bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in the intention and decision to use emergency medical services for acute coronary syndrome in Australia: a retrospective study
Authors: Eastwood Kathryn J , Shi Annie , Howell Stuart , Buttery Amanda , Bray Janet E 
Published: December 2024

BackgroundSex-based disparities in acute coronary syndrome (ACS) presentations exist and women often have worse outcomes after an ACS event. Calling the emergency medical services (EMS) initiates prehospital diagnosis and treatment and reduces in-hospital time to treatment. This study aims to identify factors affecting the intention to call EMS and EMS usage in Australian women and men.MethodsA retrospective cross-sectional analysis was conducted to identify sex differences and associated characteristics in the (1) intention to call EMS and (2) EMS use in the setting of ACS. Data sources included national survey data (2018–2020) and the Victorian Emergency Minimum Dataset (2016–2021). Multivariable analysis identified factors associated with intention and EMS use by sex.ResultsOf 34 328 survey participants, fewer men expressed an intention to call EMS if experiencing ACS symptoms than women (62.7% vs 70.4%, p<0.001). Associated factors in men included being of Aboriginal or Torres Strait Islander origin, living in Western Australia, having diabetes or having a lower education level. In both sexes, preferring a non-English language, having cardiovascular risk factors, poor symptom knowledge, living in the Northern territory or no/unclear EMS insurance status were associated with lower intentions to call EMS. Finally, women were less comfortable with calling EMS and more likely to hesitate (69.1 vs 76.7%, p<0.001).Among 51 165 ACS presentations (33.6% women) to Victorian public hospitals, fewer men presented by EMS (62.5% vs 67.7%, p<0.001), however, no associated male-specific characteristics were identified. Women preferring a non-English language or living in outer regional/remote Victoria were less likely to use EMS. Being born overseas or being referral by a healthcare provider was associated with lower EMS use in both sexes.ConclusionSex differences were identified in the intention and use of EMS during an ACS event based on cultural background, preferred language and residential regionality. These subgroups’ characteristics can be targeted with education to improve EMS use.
Semaglutide Inducing Resolution of Proliferative Diabetic Retinopathy: A Case Report
Authors: Cool Daniel , Coventon James , Sharma Abhishek 
Published: December 2024

Purpose: To describe a case of regression of proliferative diabetic retinopathy (PDR) following treatment with semaglutide.Methods: Case report.Results: The case describes a 47‐year‐old woman with Type 2 diabetes, obesity, hypertension, and dyslipidaemia who had difficulty controlling her blood sugar levels despite oral hypoglycaemic medications. She presented with PDR in her right eye and severe nonproliferative diabetic retinopathy (NPDR) in her left eye. After missing her follow‐up appointment for panretinal photocoagulation (PRP), her general practitioner initiated semaglutide therapy. Despite minimal changes in glycaemic control, the patient exhibited resolution of neovascularisation in her right eye and improved diabetic macular oedema (DMO) within 6 weeks of semaglutide therapy.Conclusion: This case report suggests a potential independent role for semaglutide in managing PDR.
Characteristics of Children, Youth, and Young Adults With Diabetes: A Cross‐Sectional Study in New Zealand Aotearoa
Authors: Mustafa Sara , Paul Ryan , Keenan Rawiri , Magliano Dianna , Chepulis Lynne 
Published: December 2024

Background: The prevalence of diabetes mellitus among children, youth, and young adults is increasing, yet limited information is known about the characteristics and management of these groups with Type 1 (T1D) and Type 2 (T2D) diabetes in primary care. The aim of the study is to explore the characteristics of people with T1D and T2D aged < 25 years across the Auckland and Waikato regions of New Zealand.Methods: Sociodemographic and clinical data were collected from electronic primary care records (February 2021–July 2022) of four primary healthcare organisations, with medication data sourced from the National Pharmaceutical dataset. Associations between sociodemographic and clinical data were conducted using chi‐square and nonparametric ANOVA.Results: Of 1198 patients, 72% had T1D and 28% had T2D. People with T1D were evenly distributed by gender but more commonly of European descent (66.7%) compared to other ethnic groups. A higher proportion of T2D was observed in females (58.2%) compared to males (41.6%) and among Māori (38.2% vs. 20.3% European; p < 0.001). Over 95% of individuals with T2D were overweight/obese. Overall, 9.5% and 23.9% of individuals with T1D and T2D, respectively, were at target for HbA1c, though median HbA1c was higher for Māori and Pasifika compared to other ethnicities (p < 0.001). In T1D, 94.7% of individuals were dispensed insulin and 7.5% and 4.4% were dispensed angiotensin‐converting enzyme (ACE) inhibitors and statins, respectively. In T2D, medication use included metformin (84.9%), insulin (76.1%), and SGLT2i/GLP1RA (59.5%).Conclusions: The increasing burden of diabetes among young individuals in New Zealand underscores the urgent need for comprehensive strategies to address obesity and socioeconomic disparities, especially among marginalised communities. Addressing socioeconomic factors such as affordable housing, living wages, and healthcare access may be important for improving diabetes outcomes, as these factors significantly influence overall childhood health and well‐being.
Association between Locoregional Failure and NFE2L2/KEAP1/CUL3 Mutations in NRG/RTOG 9512: A Randomized Trial of Radiation Fractionation in T2N0 Glottic Cancer
Authors: Guan Li , Torres-Saavedra Pedro A. , Zhao Xiaobei , Major Michael B. , Holmes Brittany J. , Nguyen Ngan K. , Kumaravelu Parasakthy , Hodge Tim , Diehn Maximilian , Zevallos Jose , Holsinger F. Christopher , Emami Bahman , Jordan Richard C. , Hayward Michele C. , Sagar Stephen M. , Morrison William , Schultz Christopher , Caudell Jimmy J. , Jones Christopher U. , Bratman Scott V. , Galloway Thomas J. , Ma Daniel J. , Yom Sue S. , Kudrimoti Mahesh , Kim Harold E. , Harris Jonathan , Le Quynh-Thu , Hayes D. Neil 
Published: December 2024

Abstract

Purpose:
NFE2L2/KEAP1/CUL3 mutations have been validated for radioresistance in cell-based assays and animal models. However, clinical validation of these biomarkers has been challenging because of multimodality treatment regimens. This study aims to investigate the association between NFE2L2/KEAP1/CUL3 mutations and patient outcomes, including local failure, locoregional failure, disease-free survival (DFS), and overall survival, using samples from a phase III trial in which patients were treated with radiation monotherapy at two controlled doses.

Patients and Methods:
We investigated NFE2L2/KEAP1/CUL3 mutations in 250 randomized patients with T2N0 glottic squamous cell carcinoma receiving definitive radiotherapy in the NRG/RTOG 9512 trial. A total of 119 patients had available biospecimens that were subjected to amplicon-based next-generation sequencing to assess for the presence of NFE2L2/KEAP1/CUL3 mutations without regard to outcomes. Mutations in NFE2L2/KEAP1/CUL3 were assessed blinded to clinical outcomes. Cox models (two-sided α = 0.05) were used to evaluate the association with clinical outcomes, performed by an independent statistical team.

Results:
Nineteen of 119 patients (16.0%) had NFE2L2/KEAP1/CUL3 mutations. Patient, treatment, and tumor characteristics were similar between those with and without mutations. Patients with mutation compared with those without had significantly more local failure [HR = 3.50; 95% confidence interval (CI), 1.56–7.89; P = 0.0025] and locoregional failure (HR = 3.80; 95% CI, 1.80–8.03; P = 0.0005). DFS was significantly worse for the mutated compared with the nonmutated group in the first 2 years (HR = 2.88; 95% CI, 1.46–5.66; P = 0.0022). The median DFS was shorter in the mutation group (10.3 months) versus those with intact NFE2L2/KEAP1/CUL3 (4.2 years).

Conclusions:
NFE2L2/KEAP1/CUL3 mutations may predict radiation treatment failure in T2N0 glottic cancer.
Machine Learning–Based Prediction for In‐Hospital Mortality After Acute Intracerebral Hemorrhage Using Real‐World Clinical and Image Data
Authors: Matsumoto Koutarou , Ishihara Kazuaki , Matsuda Katsuhiko , Tokunaga Koki , Yamashiro Shigeo , Soejima Hidehisa , Nakashima Naoki , Kamouchi Masahiro 
Published: December 2024

BACKGROUND
Machine learning (ML) techniques are widely employed across various domains to achieve accurate predictions. This study assessed the effectiveness of ML in predicting early mortality risk among patients with acute intracerebral hemorrhage (ICH) in real‐world settings.

METHODS AND RESULTS
ML‐based models were developed to predict in‐hospital mortality in 527 patients with ICH using raw brain imaging data from brain computed tomography and clinical data. The models' performances were evaluated using the area under the receiver operating characteristic curves and calibration plots, comparing them with traditional risk scores such as the ICH score and ICH grading scale. Kaplan–Meier curves were used to examine the post‐ICH survival rates, stratified by ML‐based risk assessment. The net benefit of ML‐based models was evaluated using decision curve analysis. The area under the receiver operating characteristic curves were 0.91 (95% CI, 0.86–0.95) for the ICH score, 0.93 (95% CI, 0.89–0.97) for the ICH grading scale, 0.83 (95% CI, 0.71–0.91) for the ML‐based model fitted with raw image data only, and 0.87 (95% CI, 0.76–0.93) for the ML‐based model fitted using clinical data without specialist expertise. The area under the receiver operating characteristic curve increased significantly to 0.97 (95% CI, 0.94–0.99) when the ML model was fitted using clinical and image data assessed by specialists. All ML‐based models demonstrated good calibration, and the survival rates showed significant differences between risk groups. Decision curve analysis indicated the highest net benefit when utilizing the findings assessed by specialists.

CONCLUSIONS
ML‐based prediction models exhibit satisfactory performance in predicting post‐ICH in‐hospital mortality when utilizing raw imaging data or nonspecialist input. Nevertheless, incorporating specialist expertise notably improves performance.
When a Dispute Exists: the Emerging Evidentiary Practice of the ICJ in Common Interests Proceedings
Authors: Lo Giacco Letizia 
Published: December 2024

Abstract
This contribution considers the practice of determining the existence of a dispute in proceedings before the International Court of Justice and explores the extent to which such assessment varies – or should vary – in relation to the legal interest protected. This question appears increasingly relevant in the context of common interests proceedings before the ICJ, that is, in cases in which the legal standing of the applicant(s) is based on a common interest in the compliance with erga omnes (partes) obligations. Zooming in on the requirements elaborated by the Court’s case law to date, the article argues that diverging theoretical postures – termed dialogic vs. systemic – inform the evidentiary approaches that have so far emerged and that are essentially discretionary. This contribution aims to shed light on how the Court’s evidentiary approach has adjusted to common interests proceedings to stand the test of time, while cautiously preserving the performance of the Court’s judicial function.
Angiotensin-Converting Enzyme Inhibitor (ACEI) and Angiotensin Receptor Blocker (ARB) Use are Associated With Increased Readmission After Ileostomy Creation
Authors: Gan Connie Y. , Rahman Shahrose , Flerchinger Shaun R. , Barton Jeffrey S. 
Published: December 2024

Background High output is a common cause for readmission after new ileostomy creation. The loss of sodium leads to compensatory activation of the renin-angiotensin-aldosterone system (RAAS). Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are first-line therapy for hypertension in the United States. We hypothesized that concurrent use of ACEI/ARB increases the risk of readmission following new ileostomy creation due to the loss of this compensatory mechanism. Methods Patients undergoing ileostomy creation between 2009-2022 at an integrated managed health care system were included in this retrospective study. Primary outcomes were hospital readmission and ED visit within 30-days. Additional variables included ACEI/ARB use, ileostomy type, Charlson Comorbidity Index, additional antihypertensives at discharge (furosemide, hydrochlorothiazide, spironolactone, amlodipine, nifedipine, and diltiazem), and readmission diagnosis. Descriptive and advanced statistical analysis was completed with SPSS. Results Of 540 patients, 41.9% were readmitted or visited an ED within 30 days. There was no difference in readmission or ED visit based on age, gender, or ileostomy type. Patients discharged with ACEI/ARB (37.4% vs 25.5%, P = .005) and additional antihypertensives (37.2% vs 17.3%, P = .006) were at a higher risk for readmission. Conclusions Inhibition of RAAS is associated with increased risk for hospital readmission. In patients with hypertension undergoing ileostomy creation, individualized care plans are needed with earlier antimotility agent use or intravenous rehydration plans.
Understanding the current provisions of support for people with an intellectual disabilities and/or autism in crisis: A mixed methods study
Authors: Tromans Samuel , Summers Ian , Abdullah Shahbaz , Ledger Joanne , Lennard Sarah , Bassett Paul , Colledge Remie , Bilkey Danielle , Staples Chloe , Edwards Samuel , Carr Grahame , Laugharne Richard , Shankar Rohit 
Published: December 2024

Background: There has been significant reduction in inpatient beds for people with intellectual disability and/or autism (PwID/A) in the UK in the last decade following high profile national scandals in specialist psychiatric hospitals. To reduce inappropriate admissions a new strategy (Blue-Light, an emergency multi-disciplinary meeting to prevent admission to hospital) was introduced. However, there is no research on the influence of Blue-Light on crisis management for PwID/A. Aim: To assess Blue-Light’s impact on PwID/A’s crisis presentations Methods: Co-produced with experts-by-experience, a mixed methods approach using a 13 question Likert based survey of health and social-care professionals along with semi-structured interviews of carers involved with consecutive Blue-Light patient reviews was undertaken in Cornwall UK (population: 538,000). Patient data was accessed to understand the patient journey. All data analysis was descriptive in nature. Semi-structured interviews were transcribed and thematically analysed using Braun and Clarke’s six-step process. Results: Ten patient journeys were examined. Staff interviewed had a good understanding of the Blue-Light process, Blue-Light activation practical challenges and considered Blue-Light reactive. Nearly half wanted ID/A specialist beds recommissioned. A majority wanted improved supervision and standards for third sector providers. Semi-structured interviews of 10 patient-carers identified a lack of consistency from professionals, limited infrastructure provision, the prolongation of crises and a lack of definition of crisis as carers did not feel supported by services. Conclusions: Current crisis support systems are not standardised and often leave carers feeling unsupported in crises. An evidence-based debate of crisis support and the inpatient role for PwID/A is required.
Pricing efficiency of European carbon futures market during the COVID-19 pandemic
Authors: Tripathi Abhinava , Vadhava Charu , Jha Ravi Raushan 
Published: December 2024

We investigate the effects of the COVID-19 pandemic on the efficiency of the European Union Emission Trading Scheme (EU-ETS). This study provides one of the first accounts of the pricing efficiency of EU-ETS around the final leg of its Phase (III) implementation. The study documents that the EU-ETS futures prices become informationally efficient at extremely short horizons (5–30 minutes) that are comparable to mature conventional markets. These results are robust to three methods, namely, ordinary least squares (OLS) autoregression, quantile autoregression, and variance ratio tests. Moreover, the EU-ETS futures prices impound the information content of economic activity in the major European markets at an extremely fast pace (5–30 minutes). The dynamic correlations obtained from the DCC-GARCH method suggest that the linkages between EU-ETS and economic activity remain intact, even when the effect of the pandemic is most severe. Overall, these results indicate that EU-ETS has substantially attained its stated objectives related to pricing efficiency. JEL classification: Q51, Q54, G14, G01, G10
An assessment of seven closed system transfer devices in accordance with the 2015 NIOSH vapor containment performance protocol
Authors: Armistead Lori T. , Stepanovic Michael , Earnhart Megan A. , Eckel Stephen F. 
Published: December 2024

Introduction The purpose of this study was to assess and compare the effectiveness of seven different closed system transfer device (CSTD) product lines following the 2015 NIOSH Vapor Containment Performance Protocol, using a Gasmet™ DX5000 Terra multigas FTIR analyzer. Methods Seven different CSTD systems were assessed using a two-task evaluation on their capacity to contain the NIOSH-specified challenge agent, 70% isopropyl alcohol (IPA). Task 1 simulated reconstitution and compounding steps while Task 2 simulated compounding and administration steps. Vial adapters, syringe adapters, IV bag adapters, and y-site adapters from each CSTD product line were tested. All tasks were performed in a custom-built environmental test chamber as outlined in the 2015 NIOSH protocol, with isopropyl alcohol (IPA) release detected and measured by a Gasmet™ analyzer. Results The BD PhaSeal™ CSTD product line effectively contained IPA vapor during both tasks with a task performance metric of 0.00 ppm for each task. BD PhaSeal™ Optima, Equashield®, Yukon Medical Arisure®, ICU Medical ChemoLock™, BD Texium™, and ICU Medical ChemoClave™ non-vented CSTDs demonstrated detectable and quantifiable IPA leakage during each task. The leaks occurred at different steps within the protocol, and the amount of IPA vapor detected varied. Conclusion In this study, one CSTD product line (i.e., PhaSeal™) successfully contained IPA vapor below the Gasmet™ analyzer's limit of quantification (LOQ) for IPA of 0.04 ppm for both Tasks 1 and 2, demonstrating it to be a validated closed system per the study protocol. All other CSTD product lines demonstrated some level of IPA leakage with task performance metrics above the analyzer's LOQ. However, these results tell us little about how well CSTDs contain hazardous drugs (HDs), as a universal HD surrogate for effectively assessing the closedness of all types of CSTDs has yet to be identified.
4-year clinical outcomes of anterior acetabular wall reconstruction and cup revision for treatment of anterior acetabular wall defects with iliopsoas tendinopathy following total hip arthroplasty
Authors: Nogier Alexis , Tourabaly Idriss , Ramos-Pascual Sonia , Debiesse Jean-Louis , Chen Antonia F , Saffarini Mo , Courtin Cyril 
Published: December 2024

Purpose: To assess clinical and radiographic outcomes of anterior acetabular wall reconstruction and cup revision in patients with anterior acetabular wall defects and associated iliopsoas tendinopathy (IPT) following total hip arthroplasty (THA). Methods: 7 patients with IPT (defined as groin pain that increased with active hip flexion) and pre-revision computed tomography (CT) scans showing anterior acetabular wall defects and cup-iliopsoas impingement were included. During cup revision, an autologous biconvex iliac crest graft was harvested and placed over the anterior acetabular wall defect before press-fitting a revision cup. Cup inclination and anteversion, axial and sagittal cup overhang, and iliopsoas muscle strength (0–5) were evaluated pre- and post-revision. Forgotten joint score (FJS; 0–100), Oxford hip score (OHS; 0–48), hip pain (0–10), satisfaction (0–10), graft osseointegration and resorption were evaluated post-revision. Results: Pre-revision cup inclination was 43.7 ± 9.4°, anteversion was 30.4 ± 10.5°, axial overhang was 6.6 ± 7.9 mm, and sagittal overhang was 14.2 ± 4.8 mm. Immediate post-revision cup anteversion was 33.0 ± 7.9°, inclination was 45.3 ± 5.1°, while there was no axial or sagittal overhang. At 60.3 ± 5.6 (52–70) months follow-up, 6 of 7 patients were available for assessment (1 patient had died). Iliopsoas muscle strength increased from 3.9 ± 0.7 to 4.6 ± 0.9, FJS was 77.5 ± 32.8, OHS was 40.3 ± 12.8, hip pain on VAS was 0.2 ± 0.4 at rest and 2.3 ± 2.6 during activities. Patient satisfaction with surgery was 8.3 ± 2.3, but 1 patient was dissatisfied and reported persistent hip pain. Last follow-up CT scans were available for 4 of 7 patients, with 3 showing osseointegrated grafts and no graft resorption. Conclusions: Anterior acetabular wall reconstruction and cup revision resulted in satisfactory clinical outcomes at a minimum follow-up of 4 years in 5 of 7 cases. Most patients fully recovered their iliopsoas muscle strength, had minimal to no pain, excellent FJS, and an osseointegrated acetabular wall graft.