bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk for Revision ACLR After Primary All-Inside Quadrupled Semitendinosus Hamstring Tendon Autograft ACLR With Independent Suture Tape Augmentation: A Retrospective Cohort Study
Authors: Daniel Adam V. , Smith Patrick A. 
Published: September 2024

Background: The rate of failed anterior cruciate ligament reconstruction (ACLR) remains high in the younger and more active patient populations. Suture tape augmentation (STA) in addition to ACLR may reduce the risk for revision surgery. Purpose/Hypothesis: The purpose of this study was to compare patient outcomes between patients who underwent primary all-inside quadrupled semitendinosus hamstring tendon autograft (QST-HTA) ACLR with and without STA. It was hypothesized that the STA cohort would demonstrate a lower incidence of subsequent revision ACLR while maintaining comparable patient-reported outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: All patients ≤40 years of age who received primary all-inside QST-HTA ACLR with and without independent STA augmentation were identified. The following validated patient-reported outcome measures (PROMs) were collected: visual analog scale for pain, Single Assessment Numeric Evaluation, Knee injury and Osteoarthritis Outcome Score subscales, and Tegner activity scale. KT-1000 arthrometer measurements were collected pre- and postoperatively. Cox proportional hazards model and nominal logistic regression analysis were used to assess additional variables associated with revision ACLR. Results: A total of 104 patients with a mean age of <22 years were included in the final data analysis (STA: 36 patients; control: 68 patients). Significantly fewer patients in the STA group sustained a graft failure necessitating revision surgery at the final follow-up (5.6% vs 24%; relative risk, 0.24 [95% CI, 0.06-0.97]; P = .017). Four-year graft survival was significantly higher in the STA group (97.2% vs 82.4%; P = .031). All PROMs significantly improved postoperatively except for Tegner levels, which decreased in both groups compared with their preinjury levels ( P < .001). Return to sports was similar in both groups with >70% of patients returning to their previous level of competition. Regression analysis demonstrated increased risk for revision ACLR in younger patients, high school athletes, and those with higher postoperative activity levels. Conclusion: QST-HTA ACLR with STA was associated with reduced risk for revision ACLR compared with nonaugmented QST-HTA ACLR in this young patient population. Furthermore, the addition of suture tape did not appear to affect postoperative patient-reported and return-to-sports outcomes.
Safranin removal by fine soil: thermodynamics and kinetics of adsorption
Authors: Dehghanpour Iraj , Kouchakzadeh Ghazaleh 
Published: September 2024

AbstractEnvironmental problems caused by human intervention in nature are some of the most critical challenges facing human societies. It is essential to use suitable adsorbents to remove pollutants. The abundance, natural abundance and low cost of fine soil have made it a good candidate for removing environmental pollutants. In this research, removal of safranin dye by natural and acidic-organic-treated fine soil with sulfuric acid and ethanolamine was studied. The characteristics of natural and acidic-organic-treated fine soil were confirmed using X-ray diffraction, Fourier-transform infrared spectroscopy, Brunauer–Emmett–Teller and scanning electron microscopy techniques. The adsorbents were placed in contact with different concentrations of safranin dye solution separately. After that, the effects of adsorbent amount (0.4–3.2 g L−1), contact time (0–60 min), adsorbate concentration (5–20 ppm) and pH (3–11) were evaluated regarding the optimum safranin adsorption process. The greatest adsorption capacity of fine soil was calculated as 1250 mg g–1. The experimental results were evaluated using thermodynamic and kinetic models. The data showed that the process follows the Langmuir isotherm model and pseudo-second-order kinetic model. The intraparticle diffusion model estimated the possible mechanism of dye adsorption. Overall, it can be deduced that natural fine soil is an efficient remover of human pollutants.
Dressing Mechanism and Evaluations of Grinding Performance with Porous cBN Grinding Wheels
Authors: Song Jiahao , Yao Yu , Feng Shandong , Zhao Biao , Ding Wenfeng , Xiao Guodong , Liu Qi , Xu Dongdong , Zhao Yanjun , Zhu Jianhui 
Published: September 2024

AbstractCubic boron nitride (cBN) grinding wheels play a pivotal role in precision machining, serving as indispensable tools for achieving exceptional surface quality. Ensuring the sharpness of cBN grains and optimizing the grinding wheel's chip storage capacity are critical factors. This paper presents a study on the metal-bonded segments and single cBN grain samples using the vacuum sintering method. It investigates the impact of blasting parameters—specifically silicon carbide (SiC) abrasive size, blasting distance, and blasting time—on the erosive wear characteristics of both the metal bond and abrasive. The findings indicate that the abrasive size and blasting distance significantly affect the erosive wear performance of the metal bond. Following a comprehensive analysis of the material removal rate of the metal bond and the erosive wear condition of cBN grains, optimal parameters for the working layer are determined: a blasting distance of 60 mm, a blasting time of 15 s, and SiC particle size of 100#. Furthermore, an advanced simulation model investigates the dressing process of abrasive blasting, revealing that the metal bond effectively inhibits crack propagation within cBN abrasive grains, thereby enhancing fracture toughness and impact resistance. Additionally, a comparative analysis is conducted between the grinding performance of porous cBN grinding wheels and vitrified cBN grinding wheels. The results demonstrate that using porous cBN grinding wheels significantly reduces grinding force, temperature, and chip adhesion, thereby enhancing the surface quality of the workpiece.
mTOR/miR-142-3p/PRAS40 signaling cascade is critical for tuberous sclerosis complex-associated renal cystogenesis
Authors: Zhao Shuyun , Hao Shuai , Zhou Jiasheng , Chen Xinran , Zhang Tianhua , Qi Zhaolai , Zhang Ting , Jalal Sajid , Zhai Chuanxin , Yin Lu , Bo Yufei , Teng Hongming , Wang Yue , Gao Dongyan , Zhang Hongbing , Huang Lin 
Published: September 2024

Abstract
Background
Patients with tuberous sclerosis complex (TSC) develop renal cysts and/or angiomyolipomas (AMLs) due to inactive mutations of either TSC1 or TSC2 and consequential mTOR hyperactivation. The molecular events between activated mTOR and renal cysts/AMLs are still largely unknown.

Methods
The mouse model of TSC-associated renal cysts were constructed by knocking out Tsc2 specifically in renal tubules (Tsc2f/f; ksp-Cre). We further globally deleted PRAS40 in these mice to investigate the role of PRAS40. Tsc2−/− cells were used as mTOR activation model cells. Inhibition of DNA methylation was used to increase miR-142-3p expression to examine the effects of miR-142-3p on PRAS40 expression and TSC-associated renal cysts.

Results
PRAS40, a component of mTOR complex 1, was overexpressed in Tsc2-deleted cell lines and mouse kidneys (Tsc2f/f; ksp-Cre), which was decreased by mTOR inhibition. mTOR stimulated PRAS40 expression through suppression of miR-142-3p expression. Unleashed PRAS40 was critical to the proliferation of Tsc2−/− cells and the renal cystogenesis of Tsc2f/f; ksp-Cre mice. In contrast, inhibition of DNA methylation increased miR-142-3p expression, decreased PRAS40 expression, and hindered cell proliferation and renal cystogenesis.

Conclusions
Our data suggest that mTOR activation caused by TSC2 deletion increases PRAS40 expression through miR-142-3p repression. PRAS40 depletion or the pharmacological induction of miR-142-3p expression impaired TSC2 deficiency-associated renal cystogenesis. Therefore, harnessing mTOR/miR-142-3p/PRAS40 signaling cascade may mitigate hyperactivated mTOR-related diseases.
Assessment of the effectiveness of hospital external disaster functional drills on health care receivers’ performance, using standardized patients and mass cards simulation: a pilot study from Saudi Arabia
Authors: Bajow Nidaa , Alesa Saleh , Shaheen Fatima Alzahraa Yassin , Almalki Abdulaziz , Alshamrani Ali , Alotaibi Rimaz , Aloraifi Abdulaziz , Montan Carl , Lennquist Sten , Alotaibi Mujahid 
Published: September 2024

Abstract
Background
Given the increasing frequency of disasters globally, it is critical that healthcare systems are prepared for these mass casualty events. The Saudi health system’s preparedness for mass casualty incidents needs to be more robust, potentially due to limited disaster drills and inadequate standardized patient (SP) simulation training. This study aims to (i) assess the performance of front-line hospital staff in Saudi Arabia through a functional drill and (ii) evaluate the drill’s effectiveness using SP and MAC-SIM cards, providing detailed insights into its design and execution.

Methods
A functional drill was conducted at a government hospital in Riyadh, Saudi Arabia, on December 19, 2022, using a cross-sectional approach with two phases. 141 healthcare receivers served as subjects, while 23 volunteers acted as SPs. The scenario simulated a building collapse to assess the emergency department (ED) response, interdepartmental communication, and surge capacity. Data were collected through direct observation of healthcare practitioners’ interactions with the SPs, analysis of SP data, and participant feedback. Quantitative data were analyzed descriptively, while qualitative data were examined for patterns and themes related to simulation performance and effectiveness.

Results
The hospital receivers’ performances demonstrated accurate triage categories. The ED team assessed most patients (67%) in less than 5 min. For patients requiring definitive care, such as intensive care unit, 95% spent less than 2.5 h in the ED. Most patients (65%) required ‘other treatments’. Communication was efficient in the triage zone and the yellow treatment area. Participants’ feedback on using MAC-SIM cards during the simulation was overwhelmingly positive with 82.61% reporting that MAC-SIM use helped them respond better. Experienced SPs (paramedics) with prior disaster knowledge and experience outperformed inexperienced SPs (nurses) in the functional exercise.

Conclusion
This groundbreaking study is the first in the Arabic Gulf region to use SPs with MAC-SIM cards in functional drills. The findings highlight the potential of simulation exercises to improve hospital team knowledge and performance when responding to disasters. Multiple evaluation techniques can effectively identify participant strengths and weaknesses, informing future disaster improvement plans. This information is a valuable resource for Arabic and middle-income countries where disaster medicine is still developing.
A policy analysis of sleep-related legislation for Canadian licensed childcare facilities
Authors: Hall Wendy A. , Moynihan Melissa , Reid Graham J. , McMillan Robin 
Published: September 2024

Abstract
Background
National legislative guidelines for sleep and rest are lacking in the Canadian licensed childcare sector. No review of Canadian legislation for licensed childcare facilities has focused on sleep. This paper provides a review of the Canadian provincial and territorial legislative landscape, regarding sleep, rest, and naps in licensed childcare centers.

Methods
Childcare statutes and regulations for each province and territory were identified and downloaded on a particular date. Statutes and regulations were reviewed focusing on sections articulating licensed childcare facility mandates governing sleep, rest, naps, and sleep equipment. An excel file was used to facilitate systematic data retrieval and comparisons across provinces and territories. Two authors developed and discussed themes that summarized data from the documents.

Results
No statutes indicated recommendations for sleep, rest, or naps. Only one regulation defined rest (Alberta). Our analysis of regulations identified four themes representing sleep, rest, and naps: programming (general programming, daily programming); space (dedicated space, amount of space, age-specific space); equipment (developmental appropriateness, acceptable sleep equipment, age-specific equipment); and safety (staffing during sleep/rest, sleep position, sleep monitoring, sleep equipment safety, prohibited practices). In Canada, minimal regulatory consistency is evident in required sleep programming, space, acceptability of sleep equipment, and sleep safety considerations. Most jurisdictions’ regulations indicated necessity for developmentally appropriate rest or sleep areas and equipment, in particular for infants, but there was minimal consistency in defining infant age groups.

Conclusions
Although we identified themes related to sleep across regulations, childcare regulations differ in their definitions of infants and specifications for children’s sleep and rest in licensed Canadian childcare facilities. Without adequate definitions in legislative components of appropriate sleep duration linked to children’s developmental stages, childcare facilities lack guidance to support healthy sleep for children in their care. Future research can examine translation of healthy sleep guidelines into government legislation and mandates for sleep, rest, and naps among young children in licensed childcare.
Choosing an appropriate somatic embryogenesis medium of carrot (Daucus carota L.) by data mining technology
Authors: Fallah Ziarani Masoumeh , Tohidfar Masoud , Hesami Mohsen 
Published: September 2024

Abstract
Introduction
Developing somatic embryogenesis is one of the main steps in successful in vitro propagation and gene transformation in the carrot. However, somatic embryogenesis is influenced by different intrinsic (genetics, genotype, and explant) and extrinsic (e.g., plant growth regulators (PGRs), medium composition, and gelling agent) factors which cause challenges in developing the somatic embryogenesis protocol. Therefore, optimizing somatic embryogenesis is a tedious, time-consuming, and costly process. Novel data mining approaches through a hybrid of artificial neural networks (ANNs) and optimization algorithms can facilitate modeling and optimizing in vitro culture processes and thereby reduce large experimental treatments and combinations. Carrot is a model plant in genetic engineering works and recombinant drugs, and therefore it is an important plant in research works. Also, in this research, for the first time, embryogenesis in carrot (Daucus carota L.) using Genetic algorithm (GA) and data mining technology has been reviewed and analyzed.

Materials and methods
In the current study, data mining approach through multilayer perceptron (MLP) and radial basis function (RBF) as two well-known ANNs were employed to model and predict embryogenic callus production in carrot based on eight input variables including carrot cultivars, agar, magnesium sulfate (MgSO4), calcium dichloride (CaCl2), manganese (II) sulfate (MnSO4), 2,4-dichlorophenoxyacetic acid (2,4-D), 6-benzylaminopurine (BAP), and kinetin (KIN). To confirm the reliability and accuracy of the developed model, the result obtained from RBF-GA model were tested in the laboratory.

Results
The results showed that RBF had better prediction efficiency than MLP. Then, the developed model was linked to a genetic algorithm (GA) to optimize the system. To confirm the reliability and accuracy of the developed model, the result of RBF-GA was experimentally tested in the lab as a validation experiment. The result showed that there was no significant difference between the predicted optimized result and the experimental result.

Conclutions
Generally, the results of this study suggest that data mining through RBF-GA can be considered as a robust approach, besides experimental methods, to model and optimize in vitro culture systems. According to the RBF-GA result, the highest somatic embryogenesis rate (62.5%) can be obtained from Nantes improved cultivar cultured on medium containing 195.23 mg/l MgSO4, 330.07 mg/l CaCl2, 18.3 mg/l MnSO4, 0.46 mg/l 2,4- D, 0.03 mg/l BAP, and 0.88 mg/l KIN. These results were also confirmed in the laboratory
Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study
Authors: Fults Elyse , Gerwin Jeffrey N. , Boyce Michael W. , Joseph Melissa , Wong Ambrose H. , Evans Leigh V. 
Published: September 2024

Abstract
Background
The COVID-19 pandemic had a significant impact on both the clinical practice and the psychological states of frontline physicians in the emergency department. Trainees, at the beginning of their careers and thus still developing their practice styles and identities as physicians, were uniquely affected.

Objective
In this qualitative study, we sought to explore how the pandemic environment shaped the experiences of emergency medicine resident physicians.

Methods
This was a qualitative study. We conducted in-depth interviews with emergency medicine faculty, resident physicians, and staff at a single emergency department based at an urban academic institution in the northeastern United States. Interviews were audio recorded and transcribed, and transcripts were then analyzed in an iterative process by our coding team for recurring themes related to the resident experience.

Results
We reached data saturation with 27 individuals. Of those who were interviewed, 10 were resident physicians [6 senior residents (PGY-3 or PGY-4) and 4 junior residents (PGY-1 or PGY-2)]. Three major recurring themes regarding resident physician experience emerged during our analysis of the interviews: (1) novel educational experiences dampened by negative structural forces from the pandemic, (2) fracturing of social interactions and mitigation through ad-hoc support systems and community of practice, and (3) development of negative emotions and psychological trauma including fear, resentment, and moral injury causing lasting harm.

Conclusions
Our results suggest that emergency medicine resident physicians training during the COVID-19 pandemic faced unique experiences concerning their education, social support systems, and emotional states. While the educational and social experiences were described as having both negative and positive impacts, the emotional experiences were largely negative. Residency program leadership may use these insights to improve resident preparation, wellness, and resilience in the face of future adverse events.
A mountain of waste created daily: a thematic analysis of environmental sustainability experiences of postgraduate intensive care nursing students
Authors: Sundberg Fredrika , Baid Heather , Israelsson-Skogsberg Åsa 
Published: September 2024

Abstract
Background
The healthcare sector has a negative ecological impact, and intensive care is one of the most resource-consuming areas. Nurses have a duty to contribute to climate change reduction, design climate-resilient healthcare systems, and support individuals and communities in adapting to the effects of the planetary health crisis. It is essential to incorporate environmental sustainability into nursing education so that nurses can advocate for conscientious and ethically sustainable healthcare that benefits both patients and the planet. This study aimed to explore postgraduate intensive care nursing student experiences of environmental sustainability in clinical practice at intensive care units.

Methods
Data were collected using a qualitative questionnaire, and the data were analysed using inductive thematic analysis. The participants were 24 registered nurses studying postgraduate, specialist intensive care nursing courses at four universities in the south and west regions of Sweden.

Results
The results describe critical care students’ environmental sustainability experiences in one overarching theme with five subthemes. Intensive care is a challenging context in terms of sustainability, where saving lives is the number one priority. There were good and bad sustainability habits among the staff, and awareness was key to improving. Clinical supplies come in unsustainable packages, and the participants wished for better alternatives and they wanted more knowledge and education on sustainable practices. The findings also emphasized the importance of a holistic perspective throughout each patient’s pathway.

Conclusions
Sustainability in intensive care units is somewhat unrecognised today, although intensive care nurses want that to change. The context where saving lives is prioritized makes implementing ecologically responsible practices a challenge. However, environmental sustainability in intensive care is feasible, with education needed for nurses to take on the responsibility of making improvements. Hospital management prioritizing sustainability is also important to support clinicians in implementing sustainable practices in intensive care units.
Cost-effectiveness of MLC601 in post-stroke functional recovery compared with placebo - the CHIMES & CHIMES-E studies
Authors: Chen Christopher Li Hsian , Chai Jia Hui , Pokharkar Yogesh Mahadev , Venketasubramanian Narayanaswamy 
Published: September 2024

Abstract
Background
Despite progress in stroke therapy (e.g., revascularisation interventions by thrombolysis and/or thrombectomy, organised stroke care), many stroke survivors will have impairment of neurological function. We aimed to compare the cost-effectiveness of an oral natural formulation, MLC601, versus placebo in functional recovery among subjects receiving standard of care after an ischemic stroke of intermediate severity assessed with NIH Stroke Scale at baseline (b-NIHSS 8–14).

Methods
A Markov cohort model with a 2-year time horizon was developed to simulate patients from a published randomised placebo-controlled clinical trial of MLC601 in their post-stroke functional recovery assessed by modified Rankin Score (mRS), from a health system perspective. Transition probabilities were derived from a multi-centre clinical trial in South East Asia. As cost and utility data were not collected in the trial, therefore we extracted them from the published literature. The main outcomes were incremental cost, incremental quality-adjusted life-year (QALY) gained, and incremental cost-effectiveness ratio (ICER). Besides base-case and sensitivity analyses, we performed subgroup analyses to explore the heterogeneity of patients with poor-prognosis factors (b-NIHSS 10–14, stroke onset to treatment time > 48 h, rehabilitation during first 3 month). All costs are expressed in 2022 Euro and USD, with an annual discount rate of 3% applied to costs and QALYs.

Results
Base-case analysis showed that MLC601 was cost-effective compared with placebo, with €5,080 saved and 0.45 QALY gained, resulting in an ICER of -€11,352.50 per QALY gained. Similarly, results from subgroup analyses indicated that the use of MLC601 was a dominant strategy in all subgroups with poor-prognosis factors. Sensitivity analyses revealed the results were robust.

Conclusion
Compared with placebo on top of standard stroke care, MLC601 was cost-effective in post-stroke functional recovery over two years. Due to the lack of cost and utility data from the study population, the results might not be generalizable to other settings. Further studies with country-specific data are needed to confirm the results of this study.

Trial registration
URL http://www.clinicaltrials.gov. Unique identifier NCT00554723 November 7, 2007.