bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid sparing anesthesia in patients with liver cirrhosis undergoing liver resection: a controlled randomized double-blind study
Authors: Ibrahim Eman Sayed , Metwally Ahmed A. , Abdullatif Mohamed , Eid Essam A. , Mousa Mahmoud G. , Sultan Amany A. 
Published: February 2025

Abstract

Objective
Opioid metabolism and pharmacodynamics may be affected in hepatic patients. Ketamine and dexmedetomidine are conventional anesthetics used in our daily practice. The opioid-sparing effects of this combination have not been evaluated in patients with liver cirrhosis undergoing liver resection. We aimed to investigate the potential peri-operative opioid-sparing effects of intra-operative dexmedetomidine and ketamine infusions in patients with Child A liver cirrhosis undergoing liver resection.

Methods
This study was a randomized controlled double-blind trial. 92 adult patients of both sex with Child class (A) liver cirrhosis aged 18 to 65 years entering and completing the study. We excluded patients with renal or cardiac dysfunction or contraindications from study medications.46 patients in the opioid-sparing group (OS) receiving ketamine and dexmedetomidine infusions and 46 patients in the opioid-based (OB) group as controls. The main outcome measures: were intra-operative fentanyl requirements, postoperative fentanyl requirements, visual analogue pain scores, postoperative nausea, vomiting, ileus, desaturation, intra-operative hemodynamic events, and ICU stay were recorded.

Results
The total intra-operative fentanyl consumption was significantly lower in the OS group compared with the OB group, 183.2 ± 35.61 µg and 313.5 ± 75.06 µg, respectively, P < 0.001. The postoperative 1st 48 h fentanyl consumption was significantly lower in the OS group compared with the OB group, 354.5 ± 112.62 µg and 779.1 ± 294.97 ± µg, respectively, P < 0.001. Visual analogue scores were significantly better in the OS group at the early 2-hour assessment point postoperatively. The postoperative adverse events were significantly more frequent in the opioid-based group. ICU stay was significantly shorter in the OS group.

Conclusions
Administering dexmedetomidine and ketamine infusions intra-operatively to patients with Child A liver cirrhosis undergoing liver resection resulted in notable opioid-sparing effects, with reductions of approximately 40% intra-operatively and 55% postoperatively. The opioid-sparing group exhibited improved postoperative outcomes, including reduced pain, decreased incidence of opioid-related side effects and shorter ICU stays.
Adaptations to the welsh national exercise referral scheme during the COVID-19 pandemic: a qualitative study exploring the experiences of service users and providers and supplementary out-of-pocket cost analysis
Authors: Newby Katie , Howlett Neil , Wagner Adam P. , Lloyd Nigel , Freethy Imogen , Bontoft Charis , Fakoya Olujoke , Jackson Shelley , Jackson Carla , Wills Wendy , McKibben Mary-Ann , Petherick Annie , Brown Katherine E. 
Published: February 2025

Abstract

Background
Despite the proliferation of exercise referral schemes in the UK, evidence on their efficacy is equivocal. The Welsh National Exercise Referral Scheme (NERS) is heavily used but inequalities in uptake have been reported. As a result of the COVID-19 pandemic, NERS was initially suspended and then transitioned from standard face-to-face delivery to alternative remote methods, including virtual delivery. The aim of this study was to explore the barriers and facilitators to uptake and engagement of NERS when delivered in face-to-face and virtual formats, and to examine the cost to service users of engaging with the scheme in these different ways.

Methods
This was a qualitative study with supplementary cost analysis. Maximum variation sampling was used to recruit participants. Interviews with service users (n = 21) and one person who declined the service, and three focus groups with service providers (n = 19), were conducted. Framework analysis was used to analyse the qualitative data. Quantitative data obtained through the interviews on service users’ out-of-pocket costs of attending face-to-face or virtual classes were summarised using descriptive statistics.

Results
Five themes were identified from the qualitative analysis which summarised barriers and facilitators to uptake and engagement as perceived and experienced by the different stakeholders. Themes included: opaqueness and uncertainty around referral; Exercise Referral Professionals allaying concerns and providing reassurance at scheme entry; the mixed appeal and accessibility of virtual delivery; factors that support ongoing engagement; and personal and financial circumstances restricting uptake and engagement.

Conclusions
This study indicates that offering a virtual version of NERS could make the scheme more accessible to those who are typically underserved, provided strategies to address digital inclusion are addressed. Findings provide wider evidence to inform adaptations that could be made to ensure that other exercise referral schemes can optimise virtual delivery.
Confronting needlestick and sharp injuries in healthcare: a decade of struggle and progress in a university teaching hospital
Authors: Wong Shuk-Ching , Yuen Lithia Lai-Ha , Lam Germaine Kit-Ming , Kwok Monica Oi-Tung , Siu Crystal Yuen-Ki , Li Bella Hong-Yan , Chen Jonathan Hon-Kwan , So Simon Yung-Chun , Chiu Kelvin Hei-Yeung , Cheng Vincent Chi-Chung 
Published: February 2025

Abstract

Background
Needlestick and sharp injuries (NSIs) among healthcare workers (HCWs) are a significant concern in infection prevention. This study analyzes the incidence and characteristics of NSIs at Queen Mary Hospital and assesses the effectiveness of targeted training programs for interns.

Methods
A retrospective analysis was conducted on NSI reports from 2014 to 2023, focusing on episodes involving medical, nursing, allied health, and other staff. Personal coaching training programs for newly recruited interns were implemented in 2019 to enhance safety practices. NSI episodes were analyzed in relation to patient days and full-time equivalents (FTE).

Results
During the study period, there was a mean of 464,118 patient days per year, with an average of 5,928 HCWs per year. A total of 1,076 NSI episodes were reported, resulting in a mean of 2.31 episodes per 10,000 patient days and 1.82 episodes per 100 FTE. Medical staff accounted for 502 episodes (47%), while nursing staff had 339 episodes (32%). The mean NSI episodes among medical staff were significantly higher than nursing staff per year, measured per 10,000 patient days (1.08 ± 0.21 vs. 0.73 ± 0.16, p = 0.001) and per 100 FTE (8.46 ± 1.95 vs. 1.62 ± 0.40, p < 0.001). Of the 1,076 episodes, 430 (40%) occurred in HCWs with less than 1 year of experience, with 278 (65%) attributed to interns, contributing to 26% of the overall NSI burden. Most incidents among interns occurred in wards (95%, 264/278), with 95% (252/264) involving hollow needles. Notably, 54% (149/278) involved safety-equipped devices, yet 94% (140/149) of these were not activated properly. Following targeted training, NSI rates among interns significantly decreased from 0.82 to 0.46 per 10,000 patient days (R2 = 0.977, p = 0.001) and from 6.84 to 3.40 per 100 FTE (R2 = 0.874, p = 0.020) from 2019 to 2023.

Conclusions
The study highlights the ongoing issue of NSIs among HCWs, especially inexperienced interns. While training programs have shown promise in reducing NSI rates, the high incidence of safety devices not being effectively utilized underscores the need for continuous education and hands-on training to enhance safety practices and prevent NSIs in healthcare settings.
A comparative analysis of sequence composition in different lots of a phage display peptide library during amplification
Authors: Sinkjaer Anders Wilgaard , Sloth Ane Beth , Andersen Amanda Oester , Jensen Malte , Bakhshinejad Babak , Kjaer Andreas 
Published: February 2025

Abstract

Background
To develop efficient selection strategies and improve the discovery of promising ligands, it is highly desirable to analyze the sequence composition of naïve phage display libraries and monitor the evolution of their peptide content during successive rounds of amplification. In the current study, we performed a comparative analysis of the compositional features in different lots of the same naïve phage display library and monitored alterations in their peptide compositions during three rounds of amplification.

Methods
We conducted three rounds of duplicate serial amplification of two different lots of the Ph.D.™-12 phage display library. DNA from the samples was subjected to Next-Generation Sequencing (NGS) using an Illumina platform. The NGS datasets underwent a variety of bioinformatic analyses using Python and MATLAB scripts.

Results
We observed substantial heterogeneity in the sequence composition of the two lots indicated by differences in the enhanced percentage of wildtype clones, reduced diversity (number of unique sequences), and increased enrichment factors (EFs) during amplification as well as by observing no common sequence between lots and decreased number of common sequences between the naïve library and the consecutive rounds of amplification for each lot. We also found potential propagation-related target-unrelated peptides (TUPs) with the highest EFs in the two lots, which were displayed by the fastest-propagating phage clones. Furthermore, motif analysis of the most enriched subpopulation of amplified libraries led to the identification of some motifs hypothesized to contribute to the increased amplification rates of the respective phage clones.

Conclusion
Our results highlight tremendous heterogeneity in the peptide composition of different lots of the same type of naïve phage display library, and the divergent evolution of their compositional features during amplification rounds at the amino acid, peptide, and motif levels. Our findings can be instrumental for phage display researchers by bringing fundamental insights into the vast extent of non-uniformity between phage display libraries and by providing a clear picture of how these discrepancies can lead to different evolutionary fates for the peptide composition of phage pools, which can have profound impacts on the outcome of phage display selections through biopanning.
High, but variable prevalence of Sarcocystis cruzi infections in farm-raised American bison (Bison bison) beef destined for human consumption
Authors: de Araujo Larissa S. , Gupta Aditya , Papadopoulos Marianne Dias , Naguib Doaa , Battle Jacquin , Kwok Oliver , Khan Asis , Rosenthal Benjamin , Dubey Jitender P. 
Published: February 2025

Abstract

Background
Bison (Bison bison) and cattle (Bos taurus) are closely related (can interbreed) and they also share many parasites. Cattle are commonly infected with one or more of the eight named Sarcocystis species: Sarcocystis hirsuta, S. cruzi, S. hominis, S. bovifelis, S. heydorni, S. bovini, S. sigmoideus and S. rommeli. Among these, the full life-cycle is known only for S. cruzi. Sarcocystis cruzi (transmitted via canids) is recognized as the most pathogenic Sarcocystis species, causing abortion, low milk yield and poor body growth. It has been experimentally cross-transmitted from cattle to bison and vice versa.

Methods
We tested 200 bison tongues from three commercial sources (farms) (Nebraska #141; South Dakota #36; New Jersey and Pennsylvania #23). Frozen tongues were purchased and examined for Sarcocystis infection using light microscopy, histology and quantitative PCR (qPCR) targeting 18S ribosomal DNA (18S rRNA) of S. cruzi. Lesions associated with degenerating sarcocysts were studied. The intensity of Sarcocystis infection in histological sections was quantitated.

Results

Sarcocystis cruzi-like infections were detected in 129 of 141 (91.5%) tongues from Nebraska, 36 of 36 (100%) tongues from South Dakota and two of 23 (8.6%) tongues from New Jersey and Pennsylvania. Sarcocysts were detected in histological sections stained with hematoxylin and eosin in 167 of 200 samples. Light microscopy examination revealed that the sarcocysts had thin walls (< 1 µm thick) and appeared to be S. cruzi. However, in two samples, sarcocysts had thicker walls measuring up to 2.3 µm wide and 154 µm long and the sarcocyst wall was not striated; these two samples could not be characterized further. In three tongues, degenerating sarcocysts were recognized; two of these were associated with thick-walled sarcocysts. Molecularly, S. cruzi from bison was identical to that in cattle.

Conclusions
In the present study of bison tongues, S. cruzi was the only species identified in bison using both molecular and morphological methods. An unidentified species of Sarcocystis found in two bison samples needs further study.

Graphical abstract
β-Hydroxybutyrate-induced mitochondrial DNA (mtDNA) release mediated innate inflammatory response in bovine mammary epithelial cells by inhibiting autophagy
Authors: Huo Yihui , Shen Taiyu , Feng Tianyin , Li Moli , Zhao Wanli , Loor Juan J. , Aernouts Ben , Psifidi Androniki , Xu Chuang 
Published: February 2025

Abstract

Background
In perinatal dairy cows, ketosis is a prevalent metabolic disorder that lowers milk output and performance. Mitochondrial dysfunction and chronic inflammation in mammary tissue are linked to elevated blood ketone levels, particularly β-hydroxybutyrate (BHB). Recent research has linked cytosolic mitochondrial DNA (mtDNA) with chronic aseptic inflammation by activating the cGAS-STING pathway during metabolic disorders, while autophagy activation effectively reverses this process. However, whether it is involved in mammary gland damage during ketosis is poorly understood. Therefore, this study aimed to explore the underlying mechanisms of mtDNA-induced inflammation under BHB stress and evaluate the potential therapeutic strategy of autophagy activation in mitigating this damage.

Results
Our study found an increased cytoplasmic mtDNA abundance in mammary gland tissues of dairy cows with ketosis and bovine mammary epithelial cell line (MAC-T) subjected to BHB stress. Further investigations revealed the activation of the cGAS-STING pathway and inflammatory response, indicated by elevated levels of cGAS and STING, along with increased phosphorylation levels of TBK1, P65, and IκB, and higher transcript levels of pro-inflammatory factors (IL-1B, IL-6, and TNF-α) in both in vivo and in vitro experiments. Notably, STING inhibition via si-STING transfection reversed BHB-induced inflammation. Additionally, autophagy activation appeared to protect against BHB stress by facilitating the removal of cytoplasmic mtDNA and preventing cGAS-STING pathway-mediated inflammation.

Conclusions
The findings illustrate that elevated BHB levels lead to the release of cytoplasmic mtDNA, which in turn activates the cGAS-STING pathway and triggers an inflammatory response in the mammary glands during hyperketonemia. Conversely, autophagy activation has been shown to alleviate this process by promoting cytoplasmic mtDNA degradation.

Graphical Abstract
Impact of climate and human-induced fire on the Dongyuan Lake, Southern Taiwan during the last 1850 cal years BP
Authors: Rahman Abdur , Wang Liang-Chi , Yu Neng-Ti , Yen Jiun-Yee 
Published: February 2025

Abstract
This study investigates the relationship among the wildfires, climate, and humans and their combined impact on the Dongyuan Lake in southern Taiwan using a sediment core that covered the last 1850 cal years BP. Charcoal accumulation rate (CHAR) peaks, low total organic carbon (TOC), total nitrogen (TN), TOC/TN ratios, and carbon isotopic composition (δ13Corg), combined with low sedimentation rate (SR) and silt dominance suggested a loss of organic carbon, no or low runoff and soil instability due to wildfires during 1850–1700, 1600–1450, and 1350–1100 cal years BP. This led to silt dominance, further indicating drier climatic conditions. Two intermittent wet phases during 1700–1600 and 1450–1350 cal years BP, indicated by high TOC, TN, TOC/TN ratios, and δ13Corg, suggested peatland formation. After 1100 cal years BP, increased runoff, and organic matter accumulation indicated peatification, suggesting wetter conditions characterized by higher TOC, TN, TOC/TN ratios, δ13Corg, and SR. Wetter periods continued, but the appearance of diatoms indicated shallow water levels during 750–500 cal years BP and from 350 cal years BP to the present. CHAR peaks suggest wildfire activity, and combined with archaeological evidence, this implies human-induced burning during these periods. The variation in pH and nutrient dynamics (indicated by PCA analysis of diatoms) were closely linked to wildfire intensity and frequency. Infrequent wildfires (750–500 cal years BP) caused lake acidification, while frequent fires (350 cal years BP to present) raised pH. In the past 150 years, human activities, mainly deforestation and acid rain, have contributed to lake acidification.
The impact of a 1 mm interimplant distance on the interproximal crestal bone height: a case report with a 10-year follow-up and literature review
Authors: Morales Schwarz David , Szmukler-Moncler Serge , Morales Melendez Hilde , Beuer Florian 
Published: February 2025

Abstract

Background
Between adjacent dental implants, an interimplant distance (IID) of at least 3 mm has been recommended to avoid resorbing the interproximal crestal bone. The effect of a 2 mm IID on crestal bone loss has been investigated but the literature is scarce when it comes to an IID of 1 mm. There is a need to document such clinical situations when they occur and elucidate if such a narrow IID is deleterious or not to the interproximal crest. The present case deals with an IID of 1 mm in the premolar area where, for the first time, the fate of an interimplant crest is reported after a 10-year follow-up.

Case presentation
A 57-year-old patient attended with 2 hopeless maxillary premolars. The mesio-distal space available for implant rehabilitation was too narrow to receive standard diameter implants and keep an inter-implant distance (IID) of 3 mm as recommended by accepted guidelines. A protocol of immediate implant placement and provisionalization involving 2 implants of Ø 3.5 mm was implemented; placement in the extraction sockets resulted in an IID of 1 mm. After 3 months of healing the final prosthesis was delivered; the patient has been followed for 10 years now. Surprisingly, the findings showed that the interimplant crest was maintained 1.40 mm coronal to the shoulder of the neck of the implants. Bone completely filled the space between the prosthetic concave abutments and the interproximal papilla was closing the embrasure. The literature reports only 2 experimental studies involving a 1 mm IID; both showed that this did not lead to the resorption of the interproximal bone.

Conclusions
Unexpectedly, the present case with an IID of 1 mm did not lead to the resorption of the interproximal bone after 10 years. It is speculated that the reason for that is due to the implants displaying an internal conical connection, the platform-switching feature, concave abutments and subcrestal placement. The fate of the interproximal crest of implants placed with an IID of 1 mm lacks scientific evidence. More studies are warranted to elucidate this question in order to propose the best implant treatment in cases displaying a limited mesio-distal space.
Association between chronic obstructive pulmonary disease and osteoporosis: Mendelian randomization combined with bibliometric analysis
Authors: Yang Fangjun , Wang Huaming , Liu Miaomiao , Pei Shengtai , Qiu Xiaoming 
Published: February 2025

Abstract

Background
Previous observational studies have reported an association between chronic obstructive pulmonary disease (COPD) and osteoporosis (OP). The aim of this study is to investigate the causal relationship between COPD and OP by two-sample Mendelian randomization (MR) analysis. The current status of cross-sectional research between COPD and OP in the past decade was explored through bibliometrics.

Methods
Single nucleotide polymorphisms (SNPs) that have been found to be strongly associated with COPD were used as instrumental variables (IVs) in MR Analysis. The primary outcome of the study was BMD measurement at five specific anatomical sites, namely the whole body, femoral neck, lumbar spine, forearm, and heel. These BMD measurements were derived primarily from a genome-wide association study (GWAS) and summary statistics from the International Genetic Factors Consortium for Osteoporosis (GEFOS). The main analysis method was inverse variance weighting (IVW). Multiple sensitivity analyses were performed to assess the robustness and reliability of the current MR Results. Further confirmatory MR Analysis between COPD and OP was applied. In bibliometrics. Publications were extracted from the Web of Science core collection publications related to osteoporosis and sarcopenia published between January 2014 and October 2024; Bibliometrics and visualization were performed by Microsoft Office Excel, Citespace, and R (Bibliometrix).

Results
The MR Findings suggest that there is no causal relationship between COPD and BMD at five specific anatomical sites. The results of the primary IVW MR Analysis were generally supported by our sensitivity MR Analysis. We performed MR Analysis for the validation of COPD and OP (IVW OR: 1.019; 95%CI: 0.898–1.564; p = 0.768) also did not support a causal relationship between COPD and BMD. A total of 471 articles written by 1119 organizations from 42 countries/regions by 3331 authors and published in 238 journals were identified in the bibliometric analysis. China is the leading country in terms of the number of publications. China Medical University contributed the most publications. The International Journal of Chronic Obstructive Pulmonary Disease has the highest publication in this field.

Conclusions
In conclusion, This MR Study found no causal relationship between COPD and OP, suggesting that the observed associations may be due to common genetic effects or environmental confounders. The global research trends in this field in the past decade were summarized through bibliometric analysis, and care became the focus of future research on the relationship between copd and OP.