bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of Tiny (≤3 mm) Unruptured Middle Cerebral Artery Aneurysm Treatment: An Analysis of the NeuroVascular Quality Initiative-Quality Outcomes Database Cerebral Aneurysm Registry
Authors: Padmanaban Varun , Harbaugh Thaddeus , Zhu Junjia , Zhou Shouhao , Ansari Sameer A. , Howington Jay U. , Sahlein Daniel H. , Tejada Juan G. , Wilkinson D. Andrew , Simon Scott D. , Cockroft Kevin M. , Church Ephraim W. ,   on behalf of the NVQI-QOD Registry Investigators
Published: November 2024

BACKGROUND AND OBJECTIVES:
Improved imaging modalities have led to an increased detection of intracranial aneurysms, many of which are small. There is uncertainty in the appropriate management of tiny aneurysms. The objective of this study was to use a large, multi-institutional NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD) to assess the frequency, safety, and efficacy of treatment of tiny, unruptured middle cerebral artery (MCA) aneurysms.

METHODS:
The NeuroVascular Quality Initiative-Quality Outcomes Database registry was queried for patients with tiny unruptured MCA aneurysms who underwent treatment. Tiny size was defined as an aneurysm with a maximum dimension of ≤3 mm. Demographics, aneurysm characteristics, and treatment safety were queried. Outcomes included modified Rankin Score (mRS) at discharge and the last follow-up as well as aneurysm occlusion status at discharge.

RESULTS:
Of 674 treated, unruptured MCA aneurysms, 57 (8.5%) were tiny. The mean aneurysm width was 2.2 mm, and the mean patient age was 55.9 years. Most aneurysms were treated with microsurgery (61.4%, 35/57). The overall intraoperative complication rate was 5.3% (3/57), and the postoperative complication rate was 10.5% (6/57). 10.5% (6/57) of patients were discharged to rehabilitation. At discharge, 42 (87.5%) of the treated aneurysms had complete occlusion. In the subgroup of patients with recorded follow-up data, 48.3% (14/29) had a mRS of 0 at discharge and 46.9% (15/32) had an mRS of 0 at the last follow-up (median follow-up 166 days).

CONCLUSION:
Treatment of tiny, unruptured MCA aneurysms is efficacious but may have a high rate of complications. Physicians should be cautious when deciding to treat tiny, unruptured MCA aneurysms.
So the Bone Flap Hit the Floor, Now What? An In Vitro Comparison of Cadaveric Bone Flap Decontamination Procedures
Authors: Marion Alexis , Lévesque Simon , Touchette Charles , Villeneuve Samuelle-Ariane , Huppé-Gignac Béatrice , Martin Philippe , Arsenault Christine , Iorio-Morin Christian 
Published: November 2024

BACKGROUND AND OBJECTIVES:
Over the course of their career, 66% of neurosurgeons will witness someone accidentally dropping a bone flap on the floor during a craniotomy procedure. Although this event is rare, it can have significant consequences for the patient, and little literature is available to guide management of this complication. Our objective was to compare 5 bone flap decontamination protocols for efficacy in reducing bacterial load, with the goal of safely reimplanting the dropped flap.

METHODS:
Cadaveric human bone flaps were contaminated with common operating room (OR) contaminant bacteria. The bone flaps were then subject to 1 of 5 decontamination protocols: washing in saline, mechanical debridement, washing in antibiotics, washing in alcoholic chlorhexidine antiseptic, and flash decontamination in autoclave. Inoculum from the flaps was then used to grow bacteria in petri dishes, and bacterial load after decontamination was assessed. Some flaps were physically dropped on an OR floor to simulate and evaluate a real-life contamination.

RESULTS:
The observed contamination from a flap dropped on an OR floor can be significant (up to 1070 colony-forming units cultured per flap). All protocols tested decreased bacterial load of the bone flaps to different degrees: saline by 95.7%, mechanical debridement by 97.5%, antibiotic bath by 99.5%, alcoholic chlorhexidine by 99.9%, and flash sterilization by 100.0%. Flash sterilization led to significant alterations in the flap's physical appearance.

CONCLUSION:
In the event of the accidental fall of a bone flap, decontamination by rinsing in an alcohol–chlorhexidine solution followed by 3 successive washes in saline seemed to provide the best balance between effectiveness, safety, and complexity of the method.
Biphasic DNA damage and non-canonical replication stress response govern radiation-induced senescence in glioblastoma
Authors: Ghorai Atanu , Singh Bhawna , Dutt Shilpee 
Published: November 2024

ABSTRACT
Therapy-induced senescence (TIS) in glioblastoma (GBM) residual disease and escape from TIS account for resistance and recurrence, but the mechanism of TIS manifestation remains obscure. Here, we demonstrate that replication stress (RS) is critical for the induction of TIS in residual cells by employing an in vitro GBM therapy-resistance cellular model. Interestingly, we found a ‘biphasic’ mode of DNA damage after radiation treatment and reveal that the second phase of DNA damage arises majorly in the S phase of residual cells due to RS. Mechanistically, we show that persistent phosphorylated ATR is a safeguard for radiation resilience, whereas the other canonical RS molecules remain unaltered during the second phase of DNA damage. Importantly, RS preceded the induction of senescence, and ATR inhibition resulted in TIS reduction, leading to apoptosis. Moreover, ATR inhibition sensitized PARP-1 inhibitor-induced enhanced TIS-mediated resistance, leading to cell death. Our study demonstrates the crucial role of RS in TIS induction and maintenance in GBM residual cells, and targeting ATR alone or in combination with a PARP-1 inhibitor will be an effective strategy to eliminate TIS for better treatment outcomes.
A rare case of incarcerated obturator hernia in an elderly female: Importance of timely diagnosis and choice of surgical intervention – open or laparoscopic
Authors: Resanovic Vladimir , Resanovic Aleksandar , Loncar Zlatibor 
Published: November 2024

Obturator hernia is a rare clinical condition, mainly affecting the elderly and frail patients. It is often challenging to diagnose, and carries a significant morbidity and mortality risk. We aim to highlight the importance of timely and adequate diagnosis followed by early intervention that can be done as open or laparoscopic. Furthermore, through a literature review, we intend to compare two types of surgical approaches (open vs. laparoscopic). Herein, we present the case of an 83 years old female admitted as an emergency with right lower quadrant, colicky abdominal pain, followed with nausea, vomiting and constipation. Computed Tomography (CT) scan revealed a right-sided incarcerated obturator hernia with proximal bowel distension. Emergency surgery was performed, emphasizing the importance of early intervention to prevent bowel necrosis and the need for bowel resection; due to asthma we opted for open approach. Intraoperatively, a right-sided incarcerated obturator hernia was confirmed, with a segment of small bowel herniating through the obturator canal. We discuss the role of CT scanning in diagnosis, the necessity of prompt surgical management, and the possibility of open and laparoscopic approaches through a literature review. The choice between open and laparoscopic approaches should be individualized, considering the patient’s clinical status and the potential risks and benefits of each technique. Further research comparing the long-term results of open versus laparoscopic repair in incarcerated obturator hernia is something to be explored in the efforts of achieving the highest standards of patient care and maximizing the chances for an optimal treatment outcome.
doi: https://doi.org/10.12669/pjms.40.11.9994
How to cite this: Resanovic V, Resanovic A, Loncar Z. A rare case of incarcerated obturator hernia in an elderly female: Importance of timely diagnosis and choice of surgical intervention – open or laparoscopic. Pak J Med Sci. 2024;40(11):-2755-2758. doi: https://doi.org/10.12669/pjms.40.11.9994
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A Model of Shoppertainment Live Streaming
Authors: Gu Zheyin (Jane) , Zhao Xuying , Wu D. J. 
Published: November 2024

“Shoppertainment” live streaming, a blend of entertainment and product selling, is becoming increasingly popular. In shoppertainment sessions, streamers face bandwidth constraints so balance between providing product information and entertainment (such as singing, dancing, and storytelling). We conceptualize a shoppertainment live streamer as a novel type of online retail platform that maximizes total commissions from selling a range of manufacturer products. Our study investigates how streamers can leverage entertainment bandwidth as a long-term strategy to influence manufacturers’ pricing decisions and consumers’ attendance, as well as purchasing behaviors. Our model reveals several intriguing findings. First, we find that higher entertainment bandwidth encourages more manufacturers to adopt a demand-oriented, low-pricing strategy to attract buyers rather than a margin-oriented, high-pricing strategy that appeals only to buyers who perceive a high likelihood of finding a suitable product. Second, we observe that an increase in entertainment bandwidth initially boosts consumer traffic to shoppertainment sessions, but this trend may reverse once the bandwidth becomes excessively high, indicating an inverted U-shaped relationship. Conversely, the streamer’s expected profit per attending consumer first decreases and then increases with higher entertainment bandwidth, forming a U-shaped relationship. Third, our results suggest that a commission-maximizing streamer facing bandwidth constraints should not exclusively focus on providing product information. Instead, it is advantageous to allocate significant bandwidth to entertainment, even with limited entertaining capability, and potentially beneficial to dedicate all bandwidth to entertainment if the capability is substantial. Lastly, we demonstrate that the streamer’s quality threshold moderates the impact of entertainment bandwidth on these dynamics. This paper was accepted by David Simchi-Levi, information systems. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2023.01724 .
Student Perspectives on Using the Self-Determined Learning Model of Instruction to Enhance Outcomes
Authors: Alsaeed Abdulaziz H. , Shogren Karrie A. , Scott LaRon A. , Taylor Josh P. , Raley Sheida K. , Henley Ryan C. , Zagona Alison L. , McDonald Annette F. , Hagiwara Mayumi 
Published: November 2024

Abstract
Research shows that there is a close relationship between the promotion of self-determination and positive school outcomes, including academic goal attainment outcomes in general education classes. However, research is needed to investigate how students perceive the impacts of evidence-based self-determination interventions, like the Self-Determined Learning Model of Instruction (SDLMI), when delivered by their general education teachers. Interviews were conducted with 10 students with and without disabilities who received SDLMI instruction from teachers in secondary general education classrooms. Qualitative content analysis was used to understand students’ experiences with the SDLMI and its impacts on their self-determination and academic learning. Participants shared ways that the SDLMI positively impacted their self-determination and academic learning outcomes. Students identified the impacts of providing opportunities and supports for self-determined learning in their classrooms. They also identified other factors that influence their self-determination and the use of the SDLMI for goal setting and attainment. Implications for research and practice are discussed.
Simple indices of infarct size post ST-Elevation Myocardial Infarction (STEMI) provides similar risk stratification to cardiac MRI
Authors: Sharma Lokesh , Faour Amir , Nguyen Tuan , Dimitri Hany , Vo Giau , Otton James , Burgess Sonya , Juergens Craig , French John 
Published: November 2024

Introduction
Myocardial Infarct Size (IS) determined soon after ST-segment elevation myocardial infarction (STEMI) has prognostic significance, and can be assessed by cardiac biomarker levels, electrocardiographic (ECG) parameters, and imaging modalities (including echocardiography and cardiac magnetic resonance imaging [CMRI]).

Objectives and methods
We evaluated methods of IS assessment, 12-lead ECG Selvester QRS scores and high-sensitivity Troponin T (hsTnT) levels measured ≥48hr (plateau phase of hsTnT elevation), compared to paired CMRIs and echocardiograms, in a prospective cohort of patients with STEMI undergoing percutaneous coronary intervention (PCI) during the index hospitalisation. Associations were determined between IS, as assessed by these methods, and 24-month major adverse cardiac events (MACE), a hierarchical composite of: death, stroke and hospitalization for heart failure.

Results
Of 233 patients undergoing early CMRI after STEMI, 211 patients (86% male; 54% anterior MI) had first STEMIs, median age 56 years [interquartile range 50–64], of whom 165 (78%) underwent primary PCI and 46 (22%) pharmaco-invasive PCI. Ejection fraction improved from 48% [42–54] acutely to 52% [44–60] at 2 months (p< 0.05). Plateau phase hsTnT levels, QRS scoring and CMRI-determined IS post-STEMI correlated for anterior MIs (all comparisons r>0.4, p<0.01); highest tertiles of these 3 parameters predicted 24 month MACE (log-rank <0.01). Multi-variable binary logistic regression analysis showed 72h hsTnT levels predicted 24-month MACE (p<0.01).

Conclusion
Post-PCI treatment of STEMI, hsTnT levels measured ≥48h and Selvester QRS scoring correlated with CMRI-determined IS. These parameters predicted MACE at 24 months and should be routinely assessed for post-STEMI risk stratification.
Comparing dual oral agents plus insulin vs. Triple oral agents in uncontrolled type II diabetes: A pilot study
Authors: Gul Nadia , Rehman Inayat Ur , shah Yasar , Ali Arbab Muhammad , Ali Zahid , Shehzad Omer , Goh Khang Wen , Ming Long Chiau , Suleiman Amal K. 
Published: November 2024

Introduction
Type II Diabetes mellitus (T2DM) patients often do not achieve glycemic control with oral hypoglycemic agents (OHAs). There are two main approaches to address this challenge: transitioning to a triple OHA regimen, or adding Insulin to the existing dual OHA regimen.

Aim
This study aimed to compare the efficacy of adding Insulin to dual OHAs (Sitagliptin + Metformin) against adding a third OHA to Sitagliptin + Metformin in achieving glycemic control among patients with uncontrolled T2DM.

Method
A pre-post study was conducted between 21 September 2023 and 21 December 2023 at Services Hospital Peshawar, Pakistan. Patients with uncontrolled T2DM with >7% HbA1c were divided into group 1 (Sitagliptin + Metformin plus a third OHA), and group 2 (Sitagliptin + Metformin plus pre-mixed Insulin 70/30). Glycemic control based on HbA1c values, fasting and random blood sugar levels, lipid profile, and body weight were evaluated after 3 months of therapy. The pre- and post- effect was compared by using a paired t-test.

Results
The study included n = 80 patients with T2DM. Between groups 1 and 2, no significant difference was found in HbA1c values (9.1 vs. 9, with p = 0.724). However, BMI, cholesterol, and LDL significantly decreased in group 1 compared to group 2 (p<0.001 vs. p = 0.131, p = 0.023 vs. p = 0.896, and p = 0.003 vs. p = 0.395, respectively). Additionally, the incidence of hypoglycemic episodes was significantly lower in group 1 (7.5%) than in group 2 (47.5%, p = 0.004). No significant difference was observed between the triple OHA and dual OHA plus Insulin regimens in achieving glycemic control.

Conclusion
The triple OHA regimen improved BMI, cholesterol, and LDL levels, and reduced hypoglycemic episodes more effectively than dual OHA plus Insulin, despite similar HbA1c outcomes, suggesting it may be preferable for uncontrolled T2DM.
Clinical staff reported knowledge on the existence of clinical governance protocols or tools utilised in selected South African hospitals
Authors: Sithole Nomfuneko , Chitha Wezile W. , Mnyaka Onke R. , Ncinitwa Akhona B. A. , Nomatshila Sibusiso C. , Ntlongweni Xolelwa , Maake Kedibone , Mkabela Bongiwe E. , Khosa Ntiyiso V. , Ngcobo Ziyanda B. , Chitha Nombulelo , Masuku Khanyisile , Mabunda Sikhumbuzo A. 
Published: November 2024

Introduction
Clinical governance outlines duties and responsibilities as well as indicators of the actions towards best possible patient outcomes. However, evidence of outcomes on clinical governance interventions is limited in South Africa. This study determined knowledge of clinical staff about the existence of clinical governance protocols/tools that are utilised in selected South African hospitals.

Methods
A cross-sectional study conducted among randomly sampled clinical staff at Nelson Mandela Academic (NMAH), St Elizabeth in the Eastern Cape Province and, Rob Ferreira (RFH) and Themba Hospitals in the Mpumalanga Province of South Africa. A self-administered survey questionnaire was used to collect demographic information and quality improvement protocols/tools in existence at the hospitals. Data were captured in Excel spreadsheet and analysed with STATA. Knowledge was generated based on the staff member’s score for the 12 questions assessed.

Results
A total of 720 participants were recruited of which 377 gave consent to participate. Overall, 8.5% (32/377) of the participants got none or only one correct out of the 12 protocols/tools; and 65.5% (247/377) got between two and five correct. The median knowledge scores were 41.7% (interquartile range (IQR) = 16.7%) in three of the hospitals and 33.3% (IQR = 16.7%) at NMAH (p-value = 0.002). Factors associated with good knowledge included more than five years of experience, being a professional nurse compared to other nurses, not working at NMAH as well as being a medical doctor or pharmacist compared to other staff. Overall, 74.0% (279/377) of the respondents scored below 50%; this was 84.4% (92/109) at NMAH and 66.3% (55/83) at RFH and this difference was statistically significant (p-value = 0.017).

Conclusion
Despite clinical governance implementation, there was low knowledge of clinical governance protocols/tools among clinical staff. Therefore, providing more effective, relevant training workshops with an emphasis on importance of local ownership of the concept of clinical governance, by both management and clinical staff is of great importance.
Association of tobacco purchasing behaviors with tobacco use by user groups during the COVID-19 pandemic: A mixed methods analysis
Authors: Kute Nikita G. , Ashley David L. , Spears Claire A. , Nyman Amy L. , Henderson Katherine C. , Do Vuong V. , Huang Jidong , Popova Lucy 
Published: November 2024

Purpose
To understand changes in purchasing behaviors and use of tobacco products such as e-cigarettes and cigarettes among different tobacco user groups during the COVID-19 pandemic using a mixed methods approach.

Methods
A quantitative online survey was conducted in October-November 2020 using a national probability sample of US adults (N = 1,460) comprising exclusive cigarette smokers (n = 1,080), dual users of both cigarettes and e-cigarettes (n = 143), and exclusive e-cigarette users (n = 237). Simultaneously, ten online focus groups were conducted with 61 adults in the Atlanta, GA area including exclusive smokers (n = 16), current E-cigarette users (n = 22), and transitioning (recently quit or currently quitting) smokers and/or E-cigarette users (n = 23).

Results
From the survey, dual users vs. exclusive smokers had higher odds of buying cheaper cigarette brands (adjusted odds ratio (aOR) 2.50, 95% confidence interval (CI) = 1.49, 4.20), buying cigarettes online (aOR = 2.79; 95% CI = 1.02, 7.69), buying from Indian Reservations (aOR = 3.99; 95% CI = 2.07, 7.69), buying fewer cigarettes than normal (aOR = 4.01; 95% CI = 2.42, 6.65) and buying other tobacco products (aOR = 4.44; 95% CI = 2.24, 8.79). From the focus groups, participants perceived reduced accessibility, fear of contracting COVID-19, rising prices, and convenience to influence their purchasing behaviors and tobacco use.

Conclusions
Exclusive and dual users differed in their tobacco purchasing behaviors during the COVID-19 pandemic, such that dual users were more likely to change their purchasing behaviors (e.g., buying other tobacco products) than exclusive users. Educational campaigns and public health workers may promote interventions targeting dual users either to switch to reduced-risk products or quit smoking, particularly during stressful societal situations such as the COVID-19 pandemic.

Implications
The findings inform public health educators and policymakers to develop policies and interventions carefully tailored for tobacco user groups targeting the perceived factors influencing purchasing behaviors during challenging situations affecting tobacco product availability.
Silver Treasures from the Land of Sheba: Regional Yemeni Jewelry, Marjorie Ransom (2023)
Authors: Summatavet Kärt 
Published: November 2024

Review of: Silver Treasures from the Land of Sheba: Regional Yemeni Jewelry, Marjorie Ransom (2023)
Cairo, NY: The American University in Cairo Press, 264 pp.,
ISBN 978-1-64903-333-8, p/bk, £40.00, $44.95
Prairie Interlace: Weaving, Modernisms, and the Expanded Frame, 1960–2000, Michele Hardy, Timothy Long and Julia Krueger (eds) (2023)
Authors: Nimkulrat Nithikul 
Published: November 2024

Review of: Prairie Interlace: Weaving, Modernisms, and the Expanded Frame, 1960–2000, Michele Hardy, Timothy Long and Julia Krueger (eds) (2023)
Calgary: University of Calgary Press, 248 pp.,
ISBN 978-1-77385-486-1, h/bk, $99.99
ISBN 978-1-77385-487-8, p/bk, $59.99
ISBN 978-1-77385-489-2, e-book (institutional PDF)
ISBN 978-1-77385-490-8, e-book (ePub)
Development of Time-Aggregated Machine Learning Model for Relapse Prediction in Pediatric Crohn's Disease
Authors: Jang Sooyoung , Yu JaeYong , Park Sowon , Lim Hyeji , Koh Hong , Park Yu Rang 
Published: November 2024

INTRODUCTION:
Pediatric Crohn's disease (CD) easily progresses to an active disease compared with adult CD, making it important to predict and minimize CD relapses. However, prediction of relapse at various time points (TPs) during pediatric CD remains understudied. We aimed to develop a real-time aggregated model to predict pediatric CD relapse in different TPs and time windows (TWs).

METHODS:
This retrospective study was conducted on children diagnosed with CD between 2015 and 2022 at Severance Hospital. Laboratory test results and demographic data were collected starting at 3 months after diagnosis, and cohorts were formed using data from 6 different TPs at 1-month intervals. Relapse—defined as a pediatric CD activity index ≥ 30 points—was predicted, and TWs were 3–7 months with 1-month intervals. The feature importance of the variables in each setting was determined.

RESULTS:
Data from 180 patients were used to construct cohorts corresponding to the TPs. We identified the optimal TP and TW to reliably predict pediatric CD relapse with an area under the receiver operating characteristic curve score of 0.89 when predicting with a 3-month TW at a 3-month TP. Variables such as C-reactive protein levels and lymphocyte fraction were found to be important factors.

DISCUSSION:
We developed a time-aggregated model to predict pediatric CD relapse in multiple TPs and TWs. This model identified important variables that predicted relapse in pediatric CD to support real-time clinical decision making.