bluuebunny/crossref_metadata_2025_split huggingface dataset:
Material History, Historied Materials and the Question of Epistemic Freedom in Ghana’s Medical Schools
Authors: Nott John 
Published: September 2023

Summary
Medical schools rely on a wide range of tools, technologies and materials for their teaching, on books, and bodies, and on the buildings which house them. This article considers the histories of this material culture in the three oldest medical schools operating in Ghana today. Borrowing theoretical concepts from Science and Technology Studies, medical anthropology and postcolonial political economy, this article takes that the material culture of modern medical education often binds contemporary pedagogy to outdated ideas and faraway places. The agential, proselytising nature of these historied materials agitates against the localisation of biomedicine and contributes to a distracting scientific imaginary which remains centred around historical, often imperial centres of knowledge production in Europe and North America.
‘We’ll have the bill (of costs), please’
Authors: Hewitt Edward 
Published: September 2023

Abstract
If a beneficiary of an estate or trust is unhappy with the level of legal fees that the personal representatives (PRs) or trustees have incurred and paid out of the fund, what, if anything, can he do? Over the past decade or so, several cases have grappled with this apparently simple question. The result seems to be a patchwork quilt of subtly inconsistent decisions. The latest instalment is Kenig v Thomson Snell & Passmore LLP, which provides yet another curve in the winding road to an answer, with potentially far-reaching implications, both for beneficiaries and for solicitors instructed by PRs and trustees.
Effects of extruded pet foods containing dried yeast (Saccharomyces cerevisiae) on palatability, nutrient digestibility, and fecal quality in dogs and cats
Authors: Davenport Gary M , Block Stephanie S , Adolphe Jennifer L 
Published: September 2023

Abstract
Global protein shortages and sustainability concerns have increased consumer demand for non-animal-derived protein. Dried whole-cell yeast (Saccharomyces cerevisiae) may be a suitable alternative to rendered protein meals in pet foods. The objective of this study was to investigate the effects of dried yeast in dog and cat foods on indicators that pet parents typically use to evaluate the suitability of a food for their pet. For this evaluation, two dog and two cat dry extruded diets were formulated. For each species, the test diet contained 10% dried yeast (Yeast) and the control diet was devoid of yeast (Control). Palatability, apparent total tract nutrient digestibility, and fecal quality of the foods were assessed in dogs and cats. Urine pH and specific gravity were measured in cats as indicators of urinary tract health. In dogs, the Yeast diet showed equivalent or better palatability compared to the Control diet based on total food consumption (P = 0.06), average daily consumption (day 1, P = 0.10; day 2, P = 0.54), and first choice preference over 2 consecutive days (P = 0.005). Cats showed a strong preference for the Yeast diet with more than double the consumption during the 2-d test period (P = 0.001). More cats showed a first-choice preference for the Yeast diet (24 vs. 16), but the difference was not statistically significant (P = 0.21). There were no significant differences in stool quality or nutrient digestibility when fed Yeast vs. Control diets to the dogs and cats (P &gt; 0.05). All cats produced urine with pH and specific gravity values within the normal range, though specific gravity was lower in the Control group (P = 0.003). This study provides support for the acceptability and digestibility of dog and cat diets containing dried yeast as an alternative protein source.
Competencies of junior medical doctors in managing seriously ill and injured children: time to rethink our current training approach?
Authors: Erasmus Louisa , Redfern Andrew , Smit Liezl 
Published: September 2023

Abstract

Background
The correct treatment of very ill and injured children is critical, yet little is known about the competencies of South African (SA) junior doctors in managing these children.

Methods
This survey documents SA junior doctors’ reported resuscitation training opportunities, experience, skills and knowledge.

Results
A total of 118 doctors (interns, medical officers and registrars) from paediatric departments affiliated with 7 medical schools, participated. Resuscitations were not rare events with 71% (84/118) reporting participation in &gt;10 resuscitations during the preceding 2 years. Yet a third of doctors have not attended an accredited resuscitation training course within the last 2 years; 34% (12/35) medical officers and 29% (18/63) registrars, respectively, with 42% (49/118) of all participants never receiving any formal resuscitation training during employment. Feedback on performance is not standard practice with only 8% (10/118) reporting consistent debriefing after a resuscitation. Although 72% (85/118) reported their resuscitation knowledge as adequate, 56% (66/118) passed the knowledge test.

Conclusion
This study recognized missed learning opportunities in junior doctors’ training, assessment, debriefing and knowledge which may adversely affect the quality of care in managing paediatric emergencies. This has implications for departmental and post-graduate training programmes.
General purpose models for intravenous anesthetics, the next generation for target-controlled infusion and total intravenous anesthesia?
Authors: Vellinga Remco , Eleveld Douglas J. , Struys Michel M.R.F. , van den Berg Johannes P. 
Published: September 2023

Purpose of review
There are various pharmacokinetic-dynamic models available, which describe the time course of drug concentration and effect and which can be incorporated into target-controlled infusion (TCI) systems. For anesthesia and sedation, most of these models are derived from narrow patient populations, which restricts applicability for the overall population, including (small) children, elderly, and obese patients. This forces clinicians to select specific models for specific populations.

Recent findings
Recently, general purpose models have been developed for propofol and remifentanil using data from multiple studies and broad, diverse patient groups. General-purpose models might reduce the risks associated with extrapolation, incorrect usage, and unfamiliarity with a specific TCI-model, as they offer less restrictive boundaries (i.e., the patient “doesn’t fit in the selected model”) compared with the earlier, simpler models. Extrapolation of a model can lead to delayed recovery or inadequate anesthesia. If multiple models for the same drug are implemented in the pump, it is possible to select the wrong model for that specific case; this can be overcome with one general purpose model implemented in the pump.

Summary
This article examines the usability of these general-purpose models in relation to the more traditional models.
Recent Progress in the Development and Clinical Application of New Drugs for Transthyretin Cardiac Amyloidosis
Authors: Zhou Juan , Li Yanfang , Geng Jing , Zhou Hong , Liu Lian , Peng Xiaochun 
Published: September 2023

Abstract:
Transthyretincardiac amyloidosis is a rare disease that has gained significant attention in recent years because of misfolding of transthyretin fibrils produced by the liver, leading to their deposition in the myocardium. The disease has an insidious onset, nonspecific clinical manifestations, and historically lacked effective drugs, making early diagnosis and treatment challenging. The survival time of patients largely depends on the extent of heart involvement at the time of diagnosis, and conventional treatments for cardiovascular disease do not provide significant benefits. Effective management of the disease requires treatment of its underlying cause. Orthotopic liver transplantation and combined hepato-heart transplantation have been clinically effective means of treating transthyretin cardiac amyloidosis mutants for many years. However, transplantation has many limitations in clinical practice. In recent years, the development of new drugs has brought new hope to patients. This review presents the latest advances in drug development and clinical application to provide a reference for clinicians managing transthyretin cardiac amyloidosis.
Potential Biomarker of Acute Anthracycline-induced Cardiotoxicity Among Children With Acute Lymphoblastic Leukemia: Cardiac Adriamycin-responsive Protein
Authors: Li Yiyang , Tian Chuan , Huang Si , Wang Yajun , Qiu Jiapeng , Ning Fan , Guo Junhao , Chen Qikang , Chen Riling , Ma Guoda 
Published: September 2023

Abstract:
This study aimed to investigate whether serum cardiac adriamycin-responsive protein (CARP) can serve as a sensitive and specific biomarker of anthracyclines (ANT)-induced cardiotoxicity. Fifty-five children with acute lymphoblastic leukemia were recruited. Before and after the administration of ANT, serum levels of CARP, high-sensitivity troponin T, creatine kinase-MB, and electrocardiogram were measured. Postchemotherapeutic clinical manifestations of cardiotoxicity were also investigated. Adverse cardiac events (ACEs) were graded according to the Common Terminology Criteria for Adverse Events 4.0. Then, the CARP expression was statistically analyzed among different groups. The receiver operating characteristic curve was used to evaluate the efficacy of CARP in predicting acute ANT-induced cardiotoxicity. After ANT chemotherapy, the serum CARP concentration increased in the non-ACEs group but decreased in the ACEs group (P < 0.05). In addition, not only the serum CARP levels (△CARP) was negatively correlated with the grade of ACEs (R=−0.754, P < 0.0001) but also the extent of QT interval corrected (QTc) prolongation (△QTc; R=−0.5592, P < 0.01). The area under the receiver operating characteristic curve of CARP was 90.94% (P < 0.0001), and the sensitivity and specificity were 88.64% and 91.67%, respectively, all of which are superior to △high-sensitivity troponin T, △creatine kinase-MB, and △QTc. In conclusion, serum CARP could serve as a novel sensitive and specific biomarker of acute ANT-induced cardiotoxicity, which is negatively associated with ACE grade.
MiR-590-3p Promotes the Phenotypic Switching of Vascular Smooth Muscle Cells by Targeting Lysyl Oxidase
Authors: Wang Lei , Zhang Lin , Cui Li-kun , Yue Xiao , Huang Li , Liu Na , Zhu Meng-die , Wang Zheng-bin 
Published: September 2023

Abstract:
We investigated the clinical characteristics of patients with acute aortic dissection (AAD) and miR-590-3p levels in serum, tissue, and vascular smooth muscle cells. The effect of miR-590-3p on the vascular smooth muscle cell phenotype was assessed, and the regulation of lysyl oxidase by miR-5903p was determined. C57BL/6 mice were used to investigate the incidence of AAD and effects of miR-5903p on AAD. The miR-590-3p levels were measured in the aortae of mice, and hematoxylin and eosin staining and Masson staining were performed to identify the morphological features of the aorta. Comparative analysis revealed significant differences in clinical characteristics between patients with AAD and healthy control subjects, with most patients with AAD exhibiting concomitant hypertension and nearly 50% having atherosclerosis. Lysyl oxidase was a direct target of miR-590-3p. Lysyl oxidase overexpression inhibited switching of the vascular smooth muscle cell phenotype from contractile to synthetic, but miR-590-3p overexpression significantly reversed this change. In the mouse model, miR-590-3p upregulation increased the incidence of AAD to 93.3%, and its incidence decreased to 13.3% after miR-590-3p inhibition. Hematoxylin and eosin and Masson staining revealed that the miR-590-3p agomiR group had a greater loss of the contractile phenotype in the dissected aortic wall and an increased number of muscle fibers in the aortic wall, which contributed to thickening of the aortic wall and the formation of a false lumen in aortic dissection. miR-590-3p might be pivotal in the pathogenesis of AAD. Thus, targeting miR-590-3p or its downstream pathways could represent a therapeutic approach for AAD.
First Series of Free Flap Reconstruction Using a Dedicated Robotic System in a Multidisciplinary Microsurgical Center
Authors: Beier Justus P. , Hackenberg Stephan , Boos Anja M. , Modabber Ali , Duong Dinh Thien An , Hölzle Frank 
Published: September 2023

Summary:
Robotic microsurgery is a novel technology for microsurgical free flap transplantation in reconstructive surgery. Recently, the first free flap transplantation using a dedicated robotic system for microsurgery (Symani Surgical System; Medical Microinstruments) was published for a single reconstructive case. For broader future application, evaluating its potential benefits in different anatomical regions, anastomotic configurations, and clinical scenarios is necessary. In this world-wide first free flap series using this robotic system, we describe our experience with this new technology in a multidisciplinary microsurgical center. The robotic system was used for different free flaps in a range of reconstructive applications in plastic surgery, oral and maxillofacial surgery, and head and neck surgery. A total of 23 flaps were performed, with all 23 arterial and a selection of two venous anastomoses being performed with the robotic system. Time for anastomoses was significantly longer than commonly. Five of the arterial robotic anastomoses had to be redone. All but one flap survived. We could show that this new dedicated microsurgical robotic system is feasible for carrying out robot-assisted anastomoses in end-to-end, as well as end-to-side fashion under varying clinical conditions and in different microsurgical subspecialties. However, some drawbacks still need to be overcome, which are partly related to individual and institutional learning curves, to finally estimate the potential benefit for robotic free flap surgery. Multidisciplinary application of the robotic system may accelerate this process by putting together different microsurgical backgrounds, while economic burden of establishing this new technology is spread among several departments.
Bodily maps of emotions and pain: tactile and hedonic sensitivity in healthy controls and patients experiencing chronic pain
Authors: Ojala Juhani , Suvilehto Juulia T. , Nummenmaa Lauri , Kalso Eija 
Published: September 2023

Abstract
Pain is an unpleasant sensory and emotional experience. Both pain and emotions are warning signals against outside harm. Interoception, bodily sensations of emotions can be assessed with the emBODY tool where participants colour the body parts where they feel different emotions. Bodily maps of emotions (BMoE) have been shown to be similar between healthy individuals independent of age, sex, cultural background, and language. We used this tool to analyze how these body maps may differ between healthy controls and patients with persistent pain. We recruited 118 patients with chronic pain. An algorithm-selected matched controls from 2348 individuals who were recruited through social media, message boards, and student mailing lists. After providing background information, the participants completed the bodily topography colouring tasks with the emBODY tool using tablets (patients) and online using their own devices (controls), for pain, sensitivity for tactile, nociceptive and hedonic stimuli, and for the 6 basic emotions and a neutral state. Patients with pain coloured significantly larger areas for pain and more negative emotions. On the whole, their BMoEs were dampened compared with healthy controls. They also coloured more areas for nociceptive but not for tactile or hedonic sensitivity. Patients and controls marked different body areas as sensitive to nociceptive and tactile stimulation, but there was no difference in sensitivity to hedonic touch. Our findings suggest that emotional processing changes when pain persists, and this can be assessed with these colouring tasks. BMoEs may offer a new approach to assessing pain.
Immediate CT change after thrombectomy predicting symptomatic hemorrhagic transformation
Authors: Yang Shang-Jung , Lu Yueh-Hsun , Huang Yi-Chen , Chan Lung , Ting Wei-Yi 
Published: September 2023

Background:
The prognostic value of contrast accumulation from noncontrast brain computed tomography (CT) conducted immediately after intra mechanical thrombectomy (MT) in patients with acute ischemic stroke to predict symptomatic hemorrhage was studied.

Methods:
Patients with acute ischemic stroke treated using MT between February 2015 and April 2019 were included. Contrast accumulation was defined as a high attenuation area observed on noncontrast brain CT conducted immediately after thrombectomy treatment, and the patients were categorized into (1) symptomatic hemorrhage, (2) asymptomatic hemorrhage, and (3) no hemorrhage according to the presence of hemorrhagic transformation and their clinical conditions. The pattern and extent of contrast accumulation were compared between patients with and without symptomatic hemorrhage. The maximal Hounsfield unit (HU) of cortical involvement in contrast accumulation was evaluated by calculating the sensitivity, specificity, odds ratio, and area under the receiver operating characteristic (ROC) curve.

Results:
In total, 101 patients with anterior circulation acute ischemic stroke were treated by endovascular intervention. Nine patients developed symptomatic hemorrhage and 17 developed asymptomatic hemorrhage. Contrast accumulation was associated with all types of hemorrhagic transformation (p < 0.01), and cortical involvement pattern was more frequently associated with symptomatic hemorrhage (p < 0.01). The area under the ROC curve was 0.887. The sensitivity and specificity for HU > 100 in cortical involvement predicting symptomatic hemorrhage after endovascular treatment were 77.8% and 95.7%, respectively, with an odds ratio of 77.0 (95% CI, 11.94-496.50; p < 0.01).

Conclusion:
Cortical involvement of contrast accumulation with a maximal HU > 100 predicts symptomatic hemorrhage after endovascular reperfusion treatment.
Efficacy and safety of once-daily prolonged-release tacrolimus versus twice-daily tacrolimus in kidney transplant recipients: A meta-analysis and trial sequential analysis
Authors: Wang Tair-Shin , Huang Kuan-Hua , Hsueh Kuan-Chun , Chen Hsin-An , Tam Ka-Wai , Sun Shu-Hui , Chen Cheng-Fong , Wang Chien-Ying , Tung Min-Che , Wang Yuan-Hung 
Published: September 2023

Background:
Kidney transplantation is the most important treatment for end-stage renal disease. Immunosuppressive therapies can prevent acute rejection for kidney transplant recipients. Tacrolimus is usually administered to prevent graft rejection after transplantation. Previous studies have indicated that once-daily tacrolimus may improve medication adherence. Therefore, this meta-analysis aimed to compare clinical outcomes between once-daily and twice-daily tacrolimus in de novo renal transplant patients.

Methods:
Eligible studies were identified from the Cochrane Library Database, PubMed, and Embase until July 2022. Those randomized controlled trials (RCTs) evaluating once-daily versus twice-daily tacrolimus formulations in de novo renal transplantation were included. A summary risk ratio (RR) and standardized mean difference (SMD) with the 95% confidence interval (CI) were estimated using a random-effects model.

Results:
In total, nine RCTs were included. There were no differences in biopsy-confirmed acute rejection rates between patients with once-daily and those with twice-daily tacrolimus (RR, 0.91; 95% CI, 0.73-1.13) in 12 months. Regarding renal function, there was no significant difference between the once-daily and twice-daily tacrolimus groups (SMD, −0.03; 95% CI, −0.12 to 0.07). In addition, the risk of graft failure, death, and adverse events in the first year was similar for the once-daily and twice-daily tacrolimus groups.

Conclusion:
Our major findings suggest that de novo renal transplantation recipients receiving once-daily tacrolimus immediately after transplantation have comparable efficacy and safety with those recipients who received twice-daily tacrolimus. Therefore, once-daily tacrolimus medication can be an alternative for de novo renal transplantation recipients.
Waist circumference and blood pressure in Brazilian children
Authors: Grawe Vanessa Heidemann , Mastroeni Silmara Salete de Barros Silva , Corrêa Zaíne Glaci Duarte , Mastroeni Marco Fabio 
Published: September 2023

Aim
We aimed to examine the association between waist circumference and blood pressure (BP) in children at 9 years of age.

Methods
This was a cross-sectional study of 142 children enrolled in a cohort study conducted at the participants’ homes in southern Brazil. SBP and DBP were measured using the auscultatory method. Waist circumference was measured with a 150-cm flexible tape. Logistic regression adjusted for important covariates was used to examine the association between waist circumference and BP.

Results
The prevalence of high BP in children was 20.4%. High BP was more prevalent in males (69.0%). The average SBP/DBP on the right arm was 98/60 mmHg in females and 101/62 mmHg in males. An important proportion of children was classified as having high BP and BMI (44.8%) and waist circumference (50.0%) > 85th percentile (P < 0.01). Logistic regression analysis showed that children with high BMI and waist circumference were 3.91 (95% confidence interval, 1.31–11.71, P = 0.015) times more likely to have high BP than those ≤85th percentile, even after adjusting for other covariates.

Conclusion
This study revealed that waist circumference was associated with both SBP and DBP in 9-year-old children and increased waist circumference was the determining factor of cardiovascular risk.
Intestinal proteases
Authors: Rao Sameer , Grover Madhusudan 
Published: September 2023

Purpose of review
Proteases constitute a group of enzymes that hydrolyze peptide bonds. Intestinal proteases are an integral part of gut homeostasis and digestion. This review discusses the broader classification of proteases, regulation of proteolytic activity (PA) in the intestinal tract, and how dysregulation of intestinal proteases contributes to the pathophysiology of conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and celiac disease. We also discuss recent advancements in therapeutic modulation that directly or indirectly target intestinal proteases and can be utilized to treat these illnesses.

Recent findings
Host and microbiota derived proteases have been associated with symptoms in subsets of patients with IBS, IBD and celiac disease. Elevated PA mediates barrier dysfunction, visceral hypersensitivity as well as immune activation and inflammation. Recent mechanistic studies have revealed the nature of disease-associated proteases and mechanisms regulating their activity, particularly those driven by the microbiota. Advancements in activity-based probes have allowed novel ways of in vivo imaging of PA. Newer strategies targeting proteases include monoclonal antibodies, engineered microbiota as well as specific protease inhibitors.

Summary
Significant progresses made in the detection as well as regulation of PA is likely to provide therapeutic advancements for gastrointestinal diseases.