bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACT I early feasibility study of the Voyager Ark vascular access device
Authors: Ross John , Hohmann Stephen , Glowczwski Alan , Glowczwski Justin , Potnis Anishaa , Lovelady April , Gowda Ashok 
Published: December 2024

Objective: We report the 6-month outcomes of the Ark Cannulation Trial (ACT) I early feasibility study. This investigation examined the Ark as a potential innovative access tool for overcoming cannulation-related challenges and improving arteriovenous fistula (AVF) dependent hemodialysis through targeted cannulation. Methods: During this first-in-human, interventional, prospective, single arm, single site investigation, 13 patients were treated. Cohort 1 included patients with existing fistulas meeting the criteria for Ark implantation at planned sites, including depth (4–15 mm), diameter (⩾4 mm), flow (⩾500 mL/min) and a poorly accessible cannulation zone. Cohort 2 included patients who underwent AVF creation and implantation of Arks at time of initial surgery. For both Cohorts, clinical need determined if one or two Arks were implanted. The primary endpoint was effective initial cannulation of the access site after Ark implantation. The secondary endpoint was continued access of the Ark cannulation zone for hemodialysis and evaluation of device or procedure-related adverse events collected for 6 months post-implantation. The exploratory endpoint evaluated the Ark implantation procedure. Results: Of 13 patients, 2 were withdrawn prior to initial cannulation through the Ark—1 patient due to an exacerbated baseline condition and the other patient due to loss of follow-up. In the efficacy analysis, 11 of 13 treated patients demonstrated successful primary and secondary outcomes. Of the 11 treated patients who initiated cannulation through the Arks, 100% experienced successful primary and secondary outcomes. None of the patients experienced adverse events related to the Ark and surgeons had the necessary skills to implant Arks. Conclusion: The results demonstrated the Ark could be used successfully in End-Stage Renal Disease (ESRD) patients undergoing hemodialysis three times a week. These results suggest preliminary safety and efficacy of the Ark as a promising cannulation tool for dialysis vascular access and warrant further exploration of long-term safety and effectiveness through a pivotal clinical study involving a larger population and extended follow-up.
Predictors of Enrollment and Adherence in a Randomized Tobacco Cessation Clinical Trial
Authors: Coffee Zhanette , Hsu Chiu-Hsieh , Vanderah Todd W. , Gordon Judith S. 
Published: December 2024

Background New therapeutic cessation approaches are being tested in clinical trials to engage and retain people who smoke. Our team is conducting a pragmatic randomized clinical trial (RCT) to evaluate a new treatment for tobacco dependence, but enrolling participants and ensuring adherence has been more challenging than in previous trials. Objective To determine the predictors of enrollment and adherence in the RCT. Design A secondary analysis of data from a tobacco cessation RCT. Methods Data was collected during a two-group RCT testing the efficacy of an integrative guided imagery vs behavioral treatment, with both conditions involving six weekly, hour-long sessions over 9 weeks. Results Of the 1074 randomized participants, 803 (74.8%) enrolled (completed the first session), and 631 (78.6%) of those were adherent (attended all scheduled sessions). Variables associated with enrollment included age (adjusted odds ratio [AOR], 1.01; 95% CI, 1.0003-1.02; P = 0.04) and state of residence (West Virginia vs New York (NY), AOR, 0.66; 95% CI, 0.46-0.94; P = 0.02), with older participants and those from NY more likely to enroll. Variables associated with adherence included race (Black vs White) (AOR, 2.09; 95% CI, 1.05-4.16; P = 0.04), higher education (at least some college vs high school or less) (AOR, 2.27; 95% CI, 1.58-3.26; P < 0.0001), marital status (all others vs single/never married) (AOR, 1.66; 95% CI, 1.11-2.48; P = 0.01), and state of residence (Arizona vs NY) (AOR, 0.52; 95% CI, 0.34-0.78; P = 0.002). Within Arizona, older age increased enrollment, while higher education and marriage improved adherence. Within NY, higher education was associated with both increased enrollment and adherence, while higher number of household smokers, and not reporting substance use were associated with increased adherence. Conclusion Enrolling and retaining people who smoke in cessation trials requires novel strategies. Identifying predictors of enrollment and adherence offers valuable insights for overcoming barriers in future tobacco cessation RCTs.
Gastric ultrasound: Enhancing preoperative risk assessment and patient safety
Authors: Kar Man Chan Luke 
Published: December 2024

Perioperative pulmonary aspiration is a critical complication linked to significant morbidity and mortality, particularly in high-risk populations such as patients with diabetes, obesity, gastroparesis, or those using Glucagon-Like-Peptide-1 receptor agonists (GLP-1 RAs). Standard fasting protocols may not be appropriate for these patients, as they have increased propensity of delayed gastric emptying, hence increasing the complex of the preoperative risk assessment. Gastric ultrasound (GUS) provides a non-invasive, reliable method for assessing gastric content and volume, enabling anaesthesia professionals to make informed decisions regarding aspiration risk, airway management, and surgical scheduling. By identifying patients with elevated gastric volumes, GUS has the potential to reduce aspiration-related complications and unnecessary surgical cancellations. Despite its clear clinical benefits, the adoption of GUS in anaesthetic practice remains limited, primarily due to the technical skill required for accurate quantitative assessments. Qualitative evaluations of gastric contents are simpler for beginners, but precise volume measurements, essential for risk stratification, demand more extensive training. Recent studies demonstrate that with structured training, even novice operators can achieve high diagnostic accuracy. Artificial intelligence (AI) can further enhance GUS utility by automating volume calculations, guiding probe placement, and providing real-time feedback. These capabilities could significantly shorten the learning curve and improve consistency in risk assessment. Incorporating GUS and AI tools into anaesthesia training can overcome adoption barriers, enabling clinicians to more accurately assess aspiration risk and enhance patient safety in perioperative care.
Nonsurgical Knee Osteoarthritis Treatments for Reducing Inflammation as Measured on MRI Scans: A Systematic Review of Randomized Controlled Trials
Authors: Gottreich Julia R. , Katz Jeffrey N. , Jones Morgan H. 
Published: December 2024

Background: Knee osteoarthritis (OA) is a debilitating condition, and synovitis is a structural marker of disease progression that can be identified on magnetic resonance imaging (MRI). Nonsurgical therapies have been developed with the goal of targeting this inflammation to reduce pain and slow disease progression. Purpose: To review current randomized controlled trials (RCTs) that measured changes in pain outcomes and synovitis on MRI scans after nonsurgical treatment for persons with knee OA. Study Design: Systematic review; Level of evidence, 1. Methods: The PubMed database was searched using the terms “knee osteoarthritis AND (synovitis OR inflammation)” for RCTs published between 2012 and 2022. Included were studies that collected both pain outcomes and quantitative measurements of synovitis on MRI scan before and after treatment; studies that investigated surgical treatments were excluded. We calculated standardized response means (SRMs) to analyze the effect sizes of treatment on pain and synovitis outcomes; SRMs were classified as having low responsiveness to treatment if <0.5, moderate responsiveness to treatment if between 0.5 and 0.8, and large responsiveness to treatment if >0.8. Results: Included in the review were 9 RCTs. Vitamin D and exercise therapy were the only 2 treatments that improved both pain and synovitis outcomes in comparison with their respective control groups. Statistically significant group differences in favor of treatment were seen in changes in pain after lutikizumab (anti-interleukin-1α/β dual variable domain immunoglobulin; SRM, 0.22; P = .050), allogenic human chondrocytes transduced with retroviral vector encoding transforming growth factor-β1 ( P = .0119 at 12 weeks, P = .120 at 52 weeks, and P = .0074 at 72 weeks), and Curcuma longa (turmeric; SRM, 0.35; P = .039 on the visual analog scale for pain and SRM, 0.47; P = .006 on the Western Ontario and McMaster Universities Osteoarthritis Index pain subscore). One study reported a statistically significant group difference in synovitis only after treatment with intra-articular methylprednisolone ( P = .01 at 14 weeks and P = .0006 at 26 weeks). Conclusion: Only vitamin D and exercise therapy were found to improve pain and synovitis after treatment in this review. Further research is needed to validate these findings and investigate alternative treatments for reducing pain and synovitis in persons with knee OA.
Pathogenesis of acephalic spermatozoa syndrome caused by PMFBP1 mutation
Authors: Xia Huaqiang , Zhang Juan , Mao Wuyuan , Yi Kangle , Wang Teng , Liao Lingyan 
Published: December 2024

Abstract
Background
Acephalic spermatozoa syndrome is a rare but severe type of teratozoospermia. The familial trait of acephalic spermatozoa syndrome suggests that genetic factors play an important role. However, known mutations account for only some acephalic spermatozoa syndrome patients, and more studies are needed to elucidate its pathogenesis. The current study aimed to elucidate the pathogenesis of acephalic spermatozoa syndrome caused by PMFBP1 mutation.

Results
We identified a homozygous splice site mutation (NM_031293.2, c.2089-1G > T) in PMFBP1 through Sanger sequencing. Western blotting and immunofluorescence analyses revealed that this splice site mutation resulted in the absence of PMFBP1 protein expression in the patient's sperm cells. We generated an in vitro model carrying the splice site mutation in PMFBP1 and confirmed, through RT‒PCR and Sanger sequencing, that it led to a deletion of 4 base pairs from exon 15.

Conclusion
A homozygous splice site mutation results in a deletion of 4 bp from exon 15 of PMFBP1, thereby affecting the expression of the PMFBP1 protein. The absence of PMFBP1 protein expression can lead to acephalic spermatozoa syndrome. This finding elucidates the underlying cause of acephalic spermatozoa syndrome associated with this specific mutation (NM_031293.2, c.2089-1G > T) in PMFBP1.
Task content of jobs and mothers’ employment transitions in Germany
Authors: Bogusz Honorata 
Published: December 2024

AbstractI study the association between task content of jobs and mothers’ employment transitions after the first birth in Germany. I construct measures of task content of jobs using data from the Employment Survey conducted by the German Federal Institute for Vocational Education and Training (BiBB). These indicators illustrate the career cost of children and how it is impacted by the technology- and globalization-driven labour market change. The measures are then linked to high-quality individual register data from the German Pension Fund (FDZ-RV) covering the years 2012–2020. Utilizing competing risk models, I show that women engaged in occupations with analytic and interactive task content, which are in high demand and incompatible with maternity-related employment breaks, are the most likely to transition to employment after their first birth. Conversely, women with occupations intense in routine tasks, which are more susceptible to automation or trade competition, are more likely to experience unemployment.
Adaptation of potato cultivars to phosphorus variability and enhancement of phosphorus efficiency by Bacillus subtilis
Authors: Chea Leangsrun , Alhussein Mohammad , Karlovsky Petr , Pawelzik Elke , Naumann Marcel 
Published: December 2024

Abstract
Background
Plants utilize a variety of mechanisms to adapt to fluctuations in phosphorus (P) availability. Potatoes, in comparison to other crops, often display reduced phosphorus use efficiency (PUE) due to their underdeveloped root systems; therefore, understanding the mechanisms underlying PUE is critical for improving it. This study aimed to evaluate the morphological and physiological responses of potatoes to different P levels, with a focus on root system alterations and PUE. Two potato cultivars, a table potato (cv. Milva) and a starch potato (cv. Lady Claire), were subjected to varying P levels (0.5, 2, 5, and 30 mg P L-1 supplied as KH2PO4) in a hydroponic system. Additionally, the plants grown under 0.5 and 2 mg P L-1 were treated with plant growth-promoting Bacillus subtilis (B. subtilis), compared to untreated controls, to investigate the effectiveness of B. subtilis in addressing P deficiency. B. subtilis inoculation was performed by adding a bacterial suspension weekly to the hydroponic nutrient solution.

Results
The findings illustrated Milva’s ability to efficiently allocate P and sugars to its roots under low P levels, thereby enhancing biomass and facilitating increased P uptake and PUE. Conversely, Lady Claire exhibited lower P assimilation efficiency under low P levels but demonstrated improved efficiency under high P availability. The concentration of P in the nutrient solution affected P uptake and several factors believed to be involved in P utilization, such as root morphology, sugar and indole-3-acetic acid concentration in the roots, and acid phosphatase activity. Gene expression analyses underscored the pivotal roles of StPHT1;1 and StPHT2;1 in P translocation to shoots, particularly in Lady Claire. Inoculation with B. subtilis improved P acquisition efficiency by 10% under low phosphorus levels (P0.5 and P2), particularly in Lady Claire, where shoot and root phosphorus contents increased by 13–25% and 4–13%, respectively. Additionally, B. subtilis displayed higher efficacy in mitigating P deficiency in Lady Claire compared to Milva, particularly under low P levels (P0.5 and P2).

Conclusion
Milva showed greater phosphorus efficiency than Lady Claire under low P conditions, attributed to higher P and sugar levels in roots, enhancing root growth, P uptake, and translocation to shoots, particularly to young leaves. However, Lady Claire demonstrated a notable increase in P uptake and enhanced responsiveness to B. subtilis inoculation, particularly under low P levels (P0.5 and P2). These findings provide valuable insights for optimizing P management strategies to improve PUE in potatoes, especially under low P levels.
Evaluation of the German living guideline “Protection against the Overuse and Underuse of Health Care” – an online survey among German GPs
Authors: Warkentin Lisette , Scherer Martin , Kühlein Thomas , Pausch Felix , Lühmann Dagmar , Muche-Borowski Cathleen , Hueber Susann 
Published: December 2024

Abstract
Background
The aim of this study was to evaluate the awareness and use of the German guideline “Protection against the overuse and underuse of health care” from the general practitioners’ (GPs’) perspective. In addition, the study assessed how GPs perceive medical overuse and what solutions they have for reducing it.

Methods
We performed a cross-sectional online survey with recruitment from 15.06. to 31.07.2023. Participants were members of the German College of General Practitioners and Family Physicians (DEGAM). The main outcomes were the awareness and use of the guideline.

Results
The analysis included data from 626 physicians. 51% were female and the median age was 50 years. The guideline is known by 81% of the participants, 32% read it in more detail. The majority considered the guideline a helpful tool in reducing overuse (67%). Almost 90% wished to have more guidelines with clear do-not-do recommendations. Physicians indicated in mean (M) that 30.2% (SD = 19.3%) of patients ask them for medical services that they do not consider to be necessary and that M = 30.2% (SD = 18.1%) of all GP services can be attributed to medical overuse. About half of the participants thought that overuse is a moderate or major problem in their practice (52%) and in general practice overall (58%). More participants rated that it is especially a problem in specialist (87%) and inpatient care (82%). Changes in the reimbursement system, raising awareness for the problem and more evidence-based guidelines were considered helpful in mitigating overuse.

Conclusions
Although the guideline is seen as a useful tool in mitigating medical overuse, there is still further potential for its implementation and utilisation. GPs see more overuse in the inpatient and outpatient specialist areas than in their area of practice. Instead of self-critically approaching the problem, the proposed strategies are aimed at the healthcare system itself.
Bioactive constituents from Carica papaya fruit: implications for drug discovery and pharmacological applications
Authors: kumarasinghe Hiruni Sandunika , Kim Ji-Hyang , Kim Su-Lim , Kim Kyeoung Cheol , Perera Rambukkana Maggonage Thiruni Dananj , Kim Seong-Cheol , Lee Dong-Sun 
Published: December 2024

AbstractCarica papaya, commonly known as papaya, is a fruit recognized for its substantial medicinal potential, primarily due to its wide range of bioactive compounds. This review thoroughly examines the pharmacological implications of these constituents and highlights their potential applications in drug discovery and therapy. Papaya is abundant in vitamins (A, C, and E), minerals, enzymes, and phytochemicals such as flavonoids, phenolic acids, carotenoids, and alkaloids, all of which contribute to its antioxidant, anti-aging, anti-inflammatory, and anticancer effects. The fruit demonstrates significant activity against diabetes, obesity, cardiovascular diseases, and gastrointestinal disorders. This review also discusses how environmental factors, including temperature, light, soil quality, and rainfall, impact the phytochemical composition of papaya, thereby influencing its medicinal properties. Both in vitro and in vivo studies have highlighted the therapeutic potential of papaya-derived compounds in various health conditions, including cancer, diabetes, wound healing, and cardiovascular health. Additionally, we explore papaya's role in promoting gut health and its antimicrobial properties against bacterial and viral pathogens. In conclusion, the diverse pharmacological activities of papaya's bioactive compounds position it as a valuable candidate for further research and development in drug discovery and therapeutic applications.
Optimal load attachment of a deeply embedded ring anchor in clay
Authors: Lee Junho , Aubeny Charles P. 
Published: December 2024

AbstractA Deeply Embedded Ring Anchor (DERA) system has been developed as a cost-effective solution for mooring arrays of floating offshore wind turbines (FOWTs) to the seabed. The DERA boasts several key features, including its versatility in various soil types, compact size, compatibility with diverse mooring systems, multi-line potential, and robust performance even under unintentional loading conditions. While prior preliminary studies have provided valuable insights into how the DERA can enhance cost-effectiveness by offering a high load capacity, these studies have predominantly focused on optimizing anchor performance under translational horizontal and vertical loading. However, to design the DERA optimally, we must also consider its ability to handle inclined loading conditions in addition to lateral and axial loadings. Due to its shorter length compared to a conventional caisson, the DERA has less resistance to moments, making it more sensitive to horizontal load capacity and the optimal load attachment depth concerning load angle. For this reason, our study introduces an analytical approach to evaluate the effects of inclined loading on anchor performance, utilizing the previously validated upper bound plastic limit analysis (PLA) method. In investigating the optimal load attachment of the DERA, this paper conducts a parametric study to analyze how factors such as load attachment depth, anchor aspect ratio, and load inclination affect the DERA’s load capacity. Our findings indicate that PLA can serve as a valuable analytical tool for assessing the ultimate load capacity of the DERA, particularly under inclined loading conditions.
Diagnostic accuracy of Fatty Liver Index (FLI) for detecting Metabolic Associated Fatty Liver Disease (MAFLD) in adults attending a tertiary care hospital, a cross-sectional study
Authors: Vamja Roshni , M Yogesh , Vala Vijay , Ramachandran Arya , Nagda Jay 
Published: December 2024

Abstract
Background
Metabolic-associated fatty liver disease (MAFLD) is a major public health problem worldwide. This study aimed to determine the prevalence of MAFLD and evaluate the diagnostic accuracy of the Fatty Liver Index (FLI) compared to ultrasonography for detecting fatty liver in adults attending a tertiary care hospital in Gujarat, India.

Methods
This cross-sectional study included 500 adults visiting the outpatient department between January 2023 and December 2023. MAFLD was diagnosed on ultrasound. FLI was calculated using body mass index, waist circumference, triglycerides, and gamma-glutamyl transpeptidase levels. FLI ≥ 60 indicated fatty liver. Logistic regression analysis identified factors associated with fatty liver.

Results
MAFLD prevalence was 32.2% on ultrasound. High FLI (≥ 60) was present in 26.2%. Male sex, higher BMI, waist circumference, night shift work, diabetes, and triglycerides were independent predictors of fatty liver. FLI showed excellent diagnostic accuracy with a sensitivity of 96%, specificity of 92.5%, and AUC of 0.92 for detecting fatty liver on ultrasound.

Conclusion
MAFLD prevalence among adults was high in this hospital-based sample. FLI can serve as an accurate non-invasive tool for identifying individuals with a high probability of MAFLD. These findings emphasize the need for larger population-based studies and the implementation of regular MAFLD screening programs in high-risk groups.
The roles of cognitive dissonance and normative reasoning in attributions of minds to robots
Authors: Baker Lewis J. , Li Hongyue , Hammond Hugo , Jaeger Christopher B. , Havard Anne , Lane Jonathan D. , Harriott Caroline E. , Levin Daniel T. 
Published: December 2024

AbstractAs a wide variety of intelligent technologies become part of everyday life, researchers have explored how people conceptualize agents that in some ways act and think like living things but are clearly machines. Much of this work draws upon the idea that people readily default to generalizing human-like properties to such agents, and only pare back on these generalizations with added thought. However, recent findings have also documented that people are sometimes initially hesitant to attribute minds to a machine but are more willing to do so with additional thought. In the current experiments, we hypothesized that these attribution-increasing reconsiderations could be spurred by situation-induced cognitive dissonance. In two experiments, participants completed a belief activation exercise designed to induce cognitive dissonance (writing arguments for or against prominent beliefs), viewed a video of an ambiguously intentional robot, and completed measures of cognitive dissonance. In both experiments, cognitive dissonance was associated with increased attributions of mind to the robot. Our findings provide evidence that people sometimes increase their attributions of minds when experiencing cognitive conflict, but also that activation of change-inducing concepts may impact attributions of a mind without producing conscious cognitive conflict in participants.