bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep neuromuscular blockade during radiofrequency catheter ablation under general anesthesia reduces the prevalence of atrial fibrillation recurrence when compared to moderate neuromuscular blockade: A randomized controlled trial
Authors: Oh Eun Jung , Shim Jae-Geum , Jeon Suyong , Cho Eun Ah , Lee Sung Hyun , Jeong Taeho , Ahn Jin Hee 
Published: January 2025

Background
Proper anesthesia management is required to maintain immobilization and stable breathing of the patient to improve catheter contact and stability during catheter ablation for PVI. However, it remains unclear whether the depth of neuromuscular blockade affects the results of RFCA under general anesthesia.

Methods
The patients were randomly assigned to either the moderate neuromuscular blockade group (Group M, train-of-four 1 to 2) or the deep neuromuscular blockade group (Group D, posttetanic count 1–2). The primary outcome was the 12-month AF recurrence rate using confirmed electrocardiographic diagnosis after the ablation procedure at two different neuromuscular blockade depths.

Results
Total 94 patients (47 in each group) were included in the analysis. Recurrence of AF during the A 12-month follow-up was 12 (25%) in group D and 22 (46%) in group M. The AF recurrence rate was significantly higher in group M (p =  0.03). The relative risk (RR) for the risk of 12-month AF recurrence was 0.545 in group D. AF symptom recurrence was observed during the A 12-month follow-up in 12 (25%) and 26 (54%) patients in groups D and M, respectively.

Conclusions
Compared to moderate neuromuscular blockade, deep neuromuscular blockade while performing RFCA under general anesthesia reduced 12-month AF recurrence rate. Deep neuromuscular blockade under general anesthesia is thought to increase the success rate by providing a stable surgical environment during the RFCA procedure.

Trial registration
Clinical trials of Korea KCT 0003371
Effects of photobiomodulation combined with rehabilitation exercise on pain, physical function, and radiographic changes in mild to moderate knee osteoarthritis: A randomized controlled trial protocol
Authors: Tay Yan Ling , Ahmad Mohd Azzuan , Mohamad Yahaya Nor Hamdan , Ajit Singh Devinder Kaur 
Published: January 2025

Background
Photobiomodulation, specifically high-energy photobiomodulation therapy (H-PBMT), is gaining recognition as a promising non-invasive intervention for managing knee osteoarthritis (KOA). While H-PBMT has demonstrated effectiveness in reducing pain and improving physical function, most evidence to date focuses on short-term symptomatic relief. The potential for H-PBMT to offer sustained benefits and modify the underlying progression of KOA remains insufficiently explored, warranting further investigation.

Objective
This study aims to assess the short-term and sustained effects of H-PBMT combined with rehabilitation exercises in patients with mild to moderate KOA, focusing on knee radiographic morphological changes over a 3-month follow-up period.

Methods
This protocol outlines a parallel-group, randomized, double-blind, placebo-controlled trial. Fifty participants with mild to moderate KOA (based on the Kellgren-Lawrence classification) will be randomly assigned to either the active H-PBMT plus exercise group (H-PBMT+E, n = 25) or the placebo photobiomodulation plus exercise group (PL+E, n = 25). Both groups will undergo an 8-week intervention, consisting of conventional rehabilitation exercises paired with either active or placebo photobiomodulation. H-PBMT will be delivered using the BTL-6000 HIL device with a 1064 nm wavelength, providing a total energy dose of 3190 J per 15-minute session. The treatment protocol includes both pulse mode (25 Hz, 5 W, 190 J) for analgesia and continuous mode (5 W, 3000 J) for biostimulation. Participants will be blinded to their group allocation through the use of a placebo device that mimics the active treatment without emitting therapeutic energy. Additionally, the outcome assessors will be blinded to the group allocations to ensure unbiased evaluation of the trial outcomes. The primary outcome is the Knee Injury and Osteoarthritis Outcome Score. Secondary outcomes include the Timed Up-and-Go test, Numerical Pain Rating Scale, and knee X-rays. Outcomes will be evaluated at baseline, immediately post-intervention (week 8), and at 3-month follow-up (week 20). Data will be analyzed according to the intention-to-treat principle, with a two-way repeated measures ANOVA used to assess time, group, and interaction effects.

Conclusion
This study is expected to provide valuable insights into the sustained effects and potential disease-modifying properties of combining H-PBMT with rehabilitation exercises in managing KOA. The findings could inform more effective treatment protocols, improving rehabilitation outcomes and patient quality of life.

Trial registration
Australian New Zealand Clinical Trials Registry (ACTRN12624000699561p).
Feasibility, safety and tolerability of estrogen and/or probiotics for improving vaginal health in Canadian African, Caribbean, and Black women: A pilot phase 1 clinical trial
Authors: Gill Biban , Wessels Jocelyn M. , Hayes Christina L. , Ratcliffe Jenna , Wokuri Junic , Ball Elizabeth , Reid Gregor , Kaul Rupert , Rana Jesleen , Alkhaifi Muna , Tharao Wangari , Smaill Fiona , Kaushic Charu 
Published: January 2025

Background
A dysbiotic vaginal microbiome (VMB) is associated with clinical conditions such as bacterial vaginosis (BV) and an increased risk of human immunodeficiency virus (HIV-1) infection. Considering the high prevalence of BV among African, Caribbean and Black (ACB) women, we conducted a prospective, randomized, open-label phase 1 clinical trial to determine the feasibility, safety and tolerability of administering low-dose estrogen, probiotics or both in combination to improve vaginal health and decrease HIV-1 susceptibility.

Methods
ACB women aged 18–49 from the Greater Toronto Area (GTA) were randomized to one of four study arms: intravaginal estradiol (Estring©; 7.5mg/day); a vaginal probiotic (RepHresh™ Pro-B™) administered twice daily; a combination of Estring© and vaginal RepHresh™ Pro-B™ (twice daily); or the Estring© and oral RepHresh™ Pro-B™ (twice daily), for a duration of 30 days. Feasibility was evaluated through enrolment, retention, and adherence rates, while safety and tolerability were determined by a pre- and post-treatment blood panel and reported adverse events (AEs).

Results
Overall, 63 ACB women were screened, 50 were enrolled and received the intervention while 41 completed the study, resulting in 80% enrollment and 82% retention rates. Overall adherence to the study protocol was high at 93%, with an adherence of 92% for RepHresh™ Pro-B™ and 97% for Estring©. A total of 88 AEs were reported by 29 participants which were mild (66/88; 75%) and largely resolved (82/88;93%) by the end of the study, with no serious AEs (SAEs) noted. In addition, a panel of safety blood markers measured pre- and post-intervention confirmed no clinically significant changes in blood chemistry or blood cell count.

Conclusion
Overall, the administration of intravaginal estrogen and/or probiotics in pre-menopausal ACB women is feasible, safe, and well tolerated.

Trial registration
The trial was registered with Clinicaltrials.gov (NCT03837015) and CIHR HIV Clinical Trials (CTN308).
Pseudorabies virus infection triggers pUL46-mediated phosphorylation of connexin-43 and closure of gap junctions to promote intercellular virus spread
Authors: Tishchenko Alexander , Romero Nicolás , Van Waesberghe Cliff , Delva Jonas L. , Vickman Oliver , Smith Gregory A. , Mettenleiter Thomas C. , Fuchs Walter , Klupp Barbara G. , Favoreel Herman W. 
Published: January 2025

Gap junctions (GJs) play a pivotal role in intercellular communication between eukaryotic cells, including transfer of biomolecules that contribute to the innate and adaptive immune response. However, if, how and why viruses affect gap junction intercellular communication (GJIC) remains largely unexplored. Here, we describe how the alphaherpesvirus pseudorabies virus (PRV) triggers ERK1/2-mediated phosphorylation of the main gap junction component connexin 43 (Cx43) and closure of GJIC, which depends on the viral protein pUL46. Consequently, a UL46null PRV mutant is unable to phosphorylate Cx43 or inhibit GJIC and displays reduced intercellular spread, which is effectively rescued by pharmacological inhibition of GJIC. Intercellular spread of UL46null PRV is also rescued by inhibition of the stimulator of interferon genes (STING), suggesting that pUL46-mediated suppression of GJIC contributes to intercellular virus spread by hindering intercellular communication that activates STING. The current study identifies key viral and cellular proteins involved in alphaherpesvirus-mediated suppression of GJIC and reveals that GJIC inhibition enhances virus intercellular spread, thereby opening new avenues for the design of targeted antiviral therapies.
POBREZA MENSTRUAL E DESIGUALDADE DE GÊNERO
Authors: Corrêa da Silva Ledur Taísi , Machado de Oliveira-Menegotto Lisiane , Regina Giongo Carmem 
Published: January 2025

Este estudo tem como objetivo discutir os desafios da escola diante da pobreza menstrual, considerando a percepção de professoras e professores de escolas públicas. A pesquisa adotou um delineamento exploratório e descritivo, com uso de metodologia qualitativa. Foram entrevistadas(os) doze docentes, sendo oito mulheres e quatro homens. Para a coleta de dados, foram aplicados um questionário sociodemográfico e uma entrevista semiestruturada. Os materiais coletados foram submetidos à análise de conteúdo. Os resultados revelaram que ainda há um desconhecimento sobre as leis relacionadas ao combate à pobreza menstrual e aos procedimentos adotados pelas escolas para a distribuição de absorventes. Conclui-se que apenas a distribuição de absorventes desvinculada de uma abordagem educativa e de acolhimento pode resultar em uma postura silenciosa que perpetua a desigualdade de gênero e a opressão da menstruação.
tramas da resiliência e da luta por direitos territoriais
Authors: Diniz Mendonça Mariana Tereza , Maciel Lidiane Maria , Amaral e Silva Fabiana Felix do 
Published: January 2025

O artigo tem como objetivo realizar uma análise contextual da resistência dos quilombos no cenário brasileiro contraposto ao desenvolvimento do campo de conhecimento nomeado de Planejamento Urbano e Regional/ Planejamento Territorial, realizado no guarda-chuva do Estado. Para tanto, realizou-se uma discussão do cenário histórico e processual desta condição, um levantamento de normativas que organizam as relações Estado - quilombo entre 1988 e 2023, exemplificando por meio do caso da cidade de Ubatuba/SP. Por fim, conclui-se que ainda nos instrumentos e nos debates sobre o Planejamento Territorial nos municípios os quilombos ainda são colocados à margem do debate, seus conhecimentos e saberes, modos de vida e gestão do próprio território são considerados muitas vezes como entraves ao desenvolvimento territorial da expansão urbana, negócios turísticos e grande projetos agrícolas ou de mineração.
The rigidity of eigenvalues on Kähler manifolds with positive Ricci lower bound
Authors: Chu Jianchun , Wang Feng , Zhang Kewei 
Published: January 2025

Abstract
In this work, optimal rigidity results for eigenvalues on Kähler manifolds with positive Ricci lower bound are established.
More precisely, for those Kähler manifolds whose first eigenvalue agrees with the Ricci lower bound, we show that the complex projective space is the only one with the largest multiplicity of the first eigenvalue.
Moreover, there is a specific gap between the largest and the second largest multiplicity.
In the Kähler–Einstein case, almost rigidity results for eigenvalues are also obtained.
Defining Our Mission: A Content Analysis of U.S. Emergency Management Agency Mission Statements
Authors: Savitt Amanda , Montano Samantha 
Published: January 2025

Abstract
The identity and mission of emergency management is a topic of frequent discussion among researchers and practitioners. However, the extent to which there is consensus across emergency management agencies about what their missions are is unclear. This study seeks to answer that question through a content analysis of the mission statements from 226 emergency management agencies representing all levels of government in the United States (i.e. federal, state, territorial, tribal, and local). Mission statements are a tool organizations use to indicate both externally and internally their raison d’etre. This study found there is consensus regarding emergency management agencies’ concern with “all-hazards” and the use of phases to organize their work. There were differences found in how agencies accounted for their constituencies, partner agencies, role identity, and goals. Despite some differences, this study found that overall agency mission statements across levels of government in the US align, suggesting consensus in the field of the mission of emergency management.
Unorthodox and disobedient Jewish cosmopolitans on our screens: The case of <em>Unorthodox </em>(Schrader, Winger, 2020)
Authors: Shaw Deborah 
Published: January 2025

This article explores the relationship between cosmopolitanism, and secular and orthodox Jewish identities in recent Jewish film and television dramas with a focus on the Netflix series Unorthodox (Schrader 2020). It argues that Unorthodox presents a cosmopolitan image of Berlin and has Jews constitute an affirmative, symbolic and embodied presence in the multicultural city. The article demonstrates how this stands in contrast to historical negative equations of Jewishness with parasitical and rootless cosmopolitans for Nazi Germany and Stalinist Russia. In Unorthdox secular Judaism is equated with a positive form of cosmopolitanism. Nonetheless, this is only once orthodoxy is left behind, and an enclosed Jewish ultra-Orthodox space comes to signify a negative counterpoint to Jewish cosmopolitanism.
INOVASI LKPD DIGITAL PADA MATERI SISTEM PERNAPASAN UNTUK PESERTA DIDIK KELAS XI SMA
Authors: Maharani Anggun Permata , Sari Tika Mayang 
Published: January 2025

Penelitian ini bertujuan untuk memperbaiki pemahaman peserta didik terhadap materi sistem pernapasan dengan cara menyusun dan menguji LKPD digital yang dikembangkan pada peserta didik kelas XI SMAN 5 Metro. Penelitian ini menggunakan metode research and development (R&D) model ADDIE (analysis, design, development, implementation, and evaluation) sampai pada tahap development dengan batasan pada validitas dan uji coba terbatas LKPD. Hasil penelitian menunjukan bahwa LKPD yang dikembangkan sangat menarik dengan nilai prestase sebesar 80% (ahli materi), 80% (ahli media), 90% (guru), dan 80% (peserta didik).Kata kunci: LPKD Digital, Pengembangan, Sistem Pernapasan. This research aims to improve students' understanding of respiratory system material by compiling and testing digital LKPD developed for class XI students at SMAN 5 Metro. This research uses the research and development (R&D) method of the ADDIE model (analysis, design, development, implementation, and evaluation) up to the development stage with limitations on validity and limited testing of the LKPD. The research results showed that the LKPD developed was very interesting with achievement scores of 80% (material experts), 80% (media experts), 90% (teachers), and 80% (students).Keyword: Digital LPKD, Development, Respiratory System.
Platelet reactivity clinical and biochemical markers when taking acetylsalicylic acid as part of dual antiplatelet therapy in the myocardial infarction subacute period
Authors: Pronko T. P. , Snezhitskiy V. A. , Kapytski A. V. 
Published: January 2025

Aim. To study markers that determine residual platelet reactivity in the subacute period of myocardial infarction (MI) during the administration of acetylsalicylic acid (ASA) as part of dual antiplatelet therapy.Material and methods. 405 patients with MI (79.5% men and 20.5% women, average age 58.0 years) were divided into groups based on aggregometry results. Group 1 — 11 patients with low residual platelet reactivity, group 2 — 236 patients with optimal platelet reactivity, group 3 — 158 patients with high residual platelet reactivity (HRPR). All studies were performed on days 12-14 after MI: aggregometry on a Multiplate aggregometer (Germany) with several aggregation inducers, a blood test and a study of platelet indices, determination of endothelin-1, von Willebrand factor, sP-selectin and soluble CD40 ligand levels.Results. Parameters influencing the ASPItest value according to univariate linear regression analysis: body mass index (β=0.53, 95% CI: 0.11-0.96; p=0.013); waist circumference (β=0.31, 95% CI: 0.14-0.49; p=0.0004); erythrocyte sedimentation rate (β=0.27, 95% CI: 0.12-0.42; p=0.0004); white blood cells count (β=1.47, 95% CI: 0.51-2.42; p=0.0027); platelets count (β=0.042, 95% CI: 0.019-0.064; p=0.00025); thrombocrit (β=36.8, 95% CI: 14.6-59.1; p=0.0012); mean platelet volume (β=1.94, 95% CI: 0.06-3.84; p=0.043); platelet distribution width (β=1.36, 95% CI: 0.22-2.51; p=0.02); creatinine (β=0.11, 95% CI: 0.011-0.21; p=0.03); C-reactive protein (β=0.18, 95% CI: 0.05-0.32; p=0.007); TRAP-test (β=0.18, 95% CI: 0.11-0.24; p=0.000001); fibrinogen (β=2.6, 95% CI: 1.17-4.02; p=0.0004). The binary logistic regression model to calculate the probability of developing HRPR to ASA included the following factors: platelet count, percentage of large platelet volume (PLCR), fibrinogen, endothelin-1 and von Willebrand factor. With a probability cutoff p₀=0.5412 for this model: sensitivity — 81.08%, specificity — 73.21%, classification accuracy — 76.34%, area under the ROC curve — 0.79 (CI: 0.696 - 0.883).Conclusion. There are 2.7% of patients with an excessive response to ASA and 39.0% with an insufficient response to ASA on days 12-14 of MI. Clinical and biochemical markers of HRPR to ASA in the subacute period of MI are the number of platelets, PLCR, fibrinogen, endothelin-1 and von Willebrand factor.
Dehydroepiandrosterone and cognitive impairment and impact in cardiovascular mortality among men and women 55 years and older
Authors: Shalnova S. A. , Imaeva N. A. , Imaeva A. E. , Kutsenko V. A. , Balanova Yu. A. , Kapustina A. V. , Drapkina O. M. 
Published: January 2025

Aim. To evaluate possible associations between low dehydroepiandrosterone sulfate (DHEAS) levels and cognitive impairment and their impact in cardiovascular mortality among the population 55 years and older.Material and methods. The present study was carried out as part of the prospective cohort survey "Stress, aging and health" in Russia. 1876 men and women aged 55 years and older were examined. Cognitive function was assessed at baseline and after 3 years using the Mini- Mental State Examination scale; a decrease in cognitive function corresponded to a sum of scores less than 24 out of 30 points. DHEAS levels were assessed in serum samples. All participants were ranked according to quintiles of DHEAS levels (>2.61 μmol, 2.34-2.61 μmol/L, 1.60-2.33 μmol/L, 1.05-1.59 μmol/L, <1.05 μmol/L). Mortality was estimated from the permanent death registry using standard methods. During the follow-up period (median 12 years), 315 deaths from CVD were registered.Results. A total of 1876 participants aged 55 years and older (48% men and 52% women) were included in the study. The frequency of cognitive function, both baseline and after three years in men was almost independent of the DHEAS level, while in women, low levels of cognitive function were predominant in the first quintile of DHEAS. With decreasing DHEAS levels, cognitive function decreased significantly in women (1 quintile vs. 5 quintiles of DHEAS), but no such associations were found in men. In a population of men 55 years and older, both cognitive impairment (OR: 2.08; 95% CI 1.49 to 2.92) and low DHEAS levels (OR: 1.60; 95% CI 1.05 to 2.44) were significantly associated with cardiovascular mortality. Similar results were obtained in the cohort of women — the risk of cardiovascular mortality was increased in the presence of cognitive impairment by 2.3-fold (p<0.05), low DHEAS by 1.6-fold (p<0.05), respectively. The simultaneous presence of these disorders was significantly associated with CVD mortality, but only in women.Conclusion. Based on the results of the present study, an association between baseline DHEAS levels and baseline cognitive impairment was found, but only in a female population. A prospective follow-up assessment of cognitive function failed to support the hypothesis that low DHEAS levels may predict greater decline in cognitive function. However, a significant cumulative contribution of cognitive impairment combined with low DHEAS concentration to cardiovascular mortality was observed at 12-year follow-up, but only in women.
Language proficiency, information accessibility, and healthcare service use: a qualitative case study of Nepali migrants in Finland
Authors: Khanal Shrwan Kumar 
Published: January 2025

Abstract

Background
Access to healthcare is a fundamental right, yet many migrants face barriers that prevent them from accessing timely and quality healthcare services. In Finland, there is limited research on the healthcare access and quality experienced by minority groups, such as Nepali migrants. This study examines how language proficiency and access to information affect the use of healthcare services and health outcomes within the Nepali migrant community.
Methods
This qualitative study employed semi-structured interviews with 27 working age Nepali migrants in Finland, selected through purposive sampling. The interviews explored participants’ experiences with accessing healthcare, focusing on challenges related to language barriers and the accessibility of healthcare-related information. The data were analysed thematically to identify patterns in healthcare utilisation.
Results
Participants faced significant challenges in accessing reliable healthcare information, often depending on informal networks that offered inconsistent details. Their limited proficiency in local languages made it difficult to understand healthcare processes, communicate effectively with providers, and navigate available services. Additionally, the scarcity of professional interpreters and privacy concerns related to using community-based interpreters led to suboptimal healthcare experiences. These findings suggest that such barriers may contribute to poor healthcare services and undermine healthcare rights, while also increasing perceived discrimination and the risk of exploitation among migrants.
Conclusions
Migrants in destination countries often face barriers to equitable healthcare services due to limited information accessibility and a lack of support for local languages. To address these challenges, it is crucial to provide accessible healthcare information, offer language training opportunities, and ensure the availability of professional interpreting services. Additionally, future research on migrants' health should focus on less-studied migrant groups to highlight their unique experiences.