bluuebunny/crossref_metadata_2025_split huggingface dataset:
To intubate or to resuscitate: the effect of simulation-based training on advanced airway management during simulated paediatric resuscitations
Authors: Donath C. , Leonhardt A. , Stibane T. , Weber S. , Mand N. 
Published: January 2025

Abstract
Background
We aimed to measure the effect of a 2-day structured paediatric simulation-based training (SBT) on basic and advanced airway management during simulated paediatric resuscitations.

Methods
Standardised paediatric high-fidelity SBT was conducted in 12 of the 15 children’s hospitals in Hesse, Germany. Before and after the SBT the study participants took part in two study scenarios (PRE and POST scenario), which were recorded using an audio–video system. Airway management was assessed using a performance evaluation checklist. Time to initiate ventilation, frequency, and timing of endotracheal intubation (ETI), and its influence on other life support interventions were assessed. Differences in airway management between hospitals with and without a PICU were evaluated.

Results
Two hundred twenty-nine participants formed 58 interprofessional resuscitation teams. All teams recognised apnoea in their simulated patients and initiated ventilation during the scenarios. Time to recognition of apnoea and time to initiation of ventilation did not improve significantly after SBT, but teams were significantly more likely to select appropriately sized airway equipment. ETI was attempted in 55% PRE and 40% POST scenarios (p=0.1). The duration of the entire ETI process was significantly shorter in the POST scenarios. Chest compressions (CC) were frequently discontinued during ETI attempts, which improved after SBT (PRE 73% vs. POST 43%, p = 0.035). Adequate resumption of CC after completion of intubation was also significantly more frequent in the POST scenarios (46% vs. 74%, p = 0.048). During ETI attempts, CC were more likely to be adequately continued in teams from hospitals with a PICU (PRE scenarios: PICU 20% vs. NON-PICU 36%; POST scenarios: PICU 79%, NON-PICU 22%; p < 0.01).

Conclusions
Our data suggest an association between airway management complexity and basic life support measures. Although the frequency of ETI was not significantly reduced after a 2-day SBT intervention, the duration of advanced airway management was shortened thus reducing no-ventilation time which led to fewer interruptions in chest compressions during simulated paediatric resuscitations. SBT may be adapted to the participants’ workplace to maximize its effect and improve the overall performance in paediatric resuscitation.
The impact of inflammatory response on psychological status of medical staff during COVID-19 pandemic
Authors: Wang Dong , Li Haijin , Liu Yansong , Li Hong , Liu Yangyang , Hou Lijun 
Published: January 2025

Abstract
Background
Limited research has been conducted on the relationship between inflammatory markers and psychological status in medical staff fighting COVID-19.

Objective
This article examines the psychological and inflammatory conditions of medical personnel working on the front lines of the battle against COVID-19. Methods: A total of 102 clinical staff members were included in this study. All subjects received the Symptom Checklist-90 questionnaire (SCL-90) and Posttraumatic Stress Disorder Checklist-Civilian questionnaires for assessing different mental symptoms. The levels of various inflammatory markers, including IL-1β, IL-2, IL-6, IL-8, TNF-a, and IFN-γ, along with GDNF, were evaluated.

Results
Spearman correlation analysis showed that the levels of IL-6 were positively associated with the anxiety score (Spearman’s rho = .230, p = .021), obsessive–compulsive symptoms (Spearman’s rho = .201, p = .042). The levels of IL-8 were negatively associated with the anxiety score (Spearman’s rho = -.223, p = .028), obsessive–compulsive symptoms (Spearman’s rho = -.252, p = .012), hyperarousal (Spearman’s rho = -.221, p = .028). The levels of TNF-α were positively associated with the anxiety score (Spearman’s rho = .201, p = .045), obsessive–compulsive symptoms (Spearman’s rho = .222, p = .035).

Conclusion
Generally, our results suggested that IL-6, IL-8 and TNF-α might play a role in the development of psychological symptoms among medical staff.
Experimental research on mechanical and impact properties of ceramsite prepared from secondary aluminum dross and municipal solid waste incineration ash
Authors: He Wangze , Yang Yufei , Zhu Xinghan , Yang Jinzhong , Sun Yingjie , Huang Qifei 
Published: January 2025

AbstractWith the growth of the industrial aluminum smelting sector, and the increasing proportion of incineration treatment in the field of waste management and disposal, there has been a corresponding increase in the production of secondary aluminum dross (SAD) and municipal solid waste incineration fly ash (MSWIFA) annually. In this research, ceramsite is prepared using SAD, MSWIFA, and municipal solid waste incineration bottom ash (MSWIBA) as raw materials. This study explores the impact of various factors on the mechanical properties of ceramsite and their mechanisms under different conditions, including sintering temperature, raw material ball particle size, raw material silica-alumina ratio, and sintering time. Single-factor experiments demonstrate that the compressive strength of ceramsite initially follows a non-linear ascending trend with increasing sintering temperatures. Additionally, the strength is enhanced with reductions in particle size of the raw material balls, prolongation of the sintering time, and a reduction in the silica-to-alumina ratio of the raw materials. Orthogonal experiments reveal the ideal preparation conditions for ceramsite as follows: a preheating temperature of 400 °C, a preheating duration of 20 min, a sintering temperature of 1270 °C, and a duration of 30 min. Under these conditions, the optimal composition ratio of ceramsite is Si:Al = 3, and the ideal particle size is 0.5 cm. Analysis through X-ray diffraction and scanning electron microscopy revealed the formation of new mineral phases such as sodium feldspar and potassium feldspar in the ceramsite, which display a dense structure under microscopic observation. These contribute positively to the mechanical properties of the ceramsite. Fourier-transform infrared spectroscopy analysis indicates that at a sintering temperature of 1260 °C or when the raw material ball size is 2 cm, the [SiO4] tetrahedral bands shift to higher wavenumbers, enhancing the degree of polymerization of the glass network in the ceramsite, thereby strengthening its compressive strength. As the silica-alumina ratio of the raw materials decreases and the sintering duration extends, the [SiO4] tetrahedral bands continue to shift to higher wavenumbers, further enhancing the compressive strength of the ceramsite.
Access to robot-assisted total knee arthroplasty varies significantly by race/ethnicity
Authors: Schmerler Jessica , Bergstein Victoria E. , Kagabo Whitney , Khanuja Harpal S. , Oni Julius K. , Hegde Vishal 
Published: January 2025

Abstract
Background
Racial/ethnic disparities in access to total knee arthroplasty (TKA) have been extensively demonstrated. Over the past several years, there has been a rapid increase in the utilization of robot-assisted TKA (RA-TKA). Therefore, this study sought to determine whether previously established racial/ethnic disparities extend to access to RA-TKA relative to conventional TKA.

Methods
Patients who underwent TKA from 1 January 2022 to 31 December 2022 were identified in the National Surgical Quality Improvement Program database. Patients were stratified by whether they underwent RA-TKA. Multivariable logistic regressions, controlling for demographics and comorbidities significantly different on univariate analysis, were constructed to determine whether race/ethnicity was associated with likelihood of undergoing RA-TKA relative to conventional TKA.

Results
Of the 47,898 patients who underwent TKA in 2022, 8560 (17.9%) underwent RA-TKA. On multivariable analysis, Black, Hispanic, Asian, and all other races were significantly less likely than white patients to undergo RA-TKA relative to conventional TKA (OR 0.65, 95% CI 0.59–0.70, P < 0.001; OR 0.70, 95% CI 0.64–0.77, P < 0.001; OR 0.65, 95% CI 0.55–0.76, P < 0.001; OR 0.78, 95% CI 0.66–0.92, P = 0.003, respectively).

Conclusions
The results of this study demonstrate that non-white race is associated with a significantly lower likelihood of undergoing RA-TKA relative to conventional TKA. Importantly, this reduced access to RA-TKA may represent a broader disparity in access to emerging technologies and modern care. Future work should endeavor to identify drivers of this disparity to better understand minority access to emerging technologies in TKA.
Level of evidence III.
The ability of the prognostic nutritional index to predict short-term mortality in geriatric acute heart failure
Authors: Akça Hilal , Akça Hatice Şeyma , Özkan Abuzer , Özdemir Serdar 
Published: January 2025

Abstract
Background
Heart failure is a critical cardiovascular condition, necessitating comprehensive treatment approaches and contributing to elevated mortality rates. This study aimed to evaluate the effect of the prognostic nutritional index (PNI) on the prognosis of geriatric patients diagnosed with acute heart failure.

Results
A total of 104 patients were included and evaluated retrospectively in this study; 57.7% of them were females, and 19.24% of the patients died. A statistically significant difference was identified between high (≥ 35.6) and low PNI (< 35.6) groups in terms of lymphocyte count, neutrophil–lymphocyte ratio, C-reactive protein, and albumin (p values: < 0.001, < 0.001, 0.011, and < 0.001, respectively). The area under the curve (AUC) value for albumin was 0.53 (95% CI: 0.30–0.83) with a cutoff value of 3.1 g/dL; for lymphocyte count, it was 0.61 (95% CI: 0.57–0.84) with a cutoff value of 0.34 × 103/µL; and for PNI, it was 0.58 (95% CI: 41.18–85.06) with a cutoff value of 34.6.

Conclusion
The low PNI group exhibited a significantly higher mortality rate; nonetheless, PNI alone does not hold clinical significance as a prognostic marker. However, when combined with other clinical parameters, it can contribute to a more comprehensive assessment of patients.
Eco-biofabrication of silver nanoparticles from Azadirachta indica, Gymnema sylvestre, and Moringa oleifera for lung cancer treatment
Authors: Muthu Tanya , Adusumalli Ravi , Vemuri Sathish Kumar , Indira Devi M. , Pavan Kumar P. , Banala Rajkiran Reddy , Gurava Reddy A. V. 
Published: January 2025

Abstract
Introduction
Silver nanoparticles (AgNPs) derived from natural sources have garnered significant attention due to their unique properties and eco-friendly production methods. With lung cancer remaining a major global health issue, there is a continuous need for novel and effective therapeutic approaches beyond conventional treatments such as chemotherapy, immunotherapy, and targeted therapies.

Objective
This study aims to synthesize AgNPs using plant extracts from Gymnema sylvestre, Moringa oleifera, and Azadirachta indica and to evaluate their anticancer activity, particularly their effects on gene expression in A549 lung cancer cells.

Methods
AgNPs were synthesized using green chemistry techniques and characterized by X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). Gene expression studies were performed to assess the impact of AgNPs on cancer-related genes such as VEGF and CYCLIN-D1. Cytotoxicity assays were conducted on A549 cells to determine the anticancer potential of the synthesized AgNPs compared to plant extracts alone.

Results
XRD confirmed the formation of crystalline AgNPs, while FTIR indicated the presence of bioactive compounds interacting with the nanoparticles. Gene expression analysis revealed significant downregulation of VEGF and CYCLIN-D1, suggesting inhibitory effects on angiogenesis and cell cycle progression. The synthesized AgNPs exhibited potent cytotoxic activity against A549 cells, with enhanced efficacy compared to the leaf extracts alone.

Conclusion
The study highlights the potential of AgNPs synthesized from medicinal plant extracts as promising candidates for lung cancer therapy. Their environmentally sustainable production, combined with their ability to target key cancer pathways, positions them as innovative and affordable therapeutic agents in the field of nanomedicine.
Sarcopenia and frailty as predictor of outcome in critically ill elderly patients with multiple comorbidities
Authors: Elmaleh Dina mostafa , Mohamed Dina Morsy Ahmed 
Published: January 2025

Abstract
Background
Frailty and sarcopenia are important conditions that grow more common as people age. Frailty, a multi-system illness linked to heightened vulnerability to stresses, and sarcopenia, a loss of muscle mass and function, both raise the likelihood of unfavorable health outcomes including disability or death. This work’s objective was to study the clinical utility of sarcopenia and frailty in critically ill elderly patients with multiple comorbidities.

Patients and methods
Clinical frailty scale and SARC-F scale questionnaire were done in 70 critically ill patients admitted to geriatric ICU in geriatric hospital.

Results
There was a highly significant effect of frailty on primary outcomes whether sarcopenia was present or not (which means that effect of frailty on primary outcomes is more prominent than sarcopenia). The associated factors of frailty including primary admission cause, type of associated comorbidities, and primary outcome (mortality, prolonged hospital stay, long-term ICU care) were found to be important. There was a highly significant effect on the presence of sarcopenia regarding mean age, associated comorbidities, and degree of frailty, with a higher percentage for the need of noradrenaline treatment in ICU patients, highly significant relation to patient mortality.

Conclusions
The risk of death in critical illness is increased by sarcopenia and frailty. Clinical examinations should routinely identify the risk factors for frailty and sarcopenia. By providing appropriate therapies, medical professionals in intensive care units may be able to improve patient outcomes. Clinicians may be able to get prognostic information on the survival and recovery of their frail intensive care unit patients by routinely assessing frailty at the time of admission. Crucially, this might assist patients and their families in making well-informed choices on the course of treatment while they are in critical condition. Crucially, more investigation is needed to ascertain whether there are modifiable elements that might enhance the prognosis of critically sick fragile people.
Investigating the distribution of heat transfer in a thick-walled functionally graded cylindrical shell under heat flux
Authors: Zhang Buqing , Long Zhiqiang , Liu Guoqing , Wu Zhengxin , Yan Qiang 
Published: January 2025

AbstractThe primary aim of this work is to investigate the heat transfer behavior in a thick-walled functionally graded cylindrical shell subjected to internal pressure and thermal gradients, specifically focusing on how different material grading profiles (linear, exponential, and power-law) affect thermal performance. This study examines the influence of material gradation on the temperature distribution by considering variations in Young’s modulus, thermal conductivity, expansion coefficient, and yield stress as functions of the shell’s radial position, based on the Erdogan model. Finite element analysis (FEA) utilizing ABAQUS software was used to conduct the steady-state and transient heat transport calculations in an aluminum metal/alumina ceramic shell. For a pure aluminum shell, it is about 15% of the temperature difference between the inner and outer surfaces for the inner temperature of 115 °C and the outer one of 136 °C. By contrast, the ceramic shell thermal insulation reduces the outer wall temperature by 85%: the inner surface temperature is 149 °C and the outer surface 28 °C. Besides, the analysis of several grading profiles evidenced that quite different heat transfer features occur across the component: more steep temperature gradients and higher thermal insulation result when exponential grading is used instead of a linear one. These findings highlight the role of FGM and the optimization of grading profiles in improving high-temperature thermal management applications.
Intracranial Hypotension Mechanism and Implant Retention Procedure for Patients With Titanium Mesh Exposure
Authors: Zheng Rui-Zhe , Qi Zeng-Xin , Lang Li-jian , Huang Wen-tao , Chen Jia-yu , Zhu Tong-ming , Wu Xue-Hai 
Published: January 2025

BACKGROUND AND OBJECTIVES:
The study aimed to investigate the potential pathogenesis and present an implant retention procedure for patients with titanium mesh exposure after cranioplasty.

METHODS:
The clinical data were obtained from 26 consecutive cases with titanium mesh exposure who underwent surgical treatment between 2018 and 2023. These patients' medical records, scalp photographs, operative notes, and outcomes were retrospectively analyzed. In addition, a literature search was conducted for articles describing treatment strategies for titanium mesh exposure published within the past 10 years.

RESULTS:
A total of 26 patients (15 males; mean age [±SD] 52.3 ± 15.0 years) underwent surgical treatment for titanium mesh exposure. Among the subset of patients with a history of ventriculoperitoneal shunt implantation (n = 10), low-pressure hydrocephalus was observed in 90% of cases. The pathogenesis of titanium mesh exposure can be categorized into 4 stages: ischemic stage, depletion stage, defect stage, and infection stage, with a median onset time of 392 days (range from 40 to 5114 days). Based on this, we introduce a novel technique of using a pedicled galea aponeurotica–periosteal flap in titanium mesh retention surgery for treating various types of skin defects. Consequently, 15 patients (57.8%) underwent this procedure and exhibited favorable wound healing over a follow-up period averaging at 640.4 ± 397.2 days (range 117-1573 days).

CONCLUSION:
Implant removal surgery is not the optimal choice for patients presenting with titanium mesh exposure after cranioplasty. The 4 stages of skin defect outlined in this study offer clinical guidance for managing cases of titanium mesh exposure, while highlighting intracranial hypotension as an underappreciated pathogenic factor. A pedicle galea aponeurotica–periosteal flap represents a valuable and versatile alternative for retaining the existing titanium mesh, as it ensures adequate blood supply and withstands pressure gradients.
Gene expression and DNA methylation changes in response to hypoxia in toxicant-adapted Atlantic killifish (Fundulus heteroclitus)
Authors: Aluru Neelakanteswar , Venkataraman Yaamini R. , Murray Christopher S. , DePascuale Veronica 
Published: January 2025

ABSTRACT
Coastal fish populations are threatened by multiple anthropogenic impacts, including the accumulation of industrial contaminants and the increasing frequency of hypoxia. Some populations of the Atlantic killifish (Fundulus heteroclitus), like those in New Bedford Harbor (NBH), Massachusetts, USA, have evolved a resistance to dioxin-like polychlorinated biphenyls (PCBs) that may influence their ability to cope with secondary stressors. To address this question, we compared hepatic gene expression and DNA methylation patterns in response to mild or severe hypoxia in killifish from NBH and Scorton Creek (SC), a reference population from a relatively pristine environment. We hypothesized that NBH fish would show altered responses to hypoxia due to trade-offs linked to toxicant resistance. Our results revealed substantial differences between populations. SC fish demonstrated dose-dependent changes in gene expression in response to hypoxia, while NBH fish exhibited a muted transcriptional response to severe hypoxia. Interestingly, NBH fish showed significant DNA methylation changes in response to hypoxia, while SC fish did not exhibit notable epigenetic alterations. These findings suggest that toxicant-adapted killifish may face trade-offs in their molecular response to environmental stress, potentially impacting their ability to survive severe hypoxia in coastal habitats. Further research is needed to elucidate the functional implications of these epigenetic modifications and their role in adaptive stress responses.
Antropología y derecho: reflexiones metodológicas sobre el trabajo de campo en áreas de violencia
Authors: Cajas Juan 
Published: January 2025

En este ensayo se efectúa una reflexión en torno al quehacer de la socio antropología y el papel que desempeña el investigador ante el reto de manejar información aportada por sujetos/objetos que actúan al margen de las normas del derecho. Los datos, por sus características singulares requieren de ser manejados o presentados en forma encubierta. El tema en cuestión, esto es, la necesidad de proteger la integridad de los informantes, obliga al ejercicio de una narrativa que trabaja sobre datos reales pero que se cubren con un estilo asociado a géneros como la crónica, el ensayo y la no ficción (non fiction), que consideramos puede ampliar el saber criminológico. En este escrito se utilizan datos provenientes de un trabajo de campo realizado en la frontera norte de México.
TECNOLOGIA DIGITAL EM SAÚDE MENTAL PARA O CUIDADO DE ESTUDANTES DO ENSINO SUPERIOR: UMA REVISÃO INTEGRATIVA
Authors: Carvalho de Aguiar Leidiane , Lopes Evangelista Ávila Roberlândia , De Holanda Cunha Barreto Ivana Cristina , Nazaré Oliveira Eliany , De Sousa Teixeira Jorge Samuel , Janielly Negreiros de Moraes Antonia 
Published: January 2025

Introdução: A pesquisa discute a importância do conhecimento sobre o uso de tecnologia digital na promoção da saúde mental de estudantes universitários. Fazendo debates sobre a evolução da compreensão da saúde mental ao longo da história, destacando o estigma associado aos transtornos mentais e a falta de direitos para aqueles considerados "anormais" pela sociedade. Objetivo: analisar as melhores evidências científicas relacionadas à tecnologia digital em saúde mental para estudantes universitários. Materiais e Método: Adotou a metodologia da Revisão Integrativa da Literatura (RIL), seguiu-se as seis etapas do método apresentadas pelos autores Botelho, Cunha e Macedo (2008), selecionando-se os descritores" Estudantes ", "Tecnologia digital", " saúde mental ", " Universidades”, em português e inglês, e utilizou-se o operador booleano OR. Realizou-se a busca em quatro fontes de literatura científica, no período de janeiro de 2023 a março de 2023. Resultados: a amostra final quantificou um total de 05 artigos em consonância com a temática saúde mental e tecnologia digital para estudantes universitários. Conclusão: Ao pesquisar sobre o acesso de tecnologias digitais para o cuidado de estudantes do ensino superior, constata-se que tem sido objeto de muitos estudos, entretanto quando relacionada a tecnologia digital como ferramenta de apoio a saúde mental aos estudantes mediante aos trabalhos selecionados, observa-se o quanto é escasso, e que precisa ser investigado.