bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prehospital vital sign monitoring in paediatric patients: an interregional study of educational interventions
Authors: Nielsen Vibe Maria Laden , Søvsø Morten Breinholt , Kløjgård Torben Anders , Skals Regitze Gyldenholm , Corfield Alasdair Ross , Bender Lars , Lossius Hans Morten , Mikkelsen Søren , Christensen Erika Frischknecht 
Published: January 2023

Abstract
Background
Prehospital vital sign documentation in paediatric patients is incomplete, especially in patients ≤ 2 years. The aim of the study was to increase vital sign registration in paediatric patients through specific educational initiatives.

Methods
Prospective quasi-experimental study with interrupted time-series design in the North Denmark and South Denmark regions. The study consecutively included all children aged < 18 years attended by the emergency medical service (EMS) from 1 July 2019 to 31 December 2021. Specific educational initiatives were conducted only in the North Denmark EMS and included video learning and classroom training based on the European Paediatric Advanced Life Support principles. The primary outcome was the proportion of patients who had their respiratory rate, peripheral capillary oxygen saturation, heart rate and level of consciousness recorded at least twice. We used a binomial regression model stratified by age groups to compare proportions of the primary outcome in the pre- and post-intervention periods in each region.

Results
In North Denmark, 7551 patients were included, while 15,585 patients from South Denmark were used as a reference. Virtually all of the North Denmark EMS providers completed the video learning (98.7%). The total study population involved patients aged ≤ 2 months (5.5%), 3–11 months (7.4%), 1–2 years (18.8%), 3–7 years (16.2%) and ≥ 8 years (52.1%). In the intervention region, the primary outcome increased from the pre- to the post-intervention period from 35.3% to 40.5% [95% CI for difference 3.0;7.4]. There were large variations in between age groups with increases from 18.8% to 27.4% [95% CI for difference 5.3;12.0] among patients aged ≤ 2 years, from 33.5% to 43.7% [95% CI for difference 4.9;15.5] among patients aged 3–7 years and an insignificant increase among patients aged ≥ 8 years (from 46.4% to 47.9% [95% CI for difference − 1.7;4.7]). In the region without the specific educational interventions, proportions were steady for all age groups throughout the entire study period.

Conclusions
Mandatory educational initiatives for EMS providers were associated with an increase in the extent of vital sign registration in paediatric patients ≤ 7 years. Incomplete vital registration was associated with, but not limited to non-urgent cases.
Acute otitis media-related facial nerve palsy in a child: a case report and a literary review
Authors: Castellazzi Massimo Luca , Torretta Sara , Pietro Giada Maria Di , Ciabatta Annaclara , Capaccio Pasquale , Caschera Luca , Marchisio Paola 
Published: January 2023

Abstract
Background
Acute otitis media has become a rare cause of facial palsy in children. A high index of suspicion is essential to achieve the diagnosis and to properly treat this condition to avoid permanent neurological sequelae.

Case presentation
A case of acute otitis media-related facial nerve palsy in an 18 months-old child is described and a review of the recent literature about the clinical presentation, diagnosis, and management of this condition is performed.

Conclusions
Facial paralysis is an uncommon complication of acute otitis media that requires appropriate care. As highlighted in our report, the treatment of facial nerve palsy secondary to otitis media should be conservative, using antibiotics and corticosteroids. The role of antiviral is still a matter of debate. Myringotomy and a ventilation tube should be added when spontaneous perforation of the tympanic membrane is not present. More aggressive surgical approach should be considered only when there is no significant improvement.
Vitamin C boosts DNA demethylation in TET2 germline mutation carriers
Authors: Taira Aurora , Palin Kimmo , Kuosmanen Anna , Välimäki Niko , Kuittinen Outi , Kuismin Outi , Kaasinen Eevi , Rajamäki Kristiina , Aaltonen Lauri A. 
Published: January 2023

Abstract
Background
Accurate regulation of DNA methylation is necessary for normal cells to differentiate, develop and function. TET2 catalyzes stepwise DNA demethylation in hematopoietic cells. Mutations in the TET2 gene predispose to hematological malignancies by causing DNA methylation overload and aberrant epigenomic landscape. Studies on mice and cell lines show that the function of TET2 is boosted by vitamin C. Thus, by strengthening the demethylation activity of TET2, vitamin C could play a role in the prevention of hematological malignancies in individuals with TET2 dysfunction. We recently identified a family with lymphoma predisposition where a heterozygous truncating germline mutation in TET2 segregated with nodular lymphocyte-predominant Hodgkin lymphoma. The mutation carriers displayed a hypermethylation pattern that was absent in the family members without the mutation.

Methods
In a clinical trial of 1 year, we investigated the effects of oral 1 g/day vitamin C supplementation on DNA methylation by analyzing genome-wide DNA methylation and gene expression patterns from the family members.

Results
We show that vitamin C reinforces the DNA demethylation cascade, reduces the proportion of hypermethylated loci and diminishes gene expression differences between TET2 mutation carriers and control individuals.

Conclusions
These results suggest that vitamin C supplementation increases DNA methylation turnover and provide a basis for further work to examine the potential benefits of vitamin C supplementation in individuals with germline and somatic TET2 mutations.
Trial registration: This trial was registered at EudraCT with reference number of 2018-000155-41 (01.04.2019).

Graphical Abstract
Mutational signature of extracranial meningioma metastases and their respective primary tumors
Authors: Biczok A. , Thorsteinsdottir J. , Karschnia P. , Ruf V. C. , Tonn J. C. , Herms J. , Schichor C. , Dorostkar M. M. 
Published: January 2023

AbstractExtracranial metastases of intracranial meningiomas are rare. Little is known about the mutational pattern of these tumors and their metastatic seeding. Here, we retrospectively explored the molecular alterations of these metastatic lesions and their respective intracranial tumor manifestations.Histology and genome sequencing were performed in intracranial meningiomas and their extracranial metastatic lesions operated upon between 2002 and 2021. Next-generation DNA/RNA sequencing (NGS) and methylome analysis were performed to determine molecular alterations.We analyzed the tumors of five patients with clinically suspected metastases of a meningioma using methylome analysis and next generation panel sequencing of the primary tumors as well as the metastatic lesions. Metastases were found in the spinal cord and one in the lung. In four of these patients, molecular analyses confirmed metastatic disease, while the fifth patient was found to harbor two molecularly distinct meningiomas. On pathological assessment, the primary lesions ranged from CNS WHO grades 1 to 3 (integrated molecular-morphologic meningioma classification scores 2 to 6). Of the four true metastatic cases, three out of the four metastasizing tumors harbored alterations in the BAP1 gene, comprising a stop-mutation combined with copy-number loss (WHO grade 1), copy number loss (WHO grade 3) and a frameshift mutation (WHO grade 2). Furthermore, the latter was confirmed to harbor a BAP1 tumor predisposition syndrome. The fourth metastasizing tumor had copy-number losses in NF2 and PTEN. Only one of four showed CDKN2A homozygous deletion; none showed TERT promotor mutation.Our results molecularly confirm true metastatic disease in four meningioma patients. BAP1 gene alterations were the most frequent. Larger cohorts, most likely from multicenter studies are necessary to evaluate the role of BAP-1 alterations to further understand the metastatic spread in meningiomas. for metastatic spread and might indicate patients at risk for metastatic spread. Further explorations within larger cohorts are necessary to validate these findings which might influence the clinical management in the future.
AI-based MRI auto-segmentation of brain tumor in rodents, a multicenter study
Authors: Wang Shuncong , Pang Xin , de Keyzer Frederik , Feng Yuanbo , Swinnen Johan V. , Yu Jie , Ni Yicheng 
Published: January 2023

AbstractAutomatic segmentation of rodent brain tumor on magnetic resonance imaging (MRI) may facilitate biomedical research. The current study aims to prove the feasibility for automatic segmentation by artificial intelligence (AI), and practicability of AI-assisted segmentation. MRI images, including T2WI, T1WI and CE-T1WI, of brain tumor from 57 WAG/Rij rats in KU Leuven and 46 mice from the cancer imaging archive (TCIA) were collected. A 3D U-Net architecture was adopted for segmentation of tumor bearing brain and brain tumor. After training, these models were tested with both datasets after Gaussian noise addition. Reduction of inter-observer disparity by AI-assisted segmentation was also evaluated. The AI model segmented tumor-bearing brain well for both Leuven and TCIA datasets, with Dice similarity coefficients (DSCs) of 0.87 and 0.85 respectively. After noise addition, the performance remained unchanged when the signal–noise ratio (SNR) was higher than two or eight, respectively. For the segmentation of tumor lesions, AI-based model yielded DSCs of 0.70 and 0.61 for Leuven and TCIA datasets respectively. Similarly, the performance is uncompromised when the SNR was over two and eight respectively. AI-assisted segmentation could significantly reduce the inter-observer disparities and segmentation time in both rats and mice. Both AI models for segmenting brain or tumor lesions could improve inter-observer agreement and therefore contributed to the standardization of the following biomedical studies.
Second trimester post-abortion family planning uptake and associated factors in 14 public health facilities in Central Uganda: a cross-sectional study
Authors: Atuhairwe Susan , Hanson Claudia , Tumwesigye Nazarius Mbona , Gemzell-Danielsson Kristina , Byamugisha Josaphat 
Published: January 2023

Abstract
Background
Post-abortion family planning counselling and provision are known high impact practices preventing unintended pregnancies. Little is known, however, about specific needs in the second trimester. Our study aims to assess post-abortion family planning uptake and its associated factors among women with second-trimester incomplete abortion.

Methods
We conducted a cross-sectional survey of 1191 women with incomplete second trimester abortion that received treatment at 14 comprehensive emergency obstetric care public health facilities in central Uganda from August 2018 to November 2021. We computed the post-abortion uptake of family planning within 2 weeks of treatment, described the types of methods accepted, and the reasons for declining family planning. We described the socio-demographic, reproductive, abortion-related, and health facility characteristics. We used mixed effects generalized linear models to obtain percentage differences for factors independently associated with post-abortion family planning uptake.

Results
Second-trimester post-abortion family planning uptake was 65.6%. Implants (37.5%) and progestin only injectables (36.5%) were the commonly chosen methods; natural (0.1%), permanent (0.8%), and condoms (4%) were the least chosen methods. 45.2% of the women who declined family planning desired another pregnancy soon. Women whose spouses were aware of the pregnancy or had planned pregnancy had 11% (− 10.5, 95% CI − 17.1 to − 3.8) and 12% (− 11.7, 95% CI − 19.0 to − 4.4) less uptake compared to women whose spouses were not aware of the pregnancy or those with unplanned pregnancies respectively. Uptake was 8% (− 7.8, 95% CI − 12.6% to − 3.0%) lower among Islamic women compared to Anglicans. Women who received post-abortion family planning counselling or had more than four live births had 59% (59.4, 95% CI 42.1 to 76.7) and 13% (13.4, 95% CI 4.0 to 22.8%) higher uptake compared to women who did not receive counselling or women with no live births, respectively.

Conclusions
The uptake of second-trimester post-abortion family planning in Uganda was higher than previous estimates. Post-abortion family planning counselling, grand multiparity, and the need to avoid an unplanned pregnancy enhance post-abortion family planning uptake in the second trimester. Ministry of Health should strengthen post-abortion family planning counselling, especially couple counselling; at all health facilities in the country and also ensure an adequate and accessible supply of a wide contraceptive method mix.
Investigating the components of fintech ecosystem for distributed energy investments with an integrated quantum spherical decision support system
Authors: Ai Rui , Zheng Yuhang , Yüksel Serhat , Dinçer Hasan 
Published: January 2023

AbstractThis study aimed to evaluate the components of a fintech ecosystem for distributed energy investments. A new decision-making model was created using multiple stepwise weight assessment ratio analysis and elimination and choice translating reality techniques based on quantum spherical fuzzy sets. First, in this model, the criteria for distributed energy investment necessities were weighted. Second, we ranked the components of the fintech ecosystem for distributed energy investments. The main contribution of this study is that appropriate strategies can be presented to design effective fintech ecosystems to increase distributed energy investments, by considering an original fuzzy decision-making model. Capacity is the most critical issue with respect to distributed energy investment necessities because it has the greatest weight (0.261). Pricing is another significant factor for this condition, with a weight of 0.254. Results of the ranking of the components of the fintech ecosystem indicate that end users are of the greatest importance for the effectiveness of this system. It is necessary to develop new techniques for the energy storage process, especially with technological developments, to prevent disruptions in energy production capacity. In addition, customers’ expectations should be considered for the development of effective and user-friendly financial products that are preferred by a wider audience. This would have a positive effect on fintech ecosystem performance.
Micronucleus test using formalin-fixed rat glandular stomach and colon
Authors: Ohyama Wakako , Fujiishi Yohei , Okada Emiko , Narumi Kazunori , Hayashi Makoto 
Published: January 2023

Abstract
Background
Genotoxicity in tissues other than hematopoietic tissues, such as the liver and gastrointestinal (GI) tract, is an important focus in the risk assessment of chemicals in humans. We previously developed a rat micronucleus test for the GI tract, which is the first contact tissue where chemicals are introduced into the body through oral exposure. Target cells were obtained from fresh tissue samples by ethylenediaminetetraacetic acid disodium salt (EDTA) treatment. As an improvement to this method, we have used formalin-fixed tissues instead of fresh tissues; this approach can be used for tissues that are sampled from other toxicological tests and that are archived for several years. This new method can be used for examining micronucleus induction retrospectively when needed. In the present study, we compared the performance of the EDTA method and the new method with formalin-fixed tissues (formalin-fixation method).

Results
Histological examination showed that both the EDTA and formalin-fixation methods could be used for collecting cells located in or above the proliferative zone of the GI tract tissues of rats. In addition, the collected cells were similar in shape. We conducted micronucleus tests with rat GI tract tissues by the two methods using model chemicals, which were used as positive control chemicals (a combination of diethylnitrosamine, 1,2-dimethylhydrazine dihydrochloride, and potassium bromate). The two methods showed similar results. We additionally evaluated the aging effect of tissues stored in formalin fixative. The results showed that 1 year of storage did not affect the frequency of micronucleated cells.

Conclusion
The equivalence of the EDTA and formalin-fixation methods was confirmed, and micronucleus analysis was possible up to at least 1 year after formalin fixation of the GI tract, indicating that the formalin-fixation method is valuable for the rat GI tract micronucleus test.
Nanofibrous polypeptide hydrogels with collagen-like structure as biomimetic extracellular matrix
Authors: Zhao Chengkun , Li Xing , Bian Shaoquan , Zeng Weinan , Ronca Alfredo , D’Amora Ugo , Raucci Maria Grazia , Liang Jie , Sun Yong , Jiang Qing , Fan Yujiang , Ambrosio Luigi , Zhang Xingdong 
Published: January 2023

AbstractSupramolecular peptides exhibit obvious similarities with collagen fibers in terms of self-assembly characteristics, nanofibrous structure, and responsiveness to external stimuli. Here, a series of supramolecular peptides were developed by altering the amino acid sequence, enabling the self-assembly of three types of 4-biphenylacetic acid (BPAA)-tripeptides into fibrous hydrogel through hydrogen bonding and π–π stacking under the influence of ion induction. Transmission electron and scanning electron microscopies revealed that the diameter of the fiber within nanofibrous hydrogels was ~ 10 and ~ 40 nm, respectively, which was similar with the self-assembled collagen fibers. For this reason, these hydrogels could be considered as a biomimetic extracellular substitute. Meanwhile, the gelation concentration induced by ions was even lower than 0.66 wt%, with an elastic modulus of ~ 0.27 kPa, corresponding to a water content of 99.34 wt%. In addition, the three supramolecular hydrogels were found to be good substrates for L929 cell adhesion and MC-3T3 cell proliferation. The overall results implied that BPAA-based hydrogels have a lucrative application potential as cell carriers.
Graphical Abstract
Hemoglobin A1c Variability Metrics Predict Coronary Artery Calcium and Cardiovascular Events in Type 1 Diabetes: The CACTI Study
Authors: Horton William B , Snell-Bergeon Janet K 
Published: January 2023

Abstract

Context
Interventions that decrease mean glucose have reduced rates of micro- and macrovascular complications in type 1 diabetes (T1D). However, the difference in cardiovascular risk between people with T1D and the general population endures, suggesting that factors beyond hemoglobin A1C (HbA1c) normalization drive cardiovascular outcomes.

Objective
To determine whether various HbA1c metrics predict anatomic cardiovascular disease (CVD) risk factors and/or CVD events in people with T1D.

Methods
We used linear regression to analyze the relationship of several HbA1c metrics to anatomic CVD risk factors and then used Cox regression to model their relationship to incident CVD events in the CACTI Study (ClinicalTrials.gov Identifier: NCT00005754).

Results
In linear regression models adjusted for age, sex, and T1D duration, baseline Hba1c (b = 0.3998, P = 0.0236), mean HbA1c (b = 0.5385, P = 0.0109), and HbA1c SD (b = 1.1521, P = 0.0068) were each positively associated with square root transformed coronary artery calcium volume. Conversely, only mean HbA1c (b = 1.659, P = 0.0048) positively associated with pericardial adipose tissue volume. In survival models adjusted for age, sex, and T1D duration, baseline HbA1c [hazard ratio (HR): 1.471, 95% CI: 1.257-1.721], mean HbA1c (HR: 1.850, 95% CI: 1.511-2.264), time-varying HbA1c (HR: 1.500, 95% CI: 1.236-1.821), and HbA1c SD (HR: 1.665, 95% CI: 1.022-2.711) each independently predicted CVD events over 14.3 ± 5.2 person-years of follow-up.

Conclusions/interpretation
We found that various HbA1c metrics positively correlated with CAC volume and independently predicted incident CVD events in the CACTI T1D cohort. These associations with CVD events persisted for baseline HbA1c, mean HbA1c, and time-varying HbA1c even after adjustment for numerous CVD risk factors.
Complications and Technical Consideration of Ultrasound-Guided Rectus Sheath Blocks: A Retrospective Analysis of 4033 Patients
Authors: Kwon Hyun-Jung , Kim Yeon Ju , Kim Youngmu , Kim Seonjin , Cho Hakmoo , Lee Jong-Hyuk , Kim Doo-Hwan , Jeong Sung-Moon 
Published: January 2023

BACKGROUND:
Although the ultrasound-guided rectus sheath block (RSB) is usually regarded as an easy and safe procedure in clinical settings, there is currently no report on complications incidence. Therefore, the present study investigated complications in a large cohort and described the technical considerations to minimize complications of real-time ultrasound-guided RSBs.

METHODS:
This was a retrospective cohort study of patients who underwent real-time ultrasound-guided RSBs for perioperative pain control in laparoscopic surgery with an umbilical port between February 1, 2017, and February 28, 2021, at the Asan Medical Center in South Korea. All RSBs were performed bilaterally using a 23-gauge Quincke needle, and a bilateral 2-block placement was regarded as 1 RSB. Patient data, including demographics, preoperative laboratory data, preoperative antiplatelet or anticoagulant medication with the duration of discontinuation, and type of surgery, were collected to show the study population characteristics and explore potential factors associated with adverse events such as hematoma. Ultrasound images of patients and adverse events of RSBs, including extrarectus sheath injections, vascular injuries, bowel injury, or local anesthetic systemic toxicity, were also analyzed accordingly.

RESULTS:
A total of 4033 procedures were analyzed. The mean body mass index of the patients was 24.1 (21.8–26.5) kg/m2. The preoperative laboratory data were within normal range in 4028 (99.9%) patients. Preoperative antiplatelets or anticoagulants were administered in 17.3% of the patients. Overall, 96 complications (2.4%) were observed. Among them, extrarectus sheath injection occurred in 88 cases (2.2%), which included preperitoneal injection (0.9%) and intraperitoneal injection (1.3%). Vascular injuries constituted 8 cases (0.2%) and all vascular injuries resulted in hematoma: 7 cases of inferior epigastric artery injury with rectus sheath hematoma and 1 of inferior mesenteric artery injury with retroperitoneal hematoma. Bowel injury or local anesthetic systemic toxicity was not reported.

CONCLUSIONS:
In this study of RSBs performed on 4033 patients using a 23-gauge Quincke needle in patients with low body mass index, there were 8 cases (0.2%) of vascular injury, all of which accompanied hematoma.
FACTORS AFFECTING THE CAPACITY OF THE ROAD NETWORK
Authors: Gasilova Olga S. , Kulakov Konstantin V. , Maltseva Anastasia A. , Sidorov Boris A. 
Published: January 2023

Full-scale studies of the movement of vehicles on the street and road network of large cities have been carried out. It is revealed that a large number of realignments are observed during the movement of vehicles, as factors affecting the capacity of the road network. The quantitative characteristics of car rebuilds before relocations are determined. The dependence of the number of vehicle realignments on the number of traffic lanes and the location of the vehicle in a particular lane has been established. The obtained research results should be taken into account when determining the duration of traffic light regulation cycles at intersections.
Purpose – determination of the number of realignments as factors affecting the capacity of the road network.
Methodology statistical methods of processing a full-scale experiment were used in the work.
Results: quantitative characteristics of realignments depending on the number of lanes and the composition of traffic flows are obtained.
Practical implications it is advisable to apply the obtained results in the regulation of road traffic by technical means of traffic management.