bluuebunny/crossref_metadata_2025_split huggingface dataset:
Satisfaction and attitudes towards online continuous medical education and its impact on clinical practice among physiotherapists
Authors: Shalabi Kholood Matouq , Almurdi Muneera Mohammed 
Published: January 2024

Abstract
Background
The traditional face-to-face of medical education is gradually being replaced with online education. However, the rate of adoption of online continuing medical education (OCME) as a learning method among practicing clinical physiotherapists (PTs) is unclear. The objectives of this study were to measure the satisfaction with, attitudes towards, and impact of OCME among practicing clinical PTs in Saudi Arabia (SA) and to examine the factors that affect the findings for satisfaction, attitude, and impact towards OCME.

Methods
This cross-sectional survey was conducted between October 2021 and January 2022. PTs employed at various medical facilities and specialties in Saudi Arabia completed an online survey to assess satisfaction with, attitudes towards, and impact of OCME.

Results
Of the 127 participants, 48 were female (37.8%), 44.1% were aged between 24 and 30 years. Overall, 57.5% of the respondents were satisfied with OCME compared with conventional face-to-face education, and 45.7% agreed and 18.1% strongly agreed that OCME was more flexible. Further, 52.8% of the respondents thought that OCME programs could supplement traditional face-to-face education. The majority of the participants (63.8%) agreed that participating in OCME programs increased their knowledge, and 55.1% and 51.2% agreed that attending these programs improved patient outcomes and increased their confidence in patient management, respectively. However, only 38.6% agreed that participating in OCME programs enhanced their clinical expertise. The mean satisfaction, attitude, and impact scores differed significantly according to age group, marital status, number of years of practice, and specialty (p < 0.0001). Multiple regression analysis showed that older age was independently associated with better satisfaction and more positive attitudes and impact. Further, having a specialization also seemed to improve the impact of OCME.

Conclusion
The PTs were satisfied with and had positive attitudes towards OCME, and also found that it had a positive impact on their clinical practice. Thus, existing OCME programs are a good option for expanding the number of PTs proficient in clinical care.
Experience of financial toxicity and coping strategies in young and middle-aged patients with stroke: a qualitative study
Authors: Xu Ling , Dong Qiong , Jin Aiping , Zeng Sining , Wang Kai , Yang Xiaopei , Zhu Xiaoping 
Published: January 2024

Abstract
Background
While financial toxicity (FT) is prevalent in patients with cancer, young and middle-aged patients with stroke are also affected by FT, which can exacerbate their physical and psychological challenges. Understanding the patient’s experience and response measures can further understand the impact of FT on patients with stroke, to help alleviate FT. However, little is known concerning the experience of patients with stroke with FT or their coping strategies. Therefore, this study aimed to describe the experiences of FT in young and middle-aged patients with stroke and their coping strategies.

Methods
A phenomenological method was utilized. Semi-structured interviews were conducted with 21 young and middle-aged stroke patients (aged 18–59) between October 2022 and March 2023. The participants were recruited from a tertiary hospital in Shanghai, China. The research team used NVivo 12.0 software. Giorgi’s phenomenological analysis method was used to analyse the interview data.

Results
The interview results were divided into two categories in terms of patients’ experiences of FT and their coping strategies. Nine subthemes were constructed. The experience category included four subthemes: (1) taking on multifaceted economic pressure, (2) dual choice of treatment, (3) decline in material living standards, and (4) suffering from negative emotions such as anxiety and depression. The coping strategy category included five subthemes: (1) reducing expenses, (2) improving living habits, (3) proactive participation in medical decision-making, (4) making a job position choice, and (5) seeking social support.

Conclusions
FT in young and middle-aged patients with stroke, which affected their physical and mental health, led them to implement strategies for dealing with FT. The Chinese government needs to broaden the reach of health insurance coverage and advance the fairness of healthcare policies. Healthcare professionals must pay active attention to FT in such patients in terms of strengthening their health education and considering their needs and preferences. Patients need to improve their sense of self-efficacy, actively reintegrate into society, and adhere to rehabilitation and treatment. Individuals at a high risk of stroke are recommended to purchase health insurance. Multifaceted efforts are needed to reduce the impact of FT in young and middle-aged patients with stroke.
Assessment of pre-referral treatment for malaria, diarrhea, and pneumonia by rural community health workers in Southwestern Uganda: a cross-sectional study
Authors: Matte Michael , Ntaro Moses , Kenney Jessica , Wesuta Andrew , Kawungezi Peter Chris , Bwambale Shem , Ayebare David , Baguma Stephen , Bagenda Fred , Stone Geren , Mulogo Edgar 
Published: January 2024

Abstract
Background
Pre-referral treatment aims to stabilize the child’s condition before transferring them to a higher level of healthcare. This study explored pre-referral treatment for diarrhea, malaria and pneumonia in children U5. The study aims to assess pre-referral treatment practices among community health workers (CHWs) for children aged 2 to 59 months diagnosed with malaria, diarrhea, and pneumonia.

Methods
Conducted in 2023, this study employed a quantitative retrospective analysis of secondary data gathered from March 2014 to December 2018. Among the subjects, 171 patients received pre-referral treatment, serving as the foundation for categorical data analysis, presenting proportions and 95% confidence intervals across different categories.

Results
In this cohort, 90 (53%) of the 177 children U5 were male, and age distribution showed 39 (23%), 70 (41%), and 62 (36%) in the 2–11 months, 12–35 months, and 36–60 months categories, respectively. Rapid Diagnostic Test (RDT) malaria results indicated a negative outcome in 83(60%) and positive in 55 (40%) of cases. Symptomatically, 45 (26%) had diarrhea, 52 (30%) exhibited fast breathing, and 109 (63%) presented with fever. Furthermore, 59 (35%) displayed danger signs, while 104 (61%) sought medical attention within 24 h.

Conclusion
The study analyzed a sample of 171 children under 5 years old to assess various characteristics and variables related to pre-referral treatment. The findings reveal notable proportions in gender distribution, age categories, RDT results, presence of diarrhea, fast breathing, fever, danger signs, and timely medical visits. The results highlight the need to strengthen pre-referral treatment interventions and enhance iCCM programs.
TIPARP as a prognostic biomarker and potential immunotherapeutic target in male papillary thyroid carcinoma
Authors: Zhang Jianlin , Zhou Xumin , Yao Fan , Zhang JiaLi , Li Qiang 
Published: January 2024

Abstract
Background
Male patients with papillary thyroid carcinoma (PTC) tend to have poorer prognosis compared to females, partially attributable to a higher rate of lymph node metastasis (LNM). Developing a precise predictive model for LNM occurrence in male PTC patients is imperative. While preliminary predictive models exist, there is room to improve accuracy. Further research is needed to create optimized prognostic models specific to LNM prediction in male PTC cases.

Methods
We conducted a comprehensive search of publicly available microarray datasets to identify candidate genes continuously upregulated or downregulated during PTC progression in male patients only. Univariate Cox analysis and lasso regression were utilized to construct an 11-gene signature predictive of LNM. TIPARP emerged as a key candidate gene, which we validated at the protein level using immunohistochemical staining. A prognostic nomogram incorporating the signature and clinical factors was developed based on the TCGA cohort.

Results
The 11-gene signature demonstrated good discriminative performance for LNM prediction in training and validation datasets. High TIPARP expression associated with advanced stage, high T stage, and presence of LNM. A prognostic nomogram integrating the signature and clinical variables reliably stratified male PTC patients into high and low recurrence risk groups.

Conclusions
We identified a robust 11-gene signature and prognostic nomogram for predicting LNM occurrence in male PTC patients. We propose TIPARP as a potential contributor to inferior outcomes in males, warranting further exploration as a prognostic biomarker and immunotherapeutic target. Our study provides insights into the molecular basis for gender disparities in PTC.
Cilostazol protects against degenerative cervical myelopathy injury and cell pyroptosis via TXNIP-NLRP3 pathway
Authors: Xu Fei , Tian Zhuo , Wang Zhengguang 
Published: January 2024

AbstractDegenerative cervical myelopathy (DCM) is one of the most common and serious neurological diseases. Cilostazol has protective effects of anterior horn motor neurons and prevented the cell apoptosis. However, there was no literatures of Cilostazol on DCM. In this study, we established the DCM rat model to detect the effects of Cilostazol. Meanwhile, the neurobehavioral assessments, histopathology changes, inflammatory cytokines, Thioredoxin-interacting protein (TXNIP), NOD‑like receptor pyrin domain containing 3 (NLRP3) and pro-caspase-1 expressions were detected by Basso, Beattie, and Bresnahan score assessment, Hematoxylin and Eosin Staining, Enzyme-linked immunosorbent assay, immunofluorescence and Western blotting, respectively. After treated with Cilostazol, the Basso, Beattie, and Bresnahan (BBB) score, inclined plane test and forelimb grip strength in DCM rats were significantly increased meanwhile the histopathology injury and inflammatory cytokines were decreased. Additionally, TXNIP, NLRP3 and pro-caspase-1 expressions levels were decreased in Cilostazol treated DCM rats. Interestingly, the using of siTXNIP significantly changed inflammatory cytokines, TXNIP, NLRP3 and pro-caspase-1 expressions, however there was no significance between siTXNIP and Cilostazol + siTXNIP group. These observations showed that Cilostazol rescues DCM injury and ameliorates neuronal destruction mediated by TXNIP/NLRP3/caspase-1 and pro-inflammatory cytokines. As a result of our study, these findings provide further evidence that Cilostazol may represent promising therapeutic candidates for DCM.
Effectiveness of bone grafting versus cannulated screw fixation in the treatment of posterolateral tibial plateau compression fractures with concomitant ACL injury: a comparative study
Authors: Yang Yang , Lin Xiaofang , Zhang Jianmin , Xin Hanlong , Han Dawei , Zhang Qingguo , Zhou Xiaobo 
Published: January 2024

Abstract
Background
Posterolateral tibial plateau compression fractures (PTPCF) are one of the significant factors leading to knee instability and anterior cruciate ligament (ACL) reconstruction failure. The effectiveness of fixation for such cases without the use of metal implants remains inconclusive. The aim of this study is to investigate whether the fixation with isolated bone grafting is stable enough for the treatment of PTPCF with concomitant ACL injuries.

Methods
This retrospective study analyzed patients treated for concomitant ACL injuries and PTPCF in authors’ institution. A total of 53 patients (21 males and 32 females) with an average age of 47.43 ± 14.71 years were included. Patient data were collected, including factors leading to injury, affected side, height, weight, and basic medical history. The posterior inclination angle and the lateral tibial plateau lateral inclination angle were measured to evaluate the fixation stability. Rasmussen functional score and HSS score were used to assess the knee functional recovery.

Results
The bone grafting group achieved satisfactory levels of Rasmussen score (28.22 ± 0.85) and HSS knee joint function scores (95.57 ± 1.97). The cannulated screw fixation group had a Rasmussen knee joint function score of 28.70 ± 0.92 and a HSS knee joint function score of 96.07 ± 1.93. No statistically significant difference was found (P > 0.05). The cannulated screw fixation group had a mean posterior inclination angle reduction loss of 0.20° ± 1.11°, while the bone grafting group had a reduction loss of 0.18° ± 1.01°, with no statistically significant difference (P > 0.05). The cannulated screw fixation group had a lateral inclination angle reduction loss of 0.01° ± 0.37°, and the bone grafting group had a reduction loss of 0.03° ± 0.43°, with no statistically significant difference (P > 0.05).

Conclusion
The use of bone grafting for fixation of PTPCF with accompanying ACL injuries demonstrated no substantial disparities in knee joint function. In cases of simple PTPCF, filling and compacting the bone defect underneath the tibial plateau fracture fragment can yield satisfactory fixation, obviating the necessity for supplementary cannulate screw fixation.
Evaluation of secretomes derived from human dermal and adipose tissue mesenchymal stem/stromal cells for skin wound healing: not as effective as cells
Authors: Zomer Helena Debiazi , de Souza Lima Victor Juan , Bion Monique Coelho , Brito Karynne Nazare Lins , Rode Michele , Stimamiglio Marco Augusto , Jeremias Talita da Silva , Trentin Andrea Gonçalves 
Published: January 2024

Abstract
Background
Although the paracrine effects of mesenchymal stem/stromal cells (MSCs) have been recognized as crucial mediators of their regenerative effects on tissue repair, the potential of MSC secretomes as effective substitutes for cellular therapies remains underexplored.

Methods
In this study, we compared MSCs from the human dermis (DSCs) and adipose tissue (ASCs) with their secretomes regarding their efficacy for skin wound healing using a translationally relevant murine model.

Results
Proteomic analysis revealed that while there was a substantial overlap in protein composition between DSC and ASC secretomes, specific proteins associated with wound healing and angiogenesis were differentially expressed. Despite a similar angiogenic potential in vivo, DSC and ASC secretomes were found to be less effective than cells in accelerating wound closure and promoting tissue remodeling.

Conclusions
Overall, secretome-treated groups showed intermediary results between cells- and control-treated (empty scaffold) groups. These findings highlight that although secretomes possess therapeutic potential, their efficacy might be limited compared to cellular therapies. This study contributes to the growing understanding of MSC secretomes, emphasizes the need for further protocol optimization, and offers insights into their potential applications in regenerative medicine.
Modeled microgravity unravels the roles of mechanical forces in renal progenitor cell physiology
Authors: Melica Maria Elena , Cialdai Francesca , La Regina Gilda , Risaliti Chiara , Dafichi Tommaso , Peired Anna Julie , Romagnani Paola , Monici Monica , Lasagni Laura 
Published: January 2024

Abstract
Background
The glomerulus is a highly complex system, composed of different interdependent cell types that are subjected to various mechanical stimuli. These stimuli regulate multiple cellular functions, and changes in these functions may contribute to tissue damage and disease progression. To date, our understanding of the mechanobiology of glomerular cells is limited, with most research focused on the adaptive response of podocytes. However, it is crucial to recognize the interdependence between podocytes and parietal epithelial cells, in particular with the progenitor subset, as it plays a critical role in various manifestations of glomerular diseases. This highlights the necessity to implement the analysis of the effects of mechanical stress on renal progenitor cells.

Methods
Microgravity, modeled by Rotary Cell Culture System, has been employed as a system to investigate how renal progenitor cells respond to alterations in the mechanical cues within their microenvironment. Changes in cell phenotype, cytoskeleton organization, cell proliferation, cell adhesion and cell capacity for differentiation into podocytes were analyzed.

Results
In modeled microgravity conditions, renal progenitor cells showed altered cytoskeleton and focal adhesion organization associated with a reduction in cell proliferation, cell adhesion and spreading capacity. Moreover, mechanical forces appeared to be essential for renal progenitor differentiation into podocytes. Indeed, when renal progenitors were exposed to a differentiative agent in modeled microgravity conditions, it impaired the acquisition of a complex podocyte-like F-actin cytoskeleton and the expression of specific podocyte markers, such as nephrin and nestin. Importantly, the stabilization of the cytoskeleton with a calcineurin inhibitor, cyclosporine A, rescued the differentiation of renal progenitor cells into podocytes in modeled microgravity conditions.

Conclusions
Alterations in the organization of the renal progenitor cytoskeleton due to unloading conditions negatively affect the regenerative capacity of these cells. These findings strengthen the concept that changes in mechanical cues can initiate a pathophysiological process in the glomerulus, not only altering podocyte actin cytoskeleton, but also extending the detrimental effect to the renal progenitor population. This underscores the significance of the cytoskeleton as a druggable target for kidney diseases.
Dynamical behavior of a degenerate parabolic equation with memory on the whole space
Authors: Guo Rong , Leng Xuan 
Published: January 2024

AbstractThis paper is concerned with the existence and uniqueness of global attractors for a class of degenerate parabolic equations with memory on $\mathbb{R}^{n}$

R
n

. Since the corresponding equation includes the degenerate term $\operatorname{div}\{a(x)\nabla u\}$
div
{
a
(
x
)
∇
u
}
, it requires us to give appropriate assumptions about the weight function $a(x)$
a
(
x
)
for studying our problem. Based on this, we first obtain the existence of a bounded absorbing set, then verify the asymptotic compactness of a solution semigroup via the asymptotic contractive semigroup method. Finally, the existence and uniqueness of global attractors are proved. In particular, the nonlinearity f satisfies the polynomial growth of arbitrary order $p-1$
p
−
1
($p\geq 2$
p
≥
2
) and the idea of uniform tail-estimates of solutions is employed to show the strong convergence of solutions.
The role of clinical engineers in dialysis therapy in Japan
Authors: Honma Takashi , Takagi Masao , Uchino Junji , Tsuchiya Ken 
Published: January 2024

AbstractTraditionally in Japan, dialysis treatment has been performed primarily by physicians and nurses. However, with the advancement of related medical equipment, such as the development of dialyzers and dialysis monitoring equipment, technical support by technicians has become necessary. Therefore, in 1988, the “Clinical Engineers Act” was enacted and recognized as an official national qualification for technicians to operate these devices, in light of the actual status of these technicians and the fact that further advancement and diversification of medical devices will require their expertise in the future. This is a professional qualification unparalleled anywhere in the world. In dialysis treatment, purification of dialysate and efficient removal of uremic substances are fundamental principles. Clinical engineers have contributed significantly to the elimination of biological and chemical contaminants in the process of production of dialysis water, to the development of high-performance membranes, and to the development and advancement of online HDF, a high-volume fluid replacement method. Furthermore, clinical engineers have been involved in the proposal and development of safe devices to prevent medical accidents that occur during continuous dialysis treatment for many patients. Clinical engineers will continue to contribute to the provision of the best treatment methods, not only in the development and deployment of equipment, but also in remote medicine and the utilization of large-scale data, as they are medical professionals with knowledge of both medicine and engineering. Furthermore, the scope of the profession, which started in the field of hemodialysis, has the potential to expand to include peritoneal dialysis and other modalities of renal replacement therapy.
BUDOWANIE WIZERUNKU MAREK SAMOCHODÓW OSOBOWYCH PRZY WYKORZYSTANIU PORTALU FACEBOOK
Authors: Sobiech Olaf 
Published: January 2024

Wzrastająca konkurencja, coraz mniejsza skuteczność tradycyjnej reklamy sprawia, że przedsiębiorcy poszukując nowych możliwości coraz większe budżety kierują w stronę mediów społecznościowych. Zasadniczym elementem silnej marki jest jej wizerunek, na który wpływ ma wiele czynników, jednym z nich jest skuteczna komunikacja. Media społecznościowe a w szczególności Facebook staje się pomostem komunikacji łączącym markę z konsumentem. Celem głównym artykułu jest ocena wykorzystania portalu społecznościowego Facebook do budowania wizerunku marek samochodów osobowych. Dla potrzeb realizacji celu przeprowadzono analizę działań wizerunkowych wybranych marek samochodów na portalu Facebook oraz badanie metodą ankietową wśród użytkowników tego portalu.
Head Trauma in Paediatric Patients Referring to a Spoke Hospital
Authors: Ragusa Neftj , Deut Virginia , Luotti Diego , Depaoli Alessandro , Berger Massimo 
Published: January 2024

Introduction: Head trauma (HT) is a leading cause of morbidity and mortality in children worldwide. The primary aim of this study was to describe patients presenting to our first-level Emergency Department (ED) following a HT. The secondary aims were to compare both the epidemiology and the management of paediatric patients with literature data, analyzing the appropriateness of management of children’s traumatic brain injuries according to the current guidelines.
Methods: We conducted a retrospective review of medical records of patients aged < 14 years who attended our first-level ED due to head trauma from July 1, 2021, and June 30, 2022. Clinical data, including age, gender, injury mechanism, location of trauma, time from traumatic event and ED arrival, symptoms at first evaluation, physical examination findings, radiological investigation results, medications administered in ED and prescribed at home, and outcome were collected and compared with data available in literature and current guidelines.
Results: A total of 117 children aged < 14 years who attended our first-level ED due to head trauma from July 1, 2021, and June 30, 2022, were analyzed. Most of them were males aged 1-3 years. Frontal bone was the commonest side of trauma (43% of HT). Only eleven patients (9%) had a brain CT scan and 4 of them showed pathological findings. None had signs of bleeding. Four of the patients were transferred to a HUB hospital, provided with a paediatric neurosurgery and more important none of them has developed neurological sequelae or death.
Discussion: Our 1-year observation of HT showed how this is a frequent indication for ED referral, especially in young children. In our hands less than 10% of cases required CT scan that reported pathological cases in 4 patients only (3%). We can conclude that the reduction of ionizing radiation exposition can be obtained with skilled experienced physicians.