bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis
Authors: Qiu Xiaohan , Li Xiaohui , Fu Kang , Chen Wentao , Chen Wenqiang 
Published: August 2023

Background
The function of coronary microcirculation is an important factor in predicting the prognosis of patients with acute coronary syndrome (ACS) who receive percutaneous coronary intervention (PCI) therapy. Ticagrelor, a type of oral P2Y12 inhibitor, is widely prescribed to ACS patients and can improve prognosis compared to clopidogrel. However, the efficacy of ticagrelor on coronary microcirculation, compared to clopidogrel, remains unclear. The objective of this meta-analysis was to determine the efficacy of ticagrelor on coronary microcirculation.

Methods
The PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases were comprehensively searched to identify studies until November 2022. Data was pooled using the fixed effects model or random effects model based on the level of heterogeneity. Sensitivity analyses were performed to measure the effects of potential confounders.

Results
After screening, 16 trials with a total of 3676 participants were ultimately included in the analysis. The meta-analysis revealed that compared to clopidogrel, patients receiving ticagrelor exhibited a more significant reduction in the IMR (WMD: -6.23, 95% CI: -8.41 to -4.04), a reduction in the cTFC (WMD: -1.88; 95% CI: -3.32 to -0.45), and greater increases in CFR (WMD: 0.38; 95% CI: 0.18 to 0.57), MBG (RR 1.29, 95% CI 1.12 to 1.48), and TIMI (RR 1.03, 95% CI 1.00 to 1.06).

Conclusion
Our findings suggest that, compared to clopidogrel, ticagrelor has a significant effect in reducing coronary microcirculatory resistance, enhancing coronary blood flow reserve, and improving myocardial perfusion.
Maternal health during the COVID-19 pandemic: Experiences of health workers in three Brazilian municipalities
Authors: Carvalho Ruth Helena de Souza Britto Ferreira de , Alves Maria Teresa Seabra Soares de Britto e , Silva-Junior Aluísio Gomes da , Alexandre Gisele Caldas , Coimbra Tatiana Raquel Selbmann , Moraes Maurício , Menezes Letícia Oliveira de , Oliveira Sandro Schreiber de , Thomaz Erika Barbara Abreu Fonseca , Lamy Zeni Carvalho , Barreira Lely Stella Guzman 
Published: August 2023

Objective
To analyze the experiences of maternal health workers in three Brazilian cities, located in the Northeast (São Luís), Southeast (Niterói), and South (Pelotas) regions during the first year of the COVID-19 pandemic.

Methods
Qualitative research carried out between December 2020 and February 2021. Interviews were conducted, in person or remotely, with 30 health workers, doctors and nurses, working in maternity hospitals of different degrees of complexity.

Results
Sociodemographic characteristics, employment relationships and professional qualification of the interviewees were described. Two thematic axes were identified: 1) changes in hospital organization and dynamics in the pandemic; 2) Illness and suffering of health workers. The majority of respondents were women. Most physicians had work relationships in the public and private sectors. In Niterói, health workers had better professional qualifications and more precarious work relationships (as temporary hires), compared to São Luís and Pelotas. In the context of the uncertainties resulting from the pandemic, this situation generated even more insecurity for those workers. The statements at the beginning of the pandemic covered topics such as changes in the organizational dynamics of services, healthcare, telemedicine, and interaction between health workers and users. In the health workers’ perception, the initial period of the health emergency, which resulted in intense changes in the provision of services, was marked by an increase in preterm births, perinatal mortality, and fetal losses. Work overload, fear of contamination, concern for family members and uncertainties regarding the new disease caused intense suffering in health workers who had little institutional support in the cities studied. The suffering experienced by health workers went beyond the work dimension, reaching their private life.

Conclusion
Changes caused by the pandemic required immediate adjustments in professional practices, generating insecurities in healthcare regardless of the location studied. The method of hiring health workers remained the same as the previously practiced one in each city. Due to the risk of disease transmission, measures contrary to humanization practices, and more restrictive in São Luís, were reported as harmful to obstetric care. The Covid-19 pandemic was a huge challenge for the Brazilian health system, aggravating the working conditions experienced by health workers. In addition to the work environment, it was possible to briefly glimpse its effects on private life.
Excitatory and Inhibitory Signaling in the Nucleus Accumbens Encode Different Aspects of a Pavlovian Cue in Sign Tracking and Goal Tracking Rats
Authors: Duffer Kyle , Gillis Zachary S. , Morrison Sara E. 
Published: August 2023

AbstractWhen a Pavlovian cue is presented separately from its associated reward, some animals will acquire a sign tracking (ST) response – approach and/or interaction with the cue – while others will acquire a goal tracking response – approach to the site of reward. We have previously shown that cue-evoked excitations in the nucleus accumbens (NAc) encode the vigor of both behaviors; in contrast, reward-related responses diverge over the course of training, possibly reflecting neurochemical differences between sign tracker and goal tracker individuals. However, a substantial subset of neurons in the NAc exhibit inhibitory, rather than excitatory, cue-evoked responses, and the evolution of their signaling during Pavlovian conditioning remains unknown. Using single-neuron recordings in behaving rats, we show that NAc neurons with cue-evoked inhibitions have distinct coding properties from neurons with cue-evoked excitations. Cue-evoked inhibitions become more numerous over the course of training and, like excitations, may encode the vigor of sign tracking and goal tracking behavior. However, the responses of cue-inhibited neurons do not evolve differently between sign tracker and goal tracker individuals. Moreover, cue-evoked inhibitions, unlike excitations, are insensitive to extinction of the cue-reward relationship. Finally, we show that cue-evoked excitations are greatly diminished by reward devaluation, while inhibitory cue responses are virtually unaffected. Overall, these findings converge with existing evidence that cue-excited neurons in NAc, but not cue-inhibited neurons, are profoundly sensitive to the same behavior variations that are often associated with changes in dopamine release.
Expanded tRNA methyltransferase family member TRMT9B regulates synaptic growth and function
Authors: Hogan Caley A , Gratz Scott J , Dumouchel Jennifer L , Thakur Rajan S , Delgado Ambar , Lentini Jenna M , Madhwani Kimberly R , Fu Dragony , O'Connor‐Giles Kate M 
Published: August 2023

AbstractNervous system function rests on the formation of functional synapses between neurons. We have identified TRMT9B as a new regulator of synapse formation and function in Drosophila. TRMT9B has been studied for its role as a tumor suppressor and is one of two metazoan homologs of yeast tRNA methyltransferase 9 (Trm9), which methylates tRNA wobble uridines. Whereas Trm9 homolog ALKBH8 is ubiquitously expressed, TRMT9B is enriched in the nervous system. However, in the absence of animal models, TRMT9B's role in the nervous system has remained unstudied. Here, we generate null alleles of TRMT9B and find it acts postsynaptically to regulate synaptogenesis and promote neurotransmission. Through liquid chromatography‐mass spectrometry, we find that ALKBH8 catalyzes canonical tRNA wobble uridine methylation, raising the question of whether TRMT9B is a methyltransferase. Structural modeling studies suggest TRMT9B retains methyltransferase function and, in vivo, disruption of key methyltransferase residues blocks TRMT9B's ability to rescue synaptic overgrowth, but not neurotransmitter release. These findings reveal distinct roles for TRMT9B in the nervous system and highlight the significance of tRNA methyltransferase family diversification in metazoans.
Systemic gene therapy rescues retinal dysfunction and hearing loss in a model of Norrie disease
Authors: Pauzuolyte Valda , Patel Aara , Wawrzynski James R , Ingham Neil J , Leong Yeh Chwan , Karda Rajvinder , Bitner‐Glindzicz Maria , Berger Wolfgang , Waddington Simon N , Steel Karen P , Sowden Jane C 
Published: August 2023

AbstractDeafness affects 5% of the world's population, yet there is a lack of treatments to prevent hearing loss due to genetic causes. Norrie disease is a recessive X‐linked disorder, caused by NDP gene mutation. It manifests as blindness at birth and progressive sensorineural hearing loss, leading to debilitating dual sensory deprivation. To develop a gene therapy, we used a Norrie disease mouse model (Ndptm1Wbrg), which recapitulates abnormal retinal vascularisation and progressive hearing loss. We delivered human NDP cDNA by intravenous injection of adeno‐associated viral vector (AAV)9 at neonatal, juvenile and young adult pathological stages and investigated its therapeutic effects on the retina and cochlea. Neonatal treatment prevented the death of the sensory cochlear hair cells and rescued cochlear disease biomarkers as demonstrated by RNAseq and physiological measurements of auditory function. Retinal vascularisation and electroretinograms were restored to normal by neonatal treatment. Delivery of NDP gene therapy after the onset of the degenerative inner ear disease also ameliorated the cochlear pathology, supporting the feasibility of a clinical treatment for progressive hearing loss in people with Norrie disease.
Kreativitas Guru Sejarah dalam Mengembangkan Media Pembelajaran pada SMA Negeri 1 Karangtengah dan SMA Negeri 1 Mranggen sebagai Sekolah Penggerak di Kabupaten Demak
Authors: Khasanah Nur Aini , Purnomo Arif 
Published: August 2023

Kemampuan lebih dari seorang guru dituntut dalam pembelajaran ketika sekolah itu ditetapkan sebagai Sekolah Penggerak karena manajemen yang dilakukan oleh sekolah itu lebih dibandingkan dengan sekolah lain. Guru harus bisa menggunakan dan mengembangkan media pembelajaran sejarah dengan kreativitas yang dimiliki agar pembelajaran dapat tercapai secara maksimal. Tujuan penelitian ini adalah (1) mengetahui media pembelajaran sejarah yang digunakan guru (2) menganalisis pengembangan media pembelajaran sejarah (3) menganalisis kendala-kendala yang dihadapi guru sejarah dalam mengembangkan media pembelajaran di SMA N 1 Karangtengah dan SMA N 1 Mranggen sebagai Sekolah Penggerak. Metode penelitian yang digunakan adalah metode kualitatif dengan strategi studi kasus. Hasil dari penelitian menunjukkan bahwa bahwa (1) Dalam penggunaan media guru sejarah memperhatikan beberapa kriteria dalam pemilihan media yang akan digunakan (2) kreativitas guru sejarah dalam pengembangan media pembelajaran dilakukan dengan mencari di internet serta dengan dua pola yaitu pola sendiri dan pola kelompok. Media yang digunakan dalam pembelajaran sejarah mempunyai banyak manfaatnya (3) Kendala-kendala yang dialami dalam menggunakan media pembelajaran adalah sarana prasarana yang kurang mendukung, serta kendala-kendala dalam pengembangan media adalah waktu, penyesuaian media dengan karakteristik siswa, dan faktor keterbatasan penggunaan teknologi.
Kata kunci: pengembangan media pembelajaran, pembelajaran sejarah, Sekolah Penggerak
The ability of a teacher is demanded more in learning when the school is designated as a "Sekolah Penggerak" (Driving School) due to its management being more advanced compared to other schools. Teachers must be able to use and develop historical learning media with their creativity so that learning can be achieved to the maximum extent. The objectives of this research are (1) to identify the historical learning media used by teachers, (2) to analyze the development of historical learning media, and (3) to analyze the challenges faced by history teachers in developing learning media at SMA N 1 Karangtengah and SMA N 1 Mranggen as Sekolah Penggerak. The research method used is a qualitative method with a case study strategy. The results of the research show that (1) History teachers consider several criteria in selecting media for their use, (2) the creativity of history teachers in developing learning media is done by searching on the internet and using two patterns: individual pattern and group pattern. The media used in historical learning has many benefits, (3) The challenges experienced in using learning media are the lack of supportive facilities and infrastructure, and the challenges in media development are related to time, adjusting the media to the students' characteristics, and limited use of technology.
Keywords: learning media development, historical learning, Sekolah Penggerak
Comprehensive assessment of the outcomes of inferior wall myocardial infarction according to echocardiography in patients after percutaneous coronary intervention
Authors: Akramova E. G. , Savelyev A. A. , Khamitova R. Ya. , Vlasova E. V. 
Published: August 2023

Aim. To identify significant echocardiographic parameters in the screening assessment of long-term outcomes of inferior wall myocardial infarction (MI) with primary percutaneous coronary intervention (PCI) using a logistic regression model.Material and methods. The study included the examination results of 144 people with inferior wall MI with primary PCI at admission, discharge and 6, 12, 24 months after discharge. Logistic regression analysis to identify screening outcomes of inferior wall MI included 184 variables, including 131 echocardiographic signs. Analysis of variance was performed using the ANOVA Type II method. The model quality was assessed using the likelihood ratio test and the Akaike criterion.Results. In patients with inferior wall MI and primary PCI, adverse outcomes were observed in 59,7% of cases in the form of repeated myocardial infarction and PCI, coronary artery bypass grafting, the development of stage 2 chronic heart failure, and/or rehospitalizations. For the long-term prognosis of inferior wall MI, in addition to left ventricular ejection fraction, mitral E/A, left atrial volume index and wall motion score index (WMSI), the following echocardiographic predictors were assessed: tricuspid S’ and e’, circumferential strain of the medial level, longitudinal strain of the apical and basal left ventricular levels, longitudinal strain of the segments included in the blood supply area of the circumflex artery.Conclusion. Echocardiographic parameters using Doppler and speckle-tracking technology have proven to be significant in screening outcomes of acute inferior wall MI with PCI.
Pediatric Myasthenia Gravis
Authors: Tiongson Emmanuelle 
Published: August 2023

Abstract:
Pediatric myasthenia gravis (MG) is a relatively rare, but very treatable condition. Prognosis in pediatric myasthenia gravis is favorable for minimal manifestation status (MMS) or remission when compared to adults. Ocular only presentations are more common, though severe refractory generalized MG presentations also occur. An observational examination is key to the diagnosis and follow-up of pediatric MG patients in the clinic setting. Treatment options are limited by side effect and growth considerations, as well as lack of approved MG medications in the pediatric population. Multidisciplinary care should be considered for pediatric MG, similar to other neuromuscular conditions seen in specialty care settings.
The Challenge of South Africa to Reduce Its High Unemployment
Authors: Mellet Andre 
Published: August 2023

The unemployment rate in South Africa has been in excess of 20% for many years. Various questions can be asked about policies and probable solutions to reduce unemployment. What is wrong with South African macroeconomic policies or is it rather what is wrong with economic and political coordination of policies? What is the probability of millions of South African inhabitants to rise out of poverty? Certain policies for example ASGISA have good foundations, but the main problem in South Africa is two-fold. Firstly, sustained high growth of 6% will not be achieved as long as economic principles are overshadowed by the political agenda of transformation in South Africa.Â Secondly, fundamental changes are needed in the South African economy and need urgent attention, but the lack of management at all levels in government to address the structural problems, handicap such changes.
The Worldwide Expansion of Education the Past Half-Century and its Impact upon the Global Economy
Authors: Wolhuter C. C. 
Published: August 2023

The past half-century has been witness to the largest education expansion drive in human history; as a worldwide education expansion project played itself out.Â This expansion has taken up a significant proportion of resources of nations.Â In the case of the developing countries education is almost invariably the biggest item on governmentâ€™s expenditure budgets.Â In the case of the United States of America (USA) federal funds allocated to education rose tenfold in the thirty year period 1970 to 2000, from US$ 9.2 billion to US$ 90.6 billion. One major motivation for this concentrated employment of resources is the belief that investment in education promotes, or indeed is a sine qua non for economic growth.Â Testing this supposed relation, especially in the contemporary era, is therefore timely.Â The aim of this article is to investigate the co-variation betweenÂ education effort (measured in terms of enrollment ratios) and economic performance (measured by per capita gross domestic product) of the various countries of the world, almost half a century ago; at the outset of the massive education expansion drive which took off during the second half of the twentieth century.Â
From Parents to Children: Intergenerational Transfers---A Case Study
Authors: Kumar Suchitra S 
Published: August 2023

This paper attempts to test whether women systematically get less education than their male siblings and is based on data drawn from a survey in Mumbai of 200 women and their male siblings.Â The regression models used explicitly take account of human capital factors. The results show that for similar levels of academic performances, family background etc; women systematically get less parental investment in their education than their male siblings. Thus, pure human capital models of labour market are inadequate to account for the gender perspective. Any analysis of the labour market must hence incorporate gender as an explicit variable.
Infrastructure and Human development in India: An Inter-state comparison
Authors: Gopalakrishna B.V , Leelavathi D.S. 
Published: August 2023

Economic development of a country depends very much on the availability of its infrastructural facilities particularly the development of sectors such as Agriculture, Industry and Service Sectors. An economyâ€™s infrastructure is more conveniently divided into two parts Physical Infrastructure and Social Infrastructure. Physical Infrastructure is directly concerned with the needs of such production sectors as agriculture, industry & trade. The physical infrastructure, include such services such as power, irrigation, transport telecommunication. On the other hand, social infrastructure comprising education, health and medical care, nutrition, housing and water supply which is instrumental in contributing to substantial improvements in human development, which in turn, initiate and accelerate economic development.Â Â Â Â Â Human Development is the process of widening peopleâ€™s choices and their level of well-being. The choices change over time and differ among societies according to their stage of developmentThe three essential choices for people are - to lead a long and healthy life, to acquire knowledge and to have access to the resources needed for a decent standard of living. If these choices are not available, many other opportunities remain inaccessible. Other choices, highly valued by many people include political, economic and social freedom, access to opportunities for being creative and productive and enjoying self-respect and guaranteed human rights
Inflation-Unemployment Trade Off: Evidence from Pakistan
Authors: Afzal Muhammad , Awais Samia 
Published: August 2023

High economic growth, price stability and low unemployment are the most enviable macroeconomic goals. The success of government policies is reflected in low inflation and low unemployment. The nature and costs of inflation and unemployment can have vital impact on the economy and society. Unemployment situation in Pakistan has aggravated because of rapid population growth, lacklustre economic growth, fiscal indiscipline, escalating debt-servicing and non- development expenditure which have adversely affected Pakistan economic development and poverty reduction. Import prices and fiscal indiscipline are the major causes of inflation. The empirical results show that the Phillips curve holds in Pakistan.Â The reduced-form Phillips curve structure reveals that the expected inflation is significant for all periods.The current unemployment exceeds the lagged unemployment which means that unemployment has been increasing at an increasing rate and this difference causes a significant change in current inflation. Lack of governance or bad governance has remained the crux of the problem. Unless foreign policy objectives are rationalised and good governance is assured, economic problems will haunt the policy- makers and the resolution of economic problems may assume pitiless faÃ§ade
The management of Monochorionic Monoamniotic (MCMA) twin pregnancy
Authors: Ernawati Ernawati , Qonitatillah Jihan , Sulistyono Agus 
Published: August 2023

HIGHLIGHTS

Monochorionic monoamniotic (MCMA) twin pregnancy has a significant risk of perinatal morbidity and mortality, including intrauterine fetal death (IUFD).
The risk of prematurity, the risk of death due to MCMA complications, the availability of the NICU, also high costs on preterm care were factors in deciding to terminate the pregnancy.
The ideal time to deliver monochorionic twins in order to reduce the risks of cord entanglement, growth discrepancies, and intrauterine fetal death is still a point of controversy.
Early diagnosis, intensive antenatal monitoring, patient and family decision would contribute to antenatal mortality reduction.

ABSTRACT
Objectives: To present the management of monochorionic monoamniotic (MCMA) twin pregnancy.
Case Report: Advanced prenatal treatment has improved the prognosis for Monochorionic Monoamniotic (MCMA) pregnancies; however, there is still no agreement on how to handle MCMA twins. The authors report 2 cases of monoamniotic monochorionic twin pregnancies. In the first case, a 30-years-old primi pregnant woman detected MCMA at 14 weeks of gestation; no complications related to MCMA were found; she planned delivery at 32 weeks, but one of the babies died in the womb at 31/32 weeks pregnant, a live baby born by cesarean section. The second case was a 36-year-old pregnant woman, on her third pregnancy, diagnosed with MCMA after 12 weeks of pregnancy, no complications related to MCMA, the baby was born at 32 weeks pregnant, and both babies survived. The management was the same in both cases, but different outcomes were obtained; in case 1, the baby died allegedly due to cord entanglement, which could not be detected during pregnancy.