bluuebunny/crossref_metadata_2025_split huggingface dataset:
A bit of a cough, tired, not very resilient – is that already Long-COVID? Perceptions and experiences of GPs with Long COVID in year three of the pandemic. A qualitative study in Austria.
Authors: Wojczewski Silvia , Mayrhofer Mira , Szabo Nathalie , Hoffmann Kathryn 
Published: January 2024

Abstract

Background: COVID-19 is a new multisectoral healthcare challenge. This study contributes to research on long COVID. It aims at understanding experiences, knowledge, attitudes and (information) needs that GPs have in relation to long COVID and how these evolved since the beginning of the COVID-19 pandemic.
Methods: The study used an exploratory qualitative research design. It investigated infection protection, infrastructure, framework conditions and the treatment of patients during the COVID-19 pandemic in Austria through semistructured interviews. A total of 30 semistructured interviews with GPs in different primary care settings (single practices, group practices, primary care centres) were conducted between February and July 2022. For this study, the questions relating to long COVID were analysed. The data were analysed using the qualitative content analysis software Atlas.ti.
Results: This is the first study that empirically investigated long-COVID management by GPs in a country with a Bismarck healthcare model in place. All GPs indicated having experience with long COVID. In cities, GPs tended to have slightly better networks with specialists, and GPs, especially in more rural places, would need much more support. The GPs who already worked in teams tended to find the management of COVID-19 easier. The symptoms that the physicians described as Long-Covid symptoms correspond to those described in the international literature, but it is unclear whether postCovid syndromes such PostExertinal-Malaise, autonomic dysfunction such as postural tachycardia syndrome or Mast-Cell-Overactivation-Syndrom (MCAS), and cognitive dysfunction are also recognized and correctly classified since they were never mentioned. The treatment of the patients is basically described as an enormous challenge and frustrating if the treatment does not yield significantly improved health. With this problem, the GPs feel left alone. GPs lacked information and contact information about specific health personnel or contact points that were familiar with postinfectious syndromes. Such facilities are urgently needed.
Conclusion: COVID-19 will continue to preoccupy our health care systems for a long time to come, as new variants without prevention strategies will continue to produce new patients. Therefore, it is not a question of if but when good support for GPs and adequate care pathways for people with COVID-19 will be implemented.
The integration of social accountability in the medical curriculum: A qualitative study to the change process as perceived by educational staff and students
Authors: Oudbier Janique , Boerboom Tobias , Peerdeman Saskia , Suurmond Jeanine 
Published: January 2024

Abstract
Background. In addition to (pre)clinical skills and knowledge there is more and more attention for social accountability within the medical curriculum. The integration of social accountability into the medical curriculum requires an organizational change process, which is affected by many factors. This study aims to investigate; the reaction of educational staff and students to this change; the perceived consequences resulting from this potential change; and the change antecedents that affect the reaction to change and change outcomes.
Methods. This study used a qualitative design in which semi-structured individual interviews were conducted with 28 educational staff members and 16 students at a medical school in the Netherlands, in 2021. The framework approach was used to qualitatively analyze the interviews.
Results. Most participants were in favor of more attention for social accountability within the medical curriculum but their reaction depended on their career stage, perceived autonomy, level of focus on either solutions or problems, their degree of participation in the change process, and their perceived expertise. Participants perceived several potential consequences of the change, such as a higher workload, reduction of organizational commitment, and withdrawal from the change. Examples of important antecedents of change were resources such as finances and time, a common vision, and principal support.
Conclusions. The reaction of educational staff and students to the integration of social accountability in the medical curriculum and their perceived consequences resulting from this change can be positively stimulated by taking the involved antecedents into account during the organizational change process.
Assessing the sustainability literacy of undergraduate students in a first-year writing course
Authors: Erguvan Inan Deniz 
Published: January 2024

Abstract

The significance of sustainability is increasingly accepted in society, with a consensus that higher education institutions should play a more active role in this field. As higher education institutions and society increasingly prioritize individuals' comprehension of sustainability, the need for accurate assessments of sustainability knowledge becomes more significant. To this end, this study aims to evaluate the sustainability literacy levels of students enrolled in a first-year composition course using a mixed-method sequential explanatory design. The quantitative phase involved 221 students who completed a questionnaire assessing their knowledge, skills, attitudes, and familiarity with sustainability concepts and topics. Following this, 60 students were asked to write an essay identifying Kuwait's significant sustainability challenges and proposing solutions. The results showed that gender, high school type, grade point average (GPA) value, and previous exposure to sustainability cause significant differences in students’ knowledge, skills, and attitudes about sustainability and that the students primarily associate sustainability challenges with environmental problems; social and economic challenges are rarely mentioned in essays.
Supraspinal control of motoneurons after paralysis enabled by spinal cord stimulation
Authors: Capogrosso Marco , Balaguer Josep-Maria , Prat-Ortega Genis , Verma Nikhil , Yadav Prakarsh , Sorensen Erynn , de Freitas Roberto , Ensel Scott , Borda Luigi , Donadio Serena , Liang Lucy , Ho Jonathan , Damiani Arianna , Grigsby Erinn , Fields Daryl , Gonzalez-Martinez Jorge , Gerszten Peter , Weber Douglas , Pirondini Elvira 
Published: January 2024

Abstract
Spinal cord stimulation (SCS) restores motor control after spinal cord injury (SCI) and stroke. This evidence led to the hypothesis that SCS facilitates residual supraspinal inputs to spinal motoneurons. Instead, here we show that SCS does not facilitate residual supraspinal inputs but directly triggers motoneurons action potentials. However, supraspinal inputs can shape SCS-mediated activity, mimicking volitional control of motoneuron firing. Specifically, by combining simulations, intraspinal electrophysiology in monkeys and single motor unit recordings in humans with motor paralysis, we found that residual supraspinal inputs transform subthreshold SCS-induced excitatory postsynaptic potentials into suprathreshold events. We then demonstrated that only a restricted set of stimulation parameters enables volitional control of motoneuron firing and that lesion severity further restricts the set of effective parameters. Our results explain the facilitation of voluntary motor control during SCS while predicting the limitations of this neurotechnology in cases of severe loss of supraspinal axons.
Structural stability changes of the Atlantic Meridional Overturning Circulation
Authors: Dima Mihai , Lohmann Gerrit , Knorr Gregor , Scholz Patrick , Nichita Denis 
Published: January 2024

Abstract

The proximity of the states of climatic tipping components to bifurcation points, which could mark the emergence of rapid and irreversible transitions, is a subject of major concern in the context of anthropogenic influence on climate. Among such systems, the Atlantic Meridional Overturning Circulation has one of the largest climatic impact and it could induce a cascade of abrupt critical transitions, through its multiple connections with other components. However, there is considerable uncertainty regarding the location of the overturning circulation’s current state relative to its stability thresholds.
We identify similarities between observational and simulated spatial patterns phase spaces and bifurcation diagrams linked with overturning circulation changes. Our results suggest that the AMOC already underwent a Hopf bifurcation and entered a bistable regime before 1870, that it suffered a rate-induced tipping around 1970, possibly linked with the Great Salinity Anomaly, and that it approached the attractor of its ‘off’ state.
These changes in the overturning circulation dynamics are indicative of complex structural stability changes during the preindustrial revolution, which underline the need for a long-term temporal assessment of the overturning circulation stability on multi-centennial to millennial time-scales to set its contemporary and future evolution in a long-term context.
Oral and gut microbiome profiles in early Parkinson’s disease
Authors: Stagaman Keaton , Kmiecik Matthew , Wetzel Madeleine , Aslibekyan Stella , Sonmez Teresa Filshtein , Fontanillas Pierre , Holmes Michael , Walk Seth , Houser Madelyn , Norcliffe-Kaufmann Lucy 
Published: January 2024

Abstract

Early detection of Parkinson’s disease (PD), a neurodegenerative disease with central and peripheral nerve involvement, ensures timely treatment access. Microbes influence nervous system health and are altered in PD. We examined gut and mouth microbiomes from recently diagnosed patients in a geographically diverse, matched case-control, metagenomics study. We demonstrated greater alpha-diversity in 464 PD patients versus 249 controls. The microbial signature of PD included overabundance of 16 OTUs, including Streptococcus mutans and Bifidobacterium dentium, and depletion of 28 OTUs. Machine learning models indicated sub-species level oral microbiome abundances best distinguished PD with relatively high accuracy (area under the curve: 0.758). Microbial networks were disrupted in cases, with reduced connectivity of short-chain fatty acid-producing bacteria from stool. Microbiome diversity metrics associated with non-motor autonomic symptom severity. Our results provide evidence for predictive oral taxonomic PD microbiome signatures that may be useful for early detection, particularly with peripheral nervous system involvement.
Exogenous ethephon treatment on the biosynthesis and accumulation of astragaloside IV in Astragalus membranaceus Bge. var. mongholicus (Bge.) Hsiao
Authors: Wu Haonan , Tian Yu , Wu Jiawen , Bai Zhenqing , Zhang Xiujuan 
Published: January 2024

Abstract
Background
Astragaloside IV, a prominent secondary metabolite found in Astragalus membranaceus Bge. var. mongholicus (Bge.) Hsiao (A. membranaceus), serves as a crucial indicator of A. membranaceus quality. Ethylene, acting as an exogenous signal, plays a role in regulating secondary metabolism in plants. In this study, the application of ethephon (Eth) to hydroponically cultivated A. membranaceus was employed to investigate the biosynthesis of astragaloside IV in the roots, involving both content measurement and analysis of key gene expression.
Results
The results demonstrated that the significantly accumulation of astragaloside IV was observed on the 3rd day after 200 µmol·L− 1 Eth treatment, reaching 0.269%. Among the 10 key genes involved in astragaloside IV synthesis, HMGS, FPS, CAS, CYP88D6, and CYP93E3 were found to be insensitive to Eth. On the other hand, the expression levels of AACT, HMGR, IDI, and SS exhibited a significant increase at 12 hours under Eth treatment, followed by a notable decrease at 3rd day. Additionally, SE displayed a significant decrease at 12 hours and a subsequent increase in the 3rd day under Eth treatment. The expression level of FPS, HMGR, IDI, SS, and CYP93E3 exhibited significant negative correlations with astragaloside IV content, while expression level of SE displayed a significant positive correlation.
Conclusions
These findings suggest that exogenous Eth treatment can potentially influence the synthesis of astragaloside IV by modulating the expression of FPS, HMGR, IDI, SS, CYP93E3 and SE. This study provides a theoretical basis for utilizing molecular strategies to enhance the quality of A. membranaceus.
Construction of a nursing management program for early fluid resuscitation in patients with acute pancreatitis: A Delphi study in China
Authors: He Fang , Zhang Xiaohong , Liu Jiao , Mo Shaojian , Zhang Lei , Fu Xifeng , Tian Yanzhang , Gao Fei , Liu Yan 
Published: January 2024

Abstract

Aim and Objectives:
To construct a set of scientific and feasible nursing management protocols for early fluid resuscitation in acute pancreatitis patients who can be used to guide clinical practice and enhance the treatment efficacy in these patients.
Background
Fluid resuscitation is a key means of early treatment for AP patients and has become a clinical consensus. Nurses are important practitioners of fluid resuscitation, and there is a lack of specific enforceable nursing management programs.
Methods
Through literature research, on-site research, semi-structured interviews, and other preliminary preparations of the first draft of the nursing management program for early fluid resuscitation in acute pancreatitis, the Delphi method was used to conduct two rounds of correspondence with medical and nursing experts, and then statistically analyzed.
Results
Fifteen and 14 questionnaires were distributed in two rounds, respectively, and 15 and 14 questionnaires were recovered, respectively. The positive coefficient of experts was 100%, the authority coefficient was 0.970 and 0.975, respectively; the importance assignment was x ± s; the coefficient of variation coefficient was 0.05–0.21 and 0.00–0.20, respectively; and Kendall’s harmony coefficient was 0.05, with a test level of α = 0.05. A total of 5 primary indicators, 11 secondary indicators, and 36 tertiary indicators were used to construct the Nursing Management Program for Early Fluid Resuscitation in Acute Pancreatitis.
Conclusions
The constructed nursing management plan for early fluid resuscitation in acute pancreatitis patients puts forward clear requirements and standards for nursing care in the early stage of AP treatment. This plan is in line with the principles of science and operability, has good clinical application and promotion value, and can promote standardized management of early fluid resuscitation in patients with acute pancreatitis.
Role of Dapagliflozin in Ischemic Preconditioning in Patients With Symptomatic Coronary Artery Disease – DAPA-IP study protocol
Authors: Akamine Marco Alexander Valverde , Soares Beatriz Moreira Ayub Ferreira , Telles João Paulo Mota , de Assis Arthur Cicupira Rodrigues , Rodriguez Gabriela Nicole Valverde , Soares Paulo Rogério , Chalela William Azem , Scudeler Thiago Luis 
Published: January 2024

Abstract
Background
Ischemic preconditioning (IP) is a powerful cellular protection mechanism. The cellular pathways underlying IP are extremely complex and involve the participation of cell triggers, intracellular signaling pathways, and end-effectors. Experimental studies have shown that sodium-glucose transport protein 2 (SGLT2) inhibitors promote activation of 5′-adenosine monophosphate (AMP)-activated protein kinase (AMPK), the main regulator of adenosine 5′-triphosphate homeostasis and energy metabolism in the body. Despite its cardioprotective profile demonstrated by numerous clinical trials, the results of studies on the action of SGLT2 inhibitors in IP are scarce. This study will investigate whether the effects of dapagliflozin on IP in patients with coronary artery disease (CAD).
Methods
The study will include 50 patients with multivessel CAD, documented ischemia by stress testing, and preserved left ventricular ejection fraction (LVEF). Patients will undergo 4 exercise tests, the first two, with a time interval of 30 minutes between them, after the washout period of cardiovascular or hypoglycemic medications and, the last two, after 7 days of dapagliflozin 10 mg once a day, also with a time interval of 30 minutes between them. Patients with stable multivessel CAD, preserved left ventricular ejection fraction (LVEF), and documented ischemia will be included.
Discussion
The role of SGLT2 inhibitors on IP is not clearly established. Several clinical trials have shown that SGLT2 inhibitors reduce cardiovascular events, notably heart failure. However, such studies have not shown beneficial metabolic effects of SGLT2 inhibitors, such as reducing myocardial infarction or stroke. On the other hand, experimental studies with animal models have shown beneficial effects of SGLT2 inhibitors on IP, a mechanism that confers cardiac and vascular protection from subsequent ischaemia-reperfusion (IR) injury. This is the first clinical study to evaluate the effects of SGLT2 inhibitors on IP, which could result in an important advance in the treatment of patients with stable CAD.
Disseminate Reduce Flexible Fuzzy linear regression model to the analysis of an IoT-based Intelligent Transportation System
Authors: khan Mufala , Kumar Rakesh , Dhiman Gaurav , Rakhra Manik 
Published: January 2024

Abstract
FLM with TFN coefficients that are symmetrically arranged have traditionally been used to develop fuzzy regression analysis. In this study, The FLM is generalized to the case when the dispersion of a fuzzy non-symmetric number is minimized. Here, we employ non-symmetric trapezoidal and TFN coefficients in our fuzzy linear models. Fuzzy number coefficients can be used to discover the closest approximations of non-symmetric fuzzy numbers, we suggest a fuzzy regression method leveraging existing techniques. On the basis of the suggested strategy and existing FLR-model, we finally resolve the numerical examples and also give an application of FLRM. A "smart city" is one that makes use of both traditional city services and digital ones. The system's ability to deliver services depends on the compatibility of its information technology and physical infrastructures. Some have dubbed this breakthrough "the future of innovation" since it targets all six pillars of sustainability: economic growth, social equity, effective governance, mobility options, environmental protection, and improved quality of life. Consideration should be given to mobility, one of the six pillars of smart cities. Interstate travel is impacted by interprovincial trade in road freight. Therefore, accurate provincial estimates of road freight transportation are crucial for enhancing rural traffic operations generally. Researchers build and test models with information from all 30 of Iran's regions in 2008. In modelling, POP is the primary independent variable. FLRM and POP are used to calibrate FLRA, and the resulting error values are used as a measure of the model's ability to match the data.
Assessment of carboxymethyl chitosan loaded-amygdalin nanoparticles as biocompatible drug delivery vehicle for anti-tumor efficacy
Authors: Elhoussiny Asmaa , Soliman A A F , Abd-EL-Nour K N 
Published: January 2024

Abstract
Nowadays, the development of anti-tumor drugs has been dedicated to natural products. Amygdalin is a natural herbal cyanoglycoside that has anticarcinogenic effect on many types of cancers once hydrogen cyanide (HCN)is released. It appears that if amygdalin is encapsulated in the nano-formulation, the cytotoxic effect on malignant cells can be enhanced, producing a synergistic effect while protecting normal cells and tissues.In this study, carboxymethyl chitosan nanoparticles (CMC NPs) encapsulated with amygdalin were prepared and characterized through their particle size, surface charge, chemical structure and dielectric properties.Also, the invitro drug release of amygdalin from CMC NPs was studied. Additionally, the cytotoxcity of the amygdalin and CMC-loaded amygdalin NPs were evaluated through MTT assay.The results showed that theCMC-loaded amygdalin NPs exhibited a small nano-size of 129 nm, high zeta potential value of -43 mV and confirmed the amygdalin stability and compatibility with CMC NPs. Furthermore, the CMC NPs demonstrated sustained release of amygdalin during 24 hours.Moreover, compared to free amygdalin, amygdalin-loaded CMC NPs have significant anti-cancerous effect on human colon HCT-116 and breast MCF-7 cancer cell lines while being safe on normal cells BJ1.In conclusion, CMC NPs can be employed as an efficient drug delivery vehicle for controlled and sustained release of amygdalin with enhanced cytotoxicity on malignant cells without harming normal cells.
Neurocognitive mechanisms underlying action tool knowledge tasks: the specificity of tool-tool compared to hand-tool manipulation tasks
Authors: Lesourd Mathieu , Osiurak François , martin julie , Hague Sébastien , Levitre Margolise , Clément Gautier , de Bustos Elisabeth Medeiros , Fargeix Guillaume , Magnin Eloi , Moulin Thierry 
Published: January 2024

Abstract
Our ability to use tools is heavily based on action tool knowledge, allowing us to specify the action required to use a tool. Action tool knowledge can be assessed mainly with two kinds of tasks, namely, tool-tool compatibility tasks (i.e., deciding whether two tools are grasped or manipulated in the same way) and hand-tool compatibility tasks (i.e., deciding whether a tool is correctly held in hand). While these tasks are used to assess action tool knowledge, recent data showed striking dissociations between these tasks in brain-damaged patients. In this study, we explored (1) the neural bases (Experiment 1; n = 34 healthy participants); (2) the neuropsychological dissociations (Experiment 2; n = 60 brain damaged patients); and (3) the potential cognitive mechanisms engaged during these two tasks (Experiment 3; n = 52 healthy participants). The three experiments provide convergent arguments by showing that both tasks are sharing common core computations supported by a left-lateralized brain network, but manipulation hand-tool task engaged regions outside of this brain network and is explained by visual imagery while manipulation tool-tool task is rather explained by motor imagery. Our results shed a new light on action tool knowledge tasks.
Giant clams modify crystallographic and geochemical pathways of shell formation in response to turbidity
Authors: Mills Kimberley , Sosdian Sindia , Muir Duncan , John Eleanor , Nadia Santodomingo , Johnson Kenneth , Buse Ben , Waheed Zarinah 
Published: January 2024

Abstract
Marine calcifying organisms on coral reefs are under threat from a range of anthropogenic stressors. Understanding their biomineralization pathways in different reef environments is key to unravelling their response to a rapidly changing ocean. Turbid reefs are forecast to increase throughout the 21st century and are resilient conservation hotspots, yet understudied due to a lack of information resolving biomineralization processes. Herein, for the first time, we assess the crystallographic and geochemical signatures of aragonite giant clam shells Tridacna squamosa from high and low turbid reefs in the Coral Triangle. Shell composition is strongly influenced by turbidity and biominerals formed in a high turbid reef show a more organized crystal orientation and significantly lower element-to-calcium ratios (Magnesium/Calcium, Strontium/Calcium). We hypothesize that these variations are driven by physiological changes related to the trophic flexibility of T. squamosa. Observed differences have implications for biomechanical and defence responses of shells, important in their ability to survive future change.