bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver impaction technique improves technical success rate of guidewire insertion during EUS-guided hepaticogastrostomy (with video)
Authors: Nakamura Junichi , Ogura Takeshi , Ueno Saori , Okuda Atsushi , Nishioka Nobu , Uba Yuki , Tomita Mitsuki , Bessho Kimi , Hattori Nobuhiro , Nishikawa Hiroki 
Published: August 2023

Background: If the guidewire becomes kinked by the needle, guidewire manipulation may be difficult, and can cause complications such as guidewire shearing or injury during endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). To overcome this matter, we have previously described a technical tip for preventing guidewire injury, termed ‘liver impaction technique’. However, its technical feasibility has been not reported in the setting of a large patient cohort. Objectives: The aim of study was to evaluate the clinical usefulness of the liver impaction technique during EUS-HGS. Design: Retrospective, single-center study. Methods: This retrospective study included consecutive patients who underwent EUS-HGS between April 2018 and September 2022. The primary outcome of this study was the technical success rate of guidewire insertion using the liver impaction technique. Results: A total of 166 patients were enrolled in this study. Initial successful guidewire insertion without using liver impaction technique was obtained in 108 patients (65.1%). Among 58 patients in whom guidewire insertion failed initially, guidewire advancement into the periphery of the bile duct was observed in 32 patients (55.2%) and into a non-interest bile duct branch was observed in 26 patients (44.8%). Liver impaction technique contributed to increasing the technical success rate of guidewire insertion from 65.1% to 95.8%. Overall, adverse events were observed in 12 patients (7.2%; bile peritonitis n = 9, cholangitis n = 3), and these adverse events were Grade I. Among patients who underwent liver impaction technique ( n = 58), adverse events were observed in two patients (3.4%; bile peritonitis). Also, guidewire sharing was not observed in any patients during liver impaction technique. Conclusions: In conclusion, the liver impaction technique may be helpful during EUS-HGS to obtain successful guidewire insertion into the biliary tract of interest.
Fluorescence-based Evaluation of the Efficacy of Augmented Reality-assisted Toothbrush on Oral Hygiene Practices Among 6–8 Years Old Children
Authors: Dey S , Deshmukh S , Umamaheshwari S  , Dheeraj L  , Sinchan HG  
Published: August 2023

Aim: Effective toothbrushing is the most simple way to maintain a child’s oral hygiene for a cavity-free mouth. Yet, most children find it an uninteresting task and they fail to understand its scientific basis. Augmented reality (A-R)-assisted toothbrushes for pediatric population are commercially available to make toothbrushing interactive, interesting, and educative for the child, aided by gamification providing an interactive videogame platform between the real and the virtual world. The aim of the study was to evaluate the efficacy of A-R-assisted brushing experience of children with respect to fluorescence imaging data and plaque Streptococcus mutans count at clinical and microbiological levels, respectively. Materials and Methods: A total of 32 children in the age group of 6-8 years were included and allocated in two study groups (A-R-assisted toothbrushing and manual toothbrushing). Fluorescence-based lesion area scoring was done using FC, Duerr Dental, Vistaproof, Germany. Microbiological analysis of plaque Streptococcus mutans was done to evaluate change in bacterial count. The parameters were recorded again after two weeks. Pre- and post-intervention scores were subjected to statistical analysis. Results: Significantly higher reduction of fluorescent scores and mean bacterial count were found in A-R-assisted tooth-brushing group when compared to that of manual toothbrushing. Conclusion: Based on the findings of the study, A-R-assisted toothbrushing proves to be an effective tool for motivating and maintaining oral hygiene among children and efforts should be made in incorporating this practice in daily domestic healthcare.
Epidemiology of Acute and Overuse Injuries in Underwater Rugby
Authors: Lutter Christoph , Gräber Sina , Jones Gareth , Groß Justus , Tadda Lukas , Tischer Thomas 
Published: August 2023

Background: Underwater rugby (UWR) is a team sport. Athletes require a high degree of strength, endurance, speed, and coordination involving intense physical contact. Currently, a paucity of literature exists regarding injury occurrence in UWR. Purpose: To examine the nature and prevalence of acute and overuse injuries in UWR. Study Design: Descriptive epidemiology study. Methods: Between November 2020 and March 2021, a total of 720 German UWR athletes were invited to take an online survey developed by orthopaedic specialists with UWR athletes. Data were recorded regarding general and health-related information, training habits, acute injuries that necessitated an interruption in training and/or doctor consultation, as well as overuse injuries. Overuse injuries were evaluated using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Statistical analyses included t tests or rank sum tests depending on normality of distribution. A nonparametric Kruskal-Wallis 1-way analysis of variance on ranks was used for nonnormally distributed data among several groups. Results: This study included 161 active athletes (mean ± SD, 36.1 ± 11.9 years old; 75.3% male) for analysis, of whom 90.1% were competing regularly. The performance-level distribution was as follows: first German national league (n = 73), second German national league (n = 46), state league (n = 17), district league (n = 1), and no league (n = 24). The mean ± SD sport-specific training workload was 5.6 ± 3.0 h/wk, including UWR training, additional swimming (n = 71; 44.1%), strength (n = 70; 43.5%), and/or endurance training (n = 102; 63.4%). Acute injuries were recorded in 78.9% of all athletes. The most typical locations for acute injuries were hand/finger (42.4%), head/face (concussion, ruptured eardrum; 18.1%), wrist (5.5%), or spine (5.0%). Overuse injuries were reported by 42.9% of the participants. The predominant locations for overuse injuries were hand/finger (18.8%), shoulder/clavicle (14.1%), spine and wrist (10.7% each), head/face (8.7%), and ankle joint and knee (6.7% each). Conclusion: In the current study, 3 of 4 athletes reported at least 1 acute injury, and 2 of 5 athletes reported at least 1 overuse injury. Leading injury regions were the hand/finger, head/ear, wrist, and spine.
Analysis of the vibrational characteristics of diamane nanosheet based on the Kirchhoff plate model and atomistic simulations
Authors: Zheng Zhuoqun , Deng Fengyu , Su Zhu , Zhan Haifei , Wang Lifeng 
Published: August 2023

AbstractSingle layer diamond—diamane, has been reported with excellent mechanical properties. In this work, molecular dynamics (MD) simulation and Kirchhoff plate model are utilized to investigate the vibrational characteristics of diamane sheets. The mechanical parameters of diamane sheets, including bending stiffness, Young’s modulus, Poisson’s ratio and coefficient of thermal expansion, are calibrated by using MD simulations. The natural frequencies and corresponding modal shapes of the diamane sheets predicted by the Kirchhoff plate model agree well with that obtained from the MD simulations. It is found that the edges exert marginal effect on the modal shapes when free boundary conditions are applied. Additionally, the Kirchhoff plate model considering the thermal expansion provides reasonable prediction for the natural frequencies of the diamane sheets with all boundary clamped under varying temperatures. This study offers valuable insights into the vibrational properties of diamane sheets, from both a simulation and theoretical standpoint. The findings would be beneficial for the design of nanoscale mechanical resonators utilizing these novel carbon materials.
scSNPdemux: a sensitive demultiplexing pipeline using single nucleotide polymorphisms for improved pooled single-cell RNA sequencing analysis
Authors: Wong John K. L. , Jassowicz Lena , Herold-Mende Christel , Seiffert Martina , Mallm Jan-Philipp , Lichter Peter , Zapatka Marc 
Published: August 2023

Abstract
Background
Here we present scSNPdemux, a sample demultiplexing pipeline for single-cell RNA sequencing data using natural genetic variations in humans. The pipeline requires alignment files from Cell Ranger (10× Genomics), a population SNP database and genotyped single nucleotide polymorphisms (SNPs) per sample. The tool works on sparse genotyping data in VCF format for sample identification.

Results
The pipeline was tested on both single-cell and single-nuclei based RNA sequencing datasets and showed superior demultiplexing performance over the lipid-based CellPlex and Multi-seq sample multiplexing technique which incurs additional single cell library preparation steps. Specifically, our pipeline demonstrated superior sensitivity and specificity in cell-identity assignment over CellPlex, especially on immune cell types with low RNA content.

Conclusions
We designed a streamlined pipeline for single-cell sample demultiplexing, aiming to overcome common problems in multiplexing samples using single cell libraries which might affect data quality and can be costly.
Rapid neck elongation in Sauropterygia (Reptilia: Diapsida) revealed by a new basal pachypleurosaur from the Lower Triassic of China
Authors: Liu Qi-Ling , Cheng Long , Stubbs Thomas L. , Moon Benjamin C. , Benton Michael J. , Yan Chun-Bo , Tian Li 
Published: August 2023

AbstractNeck elongation has appeared independently in several tetrapod groups, including giraffes and sauropod dinosaurs on land, birds and pterosaurs in the air, and sauropterygians (plesiosaurs and relatives) in the oceans. Long necks arose in Early Triassic sauropterygians, but the nature and rate of that elongation has not been documented. Here, we report a new species of pachypleurosaurid sauropterygian, Chusaurus xiangensis gen. et sp. nov., based on two new specimens from the Early Triassic Nanzhang-Yuan’an Fauna in the South China Block. The new species shows key features of its Middle Triassic relatives, but has a relatively short neck, measuring 0.48 of the trunk length, compared to > 0.8 from the Middle Triassic onwards. Comparative phylogenetic analysis shows that neck elongation occurred rapidly in all Triassic eosauropterygian lineages, probably driven by feeding pressure in a time of rapid re-establishment of new kinds of marine ecosystems.
Quick adaptation of the organisation of general practices during the COVID-19 pandemic in the Netherlands
Authors: Groenewegen Peter P. , van den Muijsenbergh Maria , Batenburg Ronald , Van Poel Esther , van den Broek Stijn , Bussche Pierre Vanden , Willems Sara 
Published: August 2023

Abstract
Background
General practices have adapted the practice organisation to the circumstances of the COVID-19 pandemic. In this article we describe several adjustments in general practices in the field of patient flow management, appointments, triage, referral and infection prevention. We also examined how practices relate to the policy of the government and of the professional organisations during the pandemic.

Methods
A cross-sectional online survey was conducted among a sample of 893 general practitioners (GPs) during February and March 2021. The response rate was 17%. Because the questionnaire concerns practices and not individual GPs, one practice owner per practice received an invitation with a link to the online questionnaire. One reminder has been sent.

Results
General practices adapted their organisation during the corona pandemic, partly based on information and advice from their professional organisations. The adjustments were necessary to ensure that patient care continued as much and as safely as possible, often remotely. The use of video consultations quickly increased from 6% to 65% of the practices. The cooperation with neighbouring practices improved and practices felt supported by the professional organisations.

Conclusions
The pandemic itself, remote care and stricter patient flow management have put pressure on the quality of care and patient safety. The accessibility of the practices was sometimes limited. In the perception of patients, this was stronger than in reality.
Associations between cadmium exposure and whole-body aging: mediation analysis in the NHANES
Authors: Zhang Ya , Liu Mingjiang , Xie Ruijie 
Published: August 2023

Abstract
Introduction
Even though cadmium (Cd) exposure and cellular senescence (telomere length) have been linked in previous studies, composite molecular aging biomarkers are more significant and reliable factors to consider when examining the connection between metal exposure and health outcomes. The purpose of this research was to assess the association between urinary cadmium (U-Cd) and whole-body aging (phenotypic age).

Methods
Phenotypic age was calculated from chronological age and 9 molecular biomarkers. Multivariate linear regression models, subgroup analysis, and smoothing curve fitting were used to explore the linear and nonlinear relationship between U-Cd and phenotypic age. Mediation analysis was performed to explore the mediating effect of U-Cd on the association between smoking and phenotypic age.

Results
This study included 10,083 participants with a mean chronological age and a mean phenotypic age of 42.24 years and 42.34 years, respectively. In the fully adjusted model, there was a positive relationship between U-Cd and phenotypic age [2.13 years per 1 ng/g U-Cd, (1.67, 2.58)]. This association differed by sex, age, and smoking subgroups (P for interaction < 0.05). U-Cd mediated a positive association between serum cotinine and phenotypic age, mediating a proportion of 23.2%.

Conclusions
Our results suggest that high levels of Cd exposure are associated with whole-body aging.
Association of blood total immunoglobulin E and eosinophils with radiological features of bronchiectasis
Authors: Ren Jiaqi , Chen Ai , Wang Jun , Chang Chun , Wang Juan , Sun Lina , Sun Yongchang 
Published: August 2023

Abstract
Background
Our study aimed to investigate whether serum total IgE and blood eosinophils were associated with radiological features of bronchiectasis in a Chinese cohort.

Methods
We retrospectively enrolled bronchiectasis patients who visited Peking University Third Hospital from Jan 1st, 2012 to Oct 7th, 2021. The clinical, laboratory and chest CT characteristics were analyzed in association with serum total IgE level and blood eosinophil count.

Results
A total of 125 bronchiectasis patients were enrolled, with 50.4% (63/125) female, and a mean age of 62.4 ± 14.1 years. The median serum total IgE level and blood eosinophil count were 47.7 (19.8, 123.0) KU/L and 140 (90, 230) cells/µl, respectively. In patients with a higher than normal (normal range, 0–60 KU/L) total IgE (43.2%, n = 54), more lobes were involved [4 (3, 5) vs. 3 (2, 4), p = 0.008], and mucus plugs were more common (25.9% vs. 9.9%, p =0.017) on HRCT, as compared to those with a normal level of total IgE. The higher IgE group was more likely to have bilateral involvement (p = 0.059), and had numerically higher Smith and Bhalla scores, but the differences were not statistically significant. In patients with an eosinophil count ≥ 150 cells/µl (49.6%, n = 62), the number of lobes involved was greater [4 (3, 5) vs. 3 (2, 4), p = 0.015], and the Smith and Bhalla scores were higher [9 (5, 12) vs. 6 (3, 9), p = 0.009, 7 (5, 11) vs. 5 (3, 9), p = 0.036]. The Smith score was correlated positively with the eosinophil count (r = 0.207, p = 0.020). Fractional exhaled nitric oxide (FeNO) was correlated with total IgE (r = 0.404, p = 0.001) and eosinophil count (r = 0.310, p = 0.014).

Conclusions
Our study demonstrated that serum total IgE and the blood eosinophil count were associated with the radiological extent and severity of bronchiectasis, necessitating further investigation on the role of T2 inflammation in structural abnormalities of this heterogeneous disease.
Cost-effectiveness analysis of Smart Triage, a data-driven pediatric sepsis triage platform in Eastern Uganda
Authors: Li Edmond C. K. , Tagoola Abner , Komugisha Clare , Nabweteme Annette Mary , Pillay Yashodani , Ansermino J. Mark , Khowaja Asif R. 
Published: August 2023

Abstract
Background
Sepsis, characterized by organ dysfunction due to presumed or proven infection, has a case-fatality over 20% in severe cases in low-and-middle income countries. Early diagnosis and treatment have proven benefits, prompting our implementation of Smart Triage at Jinja Regional Referral Hospital in Uganda, a program that expedites treatment through a data-driven triage platform. We conducted a cost-effectiveness analysis of Smart Triage to explore its impact on patients and inform multicenter scale up.

Methods
The parent clinical trial for Smart Triage was pre-post in design, using the proportion of children receiving sepsis treatment within one hour as the primary outcome, a measure linked to mortality benefit in existing literature. We used a decision-analytic model with Monte Carlo simulation to calculate the cost per year-of-life-lost (YLL) averted of Smart Triage from societal, government, and patient perspectives. Healthcare utilization and lost work for seven days post-discharge were translated into costs and productivity losses via secondary linkage data.

Results
In 2021 United States dollars, Smart Triage requires an annuitized program cost of only $0.05 per child, but results in $15.32 saved per YLL averted. At a willingness-to-pay threshold of only $3 per YLL averted, well below published cost-effectiveness threshold estimates for Uganda, Smart Triage approaches 100% probability of cost-effectiveness over the baseline manual triage system. This cost-effectiveness was observed from societal, government, and patient perspectives. The cost-effectiveness observed was driven by a reduction in admission that, while explainable by an improved triage mechanism, may also be partially attributable to changes in healthcare utilization influenced by the coronavirus pandemic. However, Smart Triage remains cost-effective in sensitivity analyses introducing a penalty factor of up to 50% in the reduction in admission.

Conclusion
Smart Triage’s ability to both save costs and avert YLLs indicates that patients benefit both economically and clinically, while its high probability of cost-effectiveness strongly supports multicenter scale up. Areas for further research include the incorporation of years lived with disability when sepsis disability weights in low-resource settings become available and analyzing budget impact during multicenter scale up.

Trial registration
NCT04304235 (registered on 11/03/2020, clinicaltrials.gov).
A novel phage carrying capsule depolymerase effectively relieves pneumonia caused by multidrug-resistant Klebsiella aerogenes
Authors: Cui Xiaohu , Du Bing , Feng Junxia , Feng Yanling , Fan Zheng , Chen Jinfeng , Cui Jinghua , Gan Lin , Fu Tongtong , Tian Ziyan , Zhang Rui , Yan Chao , Zhao Hanqing , Xu Wenjian , Xu Ziying , Yu Zihui , Ding Zanbo , Li Zhoufei , Chen Yujie , Xue Guanhua , Yuan Jing 
Published: August 2023

Abstract
Background
Klebsiella aerogenes can cause ventilator-associated pneumonia by forming biofilms, and it is frequently associated with multidrug resistance. Phages are good antibiotic alternatives with unique advantages. There has been a lack of phage therapeutic explorations, kinetic studies, and interaction mechanism research targeting K. aerogenes.

Methods
Plaque assay, transmission electron microscopy and whole-genome sequencing were used to determine the biology, morphology, and genomic characteristics of the phage. A mouse pneumonia model was constructed by intratracheal/endobronchial delivery of K. aerogenes to assess the therapeutic effect of phage in vivo. Bioinformatics analysis and a prokaryotic protein expression system were used to predict and identify a novel capsule depolymerase. Confocal laser scanning microscopy, Galleria mellonella larvae infection models and other experiments were performed to clarify the function of the capsule depolymerase.

Results
A novel lytic phage (pK4-26) was isolated from hospital sewage. It was typical of the Podoviridae family and exhibited serotype specificity, high lytic activity, and high environmental adaptability. The whole genome is 40,234 bp in length and contains 49 coding domain sequences. Genomic data show that the phage does not carry antibiotic resistance, virulence, or lysogenic genes. The phage effectively lysed K. aerogenes in vivo, reducing mortality and alleviating pneumonia without promoting obvious side effects. A novel phage-derived depolymerase was predicted and proven to be able to digest the capsule, remove biofilms, reduce bacterial virulence, and sensitize the bacteria to serum killing.

Conclusions
The phage pK4-26 is a good antibiotic alternative and can effectively relieve pneumonia caused by multidrug-resistant K. aerogenes. It carries a depolymerase that removes biofilms, reduces virulence, and improves intrinsic immune sensitivity.
Level and correlates of disrespect and abuse among newborns in selected public hospitals of Addis Ababa, Ethiopia
Authors: Gezahegn Rediet , Estifanos Abiy Seifu 
Published: August 2023

Abstract
Background
The provision of respectful and dignified maternal and newborn care is an important component of the quality of childbirth care. Although a growing body of evidence was generated on disrespect and abuse (D&A) of women during childbirth in the past decade there is limited evidence on D&A experienced by newborns. Our study aimed to determine the level of and factors associated with D&A among newborns.

Methods
We conducted the study in three public hospitals in Addis Ababa. We directly observed childbirth care starting from the first stage of labor through two hours after the birth of 498 mother–baby dyads. We used frequencies and percentages to describe different forms of D&A among newborns. We used binary and multivariable logistic regression analysis to assess the association between the D&A among newborns and independent variables.

Result
All of the newborns 496/496 (100%) experienced at least one form of D&A. Physical abuse was experienced by 41.1% of newborns in the form of unnecessary airway suctioning (23.2%) or slapping or holding upside down (33.5%). Additionally, 42.3% weren’t dried immediately after birth, 9.1% weren’t placed on the mother’s abdomen skin-to-skin, 61.7% had their cord cut before 1 min of birth, 34.9% weren’t breastfed within an hour of birth, 24.2% didn’t receive vitamin K and 1.8% didn’t receive tetracycline. All newborns who developed complications (69/69) received treatments without the consent of parents/caregivers. Moreover, 93.6% of parents/caregivers didn’t receive explanations regarding newborn care while the lack of breastfeeding counseling and thermal support during the immediate post-partum period was 87.3%. The likelihood of D&A was higher among newborns who were preterm (AOR = 2.02; 95% CI: 1.11–3.69), female (AOR = 2.01; 95% CI: 1.37–2.95), delivered assisted by instrument (AOR = 2.19; 95%CI: 1.20–3.99), whose mothers reside in rural areas (AOR = 1.97; 95%CI: 1.22–3.20), born from unmarried mothers (AOR = 2.77; 95%CI (1.26–6.06) and whose mothers received fewer than four-time antenatal care (ANC) visits (AOR = 2.37; 95%CI: 1.42–3.96).

Conclusion
Our study found a high magnitude D&A among newborns. Gestational age at birth, sex of the newborn, maternal residence, maternal marital status, number of ANC visits, and mode of delivery were statistically significantly associated with D&A among newborns.