bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of abdominal heat therapy on constipation
Authors: Eshaghi Amir , Norouzadeh Reza , Jadid-Milini Maryam 
Published: April 2024

Background: Constipation is one of the most common complications of the digestive system and has a significant impact on people's health and quality of life. One of the proposed non-drug interventions is the use of heat therapy. This study aimed to determine the effect of abdominal heat therapy on constipation. Aims: To identify if the use of heat therapy reduces constipation in elderly people admitted to the general internal medicine department. Methods: This study employs a triple-blind clinical trial design. A total of 92 elderly patients admitted to the internal medicine department of Sinai Hospital in Arak City in 2023 were randomly assigned to either a control or intervention group. Patients in the intervention group received local heat therapy using a standard hot water bottle with a temperature of 50°C applied to the abdomen. The control group received a hot water bottle at a temperature of 25°C. Data collection tools included the Bristol Stool Form Scale and a demographic data sheet. Analysis was conducted using SPSS 16. Results: The results showed that stool consistency was similar between the interventional and control groups before applying the hot water bag to the abdomen. A significant difference was observed on the first day (P=0.001) and the second day (P=0.005). There was a significant difference in stool consistency before the intervention, on day 1 and day 2 (P<0.001), but most people in the control group had no defecation. Conclusions: Local heat therapy improves bowel function and reduces constipation during defecation in the elderly, and its use is suggested at the same time as complementary studies.
How practitioner-led colonoscopy surveillance management improves productivity while saving money
Authors: Wargen Adele 
Published: April 2024

Background: The British Society for Gastroenterology (BSG) guidelines for post-polypectomy and post-cancer-resection surveillance were changed in October 2020, essentially excluding a large proportion of patients awaiting a surveillance colonoscopy as they now no longer fit the criteria for surveillance. Aims: To audit the colonoscopy surveillance waiting list at the Wye Valley Trust to ascertain patient appropriateness for colonoscopy under the new BSG guidelines. Methods: A practitioner-led colonoscopy surveillance clinic led by a clinical endoscopist was set up to audit the colonoscopy surveillance waiting list of over 1200 patients. The aim was to clinically assess each patient against the guidelines and determine discharge from, or continuation of, the surveillance pathway for each patient. The patients were then offered outpatient clinic appointments where fitness was assessed and appropriate investigations were finalised. Results: Patient numbers on the colonoscopy surveillance waiting list were reduced by nearly 50%, with waiting times down to 0 weeks, by facilitating practitioner-led pre-assessment and outpatient clinics, all while saving Weston General Hospital almost £300000 in the initial 9 months. Conclusions: The new colonoscopy surveillance guidelines presented an opportunity to audit and evaluate the colonoscopy guidelines in the Wye Valley Trust. The facilitation of a clinical endoscopist committed time to implement new pre-assessment processes and outpatient clinics, this process allowed the discharge of almost 50% of patients upon the colonoscopy surveillance waiting list, it created extra colonoscopy capacity for 2 week wait and urgent colonoscopies, while generating a positive financial implication for the trust.
Artificial intelligence in gastroenterology: where are we and where are we going?
Authors: Lovat Laurence B 
Published: April 2024

Background: The use of artificial intelligence (AI) is rapidly advancing in gastroenterology, most notably in the area of endoscopy, but also more widely throughout the speciality. This article reviews what AI is, how it works and some of the key advances it is bringing. AI can already improve patient triage so that resources can be better targeted at sick patients. In endoscopy, AI can improve the detection of polyps during colonoscopy and the accuracy of diagnosis, while in Barrett's oesophagus, it can improve the detection of pre-cancerous dysplasia so that all endoscopists can emulate the performance of world-class experts. Systems are being developed to automate the assessment of bowel preparation quality and report writing. The power of novel generative AI such as ChatGPT could drive major improvements in communication between busy clinicians and patients. Healthcare professionals need to ensure they understand how to manage the ‘black-box’ that is AI.
Can more be done to optimise the effect of mesalazine for IBD patients with mild to moderate ulcerative colitis?
Authors: Jazrawi Riadh 
Published: April 2024

Background Ulcerative colitis (UC) is characterised by chronic mucosal inflammation primarily in the colon. Guidelines recommend mesalazine as first-line therapy for induction of maintenance in mild-to-moderate Ulcerative colitis. Patients' preferences, response to treatment, site and extent of inflammation and cost are important considerations when selecting mesalazine therapy. Aims/Methods This article reviews mesalazine's role in ulcerative colitis and explores the factors to consider when optimising mesalazine-based therapy. Findings Up to two-thirds of patients fail to respond to induction therapy within 8 weeks, thereby prompting a switch of formulations or escalation to oral corticosteroids. While there are no major variations in efficacy, different mesalazine formulations are not interchangeable because of differences in mode of drug delivery, site of drug release and excipients. Switching mesalazine products before escalating therapy may, therefore, spare patients from wider side effects and higher costs. Conclusions Optimising mesalazine-based therapy requires individualised treatment plans based on patient preferences, site and extent of inflammation, response to treatment and potential side effects. An algorithm exists to guide the selection of alternative mesalazine formulations when required.
Institutional Efficiency And Financial Performance Of Insurance Companies In Nigeria
Authors: Ogunwale Olurotimi , Akintoye Ishola Rufus , Ogboi Charles , Ogbebor Peter Ifeanyi 
Published: April 2024

This study investigated the impact of institutional efficiency on the financial performance of insurance companies in Nigeria covering the period from 2011 to 2022. The study employed an ex-post facto research design, the estimation techniques utilized were feasible generalized least squares (FGLS) on a sample of five insurance companies were taken. The key variables used in the analysis included net profit margin (NPM) as dependent variable and claims processing efficiency (CPE), risk management effectiveness (RME), and regulatory compliance (RC) as independent variables. The findings displayed that claims processing efficiency (β =0.185, p > 0.05) had positive but no significant effect with net profit margin, risk management effectiveness rate (β =105.910, p > 0.05) is positive but not significantly influencing in net profit margin, regulatory compliance also have negative but does not significantly impact net profit margin of the selected insurance companies in Nigeria at 1% level (β =-12.504, p > 0.05). The study thus recommended, among others, that policy maker should encourage insurance companies to adopt measures that enhance institutional efficiency, such as investing in technology, improving risk management practices, and enhancing customer service.
Poetry Workshop in the Acute Inpatient Psychiatric Setting: Feasible, Acceptable, and Significantly Beneficial
Authors: Thomas-Tran Jane , Thomas-Tran Emily Phu , Eisen Katherine , Kharrazi Neda , Mason Daniel 
Published: April 2024

Objective: We investigated the feasibility and acceptability of establishing a therapeutic poetry writing workshop in an acute inpatient psychiatric setting, as well as the impact of participation on measures of mood, hope, and recovery orientation. Methods: Participants were recruited from the inpatient psychiatric units of an academic medical center. As a pre/post measure of effect of the poetry intervention, participants completed the Herth Hope Index (HHI) and the Mental Health Confidence Scale (MHCS) at baseline and follow-up, as well as a Brief Mood Survey (BMS) immediately before and after each instance of participation in the poetry workshop. Student’s t-tests were used to assess for changes on HHI, MHCS, and BMS, as well as to compare the before vs after in these metrics for individuals who attended only one workshop session versus those who attended two or more sessions to assess for dose-dependent effect of the intervention. Workshop participants also optionally completed a satisfaction survey of their qualitative experience of the group. The protocol for leading a workshop is described in detail. Results: There was a statistically significant improvement in multiple subscales of mood according to the pre- and post-measures on the BMS. Results of the HHI indicated a trend toward increased hopefulness. Results of the MHCS showed statistically significant improvement in participants’ confidence in managing day-to-day life with a mental illness. Results of satisfaction surveys indicate that participants had an overwhelmingly positive experience of the group. Conclusions and Implications for Practice: Workshops designed to foster writing and sharing poetry in a group format are likely to be clinically helpful to improve mood for patients in an acute inpatient psychiatric setting. Future research may examine the adaptability of this intervention for outpatient and virtual settings. Impact and Implications: We conducted a poetry workshop for patients in an acute inpatient psychiatric unit. Participation in the workshop even just once provided a statistically significant and clinically meaningful improvement in multiple subscales of mood and confidence in managing day-to-day life with a mental illness. Our study describes in detail the protocol for a mental health clinician to recreate a similar poetry workshop in their own clinic or hospital.
Non‐canonical IKB kinases regulate YAP/TAZ and pathological vascular remodeling behaviors in pulmonary artery smooth muscle cells
Authors: Aravamudhan Aja , Dieffenbach Paul B. , Choi Kyoung Moo , Link Patrick A. , Meridew Jeffrey A. , Haak Andrew J. , Fredenburgh Laura E. , Tschumperlin Daniel J. 
Published: April 2024

AbstractPulmonary arterial hypertension (PAH) causes pulmonary vascular remodeling, increasing pulmonary vascular resistance (PVR) and leading to right heart failure and death. Matrix stiffening early in the disease promotes remodeling in pulmonary artery smooth muscle cells (PASMCs), contributing to PAH pathogenesis. Our research identified YAP and TAZ as key drivers of the mechanobiological feedback loop in PASMCs, suggesting targeting them could mitigate remodeling. However, YAP/TAZ are ubiquitously expressed and carry out diverse functions, necessitating a cell‐specific approach. Our previous work demonstrated that targeting non‐canonical IKB kinase TBK1 reduced YAP/TAZ activation in human lung fibroblasts. Here, we investigate non‐canonical IKB kinases TBK1 and IKKε in pulmonary hypertension (PH) and their potential to modulate PASMC pathogenic remodeling by regulating YAP/TAZ. We show that TBK1 and IKKε are activated in PASMCs in a rat PH model. Inflammatory cytokines, elevated in PAH, activate these kinases in human PASMCs. Inhibiting TBK1/IKKε expression/activity significantly reduces PAH‐associated PASMC remodeling, with longer‐lasting effects on YAP/TAZ than treprostinil, an approved PAH therapy. These results show that non‐canonical IKB kinases regulate YAP/TAZ in PASMCs and may offer a novel approach for reducing vascular remodeling in PAH.
Determination of anthropometric measurements and their application in the development of clothing sizing systems for women in the regions of the Republic of Croatia
Authors: Doležal Ksenija , Brlobašić Šajatović Blaženka 
Published: April 2024

Abstract
The aim of this article is to determine the differences in the physical dimensions of the female body that form the basis of the clothing size system and compare their deviations within the three regions of the Republic of Croatia. Due to the changes in the dimensions and shape of the human body, there is a need to adjust clothing in order to achieve the best possible fit. A systematic consideration of the fit of clothing includes investigation of a number of elements and factors, especially those based on anthropometric knowledge. The results of anthropometric measurements performed on a representative sample determine the body dimensions of the measured population. By sorting and grouping the data of body measurements, clothing sizes are created, with significant differences in body shape and body proportions of individual population groups. In the clothing size system, individual body dimensions define the clothing size and form a scale determined by a norm that prescribes body shape based on two dimensions of girths, where the measurement of bust girth is the basic measurement, and the body height is the dependent variable. This research was carried out on a sample of 940 women from the region of Slavonia, 1,109 women from the region of Dalmatia, and 799 women from the City of Zagreb, classified into seven age groups. The statistical processing of the results, i.e., the method of principal components, the values of the observed body measurements, and the representation of certain categories of bust girth and body size in the measured population of each region were determined.
Thymosin α1 combined with XELOX improves immune function and reduces serum tumor markers in colorectal cancer patients after radical surgery
Authors: Sha Li , Zhang Hao , Zhang Xiwei 
Published: April 2024

Abstract
This study aimed to investigate the efficacy of thymosin α1 combined with XELOX in improving immune function and reducing serum tumor markers in patients with colorectal cancer (CRC) after radical surgery. A total of 180 patients who underwent radical surgery for CRC were divided into two groups: an observation group (n = 94) receiving thymosin α1 in combination with XELOX and a control group (n = 86) receiving XELOX alone. Immune function, inflammatory factor levels, serum tumor markers, and quality of life were assessed before and after treatment. Adverse reactions and recurrence rates were compared between the two groups in 1 and 3 years. Following therapy, there was a notable increase in the levels of CD3+, CD4+, and CD4+/CD8+ in all cohorts, particularly in the observation cohort, when compared to pre-therapy levels. Conversely, CD8+ levels decreased across all cohorts, especially in the observation cohort. Additionally, there was an increase in the levels of IL-2 and IFN-γ in the observation cohort, compared to both pre-therapy and control cohort levels, while IL-6 levels decreased. The presence of CEA, CA242, and CA724 reduced significantly across all cohorts following post-therapy, particularly in the observation cohort. Post-therapy, there was a significant increase in the scoring for role, cognitive, social, emotional, and somatic functions in all cohorts, with the most significant improvement observed in the observation cohort. There were no significant differences in the incidence of side effects across cohorts, while neutropenia events were significantly lower in the observation cohort (32.98%) compared to the control cohort (48.84%). The 12-month recurrence rate showed no statistical significance across cohorts, while the observation cohort had a significantly lower three-year recurrence rate (24.47%) compared to the control cohort (59.30%). Thymosin α1 combined with XELOX is effective in improving immune function, reducing serum tumor markers, and minimizing recurrence in CRC patients after radical surgery. This combination therapy may be a promising new direction for the treatment of CRC.
The impact of incorporating waste materials on the mechanical and physical characteristics of tile adhesive materials
Authors: Turki Samer Kareem , Ibrahim Sarmad I. , Almaamori Mohammed H. D. 
Published: April 2024

Abstract
The goal of the investigation is to produce a cement mortar for building units and a high-performance ceramic tile adhesive by using V autoclaved aerated concrete as a partial substitute for cement. The combination consists of sand, crushed limestone, and polymeric additives. The experimental procedures were conducted utilizing contemporary laboratory equipment to facilitate the manufacturing of the product and the subsequent investigation of its characteristics, in accordance with the standards outlined in EN12004 and ASTM C1660. The laboratory tests carried out, which included splitting tensile strength, bonding strength, and open application duration, have demonstrated conformity to the product standards. The raw materials undergo many examinations prior to their utilization in the preparation process. The conducted tests encompassed chemical analysis, X-ray diffraction, and viscosity evaluation. These experiments aimed to ascertain the mixing ratios and determine the optimal quantity of water required for the preparation procedure. A thickness of 3 mm was employed, rendering it very cost-effective and environmentally sustainable due to the utilization of recycled resources. This particular adhesive possesses supplementary characteristics, such as its self-sufficiency on the site, since it is readily used without the need for extra materials, requiring only the addition of the necessary amount of water. Extensive research has been conducted on a range of mix designs and particle sizes for raw materials, together with varying proportions of additives, to determine the optimal ratio that satisfies both criteria and cost considerations. The adhesion strength of the building units was determined to be 7 N/mm2, surpassing the specified value in ASTM C1660. This indicates that the material is deemed successful and meets the required specifications for its application as a mortar for building units, as per the standard stating that an adhesion strength test exceeding 5 N/mm2 is necessary. The evaluation of the characteristics of the material employed as tile adhesive mortar was conducted in accordance with the EN1348 standard, revealing satisfactory compliance with all specified criteria. The application duration of the tile adhesive exceeds 25 min, while its tensile strength surpasses 10 N/mm2, thereby meeting the criteria for classification as a Class A tile adhesive.
Experimental investigation on tensile behavior of CFRP bolted joints subjected to hydrothermal aging
Authors: Chen Hui , Li Mingjie , Shen Zhao , Zhang Yitao , Zhu Youhua , Wu Ye 
Published: April 2024

Abstract
With the help of bolted joints to assemble a complex structure, carbon fiber reinforced polymer composite (CFRP) is widely used in various fields. However, stress concentration around holes at the bolted joints leads to a decrease in bearing capacity. Composites often result in mechanical degradation subjected to a complex hydrothermal environment. Therefore, to study the tensile behavior of CFRP bolted joints subjected to hydrothermal aging, the tensile tests are conducted carefully. The influence of aging time and temperature on tensile strength is investigated based on the response history, strain contour, and failure morphology. The failure mechanism is revealed via digital image correlation technology. Finally, the experimental results demonstrate that the bearing capacity of the structure in hydrothermal aging decreases significantly. Compared with the unaged specimens, the peak force of the specimens aged for 6 weeks at 25°C and 65°C is reduced by 22.79% and 35.63%, respectively. Under both the unaged and aged, the same bearing failure is found in the tensile tests of CFRP single-bolt single-lap joints.
EU Debt Instruments and Fiscal Transparency: The Case of the EU Recovery Fund
Authors: Demir Ahmed , Garmann Sebastian 
Published: April 2024

Abstract
We study the transparency of debts incurred for the EU Recovery Fund. In our opinion, the Recovery Fund lacks transparency at various levels. We find that the Fund implements a hidden transfer scheme that splits member states into net contributors and net recipients. As a result, the national budgets of the EU member states will have to face uncertain future obligations. Finally, we hold that the Fund weakens the European fiscal rules because the debts of the Recovery Fund do not add to the national debt levels. The national debt levels therefore do not show the whole burden.
Detecting heterogeneity of spatial accessibility to sports facilities for adolescents at fine scale: A case study in Changsha, China
Authors: Cheng Shuang , Liu Wuxin , Jiang Wangyang , Li Chen 
Published: April 2024

Abstract
It is crucial for social sustainability that adolescents have access to social sports services fairly. However, there are few research studies on requirements for sports facilities and spatial accessibility of adolescents at a fine scale. Further, identifying the heterogeneity of the relationship between spatial accessibility and other factors and their scales simultaneously would be conducive to reveal the variations of spatial accessibility effectively under the potential scale effect. This research aims to explore the heterogeneity of spatial accessibility to sports facilities at a fine scale in Changsha, China. The Gaussian-based two-step floating catchment area model is first employed to evaluate spatial accessibility. Then, multiscale geographically weighted regression (MGWR) is applied to examine the relationship between spatial accessibility and its associated factors. The mean accessibility in Yuelu District (0.158) is the highest as well, and the standard deviation (0.236) is also the highest one. Both the accessibility (0.019) and its standard derivation (0.029) in Furong District are the lowest. The results show that there is a lack of balance of spatial accessibility for the clusters with different accessibility levels distributed in the study area. Some socio-economic factors, such as housing price and nighttime light intensity, have significant impacts on spatial accessibility for adolescents with spatial and scale heterogeneity by using MGWR. Based on heterogeneous distribution and association, suggestions for promoting spatial accessibility to sports facilities for adolescents are proposed.
Damage evaluation of the austenitic heat-resistance steel subjected to creep by using Kikuchi pattern parameters
Authors: Du Zechen , Risu Na , Zhang Yuetao , Chen Jianguo , Wang Xiao 
Published: April 2024

Abstract
Austenitic heat-resistance steel is widely employed in ultra-supercritical power generation because of its superior performance. This article reports the evaluation of creep damage of a typical Super304H austenitic heat-resistance steel by using the Kikuchi pattern parameters, such as band contrast (BC), mean angular deviation (MAD), and band slope (BS). It was found that the mean BC and MAD values did not show a monotonic changing trend and then an in-depth research that distinguished grain boundary and grain interior regions of Super304H steel was studied, respectively. The results manifested that, with the increase of creep time, both the mean BC and BS values showed a monotonic decreasing trend, while the MAD did not. Besides, compared with the BC, the change amplitude of BS was larger. The results indicate that the BS could be a useful indicator, which can be utilized to evaluate the creep degree of Super304H steel in a quantitative way.