bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidelay Arterial Spin Labeling Versus Computed Tomography Perfusion in Penumbra Volume of Acute Ischemic Stroke
Authors: Yan Chuming , Yu Fan , Zhang Yingjie , Zhang Miao , Li Jingkai , Wang Zixin , Lu Jie , Ma Qingfeng 
Published: March 2023

Background:
Multidelay arterial spin labeling (ASL) is a novel perfusion method of ASL, with arterial transit time (ATT) calculated by multiple postlabeling delays to correct cerebral blood flow (CBF). We verify the accuracy of multidelay ASL in evaluating the ischemic penumbra and perfusion levels in patients with acute ischemic stroke, compared with computed tomography perfusion (CTP).

Methods:
Patients with acute ischemic stroke with anterior circulation large vessel occlusion received baseline CTP, multidelay ASL, and diffusion-weighted imaging (DWI) in succession. Multidelay ASL image was processed to reconstruct ATT, CBF without ATT correction, and CBF corrected by ATT. The consistency of hypoperfusion and ischemic penumbra volume calculated by CTP and multidelay ASL were quantified by intraclass correlation coefficient (ICC) in 2-way mixed effects, absolute agreement, and single measure. Wilcoxon signed-rank test was used to compare the difference in penumbra volume between CTP, corrected ASL, and uncorrected ASL.

Results:

Thirty patients were included. Hypoperfusion volume based on multidelay ASL with different thresholds were 117.95 (87.77–151.49) mL for corrected relative CBF<40%, 130.29 (85.99–249.37) mL for CBF corrected by ATT<20 mL·100g
-1
·min
-1
, no statistical difference (
P
>0.05) compared with the volume of CTP, and consistency was almost excellent (ICC, 0.91) and substantial consistent (ICC, 0.727). The volumes of ischemic penumbra were 91.00 (42.68–125.27) mL for corrected relative CBF<40%-DWI, 108.94 (62.03–150.86) mL for CBF corrected by ATT<20 mL·100 g
-1
·min
-1
-DWI, which showed no statistical difference compared with the penumbra volume of CTP (
P
>0.05). The consistency was excellent (ICC, 0.822) and moderate (ICC, 0.501), respectively. The volume of uncorrected relative CBF <40%-DWI was 209.57 (123.21–292.45) mL, statistically larger than corrected relative CBF <40%-DWI (
P
<0.001) and CTP (
P
<0.001). The volume of uncorrected CBF<20 mL·100g
-1
·min
-1
-DWI was 186.23 (86.56–298.22) mL, statistically larger than CBF corrected by ATT<20 mL·100g
-1
·min
-1
-DWI (
P
<0.001) and CTP(
P
<0.001).

Conclusions:
The volume of ischemic penumbra determined by CBF/DWI mismatch based on multidelay ASL is consistent with CTP. The penumbra volume calculated by CBF adjusted by ATT is more accurate.
“Nourishment of the Soul” – Music, Medicine, and Food in Ottoman Culture
Authors: Haug Judith I. 
Published: March 2023

Abstract
The phrase “music is the nourishment of the soul” reflects a century-old complex of musical, medical, and astrological thinking; integrated notions of celestial and terrestrial harmony, humoral medicine and ethos theory that reach back to Ancient Greece. Adopted into Islamicate philosophy, those theories were combined with a modal system that amplified them. The present paper traces them in various Ottoman texts with the aim of understanding how concepts of music theory, astrology, medicine, and food interacted. A crucial question is whether music theory sources can be brought into a relationship with descriptions of musical (therapy) practices in hospitals.
Maunaṃ Sammatilakṣaṇam? The Eligibility of Women for Vedic Study in Dvaita Vedānta
Authors: Rao Anusha S 
Published: March 2023

Abstract
The traditional schools of Vedānta agree that women do not have the eligibility for Vedic study and ritual performance. However, commentators of Vedānta traditions must contend with references to women who are seers and learners in the Vedas. Madhva (1238–1317), the founder of Dvaita Vedānta, lays down a special category of superior (uttama) women who possess the eligibility for Vedic study. But does this category include human women, or is it limited to divine beings? This paper traces the history of shifts in the doctrine of eligibility as envisioned in the writings of major Mādhva thinkers in commentarial literature, arguing that commentators from the sixteenth century attempted to close down an earlier openness and ambiguity in the doctrine, thereby excluding human women from a special category, that would, in theory, allow them access to the Vedas.
Road guardrail beam made of natural stem (Stipa tenacissima L.) eco-composite: Impact energy absorption improvement by stems and pre-tensioning
Authors: Helaili Sofiene , Bettaieb Sirine , Tarhouni Radhoine 
Published: March 2023

Reducing accidents, deaths, and serious injuries is an objective to be achieved by every health and road authority. To avoid road leaving, rigid barriers or stretched cables are used at the edges of the roads. These structures are based on metallic materials. This paper presents an innovative structure based on a composite reinforced with natural esparto stems as road barriers absorbing shock energy. The structure is lightened and reinforced by tensioned cables to ensure the prestressing of the whole. Prestressing is a technique widely used in civil engineering but rarely in composites. To develop new crash beam barriers based on Epoxy/Alfa10% material, Charpy tests were conducted to determine the absorbed energy per section of material per weight. Knowing the energy to be absorbed, the section and weight of the barrier can be designed. In this paper, physical tests were conducted on solid, solid-compressed, perforated, and perforated-cable-reinforced specimens according to the ASTM E23-18 standard. The results show that the compression prestressing improves the Epoxy impact energy absorption by 37.22%. The Epoxy/Alfa10% composite compression prestressing improves the absorbed energy by 67.7%. The Epoxy/Alfa10% compressed, perforated, and reinforced by cables composites gives a better result than the raw Epoxy material, with a minimum improvement of 22.69% with respect to the ratio Resilience value of Charpy V-notch specimen (KCV)/weight. Reinforcement of holed samples with cables gives the best energy absorption results on all experimental tests for both materials with a value of 8.83 J. Finite element models calibrated on Aluminum to be predictive are developed for the four types of specimens.
Value of Opening the Middle Meatus in Patients With Nasal Airway Obstruction
Authors: Wei Hongzheng , Wan Lianqi , Zhang Yuan , Li Yanru , Xu Wen , Li Yunchuan , Han Demin 
Published: March 2023

Objectives While surgeries to correct the anatomical malformations that cause nasal airway obstruction (NAO) are generally successful, the outcomes of such procedures are often unsatisfactory. The aim of the present study was to assess the value of opening the middle meatus in patients with NAO. Methods Thirty-four patients with nasal obstruction due to nasal septal deviation were included in this study. After randomization, the middle meatus was either opened or not opened during septoplasty. The patients were evaluated through pre- and postoperative rhinomanometry and acoustic rhinometry. The Visual Analog Scale (VAS) scores of subjective symptoms along with responses to the 20-item Sinonasal Outcome Test (SNOT-20) were obtained before surgery and three months after surgery. Results The VAS scores and SNOT-20 responses improved significantly in both groups after surgery. The effective treatment rate based on the nasal congestion score (NCS) was 64.7% in the single group (septoplasty alone) and 100% in the combined group (septoplasty in conjunction with opening the middle meatus), and the difference was statistically significant ( P = .018). In both groups, surgery significantly improved nasal flow, resistance, minimal cross-sectional area, cross-sectional area 6 cm (CA6) from the anterior nostril and nasal volume. Nasal volume and CA6 after surgery were statistically different between the 2 groups ( P = .004 and .019, respectively). Conclusions Opening the middle meatus may further improve the subjective perception of patency on the basis of septoplasty.
Nutritional literacy levels of university academic and administrative staff: A cross-sectional study from Turkey
Authors: Demirer Büşra , Yardımcı Hülya 
Published: March 2023

Aim This study aimed to evaluate the nutritional literacy levels of university academic and administrative staff. Methods Data were collected with a questionnaire including sociodemographic variables, some eating habits, and the Nutritional Literacy Assessment Tool of Adults. A total of 413 individuals, 211 women (51.1%) and 202 men (48.9%), aged 23–64 (mean: 37.41 ± 10.04 years), were included in the study. The data obtained were evaluated with the SPSS 25.0 statistical package program. Results It was found that the nutritional literacy level of 18.15% of the participants is at the borderline, 81.85 are sufficient. Women's nutrition literacy scores are significantly higher than men's ( p = 0.034). A significant relationship was found between nutritional literacy, socioeconomic status, and some eating habits ( p < 0.05). The average daily water consumption of individuals with sufficient nutritional literacy is statistically significantly higher than those with borderline nutritional literacy ( p < 0.001). It was determined that individuals with borderline nutritional literacy skipped meals more frequently ( p < 0.05). Conclusion The present study suggests that nutritional literacy may be effective in developing healthy eating behaviors. The study's results can guide the determination of methods that will improve nutritional literacy and increase awareness in the future.
Role of the Anterior Cruciate Ligament, Anterolateral Complex, and Lateral Meniscus Posterior Root in Anterolateral Rotatory Knee Instability: A Biomechanical Study
Authors: Willinger Lukas , Athwal Kiron K. , Holthof Sander , Imhoff Andreas B. , Williams Andy , Amis Andrew A. 
Published: March 2023

Background: Injuries to the anterior cruciate ligament (ACL), Kaplan fibers (KFs), anterolateral capsule/ligament (C/ALL), and lateral meniscus posterior root (LMPR) have been separately linked to anterolateral instability. Purpose: To investigate the contributions of the ACL, KFs, C/ALL, and LMPR to knee stability and to measure instabilities resulting from their injury. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen human knees were tested robotically to determine restraints of knee laxity at 0° to 90° of flexion. An 88-N anterior-posterior force (anterior and posterior tibial translation), 5-N·m internal-external rotation, and 8-N·m valgus-varus torque were imposed and intact kinematics recorded. The kinematics were replayed after sequentially cutting the structures (order varied) to calculate their contributions to stability. Another 10 knees were tested in a kinematics rig with optical tracking to measure instabilities after sequentially cutting the structures across 0° to 100° of flexion. One- and 2-way repeated-measures analyses of variance with Bonferroni correction were used to find significance ( P < .05) for the robotic and kinematics tests. Results: The ACL was the primary restraint for anterior tibial translation; other structures were insignificant (<10% contribution). The KFs and C/ALL resisted internal rotation, reaching 44% ± 23% (mean ± SD; P < .01) and 14% ± 13% ( P < .05) at 90°. The LMPR resisted valgus but not internal rotation. Anterior tibial translation increased after ACL transection ( P < .001) and after cutting the lateral structures from 70° to 100° ( P < .05). Pivot-shift loading increased anterolateral rotational instability after ACL transection from 0° to 40° ( P < .05) and further after cutting the lateral structures from 0° to 100° ( P < .01). Conclusion: The anterolateral complex acts as a functional unit to provide rotatory stability. The ACL is the primary stabilizer for anterior tibial translation. The KFs are the most important internal rotation restraint >30° of flexion. Combined KFs + C/ALL injury substantially increased anterolateral rotational instability while isolated injury of either did not. LMPR deficiency did not cause significant instability with the ACL intact. Clinical Relevance: This study is a comprehensive biomechanical sectioning investigation of the knee stability contributions of the ACL, anterolateral complex, and LMPR and the instability after their transection. The ACL is significant in controlling internal rotation only in extension. In flexion, the KFs are dominant, synergistic with the C/ALL. LMPR tear has an insignificant effect with the ACL intact.
Serum levels and significance of soluble B-cell maturation antigen in childhood-onset systemic lupus erythematosus with renal involvement
Authors: Lin Zhilang , Yu Nannan , Cheng Cheng , Jin Bei , Zhang Qiufang , Zhuang Hongjie , Jiang Xiaoyun 
Published: March 2023

Objective The aim of this study was to investigate serum levels of soluble B-cell maturation antigen (sBCMA) in childhood-onset systemic lupus erythematous (cSLE) patients with renal involvement, and to elucidate their association with clinical characteristics. Methods 116 cases of cSLE patients with renal involvement (84 females and 32 males; median age 11.6 (10.1, 12.9) years) hospitalized in Department of Pediatric Nephrology and Rheumatology, the First Affiliated Hospital, Sun Yat-sen University and 31 healthy controls (HCs) were enrolled. Serum concentrations of sBCMA were determined using enzyme-linked immunosorbent assay (ELISA). Clinical and laboratory information of cSLE patients were retrospectively analyzed. Results Serum sBCMA levels were significantly increased in primary cSLE when compared with treated cSLE patients and HCs, whereas there was no significant difference between treated cSLE patients and HCs. Patients with high disease activity displayed higher serum sBCMA levels compared with those with no or mild to moderate disease activity. Positive correlation was observed between serum sBCMA levels and systemic lupus erythematosus disease activity index-2K (SLEDAI-2K), antinuclear antibody titers, anti-double-stranded DNA titers, erythrocyte sedimentation rate, and immunoglobulin G levels, while sBCMA levels were negatively correlated with blood white blood cell count, hemoglobin, platelet count, complement C3 and C4 levels. Serum sBCMA levels decreased as disease ameliorated after treatments among 11 cases with follow-up examinations. Conclusions In cSLE patients with renal involvement, serum sBCMA levels correlated significantly with disease activity, immunological, and hematological parameters, but not with renal parameters. Our results suggest the potential and significance of serum sBCMA as a biomarker in cSLE patients.
In Utero Exposure to Maternal Electronic Nicotine Delivery System use Demonstrate Alterations to Craniofacial Development
Authors: Kishinchand Rajiv , Boyce Mark , Vyas Heema , Sewell Leslie , Mohi Amr , Brengartner Lexie , Miller Roy , Gorr Matthew W. , Wold Loren E. , Cray James 
Published: March 2023

Objective Develop a model for the study of Electronic Nicotine Device (ENDS) exposure on craniofacial development. Design Experimental preclinical design followed as pregnant murine dams were randomized and exposed to filtered air exposure, carrier exposure consisting of 50% volume of propylene glycol and vegetable glycine (ENDS Carrier) respectively, or carrier exposure with 20 mg/ml of nicotine added to the liquid vaporizer (ENDS carrier with nicotine). Setting Preclinical murine model exposure using the SciReq exposure system. Participants C57BL6 adult 8 week old female pregnant mice and exposed in utero litters. Interventions Exposure to control filtered air, ENDS carrier or ENDS carrier with nicotine added throughout gestation at 1 puff/minute, 4 h/day, five days a week. Main Outcome Measures Cephalometric measures of post-natal day 15 pups born as exposed litters. Results Data suggests alterations to several facial morphology parameters in the developing offspring, suggesting electronic nicotine device systems may alter facial growth if used during pregnancy. Conclusions Future research should concentrate on varied formulations and exposure regimens of ENDS to determine timing windows of exposures and ENDS formulations that may be harmful to craniofacial development.
Monitoring Participant Safety in Phase I and II Interventional Trials: Options and Controversies
Authors: Hibberd Patricia L. , Weiner Debra L. 
Published: March 2023

Background The need for phase I and II clinical trials to have a data and safety monitoring plan (DSMP) is widely accepted; however, whether and/or when these trials should also have oversight by a data and safety monitoring board (DSMB) is controversial. Monitoring requirements also depend on whether the study is funded by the National Institutes of Health, funded and/or monitored by the US Food and Drug Administration (FDA), or funded by industry. However, there is little guidance about when and how to constitute a DSMB for phase I and II clinical trials. Objectives: The objectives of this article are to suggest guidelines for when and how to constitute a DSMB for phase I and II studies and to highlight the similarities and differences between DSMBs monitoring phase I and II versus phase III clinical studies. We highlight the utility of these guidelines in the safety monitoring of a mechanism of disease–based study of inhaled nitric oxide for acute vaso-occlusive crisis in pediatric patients with sickle cell disease that was funded and regulated by the FDA. Conclusion The goal of DSMPs regardless of the phase of the clinical trial is to protect participant safety and ensure the integrity and validity of the data. A DSMB can ensure that risks and data are evaluated in a timely, efficient, and unbiased manner. We describe “risk-based” guidelines to determine situations in which a DSMB may be an appropriate addition to a DSMP for phase I and II clinical trials. We also address the roles and responsibilities of the DSMB for these studies.
Ectonucleotidase NTPDase2 is Selectively Down-Regulated in Biliary Cirrhosis
Authors: Dranoff Jonathan A. , Kruglov Emma A. , Toure Joahd , Braun Norbert , Zimmermann Herbert , Jain Dhanpat , Knowles Aileen F. , Sévigny Jean 
Published: March 2023

Background Portal fibroblasts are newly identified, potentially fibrogenic liver cells that are distinct from hepatic stellate cells. The ectonucleotidase* nucleoside triphosphate diphosphohydrolase 2 (NTPDase2) is restricted to portal fibroblasts in the normal liver. However, the fate of NTPDase2 after bile duct ligation (BDL) is unknown. Aims The aim of this study was to assess the effect of experimental rat and disease-mediated human biliary cirrhosis on NTP-Dase2 expression in the liver. Methods Cirrhosis was induced in experimental rats via BDL and carbon tetrachloride (CCI4) administration. Archived human liver biopsy specimens from normal liver, primary biliary cirrhosis, or hepatitis C cirrhosis were examined. Changes in expression of NTPDase2 were determined using confocal immunofluorescence, immunoblot, and real-time polymerase chain reaction. Results Confocal immunofluorescence demonstrated a decrease in NTPDase2 expression after BDL. Immunoblot and real-time polymerase chain reaction demonstrated a decrease in NTPDase2 expression by portal fibroblasts after BDL. No decrease in NTP-Dase2 protein was noted after CCI4 administration, and NTPDase2 messenger ribonucleic acid was markedly up-regulated after CCI4 administration. Confocal immunofluorescence demonstrated a shift of NTPDase2 expression from portal areas to central areas that colocalized with α-smooth muscle actin after CCI4 administration. In human biopsy specimens, NTPDase2 expression was lost in cirrhosis owing to primary biliary cirrhosis, whereas NTPDase2 expression was shifted to bridging fibrous bands in cirrhosis owing to hepatitis C. Conclusions Loss of NTPDase2 is a common pathway in both rat and human manifestations of biliary cirrhosis. Conversely, in nonbiliary cirrhosis, NTPDase2 is shifted from the portal area to bridging fibrous bands. Elucidations of the mechanisms regulating NTP–Dase2 expression may lead to new therapeutic approaches to fibrotic liver disease.
Ear Portal: An urban-based ear, nose, and throat, and audiology referral telehealth portal to improve access to specialist ear health services for children
Authors: Alenezi Eman MA , Veselinović Tamara , Tao Karina FM , Altamimi Ali AH , Tran Tu Trang , Herbert Hayley , Kuthubutheen Jafri , McAullay Daniel , Richmond Peter C , Eikelboom Robert H , Brennan-Jones Christopher G 
Published: March 2023

Introduction Shortage of ear, nose, and throat specialists in public hospitals can result in delays in the detection and management of otitis media. This study introduced a new hospital-based telehealth service, named the Ear Portal, and investigated its role in improving access to specialist care. Methods The study included 87 children (aged 6 months to 6 years) referred to a tertiary children's hospital due to otitis media-related concerns. A specialist multidisciplinary team met fortnightly to review pre-recorded data and provide care plans. Results The service resulted in a median waiting time of 28 days to receive a diagnosis and care plan by the multidisciplinary team, compared to a mean waiting time of 450 days for a reference group receiving standard healthcare services. Most children (90.3%) received bilateral ear diagnosis. Normal findings were found in 43.9%. However, the majority required further ear, nose, and throat with or without audiology face-to-face follow-up due to a diagnosis of middle-ear disease, unknown hearing status, or concerns not related to ears. The mean time required for clinical assessments completion by research assistants and multidisciplinary team review was 37.6 and 5.1 min per participant, respectively. Discussion Children in the Ear Portal service received a diagnosis and care plan in a median of 28 days, which is within the clinically recommended timeframes. With sufficient clinical information, this service can provide faster access to specialist care than the standard healthcare pathway. The service can reduce the time required by the specialist to provide a diagnosis and care plan which may help increase the specialists’ capacity.
Association of adiposity with morbidity in Finnish adults: A register-based follow-up study
Authors: Mäki Päivi , Harald Kennet , Lindström Jaana , Männistö Satu , Laatikainen Tiina 
Published: March 2023

Aims: The aims of this study were to update risk estimates of obesity related co-morbidities and to provide evidence of the importance of obesity prevention to decision makers. Methods: The study included 25- to 74-year-old participants ( N=22,977) of the National FINRISK Studies in 1997, 2002 and 2007. Body mass index was calculated from measured weight and height at baseline. Data on morbidity were ascertained via linkage to the National Hospital Discharge Register, the Cancer Register and the records of the Social Insurance Institution of Finland until the end of year 2018. The Cox proportional hazards model was used to estimate associations between weight status and the risk of the end-point diseases during follow-up, with adjustment for age and smoking. Results: At baseline, 31% of participants had at least one of the investigated diseases. Overweight, obesity and severe obesity were associated with type 2 diabetes, gout, gallbladder diseases and knee and hip osteoarthritis during the follow-up in both men and women. The risk of coronary heart disease was increased in men who were overweight, obese and severely obese and in women who were obese and severely obese. Risk of asthma was increased only among women who were obese and severely obese. No associations were found between obesity and breast, prostate or colorectal cancer. Conclusions: The study showed a strong relationship between excess body weight and the prevalence and incidence of several diseases. Obesity prevention is essential to reduce disease burden in the future.