bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fermentation improves antioxidant capacity and γ-aminobutyric acid content of Ganmai Dazao Decoction by lactic acid bacteria
Authors: Wei Linya , Li Yiming , Hao Zina , Zheng Zhenjie , Yang Huixin , Xu Suixin , Li Shihan , Zhang Lili , Xu Yunhe 
Published: November 2023

IntroductionGanmai Dazao Decoction is a traditional Chinese recipe, and is composed of licorice, floating wheat, and jujube.MethodsEffects of lactic acid bacteria fermentation on the physicochemical properties, antioxidant activity, and γ-aminobutyric acid of Ganmai Dazao Decoction were studied. The changes of small and medium molecules in Ganmai Dazao Decoction before and after fermentation were determined by LC–MS non-targeted metabolomics.ResultsThe results showed that the contents of lactic acid, citric acid, acetic acid, and total phenol content increased significantly, DPPH free radical clearance and hydroxyl free radical clearance were significantly increased. γ-aminobutyric acid content was 12.06% higher after fermentation than before fermentation. A total of 553 differential metabolites were detected and identified from the Ganmai Dazao Decoction before and after fermentation by partial least squares discrimination and VIP analysis.DiscussionAmong the top 30 differential metabolites with VIP values, the content of five functional substances increased significantly. Our results showed that lactic acid bacteria fermentation of Ganmai Dazao Decoction improves its antioxidant effects and that fermentation of Ganmai Dazao Decoction with lactic acid bacteria is an innovative approach that improves the health-promoting ingredients of Ganmai Dazao Decoction.
Posterior reversible encephalopathy syndrome in children with malignancies – a single-center retrospective study
Authors: Kiermasz Aleksandra , Zapała Magdalena , Zwiernik Bartosz , Stręk-Cholewińska Angelika , Machnikowska-Sokołowska Magdalena , Mizia-Malarz Agnieszka 
Published: November 2023

BackgroundPosterior reversible encephalopathy syndrome (PRES) diagnosis relies on clinical and radiological characteristics. Clinical manifestations include focal neurologic deficits, hemiparesis, seizures with symptoms of intracranial hypertension, headache, nausea, vomiting, and visual field disturbances. The majority of patients have typical changes in magnetic resonance imaging. The epidemiology and outcomes of PRES in the pediatric cancer population have not been well described. Most of the available data are from retrospective analyses.ObjectiveThe aim of our study was to evaluate the clinical and radiological presentation as well as the outcome of PRES in children treated for cancers in a single center.MethodsWe analyzed data from 1,053 patients diagnosed with malignancies in a single center over 15 years to determine the incidence of PRES.Results19/1053 (1.8%) patients developed PRES. The diagnosis was accompanied by a range of clinical symptoms including hypertension, seizures, altered mental status, and headaches. Magnetic resonance imaging was performed in all patients, and 14/19 (73.7%) exhibited typical findings consistent with PRES. Four patients (21.0%) required treatment in the Intensive Care Unit.ConclusionPosterior reversible encephalopathy syndrome (PRES) is a rare but significant complication in children with cancer.There is a clear need to establish clinical criteria for PRES to improve the diagnosis and treatment of patients with PRES, particularly in the pediatric oncological population.Further studies are needed to identify the risk factors for recurrent PRES, particularly in pediatric cancer patients undergoing chemotherapy or immunosuppressive treatment.
Influence of sarcopenia on postoperative complications in patients undergoing autologous microsurgical breast reconstruction: an inverse probability of treatment weighting analysis
Authors: Lee Seung-Jun , Yang Yun-Jung , Lee Dong-Won , Song Seung-Yong , Lew Dae-Hyun , Yang Eun-Jung 
Published: November 2023

BackgroundSarcopenia is characterized by the loss of skeletal muscle mass and power. Preoperative sarcopenia may be associated with an increased risk of postoperative complications after autologous free-flap breast reconstruction surgery; however, this relationship is controversial.ObjectivesThis study aimed to determine whether preoperative sarcopenia is associated with a high complication rate in patients undergoing autologous free-flap breast reconstruction.MethodsPatients who underwent autologous free-flap breast reconstruction at our hospital between 2019 and 2021 were included in the study. Data on significant complications requiring surgical intervention were retrospectively collected from the medical records. Sarcopenia was defined as having a skeletal muscle index value &lt;41 cm2/m2. The skeletal muscle index was calculated by dividing the sum of the psoas and iliopsoas muscle areas at the level of the third lumbar vertebra by the patient’s height in meters squared. The relationship between preoperative sarcopenia and postoperative complications was investigated using an inverse probability of treatment weighting (IPTW) analysis.ResultsAmong the 203 participants, 90 (44.33%) had preoperative sarcopenia. The general patient characteristics were similar between the sarcopenia and non-sarcopenia groups after IPTW adjustment. Sarcopenia did not significantly increase the risk of flap failure or emergency surgery related to breast reconstruction before IPTW adjustment. However, after IPTW adjustment, the rates of recipient site infection and hematoma were significantly higher in participants with sarcopenia than in those without sarcopenia (p &lt; 0.001 and p = 0.014, respectively).ConclusionPreoperative sarcopenia may influence certain complications of autologous free-flap breast reconstruction surgery.
Prospective assessment of breast lesions AI classification model based on ultrasound dynamic videos and ACR BI-RADS characteristics
Authors: Qiu Shunmin , Zhuang Shuxin , Li Bin , Wang Jinhong , Zhuang Zhemin 
Published: November 2023

IntroductionAI-assisted ultrasound diagnosis is considered a fast and accurate new method that can reduce the subjective and experience-dependent nature of handheld ultrasound. In order to meet clinical diagnostic needs better, we first proposed a breast lesions AI classification model based on ultrasound dynamic videos and ACR BI-RADS characteristics (hereafter, Auto BI-RADS). In this study, we prospectively verify its performance.MethodsIn this study, the model development was based on retrospective data including 480 ultrasound dynamic videos equivalent to 18122 static images of pathologically proven breast lesions from 420 patients. A total of 292 breast lesions ultrasound dynamic videos from the internal and external hospital were prospectively tested by Auto BI-RADS. The performance of Auto BI-RADS was compared with both experienced and junior radiologists using the DeLong method, Kappa test, and McNemar test.ResultsThe Auto BI-RADS achieved an accuracy, sensitivity, and specificity of 0.87, 0.93, and 0.81, respectively. The consistency of the BI-RADS category between Auto BI-RADS and the experienced group (Kappa:0.82) was higher than that of the juniors (Kappa:0.60). The consistency rates between Auto BI-RADS and the experienced group were higher than those between Auto BI-RADS and the junior group for shape (93% vs. 80%; P = .01), orientation (90% vs. 84%; P = .02), margin (84% vs. 71%; P = .01), echo pattern (69% vs. 56%; P = .001) and posterior features (76% vs. 71%; P = .0046), While the difference of calcification was not significantly different.DiscussionIn this study, we aimed to prospectively verify a novel AI tool based on ultrasound dynamic videos and ACR BI-RADS characteristics. The prospective assessment suggested that the AI tool not only meets the clinical needs better but also reaches the diagnostic efficiency of experienced radiologists.
Results and complications of bilateral limb lengthening in achondroplasia: a retrospective analysis
Authors: Verdoni Fabio , Giorgino Riccardo , Virgilio Camilla , Nannini Alessandra , Viganò Marco , Curci Domenico , Peretti Giuseppe Michele , Mangiavini Laura 
Published: November 2023

BackgroundAchondroplasia is one of the main causes of disharmonic dwarfism. Patients with achondroplasia might have physical and psychological limitations due to their disproportionate stature. Surgical limb lengthening is the only practical option available to achieve a stature comparable to normal population range. The purpose of this study is to analyze results and complications of our lengthening protocol.MethodsA retrospective analysis was performed on 33 patients with achondroplasia (21 females and 12 males) undergoing simultaneous bilateral tibia or femur lengthening in four surgical stages from 2017 to 2021 (46 lengthening procedures, with a total of 56 tibias and 36 femurs). For each patient, patients’ characteristics and antero-posterior and lateral radiographs were obtained. The following parameters were analyzed: duration of lengthening with external fixator, amount of lengthening, complications or events that influenced outcomes and the healing index (HI).ResultsThe average tibial and femoral gain was 7.9 cm and 6.9 cm, respectively. The tibiae achieved better results than the femurs (p = 0.005). Nineteen complications were reported for 92 segments (20.7%), and the variables influencing complications were: step (p = 0.002) and fixation duration (p = 0.061).ConclusionsBilateral parallel lower limb lengthening in four surgical steps may be a viable technique in patients with achondroplasia.
The impact of digital transformation on green total factor productivity of heavily polluting enterprises
Authors: Han Jiabin , Sun Ruyu , Zeeshan Muhammad , Rehman Alam , Ullah Irfan 
Published: November 2023

IntroductionDigital transformation has become an important engine for economic high-quality development and environment high-level protection. However, green total factor productivity (GTFP), as an indicator that comprehensively reflects economic and environmental benefits, there is a lack of studies that analyze the effect of digital transformation on heavily polluting enterprises’ GTFP from a micro perspective, and its impact mechanism is still unclear. Therefore, we aim to study the impact of digital transformation on heavily polluting enterprises’ GTFP and its mechanism, and explore the heterogeneity of its impact.MethodsWe use Chinese A-share listed enterprises in the heavily polluting industry data from 2007 to 2019, measure enterprise digital transformation indicator using text analysis, and measure enterprise GTFP indicator using the GML index based on SBM directional distance function, to investigate the impact of digital transformation on heavily polluting enterprises’ GTFP.ResultsDigital transformation can significantly enhance heavily polluting enterprises’ GTFP, and this finding still holds after considering the endogenous problem and conducting robustness tests. Digital transformation can enhance heavily polluting enterprises’ GTFP by promoting green innovation, improving management efficiency, and reducing external transaction costs. The improvement role of digital transformation on heavily polluting enterprises’ GTFP is more obvious in the samples of non-state-owned enterprises, non-high-tech industries, and the eastern region. Compared with blockchain technology, artificial intelligence technology, cloud computing technology, big data technology, and digital technology application can significantly improve heavily polluting enterprises’ GTFP.DiscussionOur paper breaks through the limitations of existing research, which not only theoretically enriches the literature related to digital transformation and GTFP, but also practically provides policy implications for continuously promoting heavily polluting enterprises’ digital transformation and facilitating their high-quality development.
Compliance with medical regimen among hematological cancer patients and its association with symptoms of posttraumatic stress disorder and adjustment disorder
Authors: Springer Franziska , Esser Peter , Friedrich Michael , Ernst Jochen , Platzbecker Uwe , Vucinic Vladan , Mehnert-Theuerkauf Anja 
Published: November 2023

BackgroundHematological cancer patients must comply with extensive medical instructions to prevent cancer progression or relapse. Psychological comorbidities and patient characteristics have been shown to affect compliance. However, the impact of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) on compliance in cancer patients remains unclear. This study aims to evaluate compliance in hematological cancer patients more comprehensively and to investigate its association with PTSD and AjD symptomatology as well as sociodemographic and medical factors.MethodsHematological cancer patients were cross-sectionally assessed via validated questionnaires for PTSD (PCL-5) and AjD (ADMN-20), and three internally developed items on compliance with medical regimen, with two referring to compliance behavior and one item assessing perceived difficulties with complying. Each compliance item was analyzed descriptively. Multiple linear regression models tested the association between compliance and PTSD and AjD symptomatology, sociodemographic and medical factors.ResultsIn total, 291 patients were included (response rate 58%). Nine out of ten patients reported to either never (67%) or rarely (25%) change their medical regimen. However, 8% reported to change it once in a while or often. Compliance behavior was mostly rated as very easy (36%) or easy (45%) to implement. Nevertheless, 19% perceived it to be partly difficult or difficult to follow medical regimen. Symptoms of AjD (β = 0.31, p &lt; 0.001) were associated with more difficulties to comply. Higher compliance behavior in turn was associated with stem cell transplantation (SCT) treatment (β = −0.21, p &lt; 0.001) and lower education (β = −0.19, p = 0.002).ConclusionAlthough most patients indicated that they comply with medical regimen, a considerable subgroup of patients indicated subjectively perceived difficulties and thus seem to require additional support in implementing medical instructions possibly through improved medical communication and patient health literacy or shared decision-making.
Progression of the COVID-19 pandemic, Brazilian healthcare workers’ emotional burden and the effects on professional fulfillment at the end of the third wave: a longitudinal study
Authors: Loureiro Sonia Regina , Zuardi Antônio Waldo , Silveira Isabella Lara Machado , Crippa José Alexandre de Souza , Hallak Jaime Eduardo Cecílio , Osório Flávia de Lima 
Published: November 2023

IntroductionEven though the long-term effects of the COVID-19 pandemic on healthcare workers’ mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies.ObjectivesTo assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths).MethodsThe sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment).ResultsBrazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased.ConclusionThe lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic’s chronic effects and the need for organizations to monitor these workers’ mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.
A social innovation to empower community-led monitoring and mobilization for HIV prevention in rural Kenya: experimenting to reduce the HIV prevention policy-implementation gap
Authors: Goodman Michael , Turan Janet , Keiser Philip , Seidel Sarah , Raimer-Goodman Lauren , Gitari Stanley , Mukiri Fridah , Brault Marie , Patel Premal 
Published: November 2023

IntroductionStrong policy guidance has recently emerged identifying focal points at multiple levels and across sectors to end the persistent HIV pandemic and related inequities. Reducing the policy-implementation gap, as with the evidence-policy gap, requires strategic alignment between interventional research and policy realms. Global- and national-level HIV policy indicate a need for community-led efforts to reduce HIV stigma, and increase uptake of HIV prevention tools.MethodsThis study assesses a process-driven approach to facilitating community-led efforts to reduce HIV stigma, and build a generative context for community-led HIV prevention. The study intervention combines an adapted group-based microfinance process, a novel psychological curriculum, and leadership development at a scale now involving over 10,000 rural Kenyans across 39 villages.ResultsConsistent with interventional goals, and current relevant psychosocial theories, we find collective emotion, and HIV stigma (blame and discrimination) significantly improve with more time participating in the in the program and novel curriculum. Further, HIV stigma predicts subsequent reporting of ever being tested for HIV, and the intervention led to the development of “HIV prevention resource committees” – groups of participants committed to undergo training to reduce HIV stigma and prevent HIV within their communities.DiscussionImplications for further research to reduce the HIV policy-implementation gap are discussed, directly within this interventional context and more generally.
Characterizing the role of human behavior in the effectiveness of contact-tracing applications
Authors: Fosch Ariadna , Aleta Alberto , Moreno Yamir 
Published: November 2023

IntroductionAlthough numerous countries relied on contact-tracing (CT) applications as an epidemic control measure against the COVID-19 pandemic, the debate around their effectiveness is still open. Most studies indicate that very high levels of adoption are required to stop disease progression, placing the main interest of policymakers in promoting app adherence. However, other factors of human behavior, like delays in adherence or heterogeneous compliance, are often disregarded.MethodsTo characterize the impact of human behavior on the effectiveness of CT apps we propose a multilayer network model reflecting the co-evolution of an epidemic outbreak and the app adoption dynamics over a synthetic population generated from survey data. The model was initialized to produce epidemic outbreaks resembling the first wave of the COVID-19 pandemic and was used to explore the impact of different changes in behavioral features in peak incidence and maximal prevalence.ResultsThe results corroborate the relevance of the number of users for the effectiveness of CT apps but also highlight the need for early adoption and, at least, moderate levels of compliance, which are factors often not considered by most policymakers.DiscussionThe insight obtained was used to identify a bottleneck in the implementation of several apps, such as the Spanish CT app, where we hypothesize that a simplification of the reporting system could result in increased effectiveness through a rise in the levels of compliance.
Reducing the negative impact of accidents associated with the release of dangerous substances to environment
Authors: Marková Iveta , Kubás Jozef , Štofková Zuzana , Petrlová Katarína 
Published: November 2023

BackgroundThe article is concerned with an evaluation of the current state of emergency readiness of industrial companies in the event of dangerous substance leakage and with a presentation of textile sorbents used for the purposes of capturing an escaped substance.MethodsA part of the article is concerned with the experimental designation of sorption capacity of hydrophobic, chemical, and universal sorption mats for chosen polar (water and alcohol) and non-polar (oil and gasoline) liquids. Experiments were realized according to Standard Test Method for Sorbent Performance of Adsorbents for use on Crude Oil and Related Spills, American Society for Testing and Materials (ASTM F726-17), type I. and Test methods for non-woven fabrics, European Union International Organization for Standardization (EN ISO 9073-6:2004). The aim of the article is an experimental designation of sorption capacity of textile sorption mats using two different methods, a comparison of the acquired results and a comparison of the acquired data with the data given by the manufacturer.ResultsTextile sorbents, which can, owing to their sorption ability, allow the elimination or mitigation of a negative impact of a possible accident in the company connected with an escape of a liquid dangerous substance were tested and compared with the established values. Based on the obtained results it is possible to state that sorption capacities of the chemical and universal mat for the substrate water are equal and consistent with the data given by the manufacturer. Textile sorption mats also have a comparable sorption capacity. The sorption capacity on the substrate gasoline is the same in all textile sorbents. The adsorption capacity per unit mass all type’s sorbents was similar for non-polar liquids (gasoline was values from 6.41 to 6.57 and oil was values from 9.54 to 10.24).ConclusionThe acquired results confirmed the universality of textile sorption mats for gasoline. Sorption capacities of the chemical and universal mat for the substrate water are equal and match the data given by the manufacturer. Textile sorption mats have a maximum sorption output up to 60 s, afterwards the sorption capacity values remain unchanged.