bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term prognosis of penetrating keratoplasty in a patient with limited form of Scleroderma- a case report
Authors: Anitha Venugopal , Patwardhan Veena , Ravindran Meenakshi 
Published: September 2024

Purpose To explore the challenges of managing recurrent graft rejections in patients with Macular Corneal Dystrophy (MCD) undergoing Penetrating Keratoplasty (PKP) who also have an underlying diagnosis of Systemic Sclerosis, specifically the limited form known as CREST syndrome. Methods The case of a 47-year-old female diagnosed with MCD who underwent multiple PKPs over a 13 year period was reviewed. The patients treatment included extensive surgical interventions (PKPs, amniotic membrane transplatation, tarsorrhaphy) and medical management involving systemic and topical steroids and immunosuppressive therapy (Tacrolimus ointment). Results Initial PKP surgeries improved the patients vision, but subsequently graft rejections,both acute and chronic, required further surgical and medical interventions. Despite aggressive management, the patient experienced multiple graft failures, with the final visual outcome being significantly compromised (vision 6/60). the presence of CREST syndrome complicated the management and prognosis of graft survival. Conclusion This case illustrates the significant impact of systemic autoimmune disorders like CREST syndrome on the prognosis of PKP in patients with MCD. It highlights the necessity for diligent systemic evaluation and possibly more aggressive immunosuppresive strategies to manage graft rejections and prolong graft survival in such complex clinical scenarios.
A Simple, Fast, and Reliable Method for the Identification of Candida albicans
Authors: Chiang Su Jane Fan , Chien Mei-Kuei , Tsai Chang-Yi , Hsiao Jui-Chang , Koo Fan-Hlan , Yen Yung-Feng , Chou Yi-Chang , Cheng Chih-Chien 
Published: September 2024

Background: Candida is one of the common pathogens in nosocomial infections. Culture is the gold standard for diagnosing candidemia. Candida albicans is identified via the germ tube test, which uses serum as the culture medium, which is costly and time-consuming. This study was conducted to evaluate and compare a relatively simple, fast, and reliable method for the detection of Candida albicans. Methods: We conducted this randomized case study at Taipei City Hospital (TCH) from January 2023 to August 2023, with a total of 30 specimen culture reports collected and confirmed to be cases of Candida albicans infection. A germ tube test was performed in a 37°C water bath using serum, plasma, and safe plasma products (Fresh Frozen Plasma, FFP). Further, the same procedures were repeated with the addition of 22% bovine serum albumin (BSA) to the identification/culture. Results: By adding BSA, more than 50% of the budding phenomenon was observed in 40 minutes, which shortened the diagnosis time compared with the traditional method (2-3 hours). Using BSA can shorten the identification time for early clinical medication and improve the quality of medical care Conclusion: Using safer plasma products for germ tube test of candidiasis not only reduced the risk of infection for medical technicians but could also replace the serum used in traditional methods to increase convenience and save time. This study proposed BSA as a germ tube induction medium enhancer, which reduced the culture time, thereby enabling quicker diagnosis of C. albicans infections.
Trends in Level of Implementation of the WHO FCTC Article 5.3 in India
Authors: Bassi Shalini , Chopra Mansi , Chugh Aastha , Das Shivangi , Bhojani Upendra , Nazar Gaurang P. , Amin Adhip , Dutta Jhumki , Lal Pranay , Gupta P. C. , Arora Monika 
Published: September 2024

Introduction The tobacco industry intends to ensure continuing marketing of tobacco products by influencing and interfering in tobacco control policies. This paper assessed trends of tobacco industry interference (TII), the level of implementation, and the government’s response to enforcing Article 5.3 guidelines in India to safeguard tobacco control efforts from commercial and other vested interests of the tobacco industry. Methods We conducted a descriptive comparative analysis of four consecutive India TII Indexes (January 2018-December 2021) based on the seven key 5.3 recommendations and twenty indicators to capture (i) the Level of Industry Participation, (ii) Corporate Social Responsibility (CSR) Activities, (iii) Benefits to the Tobacco Industry, (iv) Forms of Unnecessary Interactions, (v) Transparency, (vi) Conflict of Interest, and (vii) Preventive Measures. The Southeast Asia Tobacco Control Alliance’s (SEATCA) TII Index was used to undertake this assessment. Results The comparative analysis showed that the overall score of the India TII Indexes over the years decreased from 72 (2018) to 57 (2021). Improvements were shown over the years in adherence to Article 5.3 for limiting unnecessary interactions with the tobacco industry, avoiding conflicts of interest, and having preventive measures. However, major gaps were observed in restricting industry participation, regulating their so-called CSR, providing benefits to the industry in the form of incentives, exemptions, and maintaining transparency. Conclusion The study provides the status of implementing Article 5.3 and its guidelines in India. Given the gaps in the existing measures, India needs to comprehensively adopt Article 5.3 guidelinesin all states and union territories adopting whole-of-government approach. There is an urgent need to establish an observatory for periodic compilation of the TII indexes to monitor the tobacco industry and report violations at the national and sub-national levels.
Giant “Hydra Headed” Uterine Fibroid in a Nullipara: A Case Report
Authors: Igbodike Emeka , Iwuala Ijeoma , Mbonu Chijioke , Okechukwu Ugwu , Funtua Anas , Eleje George , Akinjo Andrea , Ubom Akaninyene , Ikechebelu Joseph , Anunobi Charles , Uche Onwudiegwu 
Published: September 2024

Background: Uterine fibroids, or Leiomyoma is a type of Smooth Muscle Tumors of the uterus (SMTs) and are common in the black race. Giant uterine fibroids, on the other hand, are uncommon and may occur during patient dissimulation. Dissimulation may occur because of a dread of surgery and hospitals visits, fear of surgical death, chronic intake of herbal concussion, and a religio-traditional strong belief system on instant healing following prayers, among others. Myths like belief of defecating the uterine fibroids, some herbs that can melt them away, and the belief that such illness may follow ancestral curses can fuel dissimulation. The surgical approach can be a source of challenge, careful case selection considering the size and number of tumors can be helpful. Case report: We present a 35-year-old nulligravida who presented to the clinic with a 14-year history of progressive abdominal swelling. Examination revealed a firm mass with a symphysio-fundal height of 55 cm. She subsequently had an open abdominal myomectomy with all the myoma nodules weighing 12.9 kg in total! Histology confirmed uterine fibroid. Conclusion: It is possible to offer open myomectomy in patients with giant uterine fibroid following careful patient selection with a consent for possible hysterectomy. Dissimulation can be minimized with repetitive counseling of patients. The choice of surgery depends on the size and number of uterine fibroids, but surgical approach does not necessarily influence fecundity.
Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial
Authors: Pilloni Giuseppina , Lustberg Matthew , Malik Martin , Feinberg Charles , Datta Abhishek , Bikson Marom , Gutman Josef , Krupp Lauren , Charvet Leigh 
Published: September 2024

Background: Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home. Objective: This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS. Methods: Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT). Results: The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (−5.85 ± 6.19 vs −4.23 ± 4.34, p = 0.049) and DMMPUT (−10.62 ± 8.46 vs −8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs −0.05 ± −8.27; p = 0.04). Conclusion: At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity.
Is there a prodrome to NMOSD? An investigation of neurologic symptoms preceding the first NMOSD attack
Authors: Lee Sydney , Marrie Ruth Ann , Fadda Giulia , Freedman Mark S , Lee Liesly , Muccilli Alexandra , Vyas Manav V , Konig Andrea , Rotstein Dalia L. 
Published: September 2024

Background: It is unknown whether people with aquaporin-4 antibody positive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD) experience a prodrome, although a few cases report AQP4 + serology up to 16 years before the first attack. Objectives: To evaluate whether individuals with AQP4-IgG + NMOSD have prodromal neurologic symptoms preceding the first attack. Methods: We reviewed medical records of participants meeting the 2015 diagnostic criteria for AQP4-IgG + NMOSD from four demyelinating disease centres in the Canadian NMOSD cohort study CANOPTICS. We searched for neurologic symptoms occurring at least 30 days before the first attack. Results: Of 116 participants with NMOSD, 17 (14.7%) had prodromal neurologic symptoms. The median age was 48 years (range 25–83) at first attack; 16 (94.1%) were female. Participants presented with numbness/tingling ( n = 9), neuropathic pain ( n = 5), visual disturbance ( n = 4), tonic spasms ( n = 2), Lhermitte sign ( n = 2), severe headache ( n = 2), incoordination ( n = 2), weakness ( n = 1), psychosis ( n = 1) or seizure ( n = 1). Of eight who underwent magnetic resonance imaging (MRI) brain, orbits and/or spinal cord, five had T2 lesions. Within 1.5–245 months (median 14) from the onset of prodromal neurologic symptoms, participants experienced their first NMOSD attack. Conclusions: One in seven people with NMOSD experienced neurologic symptoms before their first attack. Further investigation of a possible NMOSD prodrome is warranted.
The influence of patient sex on pulmonary embolism evaluation, treatment modality, and outcomes
Authors: Newman Joshua , Bruno Elizabeth , Allen Sorcha , Moore Jonathan , Zilinyi Robert , Khaliq Asma , Alkhafan Fahad , Vitarello Clara , Lookstein Robert , Keeling Brent , Michael Gibson C , Rosenfield Kenneth , Secemsky Eric A , Rosovsky Rachel P , Darki Amir 
Published: September 2024

Background: Pulmonary embolism (PE) is the third-leading cause of cardiovascular mortality, accounting for 100,000 deaths per year in the United States. Although sex-based disparities have previously been described in this population, it is unclear if these differences have persisted with the expansion of PE evaluation and treatment approaches. The purpose of this study is to investigate sex-based differences in the evaluation, management, and outcomes of patients with acute PE. Methods: We performed a retrospective analysis of patients enrolled in the national Pulmonary Embolism Response Team (PERT) Consortium database between October 2015 and October 2022. We evaluated patient demographics, clinical characteristics, diagnostic imaging performed, treatment at several phases of care (pre-PERT, PERT recommendations, and post-PERT), and clinical outcomes. Results: A total of 5722 patients with acute PE (2838 [49.6%] women) from 35 centers were included. There were no differences in PE risk category between male and female patients. Women were less likely to undergo echocardiography (76.9% vs 73.8%) and more likely to receive no anticoagulation prior to PERT evaluation (35.5% vs 32.9%). PERT teams were more likely to recommend catheter-based interventions for men (26.6% vs 23.1%), and men were more likely to undergo these procedures (21.9% vs 19.3%). In a multivariable analysis, female sex was a predictor of in-hospital mortality (OR 1.53, 95% CI 1.06 to 2.21). Conclusions: In this analysis, we identified sex-based differences in the evaluation and management of patients presenting with acute PE. Subsequently, women presenting with acute PE were at higher risk of in-hospital mortality.
Comparative efficacy and safety of tenofovir amibufenamide vs tenofovir alafenamide in the initial 48-week treatment of high viral load chronic hepatitis B: A single-centre retrospective study
Authors: Zhang Qing , Xu Jianhua , Liu Dan , Wang Lilin , Ren Shan , Zheng Sujun , Chen Xinyue , Qi Li , Lu Junfeng 
Published: September 2024

Background/aim Tenofovir amibufenamide (TMF) employs innovative ProTide technology and a methylation strategy to enhance the lipid solubility and plasma stability of the amide bond, providing advantages over tenofovir alafenamide (TAF). Despite promising Phase III clinical trial results demonstrating its antiviral efficacy, real-world data on TMF remains scarce. This study evaluates the antiviral efficacy and safety of TMF compared to TAF as the initial treatment in patients with high viral loads of chronic hepatitis B (CHB). Methods We retrospectively collected clinical data from March 1 2022 to June 30 2022 for highly viremic CHB patients who received either TMF ( n = 58) or TAF ( n = 32) as their initial monotherapy at Beijing YouAn Hospital. To understand the efficacy and safety of TMF over 48 weeks, we compared the virological response rates and HBeAg/HBsAg serological clearance rates between TMF and TAF groups. Also, the changes in serum creatinine, eGFR and serum lipid levels were assessed. Results Baseline median HBV DNA levels were 7.85 (6.89, 8.36) IgIU/ml for TMF and 7.44 (6.89, 8.03) IgIU/ml for TAF. Median ALT levels were 102.0 (56.0, 210.0) U/L for TMF and 195.0 (73.5, 371.0) U/L for TAF, with HBeAg positivity rates of 70.7% and 75.0%, respectively. At 48 weeks, virological response rates (HBV DNA <10 IU/ml) were 43.5% (20/46) for TMF and 42.9% (12/28) for TAF ( p = 1.000). ALT normalization rates were 87.9% for TMF and 90.6% for TAF ( p = .969), and HBeAg serological clearance rates were 21.1% and 18.2%, respectively ( p = 1.000). No patients achieved HBsAg clearance. Compared with the baseline, LDL-C levels increased, while eGFR decreased, with no significant differences in serum creatinine, triglycerides and total cholesterol levels noted at week 48 for both TMF and TAF groups. Conclusion TMF demonstrates comparable antiviral efficacy to TAF when used as initial therapy in highly viremic CHB patients, with similar impacts on renal function and lipid profiles.
Relative clause attachment preferences of late bilinguals
Authors: Mergen Filiz , Karakoç Nihal Yetkin 
Published: September 2024

Aims and Objectives/Purpose/Research Questions: This study examines how late bilinguals parse temporarily and globally ambiguous relative clauses, and whether this preference is modulated by their reading habits. Research questions are as follows: (1) Do late bilinguals’ attachment preferences differ as the task varies, for example, translating versus identifying the NP modified by the given RC? (2) Are attachment preferences influenced by locally or globally ambiguous subject relative clauses? (3) Do late bilinguals’ reading habits have any influence on their attachment preferences in the two tasks? Design/Methodology/Approach: We used a self-paced reading task and translation task with a group of late bilinguals whose native language (L1) was Turkish and who learned English (L2) as a foreign language in formal settings ( N = 43). Data and Analysis: We performed a repeated-measures analysis of variance (ANOVA) on the data. Findings/Conclusions: We found that task type influenced participants’ attachment preferences. Greater use of the second noun phrase (NP2) as opposed to the first noun phrase (NP1) was found in the translation task, regardless of ambiguity type, which shows that proficient late bilinguals were able to perform like native speakers. In the question-answer task, however, the reverse pattern observed can be interpreted either as the L1 influence, or alternatively, the underuse of syntactic information in L2, supporting the Shallow Structure Hypothesis (SSH). We found no correlation between the attachment preferences and reading habits of the participants. Originality: This study was the first to examine parsing ambiguity in RCs through a translation task. Significance/Implications: The results may be taken into consideration in a psycholinguistic approach to translation studies. Further studies may investigate ambiguity parsing by using online tasks backed by the eye-tracking method.
Experimental investigation on shear behavior of double-row perforated GFRP rib connectors in FRP-concrete hybrid beams
Authors: Xue Weichen , Yan Dawei , Wang Yongsheng , Jiang Jiafei 
Published: September 2024

Perforated GFRP rib (PFR) connectors have been used in FRP-concrete hybrid beams due to durability and ease of construction. PFR connectors are parallel FRP plates with predrilled holes positioned in the flange of FRP beams. The optimal plate spacing needs to be determined because it affects the shear performance of PFR connectors. 18 push-out tests were conducted to investigate the effect of plate spacing ( Sl), penetrating GFRP bar diameter ( d), and concrete strength ( fc) on the failure mode, capacity, and shear load-slip (P-S) curves of double-row PFR connectors. Results showed that PFR connectors suffered plate shear failure with the concrete dowel undamaged. Typical P-S curves consisted of micro-slipping and significant-slipping phases. The shear capacity and stiffness of PFR connectors were improved by 33.3% and 45.1%, respectively, by increasing the plate spacing from 1.2 h (where h denotes the plate height) to 3.2 h. The effect of plate spacing on shear capacity and stiffness could be neglected if the ratio ( Sl/ h) was more than 3.2. Specimens with a larger diameter of penetrating bar and higher concrete strength demonstrated higher capacity and stiffness. An empirical equation based on the maximum stress failure criterion was proposed to estimate the capacity of PFR connectors, considering the plate spacing effect, and verified by available data. Additionally, a description of the P-S curve was developed and calibrated by the experimental results.
Synthesis and performance study of biomass-based suppressant and its application in radioactive aerosol sedimentation
Authors: Xie Dong , Jiang Linwen , Zhang Yugui , Li Suzhe , Tang Zengming 
Published: September 2024

The decommissioning of nuclear facilities and nuclear accidents may release a various amount of radioactive aerosols, which could pose a serious threat to the natural environment and human health. Therefore, there is a need to develop an eco-friendly aerosol suppressant to control the radioactive aerosol. In this paper, carboxymethyl cellulose (CMC), polyvinyl alcohol (PVA), rhamnolipid and sophorajaponica glycolipid were selected as the raw material, and the aerosol suppressant was prepared by solution polymerization. The sample was characterized by FTIR, TGA, viscosity, surface tension and contact angle analysis. The results indicated that the grafted reaction was successful. Rhamnolipid and sophorajaponica glycolipid effectively reduced the surface tension of the copolymer solution to 27.7 mN/m, and the contact angle between the polymer solution and experimental dust was decreased to 27.36°. The aerosol sedimentation experiment showed that the suppressant had a significant effect on aerosol. The sedimentation efficiency of concrete aerosols was 87.7%, and the sedimentation efficiency of radioactive aerosols reached 90.8%. It provided an eco-friendly and effective method to quickly and easily control and remove high-concentration radioactive aerosol.
Modelling of radiation and flow fields in in-duct ultraviolet germicidal irradiation systems with and without ribs
Authors: Ye Jinjun , Wargocki Pawel , Ai Zhengtao 
Published: September 2024

In-duct ultraviolet germicidal irradiation systems (ID-UVs) is a promising technology for the development of biosecure buildings. This study explored the Computational Fluid Dynamics (CFD) method for accurately predicting the inactivation efficiency of ID-UVs. The results showed that the setting of ‘Divisions’ is crucial to the accuracy of radiation field modelling, and 15 × 15 was considered to be a reasonable value in this study. In addition, residence time and deposition ratio are two crucial parameters determining the average UV dose (AD) received by microbial particles, thereby influencing the inactivation efficiency. For ID-UVs without ribs, the Renormalization Group (RNG) [Formula: see text] model largely overestimated these two parameters, while the Reynolds Stress Model (RSM) with correcting fluctuation velocity improved the predictive accuracy of AD by 10.0%. For ID-UVs with ribs, the RNG [Formula: see text] model overestimated the eddy size and AD by 28.6% and 12.0%, respectively. The RSM model provided results closer to the Large Eddy Simulation. Adding 0.10 H (H: duct height) ribs increased the inactivation efficiency for MS2 Bacteriophage by 19.0%–64.3%, with an additional pressure drop of only 3.3 Pa. These findings contributed to a reliable CFD framework and provided novel ideas for improving inactivation efficiency.