bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Trauma Patients Aged ≥55 With PEC in Long Stay in the Hospital and Intensive Care Unit
Authors: Resto Zulmari , Luque Ilko , López Nicole , Mendez Hector , Javier Mariel , Ramirez Marcela , Morejón Orlando , McKenney Mark 
Published: November 2024

Background Trauma and pre-existing conditions (PECs) can independently impact patient hospital length of stay (H-LOS) or intensive care unit (ICU) ICU-LOS. Pre-existing conditions impact on LOS has rarely been studied in older trauma patients aged ≥55. Our purpose is to examine the relationship between PEC status and ICU-LOS and H-LOS in this population. Methods This is a 3-year retrospective study, for calendar years 2020 through 2022. Multiple linear regression was used for analysis. Confounding factors were controlled for. Statistical significance was defined as P < 0.05. Results There were 5168 patients (54.9% female) reviewed. The age breakdown was 51.6% were 70-80 years old. The injury breakdown showed 49.1% mild injury. The mean H-LOS was 6.00 and mean ICU-LOS was 2.55. Having certain PECs increases H-LOS, including congestive heart failure (CHF) by 2.29 days ( P < 0.001), chronic obstructive pulmonary disease (COPD) by 1.10 days ( P < 0.001), and chronic renal failure (CRF) by 0.96 days ( P = 0.02). Increases in ICU-LOS were associated with having certain PECs, specially CRF by 1.03 days ( P < 0.001) and CHF by 1.47 days ( P < 0.001). Conclusion Older trauma patients aged ≥55 with certain PECs had an associated increase in ICU and hospital length of stay. Identifying PEC is essential for the care and management of any patient. Identification of PECs on injured patients is essential since this can prolong the LOS. Early involvement of specialists in patient care directed to each PEC may improve these outcomes.
Exploratory study on reference intervals of calprotectin and pentraxin 3
Authors: Alfirevic Igor , Saracevic Andrea , Cicak Helena , Galic Hrvoje , Radisic Biljak Vanja , Simundic Ana-Maria 
Published: November 2024

Introduction The aim of our study was to determine reference intervals for serum pentraxin 3 and calprotectin, as well as for urine calprotectin according to the CLSI EP28-A3C guidelines for defining, establishing, and verifying reference intervals in the clinical laboratory. Materials and methods A total of 120 serum and urine samples from either healthy volunteers or outpatients were used for reference interval establishment. The participants had CRP levels, leucocyte counts, serum urea levels, creatinine levels, and estimated glomerular filtration rates (CKD-EPI eGFRs) within the reference range and no medical history of acute/chronic inflammatory diseases/conditions or cancer. Calprotectin was measured via a commercially available turbidimetric method – the Bühhlmann fCAL® Turbo Reagent Kit – while pentraxin 3 was measured using the Human Pentraxin 3 ELISA Kit from the BioVendor Group. Results The serum calprotectin reference range was ≤3.6 mg/L, the 90% CI for the upper reference range was 3.1–4.1 mg/L, while the serum pentraxin 3 reference concentration was ≤3.0 µg/L, and the 90% CI for the upper reference range being 2.7–3.2 µg/L. Additionally, the urinary calprotectin concentration was ≤1.4 mg/L, with a 90% CI for the upper reference range of 1.0–1.7 mg/L. Conclusion This study reports sample and method-specific reference intervals for the detection of various inflammatory conditions.
Mechanical and tribological characteristics of glass fiber and rice stubble-filled epoxy-LD sludge hybrid composites
Authors: Purohit Abhilash , Pradhan Priyabrat , Palanimuthu Suresh , Kumar Arvind , Chauhan Pankaj Kumar 
Published: November 2024

In this work, bidirectional rice stubble fiber (RS), Glass fiber (GF), and Linz-Donawitz sludge (LDS) are used as reinforcement for the fabrication of epoxy (EP) based hybrid composite materials. The mechanical (tensile, flexural, compressive strength), and physical (density, void content) characteristics were evaluated as per ASTM standards. The tensile, compressive and flexural strength values of neat epoxy increased from 45 to 111 MPa, 22.5 to 58 MPa and 84 to 140 MPa respectively, with the addition of 6 % RS in EP-LDS-GF-RS composites. With the continuous addition of RS content, the density of the EP-LDS-GF composite gradually decreases, while void content increases gradually within 0.1 %, but both are higher than pure resin. Dry sliding wear tests are carried out on the composites to acquire the specific rate of wear (SWrate). Taguchi’s design of experiment analysis is used to highlight the effect of various dependent parameters on SWrate. Artificial Neural Network (ANN) tool is used to predict the combined effect of different input parameters on the SWrate. From the SEM analysis, it is observed that material removal is significantly less near the region of filler content and hence the RS content is found to be the predominant control factor affecting the wear rate of the composites.
Endovenous treatment for varicose veins of the lower limbs: Comparative histological evaluation of different techniques
Authors: Palombi Luca , Caggiati Alberto , Bianchi Pier Giovanni , Morelli Monica , Martinelli Fabio , Merenda Elisabetta 
Published: November 2024

Background In recent years, tumescent ablative techniques have been joined by non-tumescent ablative techniques. The aim of the research is to study and compare the effects produced by the different endovascular ablative techniques, from the histological point of view, at the level of the venous wall (endothelium, tunica media and adventitia). Method The study involves the use of three ablative endovascular techniques (EVLA, MOCA, CGO) on bench for the treatment of the great saphenous vein. The bench procedure was performed in the same way as described in the instructions for use (IFU) of the technical specifications. Tissue samples were formalin-fixed and paraffin-embedded (FFPE). They were stained with hematoxylin and eosin and, in a case, with anti-ERG antibody (MA5-26,245, Termo Fisher). Result No perivascular tissue was present. No hematoma or perforation of the vein wall was observed. Histopathological changes after EVLA indicated that the intima including the endothelium and sub-endothelium was completely necrotized. It was observed that the thermal-energy-induced injury in the intima did not reach deeper than the media. Overview shows that in this case the damage is homogenously spread along the entire perimeter. The most evident change in the sample treated with mechanical-chemical ablation (MOCA) technique was the endothelial damage with loss of endothelial cells. Specifically, with the ERG immunostaining it was possible to observe the presence of numerous nuclei exposed towards the lumen of the vein. In the sample treated with cyanoacrylate (CGO), no significant structural alterations were observed. However, an almost complete collapse of the endoluminal walls and the presence of cyanoacrylate residues were observed. Conclusion Different histological patterns characterize the individual treatments. However, all techniques have a common feature: the damage is not transmural and the three different layers of the venous walls are always recognizable.
Flange Size Matters: A Comparative Pilot Study of the Flange FITSTM Guide Versus Traditional Sizing Methods
Authors: Anders Lisa A. , Mesite Frem Jeanette , McCoy Thomas P. 
Published: November 2024

Background: Pumping is a common practice in the United States, but it can be uncomfortable and lead to concerns about milk supply. The fit of the flange, or breast shield, used while pumping can contribute to or alleviate these problems. Flanges are available in a wide variety of sizes, and there are inconsistencies in guidance provided by healthcare providers and pump manufacturers for parents choosing a size. There have been no studies comparing different methods of sizing in terms of comfort and milk output. Research Aims: The aim of this research was to examine differences in milk output and comfort using two methods of flange sizing. Method: A within-subject cross-over design with a convenience sample of parents exclusively feeding their own human milk was used to compare comfort and milk yield between using smaller-fit and standard-fit flanges. Participants pumped for 1 week with each set of flanges and recorded milk output and comfort outcome measures. Data were collected on participant demographics, nipple measurements, and flange sizes used. Results: When compared to the newer small-size fitting, participants using the standard fit flanges had significantly less milk output (mean difference = −15.0 g, 95% CI [−25.0, −5.0], d = −0.51, p = 0.004) and less comfort (mean difference = −1.2, 95% CI [−1.6, −0.91], d = −1.23, p < 0.001). Conclusion: Flange fitting is a process that should be individualized to the patient and may require a trial of one or more sizes during a pumping session. Smaller sizes determined using this individualized process and starting with nipple tip measurement may be used without compromising milk output or comfort.
Breastfeeding Intentions, Attitudes, and Knowledge Among Medical Students in Croatia
Authors: Franić Sara , Čatipović Marija , Zakarija-Grković Irena 
Published: November 2024

Background: Medical students should have adequate knowledge and positive attitudes toward breastfeeding to support breastfeeding dyads. No studies in Croatia have explored breastfeeding knowledge, attitudes or intentions among medical students. Research Aim: To investigate breastfeeding knowledge, attitudes and intentions among medical students at the University of Split School of Medicine. Methods: A cross-sectional study was conducted from March to April 2023, using online and written questionnaires. All medical students without children were eligible to participate. The validated Breastfeeding Intentions, Attitudes, and Knowledge Questionnaire (BIAKQ) was used. Sociodemographic data were collected. Analysis was conducted using descriptive statistics, t tests, and Mann-Whitney U test. Results: A total of 357 medical students participated (response rate 64.1%). There was no significant difference between preclinical and clinical students. Students who attended the elective “Breastfeeding Medicine” demonstrated significantly more positive attitudes toward breastfeeding (Mean Rank = 215.62) than those who did not attend (Mean Rank = 173.58; U= 5468.50, p = 0.010); however, no significant difference was found in knowledge or intentions. Female students had significantly more positive attitudes compared to male students (Mean Rank = 189.47 vs. Mean Rank = 150.55, U = 9796.50, p = 0.001), whereas male students expressed significantly more positive intentions ( M = 36.97, SD = 5.26 vs. M = 34.44, SD = 5.86, t = −3.69, p = 0.002). The mean knowledge score was 11.92 ( SD = 1.43) out of 13 points. Negative attitudes towards breastfeeding beyond 1 year and breastfeeding in public were found. Conclusion: Despite adequate breastfeeding knowledge, some medical students demonstrated negative attitudes and intentions toward breastfeeding. Including breastfeeding education into core medical subjects focusing on the importance of breastfeeding for maternal and infant health and the risks of formula feeding could help improve attitudes, especially during the clinical years. It would also be important to address prevailing prejudices.
Effectiveness of acupuncture as an adjunct to cardiac rehabilitation after coronary artery bypass grafting
Authors: Roshanzamir Sharareh , Mohamadi Jahromi Leila Sadat , Zakeri Mohadese , Ghaderpanah Rezvan , Parvin Reyhaneh 
Published: November 2024

Background: Considering the importance of cardiac rehabilitation after coronary artery bypass grafting (CABG) and the development of acupuncture over the past few decades, the aim of this study was to evaluate the effects of acupuncture on patients’ exercise tolerance, heart rate and blood pressure after CABG. Methods: Thirty-four patients with a history of recent CABG were recruited between 2019 and 2020 for this clinical trial and randomly divided into two groups receiving acupuncture plus cardiac rehabilitation (group A) and cardiac rehabilitation alone (group B). In both groups, exercise-based rehabilitation exercise was performed. Group A additionally received acupuncture at PC6, PC4, HT7 and GB20 bilaterally. Changes in blood pressure, heart rate and Borg scale score were evaluated before, during and after the course of the treatment. Results: Heart rate was significantly lower in group A compared to group B after completion of the course of the treatment (P = 0.022). However, there were no statistically significant differences between the two groups in systolic or diastolic blood pressure or Borg scale scores (P > 0.05). Nevertheless, the Borg scale scores showed a significant decrease within each group over time (P < 0.001), reflecting an improvement in the patients’ ability to tolerate activity after cardiac rehabilitation with or without acupuncture. Conclusion: Acupuncture in combination with exercise-based cardiac rehabilitation was more effective at decreasing heart rate than cardiac rehabilitation alone after CABG. Both approaches appeared to be similarly effective at improving exercise tolerance. In this study, the addition of acupuncture at the aforementioned traditional acupuncture point locations to exercise-based cardiac rehabilitation did not affect blood pressure. Trial registration number: IRCT20171208037793N1 (Iranian Registry of Clinical Trials).
High Expression of ZNF208 Predicts Better Prognosis and Suppresses the Tumorigenesis of Breast Cancer
Authors: Wei Jing , Jiao Fangzheng , Wang Xiaoya , Qiao Yifan , Yuan Zihan , Liu Fang , Fang Yan , Pan Yanfang 
Published: November 2024

Background: Breast cancer (BRCA), the hormone related malignant tumor, is well-known for poor prognosis. ZNF208 mainly acts as a transcription factor in various tumors, and the single nucleotide polymorphisms (SNPs) of ZNF208 are related to telomere length. Nevertheless, its role in breast tumorigenesis is largely unknown. Methods: We systematically investigated the gene expression, prognostic value, and promoter methylation of ZNF208 in BRCA with Gene Expression Profiling Interactive Analysis (GEPIA) and DNA Methylation Interactive Visualization Database (DNMIVD). Meanwhile, we clarified the association of ZNF208 with tumor-infiltrating immune cells (TICs) from Tumor Immune Estimation Resource (TIMER). Furthermore, we determined the biological process and functional enrichment from Cancer single-cell state atlas (CancerSEA). Finally, we verified our results with prognostic analysis and immunohistochemistry (IHC) assay. Results: We discovered that ZNF208 was downregulated in breast cancer, and low expression of ZNF208 predicted worse prognosis of BRCA patients. The promoter methylation level of ZNF208 was obviously increased, and ZNF208 was associated with TlCs in BRCA. In addition, ZNF208 could inhibit the metastasis and invasion biological processes, and regulate the MAPK and RAS signaling pathways in BRCA. Conclusion: Our findings illustrate that ZNF208 can function as a tumor suppressor and predict prognosis of breast cancer.
Development and Validation of Algorithms to Identify Individuals With Cutaneous Lupus From Healthcare Databases
Authors: Guo Lisa N. , Said Jordan T. , Woodbury Michael J. , Nambudiri Vinod E. , Merola Joseph F. 
Published: November 2024

Background: There are no validated methods to identify individuals with cutaneous lupus erythematosus (CLE) from large databases including claims data and electronic health records, severely limiting the study of the epidemiology of this disease. Objectives: To develop and validate accurate algorithms to identify individuals with CLE from healthcare records. Methods: Twelve case-finding algorithms were developed based on the International Classification of Diseases (ICD)-10 diagnosis codes, provider specialty, and medication prescription data. To validate performance, algorithms were applied to a test cohort of 300 individuals drawn from a clinical data repository of a multi-institutional healthcare network in Boston, MA. Documentation of a CLE diagnosis by a dermatologist or rheumatologist determined from chart review or supportive biopsy findings was used as the case definition standard. Performance was evaluated based on calculated positive predictive values (PPVs), specificities, and sensitivities of each algorithm. Results: PPVs ranged from 58.0% to 92.9%. The use of a single diagnosis code for CLE from any provider had poor PPV. The algorithm with the highest PPV (89.0%) while maintaining sensitivity required at least 1 ICD-10 CLE diagnosis code recorded by a dermatologist. Conclusions: Utilizing CLE diagnosis codes and dermatology as the coding provider specialty is a valid method for identifying CLE patients from electronic health records.
Evaluating Difluoromethylornithine Safety and Efficacy for Non-Melanoma Skin Cancer Chemoprevention: A Systematic Review
Authors: Koulmi Kaouthar , Cattelan Leila , Litvinov Ivan V. 
Published: November 2024

Introduction: Recent FDA approval of difluoromethylornithine (DFMO), an inhibitor of ornithine decarboxylase for the prevention of neuroblastoma in children, has renewed interest in this medication for the prevention of other cancers including keratinocyte carcinomas (KCs). It has been investigated for cancer chemoprevention, including neoplasms of the colon, breast, and prostate. Methods: We assessed the current body of literature that determines DFMO efficacy and safety in non-melanoma skin cancer prevention. A systematic search of PubMed Central, and Web of Sciences was performed. Results: In this analysis, 12 studies were included evaluating 1618 patients. Most patients were Caucasian 90% (1452/1618) with a mean age of 61 years, and 73% (1214/1618) had previously been diagnosed with KC. For oral DFMO, reduction in KC was significant in 24% (291/1214) of patients. Nonsignificant reduction was observed in 17% (207/1214) of patients. The remaining studies, representing 59% (716/1214) of patients explored DFMO’s pharmacological/biological effects without elucidating its direct impact on KC. Topical DFMO shows modest efficacy in reducing the number of actinic keratosis (AK), as indicated in 4 studies representing 38.12% (154/404) of patients. For patients taking the oral eflornithine, the most frequently reported adverse events included reversible ototoxicity (11% of patients) gastrointestinal disturbances (10.39%). For the topical DFMO transient local cutaneous eruptions were common impacting 28.76% (111/386) of patients. Conclusion: Current evidence highlights the lack of conclusive data supporting the efficacy of oral DFMO, making it difficult to recommend its use. Conversely, topical DFMO demonstrates more promising outcomes in preventing AKs, presenting a potentially useful alternative in select patients.
Association between education level and disability progression in patients with multiple sclerosis in France
Authors: Lefort Mathilde , Dejardin Olivier , Berger Eric , Camdessanché Jean-Philippe , Ciron Jonathan , Clavelou Pierre , De Sèze Jerome , Debouverie Marc , Heinzlef Olivier , Labauge Pierre , Laplaud David Axel , Le Page Emmanuelle , Lebrun-Frénay Christine , Moreau Thibault , Pelletier Jean , Ruet Aurélie , Thouvenot Eric , Vukusic Sandra , Zephir Hélène , Defer Gilles , Leray Emmanuelle 
Published: November 2024

Background: Studies have reported an association between socioeconomic status and disability progression in multiple sclerosis (MS), but findings using the pre-MS individual socioeconomic status are missing. Objective: The objective was to investigate the association between education level and disability progression. Methods: All Observatoire Français de la Sclérose en Plaques (OFSEP) patients with MS clinical onset over 1960–2014, and aged ⩾25 years at MS onset were included. Education level was classified into four categories from low (primary/secondary school) to very high (master/doctoral degree). Time from MS onset to EDSS 4.0 was studied using flexible parametric survival models adjusted for age, period, and center, and stratified by phenotype (relapsing multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS)) and sex. Results: A total of 11,586 patients were included (women/men ratio = 2.5; age = 36.7 ± 8.6 years; follow-up duration 16.7 ± 9.3 years; 86.4% RMS). For women with RMS, the risk of reaching the outcome at 5 years was inversely associated with the education level (Hazard Ratio medium: 0.74 (0.63–0.87), high: 0.51 (0.43–0.62), very high: 0.39 (0.30–0.50) vs low). Results were similar for men. In PPMS, the risk was significantly different between the extreme groups (very high vs low) for women (0.45 (0.28–0.75)) and men (0.54 (0.32–0.91)), but no gradient was evident. Conclusion: Our study showed a strong association between education level and disability progression, regardless of sex and phenotype.
Emotional impact on language practices of bilingual couples: A study of discursive positioning
Authors: Stępkowska Agnieszka 
Published: November 2024

Aims: By applying the framework of positioning theory, this study seeks to gain insight into how bilingual partners position themselves and each other when emotionally conveying their thoughts and feelings. Methodology: Based on the data collected through in-depth interviews, a qualitative analysis has been conducted to obtain the sociolinguistic complexity of private discourse between bilingual couples. Since the idea of discourse as a dynamic process of negotiating meanings by individuals is placed at the core of positioning theory, conversation is viewed as a social interaction. Data and analysis: The analysis herein presents the concept of ‘role’ in narratives which shows how individuals locate themselves and each other in talk, which has been illustrated by selected excerpts. Findings and conclusions: The data analysis of the researched couples discloses a range of language practices caused by emotions. The findings provide qualitative insights by testing the positioning theory as a means to investigate bilingual couples’ talk from a micro-cultural perspective. Originality: This study enunciates positioning theory in a critical approach for a better grasp on the ways of language use in private language contact. It unfolds an account of the dynamics of emotional situations in intimate relationships. Significance and implications: The study is intended to provoke a keen reflection on the phenomenon of language use by bilingual couples. The findings contribute to the ongoing discussion of bilingual practices at home, while the exploration of bilingual couples’ talk through a positioning lens helps understand bilingualism ‘in action’.