bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a Measure of Hospital Maternal Level of Care for the United States
Authors: Vanderlaan Jennifer , Shen Jay , McDonough Ian K. 
Published: August 2023

Abstract
Background
Lack of a validated assessment of maternal risk-appropriate care for use in population data has prevented the existing literature from quantifying the benefit of maternal risk-appropriate care. The objective of this study was to develop a measure of hospital maternal levels of care based on the resources available at the hospital, using existing data available to researchers.
Methods
This was a Secondary Data Analysis. The sample was abstracted from the American Hospital Association Annual Survey Database for 2018. Eligibility was limited to short-term acute general hospitals that reported providing maternity services as measured by hospital reporting of an obstetric service level, obstetric services, or birthing rooms. A method to identify maternal level of care was created by identifying variables in the dataset that aligned with the ACOG criteria for each maternal level. The validity of the method was measured as the level of agreement of the distribution of hospital levels with the distribution in CDC Levels of Care Assessment Tool Validation Pilot. Results were compared to hospital self-report in the database and measurement reported with another published method.
Results
The sample included 2,351 hospitals. AHA variables were available to measure resources that align with ACOG Levels 1, 2, and 3. Overall, 1219 (51.9%) of hospitals reported resources aligned with Maternal Level One, 816 (34.7%) aligned with maternal level two, and 202 (8.6%) aligned with maternal level Three. This method overestimates the prevalence of hospitals with maternal level one compared to the CDC measurement of 36.1% (Mean 52.9%; 95% CI47.2% − 58.7%), and likely includes hospitals that would not qualify as level one if all resources required by the ACOG guidelines could be assessed. This method underestimates the prevalence of hospitals with maternal critical care services (Level 3 or 4) compared to CDC measure of 12.1% (Mean 8.1%; 95%CI 6.2% – 10.0%) but is an improvement over hospital self-report (24.7%) and a prior published method (32.3%).
Conclusions
This method of measuring maternal level of care allows researchers to investigate the value of perinatal regionalization, risk-appropriate care, and hospital differences among the three levels of care.
Application of Rain Classroom combined with Team-based Learning(TBL) to teaching of case discussion for residents in Department of anesthesiology
Authors: Li Jun , Meng Yong , Han Tingting , Wang Yaoyao , Li Bo , Zhao Liang 
Published: August 2023

Abstract
Background
The purpose of this study was to explore the teaching effect of Rain Classroom combined with Team-based Learning(TBL) to case discussion of anesthesia residents.
Methods
To compare the application of Rain Classroom combined with Team-based Learning (TBL) model and traditional lecture-based Learning (LBL) model in the teaching of clinical case discussion for anesthesia residents. The resident scores and teacher's teaching effect are analyzed through data collection and analysis.
Results
The mode of Rain classroom combined with TBL made residents deeply participate in the whole process of case discussion, better completed the learning objectives, and improved the comprehensive ability of residents.The satisfaction of Rain classroom combined with TBL teaching method was significantly higher than that of LBL .
Conclusion
Rain Classroom combined with TBL teaching mode is effective in case discussion teaching of anesthesia residents, which provides reference for clinical teaching reform of anesthesiology.
A rare case of Extensive Neurogenic Heterotopic Ossification (NHO): A case report
Authors: Somani Vasav , Desai Mohan , Shaikh Ashraf , Gupta Rajan 
Published: August 2023

Abstract

Introduction Neurogenic Heterotopic ossification (NHO) is a potential sequalae and a detrimental complication following neurological insult. It is characterized by formation of localized gradually progressive, peri-articular lamellar bone formation in extra-skeletal tissues. We would like to report a rare case of heterotopic ossification involving all 4 limbs, in which we tried to restore joint mobility to improve his functional status so that he could perform his daily tasks. Case presentation We present a case of a 33-year-old bed ridden male, diagnosed with NHO involving all 4 limbs (bilateral hip, right knee, right shoulder, left elbow). The patient had a crippled posture, significant pain and impaired range of motion hampering movement of all four limbs which prevented him from lying down supine, sitting, walking and performing activities of daily living.. After three surgeries, the patient achieved wheelchair mobilization and upright posture with the assistance of calipers. Conclusion The management of NHO requires a multidisciplinary approach involving orthopaedic surgeons, neurologists & rehabilitation specialists. Prognosis of NHO depends on factors such as extent of ossification, underlying neurological condition & patients overall health.
Development and Validation of a Self-Management Self-Efficacy Scale for Premature Birth Prevention (SMSE-PBP) for women of childbearing age
Authors: Kim Sun-Hee , Lee Yu-Jin 
Published: August 2023

Abstract
Background
This study aimed to develop and evaluate the validity and reliability of a self-management self-efficacy for premature birth prevention (SMSE-PBP) in women of childbearing age (WCA).
Methods
Instrument development and validation were undertaken in three phases: conceptualization, item generation and evaluation of content validity, and evaluation of construct and concurrent validity and reliability. Data were analyzed using exploratory and second-order confirmatory factor analyses, and concurrent validity was examined using Pearson’s correlation coefficients. The reliability was analyzed using omega hierarchical and Cronbach’s ⍺.
Results
Content validity was assessed by experts and cognitive interviews of WCA. The SMSE-PBP consists of a second-order 3-dimension and 10-factor scale with 60 items; therefore, the construct and concurrent validity of the SMSE-PBP were supported. The omega values were .93 for pre-pregnancy SMSE-PBP, .92 for pregnancy SMSE-PBP, and .94 for hospital SMSE-PBP. Cronbach’s ⍺ was .88 for pre-pregnancy SMSE-PBP, .96 for pregnancy SMSE-PBP, and .96 for hospital SMSE-PBP.
Conclusions
The SMSE-PBP scale is valid and reliable for WCA; it is helpful for WCA and health professionals to assess women’s SMSE-PBP and pre-pregnancy, pregnancy, or hospital SMSE-PBP. The next steps should include assessing the relationship with pregnancy health behaviors.
The effectiveness of school-based physical activity interventions on girls' MVPA, sedentary behaviour and physical activity guideline adherence: A Systematic Review
Authors: McCarthy Nicole , Hall Alix , Nathan Nicole , Sutherland Rachel , Campbell Libby , Shoesmith Adam , Gibson Edward Riley , Gardner Carly , Neil-Sztramko Sarah , Hodder Rebecca 
Published: August 2023

Abstract
Background: Evidence suggests physical activity (PA) levels decline as children age, with levels lower for girls than boys. Consequently, many PA interventions have targeted schools to increase physical activity among children but show varying effects. However, no recent systematic review has assessed their effects specifically on girls’ PA. To address this evidence gap, we conducted a synthesis of studies included in a recent comprehensive Cochrane review of school-based PA interventions, to determine their effect on girls’ PA levels and sedentary time, and proportion of students meeting PA guidelines.
Methods: Studies assessing the effect of school-based PA interventions in students aged 6 to 18 years were considered eligible for inclusion in the original review if they: employed a randomised controlled trial design, targeted school students, and objectively assessed student PA (such as moderate-to-vigorous physical activity (MVPA)), sedentary time, or the proportion of children meeting PA guidelines across the whole day or school day. Studies from the original review were eligible for this secondary analysis if they reported eligible outcomes separately for girls. Where possible, random-effects meta-analyses were undertaken to estimate pooled effect sizes for primary outcomes.
Results: Nineteen of 89 studies from the original review were included. Meta-analysis of 14 studies (11,384 participants) indicated interventions made little to no difference to girls’ minutes of MVPA across the whole day [mean difference: 0.81 minutes/day (95% CI: -0.30, 1.91; I2=50%; low certainty evidence]. Meta-analysis of eight studies (4,811 Participants) found that school-based PA interventions probably decrease girls’ minutes of sedentary behaviour across the whole day [mean difference: -6.73 minutes/day (95% CI: -11.61, -1.85); I2=0% moderate certainty evidence]. One study measured the proportion of students meeting guidelines which found little to no difference [0.65 (95% CI: 0.23, 1.85) very low certainty of evidence] on this outcome.
Conclusions: The positive result for sedentary time but not MVPA suggests that school-based PA interventions are beneficial for improving movement of girls, but not intensity of movement. Future research should focus on improving the design of interventions in an attempt to target their impact on increasing the intensity of girls’ PA levels. Such efforts could include those that target girl specific preferences and barriers.
Thyroid dysfunction in first-episode drug-naïve major depressive disorder patients with or without psychotic symptoms
Authors: Yang Wanqiu , Zhao Na , Kang Chuanyi , Shi Jingjing , Yang Liying , Liu Jiacheng , Zheng Yue , Zhang Shuting , Wang Xiaohong , Zhang Xiangyang 
Published: August 2023

Abstract
Background
It is a common of comorbid psychotic symptoms in patients with major depressive disorder (MDD). However, there are few studies on the thyroid function of psychotic depression (PD) in first-episode drug naïve (FEDN) MDD patients. This study was to examine the difference in thyroid function between PD and NPD of first-episode drug-naïve (FEDN) major depression (MDD) and explore the related risk factors for PD in a large sample size of patients in a Chinese population.
Methods
We recruited 1718 outpatients diagnosed with FEDN MDD. The thyroid function-related parameters, including thyroid-stimulating hormone (TSH), free thyroxin (FT4, FT3)7, thyroid peroxidase antibodies (TPOAb), and anti-thyroglobulin (TGAb), socio-demographic and clinical data were collected. The Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and the positive subscale of the Positive and Negative Syndrome Scale (PANSS) were administered to score patients’ anxiety, depression, and psychotic symptoms.
Results
The elevated TSH, TPOAb, and TGAb serum accounted for 79.5%, 28.7%, and 35.9% of PD patients, respectively. Compared to NPD patients, PD patients had higher serum levels of TSH, TGAb, and TPOAb (all P < 0.001). Furthermore, logistic regression analysis demonstrated a strong association between the serum level of TSH and PD, with an odds ratio of 1.189.
Conclusions
Our findings suggest that elevated TSH levels may increase the risk of PD and highlight the importance of thyroid screening tests for the accurate diagnosis and effective treatment of PD.
"Cold" Orthogonal Translation by Psychrophilic Pyrrolysyl-tRNA Synthetase Boosts Genetic Code Expansion
Authors: Budisa Nediljko , Koch Nikolaj , Göttig Peter , Rappsilber Juri 
Published: August 2023

Abstract
Using orthogonal translation systems (OTSs) is the most efficient way to produce unnatural proteins by adding non-canonical amino acids (ncAAs) to the genetic code. In the quest to expand substrate specificity the conventional approach begins with a (hyper-)stable enzyme capable of withstanding the structural changes resulting from necessary mutations. However, we here take a radically different position by starting with an enzyme that has evolved to cope with instability, and thus may exhibit greater resilience to mutations. By engineering a psychrophilic ("cold") OTS from Methanococcoides burtonii we developed an alternative to the commonly used mesophilic and thermophilic systems. This OTS showed remarkable properties in terms of catalytic efficiency and promiscuity, even at very low ncAA concentrations. Given the broad range of applicable host organisms, we anticipate that Cold-OTS will greatly facilitate the transformation of the expanded genetic code from an academic discipline into a high-value chemistry-driven biotechnology.
Endoplasmic reticulum stress negatively regulates intestinal stem cells mediated by activation of GRP78/ATF6/CHOP signal
Authors: Fan Hancheng , Wu Jiaqiang , Wang Jie , Wang Qingyuan , Cai Yihao , Huang Hongmei , Zhao Minjun , Shu Xin , Dong Hui , Zhang Xinxin , Shao Lijian , Zeng Huihong 
Published: August 2023

Abstract
Impairment of intestinal stem cells (ISCs) is closely associated with various intestinal diseases. Endoplasmic reticulum stress (ERS) and cellular apoptosis are widely recognized as important factors during the development of intestinal diseases. However, whether ERS negatively affects numbers and differentiation ability of ISCs remains unknown. In the present study, tunicamycin (TM) was utilized to induce ERS in the mouse intestine to further investigate the underlying mechanisms on ERS-induced intestinal damage. The results showed that mice treated with TM at a dose of 1 mg/kg resulted in a significant reduction in body weight, shortening of the intestinal villi, deepening of the intestinal crypts and disruption of the intestinal barrier when compared to the control group. The numbers of ISCs, endocrine cells, goblet cells in the small intestine were significantly reduced after TM exposure. TM treatment decreased cellular proliferation and increased apoptosis in the cryptic area. Especially, Immunofluorescence double staining showed that ERS significantly increased expression of GRP78 and cellular apoptosis in ISCs. Further evidence indicated that GRP78/ATF6/CHOP signal pathway was activated while p44/42 MAPK signaling was significantly inhibited after TM treatment. These data suggest that TM-induced ERS reduces ISC numbers and diminishes ISC differentiation capacity through inhibiting cellular proliferation and increasing apoptosis.
Optimization Design of Hydrocyclone with Overflow Slit Structure based on Experimental Investigation and Numerical Simulation Analysis
Authors: Chen Shuxin , Li Donglai , Li Jianying , Zhong Lin 
Published: August 2023

Abstract

This study aims to address the issue of high energy consumption in the hydrocyclone separation process. By introducing a novel slotted overflow pipe structure and utilizing experimental and response surface optimization methods, the optimal parameters were determined. The research results indicate that the number of slots, slot angles, and positioning dimensions significantly influence the performance of the hydrocyclone separator. The optimal combination was found to be three layers of slots, a positioning dimension of 5.3mm, and a slot angle of 58°. In a Φ100mm hydrocyclone separator, validated through multiple experiments, the separation efficiency increased by 0.26% and the pressure drop reduced by 24.88% under a flow rate of 900ml/s. CFD simulation verified the reduction in internal flow field velocity and pressure drop due to the slotted structure. Therefore, this study provides an effective reference for designing efficient and low-energy hydrocyclone separators.
Isolation and functional characterization of a pathogenesis-related protein 4 gene from Panax notoginseng
Authors: Sun Hao , Li Man-Qiao , Liu Xu-Yan , Li Kui-Xiu , Liu Di-Qiu , Yang Sheng-Chao , Liu Guan-Ze 
Published: August 2023

Abstract
Pathogenesis-related (PR) proteins are a large class of proteins that accumulate in plant cells in response to multiple biotic and abiotic stresses. The PR proteins are usually divided into 17 families. Root rot is an important disease of the perennial medicinal plant Panax notoginseng, with Cylindrocarpon destructansidentified as one of the causative pathogens. However, little is known about the PR-encoding genes expressed during the infection of P. notoginsengby C. destructans. In this study, we isolated a PR4 gene (PnPR4) from P. notoginseng on the basis of a genomic analysis. The expression of this gene was significantly up-regulated in the roots of C. destructans-infected P. notoginseng plants at 72 h post-inoculation (relative to the control level). The expression of PnPR4 was affected by hydrogen peroxide, gibberellic acid, ethephon, abscisic acid, and salicylic acid. The transient expression of the PnPR4-GFP fusion gene in tobacco epidermal cells indicated that PnPR4 was localized in the cell wall (i.e., extracellular protein). In addition, the purified PnPR4 recombinant protein had antifungal activities, with inhibitory effects on C. destructans. Furthermore, the PnPR4gene was transferred into the model plant tobacco to verify its function. The overexpression of PnPR4 increased the resistance to C. destructans. In conclusion, PnPR4 contributes to the defense response of P. notoginseng to C. destructans.
Rotating square tessellations enabled stretchable and adaptive curved display.
Authors: Yu Hongyu , Hong Wei , Deng Yang , Xu Kuaile , JIAO Rui , Liu Weixuan , Cheung Yik Kin , Li Yongkai , Wang Xiaoyi , Hou Yue 
Published: August 2023

Abstract
Curved displays can adjust their shape to accommodate different objects and are used in electronics and decorative lighting. Due to the immutable pixel spacing, existing commercial curved displays are flexible but not compatible with undevelopable surfaces. Inspired by kirigami and auxetic structures, we propose a novel approach that combines luminescent elements and rotating square tessellations to create a stretchable, arbitrary curve adaptive display. We connect square islands by vertical interconnects for the first time to relieve the stress concentration and provide extra deformation patterns. The vertical interconnects are patterned on a flexible printed circuit board (FPCB) using laser cutting and folded up via specially designed molds. Further, the freed-up space by folded interconnects allows the structure to be compressed. A prototype stretchable display is demonstrated that it can maintain electrical performance under biaxial strain and adapt to different Gaussian curvature surfaces, including cylindrical, spherical, saddle and arbitrary surfaces. Theoretical models and finite element calculations are established to describe the tensile behavior of the structures under different boundary conditions and agree with the experimental results. This proposed technology paves a feasible solution of mass production of adaptive curved displays and sets the trend for the next-generation display.
Accurate Acoustic Based Deep Learning Model for Mosquitoes Species Classification
Authors: Bilal Muhammad , Rehman Ata Ur , Rafique Waqas , Fernandez-Reyes Delmiro 
Published: August 2023

Abstract
Despite global health advancements, mosquito borne diseases are still life threating and prevalent, with dengue and malaria contributing to thousands of deaths each year. However, the responsibility for transmitting these specific diseases does not lie with all mosquito species globally. Detecting mosquito species from their wingbeats acoustic data can be very effective, however, it is a challenging task to accurately distinguish specific mosquito species based on their wingbeat patterns. Our acoustic-based deep learning model for mosquito species classification uses the combination of sinc layer, one dimensional convolutional layer and long short-term memory (LSTM) layer to learn features from raw audio signals and capture the temporal dependencies between them strikingly outperforming existing methods. We achieve test accuracy of 93.59% precision of 0.9363, Recall of 0.9311 and F1 Score of 0.9335. Our model has significant potential for low-cost, non-invasive, and high-throughput identification of mosquito species, which can play a role on the prevention and control of mosquito-borne diseases. By utilizing the unique wingbeat patterns of mosquitoes, our model enables early identification and monitoring of disease-carrying species. This early detection allows for timely implementation of targeted interventions, focusing resources on the specific mosquito species responsible for disease transmission in a particular region. Additionally, acoustic-based models enhance surveillance systems by providing real-time tracking and monitoring of mosquito populations. This data-driven approach facilitates rapid response to potential disease outbreaks, enabling public health authorities to implement effective control measures and reduce the burden of mosquito-borne diseases on communities.
Quality of life in patients with breast cancer post modified radical mastectomy: a cross-sectional study
Authors: Porwal Rekha , Tripathi Rahul Dev 
Published: August 2023

Abstract
Purpose - To assess the quality of life in patients with breast cancer post Modified Radical Mastectomy.
Method: This is a Cross-sectional study aimed to assess the quality of life (QOL) in patients with breast cancer who underwent Modified Radical Mastectomy. A total of 120 participants who had undergone the procedure between May 2017 to May 2022 were included in the study. The Functional Assessment of Cancer Therapy - General (FACT-G) version 4 questionnaire was used to evaluate the Quality of Life of the participants. The participants were divided into three groups based on the duration of follow-up: Group 1 (more than three years follow-up), Group 2 (two years follow-up), and Group 3 (one-year follow-up).
Results: There were 27 participants in Group 1, 42 in Group 2, and 51 in Group 3. Spearman analysis revealed significant correlations between demographic/clinical variables and QOL. Negative correlations were found between physical well-being (PWB) and tumor stage (r = -0.90, p = 0.001), and between emotional well-being and tumor stage (r = -0.80, p = 0.0002). Positive correlations were found between social well-being (SWB) and education level (r = 0.74, p = 0.003), as well as the occupation of patients (r = 0.46, p = 0.013). Additionally, 23% of patients expressed concerns about their body image and reconstruction surgery, while 37% faced difficulties in seeking treatment due to the COVID-19 pandemic.
Conclusion: Tumor stage, Education level, Occupation, and Marital status have an impact on the Quality of life in breast cancer survivors. Quality of Life was affected due to surgical wound-related problems and difficulties in seeking adjuvant treatment during the first year of treatment. While during the consequent period, it was affected due to local and systemic recurrence, lymph-edema, and body image concerns.