bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Hypointense Focal Brain” on susceptibility-weighted imaging as a sign of venous congestion in cranial dural arteriovenous fistulas
Authors: Chen Zhou Zhao Hui , Hilario Amaya , Salvador Álvarez Elena , Cárdenas del Carre Agustín María , Romero Coronado Juan , Lechuga Vázquez Carmen , Martínez de Aragón Ana , Ramos González Ana 
Published: July 2024

Background Cranial dural arteriovenous fistulas (dAVFs) are complex neurovascular malformations accounting for approximately 10%–15% of all intracranial arteriovenous malformations. The objective is to investigate the utility of susceptibility-weighted imaging (SWI) in identifying “hypointense focal brain” as an additional helpful sign of venous congestion in cranial dAVFs. Materials and Methods A retrospective review of patients diagnosed with cranial dAVFs between January 2015 and June 2023 was conducted, and SWI was used to identify the “hypointense focal brain” sign within the venous drainage region of the dAVF. The “hypointense focal brain” on SWI was identified as a low-intensity signal within the venous drainage region, indicative of venous congestion. The presence of this imaging sign was assessed by two neuroradiologists and signal intensity measurements were performed to support the presence of the sign. Results The study included six patients with cranial dAVFs exhibiting cortical venous retrograde drainage and the “hypointense focal brain” on SWI. Follow-up imaging post-treatment revealed resolution or improvement of the hypointense signal, confirming its association with venous congestion. Signal intensity measurements further supported the presence of this imaging sign in pre-treatment scans. Conclusion The study’s findings demonstrate the presence of a reversible “hypointense focal brain” sign on SWI in patients with cranial dAVFs and CVR, which can be useful as an additional imaging sign for venous congestion.
Utilization of orthoses and assistive devices among a national sample of lower limb orthosis users
Authors: Stevens Phillip M , Hafner Brian J , Weber Eric L , Morgan Sara J , Bamer Alyssa M , Salem Rana , Balkman Geoffrey S 
Published: July 2024

Introduction Lower limb orthoses (LLOs) and assistive devices (ADs) can be used together or separately to improve mobility when performing daily activities. The goal of this study was to examine utilization of LLOs and ADs in a national sample of adult LLO users. Methods A survey was designed to ask participants whether they typically use their LLOs and/or ADs to perform 20 daily activities. LLO users from orthotic clinics across the United States were invited to complete the survey. Descriptive statistics were used to examine utilization trends. Results Survey responses from 1036 LLO users were analyzed. Community-based activities were performed with LLOs by at least 80% of participants. Activities that involved walking short distances in the home were more often performed without LLOs or ADs. Among participants with the four most prevalent health conditions, LLO use in the community was greatest among participants with Charcot-Marie-Tooth disease. Conclusions LLOs were frequently used for a wide range of community-based activities. Simultaneous use of ADs and LLOs may be most beneficial for LLO users when performing activities outside of the home. Clinicians can discuss LLO and AD use with patients to optimize their functional outcomes at home and in the community.
Serum Fructosamine as an Indicator of Perioperative Complications in Patients Undergoing Foot and Ankle Surgery
Authors: Suh Yu Min , Fisher Margaret , Hu Di , Lin Feng-Chang , Wukich Dane , Tennant Josh , Lalli Trapper 
Published: July 2024

Background: Patients with poor glycemic control are at increased risk of postoperative complications. Hemoglobin A1c (HbA1c) has traditionally been used to assess preoperative glycemic control, but with limitations. More recently, fructosamine has been tested preoperatively in patients undergoing elective total joint arthroplasty. This study aims to assess whether preoperative serum fructosamine can be used to avoid adverse outcomes in patients undergoing foot and ankle surgery. Methods: This was a retrospective chart review of all patients who underwent foot and ankle surgeries at 2 level 1 trauma centers from January 2020 to December 2021. Of those, 305 patients were tested for HbA1c and fructosamine levels preoperatively. Adverse outcomes were assessed over 30 and 90 days. Outcomes of interest were surgical site infection, wound dehiscence, unplanned return to the operating room, unplanned readmission, and death. Data were analyzed using independent 2-sample t tests. A mixed effects model was used for multivariate analysis. P values less than .05 were considered statistically significant. Results: Preoperative serum fructosamine was significantly higher ( P = .029) in those with complications within 90 days compared to those without. The mean preoperative fructosamine level was 269.2 µmol/L (SD = 58.85) in those who did have a complication vs 247.2 µmol/L (SD = 53.95) in those who did not. Clinically significant fructosamine threshold was determined using 2 different methods. Fructosamine was found to be non-inferior to HbA1c in accurately predicting postoperative complications. Conclusion: Fructosamine is a serum marker that reflects nearer term glycemic control than HbA1c. Elevation in preoperative fructosamine is associated with increased perioperative complications after foot and ankle surgery within 90 days. Preoperative fructosamine may be used in patient optimization and risk stratification when determining candidacy and timing for elective foot and ankle surgeries. Level of evidence: Level III, retrospective cohort study.
Prevalence and influencing factors of sleep disorders in medical students after the COVID-19 pandemic
Authors: Liu Jiao , Hao Qingling , Li Baozhu , Zhang Ran , Luo Guoshuai , Sun Daliang 
Published: July 2024

Abstract
Background
The prevalence of sleep disorders among medical students was high during the COVID-19 pandemic. However, fewer studies have been conducted on sleep disorders among medical students after the COVID-19 pandemic. This study investigated the prevalence and factors influencing sleep disorders among Chinese medical students after COVID-19.

Methods
A total of 1,194 Chinese medical students were included in this study from 9th to 12th July 2023. We used the Self-administered Chinese scale to collect the demographic characteristics. In addition, we used the Chinese versions of the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI) to assess subjects’ depression, anxiety, and sleep disorders, respectively. The chi-square test and binary logistic regression were used to identify factors influencing sleep disorders. The receiver operating characteristic (ROC) curve was utilized to assess the predictive value of relevant variables for sleep disorders.

Results
We found the prevalence of sleep disorders among medical students after COVID-19 was 82.3%. According to logistic regression results, medical students with depression were 1.151 times more likely to have sleep disorders than those without depression (OR = 1.151, 95% CI 1.114 to 1.188). Doctoral students were 1.908 times more likely to have sleep disorders than graduate and undergraduate students (OR = 1.908, 95% CI 1.264 to 2.880).

Conclusion
The prevalence of sleep disorders among medical students is high after COVID-19. In addition, high academic levels and depression are risk factors for sleep disorders. Therefore, medical colleges and administrators should pay more attention to sleep disorders in medical students after the COVID-19 pandemic. Regular assessment of sleep disorders and depression is essential.
Monovalent, bivalent and biparatopic nanobodies targeting S1 protein of porcine epidemic diarrhea virus efficiently neutralized the virus infectivity
Authors: Qin Huai-rui , Cao Zhi , Lu Feng-zhe , Wang Wei , Zhao Wenhui , Li Guimei , Zhang Hongliang , Wang Shubai , Qin Zhihua 
Published: July 2024

Abstract
Background
Porcine epidemic diarrhea virus (PEDV) is a highly contagious coronavirus that causes severe diarrhea and death in neonatal piglets, which has brought huge economic losses to the pork industry worldwide since its first discovery in the early 1970s in Europe. Passive immunization with neutralizing antibodies against PEDV is an effective prevention measure. To date, there are no effective therapeutic drugs to treat the PEDV infection.

Results
We conducted a screening of specific nanobodies against the S1 protein from a phage display library obtained from immunized alpacas. Through competitive binding to antigenic epitopes, we selected instead of chose nanobodies with high affinity and constructed a multivalent tandem. These nanobodies were shown to inhibit PEDV infectivity by the neutralization assay. The antiviral capacity of nanobody was found to display a dose-dependent pattern, as demonstrated by IFA, TCID50, and qRT-PCR analyses. Notably, biparatopic nanobody SF-B exhibited superior antiviral activity. Nanobodies exhibited low cytotoxicity and high stability even under harsh temperature and pH conditions, demonstrating their potential practical applicability to animals.

Conclusions
Nanobodies exhibit remarkable biological properties and antiviral effects, rendering them a promising candidate for the development of anti-PEDV drugs.
“Our program manager is a woman for the first time”: perceptions of health managers on what workplace policies and practices exist to advance women’s career progression in the health sector in Kenya
Authors: Odunga Sally Atieno , Odero Henry Owoko , Syonguvi Jackline , Mbuthia Michelle , Tanaka Sonja , Kiwuwa-Muyingo Sylvia , Kadengye Damazo T. 
Published: July 2024

Abstract
Background
Existing evidence suggests that organisation-level policies are important in enabling gender equality and equity in the workplace. However, there is little research exploring the knowledge of health sector employees on whether policies and practices to advance women’s career progression exist in their organisations. In this qualitative study, we explored the knowledge and perspectives of health managers on which of their organisations' workplace policies and practices contribute to the career advancement of women and their knowledge of how such policies and practices are implemented and monitored.

Methods
We employed a purposive sampling method to select the study participants. The study adopted qualitative approaches to gain nuanced insights from the 21 in-depth interviews and key informant interviews that we conducted with health managers working in public and private health sector organisations. We conducted a thematic analysis to extract emerging themes relevant to advancing women’s career progression in Kenya’s health sector.

Results
During the interviews, only a few managers cited the policies and practices that contribute to women’s career advancement. Policies and practices relating to promotion and flexible work schedules were mentioned most often by these managers as key to advancing women's career progression. For instance, flexible work schedules were thought to enable women to pursue further education which led to promotion. Some female managers felt that women were promoted to leadership positions only when running women-focused programs. There was little mention of capacity-building policies like training and mentorship. The health managers reported how policies and practices are implemented and monitored in general, however, they did not state how this is done for specific policies and practices. For the private sector, the health managers stated that implementation and monitoring of these policies and practices is conducted at the institutional level while for the public sector, this is done at the national or county level.

Conclusions
We call upon health-sector organisations in Kenya to offer continuous policy sensitisation sessions to their staff and be deliberate in having supportive policies and other pragmatic interventions beyond policies such as training and mentorship that can enable women’s career progression.
Tracking neuroinflammatory biomarkers in Alzheimer’s disease: a strategy for individualized therapeutic approaches?
Authors: Lista Simone , Imbimbo Bruno P. , Grasso Margherita , Fidilio Annamaria , Emanuele Enzo , Minoretti Piercarlo , López-Ortiz Susana , Martín-Hernández Juan , Gabelle Audrey , Caruso Giuseppe , Malaguti Marco , Melchiorri Daniela , Santos-Lozano Alejandro , Imbimbo Camillo , Heneka Michael T. , Caraci Filippo 
Published: July 2024

Abstract
Background
Recent trials of anti-amyloid-β (Aβ) monoclonal antibodies, including lecanemab and donanemab, in early Alzheimer disease (AD) showed that these drugs have limited clinical benefits and their use comes with a significant risk of serious adverse events. Thus, it seems crucial to explore complementary therapeutic approaches. Genome-wide association studies identified robust associations between AD and several AD risk genes related to immune response, including but not restricted to CD33 and TREM2. Here, we critically reviewed the current knowledge on candidate neuroinflammatory biomarkers and their role in characterizing the pathophysiology of AD.

Main body
Neuroinflammation is recognized to be a crucial and contributing component of AD pathogenesis. The fact that neuroinflammation is most likely present from earliest pre-stages of AD and co-occurs with the deposition of Aβ reinforces the need to precisely define the sequence and nature of neuroinflammatory events. Numerous clinical trials involving anti-inflammatory drugs previously yielded unfavorable outcomes in early and mild-to-moderate AD. Although the reasons behind these failures remain unclear, these may include the time and the target selected for intervention. Indeed, in our review, we observed a stage-dependent neuroinflammatory process in the AD brain. While the initial activation of glial cells counteracts early brain Aβ deposition, the downregulation in the functional state of microglia occurs at more advanced disease stages. To address this issue, personalized neuroinflammatory modulation therapy is required. The emergence of reliable blood-based neuroinflammatory biomarkers, particularly glial fibrillary acidic protein, a marker of reactive astrocytes, may facilitate the classification of AD patients based on the ATI(N) biomarker framework. This expands upon the traditional classification of Aβ (“A”), tau (“T”), and neurodegeneration (“N”), by incorporating a novel inflammatory component (“I”).

Conclusions
The present review outlines the current knowledge on potential neuroinflammatory biomarkers and, importantly, emphasizes the role of longitudinal analyses, which are needed to accurately monitor the dynamics of cerebral inflammation. Such a precise information on time and place will be required before anti-inflammatory therapeutic interventions can be considered for clinical evaluation. We propose that an effective anti-neuroinflammatory therapy should specifically target microglia and astrocytes, while considering the individual ATI(N) status of patients.
Clinical utility of plasma Epstein-Barr virus DNA monitoring in pediatric Epstein‐Barr virus-associated hemophagocytic lymphohistiocytosis: a Chinese retrospective observational study
Authors: Zhang Wenzhi , Yin Yuhong , Li Ying , Cheng Li , Zhao Lizhen , Peng Yun , Wu Xiaoyan 
Published: July 2024

Abstract
Background
Epstein-Barr virus DNA (EBV-DNA) is closely related to the pathogenesis and prognosis of EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The quantitative measurement of blood EBV-DNA is widely used in EBV-HLH, but there remains a lack of evidence to guide clinicians.

Methods
A retrospective analysis was conducted on clinical manifestations, laboratory tests, 310 blood EBV-DNA loads, and prognosis of 51 pediatric patients diagnosed with EBV-HLH. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cutoff values of EBV-DNA for predicting mortality and evaluating the active status of EBV-HLH.

Results
EBV-positive- lymphoma-HLH had higher initial plasma EBV-DNA load(1.10 × 106copies/ml) compared to the EBV-HLH group (1.98 × 104 copies/ml) (P = 0.006), and experienced recurrently elevated plasma EBV-DNA levels during treatment. The optimal cut-off value of initial plasma EBV-DNA load in predicting mortality was 2.68 × 105 copies/ml, with a sensitivity of 88.57% and a specificity of 56.25%. For determining the active status of HLH, the optimal cutoff value of PBMC EBV-DNA load during treatment was 2.95 × 105 copies/ml, with a sensitivity of 69.14% and a specificity of 64.71%. The cut-off value of plasma EBV-DNA for determining active status was 1.32 × 103 copies/ml, with a sensitivity of 84.34%, and a specificity of 87.67%. Patients with higher PBMC and plasma EBV-DNA at initial and those with repeated elevated plasma EBV-DNA during treatment had worse prognoses (P < 0.05).

Conclusion
Dynamic monitoring of EBV-DNA is a valuable tool for assessing disease status and predicting the prognosis of EBV-HLH, with plasma EBV-DNA being more effective than PBMC EBV-DNA. Patients with high levels of PBMC and plasma EBV-DNA at initial and those with repeated elevated plasma EBV-DNA during treatment had worse prognoses.
Effects of xenogeneic transplantation of umbilical cord-derived mesenchymal stem cells combined with irbesartan on renal podocyte damage in diabetic rats
Authors: Meng Jing , Gao Xiao , Liu Xiaojuan , Zheng Wen , Wang Yang , Wang Yinghao , Sun Zhenquan , Yin Xiaoxing , Zhou Xueyan 
Published: July 2024

Abstract
Background
The leading cause of end-stage renal disease (ESRD) is diabetic nephropathy (DN). Podocyte damage is an early event in the development of DN. Currently, there is no effective treatment strategy that can slow the progression of DN or reverse its onset. The role of mesenchymal stem cells (MSCs) transplantation in diabetes and its complications has been extensively studied, and diabetic nephropathy has been a major focus. Irbesartan exerts reno-protective effects independent of lowering blood pressure, can reduce the incidence of proteinuria in rats, and is widely used clinically. However, it remains undetermined whether the combined utilization of the angiotensin II receptor antagonist irbesartan and MSCs could enhance efficacy in addressing DN.

Methods
A commonly used method for modeling type 2 diabetic nephropathy (T2DN) was established using a high-fat diet and a single low-dose injection of STZ (35 mg/kg). The animals were divided into the following 5 groups: (1) the control group (CON), (2) the diabetic nephropathy group (DN), (3) the mesenchymal stem cells treatment group (MSCs), (4) the irbesartan treatment group (Irb), and (5) the combined administration group (MSC + Irb). MSCs (2 × 106 cells/rat) were injected every 10 days through the tail vein for a total of three injections; irbesartan (30 mg/kg/d) was administered by gavage. Additionally, the safety and homing of mesenchymal stem cells were verified using positron emission tomography (PET) imaging.

Results
The combination treatment significantly reduced the UACR, kidney index, IGPTT, HOMA-IR, BUN, serum creatine, and related inflammatory factor levels and significantly improved renal function parameters and the expression of proteins related to glomerular podocyte injury in rats. Moreover, MSCs can homing target to damaged kidneys.

Conclusions
Compared to the administration of MSCs or irbesartan alone, the combination of MSCs and irbesartan exerted better protective effects on glomerular podocyte injury, providing new ideas for the clinical application of mesenchymal stem cells.
Spline-based methods for functional data on multivariate domains
Authors: Basna Rani , Nassar Hiba , Podgórski Krzysztof 
Published: July 2024

AbstractFunctional data analysis is typically performed in two steps: first, functionally representing discrete observations, and then applying functional methods to the so-represented data. The initial choice of a functional representation may have a significant impact on the second phase of the analysis, as shown in recent research, where data-driven spline bases outperformed the predefined rigid choice of functional representation. The method chooses an initial functional basis by an efficient placement of the knots using a simple machine-learning algorithm. The knot selection approach does not apply directly when the data are defined on domains of a higher dimension than one such as, for example, images. The reason is that in higher dimensions the convenient and numerically efficient spline spaces use tensor bases that require knots located on a lattice. This fundamentally limits flexible knot placement which is fundamental for the approach. The goal of this research is two-fold: first, to propose modified approaches that circumvent the issue by coding the irregular knot selection into the topology of the spaces of tensor-based splines; second, to apply the approach to a classification problem workflow for functional data that utilizes knot selection. The performance is preliminarily accessed on a benchmark dataset and shown to be comparable to or better than the previous methods.
Deciphering the role of Moringa oleifera seeds and probiotic bacteria on mitigation of biogas production from ruminants
Authors: Elghandour Mona M. M. Y. , Pacheco Edson Brodeli Figueroa , Khusro Ameer , Tirado-González Deli Nazmín , Lackner Maximilian , Ponce-Covarrubias José Luis , De Palo Pasquale , Maggiolino Aristide , Salem Abdelfattah Z. M. 
Published: July 2024

AbstractMaintaining cleaner and more sustainable ecosystems by mitigating greenhouse gas (GHG) emissions from livestock through dietary manipulation is in demand. This study was aimed to assess the effect of Moringa oleifera seeds and probiotics (Pediococcus acidilactici BX-B122 and Bacillus coagulans BX-B118) as feed supplements on GHG production and fermentation profile from steers and sheep. The treatments included diets containing 0, 6, 12, and 18% of M. oleifera seeds meal and a mixture of probiotic bacteria (0.2 ml/g of diet). Total biogas production, CH4, CO, and H2S emission from animals (up to 48 h), rumen fermentation profile, and CH4 conversion efficiency were recorded using standard protocols. Results showed interaction among M. oleifera seeds and probiotics on asymptotic biogas production and total biogas production up to 48 h (P < 0.05). The rate of CH4 emission in steers was reduced from 0.1694 to 0.0447 ml/h using 6 and 18% of M. oleifera seeds (P < 0.05). Asymptotic CO and the rate of CO production were increased (P < 0.05) by supplementing different doses of M. oleifera seeds and probiotics. Adding 12% of M. oleifera seeds and probiotics reduced H2S production from 0.0675 to 0.0112 ml H2S/g DM (at 48 h of fermentation) in steers. In sheep, the additives mitigated H2S production from 0.0364 to 0.0029 ml H2S/g DM (at 48 h of fermentation), however there were not interaction (P = 0.7744). In addition, M. oleifera seeds and probiotics reduced the pH level and dry matter degradability (DMD) in steers and sheep (P < 0.0001) showing a positive impact on CH4:ME and CH4:OM (in steers) and CH4:SCFA (in sheep), while the interaction was not significant (P > 0.05) for CH4:SCFA (in steers) and CH4:ME and CH4:OM (in sheep). In conclusion, the interaction of M. oleifera seeds and probiotics in the feeding diet reduced GHG emissions and affected the fermentation profile of steers and sheep.