bluuebunny/crossref_metadata_2025_split huggingface dataset:
Youth Unemployment  in Bhutan: A Meta- Analysis of the Lessons  and Perspectives
Authors: Waiba Phurba Sonam 
Published: November 2024

Unemployment is an economic issue worldwide. Bhutan is no exception; particularly during and after the Covid-19 pandemic the unemployment figures, particularly, youth unemployment rates in Bhutan were surprising. Despite efforts, the issue still looks elusive and wavering with no major reduction in national unemployment figures. To this end, a comprehension of the underlying issue, the nature of the Bhutanese labour market and an understanding contributing factors are essential. In addition, evaluating the government plans and policies is key. Thus, this study has attempted to analyse the data over the past 10 years, of relevant sources such as labour force surveys, policy documents of the Royal Government of Bhutan, and other related studies. The findings are presented as tables, graphs and descriptive statistics and discussed and concluded accordingly. The study identifies three critical elements referred to as the ‘employment triangle’ that significantly influence labour market dynamics in Bhutan. Moreover, they are demographic transformation, work attitudes and educational deficits. Precisely, youth unemployment in Bhutan is influenced by factors, such as demographic transformation (job security, employee protection, absence of employment-rich economy), work attitude (conventional job choice and preference patterns, negative role of society) and educational deficit (skills mismatch, inadequate national HRD planning and support, lack of skills development or school to work transition initiatives).
Risk of major vascular events in patients without traditional risk factors after transient ischemic attack or minor ischemic stroke: An international prospective cohort
Authors: Uchiyama Shinichiro , Hoshino Takao , Minematsu Kazuo , Meledje Marie-Laure , Charles Hugo , Albers Gregory W , Caplan Louis R , Donnan Geoffrey A , Ferro José M , Hennerici Michael G , Molina Carlos , Rothwell Peter M , Wong Lawrence KS , Amarenco Pierre 
Published: November 2024

Introduction: To investigate the clinical characteristics in patients without traditional risk factors (TRFs) after transient ischemic attack or minor ischemic stroke, who were recruited in the TIAregistry.org. Patients and methods: A total of 3847 patients were analyzed. TRFs included hypertension, diabetes, hypercholesterolemia, current smoking, and atrial fibrillation. Background characteristics and outcomes at 1 and 5 years in patients without TRFs were compared to those in patients with TRFs. The primary outcome was major cardiovascular event (MACE), which was non-fatal stroke, non-fatal acute coronary syndrome, or vascular death. To evaluate the causes, we applied the ASCOD (atherosclerosis, small vessel disease, cardiac pathology, other causes or dissection) grading system. Results: One-year risk of MACE (5.3% vs 6.3%, hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.53–1.31) was comparable between patients without TRFs ( n = 402) and those with TRFs ( n = 3445). Five-year risk of MACE was significantly lower in patients without TRFs than in those with TRFs (7.9% vs 13.9%, HR 0.57, 95% CI 0.39–0.82). In patients without TRFs, causal atherosclerosis was a potent risk factor (HR 5.67, 95% CI 2.68–12.02) and ipsilateral extra- or intra-cranial arterial stenosis was only significant predictor of MACE (interaction p = 0.0046) at 5 years. Conclusion and discussion: The 5-year risk of MACE was lower in patients without TRFs than those with TRFs, although a certain level of risk persisted in the absence of TRFs. The most significant predictor of MACE in patients without TRFs was arterial stenosis.
The FORWARD Psoriasis Registry: Patient-Reported Outcomes in a Novel Psoriasis Registry and Comparison of Traditional, Dermatologist-Led Enrollment With Web-Based Patient Enrollment
Authors: Song William B. , Michaud Kaleb , Lonowski Sarah L. , Kaufmann Mark , Pearson Ryan , Del Rosso James Q. , Schumacher Rebecca , Ogdie Alexis R. , Gelfand Joel M. 
Published: November 2024

Background Real-world evidence describing the natural history of all manifestations and severities of psoriasis is needed, as existing studies often recruit from a restricted patient population, and treatment failure and dissatisfaction is common. The FORWARD Psoriasis Registry collects patient-reported data directly online from participants independent of clinician involvement. Objective To test the feasibility of this new registry design and compare baseline characteristics, patient-reported disease outcomes, and treatment utilization between participants enrolling through their clinician (primary enrollment group) and participants self-enrolling online (secondary). Methods We summarized cross-sectional enrollment data from adults with clinician-diagnosed psoriasis who enrolled in the registry from September 2023 through June 2024 and compared baseline characteristics between enrollment groups. Results The registry enrolled 1560 adults with clinician-diagnosed psoriasis from 42 states and territories in the United States. In the primary enrollment group, 68% were female, mean age was 51 years, 34% of participants had moderate or severe psoriasis based on PREPI, and 27% reported clinician-diagnosed psoriatic arthritis. Forty six percent actively used systemic therapies while 65% used topical therapies for psoriasis, and 20% were dissatisfied or very dissatisfied with their treatment. Comparatively, the secondary enrollment group reported statistically significantly worse psoriasis burden for nearly all disease outcomes. Conclusion The FORWARD Psoriasis Registry rapidly enrolled a large, national cohort of participants with psoriasis, demonstrating feasibility of participant-driven data collection. We found important differences between participants enrolling through their clinician and self-enrolled participants, highlighting the need to collect real-world evidence to understand psoriasis regardless of access to clinical care.
Proximal Tibiofibular Joint Stabilization Using an Adjustable-Length Suspensory Fixation Device
Authors: Kanakamedala Ajay C. , Hinz Maximilian , Wang YuChia , Vidal Armando F. 
Published: November 2024

Background: Proximal tibiofibular joint (PTFJ) injuries are rare injuries, and the optimal treatment is poorly understood. Surgical treatment options for PTFJ instability include reconstruction with allograft, stabilization with an adjustable-ength suspensory fixation device, open reduction and internal fixation with a screw, arthrodesis, and proximal fibular resection. Indications: In acute first-time PTFJ dislocations, nonoperative treatment may be trialed after closed reduction. Operative treatment is indicated for first-time dislocation with concomitant operative injury, an irreducible dislocation, and chronic symptomatic PTFJ instability. Taping or PTFJ injections can be helpful for diagnostic and therapeutic purposes and should be trialed before moving forward with surgical treatment. Technique Description: Multiple PTFJ stabilization and reconstruction techniques have been described for PTFJ instability. This technique describes a stabilization technique utilizing an adjustable-ength suspensory fixation device that is placed through a posterolateral approach to the knee. Results: A prior systematic review of PTFJ injuries found that approximately 59% of patients with a PTFJ dislocation were successfully treated nonoperatively with no symptoms at a mean final follow-up of 15.9 months. While multiple case reports and techniques have been reported for PTFJ stabilization using an adjustable-ength suspensory fixation device, there are limited data on outcomes of this procedure. Discussion/Conclusions: PTFJ stabilization using an adjustable-ength suspensory fixation device is a safe and technically feasible option for the treatment of PTFJ instability. It is critical to confirm the diagnosis of symptomatic PTFJ instability with either a taping trial or a diagnostic injection before proceeding with surgical treatment. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
American Society of Hematology: building a comprehensive minority recruitment and retention professional program
Authors: Rollins Margo R. , Warsame Rahma M. , Smith Melody , Molina Arturo , Rouce Rayne H. , Avalos Belinda R. , Johnson Cage S. , Lopez Jose A. , Thompson Alexis A. , Fanning Lisa , Frustace Patricia , Roche Keelin , van Havre Nathalie , Mack Devon , Flowers Christopher R. , Terrell Deirdra R. 
Published: November 2024

Abstract
In 2003, the Institute of Medicine noted the need to improve workforce diversity. The American Society of Hematology (ASH) responded by developing the Minority Recruitment Initiative (MRI) to recruit diverse physicians/scientists into hematology. We evaluated the outcomes of the program. From 2004 to 2022, there were 405 awardees. Compared with national estimates, MRI awardees were less likely to discontinue their degree programs. MRI graduate student awardees had 0% attrition (97.5% confidence interval [CI], 10.6), whereas the national minority graduate student attrition was 36%. Medical student awardees had 2.2% (95% CI, 0.61-5.6) attrition, compared with the minority medical school attrition of 5.6%. Awardees were more likely than expected to pursue hematology-oncology (5.7% minority national estimate) because 14.4% (95% CI, 8.1-23.0) of medical student awardees and 88.5% (95% CI, 70.0-97.6) of early career awardees remain in the field. ASH has developed a successful program, but continued efforts are needed to advance equity in hematology.
Incidence and characterization of secondary CNS lymphoma in 1972 patients with DLBCL: a Danish nationwide cohort study
Authors: Tolley Elisabeth Reuben , Nielsen Torsten Holm , Hersby Ditte Stampe , Østergaard Simon , Rasmussen Malin , Clausen Michael Roost , Al-Mashhadi Ahmed Ludvigsen , Egeberg Karina Moeslund , Haunstrup Laura Mors , Brieghel Christian , Niemann Carsten Utoft , El-Galaly Tarec Christoffer , Pedersen Lars Møller 
Published: November 2024

Abstract
Secondary central nervous system lymphoma (SCNSL) is a rare manifestation of diffuse large B-cell lymphoma (DLBCL) with a poor prognosis. We present updated data from a nationwide study on the incidence and clinical characteristics of SCNSL. The incidence of SCNSL was calculated considering death or relapse without SCNSL as competing risks. Risk factors associated with SCNSL were identified using a cause-specific Cox proportional hazards model. A total of 1972 patients with DLBCL were included, of which 68 (3.4%) experienced SCNSL at the first relapse. The crude 1- and 2-year cumulative incidence of SCNSL was 2.0% (95% confidence interval [CI], 1.5-2.7) and 2.6% (95% CI, 2.0-3.4), respectively. For patients with a high-risk central nervous system international prognostic index (CNS-IPI) score, the 1- and 2-year cumulative incidence was 6.4% and 7.5%, respectively. The number and location of extranodal (EN) sites were the most significant predictors of SCNSL. Specific EN sites associated with an increased risk were the bone marrow, heart, kidneys/adrenal glands, ovaries, testes, and uterus. The median overall survival (OS) after SCNSL was 3.2 months. SCNSL within 6 months after the end of treatment (EOT) was associated with a higher baseline CNS-IPI score and worse OS than SCNSL &gt;6 months after EOT. Patients with a combination of low-risk CNS-IPI and late-onset SCNSL had the most favorable prognosis. In conclusion, updated real-world population-based data on SCNSL at first relapse, adjusted for competing risks, demonstrated a lower incidence of SCNSL than previously reported, with the number and location of EN sites being the most significant predictors of SCNSL.
The volume–outcome relationship for pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension
Authors: Heuts Samuel , Kawczynski Michal J. , Leus Arthur , Godinas Laurent , Belge Catharina , van Empel Vanessa , Meyns Bart , Maessen Jos G. , Delcroix Marion , Verbelen Tom 
Published: November 2024

BackgroundWe conducted a volume–outcome meta-analysis of pulmonary endarterectomy procedures for chronic thromboembolic pulmonary hypertension to objectively determine the minimum required annual case load that can define a high-volume centre.MethodsThree electronic databases were systematically queried up to 1 May 2024. Centres were divided in volume tertiles. The primary outcomes were early mortality and long-term survival. Restricted cubic splines were used to demonstrate the volume–outcome relationship and the elbow-method was applied to define high-volume centres. Long-term survival was assessed using Cox frailty models.ResultsWe included 51 centres (52 consecutive cohorts) and divided them into tertiles (T1: <6 cases per year; T2: 6–15 cases per year, T3: >15 cases per year), comprising a total 11 345 patients (mean age 52.3 years). Overall early mortality was 6.0% (T1: 11.6%; T2: 7.2%; T3: 5.2%; p<0.001), for which a significant nonlinear volume–outcome relationship was observed (p=0.0437) with a statistically determined minimal required volume of 33 cases per year (95% CI 29–35 cases), and a modelled volume of 40 cases per year corresponding to a 5.0% mortality rate. Nevertheless, early mortality still progressively declined in higher volume centres (from 6.7% to 5.4% to 2.9% in centres performing 16–50, 51–100 and >100 procedures annually). In addition, a significant volume effect was observed for long-term survival (adjusted hazard ratio per tertile 0.75, 95% CI 0.63–0.89; p=0.001).ConclusionThere is a significant association between procedural volume and early mortality in pulmonary endarterectomy. An annual procedural volume of >33–40 cases per year may be used to define a high‑volume centre, although higher volumes still lead to progressively lower mortality rates.
Alteration of ceruloplasmin in patients with malaria: a systematic review and meta-analysis of observational studies
Authors: Kotepui Kwuntida Uthaisar , Mahittikorn Aongart , Wilairatana Polrat , Masangkay Frederick Ramirez , Kotepui Manas 
Published: November 2024

Abstract
Background
The evidences of oxidative stress-related Plasmodium infection may alter the ceruloplasmin levels were inconsistent. This systematic review and meta-analysis aimed to collate and synthesize literatures on malaria and ceruloplasmin concentrations.

Methods
The systematic review has been registered with PROSPERO (CRD42023454859). Six electronic databases were systematically searched for investigated ceruloplasmin levels in malaria: ProQuest, EMBASE, MEDLINE, Ovid, PubMed, and Scopus, from their inception to August 2023. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for cross-sectional, cohort, and case–control studies. Qualitative synthesis was undertaken to summarize findings from the included studies. For quantitative synthesis, a meta-analysis was performed using random-effects models.

Results
A total of 411 articles were retrieved, and nine studies were included in the review. The majority of included studies found significantly increased ceruloplasmin levels in malaria patients compared to uninfected controls. The meta-analysis showed a significant increase of ceruloplasmin in patients with malaria as compared to uninfected controls (P < 0.01, Hedge’s g 1.18, 95% CI 0.90–1.47, I2 59.19%, eight studies).

Conclusion
The systematic review and meta-analysis consistently revealed a significant rise in ceruloplasmin levels among malaria patients. Further research is essential to understand the variations in ceruloplasmin levels between different Plasmodium species and the severity of malaria in patients.
Effect of cerebral sinus venous thrombosis and its location on cerebral blood flow: a [15O]water PET study in acute stroke patients compared to healthy volunteers
Authors: Harloff Andreas , Blazhenets Ganna , Fostitsch Johannes , Strecker Christoph , Dersch Rick , Mayerhofer Ernst , Meyer Philipp T. 
Published: November 2024

Abstract
Background
Symptoms in acute cerebral sinus venous thrombosis (CSVT) are highly variable, ranging from headaches to fatal stroke, and the basis for this high inter-individual variability is poorly understood. The present study aimed to assess whether acute CSVT significantly alters regional cerebral blood flow (CBF), if findings differ from CBF patterns know from large-artery occlusion in stroke, and whether the pattern of CBF alterations depends on clot location. Therefore, we retrospectively analyzed 12 patients with acute CSVT 10.6 ± 4.6 days after symptom onset and ten healthy volunteers who underwent [15O]water PET (two scans each, 300 ± 14 MBq [15O]water). Static image datasets (15–75 s after injection; normalized to cerebellum) reflecting relative CBF (rCBF) were analyzed using voxel- and region-of-interest-based analysis (AAL3-atlas). We mirrored datasets of patients with left-sided CSVT to harmonize the affected hemisphere.

Results
Seven and five patients showed right- and left-sided CSVT, respectively. The superior sagittal sinus (SSS) was involved in 8/12 patients. CSVT patients had extensive rCBF deficits in the voxel-based analysis with accentuation in the right (ipsilateral) frontal cortex and caudate nucleus compared to controls, which were most pronounced in cortical areas in those with involvement of the SSS (8/12), and in subcortical areas in those without involvement of the SSS (4/12; p < 0.05, false discovery rate corrected). ROI-analysis demonstrated significant frontal (p = 0.01) and caudate nucleus (p = 0.008) rCBF deficits driven by patients with and without SSS occlusion, respectively.

Conclusions
[15O]water PET was able to visualize characteristic patterns of impaired rCBF, which were different from intracranial large-artery occlusion in acute ischemic stroke, and exhibited substantial rCBF alterations depending on the involvement of the SSS. Our findings provide novel insights into the effects of disturbed venous drainage on CBF in acute CSVT, which may aid in understanding the pathophysiology, and guide future therapy of acute CSVT.
Strategies for improving treatment retention for buprenorphine/naloxone for opioid use disorder: a qualitative study of issues and recommendations from prescribers
Authors: Young Gary J. , Young Leonard D. , Noor-E-Alam Md. 
Published: November 2024

Abstract
Background
Opioid use disorder (OUD) remains a significant public health issue as the number of opioid-related overdose deaths continues to reach new highs each year. Buprenorphine/Naloxone is a medication that has been shown to be highly effective for the treatment of OUD. However, the clinical management of patients on this medication is challenging as many patients discontinue treatment prematurely. We conducted a qualitative study focusing on experienced prescribers of buprenorphine to learn about what they believe are key challenges in prescribing this medication to patients with OUD and related strategies for improving treatment outcomes.

Methods
We conducted two rounds of interviews with 12 prescribers who were either trained as a primary care physician, nurse practitioner, or physician assistant. These prescribers were recruited from an academically-based treatment program, a community health center, and a commercial substance use disorder treatment facility. Interview data were coded and analyzed in accordance with a grounded theory approach.

Results
Key findings and related recommendations emerged for patient monitoring, integration of behavioral health with prescribing, patient volume requirements, and use of telehealth.

Conclusion
The interviews generated a number of recommendations for improving patient outcomes from buprenorphine treatment. Some of these recommendations can be implemented quite readily whereas others entail more substantial resources and time commitments.
α-Synuclein seeding amplification assays for diagnosing synucleinopathies: an innovative tool in clinical implementation
Authors: Kuang Yaoyun , Mao Hengxu , Huang Xiaoyun , Chen Minshan , Dai Wei , Gan Tingting , Wang Jiaqi , Sun Hui , Lin Hao , Liu Qin , Yang Xinling , Xu Ping-Yi 
Published: November 2024

AbstractThe spectrum of synucleinopathies, including Parkinson’s disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB), is characterized by α-synuclein (αSyn) pathology, which serves as the definitive diagnostic marker. However, current diagnostic methods primarily rely on motor symptoms that manifest years after the initial neuropathological changes, thereby delaying potential treatment. The symptomatic overlap between PD and MSA further complicates the diagnosis, highlighting the need for precise and differential diagnostic methods for these overlapping neurodegenerative diseases. αSyn misfolding and aggregation occur before clinical symptoms appear, suggesting that detection of pathological αSyn could enable early molecular diagnosis of synucleinopathies. Recent advances in seed amplification assay (SAA) offer a tool for detecting neurodegenerative diseases by identifying αSyn misfolding in fluid and tissue samples, even at preclinical stages. Extensive research has validated the effectiveness and reproducibility of SAAs for diagnosing synucleinopathies, with ongoing efforts focusing on optimizing conditions for detecting pathological αSyn in more accessible samples and identifying specific αSyn species to differentiate between various synucleinopathies. This review offers a thorough overview of SAA technology, exploring its applications for diagnosing synucleinopathies, addressing the current challenges, and outlining future directions for its clinical use.
Virtual restoration of ancient tomb murals based on hyperspectral imaging
Authors: Zeng Zimu , Qiu Shi , Zhang Pengchang , Tang Xingjia , Li Siyuan , Liu Xuebin , Hu Bingliang 
Published: November 2024

Abstract
The virtual restoration of historic murals holds immense importance in the realm of cultural heritage preservation. Currently, there are three primary technical issues. First and foremost, it is imperative to delineate the precise location where the mural necessitates restoration. Second, the original color of the mural has changed over time, resulting in a difference from its current appearance. Then, while the method utilizing convolutional neural networks is effective in restoring small defaced areas of murals, its effectiveness significantly diminishes when applied to larger areas. The primary objectives of this paper are as follows: (1) To determine the large and small areas to be restored, the authors employ hyperspectral super-pixel segmentation and support vector machine-Markov random field (SVM-MRF) classification. (2) The authors transform the hyperspectral mural images into more realistic and accurate red-green-blue (RGB) images using the Commission Internationale de l’Eclairage (CIE) standard colorimetric system. (3) The authors restored the images respectively using convolutional neural network and matching image block-based approaches depending on the size of the areas to be mended. The proposed method has enhanced the image quality assessment (IQA) in terms of both color quality and restoration effects. In contrast to the pseudo-color fusion method, the color optimization algorithm described in this research enhances the multi-scale image quality (MUSIQ) by 8.42%. The suggested technique enhances MUSIQ by 2.41% when compared to the convolutional neural network-based image inpainting algorithm.