bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulation Training to Increase Holding of Fragile Infants in Cardiac Intensive Care Units
Authors: Rachwal Christine , Smith-Parrish Melissa , Rofeberg Valerie , Graber Kelsey , Smith-Freedman Duncan , Millman Marlena Smith , Garafalo Meagan , Almeida-Santos Sonia , Panaccione Michelle , Sorensen Angela , Stuzynski Suzanne , Horn Karen , Ubertini Gina , Peruti Shana , Butler Samantha C. 
Published: September 2024

Background
Promoting bonding and neurodevelopmental care is an important element in the cardiovascular intensive care unit (CICU); however, holding of infants by family members is inconsistently practiced.

Objectives
This quality improvement study aimed to safely increase the holding of medically complex infants in the CICU by developing a holding guideline and offering simulation-based staff education.

Methods
Using consensus methodology and high-fidelity simulation, an expert work group created a holding guideline and training to increase staff confidence and competence in holding critically ill infants in the CICU. The effectiveness of the intervention was tested via a postintervention survey used to assess participants’ confidence in and comfort with holding critically ill infants and elicit suggestions for further support. Participants who engaged with the mannequin were surveyed to assess the validity of the simulation trainer.

Results
After the intervention, participants (N = 130) reported increased confidence with infant holding (76%) and greater confidence in preparing families to hold their infants. Participants (95%) strongly agreed that the simulation enabled realistic, safe practice in holding a medically complex infant with catheters and tubes. More years of experience and engagement with the simulation trainer were associated with increased posttraining confidence. Participants cited increased resources, practice, and adherence monitoring as key supports for infant holding.

Conclusions
Expert group consensus with high-fidelity simulation training is a feasible, safe, and reliable method for teaching higher risk skills and guiding protocol development.
Effect of Sepsis-3 Definition on the Classification of Patients with Sepsis or Septic Shock in South Korea
Authors: Oh Tak Kyu , Song In-Ae 
Published: September 2024

Background
Little is known about differences in patient characteristics before and after implementation of the new definition of sepsis (Sepsis-3) and whether the new definition is affecting clinical practice in intensive care units.

Objective
To examine and compare the clinicoepidemiologic characteristics of patients with sepsis or septic shock before and after implementation of Sepsis-3.

Methods
In this population-based cohort study, a nationwide registration database in South Korea was used to identify patients with sepsis or septic shock. Patients admitted to hospitals from 2012 to 2015 constituted the Sepsis-2 group, and patients admitted from 2017 to 2020 constituted the Sepsis-3 group.

Results
The study involved 443 217 patients, of whom 170 660 (38.5%) were in the Sepsis-2 group and 272 557 (61.5%) were in the Sepsis-3 group. The mean (SD) age was 73.3 (14.5) years in the Sepsis-2 group and 75.5 (14.5) years in the Sepsis-3 group. The intensive care unit admission rate was higher in the Sepsis-2 group (34.6%, 59 081 of 170 660) than in the Sepsis-3 group (21.3%, 57 997 of 272 557). Multivariable Cox regression analysis showed that 1-year all-cause mortality was 21% lower in the Sepsis-3 group than in the Sepsis-2 group (hazard ratio, 0.79; 95% CI, 0.78–0.79; P &lt; .001).

Conclusions
Implementation of the Sepsis-3 definition was associated with an increased number of patients with sepsis. Other findings suggested that patients in the Sepsis-2 group had more severe illness, with increased 1-year all-cause mortality, compared with those in the Sepsis-3 group.
Blockchain in the logistics sector: A systematic literature review of benefits and constraints
Authors: Mvubu Mandla , Naude Micheline J. 
Published: September 2024

Background: Blockchain technology is recognised in logistics and supply chain research for its ability to enhance transparency and traceability, offering real-time tracking and authentication of goods. However, constraints persist in the implementation of blockchain technology (BCT) in the logistics industry.Objectives: The purpose of this article is to provide insight into the benefits of BCT and the constraints hindering the logistics industry from implementing it.Method: Data were collected through a systematic literature review. The study followed the six steps of the PRISMA framework. A total of 56 journal articles published between 2018 and 2024 were included in the study.Results: The findings reveal seven constraints that hinder the implementation of BCT in the logistics industry. These include the following: organisational constraints; technological constraints; environmental constraints; implementation risks and costs; interoperability; supply chain fragmentation; and data issues. In addition, we highlight how the implementation of BCT could benefit the logistics industry.Conclusion: While the logistics industry faces many constraints in blockchain implementation, this technology is a digital solution for improved communication and collaboration with suppliers in the industry.Contribution: In addition to filling a gap in existing literature, this article serves as a valuable resource for driving BCT implementation in the logistics industry. The practical strategies presented for overcoming the identified barriers can assist stakeholders and policymakers in the adoption of BCT.
Apigenin ameliorates diabetic neuropathy in rats by modulating the TLR4/MyD88 signaling pathway
Authors: Yu Yan-Bo , Qiu Mi-Zhen , Zhang Da-Ying 
Published: September 2024

Objective:
To determine the neuroprotective effects of apigenin against streptozotocin (STZ)-induced diabetic neuropathy (DN).

Methods:
To induce DN, Wistar rats (150-200 g) were administered with STZ (55 mg/kg, i.p.). Then they were randomly assigned to various groups, viz., normal, diabetic control, insulin (10 IU/kg, s.c.), apigenin (5, 10, and 20 mg/kg, p.o.), and insulin (10 IU/kg) plus apigenin (20 mg/kg, p.o.). Various behavioral, biochemical, and molecular markers [tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6, Toll-like receptor 4 (TLR4), myeloid differentiation primary response 88 (MyD88), and nuclear factor erythroid 2-related factor 2 (Nrf2)] were assessed.

Results:
Apigenin (10 and 20 mg/kg, p.o.) substantially reduced plasma glucose levels, lipid profile, aspartate transaminase, alanine transaminase, glycated hemoglobin, and neural advanced glycation end products in STZ-induced DN rats (P<0.05). After apigenin intervention, STZ-induced changes in food and water intake, body weight, urine output, allodynia, hyperalgesia, and insulin levels were markedly improved (P<0.05). Neural antioxidant enzymes (superoxide dismutase and glutathione) and Na+K+ATPase activity were also considerably elevated (P<0.05) while the level of lipid peroxidation was diminished following apigenin therapy (P<0.05). Furthermore, apigenin markedly upregulated the Nrf2 mRNA level while downregulating the mRNA expressions of TNF-α and ILs and the protein expressions of TLR4 and MyD88 (P<0.05). STZ-induced histological abnormalities in the sciatic nerve were also improved by apigenin treatment.

Conclusions:
Apigenin exerts its neuroprotective effect by modulating the inflammatory and oxidative stress pathways via regulating the TLR4-MyD88 signaling pathway.
In Hospital Mortality in Acute Heart Failure with Idiopathic Cardiomyopathy and Type II Diabetes
Authors: Al-Jarallah Mohammed , Alajmi Salem Mohammed , Dashti Raja , Bulbanat Bassam , Ridha Mustafa , Sulaiman Kadhim J , Al-Zakwani Ibrahim , Alsheikh-Ali Alawi A. , Panduranga Prashanth , Alhabib Khalid F. , Al Suwaidi Jassim , Al-Mahmeed Wael , Al-Faleh Hussam , Elasfar Abdelfatah , Al-Motarreb Ahmed , Bazargani Nooshin , Asaad Nidal , Amin Haitham , Kobalava Zhanna , Brady Peter A. , Baca Georgiana Luisa , Setiya Parul , Alsaber Ahmad , Rajan Rajesh 
Published: September 2024

Abstract

Background:
Clinical characteristics and outcomes in patients with type 2 diabetes mellitus (T2DM) and acute heart failure (AHF) patients with idiopathic cardiomyopathy are not well known.

Objective:
The objective of our study is to determine all-cause mortality in patients with idiopathic cardiomyopathy presenting with AHF.

Methods:
We analyzed the data from 509 consecutive patients with idiopathic cardiomyopathy presenting with AHF to 47 hospitals in seven Middle Eastern countries (Saudi Arabia, Oman, Yemen, Kuwait, United Arab Emirates, Qatar, and Bahrain) between February and November 2012. All patients were stratified according to T2DM. The analyses were performed using the univariate and multivariate statistical techniques.

Results:
The mean age of the cohort was 52.0 ± 14.8 years. Of the 509 patients, 123 (24.2%) had T2DM and had a higher incidence of major stroke than the nondiabetic group (11.4% vs. 2.8%; P = 0.001). Diabetic patients were also more likely to be associated with hypertension than those without diabetes mellitus (78.9% vs. 21.8%; P < 0.001). Multivariate logistic regression demonstrated that those with cardiogenic shock (adjusted odds ratio [aOR], 59.3; 95% confidence interval [CI]: 20.1–207; P = 0.001) and noninvasive ventilation (NIV) (aOR: 4.19; 95% CI: 1.33–13.1; P = 0.013) were associated with higher odds of all-cause in-hospital mortality. However, age (aOR: 1.00; 95% CI: 0.96–1.03; P = 0.792), T2DM status (aOR: 0.43; 95% CI: 0.10–1.51; P = 0.207), and atrial fibrillation (aOR: 3.95; 95% CI: 0.82–17.2; P = 0.07) were not associated with higher odds of all-cause inhospital mortality.

Conclusions:
In AHF patients with idiopathic cardiomyopathy, T2DM was not associated with higher odds of all-cause inhospital mortality. Patients on NIV and cardiogenic shock were demonstrated as the independent predictors of increased inhospital mortality.
Melatonin induced Ventricular Arrhtymias
Authors: Panattil Shaju Padman , Muralidharan Priya , Panduranga Prashanth 
Published: September 2024

Abstract
Idiopathic ventricular arrhythmias are frequently encountered in clinical practices. Melatonin is a frequently used medication for treating insomnia. Melatonin is usually considered a safe option among the drugs used to control insomnia. Here, we report a patient with ventricular ectopics induced by melatonin. The patient’s ventricular ectopics and symptoms disappeared on stopping melatonin. This case illustrates the importance of history taking specifically all medication history in clinching the etiology before proceeding for invasive electrophysiological studies.
Predictors of Early and Late Mortality after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Chinese Study
Authors: Al-Jarallah Mohammed , Alajmi Mohammad , Rajan Rajesh , Dashti Raja , Setiya Parul , Alsaber Ahmad , Al-Zakwani Ibrahim , Zhanna Kobalava Davidovna , Brady Peter A. , Albalool Joud , Tse Gary 
Published: September 2024

Abstract

Background:
Patients undergoing TAVR constitute a high-risk population given their comorbidities and out-of-hospital mortality rates remain high despite significant improvements in the overall procedural outcomes.

Objectives:
The objective of this study was to determine the early and late mortality rates following transfemoral transcatheter aortic valve replacement (TAVR) and identify the risk factors for poor outcomes.

Methods:
This study population examined patients extracted from 43 publicly funded hospitals in Hong Kong between 2010 and 2019. The study constitutes retrospective analysis of mortality outcomes for severe aortic stenosis patients undergoing TAVR. The primary end points include out-of-hospital 30-day, 1-year, 1–2-year, and 2–5-year mortality rates.

Results:
A total of 448 patients underwent TAVR and were included into the study. The rates of mortality following TAVR were 1.7%, 3.3%, 1.3%, and 0.22% at 30 days, 1, 1–2, and 2–5 years, respectively. Age and chronic renal failure (CRF) were concluded to be associated with postprocedural mortality. Further analysis of the baseline echocardiographic parameters revealed a higher prevalence of right atrial enlargement (RAE) and tricuspid and pulmonary regurgitation in the deceased subgroup.

Conclusion:
We report the 30-day, 1-, 1–2-, and 2–5-year all-cause mortality for TAVR of 1.7%, 3.3%, 1.3%, and 0.22% at 30 days. Factors associated with a higher prevalence of mortality include age, CRF, RAE, and tricuspid and pulmonary regurgitation.
Safety of Discontinuation of Oral Anticoagulants in Patients with Atrial Fibrillation following Ablation: A Systematic Review and Meta-analysis
Authors: Fikri Yusuf Ananda , Lidvihurin Afina Syarah 
Published: September 2024

Abstract
The safety of discontinuing oral anticoagulants (OACs) in patients with atrial fibrillation (AF) following ablation remains controversial. The European Society of Cardiology stated that the long-term continuation of anticoagulants beyond 2 months following ablation should be based on the patient’s stroke risk profile; however, the decision remains challenging considering the lack of explicit guidelines. Furthermore, a worldwide survey showed that some centers implement a policy of withdrawing OAC therapy even in the majority of patients at high risk of thromboembolic events. To address this issue, we conducted a systematic review to investigate the safety of discontinuing OACs in patients with AF following ablation. A systematic review of cohort studies was performed. A comprehensive search for relevant literature was conducted using predefined keywords in five scientific databases (PubMed, ClinicalKey, Cochrane, EBSCOhost, and ScienceDirect). Studies that compared the incidence of thromboembolic events in the off-OAC group and on-OAC group were considered. Duplicated articles were removed. Eight studies (n = 16037) were retained for the final analysis. These studies were published between 2010 and 2021. Overall, there was no difference in the incidence of thromboembolic events between the off-OAC and on-OAC groups (odds ratio [OR] 0.81; 95% confidence interval [CI] 0.52–1.29) with lower bleeding risk in patients who discontinued OAC compared to those who remained on OAC (OR 0.30; 95% CI 0.15–0.62). Patients who discontinued OAC after AF ablation generally had a similar incidence of thromboembolism (TE) to patients who remained on OAC. This review indicates that the risk-benefit ratio favors the discontinuation of OAC in patients with successful AF ablation. However, randomized controlled trials with larger samples involving a more generalizable population are warranted to address the safety and efficacy of OAC discontinuation in patients with AF undergoing catheter ablation.
The Interplay of Personality Factors and Gender and their Correlation with Academic Achievement, Coping Mechanisms and Ego Resilience in MBBS Interns: A Cross-sectional Study
Authors: Dabholkar Devina Devdatt , Maithili Umate S. , Ramachandra V. 
Published: September 2024

Context:
Both personality and gender influence academic performance, coping skills, and resilience. Studying these factors together could help identify methods to improve academic achievement, coping mechanisms, and ego resilience.

Aim:
The aim of the study was to analyze the correlation of personality factors and gender with academic achievement, coping mechanisms, and ego resilience.

Materials and Methods:
Online forms were filled out by 112 interns in a government medical college. Sociodemographic details and academic scores were asked. Appropriate questionnaires for personality factors, coping mechanisms, and ego resilience were used. Data were analyzed using descriptive and analytic statistics using the Statistical Package for the Social Sciences software version 26.

Results:
Emotional stability had a statistically significant negative correlation with female gender, academic achievement, emotion focused, and avoidant coping. Openness to experiences and emotional stability showed a positive correlation with ego resilience. Gender did not show significant correlations with academics, coping, or resilience, although men were statistically more emotionally stable than women.

Conclusion:
Emotional stability having majority of the significant correlations may emphasize the relative importance of particular personality dimensions at different times across the lifespan. Males being more emotionally stable may indicate how they are using healthier coping styles and are more resilient compared to their female counterparts.
A Pilot Clinical Study of Mashadibasti in the Management of Pakshaghata (Hemiplegia)
Authors: Bera Sayantan , Mukherjee Sonali 
Published: September 2024

Background:

Pakshaghata is one of the diseases of central nervous system, considered as vatavyadhi in Ayurveda which occurs mainly due to vitiation of Vata. The disease pakshaghata can be compared with hemiplegia according to contemporary medicine. The mode of onset is sudden or gradual with the association of hypertension or diabetes mellitus. Loss of functions of limbs with or without the involvement of face is observed in this disease. It affects either left half or right half or both sides even. The present study is to evaluate the effect of Mashadi Basti in Pakshaghata.

Objective:
To evaluate the efficacy of Mashadi Basti, a type of medicated enema in management of Pakshaghata.

Materials and Methods:
A total of 15 patients were selected randomly. They were examined on the ground of Astavidha pariksha (eight-fold examination) from Ayurvedic point of view on the basis on specially prepared data research questionnaire. Selected subjects were administered with kala basti for 15 days and it was followed up of 30 days. Assessment was done through various variables like shareera akarmanyata or chestanivriti (Loss of motor activity), hasta pada ruja (pain in hand and leg), hasta pada sankocha (contraction in hand and leg), sira snayu shosha (rigidity), sandhibandha vimokshana (looseness of joints), and vak stambha (loss of speech), stroke specific– quality life scale, modified barthel index (MBI) and grip test.

Results:
The study showed that mashadi basti produced a significant (P < 0.05, P < 0.001) improvement in all the variables like shareera akarmanyata or chesta nivriti, hasta pada ruja, hasta pada sankocha, sira snayu shosha, sandhibandha vimokshana and vakstambha, stroke specific– quality life scale, MBI and grip test.

Conclusion:

Mashadi basti is found to be effective in Pakshaghata.
Effect of Lagerstroemia Speciosa (L.) Pers. (Jarula) Leaves Powder as a Hypoglycemic Agent in the Management of Type 2 Diabetes Mellitus
Authors: Choudhury Bishnu 
Published: September 2024

Background:
Perusal of history revels the earliest description of Madhumeha (diabetes mellitus [DM]) is found in Vedic literature of India. The hypoglycemic effect of Lagerstroemia speciosa (L.) Pers. has been date back from the old writing of Ayurveda (Bhavaprakash Nighantu).

Objective:
The objective is to assess the efficacy of L. speciosa (L.) Pers as an oral hypoglycemic agent.

Materials and Methods:
The present study is a single group, open label, clinical trial with pre-post follow-up test design on 100 subjects of type 2 DM. Subjects were intervened with L. speciosa (L.) Pers. leaves powder in the dose of 12 g daily in two divided dose ½ h before breakfast and dinner with warm water for 90 days along with advice for standard control of diet and lifestyle modification. The result of the study was determined by the changes in fasting and postprandial blood sugar and glycosylated hemoglobin (HbA1C) level before and after completion of study. Statistical analysis was done using all values which are expressed as mean ± standard deviation and “Z” test. The results were assessed through “P” value.

Results:
After 90 days of intervention, mean laboratory measured fasting and postprandial blood glucose showed a decrease from 168 and 202 mg/dl to 135 and 166 mg/dl respectively. Reduction in mean HbA1C was also observed from 7.3% to 6.5%. The rate of shift of grade was observed statistically significant (P < 0.01) in all parameters.

Conclusion:
Leaf's powder of L. speciosa (L.) Pers. showed significant hypoglycemic effect.
Assessing Stigma Toward Mental, Neurological, and Substance Use Disorders in Liberia: A Population Representative Study
Authors: Dossen S. Benedict , Mulbah J. Mike , Hargreaves April , Kumar Samhita , Mothersill David , Loughnane Gerard , Byrd Eve , Nyakoon Angie Tarr , Quoi Joseph S. , Ebuenyi Ikenna D. 
Published: September 2024

ABSTRACT.
Mental health stigma remains a major global problem associated with low self-esteem, social withdrawal, and poor health-seeking behavior in individuals. However, limited published evidence details these challenges in Liberia. Knowledge of public perceptions toward mental illness and key trends in the associations between knowledge of mental, neurological, and substance use disorders (MNSs) and stigma is crucial to designing evidence-based mental health policies and supporting service delivery. This population-representative survey explored and quantified stigma related to MNSs in four health regions in Liberia, using a multistage stratified random sampling of 1,148 residents. Four internationally validated scales were used to assess knowledge, attitudes, and perceptions toward schizophrenia, bipolar disorder, epilepsy, and substance use disorder including the 1) Mental Health Attribution Questionnaire; 2) Five Question Stigma Indicator Questionnaire to assess Community Stigma; 3) Reported Intended Behavioral Scale; and 4) Personal Acceptance Level of Conditions. Data from interviews with 1,140 participants (96% response rate) were analyzed using central tendencies, hypothesis testing with simple logistic regression, and bivariate analysis for association between dependent and independent variables. Low mental health knowledge was found to be a strong predictor of discriminatory behaviors and stigma. Results revealed that exposure to movies or television significantly predicted increased discriminatory tendencies and that a lesser degree of acceptance was shown toward substance use disorder than any of the other conditions. These findings underscore the need for increased awareness and education about mental health to eliminate stigma and promote better care and inclusion for people living with MNSs.