bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of type 2 diabetes mellitus in the elderly – Special considerations
Authors: Gadó Klara , Tabák Gy. Ádám , Vingender István , Domján Gyula , Dörnyei Gabriella 
Published: April 2024

AbstractType 2 diabetes is a frequent chronic disease. Given its strong positive association with older age, it is a significant public health issue in elderly populations. Furthermore, the aging of the population, driven by increasing life expectancy in high and middle-income countries leads to an increasing prevalence of diabetes.Although the same diagnostic criteria apply to the elderly and to younger people, there are unique aspects to the care for elderly type 2 diabetes patients. Both treatment goals and preferred medications, as well as non-pharmacological approaches should be adjusted in the elderly. For example, increasing the amount of physical activity may encounter difficulties, while introducing an appropriate diet may be more challenging. The patients' therapeutic adherence requires special attention due to cognitive and physical limitations. The most important treatment goal is to avoid hypoglycemia. Frailty, social and economic issues, comorbidities and the consequent polypharmacy frequently causing drug-drug interactions, as well as the increased danger of drug toxicity due to renal failure are only some of the problems that make the health care for old diabetes patients extremely difficult. Adequate care requires cooperation from a multidisciplinary team of health care professionals.Acute diabetes complications have a higher mortality in the elderly, thus close attention must be paid to avoid them. Family members should be involved in the care of elderly diabetes patients, and it is recommended to educate them on clinical signs of complications. Regular care for the patients including feedback on quality of life and early signs of health issues are essential.
Responding to and managing multijurisdictional outbreaks of COVID-19 in Canadian industrial worksite/work camp settings
Authors: McGill Erin , Bellos Anna , Nwosu Andrea , Zetner Adrian , Tyler Andrea , Knox Natalie , Franklin Kristyn , Patterson Kaitlin 
Published: April 2024

Abstract
Setting
Early in the COVID-19 pandemic, the Public Health Agency of Canada (PHAC) and provincial/territorial (P/T) public health identified the need for a coordinated response to complex multijurisdictional COVID-19 outbreaks. The first large multijurisdictional industrial worksite COVID-19 outbreak highlighted the risk of transmission within these congregate work settings, the risk of transmission to the broader community(ies), and the need to develop setting-specific outbreak response frameworks.

Intervention
PHAC assembled a team to provide national outbreak support for multijurisdictional COVID-19 outbreaks in May 2020. The COVID-19 Outbreak Response Unit (ORU) worked with P/T partners to develop guiding principles for outbreak response and outbreak investigation processes, guidance documents, and investigation tools (e.g., minimum data elements and questionnaires).

Outcomes
The ORU, P/T partners, and onsite industrial worksite health and safety staff leveraged outbreak investigation guidelines, industrial worksite outbreak process documents (including minimum data elements), and enhanced case questionnaires to respond to multiple COVID-19 outbreak investigations in industrial worksites. Clear roles/responsibilities and processes, along with standardized data, allowed for more efficient outbreak investigations and earlier implementation of mitigation measures.

Implications
Multijurisdictional COVID-19 outbreaks highlighted the importance of public health collaboration with industry partners onsite. The assembly of a national outbreak response team was important to facilitate information sharing and provide technical support. Lessons learned and recommendations on outbreak preparation, detection, management, and communication are included to enhance a response framework applicable to future emerging or re-emerging pathogens with epidemic and/or pandemic potential.
Imaging the Rivera and Cocos Plates Shape in Western Mexico from Local Seismicity Studies
Authors: Núñez-Cornú Francisco J. , Suárez-Plascencia Carlos , Núñez Diana 
Published: April 2024

Abstract
The geometry of the Rivera and Cocos plates subduction below the North American plate has been studied using a total of 5337 hypocenters located in the region of Nayarit, Jalisco, Colima, and Michoacán states in western Mexico. Our results show that seismic features of the subduction at Jalisco block (JB), Colima rift zone (CRZ), and Michoacán block are well differentiated. Our study supports the hypothesis that the Jalisco subduction zone is composed of two fore-arc blocks, Banderas and Jalisco fore-arc blocks, separated by the Ipala canyon (Bandy fault). In this region, the crustal thickness of the JB is ∼30 km, whereas the Michoacán block is 35 km thick. We identified four crustal blocks along the coast in the JB from shallow seismicity data. Moreover, we found that the Rivera plate is segmented into three sections with different sizes and geometries evidenced by deep seismicity data. There is no evidence of a slab below the CRZ due to seismicity being scarce, except on the coast and the Colima volcano area where deep earthquakes (&gt;70 km) are observed, which could be related to magmatic processes. The seismicity of the subduction process of the Cocos plate appears homogeneous, except for a seismic cluster at the mouth of Coalcomán River, where the epicentral area of the 1973 and 2021 earthquakes is located. Our results show that the Cocos plate is subducting with an inclination of 24°–30° and is slightly bent in a northwesterly direction. Therefore, our study suggests that current seismotectonic models of the region should be revised.
Molecular Characterization and Antimicrobial Profiling of Escherichia coli isolates from Indian Camelus
Authors: Lakeshar Mahender Miland , Chaudhary Jyoti , Kumar Sudesh , Gurjar Narasi Ram , Kumar Prateek , Bhati Taruna , Shringi B.N. 
Published: April 2024

Background: Escherichia coli is frequently associated with multiple antimicrobial resistances and a major cause of bacterial extraintestinal infections in livestock and humans. Escherichia coli resides in the lower digestive tract as harmless commensals but a subset of E. coli strains has acquired the ability due to acquisition of virulence and antibiotic genes, cause intestinal or extraintestinal diseases. Methods: In this field-laboratory investigation during 2020-2021, samples were taken from different localities of Bikaner district and surrounding are of Rajasthan. A total no. of 70 fecal samples were collected and immediately transferred to the Department of Veterinary Microbiology. In the laboratory, the collected samples were further processed for isolation and identification of E. coli bacteria. Result: Confirmation of E. coli was done using primary and biochemical test which are screened for hemolysin property, biofilm formation, antibiogram study and antibiotic resistance gene. All the isolates of E. coli used to show characteristic metallic sheen on EMB agar plate and excellent identification was done with VITEK 2 system. All the camel isolates shown partial hemolysis on sheep blood agarand 45.71% camel isolates were positive for biofilm formation. All these 70 E. coli isolates from camel were resistant to Penicillin (94.38%) which was followed by amoxicillin+sulbactam (85.71%), erythromycin (71.14%), cefixime+clavulanic acid (71.43%). Highest sensitivity to chloramphenicol (81.28%) followed by sulphadiazine (48.57%) and cotrimoxazole (48.28%). All these 70 isolates were screened for antibiotic resistance genes. On the basis of molecular screening of the antibiotic resistance genes, majority of the isolates carried BlaTEM gene in camel (56/70; 80%), followed by StrA (29/70; 41.40%), Sul-3 in (22/70; 31.42%), Sul-2 (18/70; 25.71%), aadA (28/70; 40%), tet(B) (22/70; 31.42%) isolates.
Relationship Between Parenting Educational Styles and Well-Being in Families with Autistic Children. A Systematic Review
Authors: Delgado Elena Benseny , Castro Wenceslao Peñate , Megolla Alicia Diaz 
Published: April 2024

The prevalence of diagnosed cases of autism has increased rapidly, which raise interest in studying the variables related to the well-being of these families. The purpose of this paper is to review recent literature on other variables related to family well-being such a parenting styles. We conducted a systematic review using PRISMA check list and bias assessment ESTROBE with the aim of analyzing if the concepts of autism, well-being and parenting style are related. We screened 753 references, 16 full text articles and abstracts were read. It was identified that authoritative parenting style, those based on warmth, establishing relationships and emotional bonding, and low expressed emotion were positively related to family well-being. On the other hand, authoritarian, permissive and overprotective styles, as well as critical, punishing and training-based were negatively associated with well-being and quality of family life.
Preference Signaling in the Orthopaedic Surgery Match: Applicant and Residency Program Attitudes, Behaviors, and Outcomes
Authors: Guthrie Stuart Trent , Dagher Tanios , Essey-Stapleton Jodi , Balach Tessa 
Published: April 2024

Introduction:
The orthopaedic surgery match has experienced a consistent increase in both the number of applicants and applications submitted per applicant. Preference signaling was implemented during the 2022 to 2023 application cycle in part to curtail the rising application burden on both applicants and residency programs. Our aim was to explore the impact of the preference signaling system on applicant and residency program leader attitudes, behaviors, and outcomes.

Methods:
We distributed surveys to American Orthopaedic Association/Council of Orthopaedic Residency Directors member program leaders (program directors, assistant program directors, and program coordinators) and applicants registered for the Electronic Standardized Letter of Recommendation after Universal Interview Offer Day 2022 (Fall Survey) and Match Day 2023 (Spring Survey). The surveys contained multiple-choice and numeric response questions on attitudes, behaviors, and outcomes that were analyzed and reported as percentages and medians, respectively. Open-text responses were reviewed for dominant themes.

Results:
One hundred program leaders and 378 applicants (47%) completed the Fall Survey, and 146 program leaders and 290 applicants (36%) completed the Spring Survey. A majority of applicants (71%) and program leadership (91%) support the continued use of signaling. Applicants reported a 16% reduction in the number of programs to which they applied. Program directors largely used signaling as a tool for screening applications (75%), with few programs using signaling in the ranking process (20%). Applicants reported that 81% of their interviews were from programs they signaled. Slightly more than half of programs (53%) reported filling their last slot at a higher rank order position than the average of the previous 5 years. Qualitative analysis suggests a need for more transparency in the use of signals, consideration of application and/or interview caps, and reconsideration of the other components of the application.

Conclusion:
Preference signaling in the orthopaedic surgery match was met with positive feedback and led to a reduction in the number of applications. Future research will examine the continued impact of preference signaling and assess alterations for optimizing the match process.
Randomized controlled study protocol for surgical treatment of irreducible atlantoaxial dislocation
Authors: Xue Shilin , Xu Nanfang , Chen Zan , Li Fangcai , Wang Xiangyang , Xia Yingpeng , Shen Qingfeng , Wang Bing , Wang Shenglin 
Published: April 2024

Abstract

Introduction:
Irreducible atlantoaxial dislocation (IAAD) poses a complex surgical challenge, necessitating a critical evaluation of available strategies. Surgical approaches under consideration encompass the simple posterior approach and the combined anterior and posterior approach. The former offers procedural simplicity but has inherent limitations in the extent of reduction. In contrast, the latter approach holds the potential for a more comprehensive and reliable release and reduction. However, it also presents an elevated risk of infection and surgical complexity. The choice between these two strategies remains a controversy. In this article, we delineate the framework of a multicenter randomized controlled trial. Our aim is to systematically investigate the optimal surgical approach for managing IAAD, providing insights into the most efficacious and safest course of action.
Methods and Analysis:
Study Design: This protocol represents a collaborative effort among six medical centers. It endeavors to enroll 70 IAAD patients, stratified into two distinct trial groups: the "Simple Posterior Surgery Group" and the "Combined Anterior and Posterior Surgery Group".
Primary Outcome Measures: The primary endpoints of this trial encompass a comprehensive radiological assessment and the systematic tracking of postoperative effects.
Secondary Outcome Measures: In addition to the primary endpoints, this study will encompass the meticulous evaluation of specific adverse events. Additionally, we will quantify the improvement in quality of life observed within 12 months post-surgery.
Ethics and Dissemination:
This research endeavor has received full ethical clearance from the Peking University Third Hospital (PUTH) Medical Science Research Ethics Committee (IRB00006761-M2023203). All enrolled participants will provide informed consent voluntarily. Furthermore, it is anticipated that the findings of this study will be disseminated in a scholarly manner. The results will be submitted to a peer-reviewed journal to be published as an academically rigorous report.
Trial Registration:
ClinicalTrials.gov QA57. NCT05847270. 09/26/2023
Etiology and mortality of patients with altered level of consciousness in the emergency room: a multicenter analysis before and after the coronavirus disease 2019 outbreak
Authors: Kim Keun Tae , Seo Jong-Geun , Park Jung A , Jung Chang‑Gyu , Jeon Jae Cheon , Kwon Doo Hyuk 
Published: April 2024

Abstract

New-onset altered level of consciousness (ALC) is challenging in emergency rooms (ERs), requiring focused attention. The COVID-19 pandemic has impacted healthcare systems globally, influencing ER dynamics. This study compared ALC before (BC) and after (AC) the coronavirus disease 2019 outbreak, focusing on etiology, disposition, and outcomes. This was a retrospective, multicenter study of four university hospitals in charge of an area of about five million people in South Korea. All cases were reviewed within a consortium of board-certified faculties and compared between BC (February 2018 to January 2020) and AC (March 2021 to February 2023. We reviewed to find 17,913 patients who visited the ER due to ALC, of whom 7,988 and 9,925 were in BC and AC, respectively. The overall incidence of ALC in the ER was 3.1%, higher in AC (BC vs. AC, 2.5% vs. 3.7%, p < 0.001). The most common etiology was Metabolic cause (24.8%), followed by Systemic infection (18.0%). Intracranial etiologies accounted for 29.7% of the total. Hospitalization rate increased from BC to AC (54.5–59.3%, p < 0.001). The overall mortality was 16.2%, and 5.3% of the patients with ALC died in the ER. ALCs dut to cardiogenic and vascular etiology had the highest mortality (26.8%). This study marks the first investigation on ALC in the ER comparing BC and AC.
Integrative analysis of transcriptome and metabolome provides insights into the effects on different tissues by overexpression and knockout of NtLHT1
Authors: Xing Jiaxin , Wang Wenyuan , Mi Qili , Zhang Lumin , Yang Wenwu , Xu Li , Jiang Jiarui , Xiang Haiying , He Wei , Gao Qian 
Published: April 2024

Abstract

NtLHT1 is a multifunctional amino acid transporter involved in plant development and defense responses. This study investigated the effects of NtLHT1 knockout (LHT1-KO) and overexpression (LHT1-OE) on metabolic and transcriptomic profiles across three tobacco organs-leaves, stems and roots. Metabolomics analysis showed LHT1-KO and LHT1-OE caused significant changes in metabolites from various pathways, particularly amino acids, flavonoids, lipids, and terpenoids, with the specific effects differing across organs. RNA-seq transcriptomics revealed major organ-specific transcriptional changes caused by LHT1-KO and LHT1-OE. In leaves, LHT1-KO specifically downregulated genes involved in photosynthesis like MENG and TMN7, while LHT1-OE upregulated DNA replication and photosynthesis genes. In stems, LHT1-OE induced phenylpropanoid biosynthesis genes but in roots it induced carbon metabolism and oxidative phosphorylation. Taken together, these multi-omics analyses demonstrate that NtLHT1 has heterogeneous effects across different tobacco organs, highlighting the complexity of its functional roles in plant amino acid transport, vegetative growth and Secondary metabolite biosynthesis.
3D-printing of calcium phosphates at nanoscale resolution
Authors: Zreiqat Hala , Roohani Iman , Wang Shuning , Xu Chaohui , Newman Peter , Entezari Ali , Lai Yichen 
Published: April 2024

Abstract

Calcium phosphates (CaPs) are ubiquitous in biological structures, such as vertebrate bones and teeth, and have diverse biomedical applications. Shaping CaPs at the nanoscale in 3D can unlock new possibilities in a myriad of research and industrial applications. However, fabricating inorganic materials such as CaPs with designed 3D nanostructures remains a significant challenge. Here, we introduce a novel approach to 3D print CaP structures with unprecedented sub-300 nm resolution, achieving a level of detail three orders of magnitude finer than current state-of-the-art additive manufacturing techniques for CaPs. This advancement is achieved by leveraging a bioinspired chemistry using bone prenucleation clusters, within a photoresist. This technique also enables nanopatterning of CaPs on ceramics and metals, and precise engineering of the microstructure down to the level of a single nanograin. This method will offer new frontiers in developing bioinspired metamaterials, damage-tolerant lightweight materials, cell-modulating interfaces, precision-engineered coatings, and targeted drug delivery nanovehicles.
The effect of time to neurosurgical or neuroradiological intervention therapy on outcomes after traumatic brain injury, a registry-based observational study
Authors: Pansiritanachot Wasin , Riyapan Sattha , Shin Sang Do , Chantanakomes Jirayu , Thirawattanasoot Netiporn , Rangabpai Wichayada , Somboonkul Bongkot , Jeong Joo , Song Kyoung Jun , Chiang Wen-Chiu , Jamaluddin Sabariah Faizah , Kajino Kentaro 
Published: April 2024

Abstract

Background
The evidence regarding the effect of time to neurosurgical and neuroradiological intervention on outcomes in traumatic brain injury (TBI) patients is still controversial. This study aimed to investigate the effect of time to hospital interventions on outcomes after TBI.
Methods
Adult TBI patients who received any neurosurgical or neuroradiological interventions during the year 2015-2022 in the Pan-Asian Trauma Outcome Study database were analyzed, excluding patients with unknown exposure information and unknown outcomes. The time to intervention, as the main exposure, was classified into three groups (Early, Intermediate, and Delayed) using the Restricted Cubic (RC) Spline analysis. The outcomes were in-hospital mortality and unfavorable neurological outcomes. W score was calculated to compare the quality of care among exposure groups. Multivariable logistic regression analysis and interaction analysis were performed to identify the association between the exposure groups and outcomes by calculating adjusted odds ratios (AOR) with 95% confidence intervals (CI).
Results
A total of 1,780 patients were included. From the RC Spline analysis, patients were classified into three groups according to time to intervention: Early (<1.9 h), Intermediate (1.9-4.1 h), and Delayed (>4.1 h). According to the time to intervention, W score was -8.6 in the early group, -1.1 in the intermediate group, and +0.4 in the delayed group. Patients receiving intermediate and delayed intervention had a significantly lower mortality (AOR 0.64, 95% CI 0.47-0.86 and AOR 0.66, 95%CI 0.48-0.90, respectively).
Conclusion
The early neurosurgical and neuroradiological interventions were associated with higher mortality in TBI patients, regardless of transportation modes. The quality of care should be focused and improved during the early hours of TBI.
Discrepancy between Physical Functional Decline and Physical Concerns among Alzheimer’s Disease
Authors: Fujisawa Chisato , Umegaki Hiroyuki , Sugimoto Taiki , Nakashima Hirotaka , Komiya Hitoshi , Watanabe Kazuhisa , Nagae Masaaki , Yamada Yosuke , Tajima Tomihiko , Sakai Tomomichi , Sakurai Takashi 
Published: April 2024

Abstract

Purpose
To examine the extent to which patients with amnestic mild cognitive impairment (aMCI) or Alzheimer’s disease (AD) perceive their own physical decline.
Methods
This study included 4585 outpatients (1036 normal cognition, 1712 aMCI, and 1837 mild AD) who visited a memory clinic. The patients and their families were asked about fear of falling, dizziness or unsteadiness, knee pain, and visual and hearing impairment. Logistic regression analysis was performed to examine the relationship between physical concerns and AD stage. The proportion of patients who had physical functional decline without physical concerns was also calculated according to Mini-Mental State Examination (MMSE) score.
Results
The number of physical concerns decreased from the aMCI stage, but actual physical function declined. The proportion of patients who had impaired physical function but no physical concerns increased as MMSE score decreased.
Conclusion
There was a discrepancy between physical concerns and physical functional decline among AD patients.