bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of the modified Rankin Scale in patients with aneurysmal subarachnoid hemorrhage: a randomized study
Authors: Nobels-Janssen E , Postma E N , Abma I L , Dijk J M C van , de Ridder I R , Schenck H , Moojen W A , Hertog M H den , Nanda D , Potgieser A R E , Coert B A , Verhagen W I M , Bartels R H M A , Wees P J van der , Verbaan D , Boogaarts H D 
Published: November 2022

Abstract
Purpose
The modified Rankin Scale (mRS), a clinician-reported outcome measure of global disability, has never been validated in patients with aneurysmal subarachnoid hemorrhage (aSAH). The aims of this study are to assess: 1) convergent validity of the mRS; 2) responsiveness of the mRS; and 3) the distribution of mRS scores across patient reported outcome measures (PROMs).
Methods
This is a prospective, randomized, multicenter study. The mRS was scored by a physician for all patients; subsequently for one half by structured interview and the other half by self-assessment. All patients completed EuroQoL 5D-5L, RAND-36, Stroke Specific Quality of Life scale (SS-QoL) and Global Perceived Effect (GPE). Convergent validity and responsiveness were assessed by testing hypotheses.
Results
In total, 149 patients were included for analysis. The correlation of the mRS with EQ-5D-5L was r = -0.546, with RAND-36 physical and mental component score being r = -0.439 resp. r = -0.574, and with SS-QoL r = -0.671. Three out of four hypotheses for convergent validity were met. The mRS assessed through structured interview has higher correlation with the mental component score than with the physical component score of RAND-36. Improvement on GPE was indicated by 83% of patients; the mean change score of these patients on the mRS was − 0.08 (SD 0.915). None of the hypotheses for responsiveness were met.
Conclusion
The results show that the mRS generally correlates with other instruments as expected, but it lacks responsiveness. A structured interview of the mRS is best for detecting disabling neuropsychological complaints.
Registration
URL: https://trialsearch.who.int; Unique identifier: NL7859, Date of first administration: 08-07-2019
Barriers and facilitators to publicly-funded gender-affirming surgery: The perspectives amongst a cohort of Australian clinicians
Authors: Piñón-O’Connor Katie E. , Mullens Amy B. , Debattista Joseph , Sanders Tait , Brö Annette 
Published: November 2022

Abstract
Background: Barriers to publicly-funded gender-affirming surgery (GAS) in Australia have been identified as cost, limited availability of qualified providers and lack of public hospital systems performing/offering these services. Our study explores barriers, facilitators, and potential implications for expanding, and improving publicly-funded GAS in Australia from the perspectives of an Australian cohort of gender-affirming clinicians.
Methods: We conducted semi-structured interviews with eight clinicians who currently work within gender-affirming health services in Queensland, Australia. Through ecological systems theory, gender minority stress framework, and reflexive thematic analysis, themes and subthemes were identified.
Results: Our study identified three themes and five sub-themes exploring the barriers and facilitators to publicly-funded GAS in Queensland, Australia. The first theme “I don’t know how this it’s ever going to happen” captures participant concerns that gender-affirming surgery is a misunderstood intervention within the wider medical community and this perception impedes progress of publicly-funded GAS. The second theme, “Hoping Against Hope” depicts the double-edged dilemma of maintaining hope of accessing surgery even if it is “unrealistic.” The last, and third theme, “No if, When” depicts the certainty amongst participants that publicly-funded GAS is inevitable and will become a reality in Queensland, Australia.
Conclusions: Gender-affirming clinicians indicated establishing a surgical center for excellence in trans and non-binary healthcare is an essential facilitator needed to implement publicly-funded GAS. This would allow for a best-practice decentralized model of gender-affirming care to be realized in future to optimize health and wellbeing among trans and non-binary persons. Thereremain substantial barriers, specifically at exosystem and macrosystem levels, within the public health service needing urgent attention. Implications of findings are relevant to funding, clinical practice, research, and policy within and beyond Australia.
PPARγ-dependent hepatic macrophage switching acts as a central hub for hUCMSCs-mediated alleviation of decompensated liver cirrhosis in rats
Authors: Yao Yunqi , Zhang Lin , Cheng Fuyi , Jiang Qingyuan , Ye Yixin , Ren Yushuang , He Yuting , Su Dongsheng , Cheng Lin , Shi Gang , Dai Lei , Deng Hongxin 
Published: November 2022

Abstract
Background: Decompensated liver cirrhosis (DLC), a terminal-stage complication of liver disease, is a major cause of morbidity and mortality in patients with hepatopathie. Human umbilical cord mesenchymal stem cell (hUCMSCs) therapy has emerged as a treatment novel alternative for the treatment of DLC. However, optimized therapy protocols and the associated mechanisms are not completely understood.
Methods: We constructed a DLC rat model consistent with the typical clinical characteristics combined use of PB and CCL4. By performing dynamic detection of liver morphology and function in rats for 11 weeks, the various disease characteristics of DLC and the therapeutic effect of hUCMSCs on DLC in experimental rats were fully investigated, according to ascites examination, histopathological and related blood biochemical analyses. Flow-cytometry analysis of rat liver, immunofluorescence and RT-qPCR were performed to examine the changes of liver immune microenvironment after hucMSCs treatment. RNA-seq analysis of liver and primary macrophages and hUCMSCs co-culture system in vitro were performed to explore possible signaling pathways. PPARγ antagonist, GW9662, and clodronate liposomes were used to inhibit PPAR activation and pre-exhaustion of macrophages in DLC rats’ liver respectively.
Results: We found that changing of the two key issues, the frequency and initial phase of hUCMSCs infusion can affect the efficacy of hUCMSCs and the optimal hUCMSCs treatment schedule is once every week for three weeks at the early-stage of DLC progression, providing the best therapeutic effect in reducing mortality and ascites, and improving liver function in DLC rats. hUCMSCs treatment skewed the macrophage phenotype from M1-type to M2-type through activating PPARγ signaling pathway in liver, which was approved by primary macrophages and hUCMSCs co-culture system in vitro. Both inhibition of PPARγ activation with GW9662 and pre-exhaustion of macrophages in DLC rats’ liver abolished the regulation of hUCMSCs on macrophage polarization, thus attenuating the beneficial effect of hUCMSCs treatment in DLC rats.
Conclusions: HUCMSCs treatment on DLC were attributed to the activation of the PPARγ signaling pathway in liver macrophages of DLC rats, which polarizes M1-type macrophages to M2-type, thus inhibiting inflammation and promoting the repair of damaged liver tissue. Our results about different infusion regimens comparison and mechanisms exploration provide a robust theoretical foundation for the future study design of Mesenchymal Stem Cells therapy on DLC.
Performance Improvement of an Industrial Axial Turbine: Two-Stage Power Turbine Aerodynamic Optimization
Authors: Amini Ali Mobasher , Khavari Ali , Alizadeh Mohammad 
Published: November 2022

Abstract

For high-aspect-ratio turbine blades, profile loss is dominant and its reduction is important for improving performance. In this paper, a two-stage low-pressure turbine (power turbine) is optimized in two steps: cycle optimization and aerodynamic optimization. In the cycle optimization step, the thermodynamic boundary condition of the turbine is modified. In the second step, which is the main focus of this study, the aerodynamic improvement of a turbine using a two-dimensional optimization technique is performed. The Genetic Algorithm (GA) is used in the optimization process to identify variables that satisfy a defined objective function which is subject to some constraints. The Artificial Neutral Network (ANN) is introduced to correlate variables with the defined objective functions and constraints. Maximum velocity and its location on the blade surface determine transition location and diffusion factor which directly affect total pressure losses. Therefore, in the optimization process, maximum velocity and its location are controlled and defined as objective functions. Profile shape at any given radius is represented with the camber-thickness method. The flow solver used for the aerodynamic analysis of profiles is the cascade analysis code MISES. After improving the performance of vanes and blades’ 2D sections, to be confident for performance enhancement of final power turbine ANSYS CFX is used. Finally, the aerodynamic characteristics of the power turbine using optimized geometries are discussed and compared to the original one. The results demonstrate a 1.19 percent improvement in power turbine efficiency at the same pressure ratio.
Study Title Efficacy of Interventions aiming to Increase Nurse Resilience: A Rapid Review of the Literature
Authors: Mallon Anita , Mitchell Gary , Lecturer Gillian Carter , McLaughlin Derek , Wilson Christine Brown 
Published: November 2022

Abstract
BACKGOUND
The COVID 19 pandemic has exposed and further exacerbated systemic weaknesses in the health and social care system, placing an inordinate pressure on nurses. The importance of effective resilience building interventions as a strategy to enable recovery and growth in these times of uncertainty have been advocated. The aim of this rapid review was to inform the development of a resource to support the resilience of care home nurses by extracting empirical evidence as to the efficacy of resilience building interventions undertaken with nurses
METHODS
We undertook a rapid review using quantitative studies published in peer reviewed journals that reported resilience scores using a valid and reliable scale before and after an intervention aimed at supporting nurse resilience. The databases; Cumulative Index to Nursing and Allied Health Literature, Medline and PsychInfo. and the Cochrane Library were searched. The searches were restricted to studies published between January 2011 and October 2021 in the English language. Only studies that that reported using a validated tool to measure resilience before and after the interventions were included.
RESULTS
Fifteen studies were included in this rapid review with over half of the studies taking place in the USA. No studies reported on an intervention to support resilience with care home nurses. The interventions focused primarily on hospital-based nurses in general and specialist contexts. The interventions varied in duration content and mode of delivery, with interventions incorporating mindfulness techniques, cognitive reframing and holistic approaches to building and sustaining resilience. Thirteen of the fifteen studies selected demonstrated an increase in resilience scores as measured by validated and reliable scales. Those studies incorporating ‘on the job,’ easily accessible practices that promote self-awareness and increase sense of control reported significant differences in pre and post intervention resilience scores.
CONCLUSION
Nurses continue to face significant challenges, their capacity to face these challenges can be nurtured through interventions focused on strengthening individual resources. The content, duration, and mode of delivery of interventions to support resilience should be tailored to specific populations and responsive to their unique contexts.
Which factors affect the spontaneous stone passage after flexible ureteroscopic lithotripsy for renal stones?
Authors: Liao NaiKai , TAN ShuTing , YANG GuangLin , YANG ShuBo , ZHAI GaoQiang , LI ChengYang , Mo LinJian , CHENG JiWen 
Published: November 2022

Abstract
Objectives: The aim of this study was to investigate factors predicting spontaneous stone passage after flexible ureteroscopic lithotripsy ( fURS) for renal stones.
Materials and Methods: This study included 239 patients with renal stones who underwent fURS using the dusting technique. The final outcome was evaluated 3 months postoperatively and the residual fragment status (RFs) was defined as any residual stone fragments greater than 2 mm. Univariate and multivariate analyses of possible predictive factors associated with spontaneous clearance of residual renal fragments were performed.
Results:186 patients(77.8%) had achieved an stone-free status (SFs) and 53 patients(22.2%) were considered with RFs. Univariate analysis showed the stone location, stone number, stone size, stone CT value, IPA degree, the presence of hydronephrosis and stone covered with purulent substance were all associated with RFs (P<0.05). Multivariate logistic regression analysis showed that larger stone size (P=0.001),multiple stones (P=0.038) , the IPA of <45°(P=0.035) , the presence of hydronephrosis (P=0.045), the stone CT value ≥1000 (P=0.047) were all significantly associated with higher rates of residual stone after fURS. The stone covered with purulent substance was found to be the strongest predictor of RFs (P=0.027). However, the presence of lower pole stone had no significant influence on stone clearance after fURS (P=0.263).
Conclusions: Stone number, stone size , an IPA of <45°, stone CT value ≥1000 HU, stone covered with purulent substance and presence of hydronephrosis are all predictive factors of the spontaneous clearance of residual renal fragments after fURS.
Prevalence and Factors Associated with Genital Tobacco Powder Use Among Women in the Gambia: A Mixed Study
Authors: Jaiteh Musa , Awolude Olutosin A. , Bah Haddy-Tunkara 
Published: November 2022

Abstract
Background:Genital tobacco powder, locally known as "tabaa," is a mixture of powdered tobacco and other substances that women use vaginally for sexual enhancement. Through a media report, the Ministry of Health issued a warning for women to stop the practice. However, literature search showed that no any scientific study documenting the burden of this cultural practice beyond media reports. The aim of this study was to determine the prevalence and factors associated with genital tobacco powder use among women in The Gambia.
Methods: A sequential exploratory mixed approach was used. The research was carried out in two areas of The Gambia: one rural (Farafenni) and one urban (Banjul). Focus group discussions and in-depth interviews were used to recruit (30) participants in the qualitative study. The quantitative study interviewed (400) women using structured questionnaire that was developed from the qualitative results. SPSS version 24 and STATA version 7 were used to analyze the data. Descriptive, Bivariate and multivariate statistics were used to summarize the data.
Results: Most of the study participants were between 30-39 years old who were married. The prevalence (17.0%; n=68) of genital tobacco powder was high among women aged 40 years and above (OR = 2.88; 95% CI = 1.03–8.05; p = 0.04), from Farafenni and satellite villages (OR = 2.01; 95% CI = 1.02-3.96; p = 0.04), had non-formal education (OR = 3.09; 95% CI 0.85–11.26; p = 0.02) and had husbands who traveled for 6 (OR = 6.67; 95% CI = 1.71–26.01; p= 0.006) or 12 or more months (OR = 9.64; 95% CI 3.19-29.18; p<0.001). The perception of women and peer influence were associated with genital tobacco powder use.
Conclusion: Genital tobacco powder is practiced all over the Gambia and highest in the rural areas. Socio-demographic variables such age, residence, marital status, education status were significantly associated with the practice. According to the findings, women with low level of education and have poor perception can easily be convinced by close friends/family members to use genital tobacco powder. Therefore, awareness creation is the most important intervention to mitigate this practice.
Re-translocation of photoassimilates by Nano-TiO2 spraying in favor of osmotic adjustment in water-stressed sunflower
Authors: Ramadan Taha , Sayed Suzan A. , Abd-Elaal Amna K.A. , Amro Ahmed M.A 
Published: November 2022

Abstract

Background
Water deficit is one of the main environmental stresses that modifies the biomass allocation patterns between shoots and roots. Any attempt to improve the water status of plants, especially in regions of water scarcity, will be significantly important. In this study, the effect of foliar application of nanoparticles or ordinary TiO2 on water status of Helianthus annuus subjected to water deficit stress was evaluated.
Results
The water content of H. annuus shoots or roots didn’t change significantly by spraying with different concentrations of Nano- or Ord-TiO2. The dry mass (DM), relative dry mass (RDM) and root / shoot ratio of sunflower sprayed with Nano-TiO2, when averaged across all concentrations, mostly didn’t differ significantly from those sprayed with Ord-TiO2. In roots, the DM and RDM were decreased with increasing concentration of Ord-TiO2 but unchanged significantly by spraying with Nano-TiO2. Under all levels of water availability, total osmotic potential (ψs) and osmotic potential contributed by organic substances (ψorganic) didn’t change significantly by Ord-TiO2. Nano-TiO2 doesn't have any effect on the shoot or root dry mass and osmotic potential contributed by electrolytes (ψelect). Low concentrations of Nano-TiO2 significantly decreased relative water content (RWC) and ψs due to decreasing ψorganic. The ψs and ψelect of the root sap of sunflower were greatly lower than that of leaf sap. The soluble sugars partitioning and re-translocation was mainly in the priority of osmotic adjustment of the roots as a functional equilibrium under water deficit stress.
Conclusion
The foliar application of Nano-TiO2 didn’t significantly improve the sunflower water status built up by the shortage in water supply, and the quite small effect was via re-translocation of electrolytes and organic substances from shoots to roots.
Tectona grandis: Narrow Genetic Base? A New Perspective on the Genetic Variability of Teak
Authors: Anjos Isabela Vera , Gilio Thiago A. S. , Amorim Ana Flávia S. , Jesus Jeferson G. , Chimello Antonio M. , Takizawa Fausto H. , Araújo Kelly Lana , Neves Leonarda Grillo 
Published: November 2022

Abstract
Teak (Tectona grandis Linn. f.) is considered one of the most expensive hardwoods in the world. The dispersion of the species over the years has taken the teak beyond its origin centers and little is known about the genetic origin and genetic variability. This study aimed to investigate the genetic diversity and population structure existing in a teak germplasm bank collection in Brazil. DNA was extracted from young leaves and each sample were genotyped by whole genome sequencing at 8x of coverage, the sequencing were aligned using the genome at NCBI, and SNPcalls and quality control were made. To study the population structure of the genotypes, Bayesian variational inference was used via fastStructure, the phylogenetic tree was based on the modified Euclidean distance and the clustering by the UPGMA hierarchical method. Genetic diversity was analyzed based on the pairwise genetic divergence (Fst) of Weir and Cockerham. Genotyping by sequencing resulted in a database of approximately 1.4 million of variations SNPs were used for analysis. It was possible to identify four subpopulations with genetic variability between and within the subpopulations, so this study made it possible to confirm the existence of genetic variability in teak, contrary to what was expected.
Vision Transformer Prediction of Delirium
Authors: Mulkey Malissa , Huang Huyunting , Albanese Thomas , Sunghan Kim , Yang Baijian 
Published: November 2022

Abstract
As many as 80% of critically ill patients develop delirium increasing the need for institutionalization and higher morbidity and mortality. Clinicians detect less than 40% of delirium when using a validated screening tool. EEG is the criterion standard but is resource intensive thus not feasible for widespread delirium monitoring. This study evaluated the use of limited-lead rapid-response EEG and supervised deep learning methods with vision transformer to predict delirium. This proof-of-concept study used a prospective design to evaluate use of supervised deep learning with vision transformer and a rapid-response EEG device for predicting delirium in mechanically ventilated critically ill older adults. Fifteen different models were analyzed. Using all available data, the vision transformer models provided 99.9%+ training and 97% testing accuracy across models. Vision transformer with rapid-response EEG is capable of predicting delirium. Such monitoring is feasible in critically ill older adults. Therefore, this method has strong potential for improving the accuracy of delirium detection, providing greater opportunity for individualized interventions. Such an approach may shorten hospital length of stay, increase discharge to home, decrease mortality, and reduce the financial burden associated with delirium.
Improved activity and stability for chlorobenzene oxidation over ternary Cu-Mn-O-Ce solid solution supported on cordierite
Authors: Gu Mingyang , Huang Qiong , Xu Lirui , Zhu Jie , Sun Yueyin , Tao Tao , Yang Bo , Chen Mindong , Yang Hong 
Published: November 2022

Abstract
A series of CuMnOx/CeO2/Cordierite and CuMnCeOx/Cordierite catalysts prepared by a complex method with citric acid were investigated on the performance of chlorobenzene (CB) oxidation. The effects of the molar ratio of Mn/Cu, transition metal oxide loading, calcination temperature and time were investigated as the main investigation factor on the performance. Meanwhile, XRD, SEM, BET, H2-TPR, O2-TPD and XPS were used to characterize the physicochemical properties of the samples. The results demonstrated that CuMnOx/CeO2/Cordierite catalysts with step-by-step synthesis exhibited high activity (T90 = 350oC) at the Cu/Mn molar ratio of 5:2, because the incorporation of CuO and MnOx formed CuMn2O4 spinel oxide supported on the surface of CeO2. More importantly, CuMnCeOx/Cordierite catalysts prepared by one-step synthesis exhibited the highest oxidation activity (T90 < 300oC) attributed to the low H2 reduction temperature and desorption energy of surface oxygen, and the formed Cu-Mn-O-Ce solid solution and CeO2 favorable promoted the high dispersion of CuMnOx in the supported catalysts. Enhanced oxygen concentration and mobility, abundant oxygen vacancy, high surface areas, and active sites of CuMnCeOx catalysts promoted the desorption of adsorbed Cl, which is associated with superior activity, repeatability, and stability. In addition, the possible oxidation mechanism was described to demonstrate the by-products generation and oxygen transfer of CuMnCeOx catalysts. The excellent performance for CB degradation exhibited a great promising to resolve CVOCs pollution.