bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vibration vulnerability assessment of heritage structures in Lahore: a step towards sustainable conservation
Authors: Azam Rizwan , Riaz Muhammad Rizwan , Javaid Muhammad Faraz 
Published: November 2024

AbstractLahore is among the most important historical cities in Pakistan, and many cultural heritage structures, such as Shalamar Gardens and Lahore Fort, which are recognised as World Heritage Sites by UNESCO, are located there. The rapid increase in transit operations and infrastructure development in Lahore can increase the vulnerability of nearby heritage structures to ground-borne vibrations. In this study, a vibration vulnerability assessment of the heritage structures present in Lahore was performed with the help of the framework provided by the Federal Transit Administration (FTA), USA. A remote survey was carried out to gather valuable information regarding the distance between the heritage structures and potential vibrational sources, as well as the latitude and longitude of the heritage structures, via the web-based mapping tool Google Earth. A vibration vulnerability map of heritage structures was developed on the basis of a vibration vulnerability assessment to make it convenient for policymakers to visualise the present state of heritage structures with respect to vibration vulnerability. The performed vibration vulnerability assessment was validated by experimentally measuring vibrations at the Buddha’s Tomb (Buddha Ka Awa) heritage structure. The study revealed that 17% of the heritage structures present in Lahore are vulnerable to vibrations at present, with potential vibrational sources such as road traffic, metro trains, and rail traffic. The vibration vulnerability assessment revealed that 72% of the vibrationally vulnerable heritage structures in Lahore are most influenced by vibrations from road traffic. The results of this study can aid policymakers in creating intervention packages for vibrationally vulnerable heritage structures in Lahore in relation to their respective needs, which will make it possible to achieve the sustainable conservation of heritage structures.
Effect of Ketamine on the Bispectral Index, Spectral Edge Frequency, and Surgical Pleth Index During Propofol-Remifentanil Anesthesia: An Observational Prospective Trial
Authors: Linassi Federico , Troyas Carla , Kreuzer Matthias , Spanò Leonardo , Burelli Paolo , Schneider Gerhard , Zanatta Paolo , Carron Michele 
Published: November 2024

BACKGROUND:
Ketamine administration during stable propofol anesthesia is known to be associated with an increase in bispectral index (BIS) but a “deepening” in the level of hypnosis. This study aimed to evaluate the association between the effect-site concentration of ketamine (CeK) and 2 electroencephalogram (EEG)-derived parameters, the BIS and spectral edge frequency (SEF95), after the administration of a ketamine bolus. Secondary aims included investigating the BIS and SEF95 variations with time and changes in the surgical pleth index (SPI).

METHODS:
We conducted an observational, prospective, single-center study analyzing intraoperative data from 14 adult female patients undergoing breast oncologic surgery. During stable propofol-remifentanil target-controlled infusion (TCI) anesthesia, a ketamine analgesic bolus was delivered with the target CeK set to 1 μg.mL−
1 (Domino model) corresponding to a dose of 0.57 mg.kg−
1 (interquartile range [IQR] 0.56–0.57 mg.kg−1). Once the CeK reached a value of 1 μg.mL−1, the target CeK was set to 0 μg.mL−1. We determined the median BIS, SEF95, and SPI trends with time and as a function of the modeled CeK.

RESULTS:
BIS and SEF95 showed no significant change from when ketamine was administered to when CeK=1 μg.mL−1, but a significant increase was observed at lower CeKs. The maximum BIS was reached at 16.0 minutes [10.2–22.7 minutes] after CeK=1 μg.mL−1, at CeK=0.22 μg.mL−1 [0.12–0.41 μg.mL−1]. The peak SEF95 value was observed at 10.0 minutes [8.62–14.1 minutes] after CeK=1 μg.mL−1, at CeK=0.43 μg.mL−1 [0.25–0.50 μg.mL−1]. No significant association was found between CeK and the registered SPI values.

CONCLUSIONS:
Our results show that BIS and SEF95, but not SPI, follow a CeK-dependent trend after administering a ketamine bolus. Interestingly, their peak values were not reached at CeK=1 μg.mL−1, but after several minutes after the drug infusion at CeKs in the 0.2 to 0.5 μg.mL−1 range. This may be explained by the specific pharmacodynamics of ketamine and its varying effects at different concentrations, as well as by the time delay associated with the calculation of the BIS.
Coming Out for Community, Coming Out for the Cause
Authors: Cable Umayyah 
Published: November 2024

Abstract
This article focuses on the life experience and political activism of Palestinian American lesbian activist Huda Jadallah as a representative example of how lesbian, gay, bisexual, and transgender (LGBT/queer) Arab Americans came out to both queer communities and Arab American communities in the 1980s and 1990s. The author argues that this dual outness was utilized as a strategy through which to accomplish three interrelated aims: to build a queer Arab American community, utilize that community as a starting point from which to challenge anti-Arab racism within queer communities, and challenge homophobia in Arab American communities. Based on an oral history interview with Jadallah, in conjunction with analysis of Jadallah’s personal ephemera collection, this article takes a queer archiving methodological approach to consider how outness as strategy may also be utilized with regard to queer Arab American archiving and history.
Beyond Black Girlhood
Authors: Moore Chamara 
Published: November 2024

Abstract
How can Colson Whitehead’s combining of the generic and the strange in his Pulitzer Prize–winning speculative text The Underground Railroad be read as Afro-Pessimist? This essay seeks to illuminate the ways in which Whitehead’s novel provides narratives of self-making adjacent to coming of age while reinventing the historically white genre of the Bildungsroman for an intersectional identity in early America. Using Geta LeSeur’s The Black Bildungsroman as a point of reference, the author argues that because the protagonist Cora is a Black girl born and raised under chattel slavery and thus forced to come of age before the bulk of the novel, her experience cannot be constrained to a genre defined primarily by Eurocentric traditions and frames of reference. In this way, “girlhood” has never been a possibility for her, making the novel’s ambiguous ending a clearer Afro-Pessimist argument rather than any particular milestone of maturation we see in Bildungsroman. The Underground Railroad is a case study demonstrating how Black speculative fiction authors move through and beyond the Bildungsroman genre by imbuing their Black female subjects like Cora with the agency of self-making, while using speculative elements such as transforming into a railroad to demonstrate the intractable social death of enslavement.
Impact of Contemporary Redlining on Healthcare Disparities Among Patients with Gastrointestinal Cancer: A Mediation Analysis
Authors: Chatzipanagiotou Odysseas P. , Woldesenbet Selamawit , Munir Muhammad Musaab , Catalano Giovanni , Khalil Mujtaba , Rashid Zayed , Altaf Abdullah , Pawlik Timothy M. 
Published: November 2024

Abstract
Background
Historically, housing policies have perpetuated the marginalization and economic disinvestment of redlined neighborhoods. Residential segregation persists nowadays in the form of contemporary redlining, promoting healthcare disparities. The current study sought to assess the effect of redlining on oncological outcomes of patients with gastrointestinal cancer and identify mediators of the association.

Methods
Patients with colorectal or hepatobiliary cancer were identified from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2007–2019). The contemporary redlining index, a measure of mortgage lending bias, was assessed relative to disease stage at diagnosis, receipt of appropriate treatment, textbook outcome, and mortality. Mediation analysis was used to identify socioeconomic, structural, and clinical mediating factors.

Results
Among 94,988 patients, 32.2% resided in high (n = 23,872) and highest (n = 6,791) redlining census tracts compared with 46.2% in neutral and 21.6% in low redlining tracts. The proportion of Black, Hispanic, and White patients experiencing high and highest redlining was 65.9%, 41.6%, and 27.9%, respectively. Highest redlining was associated with 18.2% higher odds of advanced disease at diagnosis, greater odds of not undergoing surgery for localized disease (adjusted odds ratio [aOR] 1.363, 95% confidence interval [CI] 1.219–1.524) or not receiving chemotherapy for advanced disease (aOR 1.385, 95% CI 1.216–1.577), and 26.7% lower odds of textbook outcome achievement. Mediation analysis for appropriate treatment quantified the proportion of the association driven by socioeconomic status, racial/ethnic minority status, racial/economic segregation, primary care shortage, and housing/transportation.

Conclusions
Contemporary redlining contributed both directly, and via downstream factors, to disparities in oncological care and outcomes of patients with gastrointestinal cancer.
Defining multilevel developmental cervical spinal stenosis using MRI
Authors: Cheung Prudence W. H. , Leung Justin H. M. , Lee Vivien W. Y. , Cheung Jason P. Y. 
Published: November 2024

AimsDevelopmental cervical spinal stenosis (DcSS) is a well-known predisposing factor for degenerative cervical myelopathy (DCM) but there is a lack of consensus on its definition. This study aims to define DcSS based on MRI, and its multilevel characteristics, to assess the prevalence of DcSS in the general population, and to evaluate the presence of DcSS in the prediction of developing DCM.MethodsThis cross-sectional study analyzed MRI spine morphological parameters at C3 to C7 (including anteroposterior (AP) diameter of spinal canal, spinal cord, and vertebral body) from DCM patients (n = 95) and individuals recruited from the general population (n = 2,019). Level-specific median AP spinal canal diameter from DCM patients was used to screen for stenotic levels in the population-based cohort. An individual with multilevel (≥ 3 vertebral levels) AP canal diameter smaller than the DCM median values was considered as having DcSS. The most optimal cut-off canal diameter per level for DcSS was determined by receiver operating characteristic analyses, and multivariable logistic regression was performed for the prediction of developing DCM that required surgery.ResultsA total of 2,114 individuals aged 64.6 years (SD 11.9) who underwent surgery from March 2009 to December 2016 were studied. The most optimal cut-off canal diameters for DcSS are: C3 < 12.9 mm, C4 < 11.8 mm, C5 < 11.9 mm, C6 < 12.3 mm, and C7 < 13.3 mm. Overall, 13.0% (262 of 2,019) of the population-based cohort had multilevel DcSS. Multilevel DcSS (odds ratio (OR) 6.12 (95% CI 3.97 to 9.42); p < 0.001) and male sex (OR 4.06 (95% CI 2.55 to 6.45); p < 0.001) were predictors of developing DCM.ConclusionThis is the first MRI-based study for defining DcSS with multilevel canal narrowing. Level-specific cut-off canal diameters for DcSS can be used for early identification of individuals at risk of developing DCM. Individuals with DcSS at ≥ three levels and male sex are recommended for close monitoring or early intervention to avoid traumatic spinal cord injuries from stenosis.Cite this article: Bone Joint J 2024;106-B(11):1333–1341.
The effect of smoking on functional outcomes and implant survival of anatomical total shoulder arthroplasty
Authors: Amador Isabella E. , Hao Kevin A. , Buchanan Timothy R. , Damrow Derek S. , Hones Keegan M. , Simcox Trevor , Schoch Bradley S. , Farmer Kevin W. , Wright Thomas W. , LaMonica Tyler J. , King Joseph J. , Wright Jonathan O. 
Published: November 2024

AimsWe sought to compare functional outcomes and survival between non-smokers, former smokers, and current smokers who underwent anatomical total shoulder arthroplasty (aTSA) in a large cohort of patients.MethodsA retrospective review of a prospectively collected shoulder arthroplasty database was performed between August 1991 and September 2020 to identify patients who underwent primary aTSA. Patients were excluded for preoperative diagnoses of fracture, infection, or oncological disease. Three cohorts were created based on smoking status: non-smokers, former smokers, and current smokers. Outcome scores (American Shoulder and Elbow Surgeons (ASES), Constant-Murley score, Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST), University of California, Los Angeles activity scale (UCLA)), range of motion (external rotation (ER), forward elevation (FE), internal rotation, abduction), and shoulder strength (ER, FE) evaluated at two- to four-year follow-up were compared between cohorts. Evaluation of revision-free survival was performed using the Kaplan-Meier method to final follow-up.ResultsWe included 428 primary aTSAs with a mean follow-up of 2.4 years (SD 0.6). Our cohort consisted of 251 non-smokers, 138 former smokers who quit a mean 21 years (SD 14) prior to surgery (25 pack-years (SD 22)), and 39 current smokers (23 pack-years (SD 20)). At two- to four-year follow-up, former smokers had less favourable SPADI, SST, and FE strength compared to non-smokers, and current smokers had less favourable SPADI, SST, ASES score, UCLA score, Constant-Murley score, FE, abduction, and ER strength compared to non-smokers. Non-smokers exhibited higher revision-free survival rates at two, five, eight, and ten years postoperatively compared to former smokers and current smokers, who had similar rates.ConclusionOur study suggests that smoking has a negative effect on aTSA functional outcomes that may persist even after quitting.Cite this article: Bone Joint J 2024;106-B(11):1263–1272.
Total elbow arthroplasty in England
Authors: Hamoodi Zaid , Sayers Adrian , Whitehouse Michael R. , Rangan Amar , Kearsley-Fleet Lianne , Sergeant Jamie , Watts Adam C. 
Published: November 2024

AimsThe aim of this study was to review the provision of total elbow arthroplasties (TEAs) in England, including the incidence, the characteristics of the patients and the service providers, the types of implant, and the outcomes.MethodsWe analyzed the primary TEAs recorded in the National Joint Registry (NJR) between April 2012 and December 2022, with mortality data from the Civil Registration of Deaths dataset. Linkage with Hospital Episode Statistics-Admitted Patient Care (HES-APC) data provided further information not collected by the NJR. The incidences were calculated using estimations of the populations from the Office for National Statistics. The annual number of TEAs performed by surgeons and hospitals was analyzed on a national and regional basis.ResultsA total of 3,891 primary TEAs were included. The annual incidence of TEA was between 0.72 and 0.82 per 100,000 persons before 2020 and declined to 0.4 due to a decrease in elective TEAs during the COVID-19 pandemic, with a slight recovery in 2022. Older patients, those of white ethnicity and females, were more likely to undergo TEA. Those who underwent elective TEA had a median wait of between 89 (IQR 41 to 221) and 122 days (IQR 74 to 189) in the years before 2021, and this increased to 183 days (IQR 66 to 350) in 2021. The number of TEAs performed by surgeons per annum remained unchanged, with a median of two (IQR 1 to 3). The median annual number of TEAs per region was three to six times higher than the median annual case load of the highest volume hospital in a region. Patients in the lowest socioeconomic group had a higher rate of serious adverse events and mortality (11%) when undergoing TEA for acute trauma.ConclusionIn England, TEA is more common in older age groups, those of white ethnicity, and females. The COVID-19 pandemic affected the incidence of elective TEA and waiting times, and the provision of TEA has not yet recovered. The Getting it Right First Time recommendation of centralizing services to one centre per region could result in up to a six-fold increase in the number of TEAs being performed in some centres.Cite this article: Bone Joint J 2024;106-B(11):1312–1320.
Changes in urgent and emergency care activity associated with COVID-19 lockdowns in a sub-region in the East of England: Interrupted times series analyses
Authors: Shabuz Zillur Rahman , Bachmann Max , Cullum Rachel , Burke Amanda , Jones Charlotte Emily Louise , Enwo Oby Otu , Dalton Alice M. , Brainard Julii , Saunders Michael , Steel Nicholas 
Published: November 2024

Background
Access to and use of urgent and emergency care in the United Kingdom’s National Health Service reduced during COVID-19 related lockdowns but demand reportedly increased since then. We investigated the impact of COVID-19 on urgent and emergency health care services activity in an eastern England population of 1.1 million.

Methods
We used health care activity data from a municipal health department, recorded at the level of discrete events (such as visits to hospital or ambulance calls) to compare system activity between 2018–2020 (pre-COVID), 2020–2021 (lockdown) and 2021–2023 (post-lockdown), carrying out interrupted time series analyses to describe changes in activity.

Results
Daily emergency department (ED) attendances were 10% (95% confidence interval 9–12%) lower during the lockdown period, and 7% (6–8%) higher in the post-lockdown period than pre-COVID. Attendances arriving by ambulance were 13% (12–14%) lower post-lockdown than pre-COVID, while attendances of arrivals by other means were 17% (16–19%) higher. Post-lockdown, overall attendances were continually reducing. ED waiting times were 45% (44–47%) longer in the post-lockdown period compared to the pre-COVID period and continued to increase post-lockdown. There was a 15% (14–16%) reduction in daily ambulance dispatches post-lockdown versus pre-COVID. Ambulance arrivals with delayed handover to hospital care exceeding 60 minutes increased by 17% (16–18%) post-lockdown versus pre-COVID, and probability of delay showed a continuously upward trend post-lockdown of 20% (19–21%) per year.

Conclusion
Patients are facing long waits in EDs to be admitted to hospital, discharged or transferred. This results in delays in ambulances handing over patients and attending to other calls, which may explain decreasing rates of ambulance dispatches. Potential solutions are likely to involve enhancing the flow through and discharge of patients from hospital, and a whole systems approach which considers the capacity of the local health and care infrastructure, including intermediate care and social care.
Prognostic value of the systemic immune-inflammation index in lung cancer patients receiving immune checkpoint inhibitors: A meta-analysis
Authors: Yang Yanhui , Li Ji , Wang Yi , Luo Lei , Yao Yi , Xie Xiaoyang 
Published: November 2024

Purpose
To explore the association between the systemic immune-inflammation index (SII) score and prognosis in immune checkpoint inhibitor (ICI)-treated patients with lung cancer.

Methods
PubMed, EMBASE, Web of Science, and CNKI databases were searched up to August 1, 2024. Progression-free survival (PFS) and overall survival (OS) were the primary outcomes queried. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined, and subgroup analysis was based on pathological type [non-small cell lung cancer (NSCLC) vs. small-cell lung cancer (SCLC)], lines of ICIs (first-line vs. second- or further-line), and combinations of other therapies (yes vs. no).

Results
Twenty retrospective studies with 2424 participants were included. The pooled results demonstrated that an elevated SII was associated with poorer PFS (HR = 1.82, 95% CI: 1.49–2.21; P < 0.001) and OS (HR = 2.31, 95% CI: 1.73–3.09; P < 0.001) in lung cancer patients receiving ICIs. Subgroup analysis stratified by pathological type, lines of ICIs and combinations of other therapies for PFS and OS further revealed the predictive role of the SII in ICI-treated lung cancer patients.

Conclusion
Based on current evidence the SII is significantly related to prognosis and could serve as a reliable prognostic indicator in lung cancer patients receiving ICIs.
Examining HPV vaccination behavior among young adults: Insights from applying the Health Belief Model
Authors: Oyedeji Oluwafemifola , Kintziger Kristina W. , Springer Cary M. , Ehrlich Samantha , Maples Jill , Gatwood Justin , Barroso Cristina S. 
Published: November 2024

Background
Despite evidence-based recommendations for HPV vaccination, uptake among young adults is suboptimal. Limited research has explored factors that may influence HPV vaccination among young adults, as well as associated promotion and informational preferences in this group. This study aimed to examine factors associated with HPV vaccination among young adults and preferences for HPV vaccine information and promotion.

Methodology
This study utilized a cross-sectional design to examine factors related to HPV vaccination among young adults on a university campus in Tennessee. Data were collected via an online survey administered to students, aged 18–26 years, from March–May 2023. Study measures included sociodemographic characteristics, health/healthcare-related factors, and perception-related measures. Data analysis included descriptive statistics and multivariable logistic regression analysis.

Results
Out of 402 participants that completed the survey, 209 reported being vaccinated against HPV. In the adjusted model, variables associated with HPV vaccination were perceived risk (adjusted OR [aOR] = 1.12; 95% confidence interval [CI]:1.05, 1.20), perceived barriers (aOR = 0.73; 95% CI: 0.66, 0.81), higher HPV knowledge (aOR = 1.17; 95% CI: 1.03, 1.33), and receipt of healthcare provider recommendations (aOR = 12.90; 95% CI: 7.08, 23.51).

Conclusions
Study findings suggest that those who are vaccinated were more likely to report receiving healthcare provider recommendations, low perceived barriers, higher HPV knowledge and perceived risk. Future HPV vaccination promotion efforts for young adults may consider increasing HPV vaccine knowledge and awareness, addressing barriers, and strengthening provider recommendations.
Coverage and determinants of Intermittent Preventive Treatment in pregnancy (IPTp) in Cameroon, Guinea, Mali, and Nigeria
Authors: Nishan M. D. Nahid Hassan , Akter Khadiza 
Published: November 2024

Introduction
Malaria poses a serious issue for pregnant women in African regions. It is crucial to comprehend the various factors that impact receiving IPTp during ANC checkups. These are important for the well-being of both pregnant mothers and their unborn children. Therefore, this study aims to investigate the determinants of IPTp coverage among women in Cameroon, Guinea, Mali, and Nigeria.

Methodology
This cross-sectional study utilized secondary data from the Malaria Indicator Surveys (MIS) across Cameroon, Guinea, Mali, and Nigeria, focusing on women who received IPTp during pregnancy with IPTp categorized dichotomously as "Yes" for ANC visits and "No" for other visits. Chi-squared tests were used to assess associations, and binary logistic regression was conducted to calculate adjusted odds ratios, confidence intervals, and p-values. Results were summarized in tables.

Results
We found IPTp coverage during ANC visits was highest in Cameroon (98.6%), followed by Guinea (97.7%), Mali (97.1%), and lowest in Nigeria (95.5%). In Guinea, rural women were less likely to receive IPTp than urban women (AOR: 0.16, 95% CI: 0.07–0.41, p<0.001). In Mali, women who received 3 or more doses were less likely to receive IPTp at ANC (AOR: 0.48, p<0.01). In Nigeria, personal transport increased IPTp uptake (AOR: 1.88, p<0.01). In Cameroon, malaria prevention messages improved IPTp coverage (AOR: 3.12, p<0.05).

Conclusions
This study highlights significant disparities in IPTp uptake, with rural Mali and Guinea facing lower coverage. In Nigeria, personal transport improved IPTp uptake. Targeted interventions are needed to improve ANC services and ensure equitable IPTp access across the study regions.