bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between spinal flexibility and bracing outcomes in adolescent idiopathic scoliosis: a literature review
Authors: Luo Chang Liang , Ma Christina Zong Hao , Zou Yi Ying , Zhang Li Sha , Wong Man Sang 
Published: December 2023

AbstractObjectivesTo identify the existing assessment methods used to measure the spinal flexibility of adolescents with idiopathic scoliosis before bracing and to evaluate the predictive effect of spinal flexibility on bracing outcomes.MethodsA broad literature search was performed in the PubMed, Web of Science, EMBASE, CINAHL, Scopus, and Cochrane Library databases to obtain relevant information about spinal flexibility and bracing outcomes. All literature was retrieved by October 14, 2023. The inclusion and exclusion criteria were meticulously determined. The quality of each included study and the level of evidence were evaluated by the Quality in Prognosis Studies (QUIPS) method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, respectively.ResultsAfter screening 1863 articles retrieved from databases, a total of 14 studies with 2261 subjects were eligible for the final analysis in this review. Overall, nine methods of flexibility assessment were identified, including supine radiographs, supine lateral bending radiographs, lateral bending radiographs but without clear positions, hanging radiographs, fulcrum bending physical method, and ultrasound imaging in the positions of supine, prone, sitting with side bending and prone with side bending. In addition, five studies demonstrated that flexibility had a strong correlation with in-brace correction, and eleven studies illustrated that spinal flexibility was a predictive factor of the bracing outcomes of initial in-brace Cobb angle, initial in-brace correction rate, curve progression, and curve regression. The results of GRADE demonstrated a moderate-evidence rating for the predictive value of spinal flexibility.ConclusionSupine radiography was the most prevalent method for measuring spinal flexibility at the pre-brace stage. Spinal flexibility was strongly correlated with the in-brace Cobb angle or correction rate, and moderate evidence supported that spinal flexibility could predict bracing outcomes.
A multicomponent intervention program to Prevent and Reduce AgItation and phySical rEstraint use in the ICU (PRAISE): study protocol for a multicenter, stepped-wedge, cluster randomized controlled trial
Authors: Kooken Rens W. J. , Tilburgs Bram , ter Heine Rob , Ramakers Bart , van den Boogaard Mark ,   on behalf of the PRAISE study group, Wiggelo-Lijbers Dieke , Klop-Riehl Margreet , Rettig Thijs C.D. , Wijnhoven JanWillem , Simons Bram , van de Weyer Rens , Bakker Stephanie , de Ruijter Wouter , Slot Stefanie , Braker-Scholtes Stefanie , Bruin Liz , Habes Quirine , Meeuws Sanne , Fleuren-Janssen Manon 
Published: December 2023

Abstract
Background
Physical restraints remain to be commonly used in agitated intensive care unit (ICU) patients worldwide, despite a lack of evidence on efficacy and safety and reports of detrimental short and long-term consequences, such as prolonged delirium and a longer ICU length of stay. Physical restraint minimization approaches have focused mainly on educational strategies and other non-pharmacological interventions. Combining these interventions with goal-directed light sedation therapy if needed may play an important contributory role in further reducing the use of physical restraints. The aim of the study is to determine the effectiveness of a multicomponent intervention (MCI) program, combining person-centered non-pharmacological interventions with goal-directed light sedation, compared to physical restraints.

Methods
A multicenter stepped-wedge cluster randomized controlled trial will be conducted in six Dutch ICUs. A power calculation based total of 480 (expected to become) agitated adult patients will be included in 26 months with a subsequent 2-year follow-up. Patients included in the control period will receive standard care with the current agitation management protocol including physical restraints. Patients included in the intervention period will be treated with the MCI program, consisting of four components, without physical restraints: education of ICU professionals, identification of patients at risk for agitation, formulation of a multidisciplinary person-centered care plan including non-pharmacological and medical interventions, and protocolized goal-directed light sedation using dexmedetomidine. Primary outcome is the number of days alive and outside of the ICU within 28 days after ICU admission. Secondary outcomes include length of hospital stay; 3-, 12-, and 24-month post-ICU quality of life; physical (fatigue, frailty, new physical problems), mental (anxiety, depression, and post-traumatic stress disorder), and cognitive health; and 1-year cost-effectiveness. A process evaluation will be conducted.

Discussion
This will be the first multicenter randomized controlled trial determining the effect of a combination of non-pharmacological interventions and light sedation using dexmedetomidine compared to physical restraints in agitated ICU patients. The results of this study, including long-term patient-centered outcomes, will provide relevant insights to aid ICU professionals in the management of agitated patients.

Trial registration
NCT05783505, registration date 23 March 2023.
Statistical optimization and gamma irradiation on cephalosporin C production by Acremonium chrysogenum W42-I
Authors: Ibrahim Asmaa A. , El-Housseiny Ghadir S. , Aboshanab Khaled M. , Startmann Ansgar , Yassien Mahmoud A. , Hassouna Nadia A. 
Published: December 2023

AbstractMost antibiotics now used in clinical practice are cephalosporins. Acremonium (A.) chrysogenum W42-I is an intermediate strain out of W42 strain improvement program whose productivity is above that of the wild-type strain to produce the broad-spectrum antibacterial cephalosporin C (CPC). As a result, fermentation process optimization is considered because it offers the ideal environment for strains to reach their full potential. Our research aimed to combine a rational design to regulate the fermentation process environment and culture media as well as to develop mutants with high productivity. Different media were tested to obtain maximum CPC production. To maximize the production of CPC, some environmental parameters were experimentally optimized via the Box-Behnken design used for response surface methodology (RSM). There were 17 tests conducted, and each experiment's reaction was recorded. Improvement of the CPC production was further achieved via mutagenesis using gamma radiation. Results revealed that a pH of 4, an incubation period of 4 days, and an inoculum size of 1% v/v using the optimized media (CPC2) were the optimum conditions for enhancing the CPC production by 4.43-fold. In addition, gamma irradiation further enhanced production to reach 3.46-fold using an optimum dose of 2 KGy. In conclusion, in comparison to initial production levels, CPC production increased 4.43-fold because of nutritional and environmental optimization. The mutant AC8 demonstrated a roughly 3.46-fold increase in activity against its parent type. Moreover, subsequent AC8 mutant culture demonstrated excellent genetic stability.
New clinical application prospects of artemisinin and its derivatives: a scoping review
Authors: Huang Yangmu , Yang Yang , Liu Guangqi , Xu Ming 
Published: December 2023

Abstract
Background
Recent research has suggested that artemisinin and its derivatives may have therapeutic effects on parasites, viruses, tumors, inflammation and skin diseases. This study aimed to review clinical research on artemisinin and its derivatives except anti-malaria and explore possible priority areas for future development.

Methods
Relevant articles in English and Chinese published before 28 October 2021 were reviewed. All articles were retrieved and obtained from databases including WanFang, PubMed/MEDLINE, the Cochrane Library, China National Knowledge International, Embase, OpenGrey, the Grey Literature Report, Grey Horizon, and ClinicalTrials.gov. Studies were selected for final inclusion based on predefined criteria. Information was then extracted and analyzed by region, disease, outcome, and time to identify relevant knowledge gaps.

Results
Seventy-seven studies on anti-parasitic (35), anti-tumor (16), anti-inflammatory (12), anti-viral (8), and dermatological treatments (7) focused on the safety and efficacy of artemisinin and its derivatives. The anti-parasitic clinical research developed rapidly, with a large number of trials, rapid clinical progress, and multiple research topics. In contrast, anti-viral research was limited and mainly stayed in phase I clinical trials (37.50%). Most of the studies were conducted in Asia (60%), followed by Africa (27%), Europe (8%), and the Americas (5%). Anti-parasite and anti-inflammatory research were mainly distributed in less developed continents such as Asia and Africa, while cutting-edge research such as anti-tumor has attracted more attention in Europe and the United States. At the safety level, 58 articles mentioned the adverse reactions of artemisinin and its derivatives, with only one study showing a Grade 3 adverse event, while the other studies did not show any related adverse reactions or required discontinuation. Most studies have discovered therapeutic effects of artemisinin or its derivatives on anti-parasitic (27), anti-tumor (9), anti-inflammatory (9) and dermatological treatment (6). However, the efficacy of artemisinin-based combination therapies (ACTs) for parasitic diseases (non-malaria) is still controversial.

Conclusions
Recent clinical studies suggest that artemisinin and its derivatives may be safe and effective candidates for anti-tumor, anti-parasitic, anti-inflammatory and dermatological drugs. More phase II/III clinical trials of artemisinin and its derivatives on antiviral effects are needed.

Graphical Abstract
An evolved pyrrolysyl-tRNA synthetase with polysubstrate specificity expands the toolbox for engineering enzymes with incorporation of noncanonical amino acids
Authors: Liu Ke , Jiang Ling , Ma Shuang , Song Zhongdi , Wang Lun , Zhang Qunfeng , Xu Renhao , Yang Lirong , Wu Jianping , Yu Haoran 
Published: December 2023

AbstractAminoacyl-tRNA synthetase (aaRS) is a core component for genetic code expansion (GCE), a powerful technique that enables the incorporation of noncanonical amino acids (ncAAs) into a protein. The aaRS with polyspecificity can be exploited in incorporating additional ncAAs into a protein without the evolution of new, orthogonal aaRS/tRNA pair, which hence provides a useful tool for probing the enzyme mechanism or expanding protein function. A variant (N346A/C348A) of pyrrolysyl-tRNA synthetase from Methanosarcina mazei (MmPylRS) exhibited a wide substrate scope of accepting over 40 phenylalanine derivatives. However, for most of the substrates, the incorporation efficiency was low. Here, a MbPylRS (N311A/C313A) variant was constructed that showed higher ncAA incorporation efficiency than its homologous MmPylRS (N346A/C348A). Next, N-terminal of MbPylRS (N311A/C313A) was engineered by a greedy combination of single variants identified previously, resulting in an IPE (N311A/C313A/V31I/T56P/A100E) variant with significantly improved activity against various ncAAs. Activity of IPE was then tested toward 43 novel ncAAs, and 16 of them were identified to be accepted by the variant. The variant hence could incorporate nearly 60 ncAAs in total into proteins. With the utility of this variant, eight various ncAAs were then incorporated into a lanthanide-dependent alcohol dehydrogenase PedH. Incorporation of phenyllactic acid improved the catalytic efficiency of PedH toward methanol by 1.8-fold, indicating the role of modifying protein main chain in enzyme engineering. Incorporation of O-tert-Butyl-L-tyrosine modified the enantioselectivity of PedH by influencing the interactions between substrate and protein. Enzymatic characterization and molecular dynamics simulations revealed the mechanism of ncAAs affecting PedH catalysis. This study provides a PylRS variant with high activity and substrate promiscuity, which increases the utility of GCE in enzyme mechanism illustration and engineering.
Graphical Abstract
Spatial and temporal disparities in air pollution exposure at Italian schools
Authors: Conte Keivabu Risto 
Published: December 2023

AbstractAir pollution poses major threats to children’s health and learning, making exposure at school particularly critical. However, some children are more exposed than others, especially depending on the socioeconomic status of their school’s neighbourhood. In this study, we explore how exposure to air pollution varies across schools, over time and by the socioeconomic characteristics of the neighbourhood using data on approximately 23 thousand schools in Italy connected with estimates on Particulate Matter 2.5 measured in µg/m3 at a 1 × 1 km resolution from 2002 to 2018 provided by the Atmospheric Composition Analysis Group (ACAG). Moreover, we create an indicator of school socioeconomic status (SES) using fine-grained information on the real estate value made available by the Italian Observatory of Real Estate Value. Results highlight three main findings. First, air quality at the location of the schools improved over time by about 35%. Secondly, SES shows an inverted U-curve with PM2.5 suggesting schools in middle SES neighbourhoods to be exposed to the highest levels of pollution. Thirdly, SES does not show a substantive association with a decrease in air pollution over time. In conclusion, air quality has improved over time in Italy, but schools still do not comply with the World Health Organization (WHO) standards and middle SES neighbourhoods remain the most exposed to air pollution.
Bortezomib in the management of anti-NMDA receptor encephalitis
Authors: de Liyis Bryan Gervais , Sutedja Jane Carissa , Evananda Maria Pramesthi Sabrina , Wibisono Ledwin Meikel , Karuniamaya Chrysanta Paramitha , Soetomo Cindy Thiovany , Susilawathi Ni Made 
Published: December 2023

Abstract
Background
Anti-N-methyl d-aspartate (NMDA) receptor encephalitis is an autoimmune encephalitis characterized by neuronal surface antibodies targeting NMDA receptor in the spinal fluid and serum. After acute disseminated encephalomyelitis, anti-NMDA receptor encephalitis is the most frequent cause of autoimmune encephalitis. Despite its clinical significance, the exact prevalence and optimal treatment strategies for this condition remain poorly understood. This comprehensive review aims to evaluate the therapeutic potential of bortezomib as a novel therapy for anti-NMDA receptor encephalitis in hopes of mitigating symptoms and improving outcomes for anti-NMDA receptor encephalitis patients.

Results
The disease is primarily triggered by immunoreactivity against the NMDA receptor 1 (NR1). Recurrence rates are of significant concern in the treatment of anti-NMDA receptor encephalitis, given that a substantial portion of patients are unresponsive to immunosuppressive and immunomodulatory therapies. Thus, the exploration of alternative therapies is necessary. In recent years, bortezomib, a proteasome inhibitor, has emerged as a potential therapeutic candidate by inhibiting autoantibody production against NMDA receptor. Bortezomib exerts immunosuppressive and immunomodulatory effects by inhibiting the production of autoantibodies against NMDA receptor. Studies suggest that bortezomib, by inhibiting proteasome activity and altering antigen presentation, can suppress autoantibody production and immune cell activation, contributing to clinical improvement. However, literature reviews on the utilization of bortezomib in the context of anti-NMDA receptor encephalitis are still highly limited.

Conclusions
Bortezomib presents a promising avenue for intervention. While initial studies suggest its potential to modify the immune response and alleviate symptoms, further comprehensive investigations are imperative to establish optimal dosing, usage guidelines, and long-term safety profiles.
Knowledge, attitude, and risk perception toward HIV-, HBV-, and HCV-infected patients among dental students of October 6 University: descriptive cross-sectional study
Authors: Tarek Noura , Madkour Gihane , Hussien Amal 
Published: December 2023

AbstractDentistry involves the use of many instruments that are sharp and deal with blood and saliva that may be contaminated with either HBV, HCV, or HIV. Professional exposure of healthcare workers (as dentists and dental students) to blood or other potentially infected biological material may cause transmission of infection to them.Transmission of infection can occur through several routes; mucosal, cutaneous, or percutaneous.Transmission of pathogens may result in an asymptomatic infection. This situation may last for weeks or months until symptoms appear. Some patients are, thus, not aware of their infectious status and may carry an asymptomatic infection when visiting a dental practice.Aim of study The objective of the current study was to detect the level of knowledge among dental students regarding the human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. The attitude and risk perception of the students about the treatment of patients with these viruses were also assessed. In our study, we determined also the relationship between knowledge, attitude, and risk perception.Methodology Six hundred eighty responded students were included in this study. They were selected from all 5 years of study to form 2 equal groups (340 students in each group), group I (junior students): 1st, 2nd, and 3rd years and group II (senior students): 4th and 5th years. The questionnaires (distributed to the students) included five main parts: the sociodemographic part, the knowledge part, the attitude part, the risk perception part, and the self-evaluation part.Results (1) The correct answer score was higher in group II than in group I (58.54% and 41.46% respectively). (2) The professional attitude score was higher in group II than in group I (60.81% and 39.19% respectively). (3) The positive risk perception was higher in group II than in group I (56.20% and 43.80% respectively).Conclusion The level of knowledge plays an important role in forming attitudes and risk perceptions toward patients with HBV, HCV, and HIV. This is of concern in dentistry and other similar fields like otolaryngology.
An investigation into the critical ingredients of intensive support teams for adults with intellectual disabilities who display challenging behaviour
Authors: Thomas Lucretia , Lloyd-Evans Brynmor , Marston Louise , Hassiotis Angela 
Published: December 2023

Aims and methodNHS England recommends the commissioning of intensive support teams (ISTs) to provide effective support to people with intellectual disability (ID) when in crisis. However, there is a paucity of evidence regarding how these services should be organised. This exploratory secondary analysis of data from the IST-ID study aimed to investigate IST characteristics that relate to clinical outcomes. The primary outcome was mean change in the total score on the Aberrant Behavior Checklist and its subscales.ResultsA measure of mental illness severity was the only variable associated with our primary outcome of reduction in challenging behaviour. Accommodation type, affective status and gender were associated with the subdomains of irritability, hyperactivity and lethargy in unadjusted and adjusted analyses.Clinical implicationsOur findings indicate that variation in clinical outcomes is influenced by individual rather than organisational factors. Further research on the theoretical fidelity of the IST-ID model is needed.
Fatness but not Fitness Linked to BrainAge: Longitudinal Changes in Brain Aging during an Exercise Intervention
Authors: Wing David , Eyler Lisa T. , Lenze Eric J. , Wetherell Julie Loebach , Nichols Jeanne F. , Meeusen Romain , Godino Job , Shimony Joshua S. , Snyder Abraham Z. , Nishino Tomoyuki , Nicol Ginger E. , Nagels Guy , Roelands Bart 
Published: December 2023

ABSTRACT

Purpose
Fitness, physical activity, body composition, and sleep have all been proposed to explain differences in brain health. We hypothesized that an exercise intervention would result in improved fitness and body composition and would be associated with improved structural brain health.

Methods
In a randomized controlled trial we studied 485 older adults who engaged in an exercise intervention (n = 225) or a non-exercise comparison condition (n = 260). Using MRI, we estimated the physiological age of the brain (BrainAge) and derived a predicted age difference compared to chronological age (BrainPAD). Aerobic capacity, physical activity, sleep, and body composition were assessed and their impact on BrainPAD explored.

Results
There were no significant difference between experimental groups for any variable at any timepoint. The intervention group gained fitness, improved body composition, and increased total sleep time but did not have significant changes in BrainPAD. Analyses of changes in BrainPAD independent of group assignment indicated significant associations with changes in body fat percentage (r(479) = 0.154, p = 0.001), and visceral adipose tissue (VAT) (r(478) = 0.141, p = 0.002), but not fitness (r(406) = -0.075, p = 0.129), sleep (r(467) range -0.017 to 0.063, p range 0.171 to 0.710), or physical activity (r(471) = -0.035 p = 0.444). With linear regression, changes in body fat percentage and VAT significantly predicted changes in BrainPAD (β = 0.948, p = 0.003) with one kg change in VAT predicting 0.948 years change in BrainPAD.

Conclusions
In cognitively normal older adults, exercise did not appear to impact BrainPAD, although it was effective in improving fitness and body composition. Changes in body composition, but not fitness, physical activity, or sleep impacted BrainPAD. These findings suggest that focus on weight control, particularly reduction of central obesity, could be an interventional target to promote healthier brains.