bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gamification as an educational tool to address antimicrobial resistance: a systematic review
Authors: Nowbuth Avis A , Asombang Akwi W , Alaboud Khuder , Souque Célia , Dahu Butros M , Pather Kyrtania , Mwanza Monica M , Lotfi Sameen , Parmar Vikram S 
Published: December 2023

Abstract

Background
Antimicrobial resistance (AMR) poses a serious threat to global healthcare, and inadequate education has been identified as a major challenge by the WHO. The human , animal and agricultural sectors contribute to the emergence of AMR. Gamification has emerged as an innovative tool to improve knowledge and change behaviours. Our study provides an overview of the literature on existing games in prescribers’ education across the One Health sectors, with a particular focus on the impact of gamification on learning.

Methods
Using the PRISMA guidelines, we searched Cochrane, PubMed, Scopus and Google Scholar for articles related to gamification for future prescribers of antimicrobials from inception until 28 March 2023. Retrieval and screening of articles was done using a structured search protocol with strict inclusion/exclusion criteria.

Results
A total of 120 articles were retrieved, of which 6 articles met the inclusion criteria for final analysis. High-income countries had the most studies, with one global study incorporating low- to middle-income countries. All games were evaluated in the human sector. Board and card games, featuring scoring and point systems, were the most prevalent game types. Most games focused on improving knowledge and prescribing behaviours of medical students, with bacteria or antibiotics as the only content. All studies highlighted the significant potential of gamification in mitigating AMR, promoting antimicrobial stewardship, and improving retention of information compared with conventional lectures.

Conclusions
Our review found an absence of studies in the animal and environmental sectors, disproportionately focused on medical students with questionable sample size, inadequate assessment of game content and effectiveness, and opportunities for game developers.
Improving antibiotic prescribing quality in out-of-hours primary care: a mixed-methods study using participatory action research
Authors: Colliers Annelies , Coenen Samuel , Teughels Stefan , Boogaerts Yentry , Vandeput Olivia , Tans Anouk , Vermeulen Helene , Remmen Roy , Philips Hilde , Anthierens Sibyl 
Published: December 2023

Abstract

Background
During out-of-hours (OOH) primary care, GPs overprescribe antibiotics for respiratory tract infections (RTIs). Many interventions have been shown to improve antibiotic prescribing quality, but their implementation in practice remains difficult. Participatory action research (PAR) aims to explore, implement and evaluate change in practice with an active involvement of local stakeholders, while generating knowledge through experience.

Objectives
To evaluate whether PAR improves antibiotic prescribing quality for RTIs during OOH primary care and simultaneously identify the pivotal lessons learned.

Methods
A mixed-methods study with a PAR approach in three OOH GP cooperatives (GPCs). Each GPC co-created a multifaceted intervention focusing on improving antibiotic use for RTIs through plan-do-study-act cycles. We quantified antibiotic prescribing quality indicators and formulated the lessons learned from a qualitative process analysis.

Results
Interventions were chosen with the GPs and adapted to be context-relevant. The willingness to work on quality and engagement of local stakeholders led to ownership of the project, but was time-consuming. In one GPC, antibiotic prescribing significantly decreased for tonsillitis, bronchitis, otitis media and acute upper RTI. In all three GPCs, use of guideline-recommended antibiotics for otitis media significantly increased.

Conclusions
Implementing multifaceted interventions through PAR can lower total and increase guideline-recommended antibiotic prescribing for RTIs in OOH primary care. Co-creating interventions with GPs to suit local needs is feasible, but reaching all GPs targeted is challenging.
Ninety Sixth-Hour Impact of Scalding Burns on End Organ Damage, Systemic Oxidative Stress, and Wound Healing in Rats Treated With Three Different Types of Dressings
Authors: Aslan Mehmet , Gül Mehmet , Üremiş Nuray , Akbulut Sami , Gürünlüoğlu Semra , Nur Özsoy Eda , Türköz Yusuf , Ateş Hasan , Akpinar Necmettin , Gül Semir , Gürünlüoğlu Kubilay , Demircan Mehmet 
Published: December 2023

Abstract
In this study, we investigated the effects of 3 different burn dressing treatments, including experimental, silver, and modern dressing materials, on systemic oxidative stress in rats with severe scald burns within the first 96 h. The rats were divided into five groups: a burn group (n = 10), a polylactic membrane group (n = 10), a silver sulfadiazine group (n = 10), a curcumin group (n = 10), and a control group (n = 10), consisting of equal numbers of female and male rats. In the first 4 groups, 30% of the rats’ total body surface area was scalded at 95°C. The burn group was not treated. Each group was treated with group-name dressing material. The control group was neither treated nor burned. The rats were sacrificed, and blood and tissue samples were obtained at the 96th hour when severe effects of oxidative stress developed postburns. Systemic inflammatory biomarkers and oxidative stress parameters were examined. In addition, apoptosis and organ damage in liver, kidney, lung, and skin tissues were evaluated biochemically and histopathologically. When the parameters were statistically analyzed, we found that the systemic levels of oxidative stress and inflammatory damage to liver, kidney, and lung tissues were lower in the 3 treated groups than in the burn group. We believe that the dressing material’s efficacy in the treatment of severe burns may be dependent on its ability to combat oxidative stress and inflammation.
ISDS 2.0: time for a doctrine of precedent?
Authors: Jarrett Martin 
Published: December 2023

Abstract
The reform process for ISDS at UNCITRAL is reaching its climax. Within the next few years, a treaty for ‘ISDS 2.0’ should emerge from this process. A key feature of ISDS 2.0 will be a new international court for resolving investor–state disputes. This court should include an appellate tribunal. A core function of this appellate tribunal will be to produce consistent case law, noting a common complaint about ‘ISDS 1.0’ is that it has produced inconsistent case law. There is good reason to believe that the appellate tribunal of ISDS 2.0 can deliver consistent case law, but the promoters behind ISDS 2.0 need to be careful what they wish for. The WTO dispute settlement system produced consistent case law, yet that achievement turned out to be a reason for its subsequent breakdown. Consistent case law apparently sounds good in theory, but it is not welcome in practice. Is there a way out of this conundrum? This article proposes that a formal doctrine of precedent is the solution. This proposal might initially provoke some surprise—a softer system of precedent is apparently the best compromise. But a doctrine of precedent can be crafted to limit adjudicative law-making power, while emphasizing states’ control over their investment–treaty obligations. This article puts forward the broad outline of this conception of a doctrine of precedent, explains why it gives effect to states’ interests, and examines the methods by which a doctrine of precedent could be adopted.
Clinicopathologic features of a novel star-shaped transactive response DNA-binding protein 43 (TDP-43) pathology in the oldest old
Authors: Carlos Arenn F , Sekiya Hiroaki , Koga Shunsuke , Gatto Rodolfo G , Casey Monica Castanedes , Pham Nha Trang Thu , Sintini Irene , Machulda Mary M , Jack Clifford R , Lowe Val J , Whitwell Jennifer L , Petrucelli Leonard , Reichard R Ross , Petersen Ronald C , Dickson Dennis W , Josephs Keith A 
Published: December 2023

Abstract
Transactive response DNA-binding protein 43 (TDP-43) pathology is categorized as type A-E in frontotemporal lobar degeneration and as type α-β in Alzheimer disease (AD) based on inclusion type. We screened amygdala slides of 131 cases with varying ages at death, clinical/neuroimaging findings, and AD neuropathologic changes for TDP-43 pathology using anti-phospho-TDP-43 antibodies. Seven cases (5%) only showed atypical TDP-43 inclusions that could not be typed. Immunohistochemistry and immunofluorescence assessed the atypical star-shaped TDP-43 pathology including its distribution, species, cellular localization, and colocalization with tau. All 7 had died at an extremely old age (median: 100 years [IQR: 94–101]) from nonneurological causes and none had dementia (4 cognitively unimpaired, 3 with amnestic mild cognitive impairment). Neuroimaging showed mild medial temporal involvement. Pathologically, the star-shaped TDP-43-positive inclusions were found in medial (subpial) amygdala and, occasionally, in basolateral regions. Hippocampus only showed TDP-43-positive neurites in the fimbria and subiculum while the frontal lobe was free of TDP-43 inclusions. The star-shaped inclusions were better detected with antibodies against N-terminal than C-terminal TDP-43. Double-labeling studies confirmed deposition of TDP-43 within astrocytes and colocalization with tau. We have identified a novel TDP-43 pathology with star-shaped morphology associated with superaging, with a homogeneous clinicopathologic picture, possibly representing a novel, true aging-related TDP-43 pathology.
A study on rose-window instability in a dielectric droplet exposed to corona discharge
Authors: Chiou Yi-Jen , Fu Chiang , Liao Ying-Hao 
Published: December 2023

Abstract
The rose-window instability (RWI) is an electrohydrodynamic instability occurring in a dielectric liquid subjected to an electric field. This instability leads to variations in the shape of the liquid and its spreading. Despite the significance of the RWI, there have been limited studies, especially concerning dielectric droplets. Thus, the aim of this study is to investigate the characteristic of rose-window instability in silicone oil droplets exposed to corona discharge. The study examines the effects of electrode gap, applied voltage, and viscosity on the formation of RWI. Increasing the electrode gap results in an enlarged rose-window lattice, accompanied by a decrease in the number of lattices. This can be attributed to a more diffusive ionic flow and a more pronounced inhomogeneity of charge distribution across the droplet surface. On the other hand, higher voltages, which enhances the ionic flow, accelerate the formation of RWI and lead to a larger inner diameter. Viscosity has little influence on the geometry of the lattice. However, droplets with low viscosity exhibit a more rapid development of instability. The observation suggests that the small Ohnesorge number (Oh), influenced by factors such as viscosity and surface tension, may play a role in the development of the rose-window instability. The influence of surface tension, although not the main focus of the study, cannot be completely disregarded as it is interconnected with the Oh and may contribute to the observed results.
Differential effects of dietary polyphenols on oral pharmacokinetics of cyclin-dependent kinase inhibitors in rats: a mechanistic framework for in vitro–in vivo extrapolation
Authors: Patil Prajakta Harish , Desai Mrunal Pradeep , Birangal Sumit , Gautham Shenoy G , Channabasavaiah Jagadish Puralae 
Published: December 2023

Abstract

Objectives
Cyclin-dependent kinase inhibitors are subject to rapid first-pass metabolism, and their oral absorption is hindered by intestinal CYP3A4 and P-gp. The present study investigates the impact of dietary polyphenols on the oral pharmacokinetics of palbociclib and ribociclib, considering their potential as modulators of CYP3A4 and P-gp.

Methods
Therefore, potential inhibitory effects of dietary polyphenols on drug metabolism and efflux of these drugs were investigated using molecular docking; in vitro preclinical assay using rat liver microsomes and Caco-2 cell monolayers; in vivo, pharmacokinetic parameters were determined in rats pretreated with dietary polyphenols.

Key findings
Curcumin and quercetin have the highest binding affinities to the PXR’s AF-2 region cluster. Curcumin and quercetin significantly inhibited both intestinal efflux and CYP3A4-mediated metabolism of palbociclib and ribociclib (P &lt; .05). In rats pretreated with curcumin, Cmax of palbociclib exhibited a 5.13% increase, while the AUC0-24h of ribociclib showed a significant increase of 18.83% (P &lt; .05). Quercetin administration, notably, impedes the pharmacokinetics of palbociclib. However, the pharmacokinetics of ribociclib remains unaffected by quercetin.

Conclusions
In conclusion, the utilization of curcumin as a bioenhancer can enhance the bioavailability of dual substrates of P-gp and CYP3A4.
Agency’s Moral Universe
Authors: Black Monica 
Published: December 2023

Abstract
Agency belongs to a distinctly moral understanding of the cosmos, buttressed by faith in an ultimately just and knowable universe. On some deep level, historians believe that the good will out. But looking at those moments when the agency concept creates cognitive dissonance—when, for example, Holocaust perpetrators’ “agency” was placed in the service of evil—reveals things about the moral universe historians think we inhabit. Using the example of post-1945 West Germany, the essay asks whether a shift toward increasingly diffuse forms of agency across various fields may be part of a larger historical, and not merely historiographical, pattern. In the “post-truth” early twenty-first century, will historians’ accounts of the past continue to be shaped by the idea of a benevolent and graspable universe, or will chaos make agency seem like an unrecognizable relic from a lost world?
Meanings of Agency, Agency of Meaning: On Synthesis and Entanglement
Authors: Burke Timothy 
Published: December 2023

Abstract
Two decades later, the conceptual problems of the term “agency” identified by Walter Johnson remain largely unresolved, in particular the analytic inhibitions that follow from what the historian Lynn Thomas has described as agency-as-argument. Taking the case of the colonial Zimbabwean chief Munhuwepayi Mangwende as a reference point, this essay argues that the microhistorical tracing of agency as meaning rather than causality is what may permit us to move past the “safe harbor” of agency-as-argument and begin to understand the full range of what people have chosen to do in the past—and to interact more effectively with what they might yet choose to do in the present.
Determinants of return migration of Estonian young adults in transnational mobility
Authors: Toomistu Terje , Lauren Ave , Annist Aet , Murakas Rein 
Published: December 2023

AbstractSince Estonia joined the European Union in 2004, there has been a steady growth in transnational mobility for work or study among Estonian young adults, a phenomenon further boosted by the economic recession of 2008–09. This article analyses the factors that have influenced or would potentially influence their return to Estonia, following an online survey of over 2,000 participants from Estonia aged 20–35 years with a recent experience of living abroad. By deploying an analysis of logistic regression, we developed two models concerning the ‘actual return factors’ (comparing the stayers with those who have returned) and the ‘aspirational return factors’ (how the migrants imagine their future location). Some of the highlights of our results demonstrate that the likelihood of return migration is significantly lower for those whose prime reasons for leaving Estonia were related to living conditions and salary abroad. The extent of people’s ties and connections to Estonia does not play a significant role in actually returning to Estonia. However, these connections do play a role, albeit limited, in envisioning one’s future in Estonia. The outcomes of our analysis suggest that diaspora policies cannot be implemented without addressing the sending country’s internal sociopolitical situation, which influences the living conditions and economic opportunities of its citizens, scrutinized particularly carefully by those who have left the country before deciding whether or not to return.
Tube Thoracostomy Complications in Patients With ARDS Requiring ECMO: Worse in COVID-19 Patients?
Authors: Laverty Robert B , Ivins-O’Keefe Kelly M , Adams Alexandra M , Flatley Meaghan J , Sobieszczyk Michal J , Mason Phillip E , Sams Valerie G 
Published: December 2023

ABSTRACT

Introduction
The incidence and management outcomes of COVID-19 patients with acute respiratory distress syndrome (ARDS) on veno-venous extracorporeal membrane oxygenation (V-V ECMO) requiring chest tubes are not well-described. This study sought to explore differences in tube thoracostomy rates and subsequent complications between patients with and without COVID-19 ARDS on V-V ECMO.

Materials and Methods
This study is a single institution, retrospective cohort study of patients with COVID-19 ARDS requiring V-V ECMO. The control cohort consisted of patients who required V-V ECMO for ARDS-related diagnoses from January 2018 to January 2021. The primary outcome was any complication following initial tube thoracostomy placement. Study approval was obtained from the Brooke Army Medical Center Institutional Review Board (C.2017.152d).

Results
Twenty-five COVID-19 patients and 38 controls were included. Demographic parameters did not differ between the groups. The incidence of pneumothorax was not significantly different between the two groups (44% COVID-19 vs. 22% control, OR 2.8, 95% CI 0.95–7.9, P = 0.09). Patients with COVID-19 were as likely to receive tube thoracostomy as controls (36% vs. 24%, OR 1.8, 95% CI 0.55–5.7). Complications, however, were more likely to occur in the COVID-19 group (89% vs. 33%, OR 16, 95% CI, 1.6–201, P = 0.0498).

Conclusions
Tube thoracostomy placement in COVID-19 patients with ARDS requiring V-V ECMO is common, as are complications following initial placement. Clinicians should anticipate the need for re-intervention in this patient population. Small-bore (14Fr and smaller) pigtail catheters appeared to be safe and efficacious in this setting, but further study on tube thoracostomy management in ECMO patients is needed.
Comparing Capabilities of Simulation Modalities for Training Combat Casualty Care: Perspectives of Combat Medics
Authors: Bailey Shannon K T , Brannick Michael T , Bowling F , Reiner Colleen C , Lyons Dennis , Llerena Luis E , Okuda Yasuharu 
Published: December 2023

ABSTRACT

Introduction
Combat casualty care requires learning a complex set of skills to treat patients in challenging situations, including resource scarce environments, multiple casualty incidents, and care under fire. To train the skills needed to respond efficiently and appropriately to these diverse conditions, instructors employ a wide array of simulation modalities. Simulation modalities for medical training include manikins, task trainers, standardized patient actors (i.e., role players), computer or extended reality simulations (e.g., virtual reality, augmented reality), cadavers, and live tissue training. Simulation modalities differ from one another in multiple attributes (e.g., realism, availability). The purpose of this study was to compare capabilities across simulation modalities for combat casualty care from the perspective of experienced military medics.

Materials and Methods
To provide a more complete understanding of the relative merits and limitations of modalities, military combat medics (N = 33) were surveyed on the capabilities of simulation modalities during a 5-day technical experimentation event where they observed medical simulations from industry developers. The survey asked them to rate each of eleven modalities on each of seven attributes. To elicit additional context for the strengths, limitations, and unique considerations of using each modality, we also collected open-ended comments to provide further insight on when and how to use specific simulation modalities.

Results
Results showed differences among the simulation modalities by attribute. Cadavers, role play, moulage, and live tissue all received high ratings on two or more attributes. However, there was no modality that was rated uniformly superior to the others. Instead, modalities appear to have unique strengths and limitations depending on the training context and objectives. For example, cadavers were seen as highly realistic, but not very reusable.

Conclusions
The study furthers our understanding of simulation modalities for medical training by providing insight from combat medics on the benefits, limitations, and considerations for implementing different modalities depending on the training context. These results may be helpful to instructors in selecting modalities for their programs.
Dose–response association between animal protein sources and risk of gestational diabetes mellitus: a systematic review and meta-analysis
Authors: Talebi Sepide , Ghoreishy Seyed Mojtaba , Ghavami Abed , Sikaroudi Masoumeh Khalighi , Nielsen Sabrina Mai , Talebi Ali , Mohammadi Hamed 
Published: December 2023

Abstract

Context
There are contradictory findings about the relationship between various animal protein sources and the risk of gestational diabetes mellitus (GDM).

Objective
The purpose of our study was to understand better the associations between total protein, animal protein, and animal protein sources and the risk of developing GDM.

Data Sources
A systematic literature search was conducted in PubMed, Scopus, and Web of Science encompassing the literature up until August 2022. A random-effects model was used to combine the data. For estimating the dose–response curves, a one-stage linear mixed-effects meta-analysis was conducted.

Data Extraction
Data related to the association between animal protein consumption and the risk of GDM in the general population was extracted from prospective cohort studies.

Data Analysis
It was determined that 17 prospective cohort studies with a total of 49 120 participants met the eligibility criteria. It was concluded with high certainty of evidence that there was a significant association between dietary animal protein intake and GDM risk (1.94, 95% CI 1.42 to 2.65, n = 6). Moreover, a higher intake of total protein, total meat, and red meat was positively and significantly associated with an increased risk of GDM. The pooled relative risks of GDM were 1.50 (95% CI: 1.16, 1.94; n = 3) for a 30 g/d increment in processed meat, 1.68 (95% CI: 1.25, 2.24; n = 2) and 1.94 (95% CI: 1.41, 2.67; n = 4) for a 100 g/d increment in total and red meat, and 1.21 (95% CI: 1.10, 1.33; n = 4) and 1.32 (95% CI: 1.15, 1.52; n = 3) for a 5% increment in total protein and animal protein, respectively. GDM had a positive linear association with total protein, animal protein, total meat consumption, and red meat consumption, based on non-linear dose–response analysis.

Conclusion
Overall, consuming more animal protein–rich foods can increase the risk of GDM. The results from the current study need to be validated by other, well-designed prospective studies.

Systematic Review Registration
PROSPERO registration no. CRD42022352303.