bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of intrathecal dexmedetomidine vs fentanyl as additives to hyperbaric bupivacaine for postoperative analgesia in women undergoing cesarean section: a systematic review protocol
Authors: Boshoff Jorica , Fourtounas Maria , Pegu Kylesh , McInerney Patricia 
Published: December 2023

Objective:
The aim of this review is to compare the effectiveness of intrathecal dexmedetomidine vs fentanyl as additives to hyperbaric bupivacaine in providing postoperative analgesia in patients undergoing cesarean section.

Introduction:
Pain following cesarean section remains a challenge, with limited treatment options due to potential undesirable parturient and neonatal side effects. Intrathecal dexmedetomidine has emerged as a favorable alternative to opioid additives to hyperbaric bupivacaine in prolonging postoperative analgesia, but its effectiveness requires further investigation.

Inclusion criteria:
The review will evaluate studies of patients who underwent cesarean section under spinal anesthesia where dexmedetomidine and fentanyl were compared as intrathecal additives to hyperbaric bupivacaine for postoperative analgesia. This review will consider randomized controlled trials, non-randomized controlled trials, and prospective cohort studies for inclusion. No limits regarding publication date or language will be applied.

Methods:
A preliminary search of PubMed and Cochrane Central Register of Controlled Trials has been conducted to identify relevant index terms and keywords, which will be applied in a second search across PubMed, Cochrane CENTRAL, Scopus, and Embase. Google Scholar, National Library of Medicine (Clinicaltrials.gov), and the World Health Organization International Clinical Trial Registry Platform will be searched to identify unpublished literature. Full-text studies will be subjected to an assessment of methodological quality, and data extraction will be performed independently by 2 reviewers. The results will be presented in both tabular and narrative format and, where possible, pooled into a meta-analysis. A Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings will be created to grade the certainty of evidence of the reported outcomes.

Review registration:
PROSPERO CRD42022364815
Sliding Mode Wheel Slip Control for Regenerative Braking of an All-Wheel-Drive Electric Vehicle
Authors: Majumdar Abhigyan , Nazari Shima 
Published: December 2023

Abstract
Regenerative braking is one of the main advantages of electric propulsion systems. In such systems, the vehicle brake controller has to prioritize safety while maximizing the recovered energy at all times. This paper proposes a two-step hierarchical brake controller for a dual-motor all-wheel-drive electric vehicle. In the first step, a novel sliding mode controller (SMC) generates the total braking torque on each axle to independently control the slip on the front and rear wheels. In the second step, the torque split controller assigns motor and friction brake torques to maximize the recovered energy. By incorporating the effects of changing vehicle speed, the proposed SMC controller accounts for the nonlinearities in vehicle dynamics and tire model and considers the weight transfer due to vehicle deceleration while being robust to disturbances. Using simulations, we show that while the traditional SMC formulation is not effective during emergency braking scenarios, the proposed formulation successfully generates control commands to bring the vehicle to a stop position at a minimum distance. Furthermore, our controller can maintain both wheels in the stable slip region, even when starting from a locked position. The performance of the proposed controller is evaluated for an emergency braking scenario and on an aggressive segment of the US06 cycle.
Supercapacitor Voltage Doubling Equalization Method Based on Adaptive Grouping
Authors: Wang Chao , Liu Xiaohu , Han Li , Wu Tiezhou , Wang Xiangyu 
Published: December 2023

Abstract
In order to improve the inconsistency of lithium-ion battery packs, an adaptive grouping supercapacitor voltage-doubling equalization circuit is proposed on the basis of capacitor equalization circuits, which combines switching arrays with clustering algorithms for grouping, and multiple batteries can be equalized at the same moment according to the energy state. The supercapacitor energy storage module can realize parallel energy storage and series energy release, which greatly improves the equalization speed and solves the problem of slowing down the equalization speed at the later stage of equalization. Building six series-connected battery simulation platforms for experiments, the experimental data results show that the scheme proposed in this paper compared with the control group program equalization time is shortened by about 50%, has a faster equalization speed, and can effectively improve the inconsistency of the battery pack, effectively verifying the feasibility of the equalization program and superiority.
Quantification of Mixing Quality Effects on Flashback Limits for H2-Rich Fuel Gases in Lean Premixed Combustion Using Laser-Induced Fluorescence of Acetone
Authors: Kim Taesung , Doll Ulrich , Faldella Filippo , Jansohn Peter 
Published: December 2023

Abstract
One of the main challenges arising from hydrogen-rich fuel mixtures is to prevent flame flashback. In typical gas turbines, the fuel is commonly injected through holes in the axial swirler vanes to achieve a high mixing quality. However, this injection method is not perfect and can cause nonhomogeneous mixing regions, so that locally rich fuel clusters can significantly increase flashback propensity. This work aims to establish a link between the local mixing quality of fuel and air and flashback limits obtained experimentally under elevated pressure conditions. The nonreacting experiments have been conducted at an atmospheric mockup test rig and acetone-planar laser-induced fluorescence (PLIF) has quantified the local fuel concentration. Zones of high equivalence ratio are evident close to the center body wall. The near-wall equivalence ratio fields reveal that the critical probability of the local equivalence ratio being greater than the one for perfect premixing is between 20% and 35% for all hydrogen concentrations at the flashback limits observed. A probability of 35% is selected as a critical threshold to derive a correlation between the local and the global equivalence ratio in technical premixing. Even though the correlation is specific to the investigated burner configuration, the presented methodology offers valuable insights into the impact of the local mixing quality on flashback propensity, which can improve flashback prediction models formulated for perfect premixing conditions.
Genome-wide screens connect HD82 loss-of-function to purine analog resistance in African trypanosomes
Authors: Trenaman Anna , Tinti Michele , Atrih Abdelmadjid , Horn David 
Published: December 2023

ABSTRACT

Nucleoside analogs have been used extensively as anti-infective agents, particularly against viral infections, and have long been considered promising anti-parasitic agents. These pro-drugs are metabolized by host-cell, viral, or parasite enzymes prior to incorporation into DNA, thereby inhibiting DNA replication. Here, we report genes that sensitize African trypanosomes to nucleoside analogs, including the guanosine analog, ganciclovir. We applied ganciclovir selective pressure to a trypanosome genome-wide knockdown library, which yielded nucleoside mono- and diphosphate kinases as hits, validating the approach. The two most dominant hits to emerge, however, were Tb927.6.2800 and Tb927.6.2900, which both encode nuclear proteins; the latter of which is HD82, a SAMHD1-related protein and a putative dNTP triphosphohydrolase. We independently confirmed that HD82, which is conserved among the trypanosomatids, can sensitize
Trypanosoma brucei
to ganciclovir. Since ganciclovir activity depends upon phosphorylation by ectopically expressed viral thymidine kinase, we also tested the adenosine analog, ara-A, that may be fully phosphorylated by native
T. brucei
kinase(s). Both Tb927.6.2800 and HD82 knockdowns were resistant to this analog. Tb927.6.2800 knockdown increased sensitivity to hydroxyurea, while dNTP analysis indicated that HD82 is indeed a triphosphohydrolase with dATP as the preferred substrate. Our results provide insights into nucleoside/nucleotide metabolism and nucleoside analog metabolism and resistance in trypanosomatids. We suggest that the product of 6.2800 sensitizes cells to purine analogs through DNA repair, while HD82 does so by reducing the native purine pool.

IMPORTANCE
There is substantial interest in developing nucleoside analogs as anti-parasitic agents. We used genome-scale genetic screening and discovered two proteins linked to purine analog resistance in African trypanosomes. Our screens also identified two nucleoside kinases required for pro-drug activation, further validating the approach. The top novel hit, HD82, is related to SAMHD1, a mammalian nuclear viral restriction factor. We validated HD82 and localized the protein to the trypanosome nucleus. HD82 appears to sensitize trypanosomes to nucleoside analogs by reducing native pools of nucleotides, providing insights into both nucleoside/nucleotide metabolism and nucleoside analog resistance in trypanosomatids.
Supplemental Material: Sulfur isotopes of lamprophyres and implications for the control of metasomatized lithospheric mantle on the giant Jiaodong gold deposits, eastern China
Authors: WANG XIANG , Wang Zaicong , et al.  
Published: December 2023

<p>The whole-rock elemental and isotopic composition of lamprophyres and mafic dikes in the Jiaodong Peninsula, eastern China, and details of modeling calculation. </p>
Association of health benefits and harms of Christmas dessert ingredients in recipes from The Great British Bake Off: umbrella review of umbrella reviews of meta-analyses of observational studies
Authors: Wallach Joshua D , Gautam Anant , Ramachandran Reshma , Ross Joseph S 
Published: December 2023

Abstract

Objective
To determine the health benefits and harms of various ingredients in Christmas desserts from The Great British Bake Off.

Design
Umbrella review of umbrella reviews of meta-analyses of observational studies.

Data sources
The Great British Bake Off website, Embase, Medline, and Scopus.

Inclusion criteria
Umbrella reviews of meta-analyses of observational studies evaluating the associations between Christmas dessert ingredients and the risk of death or disease.

Main outcome measures
Proportion of protective and harmful summary associations between ingredient groups from The Great British Bake Off Christmas dessert recipes and the risk of death or disease.

Results
48 recipes for Christmas desserts (ie, cakes, biscuits, pastries, and puddings and desserts) were provided on The Great British Bake Off website with 178 unique ingredients that were collapsed into 17 overarching ingredient groups. A literature search identified 7008 titles and abstracts, of which 46 eligible umbrella reviews reported 363 unique summary associations between the ingredient groups and risk of death or disease. Of these summary associations, 149 (41%) were significant, including 110 (74%) that estimated that the ingredient groups reduced the risk of death or disease and 39 (26%) that increased the risk. The most common ingredient groups associated with a reduced risk of death or disease were fruit (44/110, 40%), coffee (17/110, 16%), and nuts (14/110, 13%), whereas alcohol (20/39, 51%) and sugar (5/39, 13%) were the most common ingredient groups associated with increased risk of death or disease.

Conclusions
Recipes for Christmas desserts from The Great British Bake Off often use ingredient groups that are associated with reductions, rather than increases, in the risk of death or disease. This Christmas, if concerns about the limitations of observational nutrition research are set aside, you can have your cake and eat it too.
Socio-economic inequalities in and factors associated with minimum dietary diversity among children aged 6–23 months in South Asia: a decomposition analysis
Authors: Rahman Md Ashfikur , Kundu Satyajit , Rashid Harun Or , Tohan Mortuja Mahamud , Islam Md Akhtarul 
Published: December 2023

ObjectiveThis study aimed to determine the factors associated with minimum dietary diversity (MDD) and estimate the socioeconomic inequalities in MDD among children from five South Asian countries.DesignCross-sectional.SettingThe study used the most recent round of secondary databases of Demographic Health Survey data of Bangladesh (2017–2018), India (2019–2021), Maldives (2016–2017), Nepal (2018) and Pakistan (2017–2018).ParticipantsThis study used information on MDD and other explanatory variables from a total of 136 980 (weighted) children aged 6–23 months.MethodsMultivariable logistic regression was employed to identify the factors associated with MDD and concentration index (CIX) and Lorenz curve were used to measure the socioeconomic inequalities in MDD.ResultsThe overall weighted prevalence of MDD in South Asia was 23.37%. The highest prevalence of MDD was found among children from Maldives (70.7%), while the lowest was in Pakistan (14.2%). Living in affluent versus poor households, having a mother who is employed versus a mother who is unemployed, exposure to various forms of media (newspapers and magazines), seeking antenatal care (ANC) more than four times compared with those who sought ANC less than four times and having children older than 4 years old are the most common significant factors associated with MDD deficiency. This study found the value of the CIX for MDD (MDD: CI=0.0352; p<0.001) among children with a higher socioeconomic status, suggesting inequality in MDD in favour of the more among well-off households.ConclusionInequality in the prevalence of MDD favours the affluent. Health policy and intervention design should prioritise minimising socioeconomic inequalities concerning the MDD. In addition, policy-makers should prioritise the associated factors of MDD such as education, wealth status, employment, media exposure while designing intervention or policies.
Protection of the third-dose and fourth-dose mRNA vaccines against SARS-CoV-2 Omicron subvariant: a systematic review and meta-analysis
Authors: Rahman Md. Obaidur , Kamigaki Taro , Thandar Moe Moe , Haruyama Rei , Yan Fangyu , Shibamura-Fujiogi Miho , Khin Maung Soe July , Islam Md. Rafiqul , Yoneoka Daisuke , Miyahara Reiko , Ota Erika , Suzuki Motoi 
Published: December 2023

ObjectivesThe rapid spread of the SARS-CoV-2 Omicron variant has raised concerns regarding waning vaccine-induced immunity and durability. We evaluated protection of the third-dose and fourth-dose mRNA vaccines against SARS-CoV-2 Omicron subvariant and its sublineages.DesignSystematic review and meta-analysis.Data sourcesElectronic databases and other resources (PubMed, Embase, CENTRAL, MEDLINE, CINAHL PLUS, APA PsycINFO, Web of Science, Scopus, ScienceDirect, MedRxiv and bioRxiv) were searched until December 2022.Study eligibility criteriaWe included studies that assessed the effectiveness of mRNA vaccine booster doses against SARS-CoV-2 infection and severe COVID-19 outcomes caused by the subvariant.Data extraction and synthesisEstimates of vaccine effectiveness (VE) at different time points after the third-dose and fourth-dose vaccination were extracted. Random-effects meta-analysis was used to compare VE of the third dose versus the primary series, no vaccination and the fourth dose at different time points. The certainty of the evidence was assessed by Grading of Recommendations, Assessments, Development and Evaluation approach.ResultsThis review included 50 studies. The third-dose VE, compared with the primary series, against SARS-CoV-2 infection was 48.86% (95% CI 44.90% to 52.82%, low certainty) at ≥14 days, and gradually decreased to 38.01% (95% CI 13.90% to 62.13%, very low certainty) at ≥90 days after the third-dose vaccination. The fourth-dose VE peaked at 14–30 days (56.70% (95% CI 50.36% to 63.04%), moderate certainty), then quickly declined at 61–90 days (22% (95% CI 6.40% to 37.60%), low certainty). Compared with no vaccination, the third-dose VE was 75.84% (95% CI 40.56% to 111.12%, low certainty) against BA.1 infection, and 70.41% (95% CI 49.94% to 90.88%, low certainty) against BA.2 infection at ≥7 days after the third-dose vaccination. The third-dose VE against hospitalisation remained stable over time and maintained 79.30% (95% CI 58.65% to 99.94%, moderate certainty) at 91–120 days. The fourth-dose VE up to 60 days was 67.54% (95% CI 59.76% to 75.33%, moderate certainty) for hospitalisation and 77.88% (95% CI 72.55% to 83.21%, moderate certainty) for death.ConclusionThe boosters provided substantial protection against severe COVID-19 outcomes for at least 6 months, although the duration of protection remains uncertain, suggesting the need for a booster dose within 6 months of the third-dose or fourth-dose vaccination. However, the certainty of evidence in our VE estimates varied from very low to moderate, indicating significant heterogeneity among studies that should be considered when interpreting the findings for public health policies.PROSPERO registration numberCRD42023376698.
Protocol for a parallel assignment prospective, randomised, double-blinded, placebo-controlled trial to evaluate the efficacy of 0.01% atropine for near work-induced transient myopia and myopic progression in China
Authors: Qin Guanghao , Chen Jiayan , Hu Lan , Qi Yifan , Xu Ling , He Wei , Yu Sile , Pazo Emmanuel Eric , He Xingru 
Published: December 2023

IntroductionAssessment of near work-induced transient myopia (NITM) is important for permanent myopia development and progression. Atropine eye drop has been reported to be beneficial in reducing initial NITM and slowing down myopic progression. This study aimed to investigate the efficacy of 0.01% atropine in treating NITM and its possible association with the progression of refractive change in Chinese myopic children.Methods and analysisThe study is designed as a parallel assignment prospective, randomised, double-blinded, placebo-controlled trial conducted at He Eye Specialist Hospital in Shenyang, China. One hundred fifty participants will be randomly assigned in a 1:1 ratio to receive 0.01% atropine or placebo eye drop once nightly bilaterally for 1 year. Initial NITM, cycloplegic refraction, axial length, best-corrected visual acuity, intraocular pressure and pupil diameter will be measured at baseline, 4 weeks, 12 weeks, 24 weeks, 36 weeks and 48 weeks. Visual Function Questionnaire will be administered at baseline and each follow-up visit. Adverse events also will be monitored and documented at each subsequent follow-up visit.Ethics and disseminationA parallel assignment prospective, randomised, double-blinded, placebo-controlled trial to evaluate the efficacy of 0.01% atropine for near work-induced transient myopia and myopic progression registered on 10 September 2023. Ethics approval number: IRB (2023) K025.01. The study’s findings will be shared regardless of the effect’s direction.Trial registration numberNCT06034366.
Managing food waste in the inpatient population
Authors: Jonathan Adrienne 
Published: December 2023

IntroductionFor medical students, food is rarely discussed from the clinical perspective. Yet, in hospitals reduced food intake poses the risk of malnutrition, along with increased morbidity and mortality. The issue of food waste, a cause of inadequate dietary intake and a common issue within the National Health Service, is rarely addressed. The implementation of protected mealtimes has done little to solve this. This quality improvement project aimed to reduce the average amount of inpatient food waste by 20% by May 2022.MethodsA standardised meal size intervention was tested. Meals were weighed before and after meal services to collect baseline and postintervention data. The percentage consumed and the percentage wasted were then calculated. Finally, the overall average of the percentage wasted across both meal services was determined.ResultsQuantitative data showed a change in the average amount of food waste from 70.16% to 65.75%, a decrease of 4.41%. Survey results also found an increase of 3% in patient satisfaction with meal sizes.ConclusionStandardising meal sizes is shown to improve inpatient food waste and may serve as a starting point for healthcare providers to devise further strategies to reduce wastage in hospitals.
Gut microbiota predicts severity and reveals novel metabolic signatures in acute pancreatitis
Authors: Ammer-Herrmenau Christoph , Antweiler Kai L , Asendorf Thomas , Beyer Georg , Buchholz Soeren M , Cameron Silke , Capurso Gabriele , Damm Marko , Dang Linh , Frost Fabian , Gomes Antonio , Hamm Jacob , Henker Robert , Hoffmeister Albrecht , Meinhardt Christian , Nawacki Lukasz , Nunes Vitor , Panyko Arpad , Pardo Cesareo , Phillip Veit , Pukitis Aldis , Rasch Sebastian , Riekstina Diana , Rinja Ecaterina , Ruiz-Rebollo María Lourdes , Sirtl Simon , Weingarten Mark , Sandru Vasile , Woitalla Julia , Ellenrieder Volker , Neesse Albrecht 
Published: December 2023

ObjectiveEarly disease prediction is challenging in acute pancreatitis (AP). Here, we prospectively investigate whether the microbiome predicts severity of AP (Pancreatitis—Microbiome As Predictor of Severity; P-MAPS) early at hospital admission.DesignBuccal and rectal microbial swabs were collected from 424 patients with AP within 72 hours of hospital admission in 15 European centres. All samples were sequenced by full-length 16S rRNA and metagenomic sequencing using Oxford Nanopore Technologies. Primary endpoint was the association of the orointestinal microbiome with the revised Atlanta classification (RAC). Secondary endpoints were mortality, length of hospital stay and severity (organ failure >48 hours and/or occurrence of pancreatic collections requiring intervention) as post hoc analysis. Multivariate analysis was conducted from normalised microbial and corresponding clinical data to build classifiers for predicting severity. For functional profiling, gene set enrichment analysis (GSEA) was performed and normalised enrichment scores calculated.ResultsAfter data processing, 411 buccal and 391 rectal samples were analysed. The intestinal microbiome significantly differed for the RAC (Bray-Curtis, p value=0.009), mortality (Bray-Curtis, p value 0.006), length of hospital stay (Bray-Curtis, p=0.009) and severity (Bray-Curtis, p value=0.008). A classifier for severity with 16 different species and systemic inflammatory response syndrome achieved an area under the receiving operating characteristic (AUROC) of 85%, a positive predictive value of 67% and a negative predictive value of 94% outperforming established severity scores. GSEA revealed functional pathway units suggesting elevated short-chain fatty acid (SCFA) production in severe AP.ConclusionsThe orointestinal microbiome predicts clinical hallmark features of AP, and SCFAs may be used for future diagnostic and therapeutic concepts.Trial registration numberNCT04777812.