bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis of the Performance of Electroencephalogram Parameters for Monitoring the Depth of Sedation During Remimazolam Target-Controlled Infusion
Authors: Bae Myung Il , Bae Jayyoung , Song Young , Kim Minjae , Han Dong Woo 
Published: December 2023

BACKGROUND:
The changes in hypnotic indicators in remimazolam sedation remain unclear. We investigated the correlation of the electroencephalogram (EEG) parameters with the effect-site remimazolam concentration and the depth of sedation in patients receiving a target-controlled infusion of remimazolam.

METHODS:
This prospective observational study enrolled 35 patients (32 analyzed) who underwent lower extremity varicose vein surgery or lower extremity orthopedic surgery under spinal anesthesia. We administered remimazolam by target-controlled infusion using the pharmacokinetic model introduced by Schüttler et al. The EEG data were continuously recorded, including the bispectral index (BIS), patient state index (PSI), spectral edge frequency (SEF), and raw EEG signals. The relative beta ratio (RBR), defined as log (spectral power [30–47 Hz]/spectral power [11–20 Hz]), was obtained by analyzing raw EEG. The level of sedation corresponding to each effect-site remimazolam concentration was assessed using the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S). The prediction probability (Pk) and Spearman’s correlation coefficients (R) were calculated between effect-site remimazolam concentration, MOAA/S, and EEG parameters.

RESULTS:
BIS and PSI showed significantly higher Pk for effect-site remimazolam concentration (Pk = 0.76 [0.72–0.79], P < .001 for BIS; Pk = 0.76 [0.73–0.79], P < .001 for PSI) compared to RBR (Pk = 0.71 [0.68–0.74], P < .001) and SEF (Pk = 0.58 [0.53–0.63], P = .002). BIS, PSI, and RBR showed significantly higher correlation coefficients for effect-site remimazolam concentration (R = −0.70 [−0.78 to −0.63], P < .001 for BIS; R = −0.72 [−0.79 to −0.66], P < .001 for PSI; R = −0.61 [−0.69 to −0.54], P < .001 for RBR) compared to SEF (R = −0.22 [−0.36 to −0.08], P = .002). BIS and PSI also had significantly higher Pk and correlation coefficients for MOAA/S (Pk = 0.81 [0.79–0.83], P < .001; R = 0.84 [0.81–0.88], P < .001 for BIS) (Pk = 0.80 [0.78–0.83], P < .001; R = 0.82 [0.78–0.87], P < .001 for PSI) compared to RBR (Pk = 0.74 [0.72–0.77], P < .001; R = 0.72 [0.65–0.78], P < .001) and SEF (Pk = 0.55 [0.50–0.59], P = .041; R = 0.13 [−0.01 to 0.27], P = .067).

CONCLUSIONS:
BIS, PSI, and RBR showed an acceptable correlation with the effect-site remimazolam concentration and depth of sedation in this study, suggesting that these EEG-derived parameters are potentially reliable hypnotic indicators during remimazolam sedation. BIS and PSI showed superior performance as hypnotic indicators to RBR and SEF in patients receiving target-controlled infusion of remimazolam.
Physiological stress improves stem cell modeling of dystrophic cardiomyopathy
Authors: Fullenkamp Dominic E. , Willis Alexander B. , Curtin Jodi L. , Amaral Ansel P. , Dittloff Kyle T. , Harris Sloane I. , Chychula Ivana A. , Holgren Cory W. , Burridge Paul W. , Russell Brenda , Demonbreun Alexis R. , McNally Elizabeth M. 
Published: December 2023

ABSTRACT
Heart failure contributes to Duchenne muscular dystrophy (DMD), which arises from mutations that ablate dystrophin, rendering the plasma membrane prone to disruption. Cardiomyocyte membrane breakdown in patients with DMD yields a serum injury profile similar to other types of myocardial injury with the release of creatine kinase and troponin isoforms. Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are highly useful but can be improved. We generated hiPSC-CMs from a patient with DMD and subjected these cells to equibiaxial mechanical strain to mimic in vivo stress. Compared to healthy cells, DMD hiPSC-CMs demonstrated greater susceptibility to equibiaxial strain after 2 h at 10% strain. We generated an aptamer-based profile of proteins released from hiPSC-CMs both at rest and subjected to strain and identified a strong correlation in the mechanical stress-induced proteome from hiPSC-CMs and serum from patients with DMD. We exposed hiPSC-CMs to recombinant annexin A6, a protein resealing agent, and found reduced biomarker release in DMD and control hiPSC-CMs subjected to strain. Thus, the application of mechanical strain to hiPSC-CMs produces a model that reflects an in vivo injury profile, providing a platform to assess pharmacologic intervention.
Making History in 1-Hour: How Sex, Aging, Technology, and Elevation Effect the Cycling Hour Record
Authors: Harnish Christopher R. , Swinand Gregory P. , Fisher Anna E. 
Published: December 2023

ABSTRACT

Purpose
The purposes of this paper were to analyze more than a century of cycling hour records (CHR) to examine the effects of sex, age, and altitude on cycling performance. Our hypotheses were that men’s performance (distance) would exceed those of women by more than 10% but would decline at similar rates with aging and that altitude would have a small benefit which might reach a maximum.

Methods
Data were cultivated from the Facebook World Hour Record Discussion Group’s crowd-sourced database of more than 600 known hour records and verified through extensive online research and/or personal communication. Regression and statistical modelling were produced using STATA v15.0. R2 values were used to ascertain model quality with four distinct models being produced for comparisons. Alpha was set at 0.05 significance for all tests.

Results
R2 values ranged from 65% - 74.9%. Women’s distances were 10.8% shorter (p < 0.001) than those of men, but the difference was narrower than either the historical elite women’s difference of 14.2% or the current record difference of 13.3%. Age-related decline modeling indicates performance declines significantly past age 40 at a rate of 1.08% per year. Altitude had a significant (p < 0.001) marginal improvement up to 1000 m before declining. The marginal benefits of altitude were small, but this is consistent with the finding benefits reach a maximum at a moderate altitude with ‘benefits’ becoming ambiguous starting at ~1000 m. Technological advancement was estimated to be a small but significant (p < 0.001) improvement of ~0.18% per year.

Conclusions
Across decades of CHR data in well-trained endurance cyclists, men are only ~11% faster, and this difference remains stable until at least age 80. CHR attempts above 500 m likely offer at best a small advantage. Despite small year-on-year improvements, the CHR has likely improved more than 10-km due to technological advancements.
Acutely Normalizing Walking Speed Does Not Normalize Gait Biomechanics Post-Anterior Cruciate Ligament Reconstruction
Authors: Buck Ashley N. , Lisee Caroline , Bjornsen Elizabeth , Büttner Christin , Birchmeier Thomas , Nilius Alexandra , Favoreto Natalia , Spang Jeffrey , Blackburn Troy , Pietrosimone Brian 
Published: December 2023

ABSTRACTAberrant gait biomechanics in individuals with anterior cruciate ligament reconstruction (ACLR) are linked to posttraumatic osteoarthritis (PTOA) development, indicating a need to normalize gait biomechanics to prevent PTOA. ACLR individuals walk slower than uninjured controls and slower speeds are associated with aberrant gait biomechanics. Yet, it is unclear if increasing walking speed normalizes gait biomechanics post-ACLR.PurposeTo determine the effect of acutely increasing walking speed on gait biomechanics in ACLR individuals compared to their habitual speed and uninjured matched-controls.MethodsGait biomechanics were collected on 30 ACLR individuals (20 females, age: 22.0 ± 4.2 years, BMI: 24.0 ± 3.0 kg·m-2) at their habitual speed and at 1.3 m·s-1, a speed similar to controls, and 30 uninjured matched-controls (age: 21.9 ± 3.8, BMI: 23.6 ± 2.5) at their habitual speed. Functional waveform analyses compared biomechanics between:i) walking at habitual speed vs 1.3 m·s-1in ACLR individuals; andii) ACLR individuals at 1.3 m·s-1vs controls.ResultsIn the ACLR group, there were no statistically significant biomechanical differences between walking at habitual speed (1.18 ± 0.12 m·s-1) and 1.3 m·s-1(1.29 ± 0.05 m·s-1). Compared with controls (habitual speed: 1.34 ± 0.12 m·s-1), the ACLR group while walking at 1.3 m·s-1exhibited smaller vertical ground reaction force (vGRF) during early and late stance (13-28, 78-90% stance phase), greater midstance vGRF (47-61%), smaller early-to-midstance knee flexion angle (KFA; 1-44%), greater mid-to-late stance KFA (68-73, 96-101%), greater internal knee abduction moment (69-101%), and smaller internal knee extension moment (4-51, 88-96%).ConclusionsIncreasing walking speed to a speed similar to uninjured controls did not elicit significant changes to gait biomechanics, and ACLR individuals continued to demonstrate biomechanical profiles that are associated with PTOA development and differ from controls.
Biological Sex Does Not Influence Core Temperature Change and Sweating of Children Exercising in a Warm Environment
Authors: Topham Thomas H. , Smallcombe James W. , Brown Harry A. , Clark Brad , Woodward Andrew P. , Telford Richard D. , Jay Ollie , Périard Julien D. 
Published: December 2023

ABSTRACT

Purpose
To investigate the associations of biological sex and aerobic fitness (i.e., V̇O2peak) on the change in gastro-intestinal temperature (∆Tgi) and whole-body sweat rate (WBSR) of children exercising in warm conditions.

Methods
Thirty-eight children (17 boys (mean [SD]; 13.7 [1.2] years); 21 girls (13.6 [1.8] years)) walked for 45 min at a fixed rate of metabolic heat production (8 W·kg-1) in 30 °C and 40% relative humidity. Biological sex and relative V̇O2peak were entered as predictors into a Bayesian hierarchical general additive model (HGAM) for Tgi. For a subsample of 13 girls with measured body composition, body fat percent was entered into a separate HGAM for Tgi. Sex, V̇O2peak and the evaporative requirement for heat balance (Ereq) were entered into a Bayesian hierarchical linear regression for WBSR.

Results
Mean ∆Tgi for boys was 0.71 °C [90% credible intervals: 0.60, 0.82] and for girls 0.78 °C [0.68, 0.88]. A predicted 20 mL·kg-1·min-1 higher V̇O2peak resulted in a 0.19 °C [-0.03, 0.43] and 0.24 °C [0.07, 0.40] lower ∆Tgi in boys and girls respectively. A predicted ~13% lower body fat in the subsample of girls resulted in a 0.15 °C [-0.12, 0.45] lower ∆Tgi. When Ereq was standardized to the grand mean, the difference in WBSR between boys and girls was -0.00 L·h-1 [-0.06, 0.06] and a 20 mL·kg-1·min-1 higher predicted V̇O2peak resulted in a mean difference in WBSR of -0.07 L·h-1 [-0.15, 0.00].

Conclusions
Biological sex did not independently influence ∆Tgi and WBSR in children. However, a higher predicted V̇O2peak resulted in a lower ∆Tgi of children, which was not associated with a greater WBSR, but may be related to differences in body fat percent between high and low fitness individuals.
Giant cell tumor of soft tissue: GCT arising from periosteum of tibia
Authors: Ahmed Syed Kamran , Shehzad Muhammad Nirman 
Published: December 2023

Primary Giant Cell Tumor of Soft Tissue (GCT-ST) is a rare disease, a neoplasm with low potential for malignancy. It belongs to the group of Fibrohistiocytic tumors with borderline malignancy. Most commonly it presents as a painless, slow-growing mass in a superficial location. It is associated with lower local recurrence rate as compared to GCT of bone but has a higher rate for metastasis and mortality. A case of rare GCT-ST with suspicion of lung metastasis is being reported here. The lesion per-operatively appeared to be growing from the periosteum of the bone (tibia in our case). After excisional biopsy it proved to be GCT-ST which has never been reported previously in literature.
doi: https://doi.org/10.12669/pjms.40.2(ICON).8959
How to cite this: Ahmed SK, Shehzad MN. Giant cell tumor of soft tissue: GCT arising from periosteum of tibia. Pak J Med Sci. 2024;40(2):S97-S99. doi: https://doi.org/10.12669/pjms.40.2(ICON).8959
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Proibicionismo-racismo na política brasileira sobre drogas a partir do encarceramento
Authors: Sobral de Lima Leandro , Pinheiro Montenegro Dan 
Published: December 2023

Neste trabalho problematizamos os determinantes que configuram a atual política brasileira sobre drogas enquanto um dispositivo estratégico de reprodução do racismo institucional e estrutural, sistema este que dá forma e particulariza a questão racial no país, tendo como uma de suas principais expressões o encarceramento e o genocídio em massa de pessoas negras. Para tanto, analisamos o funcionamento binômico do proibicionismo-racismo no âmbito da “questão das drogas” a partir de aspectos históricos e de dados atuais sobre o encarceramento no Brasil.

Neste trabalho problematizamos os determinantes que configuram a atual política brasileira sobre drogas enquanto um dispositivo estratégico de reprodução do racismo institucional e estrutural, sistema este que dá forma e particulariza a questão racial no país, tendo como uma de suas principais expressões o encarceramento e o genocídio em massa de pessoas negras. Para tanto, analisamos o funcionamento binômico do proibicionismo-racismo no âmbito da “questão das drogas” a partir de aspectos históricos e de dados atuais sobre o encarceramento no Brasil.
Palavras-Chave: drogas; proibicionismo; racismo.
Comunidades Terapêuticas: incongruências na implementação de uma política de Estado
Authors: Nascimento Fernandes Marianna , De Oliveira Andréia 
Published: December 2023

O objeto deste artigo são as Comunidades Terapêuticas no processo de contrarreforma e privatização da Política Nacional de Saúde Mental, Álcool e outras Drogas no Sistema Único de Saúde (SUS), bem como sua funcionalidade na manutenção da ofensiva capitalista contra a universalização do direito à saúde como um dever do Estado. O objetivo é refletir sobre o amparo legal e as motivações subjacentes que impulsionam o fomento do Estado a tais instituições, que, além de não possuírem respaldo técnico-científico, têm seu modo de intervenção pautado na disciplina-trabalho-espiritualidade. Deriva de uma pesquisa de natureza qualitativa do tipo descritiva e exploratória, realizada por meio de análise documental. Os resultados apontam que no cenário de acirramento das medidas neoconservadoras e de contrarreformas o Estado brasileiro priorizou a implementação e fortalecimento de uma política pública na contramão de uma racionalidade sanitária, dos princípios do SUS e da Reforma Psiquiátrica (RP).

Palavras-Chave: Comunidades Terapêuticas; Política de Álcool e outras Drogas; contrarreforma psiquiátrica; Estado.
Políticas de Saúde Mental na Argentina: 40 anos de reformas na província de Santa Fé
Authors: Alberdi Jose María , Mutazzi Eduardo Cesar 
Published: December 2023

Este artigo tem como objetivo refletir criticamente sobre os processos de desmanicomalização e desinstitucionalização da saúde mental após o retorno da democracia, enfocando a singularidade do processo na província de Santa Fé (Argentina). De forma esquemática, analisa quatro décadas deste processo, destacando os progressos e os obstáculos enfrentados por todos os intervenientes no domínio da saúde mental. O texto está composto por três partes, uma primeira que resume as três primeiras décadas de reformas em saúde mental, uma segunda que enfoca a trajetória na província de Santa Fé e fecha o texto com conclusões que nos permitem pensar sobre os desafios de uma política de saúde mental que está por vir.

Palavras-Chave: Saúde Mental; Políticas Públicas; Desinstitucionalização.
Impact of active case-finding for tuberculosis on case-notifications in Blantyre, Malawi: A community-based cluster-randomised trial (SCALE)
Authors: Feasey Helena R. A. , Khundi McEwen , Soko Rebecca Nzawa , Bottomley Christian , Chiume Lingstone , Burchett Helen E. D. , Nliwasa Marriott , Twabi Hussein H. , Mpunga James A. , MacPherson Peter , Corbett Elizabeth L. 
Published: December 2023

Active case-finding (ACF) for tuberculosis can help find the “missing millions” with undiagnosed tuberculosis. In a cluster-randomised trial, we investigated impact of ACF on case-notifications in Blantyre, Malawi, where ACF has been intensively implemented following 2014 estimates of ~1,000 per 100,000 adults with undiagnosed TB. Following a pre-intervention prevalence survey (May 2019 to March 2020), constrained randomisation allocated neighbourhoods to either door-to-door ACF (sputum microscopy for reported cough >2 weeks) or standard-of-care (SOC). Implementation was interrupted by COVID-19. Cluster-level bacteriologically-confirmed case-notification rate (CNR) ratio within 91 days of ACF was our redefined primary outcome; comparison between arms used Poisson regression with random effects. Secondary outcomes were 91-day CNR ratios comparing all tuberculosis registrations and all non-ACF registrations. Interrupted time series (ITS) analysis of CNRs in the SOC arm examined prevalence survey impact. (ISRCTN11400592). 72 clusters served by 10 study-supported tuberculosis registration centres were randomised to ACF (261,244 adults, 58,944 person-years follow-up) or SOC (256,713 adults, 52,805 person-years). Of 1,192 ACF participants, 13 (1.09%) were smear-positive. Within 91 days, 113 (42 bacteriologically-confirmed) and 108 (33 bacteriologically-confirmed) tuberculosis patients were identified as ACF or SOC cluster residents, respectively. There was no difference by arm, with adjusted 91-day CNR ratios 1.12 (95% CI: 0.61–2.07) for bacteriologically-confirmed tuberculosis; 0.93 (95% CI: 0.68–1.28) for all tuberculosis registrations; and 0.86 (95%CI: 0.63–1.16) for non-ACF (routinely) diagnosed. Of 7,905 ACF and 7,992 SOC pre-intervention survey participants, 12 (0.15%) and 17 (0.21%), respectively, had culture/Xpert-confirmed tuberculosis. ITS analysis showed no survey impact on SOC CNRs. Despite residual undiagnosed tuberculosis of 150 per 100,000 population, there was no increase in tuberculosis notifications from this previously successful approach targeting symptomatic disease, likely due to previous TB ACF and rapid declines in TB burden. In such settings, future ACF should focus on targeted outreach and demand creation, alongside optimised facility-based screening.
Trial Registration: ISRCTN11400592.
Sedentary lifestyle of university students is detrimental to the thoracic spine in men and to the lumbar spine in women
Authors: Cepková Alena , Zemková Erika , Šooš Ľubomír , Uvaček Marián , Muyor José M. 
Published: December 2023

Background
Sitting for long periods of time and lack of physical activity in young adults can cause postural deterioration leading to rapid onset of fatigue and increase the risk of back pain. We were interested in whether there are gender differences in spinal curvature among university students with a predominantly sedentary lifestyle.

Methods
20 sedentary female (age 20 ± 0.73 years) and 39 sedentary male university students (age 20 ± 1.08 years) participated in this study. Their thoracic and lumbar curvatures were assessed while standing and sitting using a Spinal Mouse.

Results
In standing, 80.0% of the females and 69.2% of the males had a neutral position of the thoracic spine (33.25° and 35.33°, respectively). However, more males, 30.8%, than females, 10.0%, had hyperkyphosis (54.27° and 47.0°, respectively). Hypokyphosis was found in 10.0% of the females (18.50°) and none in the males. Similarly, 90.0% of the females and 97.4% of the males had neutral position of the lumbar spine (-33.11° and -29.76°, respectively). Increased hyperlordosis was found in 10.0% of the females and 2.6% of the males (-41.0° and -50.0°, respectively). Hypolordosis was not detected in either females or males. In sitting, on the other hand, 70.0% of the females and only 33.3% of the males had a neutral position of the thoracic spine (30.20° and 30.62°, respectively). Increased hyperkyphosis was found in 46.2% of the males (59.76°) and none of the females. 30.0% of the females and 23.1% of the males had light hypokyphosis (47.50° and 46.67°, respectively). Similarly, 70.0% of the females and only 38.5% of the males had a neutral position of the lumbar spine (7.0° and 6.6°, respectively). 35.9% of the males and only 5.0% of the females had a light hypokyphosis (16.14° and 16.0°, respectively). Slightly increased hyperkyphosis was identified in 25.6% of the males and 25.0% of the females (23.9° and 22.5°, respectively).

Conclusion
There are significant gender differences in spinal curvature. While in the thoracic spine it was to the detriment of the males when both standing and sitting, in the lumbar spine it is related to the females only when standing. It is therefore necessary to eliminate these spinal deviations in young adults induced by prolonged sitting during university courses by appropriate recovery modalities.
Drivers of HIV treatment interruption: Early findings from community-led monitoring program in Haiti
Authors: Policar Soeurette , Sharp Alana , Isidor Hyppolite Joanne , Alfred Gérald Marie , Steide Eva , Lucien Leïnadine , Ledan Naiké , Kavanagh Matthew 
Published: December 2023

Background
Failure to retain people living with HIV (PLHIV) in care remains a significant barrier to achieving epidemic control in Haiti, with as many as 30% lost from care within one year of starting treatment. Community-led monitoring (CLM) is an emerging approach of improving healthcare and accountability to service users, through a cycle of monitoring and advocacy. In 2020, a CLM program was launched in Haiti to identify barriers to retention and advocating for better health services.

Methods
Data from the community-led monitoring program in Haiti were analyzed, from a sample of 65 healthcare facilities in the Nord, Artibonite, and Ouest departments collected from April 2021 to February 2022. Qualitative data from six community-based focus groups and 45 semi-structured individual interviews were analyzed.

Results
Confidentiality and stigmatization emerged as barriers to care, particularly due to the separation of PLHIV from other patients in view of community members. To avoid identification, patients described traveling long distances, with the reimbursement of transportation costs described as being insufficient or unavailable. Costs of non-HIV clinical services were a frequent concern and respondents described a need for clinics to provide food during all patient visits. Stock-outs were a regular challenge; by contrast, treatment literacy did not emerge as a major barrier to retention.

Conclusions
These findings represent the first instance, to our knowledge, of original data from a community-led monitoring program being published in any country. These findings suggest that improving treatment retention for PLHIV is dependent on improving the acceptability and affordability of healthcare services. Ensuring confidentiality is critical, particularly where stigma is high. Retention could be improved by systematically strengthening patient confidentiality protections throughout the healthcare system, providing patients with sufficient travel compensation and other incentives, and delivering wraparound services provided for free. Addressing these challenges will require ongoing advocacy for community-developed recommendations and solutions.