bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ondansetron or beta-sitosterol antagonizes inflammatory responses in liver, kidney, lung and heart tissues of irradiated arthritic rats model
Authors: Maarouf Rokaya E , Abdel-Rafei Mohamed K , Thabet Noura M , Azab Khaled S , Rashed Laila , El Bakary Nermeen M 
Published: June 2024

Background Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder mainly affecting joints, yet the systemic inflammation can influence other organs and tissues. The objective of this study was to unravel the ameliorative capability of Ondansetron (O) or β-sitosterol (BS) against inflammatory reactions and oxidative stress that complicates Extra-articular manifestations (EAM) in liver, kidney, lung, and heart of arthritic and arthritic irradiated rats. Methods This was accomplished by exposing adjuvant-induced arthritis (AIA) rats to successive weekly fractions of total body γ-irradiation (2 Gray (Gy)/fraction once per week for four weeks, up to a total dose of 8 Gy). Arthritic and/or arthritic irradiated rats were either treated with BS (40 mg/kg b.wt. /day, orally) or O (2 mg/kg) was given ip) or were kept untreated as model groups. Results Body weight changes, paw circumference, oxidative stress indices, inflammatory response biomarkers, expression of Janus kinase-2 (JAK-2), Signal transducer and activator of transcription 3 (STAT3), high mobility group box1 (HMGB1), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), as well as pro- and anti-inflammatory mediators in the target organs, besides histopathological examination of ankle joints and extra-articular tissues. Treatment of arthritic and/or arthritic irradiated rats with BS or O powerfully alleviated changes in body weight gain, paw swelling, oxidative stress, inflammatory reactions, and histopathological degenerative alterations in articular and non-articular tissues. Conclusion The obtained data imply that BS or O improved the articular and EAM by regulating oxidative and inflammatory indices in arthritic and arthritic irradiated rats.
Experimental study on the flexural performance of FRP grid-reinforced ultra-high-performance concrete I-beams with different steel fiber contents
Authors: Wu Dongyan , Wu Wentao , Fu Chendong , Zhao Junliang , Lin Heng 
Published: June 2024

To adapt to harsh engineering environments, the use of structural components with fiber-reinforced polymer (FRP) grid-reinforced ultra-high-performance concrete (UHPC) is considered a new development trend. Twelve FRP grid-reinforced UHPC I-beams are fabricated to investigate the effects of the thicknesses of FRP grids (0 mm, 1 mm, 3 mm, and 5 mm) and the steel fiber contents of UHPC (0%, 1%, and 2%) on their flexural performance. Four-point bending tests are conducted to obtain the failure modes, load-deflection characteristics, and strain responses of each testing beam, and a simplified calculation method for cracking loading and flexural bearing capacity is proposed. The results reveal that the increase in FRP grid thickness, the ultimate load bearing capacity of FRP grid-reinforced UHPC structural beams increases and the ductility also can be enhanced. The presence of steel fiber effectively inhibits the cracking and increases the first cracking load of the beam during the test process, although its influence on the ultimate bearing capacity is limited. Besides, until to the cracking stage, there is no noticeable change in the tensile strain of the FRP grids as the applied load increases. It has been used to simplify theoretical calculations, which shows good agreement with the experimental results.
“Treat Me Like a Person”: Unveiling Healthcare Narratives of Muslim Women who Wear Islamic Head Coverings Through a Poststructural Narrative Study
Authors: Rahman Rezwana , Lapum Jennifer , Prendergast Nadia 
Published: June 2024

Background In Canada, the healthcare experiences and needs of Muslim women who wear Islamic head coverings are conflated with the larger Muslim community who do not wear Islamic head coverings. Understanding their specific and unique preferences and challenges is essential for tailoring care and improving healthcare encounters. Purpose The study purpose is to explore the healthcare encounters of Muslim women wearing Islamic head coverings in Canada, focusing on how discourse influences their narratives. Methods A postructuralist narrative methodology was used to understand how power, knowledge, language, and discourse impacted their experiences. Semi-structured interviews were conducted with eight Muslim women. Narrative analysis was used to dissect stories and the way these stories were told. Results Five themes were identified, including: The Fingerprint: Highlights the importance of recognizing individual identities to provide personalized care. The Membrane: Examines how societal biases and assumptions permeate healthcare professionals and impacts care. The Heartbeat: Reveals the immediate emotional and physical responses that reflect systemic challenges within healthcare encounters. Unseen: Emphasizes the lack of acknowledgement experienced by Muslim women related to their healthcare preferences and/or needs. Heard: Encompasses instances where Muslim women feel recognized by their healthcare provider; contrasts Theme #4. Conclusion This research emphasizes the diverse experiences of Muslim woman who wear an Islamic head covering and the need for healthcare professionals to move away from a one-size-fits-all approach and instead, provide care that respects the unique preferences amongst this diverse group.
Reduced Health-Related Quality of Life Due to Mobile Phone Dependence in a Sample of Chinese College Students: The Mediating Role of Chronotype and Sleep Quality
Authors: Ying Zhi-Qi , Li Dan-Lin , Liang Gang , Yin Zhi-Jian , Li Yue-Zu , Ma Rong , Qin Yu , Zheng Ya-Jie , Wang Pei , Pan Chen-Wei 
Published: June 2024

Purpose Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality. Design and Setting A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire. Sample 2014 freshmen. Measures The study measured the students’ level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS). Analysis Descriptive statistical analysis, correlation analysis, and mediation analysis. Results Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score ( P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) ( β = −.546, P < .001) and sleep quality (PSQI score) ( β = .163, P < .001). Chronotype negatively predict sleep quality ( β = −.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, β = −.008, P < .001; EQ-VAS score, β = −1.576, P < .001). Conclusion Mobile phone dependence negatively impacts students’ HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.
Simulating Civil Society in the Middle East and North Africa (MENA): Fog, Friction, and the Lebanese Port Explosion
Authors: Hajj Nadya 
Published: June 2024

Introduction Though the effects of fog and friction on decision-making are frequently simulated in military settings, they are less frequently extended to non-military and non-governmental MENA spaces. This article provides a description and evaluation of a disaster simulation rooted in the real-world event of the August 4, 2020 Lebanese port explosion. The aim of the simulation is to prompt student learning of the decision-making dynamics of CSOs amidst fog and friction in democratizing MENA spaces. Background A brief overview of the Lebanon-CSO landscape is provided. As part of their ruling strategy, sectarian elites engineer fog and friction to co-opt and fragment CSOs. This complex power sharing milieu creates dilemmas for CSOs. The Intervention The simulation was designed for an entire classroom of students to experience the fog and friction in decision-making that CSOs encounter in MENA conditions of limited resources and urgent humanitarian need. Methods and Limitations Student learning, framed by Bloom’s taxonomy of levels of intellectual behavior, was assessed using qualitative entry and exit classroom surveys based on three iterations of the simulation. Qualitative interpretive content analysis was used to categorize survey responses. The sample is not statistically significant given the small class sizes at the College. The study serves as an initial exploration for assessing the promising pedagogical benefits of the Lebanon port explosion simulation. Results Before the simulation, students had knowledge and understanding of CSOs, democratization, and the Lebanese context. After the simulation, student surveys yielded results that evidenced higher- ordered learning. Students discovered the challenge of applying their knowledge of Lebanese CSOs amidst fog. Next, the panel stress- testing and critical reflection essay exercises prompted an analysis and evaluation of CSOs as weak or fraught vehicles for democratization in the region. In sum, fog and friction prompted students to experience and learn how CSOs may subvert democratization in the MENA despite intentions to “do good.” Discussion The Lebanon port explosion survey data indicate the value of simulations as “experience vehicles” that may push students to higher orders of abstracted thinking about CSOs in the MENA. Conclusion Coupled with historical knowledge of co-optation and fragmentation strategies of elites vis-à-vis CSOs in Lebanon, the classroom simulation experience provided a low-cost and high-reward learning opportunity for students to grapple with the constraints and consequences of fog and friction on CSO decision-making.
Drug therapy problems among paediatric acute lymphoblastic leukaemia patients at Kenyatta National Hospital
Authors: Magut Faith Jelagat , Degu Amsalu 
Published: June 2024

Introduction Several studies reported that drug therapy problems (DTPs) were prevalent in cancer patients. These DTPs are still interfering with the desired treatment outcomes in patients with cancer. This study aimed to determine the prevalence, types and predictors of DTPs among paediatric acute lymphoblastic leukaemia (ALL) patients at Kenyatta National Hospital. Methods A retrospective cohort study was used to assess DTPs among ALL patients. Records of all eligible paediatric patients with ALL who received treatment in the facility between 1 January 2017 and 31 December 2021 were examined. A data abstraction tool was employed for data collection. The data entry and analysis were carried out by a statistical package for social sciences version 29.0 software. Frequency tables were utilised to present the key findings of the study. Binary logistic regression analysis was utilised to determine the predictors of DTPs. Results A total of 82 DTPs were identified with the most common type of DTP being adverse drug reaction (ADR; 59, 72.0%) and drug interaction (9, 11.0%). The most common ADRs identified were febrile neutropenia (20, 33.9%), nausea/vomiting (14, 23.7%) and anaemia (11, 18.6%). Patients with central nervous system disease (adjusted odds ratio [AOR] = 10.2, 95% CI = 1.2–85.8, p = 0.03) and treated with a combination of chemotherapy and radiotherapy (AOR = 13.5, 95% CI = 1.9–89.4, p = 0.01) were more likely to develop DTPs. Conclusion The study found that the prevalence of DTPs among paediatric ALL patients was high, with the most common DTPs being ADRs occurring in 72.0% of patients. Central nervous system metastasis and a combination of chemotherapy and radiation treatment regimens were statistically significant predictors of DTPs.
A Novel Cooling Device for Kidney Transplant Surgery
Authors: Dergham Ali , Witherspoon Luke , Power Liam , Nashed Joseph Y. , Skinner Thomas A. A. 
Published: June 2024

Background: Prolonged warm ischemia time (WIT) in kidney transplantation is associated with numerous adverse outcomes including delayed graft function and decreased patient and graft survival. Circumventing WIT lies in maintaining renal hypothermia and efficiently performing the vascular anastomosis during this portion of the procedure. Although numerous methods of intra-operative renal cooling have been proposed, most suffer from practical limitations, and none have been widely adopted. Herein we describe a novel device specifically designed to maintain renal hypothermia during kidney transplant surgery. Methods: Aluminum tubing was organized in a serpentine pattern to create a malleable, form-fitting cooling jacket to manipulate renal allografts during transplant surgery. Adult porcine kidneys were used to test the device with 4°C saline as coolant. Kidneys were placed at 24°C; surface and core temperatures were monitored using implanted thermocouples. Anastomosis of porcine kidney vessels to GORE-TEX® vascular grafts in an ex-vivo operative field was performed to assess the functionality of the device. Results: The device maintained surface and core graft temperatures of ≤5°C after 60 minutes of WIT. Furthermore, the device provided hands-free retraction and support for the allograft. We found that ex-vivo anastomosis testing was enhanced by the presence of the cooling jacket. Conclusions: This proof-of-concept study demonstrated that our novel device is a practical tool for renal transplantation and can maintain sufficiently cool graft temperatures to mitigate WIT in an ex-vivo setting. This device is the first of its kind and has the potential to improve kidney transplant outcomes by eliminating WIT during graft implantation.
Muscular branches from the ulnar artery are the basis for a pedicled partial flexor digitorum superficialis muscle flap
Authors: Czinner Martin , Hamrikova Petra , Tuček Michal , Peterkova Tereza , Kebrle Radek 
Published: June 2024

The feasibility of a pedicled flexor digitorum superficialis muscle flap was studied in 10 fresh cadavers. The number, length and distance from the flexion wrist crease of muscular branches from the ulnar artery in the distal 10 cm of the forearm were recorded. The mean number of muscular branches was 2.7 (range 1–4). The mean distance of the most distal branch was 35 mm (range 26–40) from the proximal wrist flexion crease. Its mean length was 20 mm (range 16–26). A partial muscle flap was raised on the most distal branch and transposed over the median nerve in the distal forearm. Dissection and transposition of this flap were feasible in all specimens. The reliable pattern of muscular branches to the flexor digitorum superficialis allows the elevation of a pedicled partial muscle flap that can cover the median nerve in the distal forearm. Level of evidence: V
Armed conflict as a threat to social cohesion: Large-scale displacement and its short- and long-term effects on in-group perceptions
Authors: Mayer Sabrina J , Dollmann Jörg , Jacobsen Jannes , Walter Lisa 
Published: June 2024

This study investigates the short- and long-term consequences of armed conflict and displacement on social cohesion among citizens within attacked nations, using Ukraine and Bosnia and Herzegovina as case studies. Through a pre-registered vignette study in Ukraine (December 2022; N = 1,623), we reveal a significant difference in social cohesion between those who stayed in the country during the war and those who left. This difference intensified when those who left did not want to return. A similar difference persists in Bosnia and Herzegovina 30 years after the Bosnian War (May 2023, N = 338), despite extensive reconciliation efforts. Our findings point towards an understudied consequence of armed conflict and displacement on social cohesion within the attacked nation and shed light on the challenges to post-war reconciliation.
Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated With Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands
Authors: Sardi Juan P. , Smith Justin S. , Gum Jeffrey L. , Rocos Brett , Charalampidis Anastasios , Lenke Lawrence G. , Shaffrey Christopher I. , Cheung Kenneth M. C. , Qiu Yong , Matsuyama Yukihiro , Pellisé Ferran , Polly David W. , Sembrano Jonathan N. , Dahl Benny T. , Kelly Michael P. , de Kleuver Marinus , Spruit Maarten , Alanay Ahmet , Berven Sigurd H. , Lewis Stephen J. ,   AO Spine Knowledge Forum Deformity
Published: June 2024

Study Design Prospective multicenter database post-hoc analysis. Objectives Opioids are frequently prescribed for painful spinal conditions to provide pain relief and to allow for functional improvement, both before and after spine surgery. Amidst a current opioid epidemic, it is important for providers to understand the impact of opioid use and its relationship with patient-reported outcomes. The purpose of this study was to evaluate pre-/postoperative opioid consumption surrounding ASD and assess patient-reported pain outcomes in older patients undergoing surgery for spinal deformity. Methods Patients ≥60 years of age from 12 international centers undergoing spinal fusion of at least 5 levels and a minimum 2-year follow-up were included. Patient-reported outcome scores were collected using the Numeric Rating Scale for back and leg pain (NRS-B; NRS-L) at baseline and at 2 years following surgery. Opioid use, defined based on a specific question on case report forms and question 11 from the SRS-22r questionnaire, was assessed at baseline and at 2-year follow-up. Result Of the 219 patients who met inclusion criteria, 179 (81.7%) had 2-year data on opioid use. The percentages of patients reporting opioid use at baseline (n = 75, 34.2%) and 2 years after surgery (n = 55, 30.7%) were similar ( P = .23). However, at last follow-up 39% of baseline opioid users (Opi) were no longer taking opioids, while 14% of initial non-users (No-Opi) reported opioid use. Regional pre- and postoperative opioid use was 5.8% and 7.7% in the Asian population, 58.3% and 53.1% in the European, and 50.5% and 40.2% in North American patients, respectively. Baseline opioid users reported more preoperative back pain than the No-Opi group (7.0 vs 5.7, P = .001), while NRS-Leg pain scores were comparable (4.8 vs 4, P = .159). Similarly, at last follow-up, patients in the Opi group had greater NRS-B scores than Non-Opi patients (3.2 vs 2.3, P = .012), but no differences in NRS-Leg pain scores (2.2 vs 2.4, P = .632) were observed. Conclusions In this study, almost one-third of surgical ASD patients were consuming opioids both pre- and postoperatively world-wide. There were marked international variations, with patients from Asia having a much lower usage rate, suggesting a cultural influence. Despite both opioid users and nonusers benefitting from surgery, preoperative opioid use was strongly associated with significantly more back pain at baseline that persisted at 2-year follow up, as well as persistent postoperative opioid needs.
Graft Position, Healing, and Resorption in Anterior Glenohumeral Instability: A Comparison of 4 Glenoid Augmentation Techniques
Authors: Delgado Cristina , Calvo Emilio , Díaz Heredia Jorge , Cañete Pablo , García Navlet Miguel , Ruiz Ibán Miguel Angel 
Published: June 2024

Background: The success of glenoid augmentation procedures depends on accurate placement and healing of the graft to the glenoid. Different glenoid augmentation techniques have been described, but no comparative studies between them exist. Purpose: To assess the bone graft position, healing, and resorption in a group of patients treated with 1 of 4 procedures: arthroscopic anterior bone-block procedure using either (1) fresh-frozen iliac crest allograft or (2) iliac crest autograft, (3) open Latarjet, or (4) arthroscopic Latarjet. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 40 patients (87.5% men; mean age, 29.5 ± 7.9 years) were included, with 10 patients in each of the procedure groups. The graft position in the axial and sagittal planes was assessed on postoperative computed tomography (CT). Graft healing and resorption were assessed in a second CT scan performed 1 year postoperatively. Qualitative variables were compared between the 4 procedures using the chi-square test, and quantitative variables were compared with the Student t test or Mann-Whitney U test. Results: No differences were found between the procedures in the axial or sagittal position. The healing rate was significantly lower in the allograft bone-block group (20%) compared with the autograft bone-block (80%), open Latarjet (90%), and arthroscopic Latarjet (90%) groups ( P < .001). Graft resorption developed in 17 of 40 (42.5%) cases overall. Osteolysis occurred in 100% of cases in the allograft bone-block group compared with 50% in the autograft group, 20% in the open Latarjet group, and 0% in the arthroscopic Latarjet group ( P < .001). The glenoid surface area on 1-year CT scan was significantly lower in the allograft bone-block group compared with the autograft bone-block, open Latarjet, and arthroscopic Latarjet groups ( P < .001). Conclusion: Arthroscopic bone-block, open Latarjet, and arthroscopic Latarjet procedures provided accurate bone graft positioning. However, very high rates of osteolysis and nonunion were observed in the iliac crest fresh-frozen allograft bone-block procedure when compared with the other procedures.
The Medical Student Guide to Pharmacy: Piloting an Interactive Textbook on Basic Pharmacology Principles and Clinical Correlations
Authors: Walsh Kendra L. , Warrier Sarita S. 
Published: June 2024

OBJECTIVES Despite the wide use of medications in clinical practice, graduating medical students often feel unprepared for the task of prescribing upon starting residency. With recent educational initiatives aiming to transform learning modalities, we sought to pilot an interactive textbook on basic pharmacology principles at our institution as a supplement to first-year lectures and assess its subjective impact on students’ knowledge of content as well as confidence to apply material in the real world through pre- and post-intervention surveys. METHODS First-year medical students were invited to complete non-validated, voluntary, anonymous, emailed, online surveys consisting of Likert scale and free-text response questions. Our investigation served as a pilot test for future iterations of this research. RESULTS Response rates for the pre- and post-intervention surveys were 73/145 (50%) and 38/145 (26%), respectively, with the post-intervention survey further reduced to 13 individuals who indicated use of the interactive textbook. Questions regarding interactive textbook chapters that overlapped with course content were excluded from data analysis due to an inability to separate learning gains from lectures versus the interactive textbook. Post-intervention survey responses all showed significant changes in mean Likert scale scores on student-perceived knowledge and confidence to apply material with P < .001. Free-text response questions revealed limited exposure to the field of pharmacy and interactions with pharmacists prior to medical school. CONCLUSION Our pilot study on the initial use of an interactive textbook titled The Medical Student Guide to Pharmacy presented us with valuable insight into providing first-year medical students with a clinically oriented supplemental resource within coursework on basic pharmacology. Challenges for the future include better integrating the interactive textbook into class lectures to facilitate increased use by students as well as developing more targeted, validated assessments of the impact it has on students’ learning.