.12-fold, suggesting that miRNA-200a and miRNA-200b with an increased expression of 2.07- and 4.12-fold could be predictive indicators for the risk of diabetes in obese participants.
CONCLUSION
MiRNA-200a and miRNA-200b were higher in diabetic obese participants vs non-diabetic obese participants, and insufficient vitamin D levels in obese T2DM participants may be involved in poor clinical outcome.
Treatment patterns and characteristics of patients with Post-Traumatic Stress Disorder (PTSD): A retrospective claims analysis among commercially insured population
Authors: Stanicic Filip , Zah Vladimir , Grbic Dimitrije , De Angelo Debra , Bibeau Wendy 
Published: October 2024

Objective
This retrospective claims analysis explored the treatment utilization and characteristics among patients with post-traumatic stress disorder (PTSD) of different severity.

Methods
The index date was the first PTSD claim. The analysis observed 12 months pre- and 24 months post-index. Adults with insurance gaps, cancer, or acute PTSD during the observation were excluded. Patients were categorized into three severity cohorts based on treatment and healthcare services utilization for PTSD: 1. Baseline PTSD (BP) (no PTSD visits post-index, no FDA-approved medications/ psychotherapy, and no severe mental health comorbidities); 2. PTSD without Comorbidities (PwoC) (≥1 PTSD visits post-index and no severe mental health conditions); 3. PTSD with Comorbidities (PwC) (≥1 PTSD visits post-index and severe mental health comorbidities present). For the primary analysis, cohorts were propensity-score matched. A sub-analysis examined patients with PTSD and Substance or Alcohol Use Disorder (SUD/AUD).

Results
The primary analysis observed 1714 BP, 1681 PwoC, and 1681 PwC patients. Treatment utilization rates were highest among PwC vs. other cohorts (84.5% psychotherapy, 76.1% off-label medications, and 26.1% FDA-approved medications [p<0.001]). PwC cohort also had the highest number of psychotherapy sessions and medication prescriptions per patient (20.1 sessions, 12.6 off-label prescriptions, and 2.0 FDA-approved prescriptions [p<0.001]). The proportion of days covered (PDC) indicated low medication adherence (0.25–0.40) with adherent patient rates (PDC ≥0.80) between 8.0–17.5%. The SUD/AUD sub-analysis identified 85 BP, 537 PwoC, and 3154 PwC patients. Conclusions were similar, with PwC cohort having highest treatment utilization rates (87.1% psychotherapy, 85.0% off-label medications, 28.2% FDA-approved medications [p≤0.013] with 24.4 sessions, 16.1 off-label prescriptions, and 2.0 FDA-approved prescriptions per patient [p≤0.002]). Only 4.7–11.4% of patients were adherent.

Conclusions
PwC patients received psychotherapy and pharmacotherapy more frequently than PwoC and BP patients. Medication adherence among treated patients was low. Patients with SUD/AUD had numerically higher treatment utilization and lower medication adherence.
Locally advanced cervical cancer: Neoadjuvant chemotherapy plus radical surgery an alternative approach to chemo-radiation in a low-income setting: A descriptive study
Authors: Birara Malede , Urgie Tadesse , Sium Abraham Fessehaye 
Published: October 2024

Objective
To describe the treatment outcomes of locally advanced cervical cancer managed with neoadjuvant chemotherapy (NACT) plus radical surgery at a gynecology oncology center in Ethiopia.

Methods
This was a retrospective descriptive study of management of locally advanced cervical cancer (LACC) at St. Paul’s Hospital Millennium Medical College (Ethiopia) over 5 years. Data were collected by reviewing patient records. Data were analyzed using SPSS version 23. Simple descriptive analysis was employed to analyze clinical, histologic, and treatment outcomes of LACC managed with NACT+ radical surgery. Frequency and proportions were used to present the results’ significance.

Results
A total of 98 patients were analyzed. One-third (31.6%) of cervical cancer patients with locally advanced disease were operable after neoadjuvant chemotherapy. Out of this, nodal metastasis was found in 2 patients (all pelvic lymph node metastasis). Disease recurrence within 2 years was 3% (1 recurrence within 6–12 months and 2 recurrences at 12–24 months).

Conclusion
This study supports utilization of NACT plus radical surgery for locally advanced cervical cancer, where chemoradiation is not readily available. Our findings imply that this treatment modality is a life-saving alternative treatment in a low-income setting, which is often married by shortage or unavailability of radiotherapy at the needed time before disease progression ensues.
Burden of diabetes mellitus in Weifang: Changing trends in prevalence and deaths from 2010 to 2021
Authors: Wang Xiaoyang , Ye Danyang , Chen Min , Song Liwen , Bian Jiaxiang , Huang Lingyu , Cheng Lixia 
Published: October 2024

Objective
The objective of this study is to analyze the death characteristics and burden of disease (BOD) in diabetes mellitus (DM) patients in Weifang from 2010 to 2021. The findings will serve as a foundational data source and theoretical framework for public health administrative departments in the formulation of DM-related policies.

Methods
The annual percent change (APC) and average annual percent change (AAPC) of the disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) in DM residents from 2010 to 2021 were analyzed using the Joinpoint software to reflect the changing trend of the BOD in DM patients. Additionally, we conducted an analysis of the various causes of death among these patients and compared BOD in diabetic patients with different backgrounds.

Results
From 2010 to 2021, the burden of disease, which includes DALY, YL, and YLD, has been increasing among patients with DM in Weifang. It is noteworthy that the burden of disease is particularly pronounced among male patients and those aged 75 or above. Additionally, it is observed that widowed and illiterate DM patients have comparatively longer survival times. Furthermore, among the DM patients who have unfortunately passed away, it has been identified that unspecified DM with ketoacidosis accounts for 10.03% of the deaths as a direct cause of death. In contrast, type 2 diabetes mellitus (T2DM) with kidney complications contributes to 10.23% of the deaths as the fundamental cause of death.

Conclusion
The city is faced with a significant challenge of diabetes, which is influenced by factors such as gender, age, cultural background, and marital status. Unspecified diabetes mellitus (DM) with ketoacidosis (10.03%) and T2DM with renal complications (0.23%) are identified as the primary direct and underlying causes of death among diabetic patients, respectively. This study serves as a valuable reference for other regions in terms of diabetes prevention, control, and the management of chronic diseases.
Musical Theatre for the Female Voice: The Sensation, Sound and Science of Singing, Shaun Aquilina (2023)
Authors: Macpherson Ben 
Published: October 2024

Review of: Musical Theatre for the Female Voice: The Sensation, Sound and Science of Singing, Shaun Aquilina (2023)
London and New York: Routledge, 105 pp.,
ISBN 978-1-03226-159-1, p/bk, $42.95
The Photocatalytic Activity of TiO2 Nanotube Doped Zn for Methylene Blue Degradation
Authors: Nursanto Eduardus Budi 
Published: October 2024

TiO2 nanotube (TiO2-NT) is one of the promising materials for photocatalytic water remediation. TiO2-NT doped Zn (Zn/TiO2-NT) is synthesized from P25 Degussa via one step hydrothermal method. From XRD and UV-DRS analysis, it showed that Zn as a doping material led to decrease band gap energy and decrease the crystallite size. The best results obtained was Zn/TiO2-NT with a crystallite size of 7.14 nm, and band gap energy value of 3.18 eV. Photocatalytic activity of Zn/TiO2-NT was also tested for photocatalytic activity of textile dye (methylene blue) degradation. During the photocatalytic activity for methylene blue degradation, the Zn/TiO2-NT shows higher activity compared to non-doped sample. The non-doped sample shows degradation activity of 87.72%, meanwhile the Zn/TiO2-NT shows degradation activity of 95.88%.
Improving peripheral artery disease screening and treatment: a screening, diagnosis, and treatment tool for use across multiple care settings
Authors: Rudd Kelly M. , Roberts Kristie K. , Hamilton Cooper M. 
Published: October 2024

Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease that contributes to significant morbidity and mortality, including loss of limb, myocardial infarction (MI), stroke, and death. Treatment options are often underutilized. A major limiting factor in PAD care is the ability to efficiently identify and screen at-risk patients. A PAD patient screening and clinician decision support tool was created to improve access to high-quality, evidence-based care to drive improved clinical outcomes. The tool identifies known PAD risk factors and presenting symptoms, in combination with objective data obtained via the ankle-brachial index (ABI). The tool utilizes this data to drive PAD diagnosis, risk assessment, and treatment, and it is adaptable across multiple care settings, by varied health professions. The implementation of a PAD screening and treatment toolkit enhances anticoagulation and PAD stewardship, and it has been integrated into use across various care settings.
Reclaiming and Unlocking Ancient Heritage Knowledge from Ethiopia’s Ancient Cultural Heritages
Authors: Haile Gezae 
Published: October 2024

Abstract
The purpose of this paper is to reclaim and unlock heritage knowledge related to the secular value of time and labor from a sample Ethiopian ancient Ge’ez parchment manuscript. We claim that Ethiopia’s ancient Ge’ez parchment manuscripts could be a source of heritage knowledge if systematically studied. We conducted an extensive and intensive survey to identify and select relevant ancient Ge’ez parchment manuscripts from ancient churches and monasteries in Tigray, Ethiopia. We selected one Ge’ez parchment manuscript for content analysis related to secular value time and another Ge’ez parchment manuscript for the secular value of labor and work ethics. Content analysis and interpretation including language translation from Ge’ez to Tigrinya and English was used as a method of heritage knowledge extraction, as were unlocking approaches from the selected sample Ge’ez parchment manuscripts. Digital content was also produced in order to have access to the digital content, which facilitates further content analysis. A critical evaluation of the physical condition of the sample manuscripts including their palaeography, folios, marginalia, and provenance was made in order to establish their relative age and credibility. From our content analysis, we extract and unlock valuable information and heritage knowledge domains related to the secular value of time and labor. The striking aspect in this study is that the sources of such heritage knowledge are the ancient Ge’ez manuscripts preserved for centuries in religious institutions like ancient churches and monasteries. These sources of heritage knowledge could be easily accepted by Christian farmers to address and solve their earthly problems. We, therefore, assert that the analysis of manuscripts democratizes access to knowledge, making historical collections accessible to a broader audience. Therefore, this current research paper extends the scope of previous studies from merely identifying preservation challenges and making ancient manuscripts accessible through digitization to conducting content analysis, unlocking relevant heritage knowledge domains, and disseminating the knowledge as well as preventing the loss of valuable heritage knowledge. Finally, we suggest making a paradigm shift from preserving heritage for its own sake to focusing on heritage knowledge transfer and education. This is mainly because we currently stand at a crossroads, facing a dilemma between valuing and utilizing heritage on one hand and ensuring its sustainable preservation on the other.
Crystal structure of 72,73,75,76-tetrafluoro-25,44-dimethyl-31,33,36,38-tetraoxo-31,32,33,36,37,38-hexahydro-3(2,7)-benzo[lmn][3,8]phenanthrolina-1,5(4,1)-dipyridin-1-iuma-2,4(1,2),7(1,4)-tribenzenacyclooctaphane-11,51-diium hexafluoridophosphate, [C46H28F4N4O4][PF6]2, a dicationic cyclophane
Authors: Wang Xiuteng , Wei Wei 
Published: October 2024

Abstract
C46H28F16N4O4P2, monoclinic, P21/n (no. 14), a = 9.3041(2) Å, b = 22.4679(5) Å, c = 19.9446(3) Å, β = 98.154(2)°, V = 4,127.14(14) Å3, Z = 4, Rgt
(F) = 0.0478, wRref
(F
2) = 0.1411, T = 173(2) K.
Sodium carbonate pulping of oil palm empty fruit bunches for paperboard production
Authors: Rahmi DN Muslimatul , Fatriasari Widya , Wistara Nyoman J. 
Published: October 2024

Abstract
This study investigated the use of sodium carbonate pulping in oil palm empty fruit bunch (OPEFB) pulp production for paperboard manufacturing. The pulping varying the active alkali (AA) (4.5 %, 6.5 %, 8.5 %), NaOH fraction (F) (10 %, 20 %, 30 %), and cooking time (T) (30′, 60′, 90′). The performance was evaluated based on screened pulp yield, kappa number, and delignification selectivity. Furthermore, the functional groups, S/G ratio, and morphological structure of the optimum pulp were observed. The tensile and tear indices of the OPEFB pulp paperboard were also measured. The results suggest sodium carbonate pulping at a low chemical dose successfully produced OPEFB pulp. Based on the highest delignification selectivity value of 12.74, the most effective pulping conditions were achieved with AA-6.5 %, F-30 %, and T-90′. The optimum OPEFB pulp analysis revealed a decrease in lignin proportion with the dominant degradation of the syringyl unit. Thus, the fibers are easily separable during mechanical treatment. These characteristics influenced the paperboard, resulting high tensile and tear indices of 7.90–8.15 Nm g−1 and 15.09–16.25 mN m2 g−1, respectively. Overall, this study demonstrated the potential of sodium carbonate pulping to produce high-quality pulp and paperboard from OPEFBs, highlighting the thoroughness of the research process in the pulp and paper manufacturing field.
Delayed onset arginine vasopressin deficiency after traumatic brain injury
Authors: Tomulescu Silviu-Andrei , Boto José , Gariani Karim 
Published: October 2024

Summary
Delayed arginine vasopressin deficiency (AVP-D) can present in patients following traumatic brain injury (TBI) and may occur years after the trauma, presenting with nonspecific symptoms. The objective of this case is to highlight the importance of considering the delayed onset AVP-D in patients with a history of TBI. We report a case of a patient who had sustained severe traumatic brain injury 8 years before and who presented with polydipsia, behavioural disorder and frequent falls during the last 3 months. The diagnosis of AVP-D was confirmed by water restriction with a positive response to desmopressin, and pituitary MRI showed an absent spontaneous posterior hyperintensity on T1WI. Follow-up confirmed permanent diabetes insipidus as well as a suspected anterior pituitary deficiency. Pituitary dysfunction occurs following TBI and is correlated with severity. As in our case, symptoms are generally non-specific and are difficult to explore given the patient’s neurologic sequelae. MRI 8 years post trauma showed changes in pituitary morphology. Some authors have proposed the need for active screening of post-TBI patients. This case highlights the need for clinicians to be aware that AVP-D can occur years after traumatic brain injury.

Learning points

Delayed onset post-traumatic arginine vasopressin deficiency may occur in patients with TBI and is correlated with the severity.

The clinical picture is usually non-specific and diagnosis of AVP-D is challenging in non-verbal patients.

An active screening for pituitary dysfunction is warranted in TBI patients and should be extended should one hormone deficit be identified.
Atypical thyroid tests in an athlete treated for hypothyroidism as the first symptom of pituitary dysfunction due to relative energy deficiency
Authors: Skrzypiec-Spring Monika , Kuliczkowska-Płaksej Justyna , Szeląg Adam , Bolanowski Marek 
Published: October 2024

Summary
Relative energy deficiency in sport occurs in athletes who have limited energy availability. Its typical features include reversible suppression of the hypothalamic–pituitary–gonadal axis. In addition, it may be accompanied by hepatic resistance to growth hormone, leading to a decrease in insulin-like growth factor 1 and dysregulation of the hypothalamic–pituitary–thyroid axis. We present the clinical case of a 33-year-old athlete previously treated effectively for hypothyroidism, who presented with low thyroid-stimulating hormone, low free triiodothyronine, and normal free thyroxine. Based on diet and training interviews and further laboratory tests, dysregulation of the hypothalamic–pituitary–thyroid axis and reversible hypogonadism due to insufficiency of energy available to support energy expenditure were revealed. We also discuss here challenging diagnostic dilemmas that may appear in athletes of normal body weight but result from insufficient energy supply in relation to demand, and review the literature for the clinical course and possible mechanisms underlying the relative energy deficiency.

Learning points

Atypical thyroid function tests in athletes may be the first manifestation of reversible pituitary dysfunction due to relative energy deficiency.

Typical symptoms of relative energy deficiency include reversible suppression of the hypothalamic–pituitary–thyroidal axis and hypothalamic–pituitary–gonadal axis.

Relative energy deficiency may occur in all people who train intensively, regardless of their body weight and BMI, as well as in people who have rapidly lost weight as a result of a low-calorie diet and intense exercise.