bluuebunny/crossref_metadata_2025_split huggingface dataset:
A modified Delphi survey to build expert consensus on the structure and content of an enhanced care pathway for cognitive changes after stroke in the UK
Authors: Hobden Georgina , Tang Eugene Yee Hing , Demeyere Nele 
Published: October 2024

Abstract
Background
Enhancing long-term support for post-stroke cognitive impairment is a top research priority. Addressing current gaps in UK post-stroke cognitive care provision requires a pragmatic and scalable intervention that can be integrated within the existing stroke care pathway. This study aimed to develop consensus on an initial set of core features for a UK-based monitoring and psychoeducational intervention for cognitive changes after stroke.

Methods
An expert panel of UK healthcare professionals and researchers participated in an online modified Delphi survey. Candidate intervention features were identified from clinical guidelines, existing literature, research team/collaborator expertise, and PPI group lived experience. Survey participants indicated whether they agreed/disagreed/had no opinion about including each candidate feature in the intervention and free-text responses were invited. We analysed responses for consensus (≥ 75% agreement) using descriptive statistics, with items not reaching consensus carried into subsequent rounds. Template analysis was used to identify similarities/differences in viewpoints for items that did not reach consensus.

Results
Three survey rounds were completed by 36, 29 and 26 participants, respectively. Participants agreed reviews should include a stroke-specific cognitive screen (97% agree) and assessment of other psychological changes (low mood, anxiety, fatigue: 94%, 90%, 89% agree, respectively). They agreed stroke survivors should be offered at least one review, regardless of their cognitive profile in hospital. They agreed on the importance of various cognition-focused psychoeducation topics, and formal (100% agree) and informal (79% agree) training for those conducting reviews. Consensus was not reached on the review mode (in person/remote options: 67% agree), offering reviews one-year post-discharge to patients without acute cognitive impairments (68% disagree), or including a dementia screen (63% disagree) and/or neuropsychological assessment battery (58% disagree). However, there were similarities in participant viewpoints. For example, participants emphasised the importance of onwards referral where clinically indicated.

Conclusions
The UK-based post-stroke monitoring and psychoeducation intervention was originally conceptualised as a cognitive care pathway, but expert participants agreed on the importance of simultaneously addressing related psychological changes (e.g. low mood, anxiety). There was clear consensus on a minimum set of intervention features. Recommendations outlined here may usefully inform local service improvements.
The implementation of telemedicine in wound care: a qualitative study of nurses’ and patients’ experiences
Authors: Blytt Kjersti Marie , Kolltveit Beate-Christin Hope , Graue Marit , Robberstad Mari , Ternowitz Thomas , Carlsen Siri , Iversen Marjolein Memelink 
Published: September 2024

Abstract
Background
The increasing use of telemedicine (TM) represents a major shift for health workers and patients alike. Thus, there is a need for more knowledge on how these interventions work and are implemented. We conducted a qualitative process-evaluation alongside a larger randomized controlled trial designed to evaluate a telemedicine follow-up intervention for patients with a leg- or foot-ulcer, who either have or do not have diabetes. Accordingly, the aim of this study was to explore how both health care professionals and patients experienced the implementation of TM follow-up in primary care.

Methods
The intervention comprised an interactive TM platform facilitating guidance and counselling regarding wound care between nurses in primary care and nurses in specialist health care in Norway. Nurses and patients from seven clusters in the intervention arm were included in the study. We conducted 26 individual interviews (14 patients and 12 nurses) in primary care between December 2021 and March 2022. Thematic analyses were conducted.

Results
The analyses revealed the following themes: (1) enhancing professional self-efficacy for wound care, (2) a need to redesign the approach to implementing TM technology and (3) challenging to facilitate behavioral changes in relation to preventive care. As to patients’ experiences with taking part in the intervention, we found the following three themes: (1) experience with TM promotes a feeling of security over time, (2) patients’ preferences and individual needs on user participation in TM are not met, and (3) experiencing limited focus on prevention of re-ulceration.

Conclusions
TM presents both opportunities and challenges. Future implementation should focus on providing nurses with improved technological equipment and work on how to facilitate the use of TM in regular practice in order to fully capitalize on this new technology. Future TM interventions need to tailor the level of information and integrate a more systematic approach for working with preventive strategies.

Clinical trial registration
NCT01710774. Registration Date 2012-10-17.
Assessment of the renal function of patients with anorexia nervosa
Authors: Miyahara Hiroyuki , Shigeyasu Yoshie , Fujii Chikako , Tanaka Chie , Hanzawa Mana , Sugihara Akiko , Okada Ayumi , Tsukahara Hirokazu 
Published: September 2024

Abstract
Background
A decreased glomerular filtration rate (GFR), estimated using creatinine (Cr– eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients.

Methods
The data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared.

Results
When the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values.

Conclusions
Our data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.
Knee joint position sense and kinematic control in relation to motor competency in 13 to 14-year-old adolescents
Authors: Liu Yan-Ci , Esser Patrick , Weedon Benjamin David , Springett Daniella , Joshi Shawn , Tsou Meng-Hsuan , Wang Ray-Yau , Dawes Helen 
Published: September 2024

Abstract
Background
Motor competence (MC) is a key component reflecting one’s ability to execute motor tasks and is an important predictor of physical fitness. For adolescents, understanding the factors affecting MC is pertinent to their development of more sophisticated sporting skills. Previous studies considered the influence of poor proprioceptive ability on MC, however, the relationship between lower limb joint position sense, kinematic control, and MC is not well understood. Therefore, the aim of this study was to determine the relation between joint position sense and kinematic control with MC in adolescents during a lower limb movement reproduction task.

Methods
This study was a cross-sectional design. Young people (n = 427, 196 girls and 231 boys) aged 13 to 14 years were recruited. A movement reproduction task was used to assess joint position sense and kinematic control, while the Movement Assessment Battery for Children (mABC-2) was used to assess MC. In this study, participants were categorized into the Typically Developed (TD, n = 231) and Probable Developmental Coordination Disorder (DCD, n = 80) groups for further analysis of joint position sense, kinematic control, and MC between groups.

Results
Kinematic data, specifically normalized jerk, showed a significant correlation with MC. There was no correlation between knee joint position sense and MC, and no group differences between DCD and TD were found.

Conclusions
Joint position sense should not be used as a measure to distinguish TD and DCD. Rather than joint position sense, control of kinematic movement has a greater influence on the coordination of the lower limbs in adolescents. Movement control training should be implemented in the clinical setting to target kinematic control, rather than focus on joint position sense practice, to improve motor competency.

Trial Registration Identifier
NCT03150784. Registered 12 May 2017, https://clinicaltrials.gov/study/NCT03150784.
Sbno1 mediates cell–cell communication between neural stem cells and microglia through small extracellular vesicles
Authors: Zhang Yifan , Zhu Zhihan , Li Zhinuo , Feng Jia , Long Jun , Deng Yushu , Ahmed Waqas , Khan Ahsan Ali , Huang Shiying , Fu Qingling , Chen Lukui 
Published: September 2024

Abstract
Background
Neural stem cells (NSCs) play a crucial role in the progress of ischemic stroke. Research on zebrafish embryonic demonstrates an association between Strawberry Notch 1 (Sbno1) and central nervous system development. However, the regulation and underlying mechanism of Sbno1 in NSCs have not been studied yet. Here, we investigated the role and the mechanism of Sbno1 in NSCs development and the potential therapeutic value of Sbno1 in ischemic stroke.

Methods
Adeno-associated virus (AAV) was used for overexpression or knockdown of Sbno1 in vitro or in vivo. A mouse model of MCAO was established to evaluate the neuroprotective effects of AAV-Sbno1, including balance beam test, rotarod test, and strength evaluation. H&E and immunofluorescence assessed neuronal impairment. Western blot and RT-qPCR were used to detect the expression of Sbno1 and its downstream target genes. RNA-seq and western blot were performed to explore further molecular mechanisms by which Sbno1 promoted endogenous repair of NSCs and macrophages M2 polarization. CCK8 was conducted to assess the effects of Sbno1 on NSCs proliferation. The impact of Sbno1 on NSCs apoptosis was evaluated by flow cytometry. NSCs derived from small extracellular vesicles (sEV) were obtained using ultracentrifugation and identified through nanoparticle tracking analysis (NTA) and western blot analysis.

Results
Our results showed that Sbno1 is highly expressed in the central nervous system, which plays a crucial role in regulating the proliferation of NSCs through the PI3k-Akt-GSK3β-Wnt/β-catenin signaling pathway. In addition, with overexpression of Sbno1 in the hippocampus, post-stroke behavioral scores were superior to the wild-type mice, and immunofluorescence staining revealed an increased number of newly generated neurons.
sEV released by NSCs overexpressing Sbno1 inhibited neuroinflammation, which mechanistically impaired the activation of the microglial NF-κB and MAPK signaling pathways.

Conclusions
Our studies indicate that sbno1 promotes the proliferation of NSCs and enhances endogenous repairing through the PI3k-Akt-GSK3β-Wnt/β-catenin signaling pathway. Additionally, NSCs overexpressing sbno1 improve ischemic stroke recovery and inhibit neuroinflammation after ischemia by sEV through the MAPK and NF-κB signaling pathways.
Cultural rituality and heritage revitalization values of ancestral temple architecture painting art from the perspective of relational sociology theory
Authors: Li Weicong , Xie Qian , Shi Wenwen , Lin Haopai , He Jiaxin , Ao Jinghui 
Published: September 2024

Abstract
Recent research has primarily focused on the genealogical relationship between ancestral temple painting and its spatial carriers, highlighting a shift in perspective from artistry to symbolism to kinship. While some scholars have noted the influence of ritual culture on architectural painting, few have explored its kinship relationship with architectural carriers. By incorporating relational sociology theory, this study chronologically reviews events influencing the formation of ancestral temple ritual culture, constructs a developmental model, and conducts case studies on the ethicality of architectural painting art, thus establishing a relational sociology analysis framework. Findings: (1) Ancestral temple architectural painting exhibits the ethicality and educational value inherent in Confucian concepts; (2) Themes such as immortal life, literati and scholars, and common folk simplicity highlight the spiritual and material kinship of ancestral temple painting. The vocabulary used in titles such as "He (rapprochement-和)", "He (reunification-合)", "wealth (财)", "happiness (乐)", "blessing (福)", and "longevity (寿)" reveals a positive transmission of Confucian values; (3) The five main artistic expressions of ancestral temple painting are metaphor through objects (借物喻意), the personification of events (以人喻事), using the past to illuminate the present (借古喻今), expressing aspirations through objects (托物喻志), and pun-based symbolism (谐音寓意); (4) The decorative elements of ancestral temples correspond to the forms of their painting art, with the former extending the space of the tomb sacrificial system and the latter representing artistic inheritance. The development of ancestral temple architecture has formed dual developmental contexts centered on ritual culture and supplemented by academic dissemination, fluctuating with the status of Confucianism. The relational sociology model shows that the political aspects of ancestral temples form a sub-lineage of their ritual culture, closely linked to reforms in the educational system and transformations in building functions, further influencing architectural form and decorative art.
Chromogenic mechanisms of overglaze yellow pigment produced in Jingdezhen imperial kilns during the Ming dynasty
Authors: Hao Meng , Zhang Maolin , Weng Yanjun , Xiong Zhe 
Published: October 2024

Abstract
This study employed energy-dispersive X-ray fluorescence spectrometry, Raman spectroscopy, X-ray photoelectron spectroscopy, and ultraviolet–visible-near infrared spectrophotometry to analyse eleven overglaze pigment porcelain specimens. The results show that the colouring element of the overglaze yellow pigment of Jingdezhen imperial kilns in the Ming dynasty is Fe2O3, and most of Fe2O3 can be dissolved in the lead glaze in an ionic state to make the lead glaze yellow. The chromogenic of the overglazed yellow pigment primarily depends on the concentration and coordination field of the colouring ions. The connection between the internal structure and the appearance of the overglaze yellow pigment is discussed.
Pollinator behaviour and prevalence of the anther smut Antherospora vindobonensis in its host, the Hungarian two-leaf squill (Scilla vindobonensis)
Authors: Prokop Pavol , Tučník Kristián , Provazník Zuzana , Čiamporová-Zaťovičová Zuzana , Čiampor Jr Fedor 
Published: September 2024

AbstractAnther smuts are fungal diseases that have detrimental effects on the biology of their host plants. We investigated the transmission of Anther smut Antherospora vindobonensis to its host, Scilla vindobonensis under natural and laboratory conditions. Plants flowering early in spring were less vulnerable to disease (∼ 20–30% of plants which appeared early in the season were diseased) than flowers that bloom at the end of the season (∼ 60% of plants which appeared late in the season were diseased) which contradicts the patterns observed for other anther smuts species. Diseased plants showed thicker stems, lower nectar production and smaller flower radius than healthy plants. The disease prevalence in S. vindobonensis was not influenced by plant density. The production of spores in diseased flowers was 125 times higher than the production of pollen in healthy flowers. The number of pollen grains attached to pollinator bodies from healthy plants under controlled conditions was similar to the number of spores attached from diseased plants. Experienced honeybees in the field showed almost identical preferences for healthy plants (65%) over diseased ones, as did naïve bumblebees under controlled laboratory conditions (69%). eDNA metabarcoding revealed that healthy flowers attracted a significantly higher number of arthropod species (M = 6.23, SE = 1.48) than diseased flowers (M = 2.32, SE = 0.31). Strong seasonal differences in the risk of infection suggest that S. vindobonensis solves the trade-off between low pollinator availability and low risk of infection at the beginning of the season and high risk of infection and high pollinator availability at the end of season. By reproducing early in the season, plants can reduce the risk of disease.
A study of project-based learning to intermediate EFL learners in reading class: enhancing self-regulated learning of post-secondary students in Macao
Authors: Cao Leyi 
Published: October 2024

AbstractThis study explored two new pedagogical conceptions—project-based learning (PBL) and self-regulated learning (SRL), to enhance effective English teaching and learning in Macao, and to prepare EFL learners for life-long learning. PBL makes English instruction engaging and SRL empowers learners to take ownership of their learning process. The combination of these two methodologies can facilitate students to develop into independent and efficient English learners. The study, guided by Zimmerman’s cyclical phase model of SRL and English and Kitsantas’ PBL/SRL model, was action research which aimed to investigate whether PBL could positively influence the development of intermediate EFL learners’ SRL ability at the post-secondary level in Macao. Research instruments included questionnaires, interviews, students’ reflective notes and teacher’s field notes. Both qualitative and quantitative findings indicated improvement in the students’ SRL ability, reflected in three aspects—motivation, metacognition, and behaviors. The students’ motivational beliefs were significantly strengthened, and more self-regulated behaviors were generated. Though the use of metacognitive strategies did not showcase as significant enhancement as the former elements through the study, the experimental group made progress in using some specific strategies, such as evaluating learning outcomes and making study plans. The summary of the study is that PBL was beneficial to the development of SRL. This research endeavor not only contributes to the existing body of knowledge but also serves as a catalyst for educators to advocate policy reforms, fostering the design of learner-centered, flexible, and coherent post-secondary EFL curricula.
Clinical outcomes of NBF gel application in managing mucositis associated with xerostomia
Authors: Szabó György , Németh Zsolt , Kivovics Márton 
Published: September 2024

Abstract
Background
Xerostomia, or dry mouth, can be a temporary or persistent symptom resulting from various factors, such as medication use, therapeutic radiation, chemotherapy, autoimmune conditions (e.g., Sjögren’s syndrome), and hormonal imbalances. Xerostomia often leads to associated mucositis, which significantly impacts patients’ quality of life. The nano-bio-fusion (NBF) gingival gel, a gel-type functional toothpaste containing vitamins C, E, propolis, and herbal extracts in a nano-emulsion state, has shown potential in accelerating the healing of oral mucosal lesions.

Methods
A total of 127 patients (102 females, 25 males) with persistent xerostomia were treated from 2018 to 2023. Of these, 32 patients were treated exclusively with NBF Gel, while 95 patients received NBF Gel in combination with other medications, such as pilocarpine. The underlying causes of xerostomia included irradiation and chemotherapy (12 patients), medication (40 patients), hormonal imbalance (28 patients), and Sjögren’s syndrome (47 patients). NBF Gel was applied 2–3 times daily to the tongue and oral mucosa. Treatment effectiveness was evaluated through physical examinations and a patient-reported scale ranging from 1 (no improvement) to 10 (complete improvement), focusing on the healing of mucosal lesions rather than saliva production.

Results
Both treatment groups showed significant improvements in the healing of xerostomia-associated mucositis, particularly in severe cases with visible lesions. Patients treated with NBF Gel reported improved symptoms related to mucosal health, while those who received combination therapy also experienced reduced side effects of pilocarpine due to dose reduction. The most substantial improvements were observed in patients with drug-induced and hormonally-caused xerostomia-related mucositis. No adverse side effects from NBF Gel were reported during the study.

Conclusion
NBF gingival gel proved to be beneficial in accelerating the healing of mucositis associated with xerostomia, regardless of the underlying cause, including medication use, radiotherapy, chemotherapy, hormonal imbalances, and Sjögren’s syndrome. It presents a promising adjunctive treatment to improve mucosal health and quality of life for patients suffering from xerostomia-associated mucositis.
Simulation-based evaluation of road transportation logistics in a dry port with topographic challenges
Authors: Dumetz Ludwig , Audy Jean-François , Rönnqvist Mikael , Azouzi Riadh 
Published: September 2024

AbstractThe extension of existing container terminals or the creation of new ones introduces new logistical challenges, including topographic issues and increased distances between the quays and storage yards located several kilometers away from the quay (dry port). These challenges are complex to evaluate analytically and directly impact the acceleration, deceleration, and average speed of a truck which in turn affect the productivity and synchronization of the overall terminal logistics. This paper proposes a transportation simulation model that incorporates detailed descriptions of the topographical and geometrical restrictions. Our simulation model evaluates various scenarios for container transportation logistics, including varying road design terminals and truck fleet size to enhance productivity. A case study from a potential container terminal on Canada’s St. Lawrence River is used to demonstrate the simulation model. Several scenarios with different designs are tested and the simulation provides numerical results for supporting decision makers.