bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using mobile air cleaners in school classrooms for aerosol removal: Which, where and how
Authors: Ding Er , Giri Arghyanir , Gaillard Antoine , Bonn Daniel , Bluyssen Philomena M 
Published: July 2024

Mobile air cleaners (MACs) have been proposed as a supplementary solution to combat the spread of respiratory aerosols in school classrooms. To determine which, where and how to use MACs, seven small- and medium-sized MACs were selected and assessed for different settings and configurations by 1) a decay test for determining the clean air delivery rate (CADR), and 2) a perception test with a panel of subjects, together with physical measurements, of noise and air movement. The findings show that to achieve the desired CADR (appr. 1000 m3/h for 30 students per classroom), the key factors are the induced airflow pattern and the location of the MACs. MACs with an upward air supply toward the occupied zone showed much higher CADR (max. 775–1332 m3/h) than those with a horizontal air supply (max. 219–333 m3/h). Moreover, using multiple devices simultaneously was crucial when the room size was increased, and combining mechanical ventilation could improve aerosol removal. Achieving a sufficient CADR would always lead to a noise level above the limit of 35 dB(A), yet sometimes the rating of the panel was more than 50% acceptable. The air velocities mostly fulfilled the requirement (<0.2 m/s), which aligned with the positive panel assessment. Hence, the evaluation by a panel of subjects can help to optimize the use of MACs in a classroom.
Successful completion of orthodontic therapy in a patient with osteopetrosis: Case Report
Authors: Brooks John K , Height Lillian M , Jimenez Beverly A , Anyadike Anthony C , Kvint Joseph G , Price Jeffery B 
Published: July 2024

Introduction: Orthodontic therapy in patients with osteopetrosis (OP) of the jaws has typically been contraindicated owing to the presence of poorly perfused and extremely compact bone, and the potential risk for infection and osteomyelitis. As such, completed orthodontic cases in association with OP have rarely been published. Patient concerns: A patient aged 14 years 6 months, with no known diagnosis of OP, sought orthodontic assessment for anterior crowding. Clinical findings: The patient exhibited a straight facial profile and increased mandibular facial height, competent lips, shallow mentolabial sulcus with mild mentalis strain, flat/reverse smile arc and wide buccal corridors on smiling. Primary diagnosis: The patient had a Class I incisor relationship on Class I skeletal bases with bilateral Class I molars and Class II canine relationships. This was complicated by a crossbite involving the lateral incisors and a Bolton discrepancy due to small maxillary lateral incisors. A radiologic assessment revealed polyostotic OP of the oromaxillofacial complex. Interventions: Treatment consisted of maxillary and mandibular fixed orthodontic therapy, bite turbos and elastics to level and align the dentition. Extractions of permanent teeth were not needed. Outcomes: At the conclusion of treatment, there was a slight left Class II malocclusion, with incomplete intercuspation on the left side due to tooth size discrepancy, possibly attributed to inadequate elastics compliance and the presence of osteopetrotic bone. The treatment was completed in 3 years, 1 year longer than anticipated. Conclusion: This report represents the second published account of a patient with OP successfully managed with comprehensive orthodontic care and without osseous complications. Obtaining cephalometric measurements on OP-affected patients may be imprecise owing to the presence of extremely dense bone and difficulty to identify bony landmarks. To reduce osteopetrotic sequelae, attending clinicians should consider reduced exertional orthodontic forces and closely monitor patients for adverse alveolar events.
Impact of demographic and clinical factors on in-hospital delays in acute ischemic stroke treatment
Authors: Naftali Jonathan , Tsur Gal , Auriel Eitan , Raphaeli Guy , Findler Michael , Brauner Ran , Perlow Alain , Keret Ophir , Barnea Rani 
Published: July 2024

Background Delays in reperfusion treatment, both intravenous thrombolysis (IVT) and endovascular treatment (EVT), adversely affect outcomes in patients with acute ischemic stroke (AIS). To alleviate these delays, it is essential to comprehend how patients’ baseline and stroke characteristics impact in-hospital reperfusion delays. While demographic and socioeconomic factors affect stroke outcomes, their impact on in-hospital delays remains unclear. Method This is retrospective analysis at a tertiary stroke center, encompassing AIS patients receiving IVT and / or EVT between 2019 and 2022 (re-canalization cohort). Outcomes of interest were time intervals of admission to CT and admission to recanalization. Univariable analyses explored age, gender, baseline functional status, socioeconomic status (SES), ethnicity, vascular risk factors, and stroke characteristics. Subsequently, multivariable logistic regression analyses were performed. Results Altogether, 313 patients treated with IVT and 293 with EVT were included in the re-canalization cohort. No demographic variables were found to be associated with stroke treatment time intervals. Following multivariable analysis, stroke severity (low NIHSS, p < 0.01), arrival to the hospital by other means than ambulance ( p < 0.01), and atypical stroke symptoms ( p < 0.01), were associated with in-hospital delays, both in the EVT and the IVT groups. Conclusion Our findings indicate that patients with a more severe ischemic stroke, typical stroke symptoms, and arrival by ambulance have shorter stroke treatment time intervals. These results emphasize that, in atypical cases, even a lower suspicion of stroke should promote urgent workup for stroke diagnosis. Our findings do not indicate any influence of demographic or SES on in-hospital reperfusion delays.
Validation of a model for outcome prediction after endovascular treatment for ischemic stroke
Authors: Martins Pedro , Sambhu Krishna , Tarek Mohamed , Dolia Jaydevsinh , Pabaney Aqueel , Grossberg Jonathan , Nogueira Raul , Haussen Diogo 
Published: July 2024

Introduction The recently developed MR-PREDICTS@24 h model showed excellent performance in the MR-CLEAN Registry cohort in patients presenting within 12 h from onset. However, its applicability to an U.S. population and to patients presenting beyond 12 h from last known normal are still undetermined. We aim to externally validate the MR-PREDICTS@24 h model in a new geographic setting and in the late window. Methods In this retrospective analysis of a prospectively collected database from a comprehensive stroke center in the United States, we included patients with intracranial carotid artery or middle cerebral artery M1 or M2 segment occlusions who underwent endovascular therapy and applied the MR-PREDICTS@24 h formula to estimate the probabilities of functional outcome at day 90. The primary endpoint was the modified Rankin Scale (mRS) at 90 days. Results We included 1246 patients, 879 in the early (<12 h) and 367 in the late (≥12 h) cohort. For both cohorts, calibration and discrimination of the model were accurate throughout mRS levels, with absolute differences between estimated and predicted proportions ranging from 1% to 5%. Calibration metrics and curve inspections showed good performance for estimating the probabilities of mRS ≤ 1 to mRS ≤ 5 for the early cohort. For the late cohort, predictions were reliable for the probabilities of mRS ≤ 1 to mRS ≤ 4. Conclusion The MR-PREDICTS@24 h was transferrable to a real-world U.S.-based cohort in the early window and showed consistently accurate predictions for patients presenting in the late window without need for updating.
Danazol’s use for menstrual suppression in transgender individuals: A retrospective multi-site cohort study
Authors: Scatoni Ava , Roberts Zaine , Boskey Elizabeth R , Staffa Steven , Roden Rosemary Claire , Redwood Emile , Grimstad Frances 
Published: July 2024

Background: Danazol is a synthetic progestin with androgenic effects that is approved by the Food and Drug Administration for treatment of endometriosis, benign fibrocystic breast disease, and hereditary angioedema. In recent years, increasing numbers of transgender and nonbinary individuals seeking menstrual suppression have been offered danazol due to its potential to both induce amenorrhea and cause reversible androgenic side effects including pigmentation of vellus hairs and voice changes, which may be desirable in this population. There are currently no studies assessing use of danazol within the transgender population for menstrual suppression. Objective: This study’s primary aim was to evaluate the use of danazol as a menstrual suppression agent in transgender patients. Design: This was a retrospective multisite cohort study of all individuals who had been on danazol at two tertiary care centers between 2000 and 2022. Methods: All patients prescribed danazol were identified using a search of the electronic medical records. For demographic purposes, comparisons were made between those who did and did not use danazol for the purpose of menstrual suppression. A detailed chart review was then performed to analyze the experiences of menstrual suppression in transgender and nonbinary patients. Results: Most transgender and nonbinary patients on danazol for menstrual suppression remained on it at their most recent follow-up visit, and many charts noted improvements in gender dysphoria, pelvic pain, dysmenorrhea, endometriosis, and heavy menstrual bleeding. Most transgender patients achieved amenorrhea. Conclusion: Danazol may be a reasonable option for menstrual suppression in transgender and nonbinary patients. Our findings show its potential to not only induce amenorrhea but cause desired androgenic symptoms and improve gender dysphoria, pelvic pain, dysmenorrhea, endometriosis, and heavy bleeding. While the androgenic effects of danazol are less desirable in cisgender populations, it is an attractive option for menstrual suppression in transgender and nonbinary patients.
Prediction of obstetric outcomes in sickle cell patients based on tricuspid regurgitant velocity
Authors: Lacasse Audrey , Williams Vincent , Ganguli Pallavi , Grand’Maison Sophie , Wo Bilan , Cyr Veronique , Tardif Marie-Lou , Caron Nadia , Viau-Lapointe Julien , Naessens Veronique , Mahone Michele 
Published: July 2024

Background Transthoracic echocardiography, a validated tool for risk assessment in non-pregnant population with sickle cell disease (SCD), uses tricuspid regurgitant velocity (TRV) over 2.5 m/s is an independent mortality risk factor. Its applicability in obstetrics lacks sufficient evidence. Methods In this multicenter retrospective cohort study across five tertiary centers, we aimed to validate TRV as a determinant of increased maternal and fetal risk. Data was collected on 93 women and included 21 patients with TRV of at least 2.5 m/s. The maternal primary composite outcome included occurrence of vaso-occlusive crisis, acute chest syndrome, gestational hypertension, preeclampsia, and mortality. The fetal primary composite outcome comprised perinatal mortality, premature delivery, reduced birth weight, and fetal distress. Results Adverse maternal and fetal events arose in both groups with no statistical difference. Conclusion This study cannot support TRV of 2.5 m/s or more as an independent predictor of adverse obstetric outcomes among women with SCD.
Flavonoid Variability in Carica papaya L. var. Sekaki Leaf Maturation and Its Association With Sexual Differentiation Using Targeted Metabolomics
Authors: Misnan Norazlan Mohmad , Afzan Adlin , Omar Maizatul Hasyima , Low Kah Hin 
Published: July 2024

Background Carica papaya L. is a dioecious plant with leaves known for their medicinal and nutritional value due to their rich phytochemical content, including flavonoids. Phytochemical variability arising from plant maturity and sex differences may influence the bioactivity of the plant. Objectives This research aims to investigate the variations of flavonoids in C. papaya leaves across different maturation stages and the impact of sex differences on the accumulation of these compounds. Methods An ultra-high performance liquid chromatography–tandem mass spectrometry method was developed to quantify 6 flavonoids (manghaslin, clitorin, rutin, nicotiflorin, quercetin, and isorhamnetin) in the leaves simultaneously. The acquired data were further analyzed using chemometric tools. Results Significantly higher concentrations of flavonoids were observed in shoots and young leaves in comparison to older leaves. Furthermore, distinct variations in flavonoid composition between male and female plants were also observed, especially in young leaves, as evidenced by hierarchical clustering analysis. Further analysis of flavonoid content indicates that clitorin, nicotiflorin, and rutin could serve as chemical markers to differentiate maturation stages and sexes. Conclusion The study revealed significant variations in flavonoid concentrations during leaf development and between male and female plants, highlighting the importance of understanding these differences for unlocking the full potential of C. papaya leaves in medical and nutritional applications.
Integrated Network Pharmacology, Molecular Docking, and Experimental Validation to Explore Potential Mechanisms of Sinomenine in the Treatment of Osteoarthritis
Authors: Wang Shaojun , Lai Fanglin , Xiang Ting , Xu Yan 
Published: July 2024

Objective To systematically explore the targets and signaling pathways of sinomenine (SIN) in the treatment of osteoarthritis (OA) using integrated network pharmacology, molecular docking, and experimental validation. Methods The TCMSP, SwissADME, and Pharmmapper databases were used to predict SIN targets, while the databases of GeneCards, DisGeNET, OMIM, and DrugBank were selected to acquire OA targets. Subsequently, the intersection targets of SIN and OA disease were collected using the Veeny platform. Then, the protein-protein interaction (PPI) network map of “SIN-targets-OA” was established using String database and Cytoscape software. Additionally, the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed through the Database for Annotation, Visualization and Integrated Discovery (DAVID). Additionally, the potential proteins of SIN against OA were validated via molecular docking technique. Finally, the experimental validation was performed in SW1353 cells induced by interleukin (IL)-1β. Results A total of 315 potential targets of SIN and 4300 OA-associated targets were collected from public databases, and 42 intersecting potential targets of SIN and OA disease acquired. Then, the PPI network diagram of “SIN-targets-OA” was acquired that comprised a total of 43 nodes and 82 edges. Moreover, 173 GO and 21 KEGG pathway entries were screened with a P-value <.05. Among them, peroxisome proliferator-activated receptor (PPAR) and IL-17 are the core signaling pathways. Molecular docking technique indicated strong binding energies of SIN with PPAR (−6.1 kcal/mol) and IL-17 (−6.3 kcal/mol). Lastly, SIN at the concentration of 50 μmol/L has a significant effect on IL-1β-induced SW1353 cells by the inhibition of PPAR-γ and IL-17A proteins without cytotoxicity. Conclusion This work revealed the underlying targets and signaling pathways of SIN against OA using integrated network pharmacology molecular docking, and experimental validation. These findings provide scientific evidence for the clinical application of SIN for OA treatment.
Exploring (Un)Covered Potentials of Industrial Hemp (Cannabis sativa L.) Essential Oil and Hydrolate: From Chemical Characterization to Biological Activities
Authors: Šovljanski Olja , Aćimović Milica , Sikora Vladimir , Koren Anamarija , Saveljić Anja , Tomić Ana , Tešević Vele 
Published: July 2024

Objectives The present study focused on exploring the chemical composition of essential oil and corresponding hydrolate obtained by steam distillation of industrial hemp ( Cannabis sativa L.) cultivar “Helena” (low THC content). Methods Chemical characterization of industrial hemp essential oil and hydrolate was performed by gas chromatographic and gas chromatographic-mass spectrometric analysis, while biological activities included antimicrobial and antioxidant tests. Antimicrobial activity was determined by measuring diameters of the inhibition zone by using a disc-diffusion method with nine microbial strains from ATCC culture. Moreover, minimal inhibitory concentration (MIC) as well as time-kill kinetic studies, antiadhesion, and antibiofilm formation potential were also evaluated. Antioxidant activity was evaluated through three different antioxidant assays: 2,2-diphenyl-1-picrylhydrazyl (DPPH●), 2,2′-azinobis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS●+), and reducing power (RP). Results The gas chromatography mass spectrometry analysis showed that the main compound in the essential oil was trans-caryophyllene (37.4%), followed by caryophyllene oxide (12.4%) and α-humulene (11.0%), while in the hydrolate it was 1,8-cineole (11.5%). Results showed that industrial hemp essential oil and hydrolate exhibited no antimicrobial activity against gram-negative bacteria, yeasts, and fungi, while gram-positive bacteria were sensitive. Therefore, in the following step, MIC was determined by microdilution method. The lowest MIC for essential oil (12.5%) was obtained for Enterococcus faecalis and Staphylococcus aureus, while this value doubled for Listeria monocytogenes. Conversely, the MIC for hydrolate was 100% for all gram-positive bacteria. Antioxidant activity showed that industrial hemp essential oil and hydrolate have potential as natural sources of antioxidants. Conclusion This research confirmed the previously proven antimicrobial and antioxidant activities of industrial hemp essential oil. The novelty lies in the antimicrobial and antioxidant activity of hydrolate, which is practically waste, but has great potential to be a useful by-product.
Ionised hypercalcaemia in a cat with extrahepatic biliary tract obstruction secondary to a bile duct vegetal foreign body
Authors: Pichard Diane , Bernard Pauline , Fenet Marion , Garnier Paul , Schoffit Sarah , Manzoni Sarah , Benchekroun Ghita , Manassero Mathieu , Freiche Valérie 
Published: July 2024

Case summary A 10-year-old neutered female domestic shorthair cat was presented to our hospital with a 2-day history of anorexia, vomiting and lethargy. The biochemistry panel revealed increased hepatic enzyme activity and serum amyloid A concentration. Haematological values were within reference intervals. An abdominal ultrasound identified a hyperechoic spindle-shaped structure within the common bile duct and a suspected secondary subobstruction, associated with signs of intra- and extrahepatic biliary tract inflammation. During hospitalisation, the cat developed severe and sustained ionised hypercalcaemia. Exploratory surgery was elected as a result of the lack of clinical improvement, despite supportive treatment and suspected retrograde migration of the spindle-shaped structure. Two grass awns were extracted at the junction of an extrahepatic duct and the common bile duct via choledochotomy using intraoperative ultrasound guidance. A stent was then placed in the bile duct to prevent subsequent bile leakage. Histopathology of the liver revealed a moderate neutrophilic and lymphoplasmacytic inflammation with rare bacterial colonies. Escherichia coli was cultured from a bile sample. No specific cause of hypercalcaemia was identified. The cat recovered uneventfully from surgery. Hepatic enzyme activities and hypercalcaemia progressively decreased within a few weeks after surgery and remained within the reference intervals without treatment. Therefore, hypercalcaemia was suspected to be secondary to a foreign body-related granulomatous reaction. Relevance and novel information To our knowledge, only one other feline case report of biliary tract obstruction secondary to a biliary foreign body has been described in the literature. This is also the first case reporting the use of intraoperative ultrasound to localise a vegetal foreign body within the biliary tract of a cat. This case is also unique because of the onset of hypercalcaemia suspected to be secondary to a foreign body-related granulomatous reaction.
Experiences of rural clinicians accessing specialist support via telehealth for trauma and emergency care in Queensland, Australia
Authors: Santomauro Chiara , McLanders Mia , Rae Andrew 
Published: July 2024

Objective Trauma and emergency patients presenting to rural facilities require time-critical treatment and management that is sometimes beyond the scope of clinicians in the facility. In Queensland, Australia's second largest state, telehealth infrastructure facilitates 24/7 communication between rural clinicians and tertiary-based critical care specialists. We sought to understand the current state of Queensland's emergency telehealth system from the perspective of direct end-users to inform future improvement efforts and resource allocation. Methods Semi-structured interviews were conducted with 11 rural Queensland clinicians who use telehealth to access specialist support during critical presentations. Qualitative data were analysed in three inductive phases: immersion; a combination of process coding and in vivo coding; and focused coding. Results The findings highlight that emergency telehealth support provides benefits beyond better patient care, as it fosters collegiality and alleviates professional isolation. Three key themes were identified: (a) strategies for overcoming challenges in providing trauma and emergency care in rural Queensland; (b) factors that affect perceptions of telehealth effectiveness; and (c) how support for rural trauma and emergency care can be improved. To provide context for the themes, a summary of scene-setting data is also provided. Conclusions There are both advantages and disadvantages for rural clinicians accessing telehealth specialist support for critical care. Although telehealth is seen as a vital service that supports rural clinicians and benefits patient care, the findings suggest that tools, systems and processes surrounding rural trauma and emergency care could benefit from streamlining, integration, and the introduction of fit-for-purpose technologies. Addressing limitations of efficiencies would improve support for rural clinicians and likely improve patient outcomes for rural communities.