bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimating highest capacity propulsion performance using backward-directed force during walking evaluation for individuals with acquired brain injury
Authors: LaCroix Kelli , Horelka Lauren , Hung Clif , Brown David A. 
Published: August 2024

AbstractThere are over 5.3 million Americans who face acquired brain injury (ABI)-related disability as well as almost 800,000 who suffer from stroke each year. To improve mobility and quality of life, rehabilitation professionals often focus on walking recovery soon after hospital discharge for ABI. Reduced propulsion capacity (force output of the lower limbs to counteract ground reaction forces) negatively impacts walking ability and complicates recovery during rehabilitation for brain injured people. We describe a method, using backward-directed resistance (BDR) in a robotic-based treadmill device, to allow measurement of maximum walking propulsion force (MWPF) that is not otherwise possible during overground walking assessment. Our objective was to test the construct validity of a maximum walking propulsion force (MWPF) measure that reflects a person’s propulsive strength against applied BDR, while walking on a robotic treadmill-based device for participants with acquired brain injury (ABI). Our study enrolled 14 participants with ABI at an in inpatient rehabilitation in Galveston, TX from 8/1/21 − 4/31/22. The range of weight-adjusted MWPF was 2.6–27.1% body weight (%BW), mean 16.5 ± 8.4%BW, reflecting a wide range of propulsive force capability. The strongest correlation with overground tests was between the 6-minute walk test (6-MWT) distance and the MWPF values (r = 0.83, p < 0.001) with moderate correlations between the 10-meter walk tests at comfortable (CWS) and fast speeds (FWS). The Five Times Sit-to-Stand (used as a standard clinical measure of functional lower extremity strength) and MWPF tests were poorly correlated (r = 0.26, p = 0.4). Forward model selection included 6-MWT distance, age, and overground CWS as significant partial predictors of MWPF. We conclude that this novel MWPF measure is a valid representation of maximum propulsive force effort during walking for people post-ABI. Additional research could help determine the impact of interventions designed to increase propulsive force generation during rehabilitation training to improve overground walking performance.
Effectiveness of de-implementation of low-value healthcare practices: an overview of systematic reviews
Authors: Kien Christina , Daxenbichler Julia , Titscher Viktoria , Baenziger Julia , Klingenstein Pauline , Naef Rahel , Klerings Irma , Clack Lauren , Fila Julian , Sommer Isolde 
Published: August 2024

Abstract
Background
Reducing low-value care (LVC) is crucial to improve the quality of patient care while increasing the efficient use of scarce healthcare resources. Recently, strategies to de-implement LVC have been mapped against the Expert Recommendation for Implementing Change (ERIC) compilation of strategies. However, such strategies’ effectiveness across different healthcare practices has not been addressed. This overview of systematic reviews aimed to investigate the effectiveness of de-implementation initiatives and specific ERIC strategy clusters.

Methods
We searched MEDLINE (Ovid), Epistemonikos.org and Scopus (Elsevier) from 1 January 2010 to 17 April 2023 and used additional search strategies to identify relevant systematic reviews (SRs). Two reviewers independently screened abstracts and full texts against a priori–defined criteria, assessed the SR quality and extracted pre-specified data. We created harvest plots to display the results.

Results
Of 46 included SRs, 27 focused on drug treatments, such as antibiotics or opioids, twelve on laboratory tests or diagnostic imaging and seven on other healthcare practices. In categorising de-implementation strategies, SR authors applied different techniques: creating self-developed strategies (n = 12), focussing on specific de-implementation strategies (n = 14) and using published taxonomies (n = 12). Overall, 15 SRs provided evidence for the effectiveness of de-implementation interventions to reduce antibiotic and opioid utilisation. Reduced utilisation, albeit inconsistently significant, was documented in the use of antipsychotics and benzodiazepines, as well as in laboratory tests and diagnostic imaging. Strategies within the adapt and tailor to context, develop stakeholder interrelationships, and change infrastructure and workflow ERIC clusters led to a consistent reduction in LVC practices.

Conclusion
De-implementation initiatives were effective in reducing medication usage, and inconsistent significant reductions were observed for LVC laboratory tests and imaging. Notably, de-implementation clusters such as change infrastructure and workflow and develop stakeholder interrelationships emerged as the most encouraging avenues. Additionally, we provided suggestions to enhance SR quality, emphasising adherence to guidelines for synthesising complex interventions, prioritising appropriateness of care outcomes, documenting the development process of de-implementation initiatives and ensuring consistent reporting of applied de-implementation strategies.

Registration
OSF Open Science Framework 5ruzw.
Hunger in the shadow of conflict: analyzing malnutrition and humanitarian challenges in Sudan
Authors: Mohamed Amira , Homeida Anmar 
Published: August 2024

Abstract
Background
Conflict has become a global reality, particularly impacting millions of children, with the majority of conflicts occurring in developing nations, where 90% of the world's children reside. The Horn of Africa, especially Sudan, has faced severe conflicts, with the year 2023 witnessing one of the toughest conflicts in the region, resulting in a high number of internally displaced persons and refugees. Children, especially in areas like Darfur, Khartoum, Gezira, and Kordofan, bear the brunt of ongoing large-scale conflicts, facing widespread human rights violations and resource damage.
Before the conflict that began in April 2023, Khartoum was home to numerous children's hospitals, but now only Elbuluk Hospital remains operational, facing a surge in admissions due to displacement and subsequent returns of civilians seeking medical care. Although malnutrition cases have increased, the case fatality rate associated with severe acute malnutrition has doubled from approximately 6% to 12% by March 2024, possibly due to uneven food distribution amid sporadic peace efforts.

Recommendations
Investing in grassroots organizations is crucial for facilitating effective humanitarian aid delivery, as they are uniquely positioned to identify and address local needs promptly and efficiently. Strengthening these organizations enhances their capacity to coordinate aid distribution and provide essential services tailored to regional conditions.
Persistent violations of International Humanitarian Law (IHL) in conflict zones impede humanitarian efforts. Robust collaboration between international and local stakeholders is necessary to uphold and enforce IHL, with a focus on protecting civilian lives and ensuring safe, unhindered access for humanitarian aid while respecting the dignity of all affected individuals.
Involvement of posterior hypothalamic CaMKII-positive neurons in ADHD-like behaviors in mice
Authors: Lee Changwoo , Woo Changsu , Ma Gyeong Ryeong , Choi Kyuhyun , Kang Shin Jung , Shin Ki Soon 
Published: August 2024

AbstractThis study explores the behavioral effects of modulating CaMKII-positive (CaMKII+) neurons in the posterior hypothalamus (PH). Utilizing a chemogenetic approach in mice, we discovered that the activation of CaMKII + neurons within the PH is associated with heightened locomotor activity, reduced social interaction, and impulsive behavior unrelated to anxiety or avoidance. These observed behaviors share a significant resemblance with characteristics commonly found in attention deficit and hyperactivity disorder (ADHD). Notably, treatment with clonidine, which is frequently prescribed for ADHD, effectively reduced impulsive behaviors in our mouse model. Our findings uncover the role of the PH that has not been previously explored and suggest a possible involvement of the PH in the manifestation of ADHD-like behaviors.
Small cell lung cancer: emerging subtypes, signaling pathways, and therapeutic vulnerabilities
Authors: Zhang Jing , Zeng Xiaoping , Guo Qiji , Sheng Zhenxin , Chen Yan , Wan Shiyue , Zhang Lele , Zhang Peng 
Published: August 2024

AbstractSmall cell lung cancer (SCLC) is a recalcitrant cancer characterized by early metastasis, rapid tumor growth and poor prognosis. In recent decades, the epidemiology, initiation and mutation characteristics of SCLC, as well as abnormal signaling pathways contributing to its progression, have been widely studied. Despite extensive investigation, fewer drugs have been approved for SCLC. Recent advancements in multi-omics studies have revealed diverse classifications of SCLC that are featured by distinct characteristics and therapeutic vulnerabilities. With the accumulation of SCLC samples, different subtypes of SCLC and specific treatments for these subtypes were further explored. The identification of different molecular subtypes has opened up novel avenues for the treatment of SCLC; however, the inconsistent and uncertain classification of SCLC has hindered the translation from basic research to clinical applications. Therefore, a comprehensives review is essential to conclude these emerging subtypes and related drugs targeting specific therapeutic vulnerabilities within abnormal signaling pathways. In this current review, we summarized the epidemiology, risk factors, mutation characteristics of and classification, related molecular pathways and treatments for SCLC. We hope that this review will facilitate the translation of molecular subtyping of SCLC from theory to clinical application.
Mapping the past with historical geographic information systems: layered characteristics of the historic urban landscape of Nanjing, China, since the Ming Dynasty (1368–2024)
Authors: Bai Xuefeng , Jiao Xinyu , Sakai Takeru , Xu Hao 
Published: August 2024

Abstract
The layering process of the historic urban landscape (HUL) has spatial and temporal characteristics. With the help of digital technology, building a database to collect and manage spatial information on HUL is an effective research method. Taking Nanjing since the Ming Dynasty (1368–2024) as an example, our paper proposes a framework for constructing a historical geographic information system (HGIS) for HUL. The results show that (1) ancient Chinese historical archives have good potential for use in the construction of historical landscape databases. The HGIS can visualize the evolution of HUL and realize the storage, expression, querying, and analysis of information in different formats. (2) The Republic of China is a turning point in the evolution of Nanjing’s HUL. In terms of spatial evolution, the main distribution areas of urban form and characteristic places, as well as the NACH (normalized angular choice) and NAIN (normalized angular integration) cores of the road network, all moved from the south to the north of the city. In terms of typological evolution, the urban form changes from a predominantly residential area to one that emphasizes residential, administrative, educational and industrial areas. The main types of characteristic places shifted from house gardens, temples and ancestral halls to scenic buildings and public gardens. (3) Political factors, urban planning, commercial ports, and land prices influence the layering process of the HUL. The constructed database guides the preservation of HUL from the digital heritage perspective and the construction of other historical databases with spatial characteristics.
Mechanically induced M2 macrophages are involved in bone remodeling of the midpalatal suture during palatal expansion
Authors: Li Lan , Zhai Mingrui , Cheng Chen , Cui Shuyue , Wang Jixiao , Zhang Zijie , Liu Jiani , Wei Fulan 
Published: August 2024

Abstract
Background
Palatal expansion is a common way of treating maxillary transverse deficiency. Under mechanical force, the midpalatal suture is expanded, causing local immune responses. This study aimed to determine whether macrophages participate in bone remodeling of the midpalatal suture during palatal expansion and the effects on bone remodeling.

Methods
Palatal expansion model and macrophage depletion model were established. Micro-CT, histological staining, and immunohistochemical staining were used to investigate the changes in the number and phenotype of macrophages during palatal expansion as well as the effects on bone remodeling of the midpalatal suture. Additionally, the effect of mechanically induced M2 macrophages on palatal osteoblasts was also elucidated in vitro.

Results
The number of macrophages increased significantly and polarized toward M2 phenotype with the increase of the expansion time, which was consistent with the trend of bone remodeling. After macrophage depletion, the function of osteoblasts and bone formation at the midpalatal suture were impaired during palatal expansion. In vitro, conditioned medium derived from M2 macrophages facilitated osteogenic differentiation of osteoblasts and decreased the RANKL/OPG ratio.

Conclusions
Macrophages through polarizing toward M2 phenotype participated in midpalatal suture bone remodeling during palatal expansion, which may provide a new idea for promoting bone remodeling from the perspective of regulating macrophage polarization.
Standard versus individualised positive end-expiratory pressure (PEEP) compared by electrical impedance tomography in neurocritical care: a pilot prospective single centre study
Authors: Spatenkova Vera , Mlcek Mikulas , Mejstrik Alan , Cisar Lukas , Kuriscak Eduard 
Published: August 2024

Abstract
Background
Individualised bedside adjustment of mechanical ventilation is a standard strategy in acute coma neurocritical care patients. This involves customising positive end-expiratory pressure (PEEP), which could improve ventilation homogeneity and arterial oxygenation. This study aimed to determine whether PEEP titrated by electrical impedance tomography (EIT) results in different lung ventilation homogeneity when compared to standard PEEP of 5 cmH2O in mechanically ventilated patients with healthy lungs.

Methods
In this prospective single-centre study, we evaluated 55 acute adult neurocritical care patients starting controlled ventilation with PEEPs close to 5 cmH2O. Next, the optimal PEEP was identified by EIT-guided decremental PEEP titration, probing PEEP levels between 9 and 2 cmH2O and finding the minimal amount of collapse and overdistension. EIT-derived parameters of ventilation homogeneity were evaluated before and after the PEEP titration and after the adjustment of PEEP to its optimal value. Non-EIT-based parameters, such as peripheral capillary Hb saturation (SpO2) and end-tidal pressure of CO2, were recorded hourly and analysed before PEEP titration and after PEEP adjustment.

Results
The mean PEEP value before titration was 4.75 ± 0.94 cmH2O (ranging from 3 to max 8 cmH2O), 4.29 ± 1.24 cmH2O after titration and before PEEP adjustment, and 4.26 ± 1.5 cmH2O after PEEP adjustment. No statistically significant differences in ventilation homogeneity were observed due to the adjustment of PEEP found by PEEP titration. We also found non-significant changes in non-EIT-based parameters following the PEEP titration and subsequent PEEP adjustment, except for the mean arterial pressure, which dropped statistically significantly (with a mean difference of 3.2 mmHg, 95% CI 0.45 to 6.0 cmH2O, p < 0.001).

Conclusion
Adjusting PEEP to values derived from PEEP titration guided by EIT does not provide any significant changes in ventilation homogeneity as assessed by EIT to ventilated patients with healthy lungs, provided the change in PEEP does not exceed three cmH2O. Thus, a reduction in PEEP determined through PEEP titration that is not greater than 3 cmH2O from an initial value of 5 cmH2O is unlikely to affect ventilation homogeneity significantly, which could benefit mechanically ventilated neurocritical care patients.
Improved flame retardancy and mechanical properties of bacterial cellulose fabrics via solvent exchange and entrapment of zein and gluten
Authors: Kim Hyunjin , Kim Hye Rim 
Published: August 2024

AbstractThis study aimed to improve the flame retardancy and mechanical properties of bacterial cellulose (BC) by introducing cereal proteins, namely zein and gluten. The production conditions were determined by observing residual masses of samples at 1000 ℃ using thermogravimetric analysis (TGA). According to the TGA results, the optimized production conditions for the BCs with zein and gluten were combined solvent exchange and entrapment of 20 weight% (wt.%) of zein, and entrapment of 40 wt.% of gluten, respectively. Surface characterization of BC prepared with zein and gluten under the optimal conditions confirmed that the cereal proteins were incorporated into the BC nanostructures via solvent exchange and/or entrapment and the original chemical and crystal structures of BC were not significantly changed. Limiting oxygen index (LOI) analysis confirmed that cereal proteins improved the flame retardancy of BC. In particular, the LOI of BC entrapped with gluten was 50%, which was better than that of cowhide leather. Char morphology analysis confirmed that the as-produced BCs with cereal proteins exhibited condensed-phase flame-retardant mechanism by forming intumescent chars. Analysis of the mechanical properties confirmed that compared with cowhide leather, as-produced BCs with cereal proteins possessed high tensile strength and dimensional stability, making them suitable leather substitutes.
Time to recovery from severe community-acquired pneumonia and its predictors among 6 to 59 months of age children admitted to South Wollo zone public hospitals, North East Ethiopia: a prospective follow-up study
Authors: Teferi Mekonnen , Addisu Elsabeth , Wodajo Shambel , Muche Amare , Endawekie Abel , Adane Bezawit , Dessie Tilahun , Kebede Natnael 
Published: August 2024

Abstract
Introduction
Ethiopia is one of those countries with higher burden of community acquired pneumonia among its people, under five children are the members of society that are highly affected by pneumonia particularly Severe Community Acquired Pneumonia. However, there are limited studies on time to recovery and its predictors in under-five children and most of them are retrospective which fails to address important variables that affect the time to recovery. Therefore, the aim of this study was to estimate the median time to recovery and its predictors among under five children admitted to South Wollo zone public hospitals, North East Ethiopia.

Methods
An institution-based prospective cohort study was conducted from March 10 to May 10, 2021, with 270 study subjects. A systematic random sampling technique was used. Data was collected by interview and chart review. The data were entered and analyzed using Epi Data version 3.1 and STATA version 14.0, respectively. Kaplan-Meier and Cox regression models were used to test the time and predictors of recovery from severe community-acquired pneumonia.

Results
The overall incidence of recovery rate (95% confidence interval) from Severe Community-Acquired Pneumonia was 20.45(17.84–23.46) per 100 person days observation with median (IQR) time to recovery of [3, 5] days. The predictors of time to recovery from Severe Community-Acquired Pneumonia were having comorbidities on admission [AHR = 0.49 (95%CI: 0.32,0.75)], reaching hospitals after 5 days of onset of symptoms [AHR = 0.35 (95%CI: 0.20,0.60)], having Middle Upper Arm Circumference < = 12.5 cm [AHR = 0.21 (95%CI: 0.12,0.37)], the presence of smoker in the house [AHR = 0.21 (95%CI: 0.10,0.42)] and being not fully immunized for age [AHR = 0.35 (95%CI: 0.24,0.53)].

Conclusion and recommendations
Generally the recovery time of children with Severe Community Acquired Pneumonia in the study area was within the recommended national standards. Due attention should be given to children with the identified predictors while treating them.
“But how true that is, I do not know”: the influence of written sources on the medicinal use of fungi across the western borderlands of the former Soviet Union
Authors: Prakofjewa Julia , Sartori Matteo , Kalle Raivo , Łuczaj Łukasz , Karbarz Małgorzata , Mattalia Giulia , Šarka Povilas , Prūse Baiba , Stryamets Nataliya , Anegg Martin , Kuznetsova Natalia , Kolosova Valeria , Belichenko Olga , Aziz Muhammad Abdul , Pieroni Andrea , Sõukand Renata 
Published: August 2024

AbstractFungi have been used for medicinal purposes for many centuries. This study, based on 35 historical written sources and 581 in-depth semi-structured interviews from eight countries in the western borderlands of the former Soviet Union, investigates the medicinal use of fungi by local communities. We compared the taxa and uses obtained from fieldwork and historical sources with works that advocated fungi use within Soviet herbals, representing the centralised medical system. During fieldwork, we identified eight locally used fungi and one lichen. The highest numbers of medicinal uses were documented in Russia, Estonia and Ukraine. Studies published before the Soviet era listed 21 fungal taxa and one lichen species used in the study region. However, only six of these taxa were mentioned as used by people in our field studies (Amanitamuscaria, Boletusedulis, Lycoperdon, Morchella, Phallusimpudicus and Cetrariaislandica). Notably, these same six taxa were consistently endorsed in Soviet herbals. Of the remaining three taxa recorded in the fieldwork, none were mentioned in historical written sources. However, they were promoted either in Soviet herbals (Inonotusobliquus, Kombucha) or later popular publications (Cantharelluscibarius). This highlights the significant influence of written sources on the use of fungi for medicinal purposes within the studied local communities.
Insights Into the Patient Experience of Hormone Therapy for Early Breast Cancer Treatment Using Patient Forum Discussions and Natural Language Processing
Authors: Sreenivasan Sameet , Fang Chao , Flood Emuella M. , Markuzon Natasha , Sze Jasmine Y.Y. 
Published: August 2024

PURPOSE Understanding the real-world experience of patients with early breast cancer (eBC) is imperative for optimizing outcomes and evolving patient care. However, there is a lack of patient-level data, hindering clinical development. This social listening study was performed to understand patient insights into symptoms and impacts of hormone therapy (HT) for eBC using posts from patient forums on breastcancer.org to inform future clinical research. METHODS Natural language processing (NLP) and machine learning techniques were used to identify themes related to eBC from a sample of 500,000 posts. After relevant data selection, 362,074 eBC posts were retained for further analysis of symptoms and impacts related to HT, as well as insights into symptom severity, pain locations, and symptom management using exercise and yoga. RESULTS Overall, 32 symptoms and nine impacts had significant associations with ≥one HT. Hot flush (relative risk [RR], 6.70 [95% CI, 3.36 to 13.36]), arthralgia (RR, 6.67 [95% CI, 3.53 to 12.59]), weight increased (RR, 4.83 [95% CI, 3.20 to 7.28]), mood swings (RR, 7.36 [95% CI, 5.75 to 9.42]), insomnia (RR, 4.76 [95% CI, 3.14 to 7.22]), and depression (RR, 3.05 [95% CI, 1.71 to 5.44]) demonstrated the strongest associations. Severe headache, dizziness, back pain, and muscle spasms showed significant associations with ≥one HT despite their low overall prevalence in eBC posts. CONCLUSION The social listening approach allowed the identification of real-world insights from posts specific to eBC HT from a large-scale online breast cancer forum that captured experiences from a uniquely diverse group of patients. Using NLP has a potential to scale analysis of patient feedback and reveal actionable insights into patient experiences of treatment that can inform the development of future therapies and improve the care of patients with eBC.