bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nuclear corepressor SMRT acts as a strong regulator of both β-oxidation and suppressor of fibrosis in the differentiation process of mouse skeletal muscle cells
Authors: Shimizu Hiroaki , Horibata Yasuhiro , Amano Izuki , Ritter Megan J. , Domae Mariko , Ando Hiromi , Sugimoto Hiroyuki , Cohen Ronald N. , Hollenberg Anthony N. 
Published: December 2022

Background
Silencing Mediator of Retinoid and Thyroid hormone receptors (SMRT; NCoR2) is a transcriptional corepressor (CoR) which has been recognized as an important player in the regulation of hepatic lipogenesis and in somatic development in mouse embryo. SMRT protein is also widely expressed in mouse connective tissues, for example adipocytes and muscle. We recently reported that mice with global deletion of SMRT develop significant obesity and muscle wasting which are independent from thyroid hormone (TH) signaling and thermogenesis. However, the tissue specific role of SMRT in skeletal muscle is still not clear.

Methods
To clarify role of SMRT in muscle differentiation, we made myogenic C2C12 clones which lack SMRT protein (C2C12-SKO) by using CRISPR-Cas9. Wild-type C2C12 (C2C12-WT) and C2C12-SKO cells were cultured in differentiation medium, and the resulting gene and protein profiles were compared between the two cell lines both before and after differentiation. We also analyzed muscle tissues which were dissected from whole body SMRT knockout (KO) mice and their controls.

Results
We found significant up-regulation of muscle specific β-oxidation markers; Peroxisome proliferator-activated receptor δ (PPARδ) and PPARγ coactivator-1α (PGC-1α) in the C2C12-SKO cells, suggesting that the cells had a similar gene profile to what is found in exercised rodent skeletal muscle. On the other hand, confocal microscopic analysis showed the significant loss of myotubes in C2C12-SKO cells similar to the morphology found in immature myoblasts. Proteomics analysis also confirmed that the C2C12-SKO cells had higher expression of markers of fibrosis (ex. Collagen1A1; COL1A1 and Fibroblast growth factor-2; FGF-2), indicating the up-regulation of Transforming growth factor-β (TGF-β) receptor signaling. Consistent with this, treatment with a specific TGF-β receptor inhibitor ameliorated both the defects in myotube differentiation and fibrosis.

Conclusion
Taken together, we demonstrate that SMRT functions as a pivotal transcriptional mediator for both β-oxidation and the prevention for the fibrosis via TGF-β receptor signaling in the differentiation of C2C12 myoblasts. In contrast to the results from C2C12 cells, SMRT does not appear to play a role in adult skeletal muscle of whole body SMRT KO mice. Thus, SMRT plays a significant role in the differentiation of myoblasts.
Reducing the effect of immortal time bias affects the analysis of prevention of delirium by suvorexant in critically ill patients: A retrospective cohort study
Authors: Shiotsuka Junji , Uchino Shigehiko , Sasabuchi Yusuke , Masuyama Tomoyuki , Lefor Alan Kawarai , Sanui Masamitsu 
Published: December 2022

Background
Studies assessing the effect of suvorexant on delirium prevention included patients treated before development of delirium, which can introduce immortal time bias. The objective of the present study was to evaluate the effect of suvorexant on delirium, comparing patients treated before the onset of delirium with patients treated within 72h of admission using the same dataset.

Methods
Data from adult patients admitted to the ICU from August 2018 to July 2021 were retrospectively analyzed. In “any time before” analysis, the incidence of delirium was compared for patients who received suvorexant at any time during their ICU stay (suvorexant) (unless delirium developed before treatment) with patients who either did not receive suvorexant or received suvorexant after development of delirium (control). This design was used in previously published studies. In “within 72h” analysis, the incidence of delirium was compared for patients who received suvorexant within 72 hours of admission (suvorexant) and patients who did not receive suvorexant or received it more than 72 hours after admission (control). Patients who developed delirium during the initial 72 hours were excluded from “within 72h” analysis (N = 799).

Results
“Within 72h” analysis included 1,255 patients, and “any time before” analysis included 2,054 patients (of 6599 admissions). The unadjusted hazard ratio of “any time before” analysis was 0.16 and the 95% confidence interval was 0.13–0.21 (p<0.01). The adjusted hazard ratio was 0.21, and the 95% confidence interval was 0.16–0.27 (p<0.01). “Within 72h” analysis had an unadjusted hazard ratio of 0.54 and the 95% confidence interval was 0.36–0.82 (p<0.01). However, this association lost statistical significance after adjustment for potential confounders (adjusted hazard ratio 1.02, 95% confidence interval 0.65–1.59, p = 0.93).

Conclusion
Reducing the effect of immortal time bias led to a significantly reduced effect of suvorexant for the prevention of delirium.
What happened during COVID-19 in African ICUs? An observational study of pulmonary co-infections, superinfections, and mortality in Morocco
Authors: Aissaoui Younes , Ennassimi Youssef , Myatt Ismail , El Bouhiaoui Mohammed , Nabil Mehdi , Bahi Mohammed , Arsalane Lamiae , Miloudi Mouhcine , Belhadj Ayoub 
Published: December 2022

Background
There is a growing literature showing that critically ill COVID-19 patients have an increased risk of pulmonary co-infections and superinfections. However, studies in developing countries, especially African countries, are lacking. The objective was to describe the prevalence of bacterial co-infections and superinfections in critically ill adults with severe COVID-19 pneumonia in Morocco, the micro-organisms involved, and the impact of these infections on survival.

Methods
This retrospective study included severe COVID-19 patients admitted to the intensive care unit (ICU) between April 2020 and April 2021. The diagnosis of pulmonary co-infections and superinfections was based on the identification of pathogens from lower respiratory tract samples. Co-infection was defined as the identification of a respiratory pathogen, diagnosed concurrently with SARS-Cov2 pneumonia. Superinfections include hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). A multivariate regression analysis was performed to identify factors independently associated with mortality.

Results
Data from 155 patients were analyzed. The median age was 68 years [62–72] with 87% of patients being male. A large proportion of patients (68%) received antibiotics before ICU admission. Regarding ventilatory management, the majority of patients (88%) underwent non-invasive ventilation (NIV). Sixty-five patients (42%) were placed under invasive mechanical ventilation, mostly after failure of NIV. The prevalence of co-infections, HAP and VAP was respectively 4%, 12% and 40% (64 VAP/1000 ventilation days). The most isolated pathogens were Enterobacterales for HAP and Acinetobacter sp. for VAP. The proportion of extra-drug resistant (XDR) bacteria was 78% for Acinetobacter sp. and 24% for Enterobacterales. Overall ICU mortality in this cohort was 64.5%. Patients with superinfection showed a higher risk of death (OR = 6.4, 95% CI: 1.8–22; p = 0.004).

Conclusions
In this single-ICU Moroccan COVID-19 cohort, bacterial co-infections were relatively uncommon. Conversely, high rates of superinfections were observed, with an increased frequency of antimicrobial resistance. Patients with superinfections showed a higher risk of death.
Evaluation of class participation in non-face-to-face CPR training for medical students
Authors: Cho Young Shin , Park Hye Ji , Choi Daun , Park Hang A. , Kim Sola , Park Ju Ok , Wang Soon-Joo , Lee Choung Ah 
Published: December 2022

Background
Cardiopulmonary resuscitation (CPR) education requires that learners practice key skills to promote mastery. Our aim in this study was to evaluate differences in post-education performance and class participation during CPR training between face-to- face (FF) and non-face-to-face (NFF) learning formats.

Methods
This was a randomized controlled study of third-year medical students from two university hospital, allocated to either the FF or NFF format for CPR education. The learning scenario addressed single-person CPR, consisting of chest compression only, and excluded breathing. The Kahoot! application was used for NFF. Between-group comparisons for class participation and CPR skills were based on video recordings.

Results
Seventy students participated in our study, with 35 randomly allocated to the FF and NFF groups. There were no between-group differences in terms of age, sex, previous basic life support training, and willingness and confidence in performing CPR. Compared to the FF group, the NFF group demonstrated significant differences during CPR, including fewer calling for assistance and using of defibrillator (p = 0.006), as well as fewer checking for breathing (p = 0.007), and fewer counting during chest compression (p = 0.006). Additionally, < 30% of learners in the NFF group completed rhythm analysis after the last defibrillator shock delivery and resumed immediate chest compression (p < 0.001). All students in both groups passed the post-training assessment.

Conclusion
Class participation in NFF learning was lower than that in FF learning. Although the post-education evaluation in the NFF group was not inferior, efforts on promoting active participation in NFF learning are required.
A randomized controlled trial comparing rehabilitation with isokinetic exercises and Thera-Band strength training in patients with functional ankle instability
Authors: Wang Bin , Zhang Xi , Zhu Feilong , Zhu Weiwei , Wang Xinyu , Jia Fan , Chen Wei , Zhang Ming 
Published: December 2022

Background
Although muscle strength training is a prevalent treatment for patients with functional ankle instability (FAI), previous investigations on the efficacy have yielded conflicting results.

Objective
This study aims to compare the efficacy of 6-week isokinetic strength training and Thera-Band strength training on improving ankle strength, dynamic balance ability, and function in individuals with FAI.

Methods
Fifty-two FAI patients were randomized into two treatment groups: an isokinetic strength training (IST, n = 26) group and a Thera-Band resistance training (TBT, n = 26) group. The IST group engaged in isokinetic concentric strength training with inversion, eversion, dorsiflexion, and plantar flexion, whereas the TBT group engaged in progressive resistance training with Thera-Band three times per week for six weeks. Before and after the training, an isokinetic concentric strength test of the involved ankle joint, Star Excursion Balance Test (SEBT), and Cumberland Ankle Instability Tool (CAIT) function assessment were performed.

Results
After six weeks of intervention, the strength of inversion and eversion was significantly improved in both the IST and TBT groups (p < 0.05), with the IST group exhibiting a significant (p < 0.05) improvement when compared to the TBT group. The SEBT and CAIT results were significantly (p < 0.05) improved in the IST group compared to the TBT group.

Conclusions
The six-week of isokinetic strength training is more effective than the Thera-Band progressive resistance training in improving the physical function of FAI patients.

Clinical trial registration number
This randomized controlled clinical trial has been registered in the China Clinical Trial Registry (ChiCTR2100044444) https://www.google.com/search?client=firefox-b-d&q=ChiCTR2100044444.
Pre-COVID-19 knowledge, attitude and practice among nurses towards infection prevention and control in Bangladesh: A hospital-based cross-sectional survey
Authors: Harun Md. Golam Dostogir , Anwar Md Mahabub Ul , Sumon Shariful Amin , Abdullah-Al-Kafi Md , Datta Kusum , Haque Md. Imdadul , Chowdhury A. B. M. Alauddin , Sharmin Sabrina , Islam Md Saiful 
Published: December 2022

Introduction
Hospital-acquired infections endanger millions of lives around the world, and nurses play a vital role in the prevention of these infections. Knowledge of infection prevention and control (IPC) best practices among nurses is a prerequisite to maintaining standard precautions for the safety of patients.

Aim
The study aims to assess knowledge, attitudes, and practices (KAP) towards IPC including associated factors among the nurses of a tertiary care hospital in Bangladesh.

Methods
We conducted this hospital-based cross-sectional study from October 2017 to June 2018 at Dhaka Medical College Hospital among 300 nurses working in all departments. We calculated three KAP scores for each participant reflecting their current state of knowledge and compliance towards IPC measures. Descriptive, bivariate and multivariable analyses were conducted to determine KAP scores among nurses and their associated factors.

Results
Average scores for knowledge, attitudes, and practices were 18.6, 5.4, and 15.5 (out of 26, 7, and 24), respectively. The study revealed that the majority (85.2%) of the nurses had a good to moderate level of knowledge, half (51%) of them showed positive attitudes, and only one fifth (17.1%) of the nurses displayed good practices in IPC. The respondents’ age, education, monthly income and years of experience were found to have statistical associations with having moderate to adequate level of KAP scores. Aged and experienced nurses were found more likely to have poor knowledge and unfavorable attitude toward IPC practices.

Conclusion
The majority of nurses had good IPC knowledge, but their practices did not reflect that knowledge. In particular, nurses needed to improve the proper IPC practice for better patient care and to protect themselves. Regular IPC training and practice monitoring can enhance the IPC practice among nurses.
The number of physicians is related to the number of nighttime emergency surgeries in Japan: An ecological study
Authors: Yamadori Yusuke , Hirao Tomohiro , Kanda Kanae , Shirakami Gotaro 
Published: December 2022

Purpose
Increasing the number of physicians per population may improve the quality of medical services, but there are few reports on this aspect in the field of surgery. This study aimed to examine whether the number of physicians is associated with the number of nighttime emergency surgeries, which may be one of the indicators of the quality of medical services in the field of surgery.

Methods
This was a prefecture-based ecological study utilizing open data from Japanese government surveys conducted between 2015 and 2019. The relationship between the number of physicians and the number of nighttime emergency surgeries in 47 prefectures of Japan was evaluated by correlation analysis and panel data regression analysis. The correlation analysis was conducted between the number of physicians per 100,000 population and the number of nighttime emergency surgeries per 100,000 population per year in each prefecture in Japan. In the panel data regression analysis, panel data of the prefectures in Japan from 2015 to 2019 were created. We evaluated whether the number of physicians was related to the number of nighttime emergency surgeries, independent of the number of acute care beds per 100,000 population, population density, and the elderly population ratio.

Results
From the correlation analysis, the correlation coefficient between the number of physicians per 100,000 population and the number of nighttime emergency surgeries per 100,000 population was 0.533 (P < 0.001). In the panel data regression analysis, there was a significant association between the number of physicians per 100,000 population and the number of nighttime emergency surgeries per 100,000 population (P < 0.001). The regression coefficient (95% confidence interval) for the number of physicians per 100,000 population was 0.246 (0.113–0.378).

Conclusion
The number of physicians is associated with the number of nighttime emergency surgeries.
A educação do trabalhador rural
Authors: Lacerda Gelza Araujo , Tôrres Fabiana Pionório , Alves José Eudes , Vieira Denes Dantas 
Published: December 2022

Este relato aborda sobre a construção do conhecimento sociológico pautado no diálogo, visto que, é necessário a partir de uma multiplicidade e interdisciplinaridade de saberes permanentemente, e que desafia o pesquisador o tempo todo frente os contextos sociais, impulsionando-o a elaborar modos e leituras contextualizadas com a realidade no/do Campo. Partindo desse pressuposto é importante esclarecer que por meio das indagações fez-se necessário a construção dessa pesquisa. Qual o papel desempenhado pelos movimentos sociais na construção da educação do e no campo? E quais os desafios existem frente uma educação contextualizada às realidades do homem do campo? Objetivo da pesquisa é discutir a educação camponesa numa perspectiva de aprendizagem dialogada e significativa. O presente estudo tem caráter bibliográfico e documental, fruto das aulas de sociologia rural do Mestrado em Extensão Rural da Universidade do Vale do São Francisco, analisa as contribuições das políticas educacionais referente a comunidade no/do Campo. O estudo mostra a relevância dessa discussão diante o direito à educação garantido em Lei na Constituição Federal -CF de 1988, fazendo-se valer também para a população no meio rural. O presente texto propôs por meio dos diálogos, aspectos como: as políticas públicas educacionais e a necessidade de pensar e repensar a escola, em especial a escola no/do Campo. Ajudará futuros pesquisadores no uso de uma metodologia a parir do pensamento coletivo sem discriminar, a fim de, contextualizar a sociologia rural significativa e participativa para o camponês.
Test von netzbildenden Wechselrichtern und rückspeisefähiger Ladeinfrastruktur
Authors: Kohrs Robert , Wille-Haussmann Bernhard , Rogalla Sönke , Singer Roland , Ernst Philipp , Schumann Jörn , Scheimann Bjarne 
Published: December 2022

Zusammenfassung
Die heutige Regelung von Energiesystemen basiert auf verschiedenen kleineren Einheiten, wie z. B. PV-, Speicher- oder Windenergieanlagen. Im folgenden Beitrag werden Testumgebungen für netzbildende Umrichter und Ladeinfrastruktur für Elektrofahrzeuge vorgestellt. Herkömmliche Wechselrichter können die netzregelnden Eigenschaften der Synchrongeneratoren in konventionellen Kraftwerken nicht vollständig ersetzen. Um die Netzstabilität in einem zukünftigen, auf Leistungselektronik basierenden Stromnetz zu gewährleisten, werden netzbildende Umrichterregelungskonzepte benötigt. Für deren Prüfung und Bewertung sind neue Prüfverfahren erforderlich, die eine Analyse der Wechselwirkung zwischen Wechselrichtern und dem Verbundnetz ermöglichen. Dies gilt insbesondere für den Millisekunden- und Sekundenbereich, da das Verhalten von Wechselrichtern in diesem Zeitbereich im Gegensatz zum elektromechanisch bestimmten Verhalten von Synchronmaschinen durch die Steuerungssoftware bestimmt wird. Auf der Testplattform im Multi-Megawatt-Labor können die Eigenschaften verschiedener Regelstrategien und die Reaktion auf unterschiedliche Netzstörungen im Megawatt-Maßstab untersucht werden.
Wir haben herausgefunden und nachgewiesen, dass ein Wechselrichter mindestens die folgenden vier Eigenschaften erfüllen muss, um als netzbildend zu gelten: Spannungsquellenverhalten, Trägheitsverhalten, Beitrag zur Netzqualität, netzfreundliches Überlastverhalten. Auf der mittelfristigen Zeitskala (Minuten bis Tage) gewinnen flexible Lasten und Speichersysteme für das Netzüberlastungsmanagement und den Ausgleich von Erzeugung und Last an Bedeutung. Diese Anwendungen erfordern zuverlässige Kommunikationswege zwischen SCADA-Systemen und den flexiblen Verbrauchern, z. B. für intelligentes Laden. Es wird eine Testumgebung für das Testen von Ladestationen für Elektrofahrzeuge vorgestellt, die einen digitalen Zwilling eines Elektrofahrzeugs inkl. dessen Regelung enthält, der Tests der Protokollkonformität ermöglicht. Diese Arbeit zeigt die Nachteile von alleinigen Konformitätstests auf und unterstreicht, wie wichtig es ist, die Kombination aus Lademanagement und Ladestation zu testen, um einen zuverlässigen Betrieb der Versorgungseinrichtungen für Elektrofahrzeuge zu gewährleisten.
An algorithm for PCT-guided antimicrobial therapy: a consensus statement by Japanese experts
Authors: Ito Akihiro , Shime Nobuaki , Fujishima Seitaro , Fujitani Shigeki , Komiya Kosaku , Schuetz Philipp 
Published: December 2022

Abstract
In Japan, a national antimicrobial resistance (AMR) action plan was adopted in 2016, advocating a 20% reduction in antibiotic consumption by 2020. However, there is still room for improvement to accomplish this goal. Many randomized controlled trials have reported that procalcitonin (PCT)-guided antimicrobial therapy could help to reduce antibiotic consumption without negative health effects, specifically in acute respiratory infections. In September 2018, some experts in Europe and the USA proposed algorithms for PCT-guided antimicrobial therapy in mild to moderate infection cases outside the ICU and severe cases in the ICU (the international experts consensus). Thereafter, a group of Japanese experts, including specialists in intensive care medicine, emergency medicine, respiratory medicine and infectious diseases, created a modified version of a PCT-guided algorithm (Japanese experts consensus). This modified algorithm was adapted to better fit Japanese medical circumstances, since PCT-guided therapy is not widely used in daily clinical practice in Japan. The Japanese algorithm has three specific characteristics. First, the target patients are limited to only hospitalized ICU or non-ICU patients. Second, pneumonia due to Pseudomonas aeruginosa, Staphylococcus aureus and Legionella species are excluded. Finally, a different timing of PCT follow-up measurement was proposed to meet restrictions of the Japanese medical insurance system. The adapted algorithms has high potential to further improve the safe reduction in antibiotic consumption in Japan, while reducing the spread of AMR pathogens.
Reexamining Nebuchadnezzar II’s ‘Thirteen-Year’ Siege of Tyre in Phoenician Historiography
Authors: Dixon Helen 
Published: December 2022

AbstractThis study reexamines a lynchpin of Neo-Babylonian Levantine Phoenician historiography: Nebuchadnezzar II’s purported thirteen-year siege of Tyre in the early sixth centurybce. This detail about the length of the siege can be found only in Josephus’ (first centuryce) writings, but this study’s new assessment of the (sixth-fifteenth centuryce) manuscript evidence shows that the more commonly transmitted length of the siege was “three years and ten months.” Other manuscript variations further illustrate that there was little continuous cultural memory of the length of the event. When coupled with (a) other chronological problems in Josephus’ works, (b) a review of the complex Biblical, Mesopotamian, and Classical relevant literary sources, and (c) the lack of current evidence for any destruction levels or siegeworks at the site of Tyre, the case for insisting other sources be synchronized with this thirteen-year framework weakens. Shorter sieges or raids, blockades of the island or inland ports, and periodic Babylonian military presence to extract personnel and resources are all likely scenarios for Tyre and other Levantine sites during Nebuchadnezzar’s 43-year reign. Discarding a single “thirteen-year siege” as a reliable historical detail allows scholars of the Neo-Babylonian period in the central coastal Levant to shift their attention to more interesting questions, including exploring the causes and impacts of the evident changes in Tyre’s seaward and inland trading patterns in the sixth-fifth centuries.