bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antecedents of Green Purchasing Behavior in the Arabic Gulf
Authors: Elsantil Yasmeen 
Published: May 2021

Background: Despite consumers appearing to assign great importance to green purchasing and expecting companies to produce their goods in an environmentally friendly way, they do not always exhibit this positive attitude while making purchases. Focus: This paper aims to discuss the extent to which green purchasing behavior in the Arabic Gulf is affected by individuals’ perceived environmental attitudes, concern, perceived seriousness of environmental problems, perceived environmental responsibility, perceived self-identity in environmental protection, perceived social context in environmental protection, as well as demographics. Methods: The study adopted a quantitative research approach using a survey questionnaire on a sample of 324 individuals residing in different Arab countries in the Gulf area. A 5-point Likert scale was used. Path analysis was conducted to test and evaluate the hypothesized relationships among constructs. Results: The study found importantly, by using multiple regression analyses, that consumers’ environmental concern, self-identity in environmental protection, and social context in environmental protection are significant predictors of green purchasing behavior and can predict 38.9% of green purchasing behavior. Among demographic factors, gender showed a significant effect on green purchasing behavior. Importance to Social Marketing Field: The present study enhances the social marketing literature through the understanding of green purchasing behaviors from a perspective of non-Western countries. Recommendation for Research or Practice: This paper has significant managerial implications. The findings could help marketers and government in formulating strategies that encourage green purchasing behavior in the Arabic Gulf. Limitations: Although the current study shed some light on green purchasing behaviors in the Arabic Gulf, it did not focus on a particular type of green product; rather, it looked at green purchasing behavior in general.
Human Papillomavirus Vaccine Messaging on TikTok: Social Media Content Analysis
Authors: Boatman Dannell D. , Eason Susan , Conn Mary Ellen , Kennedy-Rea Stephenie K. 
Published: May 2021

Background The human papillomavirus (HPV) vaccine is viewed as a critical tool to protect against six HPV-related cancers. Vaccination is recommended from early adolescence through age 26 years. As young people have become increasingly involved in personal health-related decisions, there is a need to tailor HPV vaccine messaging and reach this priority population on social media and digital outlets. TikTok is a growing social media platform with approximately 70% of its users between the ages of 13 and 24 years. Purpose The aim of this study was to understand HPV vaccine messaging and interactions on TikTok as a needed first step to identifying effective strategies to reach young people with important health messaging. Methods Content analysis was performed on 170 top TikToks focused on the HPV vaccine. TikToks were assessed for content, classification type, and number of interactions. Results Most TikToks were provaccine, while antivaccine TikToks had more user interactions. Cancer and prevention were the main content areas of the analyzed provaccine TikToks, while the side effects were the primary focus of antivaccine messages. Approximately 30% of all top TikToks analyzed were developed by health professionals. TikToks without an explicit vaccine opinion primarily described personal experiences and mentioned side effects most often. Implications TikTok is a growing social media platform that can be used to reach young people and encourage HPV vaccine uptake. Health professionals need to consider the interest that users have in personal experiences and address antivaccine narratives related to side effects.
Comparison of the Sterilization Efficiency of 3 Disinfectants for Dropped Anterior Cruciate Ligament Grafts: A Systematic Review and Meta-analysis
Authors: Shen Xianyue , Qin Yanguo , Zuo Jianlin , Liu Tong , Xiao Jianlin 
Published: May 2021

Background: The inadvertent contamination of anterior cruciate ligament (ACL) grafts can occur if they are accidentally dropped on the floor during ACL reconstruction. There has been no meta-analysis conducted to compare the sterilization efficiency of the different disinfectants used on dropped ACL grafts. Purpose: To compare the sterilization efficiency of 3 disinfectants to decontaminate ACL grafts as necessary. Study Design: Systematic review. Methods: A systematic literature review was performed using the MEDLINE, Embase, and Cochrane Library databases. All studies reporting the management of dropped or contaminated grafts were considered for this meta-analysis. Results: A total of 7 studies meeting inclusion criteria were identified from a literature search. The pooled results of this meta-analysis indicated that the rate of positive cultures of ACL grafts dropped on the operating room floor was 44.9% and that the commonly contaminated microbes were staphylococci and bacilli. The meta-analysis results indicated that the sterilization efficiency of a 4% chlorhexidine solution was superior to an antibiotic solution (odds ratio [OR], 0.17 [95% CI, 0.05-0.57]; P = .004) and a 10% povidone-iodine solution (OR, 0.04 [95% CI, 0.01-0.20]; P < .0001). Further, the antibiotic solution was superior to the 10% povidone-iodine solution (OR, 0.20 [95% CI, 0.07-0.55]; P = .002). Conclusion: The results of our meta-analysis demonstrated that staphylococci and bacilli were the most common contaminants on dropped ACL grafts and that decontamination using a 4% chlorhexidine solution more reliably disinfected ACL grafts. This information can help to guide surgeons as regards appropriate remedial measures.
A Blinded Randomized Trial Comparing 2 Needle Gauges for Fine‐Needle Biopsy of Thyroid Nodules
Authors: Shumrick Christopher M. , Simmonds Jonathan C. , Ogden Lorna L. , Snowden Cindi A. , Dhingra Jagdish K. 
Published: May 2021

ObjectiveTo compare diagnostic capability and patient pain between 25‐gauge (25G) and 27G needles for ultrasound‐guided fine‐needle biopsy of thyroid nodules.Study DesignProspective blinded randomized trial.SettingThyroid clinic in otolaryngology practice in a community.MethodsA prospective randomized blinded trial was conducted on 148 thyroid nodules in 107 patients undergoing ultrasound‐guided fine‐needle biopsy. Needle gauge was randomized to individual nodule. Patients were blinded to the needle size used. All specimens were assessed via the Bethesda System for Reporting Thyroid Cytopathology and assigned a morphologic quantitative score based on number of thyroid cells and lymphocytes, amount of colloid, and degree of blood/fibrin artifact in each sample. Patient pain experience was scored. A chi‐square test was used to compare nondiagnostic rates, and differences in cytologic morphology and pain scores were compared with 2‐sample Student t tests.ResultsOf the 148 nodules, 77 were biopsied with 25G needles and 71 with 27G needles. Twenty‐five percent (19/77) of the samples obtained with 25G needles yielded a nondiagnostic cytology result (Bethesda category 1) as compared with 11% (8/70) in the 27G group (P =. 0282; 95% CI, 1.47%‐25.97%). On average, samples from 25G needles had a higher blood/fibrin quantitative score (P =. 043; 95% CI, −0.64 to −0.010). There were no differences in pain between groups.ConclusionUse of a 27G needle for fine‐needle biopsies is not only safe and feasible but desirable and highly recommended, as it yields better diagnostic information.
Overexpression of wild-type IL-7Rα promotes T-cell acute lymphoblastic leukemia/lymphoma
Authors: Silva Ana , Almeida Afonso R. M. , Cachucho Ana , Neto João L. , Demeyer Sofie , de Matos Mafalda , Hogan Thea , Li Yunlei , Meijerink Jules , Cools Jan , Grosso Ana Rita , Seddon Benedict , Barata João T. 
Published: May 2021

Abstract
Tight regulation of IL-7Rα expression is essential for normal T-cell development. IL-7Rα gain-of-function mutations are known drivers of T-cell acute lymphoblastic leukemia (T-ALL). Although a subset of patients with T-ALL display high IL7R messenger RNA levels and cases with IL7R gains have been reported, the impact of IL-7Rα overexpression, rather than mutational activation, during leukemogenesis remains unclear. In this study, overexpressed IL-7Rα in tetracycline-inducible Il7r transgenic and Rosa26 IL7R knockin mice drove potential thymocyte self-renewal, and thymus hyperplasia related to increased proliferation of T-cell precursors, which subsequently infiltrated lymph nodes, spleen, and bone marrow, ultimately leading to fatal leukemia. The tumors mimicked key features of human T-ALL, including heterogeneity in immunophenotype and genetic subtype between cases, frequent hyperactivation of the PI3K/Akt pathway paralleled by downregulation of p27Kip1 and upregulation of Bcl-2, and gene expression signatures evidencing activation of JAK/STAT, PI3K/Akt/mTOR and Notch signaling. Notably, we also found that established tumors may no longer require high levels of IL-7R expression upon secondary transplantation and progressed in the absence of IL-7, but remain sensitive to inhibitors of IL-7R–mediated signaling ruxolitinib (Jak1), AZD1208 (Pim), dactolisib (PI3K/mTOR), palbociclib (Cdk4/6), and venetoclax (Bcl-2). The relevance of these findings for human disease are highlighted by the fact that samples from patients with T-ALL with high wild-type IL7R expression display a transcriptional signature resembling that of IL-7–stimulated pro-T cells and, critically, of IL7R-mutant cases of T-ALL. Overall, our study demonstrates that high expression of IL-7Rα can promote T-cell tumorigenesis, even in the absence of IL-7Rα mutational activation.
Natural attenuation along subsurface flow paths based on modeling and monitoring of a pesticide metabolite from three case studies
Authors: Herrmann Marco , Sur Robin 
Published: May 2021

Abstract
Background
Groundwater—especially for the use as drinking water—is a strictly protected resource in the existing guidelines for pesticide registration and drinking water protection in the EU. One aspect that has hardly played a role in this context so far is the attenuation of pesticide concentrations along the flow path from the regulatory leaching concentration at a depth of 1 m below the applied field to raw water abstraction systems. The soil metabolite N,N-dimethylsulfamide (DMS) is formed from two fungicidal substances: tolylfluanid and dichlofluanid. According to the EU guidance document on relevant metabolites in groundwater, DMS is a “non-relevant” metabolite. However, long-term application of the two active substances on permanent crops has resulted in elevated and quantifiable amounts of DMS in groundwater catchment areas of water supplying plants. Therefore, in the case of DMS, substantial monitoring data is available. This enables in combination with groundwater modeling, a quantitative analysis of the natural attenuation of DMS concentrations over time and distance. To this end, extensive real-world data from three case studies of drinking water catchment areas in Germany were analyzed.

Results
The environmental fate of DMS in soil and groundwater was evaluated according to the respective data determined at the study sites. Analyses using monitoring data and combined modeling approaches as well, were performed to obtain comparable results. These merged outcomes from monitoring and modeling show total attenuation factors of 12–93 from leachate at 1 m depth down to monitoring wells—close to raw water collection. If concentration attenuation further downwards to collected raw water is considered, the overall attenuation factor is even higher (40–246).

Conclusions
The conditions at the catchment areas of the three case studies are very diverse, thus providing a wide range of attenuating conditions. When following the path of DMS from its formation in soil below a treated field, to its leaching into the aquifer, and within the aquifer down to the raw water collection site, its concentration in water is continuously and consistently decreasing. The results from DMS represent conservative estimations due to non-sorptive, quick transport processes. Extended to other sorptive solutes, it represents the lower end of expected attenuation. Therefore, natural pesticide concentration attenuation processes are suggested for the consideration in regulatory pesticide risk assessments for a more realistic yet still protective evaluation of expected concentrations in raw water.
Structural variations in papaya genomes
Authors: Liao Zhenyang , Zhang Xunxiao , Zhang Shengcheng , Lin Zhicong , Zhang Xingtan , Ming Ray 
Published: May 2021

Abstract
Background
Structural variations (SVs) are a type of mutations that have not been widely detected in plant genomes and studies in animals have shown their role in the process of domestication. An in-depth study of SVs will help us to further understand the impact of SVs on the phenotype and environmental adaptability during papaya domestication and provide genomic resources for the development of molecular markers.

Results
We detected a total of 8083 SVs, including 5260 deletions, 552 tandem duplications and 2271 insertions with deletion being the predominant, indicating the universality of deletion in the evolution of papaya genome. The distribution of these SVs is non-random in each chromosome. A total of 1794 genes overlaps with SV, of which 1350 genes are expressed in at least one tissue. The weighted correlation network analysis (WGCNA) of these expressed genes reveals co-expression relationship between SVs-genes and different tissues, and functional enrichment analysis shows their role in biological growth and environmental responses. We also identified some domesticated SVs genes related to environmental adaptability, sexual reproduction, and important agronomic traits during the domestication of papaya. Analysis of artificially selected copy number variant genes (CNV-genes) also revealed genes associated with plant growth and environmental stress.

Conclusions
SVs played an indispensable role in the process of papaya domestication, especially in the reproduction traits of hermaphrodite plants. The detection of genome-wide SVs and CNV-genes between cultivated gynodioecious populations and wild dioecious populations provides a reference for further understanding of the evolution process from male to hermaphrodite in papaya.
Spanish-dementia knowledge assessment scale (DKAS-S): psychometric properties and validation
Authors: Carnes A. , Barallat-Gimeno E. , Galvan A. , Lara B. , Lladó A. , Contador-Muñana J. , Vega-Rodriguez A. , Escobar M. A. , Piñol-Ripoll G. 
Published: May 2021

Abstract
Background
Alzheimer’s disease (AD) is the most frequent cause of cognitive impairment. Community knowledge of the disease has proven to be a very important aspect of the development of interventions and the evaluation of their effectiveness. However, it is necessary to have standardized and recognized tools in different languages. The aim of the current study was to develop a cross-cultural adaptation of the Spanish Dementia Knowledge Assessment Scale (DKAS-S) and to assess their psychometric properties with cohorts of health students and professional and non-professional caregivers of AD patients from several regions of Spain.

Methods
We developed and translated the DKAS into Spanish following the forward-back-forward translation procedure. Then, we performed a cross-sectional study to assess the validity, reliability and feasibility of the DKAS-S. We also performed an analysis to obtain test-retest reliability measures. The study was performed in four medical centres across three regions in Spain. From May to September 2019, we administered the scale to students, professional and non-professional caregivers; including a subgroup of non-professional caregivers of patients with early-onset AD (< 65 years).

Results
Eight hundred forty-six volunteer participants completed the DKAS-S: 233 students (mean age 26.3 ± 9.2 years), 270 professional caregivers (mean age 42.5 ± 11.7 years) and 343 non-professional caregivers of AD patients. (mean age was 56.4 ± 13.16). The DKAS-S showed good internal consistency (Cronbach’s α = 0.819) and good test-retest reliability (time 1: 28.1 ± 8.09 vs time 2: 28.8 ± 7.96; t = − 1.379; p = 0.173). Sensitivity to change was also significant in a subgroup of 31 students who received education related to AD and dementias between each administration (time 1: 25.6 ± 6.03) to (time 2: 32.5 ± 7.12; t = − 5.252, p = 0.000). The validity of the construct was verified by confirmatory factor analysis, although there were challenges in the inclusion of some items in the original 4 factors.

Conclusions
The 25-item DKAS-S showed good psychometric properties for validity and reliability and the factorial analysis when it was administered to a population of students and professional and non-professional caregivers. It was a useful instrument for measuring levels of knowledge about dementia in Spanish population.
Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia
Authors: Rahman Rahana Abd , Atan Ixora Kamisan , Ali Anizah , Kalok Aida Mohd , Ismail Nor Azlin Mohamed , Mahdy Zaleha Abdullah , Ahmad Shuhaila 
Published: May 2021

AbstractBackgroundSpontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary.MethodsThis is a retrospective observational study involving 58 pregnancies from 1st January 2013 to 31st December 2019. Inclusion criteria were previous mid-trimester miscarriage and/or preterm birth, previous cervical surgery or short cervical length on routine sonogram. The demographic data, characteristics of each pregnancy and details of outcomes and management were described.ResultsThe majority of women were Malay with mean age and body mass index of 32.9 ± 4.2 years and 27.1 ± 6.3 kg/m2respectively. The most frequent indications for Arabin pessary insertion were previous mid-trimester miscarriage (46.4%) and early preterm birth (17.2%). A total of 73.4% of these women had the pessary inserted electively at a mean cervical length of 31.6 ± 9.1 mm at median gestation of 15.0 weeks. They were managed as outpatient (56.9%), inpatient (24.1%) or mixed (19.0%) with combination of progestogen (81.0%) and 53.4% received antenatal corticosteroids. Spontaneous preterm birth at or more than 34 weeks gestation occurred in 74.1% with birthweight at or more than 2000 g (82.4%). Despite cervical funneling in 12 women (20.7%), 66.7% delivered at or later than 34 weeks gestation and 2 (16.7%) resulted in miscarriage.ConclusionsInsertion of the Arabin pessary is beneficial to prevent spontaneous preterm birth in pregnant women who are at high risk. In particular, early insertion and close monitoring allows the best possible outcomes.Trial registrationThis study was retrospectively registered with ClinicalTrials.gov (NCT04638023) on 20/11/2020.
Orthotopic model of lung cancer: isolation of bone micro-metastases after tumor escape from Osimertinib treatment
Authors: Jarry Ulrich , Bostoën Mégane , Pineau Raphaël , Chaillot Laura , Mennessier Valentine , Montagne Pierre , Motte Emilie , Gournay Marjorie , Le Goff Arnaud , Guillaudeux Thierry , Pedeux Rémy 
Published: May 2021

Abstract
Background
Osimertinib is a third generation tyrosine kinase inhibitor (TKI) that targets the epidermal growth factor receptor (EGFR) in lung cancer. However, although this molecule is not subject to some of the resistance mechanisms observed in response to first generation TKIs, ultimately, patients relapse because of unknown resistance mechanisms. New relevant non-small cell lung cancer (NSCLC) mice models are therefore required to allow the analysis of these resistance mechanisms and to evaluate the efficacy of new therapeutic strategies.

Methods
Briefly, PC-9 cells, previously modified for luciferase expression, were injected into the tail vein of mice. Tumor implantation and longitudinal growth, almost exclusively localized in the lung, were evaluated by bioluminescence. Once established, the tumor was treated with osimertinib until tumor escape and development of bone metastases.

Results
Micro-metastases were detected by bioluminescence and collected for further analysis.

Conclusion
We describe an orthotopic model of NSCLC protocol that led to lung primary tumor nesting and, after osimertinib treatment, by metastases dissemination, and that allow the isolation of these small osimertinib-resistant micro-metastases. This model provides new biological tools to study tumor progression from the establishment of a lung tumor to the generation of drug-resistant micro-metastases, mimicking the natural course of the disease in human NSCLC patients.
Invasive breast Cancer treatment in Tanzania: landscape assessment to prepare for implementation of standardized treatment guidelines
Authors: Sood Rupali , Masalu Nestory , Connolly Roisin M. , Chao Christina A. , Faustine Lucas , Mbulwa Cosmas , Anderson Benjamin O. , Rositch Anne F. 
Published: May 2021

AbstractBackgroundIncidence of breast cancer continues to rise in low- and middle-income countries, with data from the East African country of Tanzania predicting an 82% increase in breast cancer from 2017 to 2030. We aimed to characterize treatment pathways, receipt of therapies, and identify high-value interventions to increase concordance with international guidelines and avert unnecessary breast cancer deaths.MethodsPrimary data were extracted from medical charts of patients presenting to Bugando Medical Center, Tanzania, with breast concerns and suspected to have breast cancer. Clinicopathologic features were summarized with descriptive statistics. A Poisson model was utilized to estimate prevalence ratios for variables predicted to affect receipt of life-saving adjuvant therapies and completion of therapies. International and Tanzanian guidelines were compared to current care patterns in the domains of lymph node evaluation, metastases evaluation, histopathological diagnosis, and receptor testing to yield concordance scores and suggest future areas of focus.ResultsWe identified 164 patients treated for suspected breast cancer from April 2015–January 2019. Women were predominantly post-menopausal (43%) and without documented insurance (70%). Those with a confirmed histopathology diagnosis (69%) were 3 times more likely to receive adjuvant therapy (PrR [95% CI]: 3.0 [1.7–5.4]) and those documented to have insurance were 1.8 times more likely to complete adjuvant therapy (1.8 [1.0–3.2]). Out of 164 patients, 4% (n = 7) received concordant care based on the four evaluated management domains. The first most common reason for non-concordance was lack of hormone receptor testing as 91% (n = 144) of cases did not undergo this testing. The next reason was lack of lymph node evaluation (44% without axillary staging) followed by absence of abdominopelvic imaging in those with symptoms (35%) and lack of histopathological confirmation (31%).ConclusionsPatient-specific clinical data from Tanzania show limitations of current breast cancer management including axillary staging, receipt of formal diagnosis, lack of predictive biomarker testing, and low rates of adjuvant therapy completion. These findings highlight the need to adapt and adopt interventions to increase concordance with guidelines including improving capacity for pathology, developing complete staging pathways, and ensuring completion of prescribed adjuvant therapies.