bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative drivers of postoperative prophylactic antibiotics use and resistance in Ethiopia
Authors: Steeman Samantha , Nofal Maia R. , Heyredin Ibrahim , Asmamaw Hailemichael , Tesfaye Assefa , Zhuang Alex , Gebeyehu Natnael , Merrell Sylvia Bereknyei , Weiser Thomas G. , Mammo Tihitena Negussie 
Published: October 2024

Abstract
Background
The World Health Organization (WHO) cautions against unnecessary prolongation of postoperative antibiotics to prevent surgical site infections (SSI), however this practice is still common in many countries. This study aims to describe drivers of prolonged postoperative antibiotic prescribing and clinicians’ perspectives on antibiotics resistance and stewardship in Ethiopia.

Methods
We conducted semi-structured interviews of 16 surgeons and nine surgical ward nurses at three academic referral hospitals in Addis Ababa. Audio recordings were transcribed verbatim and coded. Codes were inductively and iteratively derived between two researchers, tested for inter-rater reliability (IRR), and the codebook was consistently applied to all transcripts. Thematic analysis was performed to understand drivers of prolonged prophylactic antibiotic use in surgical patients.

Results
Interviews revealed factors contributing to postoperative prophylactic antibiotics overprescribing, including inadequate infection prevention and control (IPC) practices, wide variability in local prescribing practices, and distrust in the applicability of WHO guidelines. Antimicrobial resistance was also identified as a major concern by staff. Barriers to improving stewardship included a lack of multidisciplinary teamwork to inform prescribing decisions, while solutions included constructing appropriate context-specific guidelines and improving evidence-based practices through input from local stakeholders, including surgeons, clinical pharmacists, and nurses.

Conclusions
Study participants perceived that existing evidence and guidelines did not apply in their settings due to high rates of surgical site infections and gaps in perioperative IPC practices (e.g., availability of water for handwashing, sterility breaches). These gaps were a key contributor to prophylactic antibiotic overprescribing, reinforcing the need to strengthen upstream and perioperative surgical antisepsis processes. The findings of this study underscore the importance of engaging multidisciplinary teams in strengthening antimicrobial stewardship efforts, aligning processes to achieve compliance with best practices, and the need for rigorous, contextually appropriate studies from these settings to inform policy.
Ultrastructural characterization of hippocampal inhibitory synapses under resting and stimulated conditions
Authors: Tao-Cheng Jung-Hwa , Moreira Sandra Lara , Winters Christine A. 
Published: October 2024

AbstractThe present study uses electron microscopy to document ultrastructural characteristics of hippocampal GABAergic inhibitory synapses under resting and stimulated conditions in three experimental systems. Synaptic profiles were sampled from stratum pyramidale and radiatum of the CA1 region from (1) perfusion fixed mouse brains, (2) immersion fixed rat organotypic slice cultures, and from (3) rat dissociated hippocampal cultures of mixed cell types. Synapses were stimulated in the brain by a 5 min delay in perfusion fixation to trigger an ischemia-like excitatory condition, and by treating the two culture systems with 90 mM high K+ for 2–3 min to depolarize the neurons. Upon such stimulation conditions, the presynaptic terminals of the inhibitory synapses exhibited similar structural changes to those seen in glutamatergic excitatory synapses, with depletion of synaptic vesicles, increase of clathrin-coated vesicles and appearance of synaptic spinules. However, in contrast to excitatory synapses, no structural differences were detected in the postsynaptic compartment of the inhibitory synapses upon stimulation. There were no changes in the appearance of material associated with the postsynaptic membrane or the length and curvature of the membrane. Also no change was detected in the labeling density of gephyrin, a GABAergic synaptic marker, lining the postsynaptic membrane. Furthermore, virtually all inhibitory synaptic clefts remained rigidly apposed, unlike in the case of excitatory synapses where ~ 20–30% of cleft edges were open upon stimulation, presumably to facilitate the clearance of neurotransmitters from the cleft. The fact that no open clefts were induced in inhibitory synapses upon stimulation suggests that inhibitory input may not need to be toned down under these conditions. On the other hand, similar to excitatory synapse, EGTA (a calcium chelator) induced open clefts in ~ 18% of inhibitory synaptic cleft edges, presumably disrupting similar calcium-dependent trans-synaptic bridges in both types of synapses.
Telehealth-delivered cognitive rehabilitation for people with cognitive impairment as part of the post-COVID syndrome: protocol for a randomised controlled trial as part of the CICERO (Cognitive Impairment in Long COVID: Phenotyping and Rehabilitation) study
Authors: Vanova Martina , Patel Aysha Mohamed Rafik , Scott Iona , Gilpin Gina , Manning Emily N. , Ash Charlotte , Wittenberg Philippa , Lim Jason , Hoare Zoe , Evans Rachel , Bray Nathan , Kipps Christopher M. , Devine Ciara , Ahmed Saliha , Dunne Ross , Koniotes Anna , Warren Catherine , Chan Dennis , Suarez-Gonzalez Aida 
Published: October 2024

Abstract
Background
Between 25 and 75% of people with persistent post-acute sequelae of SARS-CoV-2 infection (PASC) experience cognitive difficulties, compromising functional ability, quality of life, and activities of daily living, including work. Despite this significant morbidity, there is a paucity of interventions for this disorder that have undergone evaluation within a formal trial setting. Therefore, we have developed a cognitive rehabilitation programme, specifically designed to address the cognitive symptoms of PASC, notably impaired attention and processing speed, while also accounting for other PASC symptoms (fatigue, post-exertional malaise) that may aggravate the cognitive impairment. This study protocol outlines a randomised controlled trial (RCT) designed to evaluate the effectiveness of this programme compared to standard clinical care.

Methods
This is a multi-centre, parallel-group, individually randomised controlled trial, comparing standard clinical care with and without cognitive rehabilitation. We will recruit 120 non-hospitalised adults (aged 30–60 years) from three NHS sites in England with a history of COVID-19 infection and cognitive impairment persisting more than 3 months after the acute infection. Participants will be randomised (1:1) to the intervention or control groups, with the latter represented as a provision of standard clinical care without cognitive rehabilitation. The cognitive rehabilitation programme consists of ten 1-hour sessions, delivered weekly. Outcomes will be collected at baseline, 3, and 6 months, with participant-defined goal-attainment scores, relating to functional goals, at 3 months as the primary outcome measure. Secondary outcomes will be cognitive function, measures of quality of life, social functioning, mental health, fatigue, sleep, post-exertional malaise, and social and health care service use. We will also evaluate the health-economic benefits of cognitive rehabilitation in this population.

Discussion
Cognitive impairment in PASC is a major cause of functional disability with no effective treatment. Accordingly, we will undertake an RCT of cognitive rehabilitation, the protocol of which is published here. If this trial is successful in delivering improvements in trial outcomes, it will address a major unmet need relating to this emergent disorder, with a significant impact on affected individuals and the wider health economy.

Trial registration
ClinicalTrials.gov NCT05731570. Registered on February 16, 2023
Pathological mechanisms and candidate therapeutic approaches in the hearing loss of mice carrying human MIR96 mutations
Authors: Lewis Morag A. , Lachgar-Ruiz Maria , Di Domenico Francesca , Duddy Graham , Chen Jing , Fernandez Sergio , Morin Matias , Williams Gareth , Moreno Pelayo Miguel Angel , Steel Karen P. 
Published: October 2024

Abstract
Background
Progressive hearing loss is a common problem in the human population with no effective therapeutics currently available. However, it has a strong genetic contribution, and investigating the genes and regulatory interactions underlying hearing loss offers the possibility of identifying therapeutic candidates. Mutations in regulatory genes are particularly useful for this, and an example is the microRNA miR-96, a post-transcriptional regulator which controls hair cell maturation. Mice and humans carrying mutations in miR-96 all exhibit hearing impairment, in homozygosis if not in heterozygosis, but different mutations result in different physiological, structural and transcriptional phenotypes.

Methods
Here we present our characterisation of two lines of mice carrying different human mutations knocked-in to Mir96. We have carried out auditory brainstem response tests to examine their hearing with age and after noise exposure and have used confocal and scanning electron microscopy to examine the ultrastructure of the organ of Corti and hair cell synapses. Bulk RNA-seq was carried out on the organs of Corti of postnatal mice, followed by bioinformatic analyses to identify candidate targets.

Results
While mice homozygous for either mutation are profoundly deaf from 2 weeks old, the heterozygous phenotypes differ markedly, with only one mutation resulting in hearing impairment in heterozygosis. Investigations of the structural phenotype showed that one mutation appears to lead to synaptic defects, while the other has a much more severe effect on the hair cell stereociliary bundles. Transcriptome analyses revealed a wide range of misregulated genes in both mutants which were notably dissimilar. We used the transcriptome analyses to investigate candidate therapeutics, and tested one, finding that it delayed the progression of hearing loss in heterozygous mice.

Conclusions
Our work adds further support for the importance of the gain of novel targets in microRNA mutants and offers a proof of concept for the identification of pharmacological interventions to maintain hearing.
The influence of sex on neuroimmune communication, pain, and physiology
Authors: Alexander Shevon N. , Green Audrey R. , Debner Emily K. , Ramos Freitas Lindsey E. , Abdelhadi Hanna M. K. , Szabo-Pardi Thomas A. , Burton Michael D. 
Published: October 2024

AbstractWith the National Institutes of Health’s mandate to consider sex as a biological variable (SABV), there has been a significant increase of studies utilizing both sexes. Historically, we have known that biological sex and hormones influence immunological processes and now studies focusing on interactions between the immune, endocrine, and nervous systems are revealing sex differences that influence pain behavior and various molecular and biochemical processes. Neuroendocrine-immune interactions represent a key integrative discipline that will reveal critical processes in each field as it pertains to novel mechanisms in sex differences and necessary therapeutics. Here we appraise preclinical and clinical literature to discuss these interactions and key pathways that drive cell- and sex-specific differences in immunity, pain, and physiology.
Balancing the encoder and decoder complexity in image compression for classification
Authors: Duan Zhihao , Hossain Md Adnan Faisal , He Jiangpeng , Zhu Fengqing 
Published: October 2024

AbstractThis paper presents a study on the computational complexity of coding for machines, with a focus on image coding for classification. We first conduct a comprehensive set of experiments to analyze the size of the encoder (which encodes images to bitstreams), the size of the decoder (which decodes bitstreams and predicts class labels), and their impact on the rate–accuracy trade-off in compression for classification. Through empirical investigation, we demonstrate a complementary relationship between the encoder size and the decoder size, i.e., it is better to employ a large encoder with a small decoder and vice versa. Motivated by this relationship, we introduce a feature compression-based method for efficient image compression for classification. By compressing features at various layers of a neural network-based image classification model, our method achieves adjustable rate, accuracy, and encoder (or decoder) size using a single model. Experimental results on ImageNet classification show that our method achieves competitive results with existing methods while being much more flexible. The code will be made publicly available.
Age at first sex and other determinants of multiple sexual partnerships among sexually active adolescent girls in Ghana: a regression analysis of the 2022 Ghana demographic and health survey
Authors: Klu Desmond , Odame Micheal Larbi , Acquah Evelyn , Dansu Charity Akpene 
Published: October 2024

Abstract
Background
Early sexual debut is a widely recognized public health issue due to its influence on lifetime multiple sexual partners which can lead to complications such as teenage pregnancy, abortion, HIV/AIDS and other sexually transmitted infections. However, there is paucity of research evidence on sexual behaviour such as age at first sexual intercourse and the number of sexual partnerships among adolescent girls in Ghana. This study aims to examine the influence of age at first sexual intercourse and other determinants on multiple sexual partnerships among adolescent girls aged 15–19 years in Ghana.

Methods
Data for this study were obtained from the 2022 Ghana Demographic and Health Survey (GDHS) conducted between October 17, 2022 and January 14, 2023. A total weighted sample of 719 sexually active adolescent girls who reported having sexual partners was extracted from the women’s data file. Data were analyzed with SPSS version 27, employing multilevel logistics regression modelling. Statistical significance was set at p < 0.05.

Results
The average age at sexual debut for adolescent girls aged 15–19 years in Ghana is 15.5 years. A little over half (51.6%) of adolescent girls reported having two or more lifetime sexual partners. Adolescent girls who initiated sex before reaching age 15 were more likely (aOR = 2.00; C.I 1.39–2.87) to have multiple partners compared to those who had their first sex before attaining age 20. After controlling for other factors, girls who had their sexual debut before age 15 had higher odds (aOR = 1.85; C.I:1.30–3.31) of engaging in multiple sexual partnerships. Girls living female headed households (aOR = 2.25; C.I:1.18–4.29] and consuming alcohol (aOR = 2.38; C.I 2.38–1.09–5.17) had higher odds of having multiple sexual partners.

Conclusion
The study findings show that early sexual debut, living in female headed household, and consuming alcohol are strong predictors of multiple sexual partnerships among adolescent girls in Ghana. It suggests the need for policies promoting delayed sexual debut and empowering adolescents to make informed decisions to improve sexual health outcomes.
DKN-01 in Combination With Tislelizumab and Chemotherapy as First-Line Therapy in Advanced Gastric or Gastroesophageal Junction Adenocarcinoma: DisTinGuish
Authors: Klempner Samuel J. , Sonbol Mohamad Bassam , Wainberg Zev A. , Uronis Hope Elizabeth , Chiu Vi K. , Scott Aaron James , Iqbal Syma , Tejani Mohamedtaki Abdulaziz , Chung Vincent , Stilian Melissa C. , Thoma Mathis , Zhang Ying , Kagey Michael H. , Baum Jason , Sirard Cynthia A. , Altura Rachel A. , Ajani Jaffer A. 
Published: October 2024

PURPOSE
The outcomes of anti–PD-1 agents plus fluoropyrimidine/platinum in frontline advanced gastroesophageal adenocarcinomas (aGEAs) remain poor. We investigated the safety, tolerability, and activity of fluoropyrimidine/oxaliplatin and tislelizumab with the DKK1-neutralizing antibody DKN-01 in aGEAs in a phase IIa open-label study.

PATIENTS AND METHODS

Patients had untreated human epidermal growth factor receptor 2–negative aGEAs, RECIST v1.1 measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status 0-1, and adequate organ function. Patients received intravenous DKN-01 300 mg once every 2 weeks, tislelizumab 200 mg once every 3 weeks, oxaliplatin 130 mg/m
2
once every 3 weeks, and capecitabine 1,000 mg/m
2
twice daily on days 1-15 of each 21-day cycle. The primary end point was safety and tolerability. Key secondary end points included objective response rate (ORR) by RECISTv1.1, progression-free survival (PFS), and overall survival (OS).

RESULTS
Between September 18, 2020, and April 8, 2021, 25 patients were enrolled. All patients who received at least one dose of DKN-01 were included in the safety analysis. Most patients had gastroesophageal junction tumors, median age was 61 years, 76% were male, and 55% were ECOG of 0. All patients reported at least one treatment-emergent adverse event. The ORR was 73% (95% CI, 49.8 to 89.3), with a disease control rate of 95%. The ORR was 90% (95% CI, 55.5 to 99.7) in the DKK1-high tumor patients and 67% (95% CI, 29.9 to 92.5) in the DKK1-low tumor patients. The median PFS was 11.3 months (95% CI, 5.8 to 12.0) and the 12-month PFS rate was 33%. The median OS was 19.5 months (95% CI, 15.2 to 24.4) with a 12-month OS rate of 76% and an 18-month OS rate of 55%.

CONCLUSION

DKN-01 can be safely combined with frontline fluoropyrimidine/oxaliplatin and tislelizumab and demonstrates encouraging activity independent of PD-L1 expression levels. A randomized phase II trial is ongoing (ClinicalTrials.gov identifier:
NCT04363801
).
Do regular quantum black holes exist?
Authors: Singh Harpreet , Nandy Malay K. 
Published: October 2024

Abstract
Regular black holes do not exist in any classical theory of gravity including Einstein's general relativity. This unappealing feature is due to the appearance of a singularity in the interior of the black hole described by any classical theory. As Hawking argued, all known laws of physics must break down at the singularity. It is thus an important question whether this singularity can disappear in a quantum mechanical description of spacetime. In this letter, we therefore quantize the black hole interior in a Kantowski-Sachs minisuperspace representation in the presence of spontaneous Klein-Gordon matter field fluctuations. This leads to a Wheeler-DeWitt equation whose solution yields the interior wave function of the black hole. The regular part of this wave function satisfies the DeWitt boundary condition in that it vanishes at the singularity. Moreover, the wave function is regular and well behaved in the region around the singularity. These features of the wave function suggest that regular black holes do exist in quantum gravity.
Degradation of coral reef ecosystems: Mathematical-dynamical modeling approach
Authors: Zhao Xin , Yu Shiyang , Fan Meng 
Published: October 2024

Abstract
This paper delves into the frontier of degradation of coral reef ecosystems, a pressing urgent issue to be addressed given the escalating threats faced by the crucial marine environments, and provides a critical assessment of recent advances, emerging trends, and valuable perspective on the studies employing mathematical-dynamical modeling approaches. This study highlights the recent developments in coral bleaching, coral-algal phase shifts, coral disease, and natural enemy bloom, all of which are thoroughly documented and comprehensively expounded. This review study also offers some valuable insights, illuminating ideas, and clear perspective into some current, emerging, and promising research directions for future studies, particularly those based on mathematical and biological modeling. These approaches are anticipated to offer a robust theoretical framework and provide crucial decision-making reference for the protection, restoration, and management of coral reef ecosystems.
Three Siblings With Familial Isolated Hypoparathyroidism: A Diagnostic Journey From CASR to Novel GCM2 Variant
Authors: Thambundit Apisadaporn , Martinez-Agosto Julian A , Kianmahd Shamshoni Jessica , Winer Karen K , Mittelman Steven D 
Published: October 2024

Abstract
We report a patient who initially presented at 4 days old with hypocalcemia, hypoparathyroidism, and elevated phosphorous level. Treatment was initiated with calcitriol, calcium carbonate (CaCO3), vitamin D, and low phosphorous formula. Family history was positive for an activating calcium sensing receptor (CASR) variant (R990G) identified previously in 2 older siblings who were treated with CaCO3 and calcitriol. However, genetic studies were negative for the CASR variant in our patient. She maintained a large calcium requirement and was admitted for multiple episodes of hypocalcemia. Further investigation revealed that the CASR variant identified in the older siblings was now considered a benign, nondisease-causing variant. Whole exome sequencing on our proband revealed a homozygous pathogenic variant in the GCM2 gene (Gln392*) consistent with a molecular diagnosis of familial isolated hypoparathyroidism. Genetic studies revealed the 2 older siblings harbor the same genetic changes and parents are heterozygous carriers for this allele. Due to persistent hypocalcemia, we initiated teriparatide. She weaned off calcitriol and achieved normocalcemia on teriparatide, CaCO3, and vitamin D. Siblings transitioned to the same treatment without complications. These findings demonstrate the importance of adequate diagnostic genetic testing and the role of variant reanalysis over time in promoting accurate diagnoses.
Ziemia. Planeta życia
Authors: Kopcewicz Jan , Sadurski Andrzej , Strobel Andrzej 
Published: October 2024

The Earth is a fascinating, unique planet that has gone through different phases of its development over the course of 4.5 billion years. The book presents the particular stages of the formation of the Solar System, the formation of planets and the internal and external structure of the Earth. The geological and biological history of our planet is also described. The factor that determined the Earth’s unique rank is the existence of life on it. The book provides the characteristics of life and the mechanisms of its origin and development. Seventy thousand years ago, Homo sapiens was an insignificant species living in a certain corner of Africa. Over the next millennia, he grew to become the master of the entire planet and the terror of the biosphere. Man has the means and possibilities to both destroy life and cause its spectacular development. The book includes the description of the history of human civilisation, its current problems and the future of life on our planet and – possibly – beyond it.