bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and antibiotic resistance in bacterial isolates of dogs with ulcerative keratitis in São Paulo State, Brazil
Authors: Casemiro Pamella A. F. , Andrade Alexandre L. , Cardozo Marita V. , Rodrigues Romário A. , Silva Jaqueline A. , Marinho Márcia , Nassar Alessandra F. C. , Castro Vanessa , Braz Guilherme H. R. , Gujanwski Cinthya A. , Padua Ivan R. M. , Moraes Paola C. 
Published: May 2024

AbstractObjectiveIdentify microorganisms present in canine eyes affected by ulcerative keratitis and assess its resistance profile to available antimicrobial drugs.MethodsSamples were collected from 88 canine eyes that exhibited ulcerative keratitis. They were identified using MALDI‐TOF and subjected to antimicrobial susceptibility testing by disk diffusion.ResultsAmong the assessed subjects, brachycephalic dogs accounted for 74.48% (50/83) of the evaluated canines. Among the 88 evaluated eyes, 90.9% (80/88) showed positive cultures, with 11.33% (10/88) of the samples isolating more than one species of bacteria. Of all bacterial isolates identified (90), Gram‐positive bacteria accounted for 63.33% (57/90), while Gram‐negative bacteria constituted 36.66% (33/90), with predominance of Staphylococcus spp. at 35.55% (32/90) being, Staphylococcus pseudintermedius at 68.75% (22/32), and Pseudomonas aeruginosa at 15.55% (14/90), respectively. Staphylococcus spp. exhibited resistance to penicillin (89.29%), sulfadiazine and trimethoprim (60.71%), and tetracycline (67.86%), while doxycycline (88.89%), cefotaxime (85.71%), chloramphenicol (82.14%), gentamicin, and moxifloxacin (78.57%) showed the highest sensitivity rates. Pseudomonas aeruginosa displayed sensitivity (100%) to gentamicin and imipenem, and resistance (8.33%) to norfloxacin, ciprofloxacin, and cefepime. Similarly, the Enterobacteriaceae family showed higher sensitivity to amikacin and gentamicin (88.89%), imipenem (88.24%), and levofloxacin (87.5%), with pronounced resistance to amoxicillin‐clavulanate (50%) and cefazolin (47.06%). This highlights multiresistance in 23.33% (21/90) of the isolates.ConclusionsThe most isolated species in canine ulcerative keratitis are S. pseudintermedius and P. aeruginosa. However, other species were also isolated, demonstrating diversity in ocular microbiota infection. There is a high‐rate multidrug resistance associated with canine ulcerative keratitis. Nevertheless, these strains exhibited sensitivity to antimicrobials commonly used in veterinary ophthalmology.
Elasto-Plastic Constitutive Behavior Prediction and Uncertainty Quantification of Damaged Composite Structure Under High-Strain Rate Loading
Authors: Kumar Vikash , Panda Subrata Kumar 
Published: May 2024

Abstract
The current research assesses the consequences of various damages (crack and delamination) and high strain loading conditions on the fiber-reinforced composite structure's elasto-plastic stress–strain (EPSS) characteristics. The constitutive responses are obtained numerically (finite element discretization) using higher-order polynomials with the help of the matlab platform. The EPSS responses are evaluated via the modified Ludwik equation and Cowper Symonds model under high strain rate loadings. The model accuracy has been tested by comparing the present numerical and the published experimental data available in the open domain. Furthermore, various numerical examples present the effect of damages (debond and/or crack), forces, and stress–strain characteristics for a wide range of strain rates (ranging from 0.001 s−1 to 50 s−1). The stochastic constitutive model is obtained to show the importance of modeling and the corresponding analysis parameters, including uncertainty quantification. Finally, a detailed understanding of the damages and geometries on the polymeric composite structure are enumerated via the delve model for the futuristic design.
Palliative care inpatients in Switzerland (2012–2021): characteristics, in-hospital mortality and avoidable admissions
Authors: Hurni Benjamin , Müller Beat , Hug Balthasar L , Beeler Patrick E 
Published: May 2024

ObjectivesPalliative patients generally prefer to be cared for and die at home. Overly aggressive treatments place additional strain on already burdened patients and healthcare services, contributing to decreased quality of life and increased healthcare costs. This study characterises palliative inpatients, quantifies in-hospital mortality and potentially avoidable hospitalisations.MethodsWe conducted a multicentre retrospective analysis using the national inpatient cohort. The extracted data encompassed all inpatients for palliative care spanning the years 2012–2021. The dataset comprised information on demographics, diagnoses, comorbidities, treatments and clinical outcomes. Content experts reviewed a list of treatments for which no hospitalisation was required.Results120 396 hospitalisation records indicated palliative patients. Almost half were women (n=59 297, 49%). Most patients were ≥65 years old. 66% had an oncologic primary diagnosis. The majority were admitted from home (82 443; 69%). The patients stayed a median of 12 days (6–20). All treatments for 25 188 patients (21%) could have been performed at home. In-hospital deaths ended 64 739 stays (54%); of note, 10% (n=6357/64 739) of in-hospital deaths occurred within 24 hours.ConclusionsIn this nationwide study of palliative inpatients, two-thirds were 65 years old and older. Regarding the performed treatments alone, a fifth of these hospitalisations can be considered as avoidable. More than half of the patients died during their hospital stay, and 1 in 10 of those within 24 hours.
Youth Employability Training Model from the Perspective of Education Poverty Reduction in Kenya and Its Enlightenment to China
Authors: Qi Jia , Liu Xiao , Wu Zhong Bo , Li Yang 
Published: May 2024

Abstract
Since the 21st century, the solution of poverty has become the focus of international assistance. And education is considered as one of the important ways to reduce poverty, more and more attention by international organizations and developing countries. Kenya, as one of the countries with the backwardness but most promising economic and social development in East Africa. It has received the attention of the World Bank. With the assistance of the World Bank, the Government of Kenya launched the KYEP project on the basis of Vision 2030, which is based on the training concept of “Education poverty reduction for youth entrepreneurship and employment”, with the goal of “Empowering young people in employment”, implementing a demand-oriented “four-in-one” skills training course through cooperative training of the World Bank and the Government of Kenya and the private sector, and ensuring the effectiveness of the project through the establishment of a multi-entity cooperative training guarantee mechanism. Practice shows that KYEP highlights Kenya’s demand-oriented approach and has achieved remarkable results in addressing youth unemployment and education for poverty reduction.
Diplomatic Essentials and Negotiating in Diplomacy
Authors: Faizullaev Alisher 
Published: May 2024

Abstract
Negotiation is the core of diplomacy, and the various elements and aspects of diplomatic practice closely relate to the organization and conduct of negotiations. This article discusses the impact of diplomatic essentials – diplomacy’s basic features stemming from its idea, spirit, culture, traditions, and methods – on negotiating in diplomatic settings. Diplomats need to use these essentials to negotiate effectively. Therefore, in diplomacy, to be a good negotiator, one needs to be a good diplomat. By analyzing the negotiation implications of diplomatic representation, aspiration, groundwork, timing, intercourse, code of conduct, and language, I argue that the essential features of international diplomacy can be seen as important assets of the strategic management of diplomatic negotiation. In other words, diplomatic actors can have a significant impact on negotiation effectiveness by using and managing these seven diplomatic essentials.
A pilot study of performance enhancement coaching for newly appointed urology registrars
Authors: Cooper Lilli , Wadhwa Karan , Rochester Mark , Biyani Chandra Shekhar , Doherty Ruth 
Published: May 2024

Objectives To assess the feasibility of performance enhancement coaching (PEC) for newly appointed Urology registrars (ST3s), specifically: whether the concept appealed, and which areas beyond technical skills acquisition were felt to be most relevant or useful. Subjects and methods All delegates on the Urology Bootcamp 2023 were invited to take part in an online survey before and after a 2-hour PEC workshop, collecting: basic demographic data, performance challenges, and the important aspects to include in, and consider with, a coaching programme. The workshop was delivered by a surgeon with a professional coaching qualification, to groups of four delegates at a time over 4 days. Ten pre-defined areas were offered during the session. Results On a scale of 1 (poor) to 10 (excellent), the 62 participants’ overall health was reported as a median of 8/10 (physical) and 7/10 (mental). Anxiety during performance was the most common concern (63%) and was accompanied by a tremor in 55%. The next most popular concerns, with 19% of responses each, were: sleep, insufficient operative skill or expertise, and worry about relationships with trainers. The commonest topics discussed were ‘the inner critic’ (100%), ‘autonomic modulation’ (69%), ‘not working, well’ (13%) and ‘optimising study’ (6%). Seventy-seven per cent were unaware of PEC for practising surgeons. All respondents felt that they would benefit from PEC to some extent (80% ≥8/10 where 10/10 was ‘very useful’), ideally at the ST3 level. Sixty-two percent of respondents said there should be a fee for trainees, whereas 38% thought it should be free and paid for by their training authorities. Conclusion The concept of PEC is acceptable to ST3 Urology trainees, with particular interest in techniques to mitigate negative self-talk and autonomic modulation techniques. Existing barriers to coaching for the surgical community would need to be addressed in designing an acceptable coaching programme.
Distinguishing between aldosterone-producing adenomas and non-functional adrenocortical adenomas using the YOLOv5 network
Authors: Piao Zeyu , Meng Mingzhu , Yang Huijie , Xue Tongqing , Jia Zhongzhi , Liu Wei 
Published: May 2024

Background You Only Look Once version 5 (YOLOv5), a one-stage deep-learning (DL) algorithm for object detection and classification, offers high speed and accuracy for identifying targets. Purpose To investigate the feasibility of using the YOLOv5 algorithm to non-invasively distinguish between aldosterone-producing adenomas (APAs) and non-functional adrenocortical adenomas (NF-ACAs) on computed tomography (CT) images. Material and Methods A total of 235 patients who were diagnosed with ACAs between January 2011 and July 2022 were included in this study. Of the 215 patients, 81 (37.7%) had APAs and 134 (62.3%) had NF-ACAs’ they were randomly divided into either the training set or the validation set at a ratio of 9:1. Another 20 patients, including 8 (40.0%) with APA and 12 (60.0%) with NF-ACA, were collected for the testing set. Five submodels (YOLOv5n, YOLOv5s, YOLOv5m, YOLOv5l, and YOLOv5x) of YOLOv5 were trained and evaluated on the datasets. Results In the testing set, the mAP_0.5 value for YOLOv5x (0.988) was higher than the values for YOLOv5n (0.969), YOLOv5s (0.965), YOLOv5m (0.974), and YOLOv5l (0.983). The mAP_0.5:0.95 value for YOLOv5x (0.711) was also higher than the values for YOLOv5n (0.587), YOLOv5s (0.674), YOLOv5m (0.671), and YOLOv5l (0.698) in the testing set. The inference speed of YOLOv5n was 2.4 ms in the testing set, which was the fastest among the five submodels. Conclusion The YOLOv5 algorithm can accurately and efficiently distinguish between APAs and NF-ACAs on CT images, especially YOLOv5x has the best identification performance.
Bone marrow lesions in knee osteoarthritis assessed by dynamic contrast-enhanced MRI with histopathological correlations
Authors: Nielsen Flemming Kromann , Sørensen Flemming Brandt , Egund Niels , Boel Lene Warner , Holm Carsten , Jurik Anne Grethe 
Published: May 2024

Background Bone marrow lesions (BMLs) in knee osteoarthritis (OA) have been assessed histopathologically and by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); however, a direct comparison of the results has not been reported. Purpose To evaluate and compare the findings by DCE-MRI and histopathology of subchondral BMLs in knee OA. Material and Methods In total, 19 patients with medial tibiofemoral knee OA undergoing total knee arthroplasty were analyzed. Preoperative MRI, including a DCE sequence, was performed, and bone biopsies were obtained from the resected specimens corresponding to BML areas. The contrast enhancement by DCE-MRI was analyzed using semi-quantitative (area under the curve [AUC]), peak enhancement [PE]), and quantitative (Ktrans, Kep) methods. Enhancement in the medial OA compartment was compared with similar areas in a normal lateral compartment, and the DCE characteristics of BMLs were correlated with semi-quantitatively graded histopathological features. Results AUC and PE were significantly higher in medial tibial and femoral BMLs compared with the values in the lateral condyles; Ktrans and Kep were only significantly higher in the tibial plateau. In the tibia, AUC and PE were significantly correlated with the grade of vascular proliferation, and PE also with the degree of marrow fibrosis. There was no significant correlation between AUC/PE and histopathological findings in the femur and no correlation between quantitative DCE parameters and histopathological findings. Conclusion BML characteristics by semi-quantitative DCE in the form of AUC and PE may be used as parameters for the degree of histopathological vascularization in the bone marrow whereas quantitative DCE data were less conclusive.
Pembrolizumab-induced type 1 diabetes
Authors: Maia Ariana , Soares Daniela M. , Azevedo Sofia , Pereira Teresa , Amaral Cláudia 
Published: May 2024

Introduction Immunotherapy has a crucial role in the current treatment of multiple malignancies. Albeit described as rare, new onset autoimmune diabetes is a potentially life-threatening complication of programmed cell death-1 (PD-1) inhibitors, such as pembrolizumab, and its predisposing factors and pathological mechanism are yet to be clarified. Case Report We present a case of a 72-year-old man with a high-grade bladder carcinoma undergoing pembrolizumab treatment. He had no personal or family history of diabetes mellitus but was diagnosed with primary hypothyroidism four months after starting pembrolizumab. Two years after starting pembrolizumab, he presented in the emergency department due to abdominal pain, anorexia, polydipsia, polyuria and vomiting over the preceding five days and he met criteria for severe diabetic ketoacidosis (DKA). Three days prior to his admission, he had received prednisolone therapy for suspected hypersensitivity related to a contrast-enhanced imaging that he performed. Management & Outcome Prompt treatment for DKA was started, with transition to insulin basal-bolus therapy after DKA resolution, with progressive glycaemic stabilization. Further investigation revealed low C-peptide levels (0.07 ng/dL, with a fasting blood glucose of 288 mg/dL), HbA1c 9.2% and positive anti-IA2 antibodies, which allowed the diagnosis of new-onset autoimmune diabetes. Pembrolizumab was transiently suspended, and the patient resumed treatment after glycaemic profile optimization under multiple daily insulin administrations two months later. Discussion This case highlights the importance of clinical suspicion and glycaemic monitoring as an integral part of treatment protocols in patients on pembrolizumab and other immune checkpoint inhibitors. Additional research and investigation into the underlying mechanisms of this condition are necessary to identify potential screening tests for individuals at higher risk of developing DM and to guide the implementation of management and preventive strategies for ketoacidosis complication.
Psychological Impact and Posttraumatic Stress Disorder Symptomatology After Ulnar Collateral Ligament Injuries in Baseball Players
Authors: Alexander Frank J. , Mastroianni Michael A. , Anderson Matthew J.J. , Skaggs Kira , Swindell Hasani W. , Reynolds Alan W. , Ahmad Christopher S. 
Published: May 2024

Background: Significant psychological impact and prevalence of posttraumatic stress disorder (PTSD) have been well documented in patients sustaining anterior cruciate ligament injury. Purpose: To examine PTSD symptomatology in baseball players after sustaining elbow ulnar collateral ligament (UCL) injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male baseball players of various competition levels (high school through Minor League Baseball [MiLB]) who underwent surgery for a UCL injury between April 2019 and June 2022 participated in the study. Before surgery, patients completed the Impact of Event Scale–Revised (IES-R) to assess PTSD symptomatology. Subgroup analysis was conducted according to level of play and player position. Results: A total of 104 male baseball players with a mean age of 19.4 years (range, 15-29 years) were included in the study; 32 players (30.8%) were in high school, 65 (62.5%) were in college, and 7 (6.7%) were in MiLB. There were 64 (61.5%) pitchers, 18 (17.3%) position players, and 22 (21.2%) 2-way players (both pitching and playing on the field). A total of 30 (28.8%) patients scored high enough on the IES-R to support PTSD as a probable diagnosis, and another 22 patients (21.2%) scored high enough to support PTSD as a clinical concern. Nineteen patients (18.3%) had potentially severe PTSD. Only 4 players (3.8%) were completely asymptomatic. Subgroup analysis revealed college players as significantly more symptomatic than high school players ( P = .02), and 2-way players were found to be significantly less susceptible to developing symptoms of PTSD compared with pitchers ( P = .04). Conclusion: Nearly 30% of baseball players who sustained a UCL injury qualified for a probable diagnosis of PTSD based on the IES-R. Pitchers and college athletes were at increased risk for PTSD after UCL injury compared with 2-way players and high school athletes, respectively.
Tooth Discoloration from 2 Silver Fluorides Used in Adults with Special Needs: A Randomized Trial
Authors: See L. , Zafar S. , Fu D. , Ha D.H. , Walsh L.J. , Lopez Silva C. 
Published: May 2024

Background: Discoloration of carious lesions after application of silver diamine fluoride lowers patient acceptance and limits its wider use for caries arrest. Objective: To assess lesion and tooth color changes from 2 novel silver fluoride (AgF) products and its relationship to caries activity (clinical visuo-tactile scores) and bacterial load (using laser fluorescence with the DIAGNOdent). Methods: A split-mouth design was followed, with matched smooth surface carious lesions in the same arch in adults with special needs randomized for 1-min treatments with AgF/potassium iodide (KI) (Riva Star Aqua, SDI) and AgF/stannous fluoride (SnF2) (Caries Status Disclosing Solution; Whiteley). Standardized images taken at baseline, immediately postoperatively, and at 3-mo review were subjected to digital image analysis to calculate delta-E and to track changes in luminosity of carious lesions. Results: Twelve participants were recruited in the study. A total of 56 teeth (28 pairs) were included. Significantly greater changes were seen in treated lesions than in the adjacent noncarious natural tooth structure, both immediately after treatment and at the 3-mo review ( P < 0.0001). Color change and caries activity were not affected by tooth type, tooth location, plaque status, salivary status, or special needs condition. AgF/SnF2 caused transitory darkening immediately on application, while AgF/KI caused the immediate formation of yellow deposits (silver iodide). Both products caused significant darkening of treated lesions at 3 mo ( P = 0.0009; P = 0.0361), with no differences between them ( P = 0.506). Responding lesions showed larger and more perceptible color changes immediately after either AgF application ( P = 0.002; P = 0.024). Conclusions: Both AgF products were highly effective for caries arrest in this patient population. Despite minor differences in the appearance of treated lesions at the time of application, both products lead to similar darkening of treated sites at 3 mo. Knowledge Transfer Statement: This study shows the usefulness of silver fluoride used in conjunction with potassium iodide or stannous fluoride for achieving caries arrest in smooth surface lesions in adults with special needs. Patients need to be informed that long-term staining of the lesion occurs with both, similar to silver diamine fluoride.
Becoming a thrombectomy-capable stroke center: Clinical and medico-economical effectiveness at the hospital level
Authors: Checkouri Thomas , Sablot Denis , Varnier Quentin , Fryder Ivan , Collemiche Francois-Louis , Azais Benoit , Dargazanli Cyril , Leibinger Franck , Cagnazzo Federico , Mahmoudi Mehdi , Lefevre Pierre-Henri , Van Damme Laurene , Gascou Gregory , Schmidt Julia , Arquizan Caroline , Plantard Carole , Farouil Geoffroy , Costalat Vincent 
Published: May 2024

Introduction: Too few patients benefit from endovascular therapy (EVT) in large vessel occlusion acute stroke (LVOS), and various acute stroke care paradigms are currently investigated to reduce these inequalities in health access. We aimed to investigate whether newly set-up thrombectomy-capable stroke centers (TSC) offered a safe, effective and cost-effective procedure. Patients and methods: This French retrospective study compared the outcomes of LVOS patients with an indication for EVT and treated at the Perpignan hospital before on-site thrombectomy was available (Primary stroke center), and after formation of local radiology team for neurointervention (TSC). Primary endpoints were 3-months functional outcomes, assessed by the modified Rankin scale. Various safety endpoints for ischemic and hemorragic procedural complications were assessed. We conducted a medico-economic analysis to estimate the cost-benefit of becoming a TSC for the hospital. Results: The differences between 422 patients in the PSC and 266 in the TSC were adjusted by the means of weighted logistic regression. Patients treated in the TSC had higher odds of excellent functional outcome (aOR 1.77 [1.16–2.72], p = 0.008), with no significant differences in the rates of procedural complications. The TSC setting shortened onset-to-reperfusion times by 144 min (95% CI [131–155]; p < 0.0001), and was cost-effective after 21 treated LVOS patients. On-site thrombectomy saves 10.825€ per patient for the hospital. Discussion: Our results demonstrate that the TSC setting improves functional outcomes and reduces intra-hospital costs in LVOS patients. TSCs could play a major public health role in acute stroke care and access to EVT.