bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of magnesium sulfate on periarticular infiltration analgesia in total knee arthroplasty: a prospective, double-blind, randomized controlled trial
Authors: Zhao Chengcheng , Wang Liying , Chen Liyile , Wang Qiuru , Kang Pengde 
Published: April 2023

AbstractBackgroundTo investigate whether adding magnesium sulfate to a periarticular infiltration analgesia (PIA) cocktail could improve pain control and functional outcomes in patients undergoing total knee arthroplasty (TKA).MethodsNinety patients were randomly assigned to the magnesium sulfate and control groups, with 45 patients in each group. In the magnesium sulfate group, patients were given a periarticular infusion of a cocktail of analgesics consisting of epinephrine, ropivacaine, magnesium sulfate, and dexamethasone. The control group received no magnesium sulfate. The primary outcomes consisted of visual analogue scale (VAS) pain scores, postoperative morphine hydrochloride consumption for rescue analgesia, and time to first rescue analgesia. Secondary outcomes were postoperative inflammatory biomarkers (IL-6 and CRP), postoperative length of stay, and knee functional recovery (assessed by knee range of motion, quadriceps strength, daily mobilization distance, and time to first straight-leg raising). Tertiary outcomes included the postoperative swelling ratio and complication rates.ResultsWithin 24 h of surgery, patients in the magnesium sulfate group had markedly lower VAS pain scores during motion and at rest. After the addition of magnesium sulfate, the analgesic effect was dramatically prolonged, leading to a reduction in morphine dosage within 24 h and the total morphine dosage postoperatively. Postoperative inflammatory biomarker levels were significantly reduced in the magnesium sulfate group compared with the control. There were no considerable differences between the groups in terms of the postoperative length of stay and knee functional recovery. Both groups had similar postoperative swelling ratios and incidences of complications.ConclusionsThe addition of magnesium sulfate to the analgesic cocktail for PIA can prolong postoperative analgesia, decrease the consumption of opioids, and effectively alleviate early postoperative pain after TKA.Trial registration: Chinese Clinical Trial Registry, ChiCTR2200056549. Registered on 7 February 2022,https://www.chictr.org.cn/showproj.aspx?proj=151489.
Factors influencing on-scene time in a physician-staffed helicopter emergency medical service (HEMS): a retrospective observational study
Authors: Fuchs Alexander , Huber Markus , Riva Thomas , Becker Stefan , Albrecht Roland , Greif Robert , Pietsch Urs 
Published: April 2023

Abstract
Background
For helicopter emergency service systems (HEMS), the prehospital time consists of response time, on-scene time and transport time. Little is known about the factors that influence on-scene time or about differences between adult and paediatric missions in a physician-staffed HEMS.

Methods
We analysed the HEMS electronic database of Swiss Air-Rescue from 01-01-2011 to 31-12-2021 (N = 110,331). We included primary missions and excluded missions with National Advisory Committee for Aeronautics score (NACA) score 0 or 7, resulting in 68,333 missions for analysis. The primary endpoint ‘on-scene time’ was defined as first physical contact with the patient until take-off to the hospital. A multivariable linear regression model was computed to examine the association of diagnosis, type and number of interventions and monitoring, and patient's characteristics with the primary endpoint.

Results
The prehospital time and on-scene time of the missions studied were, respectively, 50.6 [IQR: 41.0–62.0] minutes and 21.0 [IQR: 15.0–28.6] minutes. Helicopter hoist operations, resuscitation, airway management, critical interventions, remote location, night-time, and paediatric patients were associated with longer on-scene times.

Conclusions
Compared to adult patients, the adjusted on-scene time for paediatric patients was longer. Besides the strong impact of a helicopter hoist operation on on-scene time, the dominant factors contributing to on-scene time are the type and number of interventions and monitoring: improving individual interventions or performing them in parallel may offer great potential for reducing on-scene time. However, multiple clinical interventions and monitoring interact and are not single interventions. Compared to the impact of interventions, non-modifiable factors, such as NACA score, type of diagnosis and age, make only a minor contribution to overall on-scene time.
A comparative study of the effects of Kangaroo care by mothers and maternal grandmothers on the vital signs of hospitalized preterm newborns: a randomized controlled clinical trial study
Authors: Dargahiyan Zahra , Ghasemi Fatemeh , Karami Kimia , Valizadeh Fatemeh , Mohammadi Rasool 
Published: April 2023

Abstract
Background
Kangaroo care (KC) is an effective technique to prevent injury in newborns due to prematurity and hospitalization. Mothers of preterm newborns experience their own set of physical and mental problems. Such circumstances call for another family member to take care of the newborn. This study compared the effect of KC by mothers and maternal grandmothers on the vital signs of preterm newborns.

Methods
This parallel randomized controlled trial was done at the neonatal and NICU departments of the hospital in Kuhdasht in Iran. Eighty preterm neonates were selected through convenience sampling according to the eligibility criteria, then by stratified block randomization allocated to two groups. The control group received KC from the mother, and the intervention group received KC from the maternal grandmothers on the vital signs of preterm newborns. Vital signs were assessed 15 min before, during, and after the KC as the primary outcome. The data collection tools included a demographic questionnaire and a form to record the vital signs. Vital signs were measured by a pulse oximeter, an electronic thermometer, and observation. Data were analyzed by the chi-square test, the independent t-test, and the repeated measures ANOVA.

Results
The vital signs of newborns in each group showed a significant difference before, during, and after receiving KC (P < 0.05). Nevertheless, the vital signs of the newborns did not differ significantly between the mother and the maternal grandmother KC groups (P > 0.05).

Conclusion
KC by maternal grandmother may stabilize the vital signs of preterm newborns as much as when this type of care is provided by the mother. We, therefore, recommend the provision of KC by the maternal grandmother, as a support and substitute for the mother whenever she is incapable of being at the hospital and to enable the mother to rest.

Trial registration
Iranian Registry of Clinical Trials IRCT20211225053516N1, March 31, 2022.
The malignancy suppression and ferroptosis facilitation of BCL6 in gastric cancer mediated by FZD7 repression are strengthened by RNF180/RhoC pathway
Authors: Guo Shiwei , Deng Jingyu , Wang Pengliang , Kou Fan , Wu Zizhen , Zhang Nannan , Zhao Zhenzhen , Nie Yongzhan , Yang Lili 
Published: April 2023

Abstract
Background
B-cell lymphoma 6 (BCL6) is a transcription repressor that plays a tumor suppressor or promoting role in various tumors. However, its function and molecular mechanism in gastric cancer (GC) remain unclear. Ferroptosis, a novel programmed cell death, is closely related to tumor development. In this research, we aimed to explore the role and mechanism of BCL6 in malignant progression and ferroptosis of gastric cancer.

Methods
Firstly, BCL6 was identified as an important biomarker that attenuated the proliferation and metastasis of GC through tumor microarrays and confirmed in GC cell lines. RNA sequence was performed to explore the downstream genes of BCL6. The underlying mechanisms were further investigated by ChIP, dual luciferase reporter assays and rescue experiments. Cell death, lipid peroxidation, MDA and Fe2+ level were detected to determine the effect of BCL6 on ferroptosis and the mechanism was revealed. CHX, MG132 treatment and rescue experiments were used to explore the upstream regulatory mechanism of BCL6.

Results
Here we showed that BCL6 expression was significantly decreased in GC tissues, and patients with low BCL6 expression showed more malignant clinical features and poor prognosis. The upregulation of BCL6 may significantly inhibited the proliferation and metastasis of GC cells in vitro and in vivo. In addition, we found that BCL6 directly binds and transcriptionally represses Wnt receptor Frizzled 7 (FZD7) to inhibit the proliferation, metastasis of GC cells. We also found that BCL6 promoted lipid peroxidation, MDA and Fe2+ level to facilitate ferroptosis of GC cells by FZD7/β-catenin/TP63/GPX4 pathway. Furthermore, the expression and function of BCL6 in GC were regulated by the ring finger protein 180 (RNF180)/ras homolog gene family member C (RhoC) pathway, which had been elucidated to be involved in significantly mediating the proliferation and metastasis of GC cells.

Conclusions
In summary, BCL6 should be considered a potential intermediate tumor suppressor to inhibit the malignant progression and induce ferroptosis, which might be a promising molecular biomarker for further mechanistic investigation of GC.
A split-federated learning and edge-cloud based efficient and privacy-preserving large-scale item recommendation model
Authors: Qin Jiangcheng , Zhang Xueyuan , Liu Baisong , Qian Jiangbo 
Published: April 2023

AbstractThe combination of federated learning and recommender system aims to solve the privacy problems of recommendation through keeping user data locally at the client device during the model training session. However, most existing approaches rely on user devices to fully compute the deep model designed for the large-scale item recommendation; therefore, imposing high calculation and communication overheads on resource-constrained user devices. Consequently, achieving efficient federated recommendations across ubiquitous mobile devices remains an open research problem. To this end, in this paper we propose an efficient and privacy-preserving federated learning framework which is based on the cloud-edge collaboration for large-scale item recommendation called SpFedRec. In our method, to reduce the computation and communication cost of the federated two-tower model, a split learning approach is applied to migrate the item model from participants’ edge devices to the computationally powerful cloud side and compress item data while transmitting. Meanwhile, to enhance the feature representation, the Squeeze-and-Excitation network mechanism is used on the backbone model to optimize the perception of dominant features. Moreover, because the gradients transmitted contain private information about the user; therefore, we propose a multi-party circular secret-sharing chain based on secret sharing for better privacy protection. Extensive experiments using plausible assumptions on two real-world datasets demonstrate that our proposed method improves the average computation time and communication cost by 23% and 49%, respectively. Furthermore, the proposed model accomplishes comparable performance with other state-of-art federated recommendation models.
Prevalence and predictors of delayed initiation of breastfeeding among postnatal women at a tertiary hospital in Eastern Uganda: a cross-sectional study
Authors: Kusasira Loyce , Mukunya David , Obakiro Samuel , Kenedy Kiyimba , Rebecca Nekaka , Ssenyonga Lydia , Immaculate Mbwali , Napyo Agnes 
Published: April 2023

Abstract
Background
The rates for the delayed initiation of breastfeeding in Uganda remain unacceptably high between 30% and 80%. The reasons for this are not well understood. We aimed to determine the prevalence and predictors for the delayed initiation of breastfeeding in Eastern Uganda.

Methods
This study employed a cross-sectional study design. A total of 404 mother-infant pairs were enrolled onto the study between July and November, 2020 at Mbale regional referral hospital (MRRH). They were interviewed on socio-demographic related, infant-related, labour and delivery characteristics using a structured questionnaire. We estimated adjusted odds ratios using multivariable logistic regression models. All variables with p < 0.25 at the bivariate level were included in the initial model at the multivariate analysis. All variables with p < 0.1 and those of biological or epidemiologic plausibility (from previous studies) were included in the second model. The variables with odds ratios greater than 1 were considered as risk factors; otherwise they were protective against the delayed initiation of breastfeeding.

Results
The rate of delayed initiation of breastfeeding was 70% (n = 283/404, 95% CI: 65.3 – 74.4%). The factors that were associated with delayed initiation of breastfeeding were maternal charateristics including: being single (AOR = 0.37; 95%CI: 0.19–0.74), receiving antenatal care for less than 3 times (AOR = 1.85, 95%CI: 1.07–3.19) undergoing a caesarean section (AOR = 2.07; 95%CI: 1.3–3.19) and having a difficult labour (AOR = 2.05; 95%CI: 1.25–3.35). Infant characteristics included: having a health issue at birth (AOR = 9.8; 95%CI: 2.94–32.98).

Conclusions
The proportion of infants that do not achieve early initiation of breastfeeding in this setting remains high. Women at high risk of delaying the initiation of breastfeeding include those who: deliver by caesarean section, do not receive antenatal care and have labour difficulties. Infants at risk of not achieving early initiation of breastfeeding include those that have a health issue at birth. We recommend increased support for women who undergo caesarean section in the early initiation of breastfeeding. Breastfeeding support can be initiated in the recovery room after caesarean delivery or in the operating theatre. The importance of antenatal care attendance should be emphasized during health education classes. Infants with any form of health issue at birth should particularly be given attention to ensure breastfeeding is initiated early.
Substance use disorder bridge clinics: models, evidence, and future directions
Authors: Taylor Jessica L. , Wakeman Sarah E. , Walley Alexander Y. , Kehoe Laura G. 
Published: April 2023

Abstract
Background
The opioid overdose and polysubstance use crises have led to the development of low-barrier, transitional substance use disorder (SUD) treatment models, including bridge clinics. Bridge clinics offer immediate access to medications for opioid use disorder (MOUD) and other SUD treatment and are increasingly numerous. However, given relatively recent implementation, the clinical impact of bridge clinics is not well described.

Methods
In this narrative review, we describe existing bridge clinic models, services provided, and unique characteristics, highlighting how bridge clinics fill critical gaps in the SUD care continuum. We discuss available evidence for bridge clinic effectiveness in care delivery, including retention in SUD care. We also highlight gaps in available data.

Results
The first era of bridge clinic implementation has yielded diverse models united in the mission to lower barriers to SUD treatment entry, and preliminary data indicate success in patient-centered program design, MOUD initiation, MOUD retention, and SUD care innovation. However, data on effectiveness in linking to long-term care are limited.

Conclusions
Bridge clinics represent a critical innovation, offering on-demand access to MOUD and other services. Evaluating the effectiveness of bridge clinics in linking patients to long-term care settings remains an important research priority; however, available data show promising rates of treatment initiation and retention, potentially the most important metric amidst an increasingly dangerous drug supply.
High-flow nasal oxygen vs. standard oxygen therapy for patients undergoing transcatheter aortic valve replacement with conscious sedation: a randomised controlled trial
Authors: Scheuermann S. , Tan A. , Govender P. , Mckie M. , Pack J. , Martinez G. , Falter F. , George S. , A. Klein A. 
Published: April 2023

Abstract
Background
Minimally invasive surgery is becoming more common and transfemoral transcatheter aortic valve replacement is offered to older patients with multiple comorbidities. Sternotomy is not required but patients must lie flat and still for up to 2–3 h. This procedure is increasingly being performed under conscious sedation with supplementary oxygen, but hypoxia and agitation are commonly observed.

Methods
In this randomised controlled trial, we hypothesised that high-flow nasal oxygen would provide superior oxygenation as compared with our standard practice, 2 l min−1 oxygen by dry nasal specs. This was administered using the Optiflow THRIVE Nasal High Flow delivery system (Fisher and Paykel, Auckland, New Zealand) at a flow rate of 50 l min−1 and FiO2 0.3. The primary endpoint was the change in arterial partial pressure of oxygen (pO2) during the procedure. Secondary outcomes included the incidence of oxygen desaturation, airway interventions, the number of times the patient reached for the oxygen delivery device, incidence of cerebral desaturation, peri-operative oxygen therapy duration, hospital length of stay and patient satisfaction scores.

Results
A total of 72 patients were recruited. There was no difference in change in pO2 from baseline using high-flow compared with standard oxygen therapy: median [IQR] increase from 12.10 (10.05–15.22 [7.2–29.8]) to 13.69 (10.85–18.38 [8.5–32.3]) kPa vs. decrease from 15.45 (12.17–19.33 [9.2–22.8]) to 14.20 (11.80–19.40 [9.7–35.1]) kPa, respectively. The percentage change in pO2 after 30 min was also not significantly different between the two groups (p = 0.171). There was a lower incidence of oxygen desaturation in the high-flow group (p = 0.027). Patients in the high-flow group assigned a significantly higher comfort score to their treatment (p ≤ 0.001).

Conclusion
This study has demonstrated that high flow, compared with standard oxygen therapy, does not improve arterial oxygenation over the course of the procedure. There are suggestions that it may improve the secondary outcomes studied.

Trial registration
International Standard Randomised Controlled Trial Number (ISRCTN) 13,804,861. Registered on 15 April 2019. https://doi.org/10.1186/ISRCTN13804861
Redox dysregulation as a driver for DNA damage and its relationship to neurodegenerative diseases
Authors: Shadfar Sina , Parakh Sonam , Jamali Md Shafi , Atkin Julie D. 
Published: April 2023

AbstractRedox homeostasis refers to the balance between the production of reactive oxygen species (ROS) as well as reactive nitrogen species (RNS), and their elimination by antioxidants. It is linked to all important cellular activities and oxidative stress is a result of imbalance between pro-oxidants and antioxidant species. Oxidative stress perturbs many cellular activities, including processes that maintain the integrity of DNA. Nucleic acids are highly reactive and therefore particularly susceptible to damage. The DNA damage response detects and repairs these DNA lesions. Efficient DNA repair processes are therefore essential for maintaining cellular viability, but they decline considerably during aging. DNA damage and deficiencies in DNA repair are increasingly described in age-related neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis and Huntington’s disease. Furthermore, oxidative stress has long been associated with these conditions. Moreover, both redox dysregulation and DNA damage increase significantly during aging, which is the biggest risk factor for neurodegenerative diseases. However, the links between redox dysfunction and DNA damage, and their joint contributions to pathophysiology in these conditions, are only just emerging. This review will discuss these associations and address the increasing evidence for redox dysregulation as an important and major source of DNA damage in neurodegenerative disorders. Understanding these connections may facilitate a better understanding of disease mechanisms, and ultimately lead to the design of better therapeutic strategies based on preventing both redox dysregulation and DNA damage.
Cross-cultural adaptation of the Job Insecurity Scale (JIS) in Brazil and cross-national analysis of Job Insecurity effects in Brazil and Spain
Authors: Llosa José Antonio , Agulló-Tomás Esteban , Menéndez-Espina Sara , Heleno Camila Teixeira , de Olivera Borges Livia 
Published: April 2023

Abstract
Background
Job flexibilisation has increased interest in job insecurity and its consequences. Job insecurity, understood as a fear of losing employment, is linked to a deterioration of mental health, social relations or job satisfaction. Its study has been developed primarily in Europe, in the absence of validated psychometric scales in the Latin American context. To bridge this knowledge gap, the aim of this study is to cross-culturally adapt the Job Insecurity Scale (JIS) in Brazil, and secondly, to establish a cross-national analysis between people employed in Brazil and Spain.

Methods
As criteria for the sample, people with formally established employment in Brazil and Spain were selected. For the scale adaptation process, a sequence of EFA, CFA and validity tests are carried out, as well as a multigroup invariance according to the gender variable. The cross-national comparison compares the effect sizes of affective and cognitive job insecurity on the mental health variable measured with the GHQ-28 scale in both countries.

Results
1165 employed people participate in the study, of whom 573 reside in Brazil and 592 in Spain. The results of the scale adaptation show that the JIS is suitable for use in the Brazilian employment context. The scale offers a factorialisation in two dimensions (affective and cognitive) (CFI = 0.993; TLI = 0.987; RMSEA = 0.04; SRMR = 0.049; GFI = 0.999; NFI = 0.980) with good reliability (ω > 0.84). The cross-national comparison shows that job insecurity has a greater weight in explaining the mental health of the employed population in Brazil than in Spain, which is related to higher indicators of job insecurity in the Brazilian context.

Conclusions
With this validation we now have a validated scale of job insecurity validated for the Brazilian context. The comparison between countries shows the need to establish these analyses, since the behaviour of the phenomenon is different in the contexts studied.