bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive dissonance in tuberculosis stigma: A mixed methods analysis of tuberculosis stigma measurement in South Africa
Authors: Bergman Alanna J. , Budhathoki Chakra , Relf Michael V. , Ndlouvu Nkateko , Mthimkhulu Nomusa , Lerefolo Sibongile , Lowensen Kelly , Farley Jason E. 
Published: November 2024

Background
The Patient and Community Perspectives Towards Tuberculosis are the most common measure of tuberculosis (TB) stigma in sub-Saharan Africa. The instrument and its sub-scales (patient and community) have been quantitatively validated but have not undergone qualitative exploration in South Africa.

Methods
We explored whether the Patient Perspectives Towards Tuberculosis adequately represents stigma as experienced by people with TB in South Africa. We used mixed methods to explore differences between the lived experience of TB and the quantitative stigma score. Participants with rifampicin-resistant TB and HIV co-infection completed the quantitative scale. Among those, 30 also completed qualitative interviews about their experiences and perceptions of TB stigma. We used cognitive interviewing techniques to interrogate congruence between the two data sources.

Results
The scale demonstrated adequate factor structure with approximately normal distribution. Participants qualitatively described experiences and perceptions of stigma that contradicted their quantitative responses. The scale could not discriminate between participants who reported distressing experiences of TB stigma, and those who did not. Item wording caused confusion, and many elements of TB stigma most discussed by participants are not reflected in the scale.

Conclusions
The Patient Perspectives Towards Tuberculosis lacks theoretical and experiential domains that are central to TB stigma in South Africa. Studies validating stigma scales in new populations should integrate a mixed-methods approach to ensure content validity.
Association between admission baseline blood potassium levels and all-cause mortality in patients with acute kidney injury combined with sepsis: A retrospective cohort study
Authors: Guo Yifan , Qiu Yue , Xue Taiqi , Yan Pu , Zhao Wenjing , Wang Mengdi , Liu Cheng , Zhang Ning 
Published: November 2024

Introduction
Imbalances in blood potassium (K) homeostasis is a significant contributor to the emergence of severe complications, especially among critically ill patients. Hypokalemia and hyperkalemia are both associated with an increased risk of adverse events. However, it is not known about the impact of blood K levels on risk of intensive care units (ICU) mortality for Acute kidney injury (AKI) combined with sepsis patients. This study aimed to explore the relationship between admission blood K levels and ICU 30-day mortality in patients with AKI combined with sepsis.

Methods
We selected patients diagnosed with AKI and sepsis on their first ICU admission from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The first blood K levels within 24 hours of admission were categorized into three groups according to tertiles (T1 < 3.9 mmol/L, 3.9 ≤ T2 < 4.5 mmol/L, and T3 ≥ 4.5 mmol/L), with T2 serving as the reference. We examined the association between blood K levels and ICU 30-day mortality using accelerated failure time (AFT) models and survival analysis.

Results
A total of 8,242 ICU patients with AKI combined with sepsis were included. In multivariate AFT models, each 1 mmol/L increase in blood K levels was associated with a 13% increase in the risk of ICU 30-day mortality (p < 0.001, 95% confidence interval (CI): 1.06–1.20). Extended multivariable AFT models showed that, compared to the middle category, patients with high blood K levels (≥ 4.5 mmol/L) were associated with all-cause mortality (p = 0.002, adjusted hazard ratio (HR) = 1.22, 95% CI: 1.08–1.38), whereas those with low blood K levels (< 3.9 mmol/L) showed no significant difference (p = 0.385, adjusted HR = 1.06, 95% CI: 0.93–1.21). Kaplan-Meier curves indicated that patients with high blood K levels had higher mortality, and those with middle blood potassium levels (3.9 ≤ K < 4.5 mmol/L) had the lowest mortality.

Conclusion
The admission baseline blood K levels were significantly associated with ICU 30-day mortality in intensive care patients suffering from AKI in conjunction with sepsis. Therefore, immediate and careful correction of blood potassium imbalances may prove to be a crucial approach in improving outcomes for these patients.
Investigation of differences between chronological and vascular age in persons with multiple sclerosis
Authors: Maric Gorica D. , Pekmezovic Tatjana D. , Tamas Olivera S. , Veselinovic Nikola D. , Budimkic Maja S. , Jovanovic Aleksa L. , Mesaros Sarlota K. , Drulovic Jelena S. 
Published: November 2024

Objective
To determine vascular age (VA) in a cohort of persons with multiple sclerosis (PwMS) in Belgrade, Serbia, and to assess the difference between chronological age (CA) and VA, in this population.

Material and methods
A case-control study was conducted at the Clinic of Neurology, University Clinical Center of Serbia in Belgrade. Study participants (n = 274) were recruited during regular outpatient visits. Demographic and clinical characteristics including the presence of CVD comorbidities of PwMS were collected. Data were obtained using a questionnaire, designed and adapted for the study purposes. Additionally, fasting blood samples were collected from all participants, in order to determine their lipid profile. VA was calculated based on the patient’s sex, age, smoking status, total serum cholesterol level and systolic blood pressure (SBP) value. Afterwards, the study sample was divided into five groups with the different levels of the atherosclerotic burden, as follows: 1) PwMS without any CVD comorbidity; 2) PwMS with hyperlipidemia (HLP); 3) PwMS with HLP and hypertension (HTA); 4) PwMS with HLP, HTA and type 2 diabetes, and 5) PwMS with coronary artery disease (CAD). In the statistical analysis, for the determination of factors that are independently associated with the discrepancy between CA and VA in persons with MS, hierarchical regression analysis was performed.

Results
The mean values of CA and VA were statistically significantly different among the groups(p<0.001). Additionally, a significant difference was also detected between CA and VA (p<0.001). The highest VA (66.4±15.8 years) and the difference between CA and VA (6.5±7.3 years) were registered only in the group comprising PwMS, HPL, HTA and type 2 diabetes. Results of the hierarchical linear regression analysis showed that the Expanded Disability Status Scale (EDSS) score, Body mass index (BMI), physical activity and the presence of type 2 diabetes, explained a total of 24% of the variations in the difference between CA and VA, in our cohort of MS patients.

Conclusion
Our study showed significant difference between CA and VA in PwMS and additionally, increasing VA with atherosclerotic burden. Additionally, it has been demonstrated that crucial factors which led to the occurrence of these differences were BMI, physical activity, EDSS and the presence of type 2 diabetes.
Assessing the accuracy and consistency of answers by ChatGPT to questions regarding carbon monoxide poisoning
Authors: Qiu Jun , Zhou Youlian 
Published: November 2024

Background
ChatGPT, developed by OpenAI, is an artificial intelligence software designed to generate text-based responses. The objective of this study is to evaluate the accuracy and consistency of ChatGPT’s responses to single-choice questions pertaining to carbon monoxide poisoning. This evaluation will contribute to our understanding of the reliability of ChatGPT-generated information in the medical field.

Methods
The questions utilized in this study were selected from the "Medical Exam Assistant (Yi Kao Bang)" application and encompassed a range of topics related to carbon monoxide poisoning. A total of 44 single-choice questions were included in the study following a screening process. Each question was entered into ChatGPT ten times in Chinese, followed by a translation into English, where it was also entered ten times. The responses generated by ChatGPT were subjected to statistical analysis with the objective of assessing their accuracy and consistency in both languages. In this assessment process, the "Medical Exam Assistant (Yi Kao Bang)" reference responses were employed as benchmarks. The data analysis was conducted using the Python.

Results
In approximately 50% of the cases, the responses generated by ChatGPT exhibited a high degree of consistency, whereas in approximately one-third of the cases, the responses exhibited unacceptable blurring of the answers. Meanwhile, the accuracy of these responses was less favorable, with an accuracy rate of 61.1% in Chinese and 57% in English. This indicates that ChatGPT could be enhanced with respect to both consistency and accuracy in responding to queries pertaining to carbon monoxide poisoning.

Conclusions
It is currently evident that the consistency and accuracy of responses generated by ChatGPT regarding carbon monoxide poisoning is inadequate. Although it offers significant insights, it should not supersede the role of healthcare professionals in making clinical decisions.
Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study
Authors: Gomez Diego E. , Kopper Jamie J. , Byrne David P. , Renaud David L. , Schoster Angelika , Dunkel Bettina , Arroyo Luis G. , Mykkanen Anna , Gilsenan William F. , Pihl Tina H. , Lopez-Navarro Gabriela , Tennent-Brown Brett S. , Hostnik Laura D. , Mora-Pereira Mariano , Marques Fernando , Gold Jenifer R. , DeNotta Sally L. , Desjardins Isabelle , Stewart Allison J. , Kuroda Taisuke , Schaefer Emily , Oliver-Espinosa Olimpo J. , Agne Gustavo Ferlini , Uberti Benjamin , Veiras Pablo , Delph Miller Katie M. , Gialleti Rodolfo , John Emily , Toribio Ramiro E. 
Published: November 2024

Background
This study aimed to describe and compare therapeutic approaches for horses with acute diarrhea in different geographic regions worldwide.

Methods
Clinical information was retrospectively collected from diarrheic horses presented to participating institutions between 2016 and 2020, including fluid therapy on admission, antimicrobial drugs, probiotics, anti-endotoxic medications, anti-inflammatory drugs, gastroprotectants, digital cryotherapy, and toxin-binding agents. Seasonal and geographic differences were investigated.

Results
1438 horses from 26 participating hospitals from 5 continents were included. On admission, 65% (926/1419) of horses were administered a fluid bolus. Antimicrobial drugs were administered to 55% (792/1419) within the first 24 hours of admission, with penicillin and gentamicin being the most used combination (25%, 198/792). Horses with leukopenia (OR: 2.264, 95%CI: 1.754 to 2.921; P<0.001) or meeting systemic inflammatory response syndrome criteria (OR: 2.542, 95%CI: 1.919 to 3.368; P<0.001) had higher odds of being administered antimicrobial drugs. Other treatments administered included probiotics (15%, 215/1438), polymyxin B (13%; 187/1438), pentoxifylline (8%; 118/1438), gastroprotectants (44%; 626/1419), digital cryotherapy (34%; 489/1435), plasma transfusion (13%; 182/1410) and toxin-binding agents (36%; 515/1438).

Limitations
Due to the retrospective nature of the study, the rationale for treatment decisions was unavailable, and associations with survival could not be evaluated.

Conclusions
Treatments varied between hospitals from different geographic regions. Prospective clinical trials are required to evaluate the effects of various treatments on survival.
Biomechanical conditions of subtalar joint arthrodesis with calcaneal locking nail: A probabilistic numerical study
Authors: Pahl Timon , Radtke Albrecht , Büttner Joana F. , Mittlmeier Thomas , Weißgraeber Philipp 
Published: November 2024

Introduction
Subtalar joint arthrodesis is primarily indicated for advanced osteoarthritis, hindfoot deformity, and/or instability. During the first 6-10 weeks after surgery, there is an intermediary structurally weaker state before complete bony fusion of the calcaneus and talus occurs. Loading of the foot can lead to mechanical stresses and relative movements in the former joint gap, which can impede the fusion process. The objective of this study was to examine the mechanical healing conditions for a subtalar arthrodesis with a calcaneal locking nail.

Methods
A probabilistic finite element model of the subtalar joint with a calcaneal locking nail was created to represent the foot post-surgery that accounts for the uncertainty of the material properties. The model differentiates between cortical and cancellous bone and includes non-linear contact definitions in the subtalar joint. Multiple loading scenarios, including hindfoot inversion/eversion, were simulated to determine bone and implant stresses. Utilizing local articular coordinate systems, a displacement analysis was established to separate normal and tangential components and account for their separate effects. The loading of the locking nail was assessed through section moments.

Results
Under inversion/eversion loading, the area near the locking screws and upper end of the nail experienced the highest stresses. The maximum stresses in cortical and cancellous bone were 112±8.3 MPa and 2.1±0.2 MPa, respectively. The comparison of the von Mises and maximum principal stresses for the bones showed a load case dependency with strong effect on tensile loading states. The proposed method for the analysis of relative displacement in the local articular coordinate systems showed joint regions exhibiting normal and tangential movements that changed with the considered loading states. It was found that tangential displacements of up to 0.19 mm are related to the torsional loading of the calcaneal locking nail, which is connected to the corresponding torsional stiffness of the implant and its fixation in the calcaneus and talus. Normal displacements in the joint gap of up to -0.18 mm can be shown to be governed by the bending moments acting on the calcaneal locking nail, which are linked to the nail’s bending stiffness. The ratio of tangential and normal displacement in the critical inversion configuration was determined to be -1.1.

Conclusions
Inversion and eversion loads can lead to significant mechanical loading of the bones and to bending and torsional loading of the locking nail. The bending leads to normal displacements in the articular gap. Torsions can lead to significant tangential displacements that have been shown to promote non-union instead of bony fusion.
A 31-Year-Old Female with Inferior Paraparesis Upper Motor Neuron Type due to Destruction of Thoracic 6-7 Vertebrae due to Tuberculous Spondylitis : A Case Report
Authors: Faatih Muhammad Al , Widiastuti Widiastuti 
Published: November 2024

Background: Tuberculous (TB) Spondylitis results from the hematogenous spread of Mycobacterium Tuberculosis bacteria to the spinal blood vessels. The incidence of extrapulmonary tuberculosis in the world is 3%, of which 10% of cases are bone. This paper will describe the case of a patient with Inferior Paraparesis Upper Motor Neuron Type due to Destruction of Thoracic 6-7 Vertebrae due to Tuberculous Spondylitis at Dr. Moewardi General Hospital, Surakarta, Indonesia. In addition, this case can provide information to health services and be a step forward in discussing tuberculous spondylitis further. Purpose: This study aims to report the diagnosis and management of tuberculous spondylitis. Case Presentation: A Female, 31 years old, presented with complaints of lower limb weakness felt four months before admission and associated with back pain. The patient’s consciousness was compos mentis. There were tenderness in the back midline and neurological deficits. There was a decrease in muscle strength in the lower extremities, both left and right and also a decrease in physiological reflexes in all four extremities. There was positive Babinski on the right side and positive clonus on both sides. Thoracolumbar MRI results showed destruction of the corpus of Thoracic 6&7 Vertebrae with gibbus deformity and kyphosis with a picture of soft tissue abscess. Conclusion: The patient was diagnosed with paraparesis inferior upper motor neuron type due to destruction of thoracic 6-7 vertebrae due to tuberculous spondylitis. Then she was treated and planned for laminectomy, PSF, debridement, and corpectomy.
T cell‐expressed Ift88 is required for proper thymocyte differentiation in mice
Authors: Miller Sarah J. , Gonzalez Nancy M. , Smith Morgan E. , Croyle Mandy J. , Yoder Bradley K. , Zimmerman Kurt A. 
Published: November 2024

AbstractIntraflagellar transport protein 88 (Ift88) is required for the formation of cilia in the thymus and non‐ciliary dependent functions including T cell immune synapse formation. To test the role of Ift88 in T cell development, we performed flow cytometry analysis on thymus and spleen tissue isolated from mice lacking Ift88 in thymic epithelial cells (TECs) or T cells. Analyses indicated that TEC Ift88 deletion had no impact on thymic T cell development and minimal impact on splenic T cells. Analysis of T cells in CaggCreERT2+Ift88 tm1BkymTmG mice indicate that approximately half of DN1 thymocytes are Ift88 deficient 3 weeks post‐tamoxifen induction; Ift88 loss did not impact T cell development at the DN2‐DN4 stage or the CD4+/CD8+ double‐positive (DP) thymocyte stage. However, survival of Ift88 deficient T cells was significantly reduced at the single‐positive (SP) thymocyte stage, as was the number of CD4+ and CD8+ T cells in spleen and kidney. Despite preferential survival of Ift88‐proficient cells, the total number of T cells the in spleen and kidney was minimally impacted by Ift88 loss. These data suggest Ift88 is required for differentiation of DP thymocytes into SP thymocytes and that Ift88 proficient T cells can compensate for deficient cells to fill the open niche.
Evaluation of an alternative centrifugation protocol for reducing total turnaround time
Authors: Nicolás de Blas Reyes , Menacho Román Miriam , Olivares Romero Sara , Mesas Mariñán Claudia , Arroyo Vega Alba , Martín Gómez Graciela , Álvarez Pastor María , Castillo Menéndez Lucía , Azofra Villa María José , Pérez Sobrino María del Pilar , Arribas Gómez Ignacio 
Published: November 2024

Abstract

Objectives
Centrifugation is a key process that should be controlled to ensure an adequate sample quality. To achieve rapid, standardized, and consistent sample centrifugation, we aimed to evaluate an alternative centrifugation protocol and its impact on the results of 20 biochemical determinations in serum.

Methods
The study included 45 ambulatory patients. Two serum-separating tubes were collected from each patient (Becton Dickinson (BD) Vacutainer® SST™ II Advance, 8.5 mL Ref. 366468). One of the tubes was centrifuged at 2530 ×  g for 10 min (control method), while the other tube was centrifuged under alternative centrifugation conditions, namely 2530 ×  g for 7 min.

Results
The analysis of results revealed that calcium, total bilirubin, and magnesium exhibited a constant and proportional systematic bias. However, considering the proportional mean difference, all analytes met the desirable bias performance established by our laboratory, except for magnesium, which met the minimum bias criteria.

Conclusions
Our study demonstrates that both centrifugation protocols are interchangeable for measuring the studied analytes, thereby ensuring adequate sample quality.
Toward a Context and Feasibility Driven Entrepreneurial Education: Evidence from Entrepreneurial Intention Determinants of Malaysian Students
Authors: Stouraitis Vasilios , Kyritsis Markos , Mior Harris Mior Harun , Roberts Julie , Garwe Wadzanai , Tsanis Konstantinos 
Published: November 2024

Abstract
Irrespective of support or opportunities, evidence suggests that most higher education business students in emerging markets are still primarily guided reactively (out of personal need or temporarily) into for-profit entrepreneurship rather than through personal incentive raising doubts on the impact of University entrepreneurial push strategies and programmes. We address the lack of meso level quantitative studies and propose a new student-related context sensitive conceptual model for student entrepreneurial intention in emerging markets exploring the extent to which a context-based and feasibility-oriented conceptual model is required. We propose the components Risk and Innovation, Autonomy, National norms and number of languages spoken all affect entrepreneurial intention. Furthermore, we suggest that education has a moderating effect overall and more so on the risk and innovation component. Our theoretical framework was partially supported as we show compelling evidence that risk and innovation, autonomy, and languages spoken have a significant effect on student entrepreneurial intention. The results indicate that conceptual frameworks differ by context and entrepreneurship education in emerging markets is contingent on specific human capital of students but can be stimulated through improving cognitive institutional structures and curricula focusing on context and attitudes towards risk taking.
A comparative study of Fagonia arabica fabricated silver sulfide nanoparticles (Ag2S) and silver nanoparticles (AgNPs) with distinct antimicrobial, anticancer, and antioxidant properties
Authors: Jatoi Nouman Rasheed , Khan Muhammad Aslam , Fida Hussain Muhammad , Alarjani Khaloud Mohammed , Elshikh Mohamed S. , Al Farraj Dunia , Mansoor Hafiz Muhammad , Ihsan Junaid , Bokhari Syed Ali Imran 
Published: November 2024

Abstract
Silver sulfide (Ag2S) nanomaterials are important chalcogenides and have potential applications in photovoltaic cells, thermoelectric sensors, solar cell batteries, and infrared detectors. However, the biological properties of green synthesized silver sulfide nanoparticles (Ag2S-NPs) have been rarely explored as compared to the extensively studied silver nanoparticles (AgNPs). The current study thus investigates and compares Fagonia arabica synthesized Ag2S-NPs and AgNPs for multiple biological properties. Biosynthesis of the NPs is achieved using an aqueous extract of F. arabica, whereas physicochemical, structural, morphological, and optical characterization of the materials was undertaken using UV–Vis spectroscopy, Fourier transform infrared spectroscopy, X-ray diffractometer, scanning electron microscopy, energy dispersive spectroscopy, photoluminescence, and pH-responsive dispersion studies. Our result reveals that both the NPs exhibit excellent biological properties, yet Ag2S-NPs exhibit relatively enhanced antioxidant and in vitro anticancer potential against MCF-7 cells. However, AgNPs possess comparatively better antibacterial, antileishmanial, and antifungal properties. Most importantly, both the synthesized NPs are exceptionally well compatible with human blood cells, ensuring their safe and non-toxic properties. Being highly potent and compatible antimicrobial and anticancer materials, the F. arabica synthesized G-Ag2S-NPs and G-AgNPs can be further explored in in vivo studies.