bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral acute toxicity study on stem bark extracts of Bombax costatum Pellegr. and Vuillet on wistar albino rats
Authors: Bello Abubakar M. , Malgwi Ibrahim S. , Adegoke Salami H. , Abubakar Abdulwasi’u , Ibrahim Bilal M. , Chiroma Samaila M. 
Published: October 2022

Abstract
Background
Acute toxicity (LD50) test provides an indication on the range of doses of a substance that could be toxic to the body systems. This study was aimed at determining the LD50 of different extracts of Bombax costatum stem bark and its effects on the histology of liver and kidneys in rats.

Results
Phytochemical screening of n-hexane, ethanol and chloroform extracts of B. costatum stem bark has revealed the presence of alkaloids, flavonoid, saponins, steroid, terpenes, anthraquinones and cardiac glycosides. No mortality was recorded after testing all the different extracts on rats. However, mild body weaknesses and pilo erection were observed in the first hour of extracts’ administration. No statistically significant differences was observed in most of the serum levels of kidney function biomarkers, although a significant decrease (p < 0.05) in bicarbonate and increase (p < 0.05) in urea, respectively, were observed in chloroform extract treated group when compared to control. Further, no marked differences (p > 0.05) were observed in hematological parameters as well as in the liver functions biomarkers in all the 3 extract exposed groups when compared to the control, except significant decrease (p < 0.05) of total bilirubin level in chloroform extract exposed rats. Finally, histological sections of the liver and kidneys showed no aberrations.

Conclusions
Since no mortality and serious clinical manifestation were recorded, it is suggestive that oral acute administration of n-hexane, chloroform and ethanol extracts of B. costatum is greater than 5000 mg/kg. Hence, the plant has high safety margin and can be used within the dose of 5000 mg/kg body weight.
Mineral profile, carbohydrates fractionation, nitrogen compounds and in vitro gas production of elephant grass silages associated with cactus pear
Authors: de Sousa Cunha Diego , da Conceição da Silva Rodrigues Jessica Maria , de Jesus Pinheiro Costa Claudenilde , da Silva Lima Raquel , de Almeida Araújo Cleyton , de Oliveira Getúlio Figueiredo , Campos Fleming Sena , Magalhães André Luiz Rodrigues , de Araújo Gherman Garcia Leal , Gois Glayciane Costa 
Published: October 2022

Abstract
Background
The high amount of soluble carbohydrates and the reduced dry matter content in cactus pear can cause excessive fermentation, resulting in nutrient losses, when it is preserved in the silage form. Thus, the association of cactus pear with elephant grass in the production of mixed silages may reduce nutritional losses during the ensiling process. Thus, the aim was to evaluate the mineral profile, carbohydrates fractionation, nitrogen compounds, and in vitro gas production of elephant grass silages associated with a cactus pear levels (0, 150, 300, and 450 g/kg on dry matter basis). The study was carried out in a completely randomized design, with 4 treatments and 5 replications, totaling 20 experimental silos.

Results
The increase in cactus pear levels in elephant grass silages composition provided an increase in the contents of K (P = 0.013), Ca (P < 0.001), Mg (P < 0.001), Na (P = 0.001), B (P = 0.044) and Zn (P = 0.016), reduced P (P = 0.039) and promoted a quadratic effect for Fe (P = 0.045) content. The addition of cactus pear levels in elephant grass silages increased the total carbohydrates (P < 0.001) and A + B1 fraction (P = 0.002) and promoted a quadratic effect for B2 fraction (P = 0.032). For nitrogen compounds, the increase in cactus pear levels in elephant grass silages composition reduced the B1 + B2 fraction (P = 0.002) and increased the C fraction (P = 0.007). There was no effect of cactus pear levels on the in vitro gas production of elephant grass silages (P > 0.05).

Conclusions
Under the experimental conditions, the addition of cactus pear in elephant grass silage at levels up to 450 g/kg dry matter does not affect the in vitro gas production, however, it improves the mineral profile, contributes to the increase in the total carbohydrate content and the A + B1 fraction in the silages. Besides this, cactus pear addition reduces the B1 + B2 protein fraction, increasing the fraction C content in the silages, suggesting the necessity to supply an additional soluble nitrogen source for good ruminal functioning.
Etiology and presenting features of vocal cord paralysis: changing trends over the last two decades
Authors: Bhatta Subash , Gandhi Sachin , Ghanpur Asheesh Dora , Ganesuni Dushyanth 
Published: October 2022

Abstract
Background
The study was performed to evaluate the changing trends in etiology and presenting features of vocal cord paralysis (VCP) from March 1998 to March 2020.

Methods
Patient’s record collected from hospital database and divided into two groups, from March 1998 to March 2009 and from April 2009 to March 2020, to evaluate the changing trends in etiology and presenting features.

Results
Total of 711 VCP patients, 80.3% with unilateral (UVCP) and 19.7% with bilateral vocal cord paralysis (BVCP) included. The commonest etiology was non-surgical (57.1%) for UVCP and surgical (55.7%) for BVCP. The commonest surgical etiology was thyroid and parathyroid surgery for both UVCP (16.6%) and BVCP (38.5%). The commonest non-surgical etiology was idiopathic for UVCP (23.1%) and malignancies for BVCP (13.6%). There was increase in surgical etiology for both UVCP (39.3 to 45.3%) and BVCP (51.2 to 57.7%), and decrease in non-surgical etiology for both UVCP (60.7 to 54.6%) and BVCP (48.8 to 42.3%). The change in voice was most common presenting features for both UVCP (69.2%) and BVCP (92.8%). The frequency of the presenting features was comparable, with decrease in the duration of symptom onset over the time period.

Conclusion
The most common etiology for UVCP was idiopathic, and for BVCP was thyroid and parathyroid surgery. For both, UVCP and BVCP there was increasing trend for surgical and decreasing trend for non-surgical etiology. The change in voice was the most common presenting complain, with decrease in duration of symptom onset over time period.
Diagnosis and Medical Management of Parkinson Disease
Authors: Thaler Avner , Alcalay Roy N. 
Published: October 2022

ABSTRACT

PURPOSE OF REVIEW
Parkinson disease (PD) is a common neurodegenerative movement disorder, the prevalence of which is rising as the world population ages. It may present with motor and nonmotor symptoms, and symptomatic treatment significantly improves quality of life. This article provides an overview of the workup and differential diagnosis for PD and reviews genetic and environmental risk factors and current treatments.

RECENT FINDINGS
Novel treatments for the motor (eg, fluctuations and off times) and nonmotor (eg, hallucinations and orthostatic hypotension) complications of PD have been approved in recent years. In addition, with recent advances in our understanding of the genetics of PD, significant research is focusing on identifying at-risk populations and introducing genetically targeted interventions (precision medicine).

SUMMARY
PD is a heterogeneous neurodegenerative movement disorder. Affected individuals may receive substantial symptomatic relief from nonpharmacologic, pharmacologic, and surgical interventions. Although no intervention to modify the progression of PD is currently available, precision medicine and modulation of the immune system are a major focus of ongoing research.
Surgical Therapies for Parkinson Disease
Authors: Rawls Ashley E. 
Published: October 2022

ABSTRACT

PURPOSE OF REVIEW
Parkinson disease (PD) is a progressive neurodegenerative disorder that is often difficult to manage with medications alone. This article reviews the current therapeutic surgical interventions for PD, patient selection criteria, timing of patient referral to surgical services, procedure overview, and future directions.

RECENT FINDINGS
Adaptive, or closed-loop, deep brain stimulation is a promising therapy that can detect ongoing circuit changes and deliver appropriate stimulation based on the patient’s dominant symptom and level of dopaminergic medication.

SUMMARY
Patients with PD can benefit from surgical interventions that can be added to their medication regimen. These patients should be referred to comprehensive centers that offer complete multidisciplinary screening evaluation to ensure appropriate patient selection and intervention selection. With the appropriate surgical intervention and continued management from their care team, patients with PD can maximize their quality of life.
Diagnosing Common Movement Disorders in Children
Authors: O’Malley Jennifer A. 
Published: October 2022

ABSTRACT

PURPOSE OF REVIEW
This article is designed to help the clinician identify the most common pediatric movement disorders and recognize benign versus pathologic movements in infancy and childhood, with a particular focus on treatable conditions and those that should not be missed.

RECENT FINDINGS
As telehealth has become more prevalent as a means of providing health care services, the challenges of obtaining relevant examination findings during telehealth encounters for assessment of children with movement disorders have become evident.

SUMMARY
Although many children who present with a chief complaint of “abnormal movements” are found to have a benign, self-resolving etiology, it is critical that neurologists accurately recognize benign versus pathologic movements in children to ensure appropriate diagnosis and intervention.
Lolita in Humbert Humbert’s Camera Obscura and Lolita in Vladimir Nabokov’s Camera Lucida
Authors: Jung Byungsam 
Published: October 2022

Abstract
This article analyzes two types of visual perception in Vladimir Nabokov’s Lolita (1955): camera obscura and camera lucida, terms that are taken from photography and painting, respectively. By applying these terms, this article identifies a visual dilemma in how an artist perceives the object during the process of artistic creation—in a sense, a photographer cannot see the object itself at the moment of capturing the exposure, and a painter has to cease looking at the object and depict it from memory. Based on this visual dilemma, this article analyzes the two types of writing in Lolita: Humbert Humbert’s private diary written with his photographic memory and his manuscript for publication, his confession, written with his painterly imagination. This article argues that Humbert’s two ways of inscribing, camera obscura and lucida, fail to capture the full reality of the object because they are both based on his memory and inspiration rather than a vision of reality. Humbert is seized by his own inspiration that has been derived from his illusion, Lolita, that does not necessarily represent the reality of the object, Dolores. These examples epitomize Nabokov’s view that art has no or minimal relation to life.
Historicist Cosmopolitanism from Scandinavia’s First Novel
Authors: Larsen Mads 
Published: October 2022

AbstractToday’s political despondency is informed by how Western populations no longer believe in the cosmopolitan stories that underpinned the modern world. Before Kantian universalism became hegemonic, the eighteenth century offered a variety of perspectives, like those of outpost philosophers Giambattista Vico and Johann Gottfried Herder. The scholarly and dramatic works of another thinker from the European periphery, Ludvig Holberg, have recently received new attention for their historicist themes. The ornery Norwegian polymath is praised for having anticipated the transnational cosmopolitanism that has reemerged in the past decades. Holberg was Scandinavia’s preeminent Enlightenment figure and is still beloved for his stage comedies. His only European success, Niels Klim’s Underground Travels (1741), argues for a cosmopolitanism situated in history, geography, and local culture. This article analyzes how the novel subverts its conte philosophique form to criticize common Enlightenment views on reason, universalism, and colonialism. Holberg’s philosophical “agonism of difference,” inferred from Niels Klim’s themes, is then used to evaluate four contemporary cosmopolitanisms: Appiah’s “universality plus difference” (2006), Tully’s “agonistic dialogue” (2008), and Habermas’s “legal order” (1997) and “postmetaphysical reason” (2019). What emerges suggests that Holberg anticipated a cultural collapse similar to what we experience today.
Leveraging the Multidisciplinary Tumor Board for Dissemination of Evidence-Based Recommendations on the Staging and Treatment of Gastric Cancer: A Pilot Study
Authors: Mehta Shivani N. , Shenvi Edna C. , Blair Sarah L. , Caudle Abigail , Lowenstein Lisa M. , Kelly Kaitlyn J. 
Published: October 2022

AbstractBackgroundCompliance with evidence-based treatment guidelines for gastric cancer across the United States is poor. This pilot study aimed to create and evaluate a change package for disseminating information on the staging and treatment of gastric cancer during multidisciplinary tumor boards and for identifying barriers to implementation.MethodsThe change package included a 10-min video, a brief knowledge assessment, and a discussion guide. Commission on Cancer-accredited sites that perform gastrectomy were invited to participate. Participants completed the Organizational Readiness for Implementing Change (ORIC) scale (range, 12–60) and scales to measure the feasibility, acceptability, and appropriateness (score range, 4–20). Semi-structured interviews were conducted to further define inner and outer setting barriers.ResultsSeven centers participated in the study. A total of 74 participants completed the pre-video knowledge assessment, and 55 participants completed the post-video assessment. The recommendations found to be most controversial were separate staging laparoscopy and modified D2 lymphadenectomy. Sum scores were calculated for acceptability (mean, 17.43 ± 2.51) appropriateness (mean, 16.86 ± 3.24), and feasibility (mean, 16.14 ± 3.07) of the change package. The ORIC scores (mean, 46.57 ± 8.22) correlated with responses to the open-ended questions. The key barriers identified were patient volume, skills in the procedures, and attitudes and beliefs.ConclusionsThe change package was moderately to highly feasible, appropriate, and acceptable. The activity identified specific recommendations for gastric cancer care that are considered controversial and local barriers to implementation. Future efforts could focus on building skills and knowledge as well as the more difficult issue of attitudes and beliefs.
Postgraduate education in healthy and active ageing: learning needs, curriculum and expected outcomes: a scoping review protocol
Authors: Wiggin Daisy , Penič Benjamin , Sulopuisto Outi , Setti Annalisa , Mali Jana , Stitzel Andrea , Kuisma Raija , Baptista Fátima , Kukkonen Tuula , Konstantakopolou Olympia , Timonen Liisa , Carnide Filomena , Velanoki Venetia-Sofia , Ströckl Daniela Elisabeth , Zymbal Vera , Cardadeiro Graça , Nevala Elina , Kaitelidou Daphne , Sourtzi Panayota , Hlebec Valentina , Filipovič Hrast Maša , Timmons Suzanne 
Published: October 2022

Background: As the European population ages, it becomes increasingly important to promote and facilitate healthy and active ageing and age-friendly societies. Professionals across a range of disciplines and sectors need knowledge and skills to support both. Objective: This scoping review aims to identify and map the literature on learning needs, learning outcomes and respective curricula in healthy and active ageing and age-friendly society concepts. Inclusion criteria: Studies focused on the teaching/learning process in healthy and active ageing and/or age-friendly society, of any design type, are eligible. Included studies may focus on undergraduate, postgraduate or continuing education and on any aspect of the educational process, such as needs analysis, content delivery, learner satisfaction/acceptability, or education outcome. Methods: This review will follow the Joanna Briggs Institute (JBI) methodology for conducting scoping reviews. Four electronic databases, PubMed, EBSCO (Academic Search Complete), Scopus and Applied Social Sciences Index and Abstracts (ASSIA), will be searched, limited to studies published from 1st January 2000. Text language will be limited to English, German, Greek, Portuguese, Finnish, and Slovenian. Google Scholar and Research Gate will be searched for grey literature, limited to the first 50 results of each. Title and abstract screening, followed by full-text screening will be undertaken independently by at least two reviewers. The JBI extraction tool will be adapted for data extraction. Quality assessment will be conducted using a tool developed by Hawker and colleagues. A narrative synthesis will outline the data in relation to the aims and objectives outlined.
Development and implementation of a customised rapid syndromic diagnostic test for severe pneumonia
Authors: Navapurkar Vilas , Bartholdson Scott Josefin , Maes Mailis , Hellyer Thomas P , Higginson Ellen , Forrest Sally , Pereira-Dias Joana , Parmar Surendra , Heasman-Hunt Emma , Polgarova Petra , Brown Joanne , Titti Lissamma , Smith William PW , Scott Jonathan , Rostron Anthony , Routledge Matthew , Sapsford David , Török M. Estée , McMullan Ronan , Enoch David A , Wong Vanessa ,   VAP-Rapid investigators, Curran Martin D , Brown Nicholas M , Simpson A John , Herre Jurgen , Dougan Gordon , Conway Morris Andrew 
Published: October 2022

Background: The diagnosis of pneumonia has been hampered by a reliance on bacterial cultures which take several days to return a result, and are frequently negative. In critically ill patients this leads to the use of empiric, broad-spectrum antimicrobials and compromises good antimicrobial stewardship. The objective of this study was to establish the performance of a syndromic molecular diagnostic approach, using a custom TaqMan array card (TAC) covering 52 respiratory pathogens, and assess its impact on antimicrobial prescribing. Methods: The TAC was validated against a retrospective multi-centre cohort of broncho-alveolar lavage samples. The TAC was assessed prospectively in patients undergoing investigation for suspected pneumonia, with a comparator cohort formed of patients investigated when the TAC laboratory team were unavailable. Co-primary outcomes were sensitivity compared to conventional microbiology and, for the prospective study, time to result. Metagenomic sequencing was performed to validate findings in prospective samples. Antibiotic free days (AFD) were compared between the study cohort and comparator group. Results: 128 stored samples were tested, with sensitivity of 97% (95% confidence interval (CI) 88-100%). Prospectively, 95 patients were tested by TAC, with 71 forming the comparator group. TAC returned results 51 hours (interquartile range 41-69 hours) faster than culture and with sensitivity of 92% (95% CI 83-98%) compared to conventional microbiology. 94% of organisms identified by sequencing were detected by TAC. There was a significant difference in the distribution of AFDs with more AFDs in the TAC group (p=0.02). TAC group were more likely to experience antimicrobial de-escalation (odds ratio 2.9 (95%1.5-5.5)). Conclusions: Implementation of a syndromic molecular diagnostic approach to pneumonia led to faster results, with high sensitivity and impact on antibiotic prescribing.
The CINAMR (Clinical Information Network-Antimicrobial Resistance) Project: A pilot microbial surveillance using hospitals linked to regional laboratories in Kenya: Study Protocol
Authors: Akech Samuel , Nyamwaya Brian , Gachoki Jackline , Ogero Morris , Kigo Joyce , Maina Michuki , Mutua Edna , Ooko Ednah , Bejon Philip , Mwarumba Salim , Bahati Felix , Mvera Benedict , Musyimi Robert , Onsare Robert , Hutter Jack , Tanui Emmanuel , Wesangula Evelyn , Turner Paul , Dunachie Susanna , Lucey Olivia , McKnight Jacob ,   CINAMR Investigators
Published: October 2022

Background: Antimicrobial resistance (AMR) is a global threat and is thought to be acute in low-and middle-income country (LMIC) settings, including in Kenya, but there is limited unbiased surveillance that can provide reliable estimates of its burden. Current efforts to build capacity for microbiology testing in Kenya are unlikely to result in systematic routine microbiological testing in the near term. Therefore, there is little prospect for microbiological support to inform clinical diagnoses nor for indicating the burden of AMR and for guiding empirical choice of antibiotics. Objective: We aim to build on an existing collaboration, the Clinical Information Network (CIN), to pilot microbiological surveillance using a ‘hub-and-spoke’ model where selected hospitals are linked to high quality microbiology research laboratories. Methods: Children admitted to paediatric wards of 12 participating hospitals will have a sample taken for blood culture at admission before antibiotics are started. Indication for blood culture will be a clinician’s prescription of antibiotics. Samples will then be transported daily to the research laboratories for culture and antibiotic susceptibility testing and results relayed back to clinicians for patient management. The surveillance will take place for 6 months in each hospital. Separately, we shall conduct semi-structured interviews with frontline health workers to explore the feasibility and utility of this approach. We will also seek to understand how the availability of microbiology results might inform antibiotic stewardship, and as an interim step to the development of better national or regional laboratories linked to routine surveillance. Conclusions: If feasible, this approach is less costly and periodic ‘hub-and-spoke’ surveillance can be used to track AMR trends and to broadly guide empirical antibiotic guidance meaning it is likely to be more sustainable than establishing functional microbiological facilities in each hospital in a LMIC setting.
Old Karelian personal names
Authors: Kuzmin Denis 
Published: October 2022

The article analyzes old personal names of the Karelian population. As the author demonstrates, the revealed corpus of historical Karelian names is yet very incomplete and severely understudied. This is to be due to a number of causes, including the relative scarcity of names recorded in historical documents, the limited number of sources, and the lack of research devoted to medieval Karelian names. Thus, this article is the author’s look into the evolution of the old given names of Karelians and a step towards their further description and study.
Kokkuvõte. Denis Kuzmin: Vanad karjalaste isikunimed. Artiklis analüüsitakse Karjala elanikkonna vanu isikunimesid. Nagu autor näitab, on teadaolevate ajalooliste karjalaste nimede korpus veel väga puudulik ja väheuuritud. Põhjusi selleks on mitu, sealhulgas ajalooürikutes kirja pandud nimede suhteline nappus, allikate piiratus, keskaegsete karjala nimede vähene uuritus. Käesolev artikkel annab ülevaate karjalaste vanade eesnimede kujunemisest ning on samm nende edasise kirjeldamise ja uurimise suunas.