bluuebunny/crossref_metadata_2025_split huggingface dataset:
sFlt-1/PLGF ratio: A promising marker for early detection of preeclampsia in the second and third trimester
Authors: Kaur Mandeep , Kukreja Sahiba , Arora Siddhant , Kaur Sukhjeet , Gill Manmeet Kaur 
Published: October 2024

: Preeclampsia (PE), characterized by endothelial dysfunction, remains a significant concern in obstetrics due to its association with maternal and fetal morbidity and mortality. One significant contributor to the clinical manifestations of PE is the imbalance in the placental release of various angiogenesis regulatory factors into the maternal circulation. Low levels of the pro-angiogenic biomarker Placental Growth Factor (PLGF) and high levels of antiangiogenic biomarker sFlt-1 (soluble Fms like tyrosine kinase -1) levels are detectable several weeks before the clinical presentation of PE, making them a promising marker for early diagnosis.: This study investigates the utility of the sFlt-1/PLGF ratio in predicting and diagnosing preeclampsia during the second and third trimesters of pregnancy.: A prospective cohort study was conducted with 150 study participants comprising normotensive controls and preeclamptic cases, diagnosed based on blood pressure and proteinuria criteria. Serum samples collected in the second trimester (24-28 weeks) and third trimester (&#62;28 weeks) were analyzed for PLGF and sFlt-1 levels using ELISA kit method. The sFlt-1/PLGF ratio was calculated and evaluated for its diagnostic accuracy through ROC curve analysis.: Significantly lower PLGF levels and higher sFlt-1 levels in preeclamptic pregnancies compared to normotensive pregnancies were seen in both trimesters (p &#60; 0.001). The sFlt-1/PLGF ratio was markedly elevated in preeclampsia, showing strong predictive characteristics with an AUC of 0.929 (sensitivity 90%, specificity 90%) in the second trimester and an AUC of 0.986 (sensitivity 90%, specificity 96.7%) in the third trimester. These findings highlight the potential of the sFlt-1/PLGF ratio as a biomarker for early detection and risk stratification in pregnancies complicated by preeclampsia.
Reparto del poder, artimañas y consejos para el exitoso gobierno del virreinato del Perú en los siglos XVI y XVII
Authors: Suárez Margarita 
Published: October 2024

En este artículo se analiza cómo el reparto del poder entre las instituciones peninsulares y los virreyes coexistió a la par de vías legales y oficiosas que se establecieron para dar cabida a las aspiraciones de los diversos estamentos virreinales. Si bien el poder de los virreyes y el de las élites aumentó desde finales del siglo XVI bajo el amparo de la boyante producción minera, el sistema polisinodial no permitió el ascenso de las élites peruanas al interior de este. El resultado fue un sistema cuyos fundamentos fueron burlados con artimañas, consejos y hasta con la evasión del cumplimiento de las leyes y la corrupción del patronazgo, lo que terminaría viciando el sistema de dones que había funcionado con éxito y permitido la unión del imperio hispánico en los inicios de la Europa moderna.
El declive de los séquitos de los virreyes mexicanos del siglo XVIII: Tendencias y excepciones
Authors: Rosenmüller Christoph 
Published: October 2024

En este artículo, argumento que el volumen de los séquitos de los virreyes que llegaron a la Nueva España disminuyó durante el siglo XVIII, pero con marcadas excepciones. Mientras que los aristócratas de principios de siglo llevaban comitivas considerables, con el marqués de Casafuerte (1722-1734) se nota una tendencia hacia séquitos modestos, compuestos de una veintena de criados (es decir, asistentes o clientes). La llegada de Juan Francisco de Güemes y Horcasitas en 1745 reforzó esta tendencia, porque solamente su esposa, sus ocho hijos y quizás un puñado de criados lo acompañaron como resultado de un nombramiento anterior en América. Sin embargo, algunos virreyes casados con esposas de importancia social rompieron el esquema. Las virreinas tenían derecho a disponer de criadas y criados para su servicio exclusivo, lo que contribuía a aumentar sus séquitos notablemente. De esta manera, el marqués y la marquesa de las Amarillas cruzaron el Atlántico con su hijo y sesenta y seis criados y criadas a mediados de siglo, mientras que treinta y tres criados y criadas viajaron con el marqués de Branciforte y su esposa María Antonia de Godoy y Álvarez de Faria en el año 1794. El patronazgo virreinal disminuyó a lo largo del siglo, pero con importantes contracorrientes.
Increased lipoprotein (a) as an additional factor in the failure to achieve target blood pressure levels and lipid spectrum optimal parameters in patients with arterial hypertension and multifocal atherosclerosis
Authors: Vedenskaya S. S. , Smolenskaya O. G. 
Published: October 2024

Aim. To establish the frequency of achieving target of blood pressure (BP) levels and lipid spectrum parameters (LS) in patients with arterial hypertension (AH) and multifocal atherosclerotic lesion (MFAL) with normal and elevated levels of lipoprotein (a) (Lp(a)) in real clinical practice.Material and methods. The study included 110 patients with AH and MFAL, median age was 59.0 (51.0; 64.3) years. Depending on the level of Lp(a), all patients were divided into 2 groups: group 1 — 72 patients (65.5%), Lp(a) level was ≤50 mg/dl (13.2 (3.7; 21.1)), group 2 — 38 patients (34.5%) Lp(a) level was >50 mg/dl (89.5 (62.5; 110.0)). The diagnosis of MFAL included damage to two or more arterial basins according to carotid artery, abdominal aorta and lower extremities arteries duplex scan. Patients of both groups received antihypertensive, lipid-lowering, and antiplatelet therapy.Results. Patients in groups 1 and 2 showed similar blood pressure levels and frequency of antihypertensive therapy use. In both groups, the majority of patients were on a free combination of antihypertensive drugs, only a third of patients used a fixed combination. In most cases, patients of both groups did not reach the target blood pressure levels (63.9% — group 1, 55.3% — group 2), despite the fact that the average blood pressure figures were relatively low (132;83 mmHg in each group). Drug control was also unsatisfactory in both groups, regardless of the level of Lp(a). However, all drug indicators were significantly worse in group 2, despite comparable lipid-lowering therapy, which more often included statin monotherapy. Combination therapy with lipid-lowering drugs was used in patients of groups 1 and 2 only in 20.8% and 10.5%, respectively. Parameters of low-grade inflammation high-sensitivity C-reactive protein and interleukin-6 did not differ between the groups and did not exceed the reference values.Conclusion. An increased level of Lp(a) may be accompanied by drug disorders and increased BP in patients with MFAL. Due to the lack of effective Lp(a) reducing therapy, the prevention of cardiovascular events in such patients should focus on BP and lipid spectrum correction. The use of fixed combinations, including antihypertensive and lipid-lowering drugs, can lead to improved adherence to therapy, increased BP and LS control.
Arthroscopic Resection of Acromioclavicular Joint Cysts and Distal Clavicle
Authors: Williams Anna B. , Inclan Paul M. , Thacher Ryan R. , Gulotta Lawrence V. 
Published: October 2024

Case:
This case report describes 3 patients who developed acromioclavicular joint cysts secondary to rotator cuff arthropathy. The patients underwent arthroscopic cyst decompression and distal clavicle resection, resulting in successful excision of the cyst and minimal cyst recurrence.

Conclusion:
Based on these cases, arthroscopic cyst decompression with concomitant distal clavicle resection should be considered as an effective alternative to serial aspirations or open cyst excision and distal clavicle resection.
Effect of virtual case-based learning (CBL) using the flipped class and peer instruction on the motivation to learn basic sciences
Authors: Alizadeh Maryam , Saramad Alireza , Rafiepoor Haniyeh , Taghvaei Ali , Rayati Roya , Sibevei Sajjad , Seyyedlar Zeynab Sarparast , Peighambardoust Sana , Zomorrodi Amirhasan , Taghavi Azadeh Angouraj 
Published: October 2024

Abstract

Background
The purpose of this quasi-experimental study was to investigate the effect of virtual case-based learning sessions on the learning motivation of first- and second-year medical students.
Methods
A total of 263 students, 133 in the intervention group and 130 in the control group, were enrolled in the study. The control group consisted of medical students who had not previously participated in virtual case-based learning sessions and were trained in the same curriculum as the intervention group. Two questionnaires were developed to assess learning motivation in basic science and motivational consequences of virtual case-based learning sessions. The questionnaires were designed through individual interviews with students and validated using Lawshe's method and Cronbach's Alpha. Each virtual case-based discussion consisted of three phases and participants were randomly divided into groups and assigned trained moderators.
Results: The mean age of both groups was 19.17 (SD=1.23) and 19.37 (SD=0.84), respectively, with a gender ratio of 1:3 in both groups. The results of the study indicated that virtual case-based learning sessions had a significant impact on the learning motivation of basic science students (T=10.195 DF=16.461 P > 0.01).
Conclusions
The study provides valuable insights into the effectiveness of virtual case-based learning sessions and suggests avenues for future research. The findings of this study could be useful for educators and institutions seeking to enhance the learning motivation of medical students through virtual case-based learning sessions. However, further research is needed to investigate the long-term effects of virtual case-based learning on student motivation and academic performance.
O2-Nanobubble of Iron-Porphyrin conjugated Polyaspartamide for Molecular Ultrasound Contrast Effect
Authors: Cho Yoon Na , Lim Jun Woo , Oh Seung Joo , Han Sa Ra , Cho Sungwoo , Jeong Jimin , Han Byoung Hee , Jeong Jae Hyun 
Published: October 2024

Abstract

Objective
This study aimed to prepare oxygen-nanobubbles incorporating ferrous porphyrin to emulate the oxygen-capturing ability of hemoglobin porphyrin in red blood cells.
Results
We synthesized poly(2-hydroxyethyl aspartamide) (PHEA) grafted with ferrous porphyrins (Iron-P-PHEA) and created nanobubbles using 1,2-Dipalmitoyl-sn-glycero-3-phosphocholine (DPPC). These nanobubbles trapped oxygen and retained it over a 2-hour period. The O2-nanobubbles demonstrated an enhanced photoacoustic effect as an ultrasound contrast agent, as confirmed by Doppler ultrasound testing.
Conclusions
The innovative strategy for O2-nanobubble preparation enhances the efficiency of targeted delivery in molecular optical and ultrasound imaging.
Effects of health education based on self-determination theory on hemodialysis knowledge, self-management and negative emotions in maintenance hemodialysis patients
Authors: Zhang Jiquan , Xu Fan , Zhuang Peimin , Xu Xingying , Zou Zhaohua , Qing Wei 
Published: October 2024

Abstract

To explore the application effect of health education based on self-determination theory on hemodialysis knowledge, self-management and negative emotions in maintenance hemodialysis patients. The research is a quasi-randomized control trial, a total of 86 maintenance hemodialysis patients who met the exclusion criteria were included (43 patients each in the intervention group and the control group). The control group received routine care, and the intervention group implemented health education guided by self-determination theory on the basis of the control group. Three months after the intervention, the two groups were compared in terms of hemodialysis knowledge, self-management, interdialytic weight gain value and anxiety and depression. Before the intervention, there was no statistical difference in the comparison of hemodialysis knowledge scores, self-management scores, interdialytic weight gain value and anxiety and depression scores (P > 0.05). After 3 months of intervention, the hemodialysis knowledge scores of the intervention group was higher than that of the control group and baseline; the scores of the intervention group in problem solving, partnership, emotional processing, executive self-care dimensions and the total self-management scores were higher than that of the control group and baseline; the interdialytic weight gain value of the intervention group was lower than that of the control group and baseline; the anxiety and depression scores of the intervention group were lower than that of the control group and baseline. All these differences were statistically significant (P < 0.05). Health education based on self-determination theory can improve the hemodialysis knowledge level and self-management ability of maintenance hemodialysis patients, and reduce the interdialytic weight gain value and anxiety and depression level, which is worthy of clinical promotion.
Distortion Analysis of BS L168 Aeronautical Aluminum Alloy Thin-Walled Parts during High-Speed Milling
Authors: Rajagopal Balaji , Rajagopal Balaji , Narayanaperumal Arunachalam , Chettu Kanna Babu 
Published: October 2024

Abstract

In the modern aviation industry, the use of thin-walled monolithic integrated parts made of aluminum alloys has significantly increased due to their high strength-to-weight ratio which reduces the overall weight of the aircraft, shortens assembly build cycle times, lower fuel consumption and improved performance. When slender, thin-walled components with varying contours are machined from BS L168 aluminum alloy bars commonly used in combat aircraft, distortion ranging from 5 to 12 mm along the wall thickness are often observed prior to lug removal. This is due to high milling forces, increased temperatures at the cutter-component interface zone, plastic deformation, low rigidity and the redistribution of internal stresses. Thin-walled components, which inherently lacking stiffness, are more prone to deformation, adversely affecting surface finish and often preventing parts from being properly aligned for subsequent operations. As a result, post-machining rework is frequently required, or, in some cases, parts are rejected due ti tight tolerance. This research analyses how cutting forces, thermal loads, surface finish, high material removal rates, residual stresses, cutter wear, and chip generation influence the distortion behaviour of thin-walled parts made from BS L168 Al alloy bars during high-speed milling (HSM) operations, aiming to identify factors contributing to distortion in real industrial scenarios and to develop strategies to minimize them, ensuring the production of high-precision parts with optimal structural integrity. Thin-walled, monolithic integrated parts of varying thickness and contour are milled into complex aircraft components using optimized cutting parameters under both dry and wet machining conditions. This is achieved with improved clamping, increased rigidity, the introduction of wax filling into pockets to add firmness to the workpiece, and intermittent stress-relieving operations after rough machining. The initial machining-induced residual stresses (MIRS) were studied using XRD, as high tensile stresses can cause micro-cracks and surface damage, impacting the part's structural integrity. Cutter wear and chip generation are also critical factors influencing stress and deformation in thin walls and were examined using a Scanning Electron Microscope (SEM) to analyse the impact of distortion across the wall thickness. Distortions in wall thickness were quantified with a coordinate measuring machine (CMM). The results indicated that HSM under wet machining of aircraft monolithic thin-walled parts, with optimized cutting parameters, improved clamping, and enhanced processes, had a substantial impact on reducing distortions. This technique led to a 30.56–48.93% reduction in distortion along the wall thickness of thin-walled components compared to dry machining.
Benzodiazepine agonist treatment for patients with benzodiazepine dependence undergoing opioid agonist treatment: a study protocol for the randomized controlled trial BMX-BAR
Authors: Chalabianloo Fatemeh , Fadnes Lars Thore , Assmus Jörg , Mordal Jon , Solli Kristin K , Dale Kjetil S , Andersen Christina D , Ohldieck Christian , Løberg Else-Marie , Johansson Kjell Arne 
Published: October 2024

Abstract

Background
There is a lack of knowledge on effective treatment methods for comorbid benzodiazepine dependence in populations undergoing opioid agonist treatment (OAT). Tapering and discontinuation of benzodiazepines has long been considered the standard treatment, even though there is limited evidence for this practice. There is also limited research on benzodiazepine agonist treatment, however, peer and clinical experiences indicate that such approaches may be beneficial for a subgroup of the patients with long-lasting benzodiazepine dependence not responding to other treatment approaches. A randomized controlled trial will be conducted to compare the efficacy and safety of stabilizing agonist treatment using prescribed benzodiazepines with standard treatment in reducing illicit benzodiazepine use.
Methods
The target sample is 108 participants at outpatient OAT clinics in five Norwegian cities/counties (Bergen/Vestland, Tønsberg/Vestfold, Skien/Telemark, Fredrikstad/Østfold and Tromsø/Troms). The main inclusion criteria are benzodiazepine dependence of ≥5 years, using ≥5 days a week during the last month, and previous attempts at tapering. Participants will be randomly assigned to receive either a 26-week benzodiazepine stabilizing treatment (15-30 mg diazepam or 50-100 mg oxazepam daily), or a 20-week tapering using the same medications and equivalent initial dosages. All participants will be given access to consultations from OAT therapists with psychosocial follow-up in accordance with current clinical practice.
The primary outcome is the use of illicit benzodiazepines assessed by observed urinary tests at week 24. Secondary outcomes include mental health symptoms, quality of life, cognitive performance, violence risk, other substance use, treatment retention, and life satisfaction. Additionally, the study will assess treatment-related adverse events as well as the cost-effectiveness of the intervention.
Discussion
This is the first randomized controlled trial of benzodiazepine agonist treatment for benzodiazepine dependence. The research project will assess efficacy and safety of stabilizing treatment with prescribed benzodiazepines compared to benzodiazepine tapering and discontinuation regarding use of illicit benzodiazepines and accordingly well-being of patients with concurrent benzodiazepine and opioid dependence undergoing OAT. If the intervention is found to be efficacious and safe, it will be considered one of the options to standard treatment for this patient group.
Trial registration
EU trial number: EudraCT: 2021-004981-37. Registered on December 13, 2021
Long-Term Functional Outcomes After Surgical Treatment of Displaced Midshaft Clavicle Fractures: A Retrospective Cohort Study
Authors: Lopiz Yaiza , Rodriguez-Zamorano Patricia , Díaz Macarena Diz , García-Fernandez Carlos , Marco Fernando 
Published: October 2024

Abstract

Introduction:
Long-term studies on clavicle fractures are scarce, making new data in this field particularly valuable. This study aimed to assess long-term clinical and radiographic outcomes, as well as the quality of life in patients treated with pre-contoured plates for midshaft clavicle fractures, while identifying potential outcome-associated risk factors.
Methods:
Between 2010 and 2020, 91 patients with displaced midshaft clavicle fractures treated by open reduction and internal fixation with pre-contoured plates were identified from 987 cases. Seventy-six of these patients were prospectively reviewed to assess clinical status (using DASH, Constant score, and EQ-5D/EQ-VAS for quality of life) and hardware-related outcomes at the most recent follow-up.
Results:
At an average follow-up of 64 months (range: 39–179), patients reported excellent outcomes: a mean Constant score of 91, a QuickDASH of 0.3, an EQ-5D of 0.94, and an EQ-VAS of 81.5. Active forward flexion, abduction, and external rotation were 177º, 175º, and 60º, respectively. Hardware removal was required in 11% of patients, with 30.7% reporting discomfort. Complications were minimal (5.5%), including 2 cases of non-union, 2 superficial wound infections, and 1 partial wound dehiscence. No refractures were observed. There was no significant association between fracture pattern (AO classification) or vertical displacement and functional outcomes (p = .578; p = .137). However, postoperative lengthening showed a significant correlation with QuickDASH scores (p = .019). Patient characteristics (BMI, age, gender, sports participation, or occupation) were not significantly associated with functional outcomes, complications, or hardware removal (p > .05).
Conclusion:
Although preoperative fracture displacement and hardware removal were not linked to poorer functional outcomes, up to 30% of patients reported discomfort post-surgery. Despite this, their perceived quality of life remained high. These findings provide valuable insights into long-term outcomes for patients treated with pre-contoured plates, underscoring the need for ongoing follow-up in this population.
Level of evidence
Level III, Retrospective Cohort Design, Treatment Study.
Sleep and wake intrusions: A continuous approach to explain insomnia and sleep state misperception.
Authors: Herzog Ruben , Crosbie Flynn , Aloulou Anis , Hanif Umaer , Chennaoui Mounir , Léger Damien , Andrillon Thomas 
Published: October 2024

Abstract

Understanding insomnia is crucial for improving its diagnosis and treatment. However, many subjective complaints about insomnia do not align with objective measures of sleep quality, as is the case in sleep state misperception (SSM). We addressed this discrepancy by measuring sleep intrusions and stability in polysomnographic (PSG) recordings from a large clinical database. Using advanced machine learning techniques, we inferred hypnodensities—a continuous and probabilistic measure of sleep dynamics—, and analyzed them via information theory to measure intrusions and stability in a principled way. We found that insomnia with SSM is associated with sleep intrusions during intra-sleep wakefulness, while insomnia without SSM is characterized by wake intrusions during sleep, suggesting a specific etiology for SSM. By mapping these metrics to micro and macrostructural sleep features, we provided a continuous and interpretable framework for measuring sleep quality. This integrative approach values subjective insomnia complaints and aligns them with physiological data, offering a more accurate and comprehensive understanding of sleep quality and its disorders.