bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different microbial ecological agents change the composition of intestinal microbiota and the levels of SCFAs in mice to alleviate loperamide-induced constipation
Authors: Zhang C. , Wang L. , Liu X. , Wang G. , Guo X. , Liu X. , Zhao J. , Chen W. 
Published: April 2024

Abstract
Probiotics exert beneficial effects by regulating the intestinal microbiota, metabolism, immune function and other ways of their host. Patients with constipation, a common gastrointestinal disorder, experience disturbances in their intestinal microbiota. In the present study, we investigated the effectiveness of two microbial ecological agents (postbiotic extract PE0401 and a combination of postbiotic extract PE0401 and Lacticaseibacillus paracasei CCFM 2711) in regulating the makeup of the intestinal microbiota and alleviating loperamide hydrochloride-induced constipation in mice. We also preliminarily explored the mechanism underlying their effects. Both microbial ecological agents increased the abundance of the beneficial bacteria Lactobacilli and Bifidobacterium after administration and were able to relieve constipation. However, the degree of improvement in constipation symptoms varied depending on the makeup of the supplement. The postbiotic extract PE0401 increased peristalsis time and improved faecal properties throughout the intestinal tract of the host. PE0401 relieved constipation, possibly by modulating the levels of the constipation-related gastrointestinal regulatory transmitters mouse motilin, mouse vasoactive intestinal peptide, and 5-hydoxytryptamine in the intestinal tract of the host and by increasing the levels of the short-chain fatty acids (SCFAs) acetic acid, propionic acid, and isovaleric acid. It also increased the relative abundance of Lactobacillus and Bifidobacterium and reduced that of Faecalibaculum, Mucispirillum, Staphylococcus, and Lachnoclostridium, which are among the beneficial microbiota in the host intestine. Furthermore, PE0401 decreased the levels of constipation-induced host inflammatory factors. Therefore, the two microbial ecological agents can regulate the intestinal microbiota of constipation mice, and PE0401 has a stronger ability to relieve constipation.
“Emergency Room Incision and Drainage of Perirectal Abscess is Equivalent to Incision and Drainage in the Operating Room”
Authors: Maniskas Seija A. , Jebbia Mallory I. , Nasir Dena , Akopian Gabriel , Kaufman Howard S. , Golan Juliane Y. 
Published: April 2024

Background Current guidelines for management of anorectal abscesses make no recommendations for operative vs bedside incision and drainage (I&D). The purpose of this study was to determine if management in the operating room is necessary to adequately drain anorectal abscesses and prevent short-term complications for patients presenting to the emergency department (ED). Methods Patients with perirectal abscesses were identified and divided into two groups based on intervention type: “bedside” or “operative.” Demographic, laboratory, and encounter data were obtained from the medical record. Study outcomes included 30-day complications (return to the ED, reintervention, and readmission). Data were analyzed with univariate and multivariate analyses using SPSS (version 28). Results A total of 113 patients with anorectal abscesses were identified. Sixty-six (58%) underwent bedside I&D and 47 (42%) operative I&D. The overall complication rate was 10%. A total of 9 patients (6 bedside and 3 operative) returned to the ED. Six of these patients required reintervention (5 bedside and 1 operative), and 1 was readmitted. Two patients from the bedside group required a second I&D during their index admission. Pre-procedure SIRS ( P = .02) was found to be associated with 30-day complications. Provider specialty and training level were not associated with 30-day complications. Discussion In this study, for patients presenting to the ED, bedside drainage was found to be an adequate management strategy to achieve complete drainage without a significant increase in the rate of complications when compared to operative drainage.
A Standardized Post-gastrostomy Feeding Protocol for Pediatric Patients Reduces Time to Postoperative Goal Feeding Volume
Authors: O’Guinn MaKayla L. , Keane Olivia A. , Lee William G. , Gayer Christopher P. , Zobel Michael J. 
Published: April 2024

Background Gastrostomy creation is a common pediatric surgical procedure, but the time to initiation of feeds and to goal feeding volumes postoperatively varies greatly. Delays in reaching goal feeding volumes promote malnutrition and may prolong hospital length of stay. We hypothesized that implementing an accelerated, standardized post-gastrostomy feeding protocol would allow patients to reach goal feeding volumes sooner, without increasing postoperative complications. Methods We conducted a retrospective cohort study of children who underwent gastrostomy tube placement between 1/1/2022 and 11/30/2023. The feeding protocol was implemented on 11/16/2022, with patients separated into pre- and post-protocol cohorts. Abstracted data included comorbidities, time to initiation of enteral feeds, time to goal feeding volume, and postoperative complications. Results 322 patients were included: 166 pre-protocol and 156 post-protocol. The post-protocol cohort had a greater proportion of patients with gastrointestinal and/or cardiac comorbidities ( P < .001). Through the protocol, postoperative enteral feeds were initiated significantly faster (5.4 hrs [IQR 43-7.7] vs 7.0 hrs [IQR 5.6-14.3]; P < .001). The post-protocol cohort also achieved goal feeding volumes sooner (12.8 hrs [IQR 9.1-25.3] vs 26.3 hrs [IQR 21.6-38.9]; P < .001). Postoperative complication rates did not differ between cohorts. Sub-analysis of children with complex cardiac conditions also demonstrated faster time to goal nutrition without an associated increase in postoperative events. Discussion These findings demonstrate that our accelerated post-gastrostomy feeding protocol was effective in achieving goal enteral nutrition earlier without increasing postoperative adverse outcomes. This protocol may be used by other centers to safely expedite time to goal enteral feeds in children postoperatively.
Impact of Cardiac Pacemaker Implantation in Patients With Acute Traumatic Cervical Spinal Cord Injury
Authors: Kim Maru , Firek Matthew , Coimbra Bruno Cammarota , Allison-Aipa Timothy , Zakhary Bishoy , Coimbra Raul 
Published: April 2024

Background Cardiac pacemaker implantation may be indicated in patients with refractory bradycardia following a cervical spinal cord injury (CSCI). However, evidence about the impact of this procedure on outcomes is lacking. We planned a study to assess whether the implantation of a pacemaker would decrease mortality and hospital resource utilization in patients with CSCI. Methods Adult patients with CSCI in the Trauma Quality Improvement Program (TQIP) database between 2016 and 2019 were retrospectively analyzed. Patients were divided into “pacemaker” and “non-pacemaker” groups, and their baseline characteristics and clinical outcomes were analyzed. Results A total of 6774 cases were analyzed. The pacemaker group showed higher in-hospital rates of cardiac arrest, myocardial infarction, and longer duration of mechanical ventilation and ICU stay than the non-pacemaker group. Nevertheless, pacemaker placement was associated with a significant decrease in mortality (4.2% vs 26.0%, P < .01). Conclusions Patients with CSCI requiring a pacemaker placement had better survival than those treated without a pacemaker. Pacemaker implantation should be highly considered in patients who develop refractory bradycardia after CSCI.
Effect of microcrystalline cellulose on mechanical properties of flax-jute-epoxy hybrid composite materials using vacuum bagging
Authors: Ganesan Dharmalingam , Murali Arun Prasad , Salunkhe Sachin , Tarigonda Hariprasad , Naranje Vishal 
Published: April 2024

Nowadays, synthetic fibres are replaced with hybrid composite fibres which consist of low energy production, biodegradability, resource renewability, less hazardous and easy handling of manufactured composites. The present work focuses on the effect of microcrystalline cellulose (MCC) particles by varying the percentage concentration (0 wt %, 2 wt % and 4 wt %) in the flax-jute-epoxy composite materials. The MCC particle is mixed with epoxy resin as matrix material and flax-jute fibres as reinforcements in the composite panels fabricated using the vacuum bagging method. The tensile, flexural, impact, hardness and thermogravimetric tests were performed on the fabricated composite panels per the ASTM standard. The experimental results show that with the addition of 2 wt % MCC particle, sample 2 has higher tensile strength, flexural strength and impact strength than sample 1 (0 wt % MCC) and sample 3 (4 wt % MCC). It can be noted that due to the addition of MCC particles, overall mechanical properties improved as a result of good interfacial bonding between matrix and fibres which are evident through SEM analysis. Similarly, thermal stability of the composites also improved in the flax-jute hybrid fibre composites particularly in 2 wt % MCC.
Aqueous Extract of Terminalia bellirica Fruits Improves Insulin Sensitivity, Controls Hyperglycaemia and Improves SIRT1 Expression in High-fat Diet and Streptozotocin-induced Type 2 Diabetes in Rats
Authors: Agrawal Ojaskumar D. , Kulkarni Yogesh A. 
Published: April 2024

Background Plants from the genus “Terminalia” are well known for their various pharmacological and medicinal properties. Terminalia bellirica is considered a vital medicinal plant from the genus Terminalia. It has been reported for its astringent, antipyretic, and purgative effects. It is also used to treat dyspepsia, tropical pulmonary eosinophilia, allergic eruptions, bronchitis, upper respiratory tract infections, and leprosy. The present research study aimed to investigate the antidiabetic activity of T. bellirica in an experimental model of type 2 diabetes in experimental rats. Materials and Methods In rats, type 2 diabetes was induced by the alteration in the diet by administration of a high-fat diet for 15 days, followed by the administration of streptozotocin (35 mg/kg, i.p.). The experimental animals were given 500 and 1,000 mg/kg of T. bellirica aqueous fruit extract for six weeks. Liver enzymes and lipid parameters, homeostatic model assessment–insulin resistance, insulin sensitivity index, glycohemoglobin, and oral glucose tolerance tests were performed at the end of the study. Histopathology and immunohistochemical analysis for the SIRT1 expression of pancreatic tissue were also performed. Results The selected doses of the aqueous extract of T. bellirica (500 and 1,000 mg/kg) significantly reduced blood glucose ( p < 0.05). The 1,000 mg/kg dose of T. bellirica notably decreased glucose tolerance ( p < 0.001) in experimental animals. A high dose of T. bellirica significantly reduced resistance ( p < 0.001). The lipid profile was improved significantly ( p < 0.01) at both the selected dose levels. Glycohemoglobin concentration was significantly reduced in experimental animals ( p < 0.001) at both dose levels. The extract treatment increased the expression of SIRT1 in the pancreas. Conclusion The results of the present study indicate that the extract has significant effects on the management of type 2 diabetes.
Rapidly expanding gender-affirming care based on consensus instead of evidence justifies rigorous governance and transparency
Authors: Amos Andrew James 
Published: April 2024

Objective Public services offering gender-affirming care to minors have rapidly expanded across Australia. Despite limited evidence of safety and efficacy, no public information about these services is routinely available. Data from freedom of information requests sent to Australian public gender services for minors is summarised. Gender service numbers increased rapidly in Queensland (2017:190 – 2022:922) and in Victoria (2019:472 – 2023:1290). Limited transparency prevented strong confidence in the number of patients receiving hormone therapy. Staff FTE employed by gender services jumped after 2020 in NSW (to 16.7 across two sites in 2023), Queensland (to 11.4 in 2023), Victoria (to 9.4 in 2022), and WA (to 10.2 in 2023). Conclusions Despite low confidence in their safety and efficacy, the number of patients seen by public gender services has expanded rapidly since 2018. Limited transparency makes it difficult to judge the number of patients seen, treatments provided, and outcomes achieved. Safe, effective care of this vulnerable group requires clear treatment goals, and annual reporting.
Alpha-chloralose poisoning in 25 cats: clinical picture and evaluation of treatment with intravenous lipid emulsion
Authors: Lundgren Sandra , Dreimanis Kristoffer , Engdahl Karolina , Windahl Ulrika , Tegner Cecilia 
Published: April 2024

Objectives The aims of this study were to describe the clinical picture and progression in cats with alpha-chloralose (AC) intoxication and to determine if treatment with intravenous (IV) lipid emulsion (ILE) influenced either the serum concentration of AC or the clinical signs. Methods Cats with suspected AC poisoning admitted to a university small animal hospital were included. The cats were randomised into two groups: one receiving 20% ILE at a dose of 300 mg/kg as a 2 min bolus, followed by a 1500 mg/kg continuous rate infusion over 30 mins (IL+ group) and the other receiving IV fluid therapy with Ringer’s acetate (IL− group). Serum samples were drawn at 0, 2, 12 and 24 h after admission. Samples were tested for AC with a novel validated, quantitative, ultra-high-performance liquid chromatography-tandem mass spectrometry method. Vital and predefined clinical signs were noted at the times of sampling and patients were scored using a previously described intoxication severity score. Telephone interviews were conducted after discharge to assess outcome. Results A total of 25 cats were enrolled: 13 cats in the IL+ group and 12 in the IL− group. The most common clinical signs at presentation were tremor (n = 22, 88.0%), cranial nerve deficits (n = 20, 80.0%) and bradycardia (n = 19, 76.0%). No significant difference in AC concentration or change in intoxication score over time was found between the IL+ and IL− groups at any time point ( P >0.05). All cats recovered within 72 h. Conclusions and relevance ILE did not have any effect on the AC serum concentration or clinical signs in AC-poisoned cats. All cats survived until follow-up. In cats with an acute onset of the described neurological signs, AC intoxication is an important differential diagnosis with an excellent prognosis.
Functional and Esthetic Outcomes of Either Surgically or Conservatively Treated Anterior Frontal Sinus Wall Fractures: A Long-Term Follow-Up
Authors: Solmell Oscar , Sunnergren Ola , Qureshi Abdul Rashid , Alinasab Babak 
Published: April 2024

Study Design Retrospective cohort study. Objective Frontal sinus fractures (FSFs) can lead to a range of clinical challenges, including facial deformity, impaired facial sensation, cerebrospinal fluid (CSF) leakage, sinus drainage impairment, chronic sinus pain and mucocele formation. The optimal management approach, whether surgical or conservative, remains a topic of ongoing discussion. The aim of this study was to evaluate and compare the functional and esthetic outcomes of patients with surgically and conservatively treated FSFs. Methods In this retrospective study, patients treated for FSFs at the Karolinska university hospital 2004 to 2020 were identified in hospital records and invited to participate in a long-term follow-up. Sequelae and satisfaction with the esthetic result were assessed trough questionnaires and physical examinations. Results A total of 93 patients were included in the study, with 49 presenting isolated anterior wall fractures and 44 presenting combined anterior and posterior wall fractures. Surgical intervention was performed in 45 cases, while 48 were managed conservatively. Among patients with moderate anterior wall fractures (4-6 mm dislocation), 80% of surgically treated patients compared to 100% of conservatively treated patients expressed satisfaction with their cosmetic outcomes at follow-up ( P = .03). In conservatively treated patients with a forehead impression, the anterior wall fracture dislocation ranged from 5.3 to 6.0 mm ( P < .0001). Approximately 50% of surgically treated patients vs 15% of conservatively treated patients developed impaired forehead sensation at follow-up ( P = .03). Thirty-six percent of surgically treated patients reported dissatisfaction with surgery-related scarring, particularly those who underwent surgery via laceration or bicoronal incision. Conclusions This study suggests that anterior FSFs with a dislocation of 5 mm or less can be effectively managed conservatively with high patient satisfaction, low risk of long-term forehead sensation impairment and without potential development of forehead impression. Bicoronal incision or incision via a laceration may be associated with esthetic dissatisfaction and late sequelae such as alopecia.
Structured medication reviews in Parkinson’s disease: pharmacists’ views, experiences and needs – a qualitative study
Authors: Oonk Nicol G. M. , Dorresteijn Lucille D. A. , te Braake Eline , Movig Kris L. L. , van der Palen Job , Nijmeijer Henk-Willem , van Kesteren Mirjam E. , Bode Christina 
Published: April 2024

Background: Executing structured medication reviews (SMRs) in primary care to optimize drug treatment is considered standard care of community pharmacists in the Netherlands. Patients with Parkinson’s disease (PD) often face complex drug regimens for their symptomatic treatment and might, therefore, benefit from an SMR. However, previously, no effect of an SMR on quality of life in PD was found. In trying to improve the case management of PD, it is interesting to understand if and to what extent SMRs in PD patients are of added value in the pharmacist’s opinion and what are assumed facilitating and hindering factors. Objectives: To analyse the process of executing SMRs in PD patients from a community pharmacist’s point of view. Design: A cross-sectional, qualitative study was performed, consisting of face-to-face semi-structured in-depth interviews. Methods: The interviews were conducted with community pharmacists who executed at least one SMR in PD, till data saturation was reached. Interviews were transcribed verbatim, coded and analysed thematically using an iterative approach. Results: Thirteen pharmacists were interviewed. SMRs in PD were considered of added value, especially regarding patient contact and bonding, individualized care and its possible effect in the future, although PD treatment is found already well monitored in secondary care. Major constraints were time, logistics and collaboration with medical specialists. Conclusion: Although community pharmacist-led SMRs are time-consuming and sometimes logistically challenging, they are of added value in primary care in general, and also in PD, of which treatment occurs mainly in secondary care. It emphasizes the pharmacist’s role in PD treatment and might tackle future drug-related issues. Improvements concern multidisciplinary collaboration for optimized SMR execution and results.
Parameter Estimation of a Valve-Controlled Cylinder System Model Based on Bench Test and Operating Data Fusion
Authors: Su Deying , Wang Shaojie , Lin Haojing , Xia Xiaosong , Xu Yubing , Hou Liang 
Published: April 2024

AbstractThe accurate estimation of parameters is the premise for establishing a high-fidelity simulation model of a valve-controlled cylinder system. Bench test data are easily obtained, but it is challenging to emulate actual loads in the research on parameter estimation of valve-controlled cylinder system. Despite the actual load information contained in the operating data of the control valve, its acquisition remains challenging. This paper proposes a method that fuses bench test and operating data for parameter estimation to address the aforementioned problems. The proposed method is based on Bayesian theory, and its core is a pool fusion of prior information from bench test and operating data. Firstly, a system model is established, and the parameters in the model are analysed. Secondly, the bench and operating data of the system are collected. Then, the model parameters and weight coefficients are estimated using the data fusion method. Finally, the estimated effects of the data fusion method, Bayesian method, and particle swarm optimisation (PSO) algorithm on system model parameters are compared. The research shows that the weight coefficient represents the contribution of different prior information to the parameter estimation result. The effect of parameter estimation based on the data fusion method is better than that of the Bayesian method and the PSO algorithm. Increasing load complexity leads to a decrease in model accuracy, highlighting the crucial role of the data fusion method in parameter estimation studies.
Physical activity changes and related factors in chronic heart failure patients during the postdischarge transition period: a longitudinal study
Authors: Meng Yingtong , Zhang Tingting , Ge Xiaohua , Zheng Qingru , Feng Tienan 
Published: April 2024

Abstract
Background
Physical activity (PA) is essential and effective for chronic heart failure (CHF) patients. A greater understanding of the longitudinal change in PA and its influencing factors during the postdischarge transition period may help create interventions for improving PA. The aims of this study were (1) to compare the change in PA, (2) to examine the influencing factors of PA change, and (3) to verify the mediating pathways between influencing factors and PA during the postdischarge transition period in CHF patients.

Methods
A total of 209 CHF patients were recruited using a longitudinal study design. The Chinese version of the International Physical Activity Questionnaire (IPAQ), Patient-reported Outcome Measure for CHF (CHF-PRO), and the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart) were used to assess PA, CHF-related symptoms, and kinesiophobia. The IPAQ score was calculated (1) at admission, (2) two weeks after discharge, (3) two months after discharge, and (4) three months after discharge. Two additional questionnaires were collected during admission. Generalized estimating equation (GEE) models were fitted to identify variables associated with PA over time. We followed the STROBE checklist for reporting the study.

Results
The PA scores at the four follow-up visits were 1039.50 (346.50-1953.00) (baseline/T1), 630.00 (1.00-1260.00) (T2), 693.00 (1-1323.00) (T3) and 693.00 (160.88–1386.00) (T4). The PA of CHF patients decreased unevenly, with the lowest level occurring two weeks after discharge, and gradually improving at two and three months after discharge. CHF-related symptoms and kinesiophobia were significantly associated with changes in PA over time. Compared with before hospitalization, an increase in CHF-related symptoms at two weeks and two months after discharge was significantly associated with decreased PA. According to our path analysis, CHF-related symptoms were positively and directly associated with kinesiophobia, and kinesiophobia was negatively and directly related to PA. Moreover, CHF-related symptoms are indirectly related to PA through kinesiophobia.

Conclusion
PA changed during the postdischarge transition period and was associated with CHF-related symptoms and kinesiophobia in CHF patients. Reducing CHF-related symptoms helps improve kinesiophobia in CHF patients. In addition, the reduction in CHF-related symptoms led to an increase in PA through the improvement of kinesiophobia.

Trial Registration
The study was registered in the Chinese Clinical Trial Registry (11/10/2022 ChiCTR2200064561 retrospectively registered).