bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disposal practices, knowledge and attitude of adult patients visiting outpatient pharmacy services towards unused medicines in Debre Tabor, Northwest Ethiopia: a descriptive cross-sectional study
Authors: Yazie Taklo Simeneh , Siyum Zekarias , Assefa Ayenew , Teshome Assefa Agegnehu , Belete Abebe Muche , Debasu Addisu Zenaw 
Published: October 2024

ObjectiveAccumulation at home and improper disposal of unused medicines pose a major public health problem. Knowledge and attitude of patients may contribute to accumulation and disposal practice of unused medicines. As there are no such data at the study setting, this study aimed to assess disposal practices, knowledge and attitude of adult patients visiting outpatient pharmacy (OPD) towards unused medicines.DesignDescriptive cross-sectional design.SettingDebre Tabor Comprehensive Specialized Hospital, Debre Tabor, Ethiopia.ParticipantsAdults who visited OPD services agreed to participate and were selected using systematic random sampling technique from 31 May to 30 June 2022. Data were collected through face-to-face interview using a questionnaire.Data analysisData were entered and analysed using SPSS V.26.0. Variables of interest were described in frequency and presented in tables.ResultsIn total, 257 participants were included in the analysis. Of these, 55.6% were male. The prevalence of unused medicines at home was 47.5%. The majority of respondents (183, 71.2%) knew that improper disposal of unused medicines could cause harm. However, more than half of respondents did not know about medicine waste and had no prior information about medicine disposal instructions. Regarding their attitude, 203 (79%) of respondents ‘agreed’ that there are potential risks associated with having unused medicines at home, and 163 (63.4%) ‘strongly agreed’ that children are more vulnerable to the risks associated with unused medicines. The most preferred disposal practice for unused medicines was throwing them in household garbage (108, 42%) followed by flushing down the toilets/sinks (77, 30%).ConclusionThe majority of participants disposed of unused and expired medicine in household garbage and toilets/sinks. This is in contrast to the recommendations of national and international policies and guidelines for safe and appropriate pharmaceutical waste disposal.
Impact of developmental language disorders on mental health and well-being across the lifespan: a qualitative study including the perspectives of UK adults with DLD and Australian speech-language therapists
Authors: Wilmot Adrienne , Boyes Mark , Sievers Rachel , Leitão Suze , Norbury Courtenay 
Published: October 2024

ObjectiveThis study aims to explore the educational, occupational and socioemotional experiences of people with developmental language disorder (DLD) across the lifespan to gain insight into risk and protective factors for mental health.DesignQualitative analysis of focus groups and written submissions. Data were combined and analysed using Braun and Clarke’s reflexive thematic analysis approach within a critical realist framework.SettingSoutheast England and Western Australia.ParticipantsSix adults with DLD from England and five speech-language therapists from Western Australia participated in focus groups and/or contributed written responses to the research team.ResultsWe developed four themes: ‘perspectives on diagnosis and living with an invisible disability’ explores participants’ perspectives on diagnosis, the difficulty getting a diagnosis and perceptions of DLD as widely misunderstood; ‘school struggles and self-esteem from past to present’ details school experiences and their impact on mental health; ‘DLD across the lifespan’ explores DLD in adulthood with a focus on workplace difficulties, emotional well-being and mental health; ‘A sense of belonging: communication, connection and support’ provides a lived experience account into the social participation difficulties of adults with DLD and the importance of social support.Conclusions and implicationsAdults with DLD may experience poor self-esteem, anxiety and depression. These mental health concerns may result from (a) exhaustion due to masking/compensating for neurodevelopmental differences, (b) loneliness and/or disempowerment due to difficulties with social interaction and (c) adverse experiences such as bullying, discrimination and a lack of appropriate accommodation at school and in the workplace. A lack of awareness and support for people with DLD from health, education and employment providers was also seen as a contributing factor to poor mental health. Diagnosis may serve a protective function for mental health via self-understanding, self-esteem and self-advocacy.
New constraints to subduction zone arc and backarc mantle temperatures: a test of the corner flow model
Authors: Hyndman Roy D. , Wang Kelin 
Published: October 2024

The heat source for the hot volcanic arc of subduction zones and the uniformly warm backarc is not well understood, particularly where backarc extension is absent. In the widely studied corner flow model, the traction of the underthrusting plate drags down the overlying viscous mantle, and the induced shallower seaward flow brings in heat from the landward and deeper asthenosphere. However, earlier comparisons with observations, especially backarc heat flow, gave poor agreement. There are several new constraints to the temperatures and structures above the underthrusting plate and in the backarc, especially those in western North America, for comparison with model predictions. Seismic receiver functions map horizontal boundaries, including the lithosphere–asthenosphere boundary (LAB). Seismic shear wave tomography gives mantle velocity–depth that provides an approximate proxy for temperature. Attenuation of seismic wave speed indicates high temperature or partial melting. The presence of recent backarc volcanics and their geochemistry give the depth and temperature of the LAB. From these constraints in western North America, the LAB reflects ponding of partial melt, is consistently at a depth of 65 ± 3 km and temperature of 1350 ± 25 °C, and overlies nearly constant temperature (adiabatic) asthenosphere across the backarc from Mexico to Alaska. These depth and temperature estimates are greatly different from corner flow model predictions. An alternative hypothesis more consistent with these constraints is vigorous small-scale convection in the backarc asthenosphere. Whether or how this convection coexists with the large-scale flow patterns inferred from the interpretation of seismic anisotropy analyses and to what degree it prevails in the arc–forearc region deserve further research.
Optimal Layout of Urban Green Space System Based on the Coupling Model of Spatial Reconstruction
Authors: Liu Wei , Jiang Wei , Ding Chengcheng , Mei Xiaoqing , Zhou Hanzhang 
Published: October 2024

In the layout of urban planning, the rational design of green land includes the optimal choice of landscape and vegetation, which needs to solve the conflict of local/global optimal solution and understand the rationality of urban green layout with multi-objective natural language. According to the demand for multi-objective optimal solutions in urban green land planning, we study the target deep learning algorithm based on space vector mutation operation. In this paper, we propose to search for a local optimal solution based on Diversity Indicator Double and Niched Local Search Evolutionary Algorithm diversity fitness and filter the information of objective space and decision space through the niche method. It intends to avoid the imbalance between the diversity of goal space and decision space caused by the wrong distance information. By improving genetic diversity, we take the complex changes of gene vector reaction in generating offspring as the research focus. Based on the improvement of multi-objective non-dominated genetic variation, we search for the optimal transfer function relationship in the primary stage of variation to achieve the goal. For high-dimensional planning with constraints, we first select the coupling model to reduce the dimension, and then combine the spatial reconstruction data clustering to complete the clustering. Priority is given to the optimal selection of the output of the non-dominated solution set obtained in each stage to improve the algorithm’s performance. Experiments show that the proposed algorithm, combined with the use of different mutation strategies, outperforms the current mainstream algorithms in solving multi-objective problems of natural language understanding, especially in solving complex relational problems, which is 10.2% and 15.6% higher than other algorithms. The frequency of parameter operation can be updated in real-time, which strengthens the convergence effect of the algorithm. It is proved that the research content of this paper has better application potential in multi-objective spatial decision-making. The research content of this paper can not only achieve intelligent layout optimization for urban green space system but also carry out reasoning for large-scale spatial layout. The effect is higher than the current mainstream algorithm and plays a role in promoting science and technology for future urban construction and long-term planning.
Incidence of Chronic Thromboembolic Pulmonary Hypertension After Pulmonary Embolism in the Era of Direct Oral Anticoagulants: From the COMMAND VTE Registry‐2
Authors: Ikeda Nobutaka , Yamashita Yugo , Morimoto Takeshi , Chatani Ryuki , Kaneda Kazuhisa , Nishimoto Yuji , Kobayashi Yohei , Ikeda Satoshi , Kim Kitae , Inoko Moriaki , Takase Toru , Tsuji Shuhei , Oi Maki , Takada Takuma , Otsui Kazunori , Sakamoto Jiro , Ogihara Yoshito , Inoue Takeshi , Usami Shunsuke , Chen Po‐Min , Togi Kiyonori , Koitabashi Norimichi , Hiramori Seiichi , Doi Kosuke , Mabuchi Hiroshi , Tsuyuki Yoshiaki , Murata Koichiro , Takabayashi Kensuke , Nakai Hisato , Sueta Daisuke , Shioyama Wataru , Dohke Tomohiro , Kimura Takeshi ,   the COMMAND VTE Registry‐2 Investigators
Published: October 2024

Background
Chronic thromboembolic pulmonary hypertension (CTEPH) is a life‐threatening complication post‐acute pulmonary embolism (PE). The assessment of CTEPH incidence and risk factors post‐acute PE in the era of direct oral anticoagulants remains insufficient.

Methods and Results
The COMMAND VTE Registry‐2 (contemporary management and outcomes in patients with venous thromboembolism registry‐2) is a multicenter registry that recruited consecutive patients with acute symptomatic venous thromboembolism from 31 centers across Japan. The primary outcome was to demonstrate the detection rate of CTEPH after acute PE in routine clinical practice. Out of the 5197 patients with venous thromboembolism included in the COMMAND VTE Registry‐2, 2787 were diagnosed with acute PE. Following a median follow‐up duration of 747 days, 48 cases of CTEPH were detected, and the cumulative diagnosis of CTEPH in routine clinical practice was 2.3% at 3 years. Independent risk factors for the detection of CTEPH by multivariable Cox regression analysis included women (hazard ratio [HR] 2.09 [95% CI, 1.05–4.14]), longer interval from symptom onset to diagnosis of PE (each 1 day, HR 1.04 [95% CI, 1.01–1.07]), hypoxemia at diagnosis (HR 2.52 [95% CI, 1.26–5.04]), right heart load (HR 9.28 [95% CI, 3.19–27.00]), lower D‐dimer value (each 1 μg/mL, HR 0.96 [95% CI, 0.92–0.99]), and unprovoked PE (HR 2.77 [95% CI, 1.22–6.30]).

Conclusions
In the direct oral anticoagulant era, the cumulative diagnosis of CTEPH after acute PE was 2.3% at 3 years, and several independent risk factors for CTEPH were identified, which could be useful for screening a high‐risk population after acute PE.
Oncocytic Adrenal Neoplasms: Clinical Profiles and Long-Term Outcomes
Authors: Sada Alaa , Joseph Josiane , Alsibai Reem , Habermann Elizabeth B. , Foster Trenton R. , Lyden Melanie L. , Dy Benzon M. , Bancos Irina , McKenzie Travis J. 
Published: October 2024

Background: Oncocytic adrenal neoplasms, defined by ≥90 % of oncocytic cells, are rare. The significance of oncocytic changes within an adrenal neoplasm remains unclear. Methods: A retrospective study of adults who underwent adrenalectomy at a large center identified pure oncocytic neoplasms on final pathology (1997-2022). Neoplasms were categorized based on Lin-Weiss-Bisceglia system as malignant, benign, or of uncertain malignant potential. Analysis was performed using Fisher exact, Kruskal-Wallis tests, and Kaplan-Meier analysis. Results: Among a total of 33 patients, 24% had benign, 36% malignant, and 39% neoplasm of uncertain malignant potential. None of the benign neoplasms recurred, while 50% of the malignant neoplasms recurred (median of 40 months). Two of 13 neoplasms initially thought to be of uncertain malignant potential recurred as distant metastatic adrenocortical carcinoma at 11 and 25 months, over a median follow-up duration of 31 months. Ki67% was available for 20 patients: median (IQR) Ki67% was 5 (1, 5) for benign, 10 (6, 15) for malignant, and 6.5 (5, 10) for neoplasms of uncertain behavior, P = 0.05. Recurred neoplasms had higher Ki67% at initial resection compared to cases that did not recur. Conclusion: While oncocytic adrenal neoplasms are rare, a significant proportion are malignant or have malignant potential. Judicious follow-up is required for oncocytic adrenal neoplasms of uncertain malignant potential, as they can recur as metastatic adrenocortical carcinoma. Ki67% should always be obtained in cases of malignancy or uncertain malignant potential as it can predict recurrence. Larger studies are needed to evaluate the appropriate follow-up protocols for these neoplasms.
Analysis of data from a national micronutrient survey with a linear mixed model: estimates, predictions and lessons for future surveys
Authors: Pswarayi Hakunawadi Alexander , Joy Edward J M , Gashu Dawd , Sandalinas Fanny , Belay Adamu , Lark R Murray 
Published: October 2024

Background: Because micronutrient deficiencies affect public health, countries monitor population status by national-scale, multi-stage, micronutrient surveys (MNS). In design-based surveys, inclusion probabilities are specified for sample units and the corresponding sample weights allow design-unbiased estimates to be made of population parameters. Corrections may be possible on departures from the design; an alternative is to use linear mixed models (LMM), with an estimated covariance structure reflecting the sampling design, to obtain model-based estimates. Design: The Ethiopia National Micronutrient Survey (2016) specified inclusion probabilities at enumeration area (EA) and household (HH) levels, and sample weights are provided. However, the design was not followed as it would have resulted in insufficient sampling from women of reproductive age. Results: Having found no evidence that sample weights were informative for target serum micronutrient concentrations (Zn), we estimated LMM parameters, with Regions as fixed effects, and the variation of individuals nested within households, households within EA, and EA within regions, random effects. We obtained LMM standard errors, Best Linear Unbiased Estimates (BLUEs) of regional means, and empirical Best Linear Unbiased Predictions for sampled/unsampled EA and HH. The probability that each true regional mean exceeded the sufficiency threshold [Formula: see text] was evaluated. The variances of BLUEs of regional means, under alternative sampling designs, were bootstrapped from LMM variance components. Conclusions: We demonstrate use of LMM to obtain model-unbiased estimates and predictions when surveys deviate from the original design; and the use of LMM variance components to evaluate alternative designs for further sampling, or for sampling comparable populations.
Effect of Dexmedetomidine on Rescue Analgesic Needs in Non-intubated Intensive Care Patients
Authors: Andrei Sophie E. , Zhuo Wenxin , Shiekh Kellie N. , Reinert Justin P. 
Published: October 2024

Background: Dexmedetomidine is a centrally acting alpha-2-adrenoceptor agonist that is usually used in the intensive care unit (ICU) for its sedative, analgesic, and anxiolytic properties. Studies have shown that dexmedetomidine can be an effective adjunct analgesic, but they are limited and usually use a population of intubated patients. To better evaluate the role of dexmedetomidine use in the adult ICU, more information needs to be gathered on its analgesic effect and its utility in non-intubated patients. Methods: This study was a retrospective cohort analysis between adult non-intubated ICU patients on dexmedetomidine and non-intubated ICU patients not on dexmedetomidine who were admitted to a 302-bed tertiary academic medical center between October 1, 2022, and August 31, 2023. Inclusion criteria necessitated an as-needed opioid order with a corresponding pain score and at least 1 other pain assessment and no history of symptomatic bradycardia, nor could it be present on admission. The primary study objective was to assess the amount of morphine milligram equivalents (MMEs) received during ICU admission with concomitant dexmedetomidine infusion. Secondary outcomes included the time to first dose of rescue opioid analgesia and ICU length of stay. Results: A total of 38 patients were included. Baseline demographics did not differ significantly between groups. There was a significant statistical difference in the total amount of MMEs received, with the dexmedetomidine group having significantly less than the control group ( P < 0.001). The dexmedetomidine group also had a significantly longer time to first rescue analgesia dose ( P = 0.025) and a significantly increased incidence of delirium ( P < 0.001). There was no difference in other adverse events between groups. Conclusion: Dexmedetomidine significantly decreased MME requirements and increased time to first rescue analgesia dose in non-intubated ICU patients without increasing adverse effects but was associated with an increased incidence of delirium.
Modelling Method and Meshing Characteristics of a Novel Curve-Surface Conjugate Internal Gear Drive
Authors: Ye Xinxin , Zhang Luhe , Wang Dongyu , Jiang Jingming , Luo Wenjun , Chen Bingkui 
Published: October 2024

AbstractSpace exploration has become a major focus in the field of technology, with gear transmissions in aerospace equipment playing a crucial role. In the extreme environment of space, gear transmissions face challenges like large temperature differentials, deformation and maintenance difficulties, which will severely impact transmission accuracy and service life. To meet the growing demands for high-performance gear transmissions with high transmission efficiency and error adaptability in the aerospace field, this paper proposes a novel curve-surface conjugate internal gear drive consisting of an involute internal gear and a curve-surface gear. The fundamental theory of curve-surface conjugation is introduced, and the construction method for curve-surface gear based on a selected contact path and meshing tube is presented. The analysis models including induced curvature, sliding ratio and tooth contact analysis with errors (ETCA) are simulated to evaluate the meshing characteristics. Additionally, prototypes are manufactured and experimental setups are established to validate the transmission performance. These results indicate that as the rotational speed increases, the transmission efficiency of the curve-surface conjugate internal gear drive improves, which is contrary to the trend observed in involute gear drives. And the transmission efficiency of the curve-surface conjugate internal gear drive surpasses that of the involute gear drive at higher rotational speeds. Moreover, this novel gear drive exhibits excellent error adaptability, maintaining intact contact paths and high transmission efficiency even in the presence of assembly errors. This study provides new ideas for the design and manufacture of high-performance gear transmissions from the perspective of spatial geometric elements.
Screening of hub genes for sepsis-induced myopathy by weighted gene co-expression network analysis and protein-protein interaction network construction
Authors: Wang Jianhao , Han Kun , Lu Jinshuai 
Published: October 2024

AbstractSepsis-induced myopathy is one of the serious complications of sepsis, which severely affects the respiratory and peripheral motor systems of patients, reduces their quality of life, and jeopardizes their lives, as evidenced by muscle atrophy, loss of strength, and impaired regeneration after injury. The pathogenesis of sepsis-induced myopathy is complex, mainly including cytokine action, enhances free radical production in muscle, increases muscle protein hydrolysis, and decreases skeletal muscle protein synthesis, etc. The above mechanisms have been demonstrated in existing studies. However, it is still unclear how the overall pattern of gene co-expression affects the pathological process of sepsis-induced myopathy. Therefore, we intend to identify hub genes and signaling pathways. Weighted gene co-expression network analysis was our main approach to study gene expression profiles: skeletal muscle transcriptome in ICU patients with sepsis-induced multi-organ failure (GSE13205). After data pre-processing, about 15,181 genes were used to identify 13 co-expression modules. Then, 16 genes (FEM1B, KLHDC3, GPX3, NIFK, GNL2, EBNA1BP2, PES1, FBP2, PFKP, BYSL, HEATR1, WDR75, TBL3, and WDR43) were selected as the hub genes including 3 up-regulated genes and 13 down-regulated genes. Then, Gene Set Enrichment Analysis was performed to show that the hub genes were closely associated with skeletal muscle dysfunction, necrotic and apoptotic skeletal myoblasts, and apoptosis in sepsis-induced myopathy. Overall, 16 candidate biomarkers were certified as reliable features for more in-depth exploration of sepsis-induced myopathy in basic and clinical studies.