bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocols for ischemic stroke in Flemish hospitals: correlation between availability and content versus adherence
Authors: Lens Charlotte , Hermans Lotte , Weltens Caroline , Vanhaecht Kris , Lemmens Robin , Coeckelberghs Ellen 
Published: February 2025

Abstract
Background: Stroke is globally one of the leading causes of mortality and disability. Adhering to evidence-based guidelines and protocols can improve quality of care for ischemic stroke patients. We aimed to compare the availability and content of specific protocols versus adherence to these key intervention in clinical daily practice among Flemish hospitals. We selected five key interventions for managing ischemic stroke patients. These key interventions encompassed the measurement of body temperature, glycaemia monitoring, screening of Swallowing function according to the Fever, Sugar and Swallowing protocol (FeSS protocol) and depression and Activities of Daily Living (ADL), (FeSS+ key-interventions).
Methods: A systematic quantitative and qualitative approach was designed to analyse specific protocols from 24 hospitals. A predefined data extraction matrix for the five FeSS+ key interventions was utilized for data collection. Using this matrix, protocols were scored according to completeness of content, regarding the FeSS+ interventions. These scores were used to calculate a total protocol content score, i.e. a total score for the five FeSS+ interventions and an individual score for each key intervention separately, ranging between 0 and 1, per hospital. A score of zero indicates absence of the FeSS+ interventions in the protocols, while a score of one signifies complete coverage of these interventions. In addition, we assessed the correlation between the availability and content of these protocols in relation to the adherence to interventions documented for 30 patients per hospital.
Results: The mean total protocol content score was 0.40±0.20, ranging from 0.64±0.25 for glycaemia management to 0.1±0.28 for ADL screening. With regard to the individual FeSS+ key interventions, we identified a correlation between protocol characteristics and adherence for glycaemia (rs = 0.42, p = 0.04), depression screening (rs = 0.43, p = 0.04) and ADL screening (rs = 0.44, p = 0.03). Total FeSS+-protocol content also correlated with adherence (r = 0.6140, p = 0.0014).
Conclusion: Protocol characteristics for the FeSS+ key interventions were variable and rather limited, especially for ADL- and depression screening. The identified relationship between the content of protocols and adherence to interventions underscores the value of defining these activities in hospital documentation to improve stroke care.
Penile rehabilitation after radical prostatectomy using low-intensity shockwave therapy for erectile function: late results findings from a randomized clinical trial
Authors: Lessa Pedro Fernandes , Baccaglini Willy , Salles Matheus Pascotto de , Silva Reuli Cordeiro da , Pazeto Cristiano Linck , Lopes Leonardo Seligra , Glina Sidney 
Published: February 2025

Abstract

Background
There is still few evidence to support the use of low-intensity extracorporeal shockwave therapy (LiESWT) in rehabilitation of erectile function after radical prostatectomy (RP).

Aim
The aim of this study is to assess the long-term results of LiWEST as a penile rehabilitation method in patients who underwent RP.

Methods
This is an assessment of the late results outcomes of our previous clinical trial registered in ReBEC (ensaiosclinicos.gov.br) RBR-85HGCG. Patients were randomized in two groups with two parallel arms and an allocation ratio of 1:1. The control group received tadalafil 5 mg/day, while the experimental group received tadalafil 5 mg/day and were submitted to 2400 shocks/session-week distributed on four different penile regions across 8 weeks of treatment. Both groups started the penile rehabilitation after the removal of the transurethral catheter. Sexual function was assessed by International Index of Erectile Function (IIEF-5) score.

Outcomes
A difference in IIEF-5 without statistical significance between the experimental and control groups.

Results
Among 77 patients included in our previous analysis, 35 patients were reassessed after a median follow-up of 45 months (95% CI, 42-50 months). Seventeen of them had to be excluded from the analysis for biochemical recurrence and/or new interventions. Remaining 7 and 11 patients in the experimental and control group, respectively. The final mean IIEF-5 score between experimental and control groups showed a difference in favor of the LiWEST group, not statistically significant (18.85, SD 5.66, 95% CI, 13.61-24.1 x 16.63, SD 5.48, 95%CI, 12.9- 20.31; respectively; P = 0.42). Subgroup analysis in patients still using IPDE5 there is a higher difference between mean IIEF5, however not statistically significantly (18.5, SD 6.12, 95%CI 12.07-24.92 x 15.85, SD 3.62, 95% CI, 12.50-19.20, P = 0.35).

Clinical implications
This study highlights that LiESWT may offer limited long-term benefit for erectile function recovery after RP.

Strengths & Limitations
This study provides valuable long-term data on the use of LiESWT as a penile rehabilitation method after RP. The randomized design and parallel group structure strengthen the reliability Journal of Sexual Medicine Journal of Sexual Medicine For Peer Review of findings, with clear intervention protocols. However, limitations include a small final sample size due to patient exclusions, which likely impacted statistical power and the generalizability of results. Additionally, while differences in IIEF-5 scores favored the LiESWT group, the lack of statistical significance limits the ability to draw definitive conclusions about its effectiveness.

Conclusion
The LiESWT showed no impact on long-term results of penile rehabilitation in patients submitted to RP.
Icariin improves erectile function in spontaneously hypertensive rats by downregulating GRK2 in penile cavernous tissue
Authors: Li Yanke , Jiang Jun , Jiang Rui 
Published: February 2025

Abstract

Background
Hypertension is an independent risk factor for erectile dysfunction (ED). Icariin can improve erectile function of spontaneous hypertensive rats (SHRs). GRK2 is closely related to the phosphorylation of eNOS and endothelial function.

Aim
To explore whether icariin can improve erectile function in SHRs by regulating the expression of GRK2 in penile cavernous tissue.

Methods
Eight-week-old WKY and SHR rats were randomly divided into four groups (n = 6 per group) as follows: WKY, WKY + icariin, SHR and SHR + icariin. The WKY + icariin and SHR + icariin groups were treated with 10 mg/kg/day icariin. After 4 weeks, the ICPmax/mean arterial pressure (MAP), serum testosterone, the levels of GRK2, p-AKT/AKT, p-eNOS/eNOS, and caspase-3; the protein interaction between GRK2 and AKT; the levels of nitric oxide (NO), superoxide dismutase (SOD), and malondialdehyde (MDA); and the level of apoptosis in rat penile cavernous tissue were measured.

Outcome
The expression of GRK2 in penile cavernous tissue of SHR was significantly higher than that in WKY rats, resulting in the inhibition of the AKT/eNOS/NO pathway, increased levels of oxidative stress and apoptosis, and the impairment of erectile function.

Results
The ICPmax/MAP ratio in the SHR group was significantly lower than those in WKY and SHR + icariin groups (P &lt; .01). In the SHR + icariin group, the expression levels of GRK2 and caspase-3, the interaction between GRK2 and AKT, the level of MDA and the rate of apoptosis in the penile cavernous tissue were significantly lower, and the levels of p-AKT and p-eNOS, the p-AKT/AKT and p-eNOS/eNOS ratios, and NO and SOD were significantly greater than those in the SHR group (P &lt; .01).

Clinical Implications
Icariin may improve the erectile function of hypertension by downregulating GRK2 expression in penile cavernous tissue.

Strengths and Limitations
The specific mechanism via which icariin downregulates GRK2 needs to be further elucidated.

Conclusion
Icariin downregulates the expression of GRK2 in the penile cavernous tissue of SHRs, upregulates the AKT/eNOS/NO pathway, decreases oxidative stress and apoptosis, and ultimately improves erectile function.
Description of the Problem: Uniform Laws and Damages
Authors: Zeller Bruno 
Published: February 2025

Abstract
This introductory chapter provides an overview of the economic and legal landscape in which any determination of damages takes place. Whenever a contract is being negotiated, each party attempts to identify and minimize the risks involved in the sale of goods. Several issues are important such as which law is to apply, and which jurisdiction is to be preferred. This is so as the question of calculating damages in cases of a breach is tied up in the choice of a legal system. The problem is that as long as transnational laws are not ratified and importantly embraced by the business community; a truly seamless trade system will not eventuate despite the existence of a physical transnational supply network. The United Nations Convention on Contracts for the International Sale of Goods (CISG), despite perceived shortcomings, is still the only harmonized sales law as ninety-seven countries have ratified the Convention.
Regional Developments and the CISG
Authors: Zeller Bruno 
Published: February 2025

Abstract
This chapter explores the various regional developments in relation to their utility compared with the United Nations Convention on Contracts for the International Sale of Goods (CISG). There were several regional developments in attempting to draft contract laws which were either in competition with the CISG or attempted to assist the CISG in the harmonization effort of creating a global contract law. The EU was a big driver in this attempt, not only creating the Principles of European Contract Law (PECL) but also the Common Frame of Reference (CFR) and lately, the Common European Sales Law (CESL). It can be argued that the problem in the EU is the issue that formulating agencies are not flexible in choosing an instrument and in conceiving ways in which hard and soft law may best supplement each other.
A calculus for modal compact Hausdorff spaces
Authors: Bezhanishvili Nick , Carai Luca , Ghilardi Silvio , Zhao Zhiguang 
Published: February 2025

Abstract
The symmetric strict implication calculus $\mathsf{S}^{2}\mathsf{IC}$ is a modal calculus for compact Hausdorff spaces. This is established through de Vries duality, linking compact Hausdorff spaces with de Vries algebras—complete Boolean algebras equipped with a special relation. Modal compact Hausdorff spaces are compact Hausdorff spaces enriched with a continuous relation. These spaces correspond, via modalized de Vries duality, to upper continuous modal de Vries algebras. In this paper, we introduce the modal symmetric strict implication calculus $\mathsf{MS}^{2}\mathsf{IC}$, which extends $\mathsf{S}^{2}\mathsf{IC}$. We prove that $\mathsf{MS}^{2}\mathsf{IC}$ is strongly sound and complete with respect to upper continuous modal de Vries algebras, thereby providing a logical calculus for modal compact Hausdorff spaces. We also develop a relational semantics for $\mathsf{MS}^{2}\mathsf{IC}$ that we employ to show admissibility of various $\Pi_{2}$-rules in this system.
Two temperature-responsive RNAs act in concert: the small RNA CyaR and the mRNA ompX
Authors: Guanzon David A , Pienkoß Stephan , Brandenburg Vivian B , Röder Jennifer , Scheller Daniel , Dietze Alisa , Wimbert Andrea , Twittenhoff Christian , Narberhaus Franz 
Published: February 2025

Abstract
Bacterial pathogens, such as Yersinia pseudotuberculosis, encounter temperature fluctuations during host infection and upon return to the environment. These temperature shifts impact RNA structures globally. While previous transcriptome-wide studies have focused on RNA thermometers in the 5′-untranslated region of virulence-related messenger RNAs, our investigation revealed temperature-driven structural rearrangements in the small RNA CyaR (cyclic AMP-activated RNA). At 25°C, CyaR primarily adopts a conformation that occludes its seed region, but transitions to a liberated state at 37°C. By RNA sequencing and in-line probing experiments, we identified the Shine–Dalgarno sequence of ompX as a direct target of CyaR. Interestingly, the ompX transcript itself exhibits RNA thermometer-like properties, facilitating CyaR base pairing at elevated temperatures. This interaction impedes ribosome binding to ompX and accelerates degradation of the ompX transcript. Furthermore, we observed induced proteolytic turnover of the OmpX protein at higher temperatures. Collectively, our study uncovered multilayered post-transcriptional mechanisms governing ompX expression, resulting in lower OmpX levels at 37°C compared with 25°C.
Structural basis of endo-siRNA processing by Drosophila Dicer-2 and Loqs-PD
Authors: Cao Na , Wang Jia , Deng Ting , Fan Boming , Su Shichen , Ma Jinbiao , Wang Hong-Wei 
Published: February 2025

Abstract
Endogenous small interfering RNAs (endo-siRNAs or esiRNAs) originate from either elongated endogenous transcripts capable of forming complex fold-back structures or from double-stranded regions generated through intermolecular base pairing of convergently transcribed mRNAs. The mechanism of maturation and functionality of esiRNAs exhibit significant variation across diverse species. In Drosophila melanogaster, esiRNAs reside in both somatic and germline cells, where they serve as post-transcriptional modulators for specific target RNAs. Their maturation process critically relies on Dicer-2 (Dcr-2), with the assistance of its cofactor Loqs-PD. In this study, we have successfully elucidated the cryo-EM structures of Dcr-2/Loqs-PD complex bound to esiRNA precursors (pre-esiRNAs) in various states. Our structural and biochemical results reveal that ATP is essential for the cleavage of esiRNAs by the Dcr-2/Loqs-PD complex, a process analogous to the cleavage of double-stranded RNA (dsRNA). When Loqs-PD is present, pre-esiRNAs are preferentially loaded onto the Helicase domain of Dcr-2. Moreover, as the Helicase domain exhibits a preference for binding to the rigid end of double-stranded RNA, Dcr-2 tends to cleave pre-esiRNA from the small closed loop end, rather than the loose and flexible open end.
Big cities fuel inequality within and across generations
Authors: Connor Dylan S , Xie Siqiao , Jang Jiwon , Frazier Amy E , Kedron Peter , Jain Garima , Yu Yilei , Kemeny Tom 
Published: February 2025

Abstract
Urbanization has long fueled a dual narrative: cities are heralded as sources of economic dynamism and wealth creation yet criticized for fostering inequality and a range of social challenges. This paper addresses this tension using a multidisciplinary approach, combining social sciences methods with satellite imagery-based spatial pattern analysis to study the US urban expansion over the past century. We examine the impact of physical urban spatial characteristics (size, population density, and connectedness) on equality of opportunity, measured through intergenerational mobility, as well as its association with levels of income, wealth, and social capital. Our findings confirm that contemporary cities, particularly population-dense and expansive ones, are indeed divisive forces—acting as centers for income and wealth generation but failing to deliver equal opportunities for economic mobility. Perhaps surprisingly, this polarizing dynamic is a recent phenomenon. In the past, the most urbanized regions performed well in terms of income creation and equality of opportunity. Our analysis supports the hypothesis that the mid-20th century marked a pivotal shift toward more unequal and less inclusive patterns of urban growth.
Building healthier communities: the role of health educational programs in enhancing health literacy in Prairie View, Texas
Authors: Lewis Joshua , Pride Lornee , Hollis Melanie , Griffith Patrick 
Published: February 2025

Abstract

Introduction
Increasing health literacy, the ability to understand and process health information, within underserved communities can improve health outcomes. We hypothesized that educational programs tailored by age group would effectively improve an individual’s health literacy in underserved communities. Our study examined the implication of a health-related education program among different age groups in Prairie View, Texas.

Objectives
The study aimed to (i) improve health literacy within the Prairie View, Texas community; (ii) encourage healthy lifestyles in study participants; and (iii) provide an educational experience for medical and pre-medical students.

Methods
Monthly educational modules were presented for 5 months to three groups (high school students, college students, and older adults). The improvement in health literacy after the study was evaluated based on the average of correct responses on the pre- and post-monthly assessments. We also assessed the change in pre-med and medical students’ willingness to work within underserved communities.

Results
The average percentage of correct answers increased. By the end of the study, high school students answered 96% of the questions correctly, college students answered 95% correctly, and older adult participants answered 90% correctly. Medical student and pre-med student willingness to practice medicine in underserved communities increased.

Conclusion
Programs to increase health literacy within underserved communities can lead to improved medical knowledge competency, positive health outcomes, and informed decision making. Students exposed to the research were more willing to practice medicine in underserved communities.
Radiological safety assessment of monazite industry worker due to NORM inhalation
Authors: Lee Seong Yeon , Jin Yong Ho , Kim Min Seong , Kim Ji Woo , Kim Kwang Pyo 
Published: February 2025

Abstract
Monazite is used as a raw material for the production of rare earth elements. The workers in the monazite industry are exposed to radiation from the raw material. Therefore, internal radiation dose should be assessed for radiological safety assessment of the workers. The objective of this study is to assess the internal radiation dose to workers of the monazite industry in Korea by means of measured particulate. Particulate properties, including size distribution, density, shape, and radioactivity concentration were analyzed. Then, the internal radiation dose coefficients were derived using the IMBA software. Work scenarios were derived by identifying the work time. Finally, internal radiation doses were calculated with the collected and calculated data. The internal radiation dose ranged from 7.48 × 10−3 to 3.25 × 10−1 mSv y−1 with dose difference by orders of magnitude. It is highlighted why such data should be directly collected at sites to realistically assess radiation dose to workers.
Evaluation of the self-shielding characteristics of an innovative radiosurgical system ZAP-X
Authors: Mingsheng Li , Xiangjie Ma , Ya Liu , Xiao Wei , Quanfu Sun , Jinsheng Cheng 
Published: February 2025

Abstract

Purpose
The aim of this study was to evaluate the radiation level of a ZAP-X self-shielding system by comparing it with the requirements of the Chinese radiation protection standards and to provide a practical solution for the operation of ZAP-X in China.

Methods
Under the maximum workload of the ZAP-X system, the weekly radiation dose and the instantaneous dose rate (IDR) outside the safety perimeter of the ZAP-X system were compared to the requirements of relevant standards.

Results
The maximum weekly and annual dose equivalents, derived from the IDRs and accumulative doses, were as follows:1.99 μSv/week and 0.10 mSv/year, and 3.47 μSv/week and 0.17 mSv/year, respectively.

Conclusion
The radiation levels around the ZAP-X system meet the requirements of the weekly and annual dose constraints in relevant Chinese standards. The IDRs generated by the ZAP-X system do not meet the requirements of the existing radiation protection standards. A viable solution is to adjust the safety perimeter to comply with existing standards.
Non-Biological Modular Knee Arthrodesis for Prosthetic Infections With Large Defects at 5-year Follow-up: An Alternative to Amputation
Authors: Farid Yasser R. 
Published: February 2025

Introduction:
Treatment of recurrent periprosthetic knee infections is challenging. Arthrodesis may be inapplicable in prosthetic infections with large defects and amputation prosthetics do not restore adequate function. A novel implant was used for non-biological arthrodesis in infections with large defects for which amputation was otherwise considered necessary.

Methods:
Patients who had the Biomet Orthopedic Salvage System (OSS) for non-biological knee arthrodesis with a minimum 2 years of follow-up or early failure and patients who received it as a temporary spacer before the second stage revision were identified and their charts were reviewed.

Results:
Eighteen patients were included. Four patients had temporary spacers then, second stage revision. One patient had amputation for recurrent infection, and 3 were infection-free at the last follow-up. In 14 patients, non-biological arthrodesis was performed. There were 11 females and 3 males with a mean age of 65 years. Bone loss at the knee was 11 to 47 (average 26) centimeters. Seven patients had recurrent infection: 5 remained on antibiotic suppression and retained functional extremities whereas 2 patients required above-the-knee amputation. A third patient required amputation for early spacer dislocation. Eleven patients (79%) retained functional extremities, and revision-free implant survival was 50% at an average 59 months (range 24 to 126 mo).

Conclusion:
Results of non-biological arthrodesis in prosthetic knee infection with large defects were encouraging. Patients should be counseled that although the procedure may offer an alternative to amputation, the goal is containment rather than cure of infection.