bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantification of muscle recovery in post-ICU patients admitted for acute pancreatitis: a longitudinal single-center study
Authors: Hosse Clarissa , Beetz Nick L. , Fehrenbach Uli , Elkilany Aboelyazid , Auer Timo A. , Gebauer Bernhard , Pille Christian , Geisel Dominik , Kolck Johannes 
Published: September 2024

Abstract
Objectives
Critically ill patients with severe pancreatitis exhibit substantial muscle wasting, which limits in-hospital and post-hospital outcomes. Survivors of critical illness undergo extensive recovery processes. Previous studies have explored pancreatic function, quality of life, and costs post-hospitalization for AP patients, but none have comprehensively quantified muscle loss and recovery post-discharge. By applying an AI-based automated segmentation tool, we aimed to quantify muscle mass recovery in ICU patients after discharge.

Materials
Muscle segmentation was performed on 22 patients, with a minimum of three measurements taken during hospitalization and one clinically indicated examination after hospital discharge. Changes in psoas muscle area (PMA) between admission, discharge and follow up were calculated. T-Test was performed to identify significant differences between patients able and not able to recover their muscle mass.

Results
Monitoring PMA shows muscle loss during and gain after hospitalization: The mean PMA at the first scan before or at ICU admission (TP1) was 17.08 cm², at the last scan before discharge (TP2), mean PMA was 9.61 cm². The percentage change in PMA between TP1 and TP2 ranged from − 85.42% to -2.89%, with a mean change of -40.18%. The maximum muscle decay observed during the stay was − 50.61%. After a mean follow-up period of 438.73 days most patients (81%) were able to increase their muscle mass. Compared to muscle status at TP1, only 27% of patients exhibited full recovery, with the majority still presenting a deficit of 31.96%.

Conclusion
Muscle recovery in ICU patients suffering from severe AP is highly variable, with only about one third of patients recovering to their initial physical status. Opportunistic screening of post-ICU patient recovery using clinically indicated imaging and AI-based segmentation tools enables precise quantification of patients’ muscle status and can be employed to identify individuals who fail to recover and would benefit from secondary rehabilitation. Understanding the dynamics of muscle atrophy may improve prognosis and support personalized patient care.
Effect of mothers‘ health literacy on early childhood allergy prevention behaviours: results from the KUNO-Kids health study
Authors: Pawellek Maja , Köninger Angela , Melter Michael , Kabesch Michael , Apfelbacher Christian , Brandstetter Susanne ,   KUNO-Kids study group, Ambrosch Andreas , Arndt Petra A. , Baessler Andrea , Berneburg Mark , Böse-O’Reilly Stephan , Brunner Romuald , Malfertheiner Sara Fill , Franke André , Häsler Robert , Häusler Sebastian , Heid Iris , Heinze Stefanie , Högler Wolfgang , Kerzel Sebastian , Koller Michael , Leitzmann Michael , Lennon Áine , Rothfuß David , Rösch Wolfgang , Schaub Bianca , Weidinger Stephan , Wellmann Sven 
Published: September 2024

Abstract
Background
Parents can engage in several behaviours with regard to early childhood allergy prevention (ECAP). These can be related to diet of mother/child and the modification of the home environment; not all of them are justified by current evidence. Previous studies showed that parental health literacy (HL) is related to favourable health behaviours directed at the child. This study aimed to investigate the causal effect of mothers’ HL on ECAP behaviours and to test different moderators of this effect.

Methods
One thousand six hundred sixty-two mothers participating in the KUNO-Kids health study in the area of Regensburg, Germany were surveyed on HL (assessed via the health care scale of the Health Literacy Survey-EU questionnaire, HLS-EU-Q47) and ECAP behaviours implemented during pregnancy and the child’s first year of life. Patterns in ECAP behaviours were identified by latent class analysis. Multinomial regression modelling was performed with HL as exposure, ECAP as outcome variable, allergy risk, parental competence and bonding, anxiety and depression as moderators as well as potentially confounding variables.

Results
We identified three classes of ECAP behaviours (class 1: „breastfeeding “ N = 871; class 2: „allergen-avoidance “ N = 490; class 3: „mixed behaviours “ N = 301). In univariable as well as fully adjusted regression models, compared to class 1, class 2 was negatively, and class 3 was not associated with HL. None of the tested moderating variables altered the association between HL and ECAP significantly.

Conclusions
We found an effect of mothers’ HL on ECAP behaviours: lower HL of mothers increased allergen-avoiding behaviour directed at their child, while decreasing the chance of exclusive breastfeeding. Improving HL could contribute to the implementation of recommended ECAP behaviours in families, especially to the reduction of allergen-avoiding behaviours.
Bridging the generational gap between nurses and nurse managers: a qualitative study from Qatar
Authors: Abujaber Ahmad A. , Nashwan Abdulqadir J. , Santos Mark D. , Al-Lobaney Nabeel F. , Mathew Rejo G. , Alikutty Jamsheer P. , Kunjavara Jibin , Alomari Albara M. 
Published: September 2024

Abstract
Background
The nursing workforce comprises multiple generations, each with unique values, beliefs, and expectations that can influence communication, work ethic, and professional relationships. In Qatar, the generational gap between nurses and nurse managers poses challenges to effective communication and teamwork, impacting job satisfaction and patient outcomes.

Aim
This study investigates the generational gap between nurses and nurse managers in Qatar, aiming to identify strategies to enhance collaboration and create a positive work environment.

Methods
A qualitative research design was used, involving semi-structured interviews with 20 participants, including frontline nurses and senior nurse managers. Participants were purposively sampled to represent different generations. Data were collected through face-to-face and virtual interviews, then transcribed and thematically analyzed.

Findings
Four key themes emerged: Optimizing the Work Environment: Older generations preferred transformational and situational leadership, while younger nurses valued respect, teamwork, accountability, and professionalism. Strengthening Work Atmosphere through Communication and values: Older nurses favored face-to-face communication, while younger nurses preferred digital tools. Cultivating Respect and Empathy: Younger nurses emphasized fairness in assignments and promotions, while older nurses focused on empathy and understanding. Dynamic Enhancement of Healthcare Systems: Younger nurses were more adaptable to technology and professional development, while older nurses prioritized clinical care and patient outcomes.

Conclusion
The study reveals significant generational differences in leadership preferences, communication styles, and adaptability to technology. Addressing these gaps through effective leadership, ongoing education, and open communication can improve job satisfaction and patient care.
Impeding microbial biofilm formation and Pseudomonas aeruginosa virulence genes using biologically synthesized silver Carthamus nanoparticles
Authors: Abdel-Fatah Sobhy S. , Mohammad Nasser H. , Elshimy Rana. , Mosallam Farag M. 
Published: September 2024

AbstractLong-term antibiotic treatment results in the increasing resistance of bacteria to antimicrobials drugs, so it is necessary to search for effective alternatives to prevent and treat pathogens that cause diseases. This study is aimed for biological synthesis of silver Carthamus nanoparticles (Ag-Carth-NPs) to combat microbial biofilm formation and Pseudomonas aeruginosa virulence genes. Ag-Carth-NPs are synthesized using Carthamus tenuis aqueous extract as environmentally friendly method has no harmful effect on environment. General factorial design is used to optimize Ag-Carth-NPs synthesis using three variables in three levels are Carthamus extract concentration, silver nitrate concentration and gamma radiation doses. Analysis of response data indicates gamma radiation has a significant effect on Ag-Carth-NPs production. Ag-Carth-NPs have sharp peak at λ max 425 nm, small and spherical particles with size 20.0 ± 1.22 nm, high stability up to 240 day with zeta potential around − 43 ± 0.12 mV, face centered cubic crystalline structure and FT-IR spectroscopy shows peak around 620 cm−1 that corresponding to AgNPs that stabilized by C. tenuis extract functional moiety. The antibacterial activity of Ag-Carth-NPs against pathogenic bacteria and fungi was determined using well diffusion method. The MIC values of Ag-Carth-NPs were (6.25, 6.25, 3.126, 25, 12.5, 12.5, 25 and 12.5 µg/ml), MBC values were (12.5, 12.5, 6.25, 50, 25, 25, 50 and 25 µg/ml) and biofilm inhibition% were (62.12, 68.25, 90.12, 69.51, 70.61, 71.12, 75.51 and 77.71%) against Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis, Candida tropicalis and Candida albicans respectively. Ag-Carth-NPs has bactericidal efficacy and significantly reduced the swarming, swimming motility, pyocyanin and protease production of P. aeruginosa. Furthermore, P. aeruginosa ToxA gene expression was significantly down regulated by 81.5%, while exoU reduced by 78.1%, where lasR gene expression reduction was 68%, while the reduction in exoU was 66% and 60.1% decrease in lasB gene expression after treatment with Ag-Carth-NPs. This activity is attributed to effect of Ag-Carth-NPs on cell membrane integrity, down regulation of virulence gene expression, and induction of general and oxidative stress in P. aeruginosa. Ag-Carth-NPs have no significant cytotoxic effects on normal human cell (Hfb4) but have IC50 at 5.6µg/mL against of HepG-2 cells. Limitations of the study include studies with low risks of silver nanoparticles for in vitro antimicrobial effects and its toxicity.
Giving a voice to “the silent killer”: a knowledge, attitude and practice study of diabetes among French Guiana’s Parikweneh people
Authors: Rapinski Michael , Cuerrier Alain , Davy Damien 
Published: September 2024

Abstract
Background
The prevalence of type 2 diabetes (T2D) in the French overseas department of French Guiana, South America, nearly doubles that in its European counterpart, Metropolitan France. This region is demographically diverse and includes several populations of Indigenous Peoples. Although such populations are at particular risk of developing T2D across the Americas, very little is known about their health status in French Guiana, and accurate numbers of diabetic patients do not exist.

Methods
In light of a potential public health crisis, an ethnomedicinal study of diabetes experienced by Indigenous Parikweneh was conducted to provide better insight into the knowledge, attitudes and practices (KAP) related to this quickly emerging disease in French Guiana. Altogether, 75 interviews were conducted with community members and Elders, as well as healthcare professionals and administrators providing services to the Parikweneh population of Macouria and Saint-Georges de l’Oyapock.

Results
Interviews suggest a high incidence of T2D in this population, with cases that have risen quickly since the mid-twentieth century. Parikweneh participants linked the development of the illness to dietary changes, notably through the introduction of new and sweet foods. Recognizing the complexity of diabetes and its symptoms, diabetic patients highlighted the importance of biomedical treatments and follow-ups, though they frequently alternated or used them concomitantly with Parikweneh medicines. With the help of biomedical tools (i.e. glucometer), local medicinal practices mirrored biomedical approaches through dietary adaptation and the use of medicinal animals and plants for glycaemic control and the treatment of complications from the disease.

Conclusion
Parikweneh are appropriating T2D into their knowledge system and adapting their health system in response to this relatively new health concern. A greater understanding of local practices and perceptions relating to T2D among medical staff may therefore be beneficial for meeting patients’ needs, providing greater autonomy in their health path, and improving treatment outcomes.
Predictors for the incidence of pneumonia among HIV-infected children on antiretroviral therapy in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia: a multicenter retrospective follow-up study
Authors: Mekonnen Gebrehiwot Berie , Baye Fikadie Dagnew , Kerebeh Gashaw , Fekadie Mengistu Melak , Kassie Yohannes Tesfahun , Demile Tiruye Azene , Belay Alamirew Enyew , Belayneh Asnake Gashaw , Legesse Bruck Tesfaye , Wondie Wubet Tazeb , Messelu Mengistu Abebe 
Published: September 2024

Abstract
Background
Human Immune deficiency Virus (HIV) infected children are at higher risk of developing pneumonia. Particularly, in the early phase of HIV infection, the risk of acquiring pneumonia is high, and it remains a major public health problem even after the test and treatment strategy. There is no clear evidence of the overall incidence of pneumonia among HIV-infected children in Amhara region. Aimed to assess the incidence of pneumonia and its predictors among HIV-infected children receiving Antiretroviral therapy in Amhara Region Comprehensive Specialized Hospitals, 2022.

Methods
A multicenter retrospective follow-up study was conducted from June 10, 2014, to February 28, 2022, among 430 HIV-positive children receiving antiretroviral therapy. A simple random sampling technique was used. The data was taken from the national antiretroviral intake and follow-up forms. The data were collected via the KoBo toolbox and analyzed using Stata version 17. The Kaplan–Meier curve and log-rank test were employed. Bivariable and multivariable Cox regression was carried out to identify predictors of pneumonia and a P-value < 0.05 was considered significant in to multivariable analysis.

Results
A total of 407 children with a record completeness rate of 94.7% were analyzed in the study. The incidence rate of pneumonia was 4.55 (95% CI; 3.5, 5.92) per 100 person-years observation. The mean survival time was 77.67 months and the total times at risk during follow-up period were yielding 1229.33 person-year observations. Having CD4 cell count below threshold [AHR; 2.71 (95% CI: 1.37, 5.35)], WHO stage III and IV [AHR: 2.17 (95% CI: 1.15, 4.08)], ever had fair and poor treatment adherence [AHR: 2.66 (95% CI: 1.45, 4.89)], and not initiated antiretroviral therapy within seven days [AHR: 2.35 (95% CI: 1.15, 4.78)] were the positive predictors for incidence of Pneumonia.

Conclusions
In this study, the incidence of pneumonia was lower than the previous studies. CD4 cells below the threshold, ever had fair and poor adherence to antiretroviral therapy, WHO stage III and IV, and not initiated antiretroviral therapy within seven days were significant predictors. Therefore,, it is crucial to detect baseline assessment and give attention to those identified predictors promptly, and timely initiation of antiretroviral therapy need special attention.
Hemoglobin and total bilirubin may affect tacrolimus clearance in liver transplant patient following the early postoperative period: a case report
Authors: Tharanon Vichapat , Iamrahong Pansa , Tuamsem Jutamas , Choochaeam Kunvadee , Auamnoy Titinun , Sobhonslidsuk Abhasnee 
Published: September 2024

Abstract
Background
Tacrolimus is a potent calcineurin inhibitor (CNI) that is principally used as a first-line immunosuppressant for the prophylaxis of allograft rejection in liver transplantation (LT) patients. In clinical practice, prescribing the optimal tacrolimus dosage is complicated by its narrow therapeutic index and high pharmacokinetic variability. Thus, performing therapeutic drug monitoring (TDM) of only tacrolimus may not provide optimal drug levels. However, other influential clinical factors affecting tacrolimus levels, such as hemoglobin (Hb), hematocrit, and total bilirubin (TBIL), should be considered while adjusting tacrolimus levels. This case report aims to introduce clinicians and their teams to taking the pharmacokinetic prediction equation into consideration for a better understanding of tacrolimus dosage adjustment during the early postoperative LT.

Case presentation
In this case report, an 18-year-old male patient of Thai ethnicity was admitted for orthotropic liver transplantation, and tacrolimus was prescribed as a cornerstone immunosuppressive agent. In the immediate postoperative period, which is the most challenging period in liver transplantation, the population pharmacokinetics predictive equation was clinically used to assist in dosage adjustment of tacrolimus by considering the significant clinical factors in this case.
Hemoglobin and total bilirubin levels were deemed significant clinical factors affecting the oral clearance (CL/F) of tacrolimus. First, a decrease in the Hb concentration increases the free drug concentration and therefore increases the CL/F of tacrolimus. Second, an elevated TBIL decreases the biliary excretion of tacrolimus, resulting in a decrease in the CL/F of tacrolimus. Thus, dose optimization of tacrolimus would be accurate when taking the pharmacokinetic prediction equation into consideration. Moreover, the results may contribute to a better understanding of tacrolimus pharmacokinetic variability in each transplant patient during the immediate postoperative course.

Conclusions
Hemoglobin and total bilirubin were significant clinical factors influencing the oral clearance of tacrolimus early after liver transplantation. A decrease in the hemoglobin concentration would increase the free drug concentration and therefore increase the oral clearance of tacrolimus. An elevated total bilirubin decreases the biliary excretion of tacrolimus, resulting in a decrease in the oral clearance of tacrolimus.
Dependency-aware online task offloading based on deep reinforcement learning for IoV
Authors: Liu Chunhong , Wang Huaichen , Zhao Mengdi , Liu Jialei , Zhao Xiaoyan , Yuan Peiyan 
Published: September 2024

AbstractThe convergence of artificial intelligence and in-vehicle wireless communication technologies, promises to fulfill the pressing communication needs of the Internet of Vehicles (IoV) while promoting the development of vehicle applications. However, making real-time dependency-aware task offloading decisions is difficult due to the high mobility of vehicles and the dynamic nature of the network environment. This leads to additional application computation time and energy consumption, increasing the risk of offloading failures for computationally intensive and latency-sensitive applications. In this paper, an offloading strategy for vehicle applications that jointly considers latency and energy consumption in the base station cooperative computing model is proposed. Firstly, we establish a collaborative offloading model involving multiple vehicles, multiple base stations, and multiple edge servers. Transferring vehicular applications to the application queue of edge servers and prioritizing them based on their completion deadlines. Secondly, each vehicular application is modeled as a directed acyclic graph (DAG) task with data dependency relationships. Subsequently, we propose a task offloading method based on task dependency awareness in deep reinforcement learning (DAG-DQN). Tasks are assigned to edge servers at different base stations, and edge servers collaborate to process tasks, minimizing vehicle application completion time and reducing edge server energy consumption. Finally, simulation results show that compared with the heuristic method, our proposed DAG-DQN method reduces task completion time by 16%, reduces system energy consumption by 19%, and improves decision-making efficiency by 70%.
Which factors are associated with acquired weakness in the ICU? An overview of systematic reviews and meta-analyses
Authors: Fuentes-Aspe Rocío , Gutierrez-Arias Ruvistay , González-Seguel Felipe , Marzuca-Nassr Gabriel Nasri , Torres-Castro Rodrigo , Najum-Flores Jasim , Seron Pamela 
Published: September 2024

Abstract
Rationale
Intensive care unit-acquired weakness (ICUAW) is common in critically ill patients, characterized by muscle weakness and physical function loss. Determining risk factors for ICUAW poses challenges due to variations in assessment methods and limited generalizability of results from specific populations, the existing literature on these risk factors lacks a clear and comprehensive synthesis.

Objective
This overview aimed to synthesize risk factors for ICUAW, categorizing its modifiable and nonmodifiable factors.

Methods
An overview of systematic reviews was conducted. Six relevant databases were searched for systematic reviews. Two pairs of reviewers selected reviews following predefined criteria, where bias was evaluated. Results were qualitatively summarized and an overlap analysis was performed for meta-analyses.

Results
Eighteen systematic reviews were included, comprising 24 risk factors for ICUAW. Meta-analyses were performed for 15 factors, while remaining reviews provided qualitative syntheses. Twelve reviews had low risk of bias, 4 reviews were unclear, and 2 reviews exhibited high risk of bias. The extent of overlap ranged from 0 to 23% for the corrected covered area index. Nonmodifiable factors, including advanced age, female gender, and multiple organ failure, were consistently associated with ICUAW. Modifiable factors, including neuromuscular blocking agents, hyperglycemia, and corticosteroids, yielded conflicting results. Aminoglycosides, renal replacement therapy, and norepinephrine were associated with ICUAW but with high heterogeneity.

Conclusions
Multiple risk factors associated with ICUAW were identified, warranting consideration in prevention and treatment strategies. Some risk factors have produced conflicting results, and several remain underexplored, emphasizing the ongoing need for personalized studies encompassing all potential contributors to ICUAW development.
Exploring instructional design in K-12 STEM education: a systematic literature review
Authors: Halawa Suarman , Lin Tzu-Chiang , Hsu Ying-Shao 
Published: September 2024

AbstractThis study aimed to analyze articles published in the Web of Science database from 2012 to 2021 to examine the educational goals and instructional designs for STEM education. We selected articles based on the following criteria: (a) empirical research; (b) incorporating instructional design and strategies into STEM teaching; (c) including intervention; (d) focusing on K-12 education and on assessment of learning outcomes; and (e) excluding higher education and STEAM education. Based on the criteria, 229 articles were selected for coding educational goals and instructional designs for STEM education. The aspects of STEM educational goals were coded including engagement and career choice, STEM literacy, and twenty-first century competencies. The categories of instructional designs for STEM education were examined including design-based learning, inquiry-based learning, project-based learning, and problem-based learning. The results showed that engagement and career choices and STEM literacy were mainly emphasized in STEM education. Design-based learning was adopted more than inquiry-based, project-based, or problem-based learning, and this instructional design was mainly used to achieve STEM literacy. It is suggested that studies on twenty-first century competencies may require more research efforts in future STEM education research.