bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing Hand Hygiene compliance in surgical wards: A Quality Improvement Initiative using two Plan- Do- Study- Act (PDSA) cycles
Authors: Rehman Ibad ur , Shafqat Muhammad Daniyal , Shafqat Muhammad Danish , Rehman Hammad ur , Rasool Talha , Amir Muhammad Ayhan , Satti Rida Altaf , Farooqui Fareeha , khan saad , Munir Aqsa , Iqbal Javed 
Published: October 2024

Abstract

Background:
Due to invasive procedures, healthcare-associated infections (HCAIs) present major risks, especially in surgical wards. Healthcare workers (HCWs) often show low adherence to hand hygiene (HH), with compliance close to 60%. Hand hygiene (HH) is a straightforward yet highly effective measure to prevent HCAIs. This study evaluated and enhanced HH adherence in the surgical wards of a tertiary hospital in Islamabad using the Plan-Do-Study-Act (PDSA) quality improvement (QI) method.
Methodology:
This prospective, quasi-experimental quality improvement study occurred in the surgical wards of a tertiary hospital in Islamabad from March to July 2024. With approval, all healthcare workers (HCWs), including doctors, nurses, and medical students, participated. Three monitoring phases were conducted on 750 hand hygiene (HH) opportunities: before the intervention, after the first PDSA cycle, and after the second PDSA cycle. The interventions included regular feedback, improved hand rub dispenser placement, and educational workshops. Statistical analysis used the chi-square test with a significance level of p < 0.05.
Results:
Pre-intervention HH compliance was 48%, with 114 out of 150 opportunities observed as compliant. After the first intervention, compliance improved to 67%, and following the second intervention, compliance increased further to 80.4% (281/350 opportunities). Significant improvements were noted in HH moments before patient contact, aseptic procedures, and after body fluid exposure (p < 0.001). However, compliance after patient contact remained more challenging. The main barriers identified were forgetfulness, inconvenient dispenser locations, and insufficient training, all addressed through targeted interventions.
Conclusions:
Implementing QI methodologies, specifically PDSA cycles, significantly improved HH compliance in the surgical wards, improving patient safety and reducing the risk of HCAIs. Continuous education, improved accessibility to hand hygiene supplies, and real-time feedback were vital in sustaining compliance improvements. This study demonstrates the value of structured, iterative interventions in fostering lasting behavioral change among HCWs.
Factors for Predicting Time to Acceptance in the Journal of the American Academy of Orthopaedic Surgeons
Authors: Crawford Ethan , Gergoudis Maria , Whitaker Sarah , Laubach Logan , Yeramosu Teja , Patel Nirav 
Published: October 2024

Abstract

Purpose
The Journal of the American Academy of Orthopaedic Surgeons (JAAOS) is a high-impact journal that publishes crucial research to inform surgeons’ clinical decision-making. The purpose of this study was to determine the median time from submission to acceptance for articles published by the JAAOS and to evaluate factors which may influence time to acceptance.
Methods
All studies published in JAAOS from 2020-2022 were obtained. Abstracts were screened for submission and acceptance dates, and time to acceptance was calculated. Studies were excluded if dates were unavailable. Data extracted included article type, main topic, and sex of the first author. Simple linear regression, analysis of variance (ANOVA), and independent samples t-test were utilized for univariate analysis. For multivariate analyses, a standard least squares regression was applied.
Results
We analyzed 754 articles. Over the past 3 years, time to acceptance has not significantly changed (p = 0.894). Regarding article type, letters had the shortest time to acceptance (median 5 days, IQR 2-10, p<0.0001), while interventional studies had the longest time to acceptance (median 171.5 days, IQR 106-309.5).. Articles pertaining to COVID-19 (median 62 days, IQR 2-121) and diversity (median 90 days, IQR 24-156) had the shortest times to acceptance. Articles pertaining to radiology (median 189.5 days, IQR 100-309.5) and trauma (median 183 days, IQR 126.5-269.5) had the longest times to acceptance (p<.0008). Time to acceptance was not significantly different between male and female first authors.
Conclusion
This study provides a tool for authors to estimate their mean time from submission to acceptance based on the characteristics of their study. With literature submissions constantly increasing each year with unknown times to acceptance, authors may make a more informed decision with journal selection based on the qualities of their study.
Preoperative Immunotherapy Combined with Chemotherapy: Evaluation of Nutritional and Immune-inflammatory Status in ESCC and Its Impact on Perioperative Period
Authors: Liu Qingwen , Hu Junxi , Chen Yong , He Wenbo , Hou Jiaqi , Shu Yusheng , Wang Xiaolin 
Published: October 2024

Abstract

Objectives
To investigate the effects of neoadjuvant therapy (NT) on the nutritional and immune-inflammatory status of patients with esophageal squamous cell carcinoma (ESCC), and to identify the relevant indicators that influence adverse perioperative outcomes.
Methods
From March 2021 to March 2024, a retrospective study was conducted on 78 patients clinically diagnosed ESCC who underwent surgery following immunotherapy and chemotherapy. The nutritional and immune-inflammatory status of pre-NT and pre-operation were compared, and logistic regression model and linear regression model were employed to investigate the indicators influencing postoperative complications and the duration of postoperative hospitalization.
Results
The malnutrition rates pre-NT and pre-operation were 37.2% and 44.9% respectively, p = 0.329. Preoperative indicators of nutritional status decreased compared with those pre-NT, but the differences were not statistically significant. The systemic immune-inflammation index (SII), white blood cell (WBC), neutrophil (NE) and platelet (PLT) counts showed significant decrease pre-operation compared to pre-NT (p < 0.05), while lymphocyte (LYC) and monocyte (MO) counts also decreased but not significantly (p > 0.05). Malnutrition under GLIM criteria was identified as an independent risk factor for postoperative complications (OR 11.366, 95% CI 1.079; 119.706, p = 0.043), and a reduction in intake by 50%-75% was an independent risk factor for prolonged postoperative hospital stay (OR 6.651, 95% CI 2.653; 10.648, p = 0.001).
Conclusion
The prevalence of malnutrition in patients with ESCC is high. Preoperative NT is not a primary factor exacerbating malnutrition but does suppress the body's immune-inflammatory status. In clinical practice, the predictive value of malnutrition under GLIM criteria and its indicators for adverse perioperative outcomes is significantly greater.
Mechanism of gas film formation and evolution on anode in microbubbles flow electrolytic plasma polishing
Authors: Wang Juan , Sun Huanwu , Fan Ruilong , Yang Dongliang , Xiang Yuxia , Duan Haidong 
Published: October 2024

Abstract

Microbubbles flow electrolytic plasma polishing (MF-EPP) facilitates controllable electrolytic plasma polishing (EPP) using a low-power supply. It is well established that a vapor gaseous envelope (VGE) around a workpiece is essential for EPP polishing. Nonetheless, the generation condition and its control parameter of a local gas film on the workpiece surface in MF-EPP is not fully understood. In this study, an analysis by the electrochemical and hydrothermal reactions revealed that the gas composition on the anode surface is mainly composed of water vapor, which is heated by Joule heat, and electrolysis gases such as oxygen, fluorine, hydrogen, and nitrogen. By analyzing formation conditions and calculating the volume flux of each gas, it was found that vapor is the main component of the gas film. For the vapor characteristics, the bubble nucleation and growth model has been established. On this basis, the main factors affecting the nucleation, growth, and coalescence of bubbles were then analyzed, indicating that superheating and heat flow density are the principal factors affecting the aggregation of bubbles and thus the formation of a gas film. It was determined that the presence of electrolytic gases exerts a beneficial influence on the nucleation of vapor bubbles. Additionally, a bubble dynamics model was constructed based on the conservation of energy, and the impact of processing parameters on the evolution of bubbles was analyzed. The threshold for the formation of a stable gas film under the conditions of this experiment was determined to be a voltage of 350 V and an initial electrolyte temperature of 80°C. The applicability of the model was validated through experimentation, and the establishment of the model provides theoretical and experimental references for the formulation and optimization of MF-EPP machining process parameters.
A Hybrid Process of Electrochemical Discharge Machining (ECDM) and High-Speed Milling (HSM) on Quartz Glass
Authors: Tong Hao , Luo Yuge , Liu Guodong , Li Yong , Nawaz Shan Ali 
Published: October 2024

Abstract

In traditional machining processes, surface microcracks are prone to generate due to the hardness and brittleness of quartz glass. A hybrid process of electrochemical discharge machining (ECDM) and high-speed milling (HSM) is proposed for efficiently machining quartz glass without surface microcracks. During ECDM-HSM process, a "mushroom cloud" gas film is found by a high-speed camera, which facilitates to constraint discharges to a tool-electrode end. Machining experiments of ECDM-HSM obtains the processing effect of key factors of tool rotation speed, applied voltage, and feed rate. The higher rotation speed requires higher critical voltage to start discharges. The high feed rate can improve machining efficiency and quality significantly owing to the combined action of plastic cutting, discharges, and chemical reaction. The homogenization mechanism of discharging energy and the transition mechanism of plastic cutting are proposed for illuminating the processing effect. The matching mapping of key parameters is established for optimizing the processing parameters. As an example, a regular groove without surface microcracks is machined with the processing efficiency improved up to 20 times as compared with that of HSM.
Title: 'Identification of potential growth centre in auto-transplanted costochondral graft in Temporomandibular joint- an experimental study on New Zealand white rabbit'.
Authors: Sultana Jachmen , Rahman Prof. Dr. Quazi  Billur , Chowdhury Prof. Dr. Emdadul Haque , Juyena Prof. Dr. Nasrin Sultana , B Prof. Dr. Md. Abul 
Published: October 2024

Abstract

Introduction
Relapse of Temporomandibular joint (TMJ) ankylosis and facial deformity are the common complications of reconstruction of TMJ by costochondral graft (CCG), especially in children. An unpredictable growth pattern in CCG is considered to be responsible for frequent relapse. However, CCG is regarded as a primary growth centre with inherent growth potential. Therefore, the lack of clear experimental evidence of predictability of growth patterns emphasizes further experiments.
Materials and Methods
To identify the potential growth centre of CCG in TMJ, an experimental study was done on 144 New Zealand white rabbits, 72 experimental and 72 control, which were divided into three batches. Each batch contains 48 (24 experimental and 24 control) male rabbits of known ages and species: growing (3–4) and adult (12–18) months old. After TMJ interpositional gap arthroplasty using a variable thickness of 1-mm and 4-mm cartilaginous cap with CCG follow-up was done clinically, radiologically and biochemically; sacrifices were done in batches after the 4th, 12th and 24th weeks and examined histologically.
Results
Clinically, facial changes were consistent with graft’s growth and a trend of regaining facial symmetry was observed from the 12th week to the 24th week. Radiologically, the graft’s growth was remarkable in terms of length and width. Biochemically, increased serum bone-specific alkaline phosphatase level was found in both age groups, but it was noticeably high among the growing rabbits at the 24th week of observation. Histologically, the costochondral junction (CCJ) zone of the CCG showed a distinctive histological arrangement and pattern of cell proliferation which embodied the normal endochondral bone formation. The features of growth plate cartilage with specific zonal distribution determined the intrinsic growth capacity of CCG.
Conclusion
It is well-established that the growth centre is present at the CCJ of the graft along with its actual pattern of growth, which is no to minimal growth at the 4th week, maximum growth at the 12th week and slightly increased to remain static at the 24th week.
30-day and lasting impacts on utilizing a novel orthotic insole for tactile stimulation in diabetic peripheral neuropathy: a double-blind, randomized, sham-controlled trial
Authors: Thimabut Wachirayongyot , Thimabut Natapatchakrid , Peng Liang , Hou Zeng-Guang 
Published: October 2024

Abstract

Background
Diabetic peripheral neuropathy (DPN) can lead to diabetic foot ulceration (DFU) and disabilities. DPN also increases vibration perception threshold (VPT) and decreases tactile sensitivity. Applying a vibrating insole is an efficient way to decrease VPT and improve tactile sensibility.
Objective
To investigate the continuing and lasting effects of applying a novel vibrating orthotic insole (VOI) combined with a newly designed stimulus (a random 0–100 Hz square wave pulse signal integrated with pseudorandom white noise via a stochastic resonance approach) for tactile stimulation in DPN.
Methods
A randomized sham-controlled trial with a parallel design and a double-blind strategy was conducted in this study. Sixty-four mild-to-moderate DPN were randomized by a computer-generated algorithm into two interventions: 1) using the VOI mixed with the newly designed stimulus; 2) using the VOI with only 100 Hz frequency vibration. Each intervention was done at home for sixty minutes a day over thirty days. VPT outcomes were assessed on the 1st, 15th, and 30th days. Following up on the remaining effects of employing the VOI combined with the newly designed stimulus was performed after completing Intervention 1 by evaluating VPT values every seven days.
Results
Intervention 1 could significantly reduce VPT and effectively enhance tactile sensation (P<0.001). In contrast, Intervention 2 considerably increased VPT. Follow-up, VPT was steady at the end of Intervention 1 for the first week before progressively rising over a month; after that, it rose until it exceeded baseline, which took approximately two to three months.
Conclusions
Utilizing the VOI in conjunction with a random 0–100 Hz square wave pulse signal and pseudorandom white noise via a stochastic resonance approach could offer lowering VPT, maintaining decreased VPT, and improving tactile sensitivity. The VOI may benefit neurorehabilitation in DPN, e.g., preventing DFU and its recurrence, restoring/prolonging tactile sensation, slowing DPN deterioration, and avoiding lower extremity amputation.
Trial registration
Thai Clinical Trials Registry: TCTR20230601001 (ThaiClinicalTrials.org).
Effect of organic waste material and rhizobacteria on growth and physiology of Brassica juncea (L.) Czern. under salinity stress
Authors: Kareem Noreen , Rashid Madiha , Noreen Zahra , Usman Sheeraz , Shah Anis Ali , Khaleel Fareeha , Ilyas Anam , Riaz Ahsan , Gatasheh Mansour K. , Shaffique Shifa 
Published: October 2024

Abstract

Salinity is one of the major environmental problems in arid and semi-arid region which affect the plant physiological and yield attributes. Organic waste materials such as banana peels and eggshells contain essential nutrients that are necessary for plant growth and development. The inoculation of rhizobacteria allows to decrease the hazardous effects of salinity stress. The present study was conducted to evaluate the potential of organic waste material and rhizobacteria on growth and physiology of Brassica juncea (L.) Czern. under salinity stress. The experiment consisted of various treatments including eggshells (20g), banana peel (20g), rhizobacteria (30ml Bacillus megaterium) and NPK(0.033kgh− 1). In the current study, salt stress 0 mM and 150 mM NaCl concentration was applied. From outcome of current study, it is shown that salt stress caused changes in morphological, physiological, biochemical and yield parameters. Peel powder treatment and Bacillus megaterium strain play major role as growth regulators for plant development under salt stress. Among the treatments, eggshells and banana peels significantly enhanced the antioxidant activity (CAT, POD, SOD and total soluble protein), total phenolic, leaf proline, reduced the oxidative stress markers (MDA, H2O2) and promoted membrane stability and yield attributes. However, carotenoids content increased under NPK treatment.
Health-seeking delay and potential determinants among pulmonary tuberculosis patients: a retrospective survey in China
Authors: Fan Mingkuan , Liu Yushu , Liu Kui , Li Tao , Zhang Canyou , Li Yuhong , Liu Xiaoqiu , Cheng Jun , Zhang Hui , Wang Li 
Published: October 2024

Abstract

Background
Understanding the health-seeking delay (HSD) in pulmonary tuberculosis (PTB) patients aids tailored strategies to curb transmission. This study aims to assess HSD and factors in China, considering the COVID-19 impacts.
Methods
Symptomatic PTB patients diagnosed from 2019 to 2022 were sampled using multistage stratified clustering. A semi-structured questionnaire was utilized to assess their HSD. Participants were divided to pre (2019) and epidemic (2020–2022) groups, the latter further categorized to 12 subgroups byⅠ–Ⅳstages and 3 levels of stringency in public health and social measures(PHSMs). Categorical variables were presented as counts (percentages), while continuous as median (Interquartile Range). The time between patient onset symptom and initial health facility visiting was defined as the health-seeking interval (HSI), HSIs of epidemic group and subgroups were compared with those of the 2019. Factors associated with HSD were analysed, univariable and multivariable analysis were performed by chi-square tests and binary logistic regression separately.
Results
Sum of 759 PTB patients, 391 diagnosed pre and 368 during the epidemic. HSI was 14 (7–30) days for all patients, with no significant difference between two groups [12 (7–30) days vs. 15 (6–30) days, P = 0.852]. Among the 12 subgroups, only under strict PHSMs in stage I and medium PHSMs in stage II showed significant differences in HSIs compared to 2019[10 (3–15) days vs. 20 (10–30) days, 10 (3–17.5) days vs. 20 (8.5–50) days] (P = 0.013, 0.038). HSD proportions were comparable between the two groups (48.1% vs. 51.6%, P = 0.328). Self-medication before seeking health was a common factor for HSD (AOR: 3.057/2.868, 95% CI: 1.888–4.950/1.718–4.787). During the epidemic, solely cough and expectoration were prone to HSD (AOR: 2.144, 95% CI: 1.288–3.569), and passive case-finding posed a higher HSD risk than active (AOR: 30.987, 95% CI: 3.904-245.932). Most patients with HSD misinterpreted PTB, while a few cited epidemic inconvenience and fear of COVID-19.
Conclusions
HSD among PTB patients remains prevalent, the COVID-19 epidemic exerted limited impact. Individual, epidemic and health provider factors mediated the HSD. Increasing PTB awareness, enhancing health services accessibility during epidemics, and expanding active case-finding are recommended to minimize the delays.
Down-regulated expression of the palmitoyl-acyl carrier protein thioesterase (FatB) gene enhanced oleic and linoleic acid accumulation in rice (Oryza sativa) seed
Authors: Luo Jixun , Zaplin Ella Simone , Xu Xiaoyu , Su Xianyue , Devilla Rosangela , Howitt Crispin A , Li Zhongyi , Blanchard Chris , Rahman Sadequr , Zhou Xue-Rong 
Published: October 2024

Abstract

Background
Rice (Oryza sativa) seed lipids contain about 25% saturated fatty acids, dominated by palmitic acid. Reduction of saturated fat consumption is recommended for health concerns and so reducing palmitic acid content is of interest for the rice bran oil industry. In higher plants, palmitoyl-acyl carrier protein thioesterase (FatB) controls the release of palmitic acid from acyl carrier protein and its accumulation in oil.
Results
In this study, four rice OsFatB genes were identified, and their expression patterns were analyzed in seed by the reverse-transcription quantitative PCR. Two types of rice lines were obtained with down-regulated OsFatB expression: an OsFatB1 knockout mutant obtained via Tos17 insertion and transgenic rice lines in which expression of the four OsFatB genes using RNAi technology. Both types exhibited partial reductions of palmitic acid content (11% and 21–55%, respectively) and a slight reduction in myristic acid content. Increased oleic and linoleic acid content was observed in the transgenic rice lines but not in the Tos17 insertion line.
Conclusion
These results demonstrated that the palmitic acid content is controlled by multiple OsFatBs, and the contribution of OsFatB1 is limited.
Integrative study of subcellular distribution, chemical forms, and physiological responses for understanding cadmium tolerance in two garden shrubs
Authors: Yu Shiyin , Wang Shan , Tang Min , Pan Shuzhen , Wang Meixian 
Published: October 2024

Abstract

Background and aims Urban ornamental shrubs have significant potential for restoring cadmium (Cd)-contaminated soil. Simulated pot pollution was applied to Buxus sinica and Ligustrum × vicaryi to study their Cd enrichment characteristics and tolerance mechanisms.
Methods Cd content and accumulation were analyzed in different plant organs, subcellular distribution and chemical forms of Cd in the roots, and the effects of Cd on the ultrastructure of root cells under various Cd concentrations (0, 25, 50, 100, and 200 mg·kg⁻¹).
Results (1) With increasing Cd treatment levels, the total biomass of B. sinica gradually decreased, while L. ×vicaryi exhibited a stimulation effect at low Cd concentrations and inhibition at high Cd concentrations. (2) The Cd content in different organs of both shrubs increased with rising Cd levels, with L. × vicaryi showing a significantly higher increase than B. sinica, indicating a stronger Cd accumulation capability in L. × vicaryi. (3) Cd in the root of both shrubs was primarily present in NaCl-extractable forms, and was majorly bound to the cell wall. (4) Excessive Cd caused damage to the cellular structure of B. sinica leaves, while the cells of L. × vicaryileaves maintained normal morphology. (5) In both shrubs, Cd primarily binds to the cell wall through hydroxyl, amino functional groups, and soluble sugars.
Conclusion Converting Cd to less active forms, immobilizing Cd in the cell wall, and providing binding sites through functional groups may be crucial resistance mechanisms for both shrubs in response to Cd stress.