bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visualizing the dynamic mechanical power and time burden of mechanical ventilation patients: an analysis of the MIMIC-IV database
Authors: Chen Han , Chen Zhi-Zhong , Gong Shu-Rong , Yu Rong-Guo 
Published: November 2023

Abstract
Background
Limiting driving pressure and mechanical power is associated with reduced mortality risk in both patients with and without acute respiratory distress syndrome. However, it is still poorly understood how the intensity of mechanical ventilation and its corresponding duration impact the risk of mortality.

Methods
Critically ill patients who received mechanical ventilation were identified from the Medical Information Mart for Intensive Care (MIMIC)-IV database. A visualization method was developed by calculating the odds ratio of survival for all combinations of ventilation duration and intensity to assess the relationship between the intensity and duration of mechanical ventilation and the mortality risk.

Results
A total of 6251 patients were included. The color-coded plot demonstrates the intuitive concept that episodes of higher dynamic mechanical power can only be tolerated for shorter durations. The three fitting contour lines represent 0%, 10%, and 20% increments in the mortality risk, respectively, and exhibit an exponential pattern: higher dynamic mechanical power is associated with an increased mortality risk with shorter exposure durations.

Conclusions
Cumulative exposure to higher intensities and/or longer duration of mechanical ventilation is associated with worse outcomes. Considering both the intensity and duration of mechanical ventilation may help evaluate patient outcomes and guide adjustments in mechanical ventilation to minimize harmful exposure.
Precise prediction of polar motion using sliding multilayer perceptron method combining singular spectrum analysis and autoregressive moving average model
Authors: Wu Kezhi , Liu Xin , Jin Xin , Chang Xiaotao , Sun Heping , Guo Jinyun 
Published: November 2023

AbstractThe precise prediction of polar motion parameters is needed for the astrogeodynamics, navigation and positioning of the deep space probe. However, the current prediction methods are limited to predicting polar motion for specific periods, either short- or long-term. In this study, a sliding multilayer perceptron (MLP) method combined singular spectrum analysis (SSA) and autoregressive moving average (ARMA) for short- and long-term polar motion prediction was proposed. MLP was introduced into PM prediction due to its automatic learning characteristics and its ability to effectively process nonlinear and multi-dimensional data. The SSA was used to extract and predict the principal components of polar motion, while the remaining components were predicted using ARMA. In the meantime, SSA and ARMA were used to provide training data and target learning data for the MLP model. MLP input data were constructed by sliding processing with a window of 7 days, composed of n series of the same length (18 years). Finally, MLP was employed to predict the residuals generated during SSA and ARMA prediction. To evaluate the accuracy of the proposed method, the polar motion prediction was applied for a 364-day lead time based on the IERS EOP 14C04 product. The method outperformed the IERS Bulletin A, as demonstrated by the mean-absolute errors of the x and y components of polar motion on the 30th day, which were lower (5.14 mas and 3.37 mas, respectively) than those predicted by IERS Bulletin A (6.66 mas and 3.94 mas). Similarly, the mean-absolute errors on the 364th day were 17.79 mas and 16.29 mas, respectively, compared to the 19.24 mas and 18.81 mas predicted by IERS Bulletin A.
Graphical Abstract
Post-insertion technique to introduce targeting moieties in milk exosomes for targeted drug delivery
Authors: Jang Hochung , Kim Hyosuk , Kim Eun Hye , Han Geonhee , Jang Yeongji , Kim Yelee , Lee Jong Won , Shin Sang Chul , Kim Eunice EunKyeong , Kim Sun Hwa , Yang Yoosoo 
Published: November 2023

Abstract

Background
Recently, increased attention has been given on exosomes as ideal nanocarriers of drugs owing to their intrinsic properties that facilitate the transport of biomolecular cargos. However, large-scale exosome production remains a major challenge in the clinical application of exosome-based drug delivery systems. Considering its biocompatibility and stability, bovine milk is a suitable natural source for large-scale and stable exosome production. Because the active-targeting ability of drug carriers is essential to maximize therapeutic efficacy and minimize side effects, precise membrane functionalization strategies are required to enable tissue-specific delivery of milk exosomes with difficulty in post-isolation modification.

Methods
In this study, the membrane functionalization of a milk exosome platform modified using a simple post-insertion method was examined comprehensively. Exosomes were engineered from bovine milk (mExo) with surface-tunable modifications for the delivery of tumor-targeting doxorubicin (Dox). The surface modification of mExo was achieved through the hydrophobic insertion of folate (FA)-conjugated lipids.

Results
We have confirmed the stable integration of functionalized PE-lipid chains into the mExo membrane through an optimized post-insertion technique, thereby effectively enhancing the surface functionality of mExo. Indeed, the results revealed that FA-modified mExo (mExo-FA) improved cellular uptake in cancer cells via FA receptor (FR)-mediated endocytosis. The designed mExo-FA selectively delivered Dox to FR-positive tumor cells and triggered notable tumor cell death, as confirmed by in vitro and in vivo analyses.

Conclusions
This simple and easy method for post-isolation modification of the exosomal surface may be used to develop milk-exosome-based drug delivery systems.

Graphical Abstract
Observation of behavioural skills by medical simulation facilitators: a cross-sectional analysis of self-reported importance, difficulties, observation strategies and expertise development
Authors: Mommers Lars , Verstegen Daniëlle , Dolmans Diana , van Mook Walther N. K. A. 
Published: November 2023

Abstract
Background
The association between team performance and patient care was an immense boost for team-based education in health care. Behavioural skills are an important focus in these sessions, often provided via a mannikin-based immersive simulation experience in a (near) authentic setting. Observation of these skills by the facilitator(s) is paramount for facilitated feedback with the team. Despite the acknowledgement that trained facilitators are important for optimal learning, insight into this observation process by facilitators is limited.

Objectives
What are the self-reported current practices and difficulties regarding the observation of behavioural skills amongst facilitators during team training and how have they been trained to observe behavioural skills?

Methods
This cross-sectional study used a pilot-tested, content-validated, multi-linguistic online survey within Europe, distributed through a non-discriminative snowball sampling method. Inclusion was limited to facilitators observing behavioural skills within a medical team setting.

Results
A total of 175 persons filled in the questionnaire. All aspects of behavioural skill were perceived as very important to observe. The self-perceived difficulty of the behavioural skill aspects ranged from slightly to moderately difficult. Qualitative analysis revealed three major themes elaborating on this perceived difficulty: (1) not everything can be observed, (2) not everything is observed and (3) interpretation of observed behavioural skills is difficult. Additionally, the number of team members health care facilitators have to observe, outnumbers their self-reported maximum. Strategies and tools used to facilitate their observation were a blank notepad, co-observers and predefined learning goals. The majority of facilitators acquired observational skills through self-study and personal experience and/or observing peers. Co-observation with either peers or experts was regarded as most learn some for their expertise development. Overall, participants perceived themselves as moderately competent in the observation of behavioural skills during team training.

Conclusions
Observation of behavioural skills by facilitators in health care remains a complex and challenging task. Facilitators’ limitations with respect to attention, focus and (in)ability to perform concomitant tasks, need to be acknowledged. Although strategies and tools can help to facilitate the observation process, they all have their limitations and are used in different ways.
Ultrasound-guided percutaneous retrieval of non-radiopaque radial line using a microsnare
Authors: Alaeddin Hasan , Elsaadany Amr , Rashid Akhtar Mohammad 
Published: November 2023

AbstractRadial arterial lines are inserted in critically ill patients admitted to hospital intensive care units for continuous monitoring of their blood pressure. On removal the line can rarely become transected, potentially leading to thrombosis of the radial artery. Retrieval of the broken fragment can be achieved by open surgery, however other retrieval methods using ultrasound-guidance have been performed as they are considered safer and less invasive. We describe our technique of ultrasound-guided percutaneous retrieval of a broken non-radioopaque radial line in one patient, which involved the use of a microsnare. Under local anaesthesia and ultrasound guidance, a 6 Fr 5.5 cm short brite tip sheath was introduced into the radial artery, followed by a microsnare which was used to capture the arterial line, track the line back into the sheath and remove it uneventfully. The use of a microsnare under ultrasound-guidance is only one method to retrieve transected radial lines, with other interventional methods described in the literature. It enables a minimally invasive and safer approach to this potentially critical challenge and can help affected patients avoid open surgery to achieve the same management outcome.
Functional bony entrapment of the dorsalis pedis artery caused by cranial subluxation in the talonavicular joint
Authors: Mostafa Karim , Wolf Carmen , Bürger Matthias , Kapahnke Sebastian , Michaelis Thorben , Berndt Rouven , Rusch Rene , Andersson Julian , Schäfer Philipp Jost 
Published: November 2023

Abstract A 66-year-old female presented in the emergency department with Blue-Toe-Syndrome (BTS) and signs of osteitis of her left big toe. Imaging workup of the peripheral vasculature showed no findings. Upon invasive angiography, severe focal stenosis of the dorsalis pedis artery (DPA) could be seen at the talonavicular joint. Complete regression of the stenosis was inducible by dorsal extension in the ankle joint. Further imaging revealed an underlying subluxation of the talonavicular joint as cause of the arterial compression. Entrapment of the DPA is a rare condition and most often described in relation to connective tissue bands or variant muscular tendons (McCabe et al. 70:213–8, 2021; Weichman et al. 24:113, 2010; Smith et al.58:212–4, 2013; Griffin et al. 20:325–8; 2012). In the presented case, bony compression of the PDA due to cranial subluxation of the talus was seen as the cause of BTS and osteitis of the phalanx of the first toe.
Non-invasive vagus nerve stimulation: the future of inflammatory bowel disease treatment?
Authors: Bonaz Bruno 
Published: November 2023

AbstractThe vagus nerve regulates inflammation and cytokine release through the inflammatory reflex. Recent pilot clinical trials using implantable bioelectronic devices have demonstrated the efficacy of vagus nerve stimulation (VNS) in adult patients with inflammatory bowel diseases (IBD) as an alternative to drug treatments. However, the use of non-invasive VNS should be of interest in adults with IBD and even more in pediatric IBD. In this issue of Bioelectronic Medicine, Sahn et al. report that non-invasive transcutaneous auricular VNS attenuated signs and symptoms in a pediatric cohort with mild to moderate IBD thus opening new therapeutic avenues in the management of pediatric but also adult IBD patients.
Assessing the fidelity of a behavioural intervention involving academic detailing in general practice: a sub-study of the ‘Implementing work-related Mental health guidelines in general PRacticE’ (IMPRovE) trial
Authors: Camões-Costa Vera , Chakraborty Samantha , Mozaffari Fatima , Collie Alexander , Kenardy Justin , Brijnath Bianca , Mortimer Duncan , Enticott Joanne , Kidd Michael , Trevena Lyndal , Reid Sharon , Mazza Danielle 
Published: November 2023

Abstract
Background
Assessing the fidelity of intervention components enables researchers to make informed judgements about the influence of those components on the observed outcome. The ‘Implementing work-related Mental health guidelines in general PRacticE’ (IMPRovE) trial is a hybrid III trial aiming to increase adherence to the ‘Clinical Guidelines for the diagnosis and management of work-related mental health conditions in general practice’. IMPRovE is a multifaceted intervention, with one of the central components being academic detailing (AD). This study describes the fidelity to the protocol for the AD component of the IMPRovE intervention.

Method
All AD sessions for the trial were audio-recorded and a sample of 22% were randomly selected for fidelity assessment. Fidelity was assessed using a tailored proforma based on the Modified Conceptual Framework for fidelity assessment, measuring duration, coverage, frequency and content. A descriptive analysis was used to quantify fidelity to the protocol and a content analysis was used to elucidate qualitative aspects of fidelity.

Results
A total of eight AD sessions were included in the fidelity assessment. The average fidelity score was 89.2%, ranging from 80 to 100% across the eight sessions. The sessions were on average 47 min long and addressed all of the ten chapters in the guideline. Of the guideline chapters, 9 were frequently discussed. The least frequently discussed chapter related to management of comorbid conditions. Most general practitioner (GP) participants used the AD sessions to discuss challenges with managing secondary mental conditions. In line with the protocol, opinion leaders who delivered the AD sessions largely offered evidence-based strategies aligning with the clinical guideline recommendations.

Conclusions/implications
The IMPRovE AD intervention component was delivered to high fidelity. The sessions adhered to the intended duration, coverage, frequency, and content allowing participating GPs to comprehend the implementation of the guideline in their own practice. This study also demonstrates that the Modified Conceptual Fidelity Framework with a mixed methods approach can support the assessment of implementation fidelity of a behavioural intervention in general practice. The findings enhance the trustworthiness of reported outcomes from IMPRovE and show that assessing fidelity is amenable for AD and should be incorporated in other studies using AD.

Trial registration
Australian New Zealand Clinical Trials Registry ACTRN 12620001163998, November 2020.
QSAR modeling, molecular docking, dynamic simulation and ADMET study of novel tetrahydronaphthalene derivatives as potent antitubercular agents
Authors: Moulishankar Anguraj , Sundarrajan T. 
Published: November 2023

Abstract
Background
Tuberculosis is an air-borne contagious disease caused by slow-growing Mycobacterium tuberculosis (Mtb). According to Global Tuberculosis Report 2022, 1.6 million people were infected by tuberculosis in 2021. The continuing spread of drug-resistant tuberculosis (TB) is one of the most difficult challenges to control the tuberculosis. So new drug discovery is essential to the treatment of tuberculosis. This study aims to develop a QSAR model to predict the antitubercular activity of tetrahydronaphthalene derivatives. The QSARINS was used in this study to develop the QSAR predictive model.

Results
A number of tetrahydronaphthalene derivatives with MIC90 values were obtained from the literature to develop the QSAR predictive model. The compounds were divided into two sets: a training set consisting of 39 compounds and a test set containing 13 compounds. The best predictive Model 4 has R2: 0.8303, Q2LOO: 0.7642, LOF: 0.0550, Q2-F1: 0.7190, Q2-F2: 0.7067, Q2-F3: 0.7938 and CCCext: 0.8720. Based on the developed QSAR equation, the new compounds were designed and subjected to molecular docking, molecular dynamics and ADMET analysis.

Conclusion
In the QSAR model, the molecular descriptors of MATS8s, Chi4, bcutv8, Petitjeant and fr_aniline were highly influenced the antitubercular activity. The developed QSAR model helps to predict the antitubercular activity of tetrahydronaphthalene derivatives.
Parathyroid gland preservation in laryngectomy patients with total thyroidectomy
Authors: Alsedra Sundus , Zahran Mohamed , Mina Amir Gorguy , Ayoub Mohamed Gamal , Youssef Ahmed 
Published: November 2023

Abstract
Background
Postoperative hypocalcemia in laryngectomy patients can occur when part or whole of the thyroid gland has been removed. Preservation of the parathyroid glands in situ is considered one of the initial measures to prevent postoperative hypocalcemia even if all thyroid gland is removed. Our study aims to assess the efficacy of parathyroid gland preservation in situ to prevent postoperative hypocalcemia in cases where total laryngectomy is done with total thyroidectomy.

Methods
The study included all laryngectomy patients done during a period from April 2020 to May 2021. Parathyroid gland preservation was done in both primary (12 cases) and salvage (16 cases). Both PTH and corrected calcium level were measured at different time points and used as a guide for further replacement.

Results
We studied the association between outcome including recovery from transient hypocalcemia and certain variables like age, type of surgery, stage of tumor, and extent of neck dissection. Regarding type of surgery, all patients that underwent primary laryngectomy were totally recovered (n = 12, 100%); however, salvage cases were partially recovered (n = 10, 62.5%).

Conclusion
Parathyroid preservation is achievable in cases of salvage laryngectomy in addition to primary laryngectomy with total thyroidectomy. Early monitoring of the patients PTH and Ca during their hospital stay is a good indicator of successful preservation. Long-term follow-up is advised for potential recovery from transient hypoparathyroidism.
Reimagining local worlds: Wen village conservation and regeneration by Amateur Architecture Studio
Authors: Ren Xiang 
Published: November 2023

AbstractThis article theorises the local world as a conceptual scaffold for future conservation and regeneration. It aims to catalyse a theoretical dialogue across the East and West to understand how ordinary places and lifeworlds are preserved, reproduced, and possibly reimagined. The local worlds discussed herein are conceptualised as the worlds of many, the worlds of relating, the worlds of structuring and the worlds of becoming. These four cardinal points present a source of open-endedness and futurity for contemporary architectural reinterpretation. The current article examines the characterisation of the Wen village conservation and regeneration project, led by the Amateur Architecture Studio in Zhejiang Province of China (2012–2016), as an architectural reimagination of local worlds, with a strong sensitivity to the ordinary places and lifeworlds of rural China and juxtapositions of new local worlds within old worlds. By piecing together the flows and fragments of the architectural process, this article shows how locally situated designs and dynamics have shaped the project in both its formation and afterlife, both ethically and contemporarily. Using close readings of popular and oral accounts from both architect’s and users’ perspectives, this article extends the case study by broadening theoretical conversations about contemporary architecture’s capacity to reimagine local worlds.
Translingualism: A Poetics of Language Mixing and Estrangement
Authors: Ostashevsky Eugene 
Published: November 2023

AbstractThis essay attempts to think through what a “translingual” poetics might be like for contemporary poetry. Its first section discusses the term translingual as it is used in some areas of applied linguistics. The second section constructs an imaginary scenario where a poem employs more than one language and examines the relations between them. The third section asks whether the term translingual poetry might be used to refer not just to language-mixing but rather to a special way of handling even a single language. The fourth section tries to think of “translingual poetry” as one where the poet assumes the linguistic strategies of the language learner. The essay also revisits the argument by the Russian Formalist critics that the language of poetry resembles a foreign language.
A ascensão geoeconômica do leste asiático na segunda metade do século xx: méritos e incompletudes das interpretações analíticas | The geoeconomic rise of east asia in the second half of the xxth century: merits and incompleteness of analytical interpretations
Authors: Moura Rafael Shoenmann de 
Published: November 2023

O principal objetivo deste artigo é analisar as principais literaturas debruçadas sobre a ascensão geopolítica e geoeconômica da região conhecida como Leste Asiático, termo aqui empregado em alusão aos casos históricos do Japão, da Coreia do Sul e de Taiwan. Dessa forma, serão colocadas em escrutínio três narrativas que buscaram dar respostas e explicações acerca de tal ascensão regional: a liberal, incorporando uma perspectiva centrada na teoria ricardiana das vantagens comparativas do comércio; a institucionalista, com ênfase sobre as políticas domésticas e engenharia institucional do Estado fomentando o desenvolvimento; e, por fim, a narrativa geopolítica, centrada em fatores sistêmicos que possibilitaram tais trajetórias. Após mapear essas três grandes interpretações, enfim procederei com uma visão crítica acerca de seus acertos e erros.Palavras-chave: Leste Asiático. Desenvolvimento. Economia Política.ABSTRACTThe main goal of this article is to analyze the main literatures focused on the geopolitical and geoeconomic rise of the region known as East Asia, term here employed in allusion to the historical cases of Japan, South Korea and Taiwan. Thus, three narratives that sought to provide answers and explanations about such regional rise will be scrutinized: the liberal one, incorporating a perspective centered on the Ricardian theory of comparative advantages of trade; the institutionalist, with an emphasis on domestic policies and institutional engineering of the State to foster development; and, finally, the geopolitical narrative, centered on systemic factors that made such trajectories possible. After mapping these three major interpretations, I will finally proceed with a critical view of their successes and errors.Keywords: East Asia. Development. Political Economy. Recebido em: 03 out. 2022 | Aceito em: 08 fev. 2023.