bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extending the concept of moral distress to parents of infants hospitalized in the NICU: a qualitative study in Greece
Authors: Voultsos Polychronis , Arabatzi Maria , Deligianni Maria , Tsaroucha Alexandra K. 
Published: May 2024

Abstract
Background
The hospitalization of infants in the neonatal intensive care unit (NICU) is an ethically challenging situation. A limited number of studies have extended the concept of moral distress to parents of infants hospitalized in the NICU. This topic requires further investigation.

Methods
The present prospective qualitative study was conducted from February 2023 to May 2023. Data were collected through semistructured in-depth interviews, which were conducted in-person with fifteen parents of infants who were hospitalized in the NICU at the time of the interviews. Purposive sampling was used. The data were classified and analyzed using thematic analysis.

Results
Three themes emerged from the data analysis performed for this empirical study. One intrapersonal dimension featuring two aspects (one dynamic and one static) and another interpersonal dimension focusing on parental moral distress emerged from the data analysis. Furthermore, seven subthemes emerged across these themes: (1) self-directed negative feelings were experienced by parents due to their inability to fulfill their caregiving/parental roles; (2) intense internal conflict was experienced by parents in response to a moral dilemma that was difficult, which was perceived as irresolvable; (3) objectively unjustified, self-directed negative feelings of guilt or failure were experienced by parents; (4) parents experienced moral distress due to the poor image of the ill infants; (5) inadequate information may predispose parents to experience moral distress (6) neonatologists’ caring behaviors were unduly perceived by parents as paternalistic behaviors; (7) reasonable or justified institutional rules were unduly perceived by parents as constraint.

Conclusions
In general, the results of this study support the integrated definition of parental moral distress proposed by Mooney-Doyle and Ulrich. Furthermore, the present study introduces new information. The study distinguishes between the dynamic and static aspects of the intrapersonal dimension of the phenomenon of parental moral distress. Moreover, participants experienced moral distress because they unduly perceived certain situations as causing moral distress. In addition, inadequate information may predispose parents to experience moral distress. The findings of this study may contribute promote family-centered care in the NICU context.
Bone health in young adults with type 1 diabetes and progressive eGFR decline
Authors: Babalola Funmbi , Hamilton Jill , Zappitelli Michael , Elia Yesmino , Curtis Jacqueline , Moineddin Rahim , Mahmud Farid H. 
Published: May 2024

Abstract
Background
Type 1 Diabetes (T1D) is associated with increased risk of fractures, worsened by presence of microvascular complications. This study’s objective is to determine the impact of progressive decline in estimated glomerular filtration rate (eGFR) on bone biomarkers and bone microarchitecture in youth with T1D.

Methods
Slopes of eGFR were calculated using measures obtained at four timepoints from adolescence to young adulthood. Participants were identified as eGFR decliners if eGFR decreased ≥ 3ml/min/1.73m2/year. Bone health was assessed in young adulthood by high resolution peripheral quantitative computed tomography (HRpQCT Xtreme CTII) and bone biomarkers; osteocalcin, procollagen 1 intact n-terminal pro-peptide (P1NP), c-terminal telopeptide (CTX), and bone specific alkaline phosphatase. The relationship between diabetes duration, glycated hemoglobin, body mass index (BMI) and vitamin D level on bone biomarkers and microarchitecture was evaluated. Linear regression analysis was used for the statistical analysis in this study.

Results
Ninety-nine study participants were studied with longitudinal evaluation of eGFR over 7.4 ± 1.0 years with mean age of 14.7 ± 1.7 years at baseline. Cross sectional evaluation of bone was performed at 21.3 ± 2.1 years. 44% participants had eGFR decline and showed 5% higher cortical porosity diameter than non-decliners (p = 0.035). Greater diabetes duration was associated with higher trabecular separation (p = 0.004) and lower trabecular number (p = 0.01). Higher level of 25 hydroxy-vitamin D was associated with lower trabecular separation (p = 0.01). Elevated glycated hemoglobin (p = 0.0008) and BMI (p = 0.009), were associated with lower markers of bone formation.

Conclusion
Mild increase in cortical porosity diameter was found in youth with T1D and eGFR decline, however, overall measures of bone microarchitecture on HR-pQCT were similar between both groups and there were no statistically significant changes in bone biomarkers. Hence, skeletal impairments were limited in youth with different eGFR trajectories near peak bone mass. Longitudinal HR-pQCT studies are needed to further understand the impact of eGFR decline on bone microarchitecture. Optimal glycemic control, normal BMI and vitamin D status were supported by this study as important markers for good bone health.
Invasive pulmonary aspergillosis among patients with severe community-acquired pneumonia and influenza in ICUs: a retrospective cohort study
Authors: Lee Wei-Chun , Chang Che-Chia , Ho Meng-Chin , Lin Chieh-Mo , Leu Shaw-Woei , Lin Chin-Kuo , Fang Yu-Hung , Huang Shu-Yi , Lin Yu-Ching , Chuang Min-Chun , Yang Tsung-Ming , Hung Ming-Szu , Chou Yen-Li , Tsai Ying-Huang , Hsieh Meng-Jer 
Published: May 2024

Abstract
Rationale
The prevalence, clinical characteristics, and outcomes of invasive pulmonary aspergillosis in patients with severe community-acquired pneumonia (CAP) in intensive care units remain underestimated because of the lack of a disease-recognition scheme and the inadequacy of diagnostic tests.

Objectives
To identify the prevalence, risk factors, and outcomes of severe CAP complicated with invasive pulmonary aspergillosis (IPA) in intensive care units (ICUs).

Methods
We conducted a retrospective cohort study including recruited 311 ICU-hospitalized patients with severe CAP without influenza or with influenza. Bronchoalveolar lavage fluid (BALF) samples were from all patients and subjected to mycological testing. Patients were categorized as having proven or probable Aspergillus infection using a modified form of the AspICU algorithm comprising clinical, radiological, and mycological criteria.

Measurements and main results
Of the 252 patients with severe CAP and 59 influenza patients evaluated, 24 met the diagnostic criteria for proven or probable Aspergillus infection in the CAP group and 9 patients in the influenza group, giving estimated prevalence values of 9.5% and 15.3%, respectively. COPD and the use of inhaled corticosteroids were independent risk factors for IPA. IPA in patients with severe CAP was significantly associated with the duration of mechanical support, the length of ICU stay, and the 28-day mortality.

Conclusions
An aggressive diagnostic approach for IPA patients with severe CAP and not only influenza or COVID-19 should be pursued. Further randomized controlled trials need to evaluate the timing, safety, and efficacy of antifungal therapy in reducing IPA incidence and improving clinical outcomes.
Improving quality of stored Trichogramma evanescens (Hymenoptera: Trichogrammatidae) by inducing diapause or quiescence
Authors: Mashal Shaimaa , Agamy Essam , El-Husseini Monir , Abd El-Wahab Tarek , El Behery Huda 
Published: May 2024

Abstract
Background
Efficacy of parasitic wasps from the genus Trichogramma to attack the eggs of numerous important pests in various agricultural crops makes them one of the most prevalent biocontrol agents. In Trichogramma, the pre-pupal stage can survive during the cold season in a dormant state (diapause or quiescence). The optimal conditions for the induction of this pause of development during mass rearing to store the parasitoid for a long time in good quality depend on the species. In the present study, four factors [the incubation periods (24 and 48 h), diapause induction temperatures (9 and 11 °C), durations of the diapause induction (from 0 to 6 weeks), and the periods of storage (from 0 to 6 months)], were experimented to force Trichogramma evanescens Westwood, reared on Sitotroga cerealella, to enter diapause or quiescence and estimating their impacts on the efficacy of stored parasitoid.

Results
Results confirmed that the life parameters of T. evanescens as the percentage of adult emergence, female percentage, rates of wing deformation of emerged adults, and fecundity of emerged females were significantly affected by all experimented factors. The pre-storage treatments made it possible to store the parasitoid for at least 2 months at 3 °C, with no much changes in their fitness, the emergence rate of adults reached more than 80%, and the egg-laying efficacy of females reached more than 42 eggs per emerged female, when diapause induction treatments were applied for 5 weeks at 11 °C after 24 h of incubation. Furthermore, there is the possibility of storage for 6 months with an acceptable level of parasitoid’s quality, when diapause induction treatments were applied for 5 weeks at 9 °C after 24 h of incubation, the emergence rate reached 70%, and the number of eggs per female was 52 eggs, while no emergence of adult insects was recorded after 3 months of cold storage without diapause induction treatments.

Conclusion
Two storage programs were reached for T. evanescens (depending on the adult emergence rate and fecundity of emerged females). There is a long-term storage (6 months), when diapause was induced at a low temperature (9 °C) after 24 h of incubation. Short-term storage (from 2 to 4 months), when quiescence was induced under a higher temperature of 11 °C after both 24 and 48 h of incubation.
Current Challenges and Future Directions in the Assessment of Glucocorticoid Status
Authors: Clarke Sophie A , Eng Pei Chia , Comninos Alexander N , Lazarus Katharine , Choudhury Sirazum , Tsang Christie , Meeran Karim , Tan Tricia M , Dhillo Waljit S , Abbara Ali 
Published: May 2024

Abstract
Glucocorticoid (GC) hormones are secreted in a circadian and ultradian rhythm and play a critical role in maintaining physiological homeostasis, with both excess and insufficient GC associated with adverse effects on health. Current assessment of GC status is primarily clinical, often in conjunction with serum cortisol values, which may be stimulated or suppressed depending on the GC disturbance being assessed. In the setting of extreme perturbations in cortisol levels ie, markedly low or high levels, symptoms and signs of GC dysfunction may be overt. However, when disturbances in cortisol GC status values are less extreme, such as when assessing optimization of a GC replacement regimen, signs and symptoms can be more subtle or nonspecific. Current tools for assessing GC status are best suited to identifying profound disturbances but may lack sensitivity for confirming optimal GC status. Moreover, single cortisol values do not necessarily reflect an individual's GC status, as they are subject to inter- and intraindividual variation and do not take into account the pulsatile nature of cortisol secretion, variation in binding proteins, or local tissue concentrations as dictated by 11beta-hydroxysteroid dehydrogenase activity, as well as GC receptor sensitivity. In the present review, we evaluate possible alternative methods for the assessment of GC status that do not solely rely on the measurement of circulating cortisol levels. We discuss the potential of changes in metabolomic profiles, micro RNA, gene expression, and epigenetic and other novel biomarkers such as growth differentiating factor 15 and osteocalcin, which could in the future aid in the objective classification of GC status.
Premature sexual initiation - a problem or an everyday occurrence for today's adolescents
Authors: Pawłowski Piotr , Szymańska Kamila , Nowak Katarzyna , Kościołek Aneta 
Published: May 2024

Human sexuality is a component of a holistic being, a biopsychosocial state, defined by the World Health Organization as health. It is manifested in aspects of relationship, desire, sexual behavior, orientation, among others. Every year, more and more reports say that the age of sexual initiation is shifting towards younger years. It is worth noting that, according to analyses, the sexuality of the young does not differ from that of the 20th century. In boys, the motivation to engage in sexual activity is usually lust, in girls it is love and emotion. This condition is influenced by many factors: biological, genetic, environmental, family, as well as psychological factors like personality and temperament. The health care system should promote appropriate sexual behavior, along with sex education and awareness of the consequences of risky behavior, including those related to venereal aspects.
Heat acclimation improves exercise performance in hot conditions and increases heat shock protein 70 and 90 of skeletal muscles in Thoroughbred horses
Authors: Ebisuda Yusaku , Mukai Kazutaka , Takahashi Yuji , Yoshida Toshinobu , Matsuhashi Tsubasa , Kawano Aoto , Miyata Hirofumi , Kuwahara Masayoshi , Ohmura Hajime 
Published: May 2024

AbstractThis study aimed to determine whether heat acclimation could induce adaptations in exercise performance, thermoregulation, and the expression of proteins associated with heat stress in the skeletal muscles of Thoroughbreds. Thirteen trained Thoroughbreds performed 3 weeks of training protocols, consisting of cantering at 90% maximal oxygen consumption (VO2max) for 2 min 2 days/week and cantering at 7 m/s for 3 min 1 day/week, followed by a 20‐min walk in either a control group (CON; Wet Bulb Globe Temperature [WBGT] 12–13°C; n = 6) or a heat acclimation group (HA; WBGT 29–30°C; n = 7). Before and after heat acclimation, standardized exercise tests (SET) were conducted, cantering at 7 m/s for 90 s and at 115% VO2max until fatigue in hot conditions. Increases in run time (p = 0.0301), peak cardiac output (p = 0.0248), and peak stroke volume (p = 0.0113) were greater in HA than in CON. Pulmonary artery temperature at 7 m/s was lower in HA than in CON (p = 0.0332). The expression of heat shock protein 70 (p = 0.0201) and 90 (p = 0.0167) increased in HA, but not in CON. These results suggest that heat acclimation elicits improvements in exercise performance and thermoregulation under hot conditions, with a protective adaptation to heat stress in equine skeletal muscles.
Transfer five ways: applications of multiple distinctive collexeme analysis to the dative alternation in Mandarin Chinese
Authors: Liao Shengyu , Gries Stefan Th. , Wulff Stefanie 
Published: May 2024

Abstract
The dative alternation has been extensively studied in the world’s languages, and the meanings of the verbs participating in the alternation have been shown to play a key role in determining its argument realization options. The present paper presents a multiple distinctive collexeme analysis approach to the dative alternation in Mandarin Chinese, which involves a choice of one of five functionally similar alternants, and it does so by also discussing several ways to improve how this has been done statistically in most previous analyses. Linguistically, we identify the core semantic differences of the five constructions based on which verbs statistically prefer to occur in which pattern, focusing on semantic potential and direction of transfer. Methodologically, this study contributes to the slowly growing body of studies that use collexeme strengths that are not only less related to frequency than the traditional methods (i.e., association is measured in a less diluted way) and that are directional (i.e., we can focus on one direction of association from the verb to the construction).
What is diagnostic safety? A review of safety science paradigms and rethinking paths to improving diagnosis
Authors: Choi Justin J. 
Published: May 2024

Abstract
Diagnostic errors in health care are a global threat to patient safety. Researchers have traditionally focused diagnostic safety efforts on identifying errors and their causes with the goal of reducing diagnostic error rates. More recently, complementary approaches to diagnostic errors have focused on improving diagnostic performance drawn from the safety sciences. These approaches have been called Safety-II and Safety-III, which apply resilience engineering and system safety principles, respectively. This review explores the safety science paradigms and their implications for analyzing diagnostic errors, highlighting their distinct yet complementary perspectives. The integration of Safety-I, Safety-II, and Safety-III paradigms presents a promising pathway for improving diagnosis. Diagnostic researchers not yet familiar with the various approaches and potential paradigm shift in diagnostic safety research may use this review as a starting point for considering Safety-I, Safety-II, and Safety-III in their efforts to both reduce diagnostic errors and improve diagnostic performance.
Trivalent Gd incorporated Zn2SiO4 phosphor material for EPR and luminescence investigations
Authors: Singh Vijay , Bhatia Kanika , Rao Allam Srinivasa , Joo Ji Bong 
Published: May 2024

Abstract
Zn2SiO4:Gd3+ powder was obtained by the sol–gel preparation technique and then characterized by using Fourier-transform infrared spectroscopy and X-ray diffraction techniques. The sample exhibited photoluminescence in the ultraviolet spectral zone with a maximum emission wavelength of 314 nm. Ultraviolet emission in the range of 305–320 nm is also called ultraviolet-B emission. This UV range emission is used in lamps for skin treatment and phototherapy. The electron paramagnetic resonance spectrum recorded for the Zn2SiO4:0.015Gd3+ phosphor revealed g values of 3.46, 2.64, and 2.20, confirming the presence of Gd3+ ions in the small ligand field. Furthermore, Gd3+ ions attain tetrahedral symmetry in the prepared host compound.
Liquiritin: A natural flavonoid with potential cardiovascular protection
Authors: Zhou Lan , Peng Jia-zhi , Zhou Peng 
Published: May 2024

Liquiritin is a flavonoid glycoside extracted from traditional Chinese medicine, Radix et Rhizoma Glycyrrhizae. The provided evidence has demonstrated that liquiritin is found beneficial in treating cardiovascular diseases. Inflammation and oxidation play key roles in cardiovascular diseases. In this review, the natural sources, biosynthesis, pharmacology and molecular docking of liquiritin were reviewed for the first time. Additionally, we have highlighted the target prediction of liquiritin. Docking results displayed that the three targets with the largest difference in VINA scores were toll-like receptor 4 (TLR4), Kelch-like ECH-associated protein 1 (Keap-1), and adenosine monophosphate-activated protein kinase (AMPK), which suggested that liquiritin was likely to act on TLR4, Keap-1, and AMPK. The present study provides theoretical basis for future development and research of liquiriritin in treating cardiovascular diseases.
A comparative study on outcome of endonasal dacryocystorhinostomy with and without silicone intubation-otorhinolaryngology
Authors: Karkare Ajay , Singh Arvind 
Published: May 2024

Background: Epiphora or “tearing eye” is a functionally and socially, bothersome symptom. Dacryocystitis is an inflammatory condition of the nasolacrimal sac caused due to an obstruction within the nasolacrimal duct (NLD). Dacryocystitis can be classified as acute and chronic or acquired and congenital. Chronic dacryocystitis is almost always managed surgically. The present study was undertaken for comparative study of outcomes of endonasal Dacryocystorhinostomy (DCR) done with and without silicone intubation.
Methods: The 50 cases dacryocystitis were selected. The patients were divided in group A cases (with intubation) and group B controls (without intubation) randomly. A detailed history was taken followed by general physical and clinical otorhinolaryngological examination. Patients were evaluated with nasal endoscopy, DCG (Dacrocystogram), through which site of obstruction was located.
Results: In our study, Among the cases 18 subject presented with right dacryocystitis and 7 with left dacryocystitis. Similarly, among the controls, 20 subjects presented with right dacryocystitis and 5 presented with left dacryocystitis. According to modified Likert’s score, at the end of 6 months when a nasal endoscopy was done along with syringing 96% of the cases had patent rhinostomy while only 80% of the controls showed patency. Post operative epistaxis was evident in 6 cases and 4 controls.
Conclusions: Endonasal DCR with and without stenting, had more or less similar results, with equal post op complications. Though, with stenting, success rates were high as shown in our study.
A study of the prevalence of Onodi cells in a North Indian population
Authors: Sharma Preeti , Kanotra Sonika , Bahir Seerat , Khan Yasir A. , Batt M. Zahid , Ahmed Qazi S. , Bhat Misba M. , Gupta Kshitij 
Published: May 2024

Background: Onodi cells are a type of posterior ethmoid cells which extend superior and lateral to the sphenoid sinus. As these cells have a close relationship with the optic nerve and the internal carotid artery, it becomes important to be aware about their presence preoperatively to prevent injury to these vital structures. Aim of the study was to identify the presence of the Onodi cell with computed tomography (CT) scan and to determine its prevalence and gender distribution of these cells in a north Indian population.
Methods: CT scan of nose and paranasal sinuses of 300 adult patients were studied retrospectively to determine the prevalence of Onodi cells.
Results: The overall prevalence of Onodi cells was found to be 20.33%. Of this, 24 (57%) were present in males and 17 (43%) in females. Out of 61 Onodi cells, 30 (49.2%) were right-sided, 10 (16.4%) left-sided, 13 (21.3%) central and 8 (13.1%) were bilateral.
Conclusions: The presence of Onodi cell in every fifth person makes it important to have a knowledge of their presence preoperatively to prevent adverse surgical complications.
Non recurrent laryngeal nerve: be vigilant
Authors: Dhingra Preeti , Raghuwanshi Kaustubh , Naga Mahendra Sirigiri , Agrawal Ritesh 
Published: May 2024

The nonrecurrent laryngeal nerve (NRLN) is a rare variant of the RLN, which results from the partial failure of pharyngeal apparatus during embryological development. It’s a rare anatomical variation in which the nerve doesn’t descend to the thorax and enters the larynx directly from the vagus nerve in the neck. It’s an uncommon anatomical variation usually associated with subclavian artery abnormalities, so identification of these vascular anomalies before the surgery is important to avoid nerve injury. These anomalies lead to difficulty in finding the RLN and hence the chances of injury to the nerve are more. Lack of knowledge about the course of RLN, its anatomical variations and its relationship to the vital structures poses the risk of iatrogenic damage of the nerve. Most of the cases of NRLN are diagnosed intraoperatively, as there is no specific test for this. So, surgeons should always be vigilant about the NRLN during thyroid and parathyroid surgeries.