bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unravelling the role of poly(methyl methacrylate) (PMMA) molecular weight in poly(vinylidene fluoride) (PVDF)/PMMA/expanded graphite (ExGr) blend nanocomposites: Insights into morphology, thermal behavior, electrical conductivity, and wetting property
Authors: Augustin Nikhitha , Muraliharan Pranesh , Sabu Aleena , Koothanatham Senthilkumar Kanya , Annamalai Pratheep Kumar , Brahmadesam Thoopul Srinivasa Raghava Ramanujam 
Published: March 2024

Poly(vinylidene fluoride) (PVDF) based conducting polymer composites with carbon nanomaterials can be used for mechanical energy harvesting through piezoelectric or triboelectric effect. This study aims to investigate the influence of PMMA molecular weight on the electrical, thermal, and wetting properties of PVDF/40 wt.% PMMA blend nanocomposites reinforced with expanded graphite (ExGr). The blend nanocomposites with 40 wt.% PMMA have been prepared by solution blending method by using two different molecular weights of PMMA whose melt flow indices are 2 g/10 min and 2.3 g/10 min. The coexistence of the electroactive gamma and non-polar alpha phases of PVDF in the blend nanocomposites has been confirmed by X-ray diffraction, Fourier transform infrared spectroscopy and differential scanning calorimetry analyses. While overall crystallinity (%) of low molecular weight PMMA employed blend nanocomposites is lower than that of high molecular weight PMMA blended nanocomposites, the electroactive gamma phase has been found to increase in the former blend nanocomposites. The dispersion of graphite nanosheets has been observed to be better in high molecular weight PMMA employed blend nanocomposites which results in higher electrical conductivity. Impedance analysis of PVDF-40 wt.% PMMA-2 wt.% ExGr blend nanocomposite with high molecular weight PMMA results in enhanced interjunction capacitance (74.5 pF) in comparison to low molecular weight PMMA mixed blend nanocomposites (68 pF). Water contact angle (WCA) increases with molecular weight of PMMA and ExGr loading level. Thermogravimetric analysis has shown that the char content (above 500°C) is slightly higher for the blend with low molecular weight PMMA than with high molecular weight PMMA.
Distance follow-up by a remote medical care centre improves adherence to CPAP in patients with obstructive sleep apnoea over the short and long term
Authors: Schisano Matteo , Libra Alessandro , Rizzo Ludovica , Morana Giorgio , Mancuso Salvatore , Ficili Antonella , Campagna Davide , Vancheri Carlo , Bonsignore Maria R , Spicuzza Lucia 
Published: March 2024

Background Adherence to continuous positive air pressure (CPAP) in patients with obstructive sleep apnoea (OSA) has remained invariably low over the last decades. Remote monitoring of the nocturnal CPAP treatment, within telemedicine (TM)-based follow-up programs, in these patients has been suggested as a potential tool to improve adherence and release the workload of sleep units. The aim of this study was therefore to assess whether a follow-up program carried out by a Remote Medical Care Centre (RMCC), outside the sleep unit, improves adherence to CPAP in the short and long term in patients with OSA. Methods In this pilot protocol, we enrolled 37 patients starting CPAP in our Sleep Centre (SC). After three months of standard care in our SC, patients initiated a six-month remote follow-up carried out by the RMCC, functioning as an intermediary between patients and SC. Monthly reports and indication for face-to-face visits were sent to the SC for six months. After this period patients returned to usual care for one year. Results were compared with those obtained in 38 patients (controls) followed with usual care over the same time range. Results Mean nightly use of CPAP increased from 3.2 ± 2.4 h pre-RMCC to 5.2 ± 1.9 h post-RMCC ( p < 0.0001). Nights/month of CPAP use improved from 19.8 ± 9.2 to 25.2 ± 2.5 ( p < 0.05) and nights/month with CPAP use >4 h from 12.5 ± 10 to 21.03 ± 8.9 ( p < 0.05). This improvement remained stable after 12 months from the return of patients to usual care. No significant changes in CPAP use were observed in controls over the time. Conclusion A six-month follow-up through a remote facility can significantly improve adherence to CPAP in the short and long term. This pilot study provides a solid base for the design of multicentre randomized trials focusing on new models which are able to increase the long-term efficacy of TM programs.
Expression Analysis of Phenylpropanoid Pathway Genes and Phenylpropanoid Accumulation in Different Organs of Chelidonium majus L.
Authors: Kwon Haejin , Sathasivam Ramaraj , Yoon Jiwon , Park Chanung , Park Nam Il , Chung Yong Suk , Park Sang Un 
Published: March 2024

Objective This study set out to examine the phenylpropanoid pathway gene expression and phenolic compound accumulation in different organs of Chelidonium majus (C. majus). Methods Total RNA was extracted and expression of phenylpropanoid biosynthesis genes was assessed using quantitative real-time polymerase chain reaction in different organs of C. majus. In addition, the phenylpropanoid compounds were analyzed from different organs of C. majus by using high-performance liquid chromatography. Results The results demonstrate the variance in the expression levels of phenylpropanoid pathway genes in the flowers, leaves, stems, and roots of C. majus. CmPAL and CmC4H were expressed at their greatest levels in the stem, while CmCHS and CmCHI were strongly expressed in the leaf, and CmF3H, CmFLS, Cm4CL, and CmDFR were more abundant in the flower. The total phenolic contents in the different organs also varied significantly. The highest value was recorded in the flowers (2152.89  ±  78.71 μg/g dry wt.), which was 54.26 times higher than the lowest values obtained from roots (39.68  ±  0.05 μg/g dry wt.). Except for roots, rutin showed the highest level in all other organs. According to a heat map, the majority of the phenolic compounds were highest in the flower. By using variable importance in projection analysis, the most significant metabolite was found to be chlorogenic acid, which had a positive association with all phenolic chemicals, but it showed a negative correlation with trans-cinnamic acid. Except for trans-cinnamic acid, all other phenolic compounds likewise showed positive correlation with other phenolic compounds. Conclusions This work offers pertinent data on the expression analysis of genes involved in the phenylpropanoid biosynthetic pathway and the presence of phenolic compounds in C. majus. These findings will be helpful for the researcher to understand the relationship between the expression level of phenylpropanoid pathway genes and phenylpropanoid compound accumulation in C. majus.
Relationship Between Running Biomechanics and Core Temperature Across a Competitive Road Race
Authors: DeJong Lempke Alexandra F. , Szymanski Michael R. , Willwerth Sarah B. , Brewer Gabrielle J. , Whitney Kristin E. , Meehan William P. , Casa Douglas J. 
Published: March 2024

Background: Outdoor races introduce environmental stressors to runners, and core temperature changes may influence runners’ movement patterns. This study assessed changes and determined relationships between sensor-derived running biomechanics and core temperature among runners across an 11.27-km road race. Hypothesis: Core temperatures would increase significantly across the race, related to changes in spatiotemporal biomechanical measures. Study Design: Cross-sectional cohort study. Level of Evidence: Level 3. Methods: Twenty runners (9 female, 11 male; age, 48 ± 12 years; height, 169.7 ± 9.1 cm; mass, 71.3 ± 13.4 kg) enrolled in the 2022 Falmouth Road Race were recruited. Participants used lightweight technologies (ingestible thermistors and wearable sensors) to monitor core temperature and running biomechanics throughout the race. Timestamps were used to align sensor-derived measures for 7 race segments. Observations were labeled as core temperatures generally within normal limits (<38°C) or at elevated core temperatures (≥38°C). Multivariate repeated measures analyses of variance were used to assess changes in sensor-derived measures across the race, with Bonferroni post hoc comparisons for significant findings. Pearson’s r correlations were used to assess the relationship between running biomechanics and core temperature measures. Results: Eighteen participants developed hyperthermic core temperatures (39.0°C ± 0.5°C); core temperatures increased significantly across the race ( P < 0.01). Kinetic measures obtained from the accelerometers, including shock, impact, and braking g, all significantly increased across the race ( P < 0.01); other sensor-derived biomechanical measures did not change significantly. Core temperatures were weakly associated with biomechanics (| r range|, 0.02-0.16). Conclusion: Core temperatures and kinetics increased significantly across a race, yet these outcomes were not strongly correlated. The observed kinetic changes may have been attributed to fatigue-related influences over the race. Clinical Relevance: Clinicians may not expect changes in biomechanical movement patterns to signal thermal responses during outdoor running in a singular event.
Quality improvement project to improve inhaler delivery in the intensive care unit
Authors: Ye QinHao Jonathan , Kalyanasundaram Ganesh , Toh Hsiao Peng , Leo Qian Wen , Nathan Linda Marie , Cunanan Aubrey , Tan Han Ying Jessica , Sharma Kiran 
Published: March 2024

Background Late 2022, an ICU nurse discovered that Seretide™ (salmeterol/Fluticasone) Evohaler, a commonly used inhaler, did not change its dose counter when used with the inhaler connector 22M-22F. This was identified as a medication safety issue. Knowledge gaps of inhaler use in mechanically ventilated patients were identified as well. Aims To effectively administer metered dose inhalers to ventilated patients and increase its accuracy and safety. Methods We instituted education programs for healthcare professional in the ICU and introduced a new inhaler connector RTC 24-V. This was compared with the existing 22M-22F connector in a comparative study. Results The dose counter of Seretide™ recorded prior to initiation and extubation showed an obvious drop in doses ranging from 15 to 63 in patients randomized to use RTC 24-V, compared to 0 to 2 drop in doses for patients using 22M-22F. A total of 51 pre study and 33 post study questionnaires were completed. Confidence that the accurate dose of medications was administered rose from 58.8% to 84.8% after using the RTC 24-V. Responses that there was no issue compromising patient safety rose from 0% to 51.5% and fewer staff expressed concern about disconnections causing infections, dropping from 51% to 9.1%. 93.9% of respondents chose the new RTC 24-V as the preferred inhaler connector. Conclusion The new inhaler connector RTC 24-V was assessed to have less medication errors. ICU healthcare professionals expressed greater confidence in its safety and accuracy. We will implement the use of this connector with continued medical education.
Spindle cell carcinomaof the larynx: A case report and literature review
Authors: Mousli Alia , Friaa Ferdaous , Boudhina Emna , Kamoun Selma , Abidi Rim , Nasr Chiraz 
Published: March 2024

Introduction Spindle cell carcinoma (SCC), also called sarcomatoid carcinoma or carcinosarcoma, represents a rare variant of squamous cell carcinoma that may involve multiple organs, including the larynx. It is a mixed tumor, composed of both malignant epithelial and mesenchymal elements. As the larynx appears to be an unusual site, we report a case of treated SCC laryngeal as well as a literature review of such tumor. Observation A 72-year-old male, with 2 months’ history of a progressive worsening dysphonia, was examined. The patient examination showed no cervical adenopathy, while direct laryngoscopy detected a voluminous budding formation of the anterior commissure. A biopsy was performed, in which an undifferentiated carcinoma was identified. The computed tomography (CT) confirmed the existence of a glottic tumor, which completely obstructs the lumen of the larynx. No metastasis were noticed elsewhere on the PET-CT. The tumor was then classified as T3 N0 M0. The patient underwent a total laryngectomy, thyroidectomy and neck dissection. The definitive histopathological analysis confirmed the diagnosis of SCC of the larynx with negative surgical margins. Afterward, the patient underwent adjuvant radiotherapy (RT) on the tumor bed. Conclusion Primary laryngeal SCC is a very rare malignancy with a tendency to occur with controlateral lymph node metastasis at an early stage of the disease. Combining surgery and postoperative RT is recommended due to its aggressive profile.
Palestinian Nursing Students’ Perspective of Clinical Decision-Making
Authors: Al Ali Mohammad Faisal 
Published: March 2024

Introduction One of the most important aspects of nursing education and practice is clinical decision-making (CDM), which is also crucial to clinical competency. Objective The study aimed to assess the CDM of undergraduate nursing students by using the CDM nursing scale. Method The study was cross-sectional and involved 315 nursing student participants. Data collection utilized the Clinical Decision-Making Scale, which comprises domains such as “canvassing of objectives and values,” “search for alternatives or options,” “evaluation and reevaluation of consequences,” and “search for information and unbiased assimilation of new information.” Statistical analyses included Pearson correlation, ANOVA, and independent t-tests. Data collection occurred during the second semester of 2023. Results The results indicated that the mean age of the students was 21.69 ( SD = 1.6) years. In terms of gender, the majority were males, constituting 216 (68.6%) of the participants. Among the participants, 105 (33.3%) were from the second year, 108 (34.3%) from the third year, and 102 (32.4%) from the fourth year. The analysis revealed that the average CDM score was 129.8 ( SD = 17.5). Additionally, examination of the subscales of CDM showed that the highest subscale score was for “search for information and unbiased assimilation of new information” ( M = 33.1, SD = 5.3), while the lowest subscale score was for “search for alternatives or options” ( M = 31.8, SD = 6.0). Furthermore, the analysis demonstrated a significant difference between academic year level and the mean CDM scores ( p < .05), along with a positive relationship between the CDM score and students’ age ( r = .67, p = .001). Conclusion The findings revealed that nursing students exhibit a moderate level of CDM. Moreover, it was revealed that students’ CDM is influenced by both their age and academic year level.
The Relationship Between Emotional Intelligence and Coping Behaviors among Nurses in the Intensive Care Unit
Authors: Jawabreh Nida 
Published: March 2024

Introduction Nurses are expected to experience chronic stress and be involved in unhealthy actions more frequently due to the rising demands of medical care, which impact every aspect of their individual and professional lives. Individuals with higher emotional intelligence could cope and adjust to environmental changes and social constraints better than those with lower emotional intelligence. Objective The objective of this study was to assess the relationship between the emotional intelligence and coping behaviors of nurses in the intensive care units (ICUs) in the West Bank. Methods The study was a cross-sectional method done on convenience sample of 266 ICU nurses. Data collection was performed by “Schutte Self Report Emotional Intelligence Test” (SSEIT) and the “Coping Behavior Inventory”. Statistical analysis was completed using SPSS version 23. Pearson correlation was used to measure the relationship between the emotional intelligence and coping behaviors. Results The analysis indicated that emotional intelligence was high (mean ± SD = 150.8 ± 2.1, range 33–165). Also, the analysis indicated that coping behavior of the participants was moderate (mean ± SD = 29.3 ± 15.2, range 0–76). Furthermore, the analysis indicated that there was a moderate positive relationship between nurses’ emotional intelligence and their coping behaviors. Conclusion Coping behavior was indicated to have a moderately positive relationship with emotional intelligence. However, social skills or managing others’ emotions indicated low positive relationship and emotional intelligence. There is a negligible correlation between emotional intelligence and perception of emotions, managing emotions in the self, and utilizing emotions. Training in emotional intelligence is essential for nurses since it improves both their personal and professional life and coping mechanisms.
Infantile Myofibroma of the Frontal Bone: A Case Report
Authors: Alawi Khalifa Al , Abri Ruqaya Al , Shaqsi Sultan Al , Habsi Jehad Al , Al Azri Ahmed , Balushi Taimoor Al 
Published: March 2024

Background: Infantile myofibroma stands as the most prevalent fibrous neoplasm within the pediatric population, despite its rarity. The majority of these tumors manifest within the initial 2 years of life. Clinically, myofibroma lesions are classified into solitary and multicentric tumors. Methods: We present a case of infantile myofibroma located within the frontal bone of a 16-month-old infant. Initial evaluation of the swelling and its spread was conducted using CT and MRI scans. Subsequently, the diagnosis was confirmed through a core needle biopsy. Results: The tumor underwent surgical excision with 1 cm safety margin and immediate reconstruction with strips of calvaria bone graft. Histopathology of the specimen showed complete tumor clearance with actual margin of 7 mm. Conclusion: The surgical resection of cranial benign bone tumors should be meticulously planned with a multidisciplinary approach. Wherever possible, immediate reconstruction should be conducted to avoid the morbidity of a subsequent procedure.
Amino acid supplementation confers protection to red blood cells before Plasmodium falciparum bystander stress
Authors: Binns Heather Colvin , Alipour Elmira , Sherlock Cameron E. , Nahid Dinah S. , Whitesides John F. , Cox Anderson O’Brien , Furdui Cristina M. , Marrs Glen S. , Kim-Shapiro Daniel B. , Cordy Regina Joice 
Published: March 2024

Abstract
Malaria is a highly oxidative parasitic disease in which anemia is the most common clinical symptom. A major contributor to the malarial anemia pathogenesis is the destruction of bystander, uninfected red blood cells (RBCs). Metabolic fluctuations are known to occur in the plasma of individuals with acute malaria, emphasizing the role of metabolic changes in disease progression and severity. Here, we report conditioned medium from Plasmodium falciparum culture induces oxidative stress in uninfected, catalase-depleted RBCs. As cell-permeable precursors to glutathione, we demonstrate the benefit of pre-exposure to exogenous glutamine, cysteine, and glycine amino acids for RBCs. Importantly, this pretreatment intrinsically prepares RBCs to mitigate oxidative stress.
Cost-effectiveness of bevacizumab therapy in the care of patients with hereditary hemorrhagic telangiectasia
Authors: Wang Daniel , Ito Satoko , Waldron Christina , Butt Ayesha , Zhang Ellen , Krumholz Harlan M. , Al-Samkari Hanny , Goshua George 
Published: March 2024

Abstract
No US Food and Drug Administration- or European Medicines Agency-approved therapies exist for bleeding due to hereditary hemorrhagic telangiectasia (HHT), the second-most common inherited bleeding disorder worldwide. The current standard of care (SOC) includes iron and red cell supplementation, alongside the necessary hemostatic procedures, none of which target underlying disease pathogenesis. Recent evidence has demonstrated that bleeding pathophysiology is amenable to systemic antiangiogenic therapy with the anti-vascular endothelial growth factor bevacizumab. Despite its high cost, the addition of longitudinal bevacizumab to the current SOC may reduce overall health care resource use and improve patient quality of life. We conducted, to our knowledge, the first cost-effectiveness analysis of IV bevacizumab in patients with HHT with the moderate-to-severe phenotype, comparing bevacizumab added to SOC vs SOC alone. The primary outcome was the incremental net monetary benefit (iNMB) reported over a lifetime time horizon and across accepted willingness-to-pay thresholds, in US dollar per quality-adjusted life year (QALY). Bevacizumab therapy accrued 9.3 QALYs while generating $428 000 in costs, compared with 8.3 QALYs and $699 000 in costs accrued in the SOC strategy. The iNMB of bevacizumab therapy vs the SOC was $433 000. No parameter variation and no scenario analysis, including choice of iron supplementation product, changed the outcome of bevacizumab being a cost-saving strategy. Bevacizumab therapy also saved patients an average of 133 hours spent receiving HHT-specific care per year of life. In probabilistic sensitivity analysis, bevacizumab was favored in 100% of all 10 000 Monte Carlo iterations across base-case and all scenario analyses. Bevacizumab should be considered for more favorable formulary placement in the care of patients with moderate-to-severe HHT.
Slideflow: deep learning for digital histopathology with real-time whole-slide visualization
Authors: Dolezal James M. , Kochanny Sara , Dyer Emma , Ramesh Siddhi , Srisuwananukorn Andrew , Sacco Matteo , Howard Frederick M. , Li Anran , Mohan Prajval , Pearson Alexander T. 
Published: March 2024

AbstractDeep learning methods have emerged as powerful tools for analyzing histopathological images, but current methods are often specialized for specific domains and software environments, and few open-source options exist for deploying models in an interactive interface. Experimenting with different deep learning approaches typically requires switching software libraries and reprocessing data, reducing the feasibility and practicality of experimenting with new architectures. We developed a flexible deep learning library for histopathology called Slideflow, a package which supports a broad array of deep learning methods for digital pathology and includes a fast whole-slide interface for deploying trained models. Slideflow includes unique tools for whole-slide image data processing, efficient stain normalization and augmentation, weakly-supervised whole-slide classification, uncertainty quantification, feature generation, feature space analysis, and explainability. Whole-slide image processing is highly optimized, enabling whole-slide tile extraction at 40x magnification in 2.5 s per slide. The framework-agnostic data processing pipeline enables rapid experimentation with new methods built with either Tensorflow or PyTorch, and the graphical user interface supports real-time visualization of slides, predictions, heatmaps, and feature space characteristics on a variety of hardware devices, including ARM-based devices such as the Raspberry Pi.