bluuebunny/crossref_metadata_2025_split huggingface dataset:
How a Child Understands Death: Attachment Theory Perspective
Authors: Aleem Sadia 
Published: August 2024

Background: Little is empirically known about how young children understand death or how this perception is affected by their attachment to parents. Method: One hundred and ten children between the ages of 5 and 10 years participated in this study, which assessed both children’s understanding of death and their fear of death. Parental attachment style was measured using parental self-report. Results: A correlation analysis found that a greater understanding of death was associated with lower levels of death anxiety when the children were securely attached. These results provide some empirical support for the widespread belief that discussing death and dying in biological terms is the best way to alleviate the fear of death in young children when parents have a strong bond with their children. Conclusion: Understanding of death and fear of death in children are associated with an insecure parental attachment style.
Advance-selling strategies under platform competition
Authors: Zhang Zhi-jian , Li Chao-hao , Li Guang-quan , Zhou Ya-di , Wan Mi-yu 
Published: August 2024

With the competition between e-commerce platforms intensifying, advance-selling has gradually become a mainstream marketing strategy. This article establishes a mathematical model of competition between two platforms and retailers, considering four scenarios: spot-sale only, advance-selling only, spot-sale with coupons, advance-selling with coupons. The study explores the impact mechanism of platform competition on advance-selling strategies. The results show that when the advantage of product evaluation is large, the unit transaction cost is small or the product cost is low, the retailers should actively adopt the advance-selling scheme with discount pricing. Compared with low-value products, high-value products are priced higher and have greater demand, which can bring higher revenue to the retailers and the platforms. The benefits of the advance-selling scheme are limited, but the issuance of coupons could increase the revenue of both platforms and retailers, and the value of platform coupons in the spot-sale market is higher. JEL Classification: L81, C79
Investigating fabric interlayer effects on tensile loading limits of adhesively bonded single-lap composite joints
Authors: Taş Hamza , Soykok Ibrahim Fadil 
Published: August 2024

This paper investigates enhancing the effectiveness of glass fiber/epoxy composite single-lap bonded joints by using fabric interlayers between the adherends. It was aimed to evaluate the changes in the joint tensile strength depending on the parameters such as different interlayer fabric types (S2-glass fabric and Kevlar fabric), numbers of interlayers (0, 1, 2, and 3), clamping pressure (0, 4, and 6 MPa), and temperature (20, 55, and 80°C) applied to the joint region throughout the curing period. Significant enhancements in peak tensile forces were observed by varying these parameters. The most substantial increase in tensile properties was achieved for the joint with two-layer S2 fabric fabricated at 4 MPa pressure and 55°C curing temperature, denoted as “2L-S2-P4-T55.” Compared to a non-layered joint, those with 1, 2, and 3 S2 fabric interlayers exhibited 35.5%, 39.6%, and 45.2% increases in tensile peak force, respectively. Increasing bonding pressure from 0 MPa to 4 MPa resulted in a 5.2% tensile failure load increase for double S2 fabric interlayered joints cured at 20°C, but a 6.7% decrease at 6 MPa. Using one-layer Kevlar fabric instead of one-layer S2 fabric caused a 15.2% drop in tensile peak force, still 14.9% higher than the non-layered joint.
The Effects of Opioid Administration on Clostridioides Difficile Infection: A Retrospective Cohort Study
Authors: Anderson Erin , Brown Brooke Hendrix , Brown Skyler , Freeman Nikki , Yates John R. 
Published: August 2024

Background: Clostridioides difficile ( C. difficile) is a leading cause of healthcare-associated infections. Using opioids while infected with C. difficile may hypothetically lead to reduced clearance of the organism and higher risk of progressing to severe or fulminant infection. Objective: The objective of this study was to determine if opioid use leads to worsening of C. difficile infection. Methods: This was a single-center, retrospective cohort study of patients with C. difficile infection. The primary endpoint was progression to severe or fulminant disease, defined as serum creatinine greater than 1.5 mg/dL or over 50% of baseline, white blood cells above 15,000 cells/mm3, shock requiring vasopressors, ileus, toxic megacolon, or vancomycin dose increase. Secondary outcomes included hospital length of stay and time to resolution of diarrhea. The groups were stratified based on average morphine milligram equivalents received during the treatment. Results: A total of 73 patients were included in the non-opioid group and 93 patients in the opioid group. The composite outcome occurred in 16 patients (21.9%) without opioids vs 26 patients (28.0%) with opioids; ( P = 0.37). The average length of stay was 7.2 days without opioids and 9.3 days with opioids ( P = 0.11) and the average time to resolution of diarrhea was 3.5 days without opioids and 5.5 days with opioids ( P = 0.40). Conclusion: There was no significant difference in the rate of progression to severe or fulminant disease. There was a numerical trend towards increase in progression in patients who had opioids, primarily driven by those who had higher dosages of opioids used.
Study on the allowed maximum amplitudes of low-order polygonal wear on resilient wheels based on operational safety
Authors: Zhong Shuoqiao , Zhou Xin , Sheng Xiaozhen , Hou Chuanlun , Qi Yuan , Baeza Luis 
Published: August 2024

Following the extensive use of resilient wheels on trams, several subways in China have started pre-launch testing of resilient wheels. While it remains at an early stage, the long-term behavior of the wheel has become a great concern for subway operators and wheel suppliers. To address the concern, this study focuses on derailment risk by evaluating the allowed maximum amplitudes of low-order polygonal wear on resilient wheels. Firstly, a metro vehicle-track dynamic system model equipped with resilient wheels is built. Then, based on the operation safety index and current re-profiling regulations for conventional wheels, the influence of wheel axial and radial stiffness on the radial amplitude limits of resilient wheel polygonal wear is analyzed. To perform the analysis, firstly the commonly-used stiffness for a resilient wheel (300 kN/mm in radial direction and 50 kN/mm in axial direction) is adopted to study the effect of resilient wheel polygonization on wheel load reduction ratio. Then, wheel load reduction ratio is predicted for different radial (up to 600 kN/mm) and axial (up to 100 kN/mm) stiffnesses of the resilient wheel and different orders (up to 10) of wheel polygonization of 1 mm amplitude. A contour plot is provided to illustrate how the wheel load reduction ratio varies with the harmonic order and amplitude of wheel polygonization under different combinations of resilient wheel’s equivalent axial and radial stiffnesses. It is found that, with the increase of the amplitude of the polygonal wear of a certain harmonic order on resilient wheel, the number of the available combinations of the equivalent stiffnesses adopted by the resilient wheel becomes less by considering the operation safety indexed with wheel load reduction ratio. Besides, depending on the stiffness of the resilient wheel, the allowed amplitude corresponding to the polygonization of each order has been suggested with the contour plots.
Non-invasive Assessment of Microstructural Changes After CyberKnife Radiosurgery for Trigeminal Neuralgia Using Diffusion Tensor Imaging
Authors: Raja Rabbi Jebus 
Published: August 2024

Background and Aims: Given the absence of a universally accepted non-invasive and objective clinical tool to predict a patient’s response to stereotactic radiosurgery for Trigeminal Neuralgia (TN), this research endeavoured to appraise the potential of Diffusion Tensor Imaging as a predictive tool in managing TN. Objective: This study aimed to assess microstructural changes in the trigeminal nerve following CyberKnife radiosurgery (CKRS) for TN using diffusion tensor imaging (DTI) and to correlate these changes with clinical outcomes. Methods: Twenty-eight TN patients treated with CKRS underwent pre and 4-month post-treatment Three-Tesla magnetic resonance imaging scans with DTI metrics, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were collected. Clinical outcomes were assessed using the Barrow Neurological Institute Pain Intensity Score (BNI-PIS) at fourth, sixth and ninth months post-CKRS. Results: Twenty-four patients reported good pain relief (responders), while four patients did not experience adequate relief (non-responders). Responders exhibited significantly lower FA (mean drop of 13.8%, P < .001) and lower RA (mean drop of 16.1%, P < .001) compared to non-responders. RD, AD and MD remained constant across the study cohort. Conclusion: DTI metrics, particularly FA and RA, at 4 months post-CKRS, emerged as predictors of long-term treatment effectiveness for TN. These findings suggest the potential utility of DTI in evaluating microstructural changes in the trigeminal nerve post-CKRS and predicting clinical outcomes.
Australian specialised mental healthcare labour shortages: Potential interventions for consideration and further research
Authors: Looi Jeffrey CL , Allison Stephen , Bastiampillai Tarun , Hensher Martin , Kisely Steve , Robson Stephen J 
Published: August 2024

Objective Specialised mental healthcare delivery is highly labour intensive, and the COVID-19 pandemic has exacerbated workforce shortfalls. We explore the information on the mental healthcare labour supply in Australia from a health policy viewpoint. Our purpose is to stimulate discussion, further research and development of interventions. Conclusions The mental healthcare labour market has a number of features that make it prone to shortages and other distortions. These include: the labour-intensive nature of healthcare work;, long-training periods; that traditional policy levers like pay are only partially effective; as well as other challenges in retaining and recruiting mental health nurses and psychiatrists, especially in public mental health services. Further research is needed to develop and evaluate effective interventions.
Effect of Immune Thrombocytopenic Purpura Medications on Depression Risk: An Analysis of NHANES Data
Authors: Zheng Feiyue , Yu Zhengwei , Zhang Zhang , Miao Jinli , Wang Wenmin , Wu Jiaying , Rao Yuefeng 
Published: August 2024

Background: Immune thrombocytopenic purpura (ITP) in adults typically develops slowly and insidiously. The ITP medications might be linked to psychological disorders, but the connection is not well-understood. Objective: This study aimed to examine the association between ITP medication use and the risk of depression among participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Methods: Using data from 70 190 NHANES participants, we conducted a cross-sectional study, excluding individuals under 18 years, with hypertension, HIV, hepatitis C, and various comorbidities. A total of 17 299 individuals were included in the analysis of this study. We identified 2 populations within this study: those using ITP medications, including prednisone, dexamethasone, and rituximab and those not using ITP drugs. Depression status was assessed using the Patient Health Questionnaire–9 (PHQ-9), and the relationship between ITP medication use and depression was analyzed through multivariate logistic regression. Results: There was no significant association between ITP medication use and an increased risk of depression after adjusting for demographic and health-related variables. Notably, among the study participants, 1.8% of the non-depressed population were on ITP medication compared with 0.3% in the depressed population. The analysis revealed varying depression risks associated with different sociodemographic factors. For instance, the correlation between ITP medication and depression risk was influenced by a combination of age, race, income, and smoking status. Conclusion and Relevance: The study suggests that ITP medication use does not independently increase the risk of depression. This finding is crucial for guiding clinical decisions and managing patient expectations regarding ITP treatment and its psychological impacts.
Aberrant HIF1- α and SIX-1 Expression is Associated with Poor Prognosis in Acute Myeloid Leukemia Patients with Isocitrate Dehydrogenase 1 Mutations
Authors: Ali Tariq , Usman Rohma , Shah Syed Alasar , Parvez Aamir , Anwar Summayya , Muneer Zahid , Saeed Muhammad 
Published: August 2024

Background IDH1 mutations are common in many cancers, however, their role in promoting the Warburg effect remains elusive. This study elucidates the putative involvement of mutant-IDH1 in regulating hypoxia-inducible factor (HIF1-α) and Sine-Oculis Homeobox-1 (SIX-1) expression. Methodology Genetic screening was performed using the ARMS-PCR in acute myeloid leukemia (AML), brain, and breast cancer (BC) cohorts, while transcript expression was determined using qPCR. Further, a meta-analysis of risk factors associated with the R132 mutation was performed. Results Approximately 32% of AML and ∼60% of glioma cases were mutants, while no mutation was found in the BC cohort. ‘AA’ and TT’ were associated with higher disease risk (OR = 12.18 & 4.68) in AML and had significantly upregulated IDH1 expression. Moreover, downregulated HIF1-α and upregulated SIX-1 expression was also observed in these patients, suggesting that mutant-IDH1 may alter glucose metabolism. Perturbed IDH1 and HIF-α levels exhibited poor prognosis in univariate and multivariate analysis, while age and gender were found to be contributory factors as well. Based on the ROC model, these had a good potential to be used as prognostic markers. A significant variation in frequencies of R132 mutations in AML among different populations was observed. Cytogenesis ( R2 = 12.2%), NMP1 mutation status ( R2 = 18.5%), and ethnic contributions ( R2 = 73.21%) were critical moderators underlying these mutations. Women had a higher risk of R132 mutation (HR = 1.3, P < 0.04). The pooled prevalence was calculated to be 0.29 (95% CI 0.26-0.33, P < 0.01), indicating that IDH1 mutations are a significant prognostic factor in AML. Conclusion IDH1 and HIF1-α profiles are linked to poor survival and prognosis, while high SIX-1 expression in IDH1 mutants suggests a role in leukemic transformation and therapy response in AML.
Evaluation of oral silymarin formulation efficacy in prevention of doxorubicin induced hepatotoxicity in patients with non-metastatic breast cancer
Authors: Fatemi Shandiz Ashkan , Karimi Gholamreza , Dayyani Mahdiyeh , Hosseini Sare , Elyasi Sepideh 
Published: August 2024

IntroductionChemotherapy-induced hepatotoxicity is a common complication in breast cancer patients, especially with doxorubicin-containing regimens. Liver enzyme abnormality is reported in 34.8% of patients undergoing AC-T regimen and fatty liver is reported in 30% to 50% of cases. Antioxidant and anti-inflammatory properties of silymarin, a polyphenolic flavonoid extract derived from Silybum marianum, may be useful in preventing chemotherapy-induced hepatotoxicity. This study evaluated the effect of oral silymarin for preventing doxorubicin induced hepatotoxicity in non-metastatic breast cancer patients.MethodsIn this triple-blind, placebo-controlled clinical trial, 50 patients with non-metastatic breast cancer were assigned to receive either 140 mg silymarin tablets or the placebo three times daily for 63 days and were evaluated for liver function test before the study and at the end of each chemotherapy cycle (every 3 weeks) for 4 cycles. In addition, an ultrasonography assessment was performed upon entry and the end of the study.ResultsBased on ultrasonography, the fatty liver grade was significantly higher in the placebo group at the end of the study. Moreover, the serum levels of aspartate aminotransferase ( p = 0.015) and alkaline phosphatase ( p = 0.004) at 6-week intervals, and the serum level of alkaline phosphatase ( p = 0.002) at 9-week intervals were significantly lower in the silymarin group.ConclusionOral formulation of silymarin 420 mg/day for 63 days significantly prevented hepatotoxicity caused by doxorubicin in patients with non-metastatic breast cancer mostly based on liver ultrasonography but not laboratory parameters. Further investigations are suggested on different doses, durations and formulations of silymarin, particularly nano-formulations for increasing its oral bioavailability.
Evaluating ChatGPT's efficacy and readability to common pediatric ophthalmology and strabismus-related questions
Authors: Ahmed H Shafeeq , Thrishulamurthy Chinmayee J 
Published: August 2024

Introduction The rise in popularity of chatbots, particularly ChatGPT by OpenAI among the general public and its utility in the healthcare field is a topic of present controversy. The current study aimed at assessing the reliability and accuracy of ChatGPT's responses to inquiries posed by parents, specifically focusing on a range of pediatric ophthalmological and strabismus conditions. Methods Patient queries were collected via a thematic analysis and posed to ChatGPT 3.5 version across 3 unique instances each. The questions were divided into 12 domains totalling 817 unique questions. All responses were scored on the response quality by two experienced pediatric ophthalmologists in a Likert-scale format. All questions were evaluated for readability using the Flesch-Kincaid Grade Level (FKGL) and character counts. Results A total of 638 (78.09%) questions were scored to be perfectly correct, 156 (19.09%) were scored correct but incomplete and only 23 (2.81%) were scored to be partially incorrect. None of the responses were scored to be completely incorrect. Average FKGL score was 14.49 [95% CI 14.4004–14.5854] and the average character count was 1825.33 [95%CI 1791.95–1858.7] with p = 0.831 and 0.697 respectively. The minimum and maximum FKGL scores were 10.6 and 18.34 respectively. FKGL predicted character count, R²=.012, F(1,815) = 10.26, p = .001. Conclusion ChatGPT provided accurate and reliable information for a majority of the questions. The readability of the questions was much above the typically required standards for adults, which is concerning. Despite these limitations, it is evident that this technology will play a significant role in the healthcare industry.
Retinal layer thinning for monitoring disease-modifying treatment in relapsing multiple sclerosis—Evidence for applying a rebaselining concept
Authors: Bsteh Gabriel , Hegen Harald , Krajnc Nik , Föttinger Fabian , Altmann Patrick , Auer Michael , Berek Klaus , Kornek Barbara , Leutmezer Fritz , Macher Stefan , Monschein Tobias , Ponleitner Markus , Rommer Paulus , Schmied Christiane , Zebenholzer Karin , Zulehner Gudrun , Zrzavy Tobias , Deisenhammer Florian , Di Pauli Franziska , Pemp Berthold , Berger Thomas 
Published: August 2024

Background: Employing a rebaselining concept may reduce noise in retinal layer thinning measured by optical coherence tomography (OCT). Methods: From an ongoing prospective observational study, we included patients with relapsing multiple sclerosis (RMS), who had OCT scans at disease-modifying treatment (DMT) start (baseline), 6–12 months after baseline (rebaseline), and ⩾12 months after rebaseline. Mean annualized percent loss (aL) rates (%/year) were calculated both from baseline and rebaseline for peripapillary-retinal-nerve-fiber-layer (aLpRNFLbaseline/aLpRNFLrebaseline) and macular-ganglion-cell-plus-inner-plexiform-layer (aLGCIPLbaseline/aLGCIPLrebaseline) by mixed-effects linear regression models. Results: We included 173 RMS patients (mean age 31.7 years (SD 8.8), 72.8% female, median disease duration 15 months (12-94) median baseline-to-last-follow-up-interval 37 months (18-71); 56.6% moderately effective DMT (M-DMT), 43.4% highly effective DMT (HE-DMT)). Both mean aLpRNFLbaseline and aLGCIPLbaseline significantly increased in association with relapse (0.51% and 0.26% per relapse, p < 0.001, respectively) and disability worsening (1.10% and 0.48%, p < 0.001, respectively) before baseline, but not with DMT class. Contrarily, neither aLpRNFLrebaseline nor aLGCIPLrebaseline was dependent on relapse or disability worsening before baseline, while HE-DMT significantly lowered aLpRNFLrebaseline (by 0.31%, p < 0.001) and aLGCIPLrebaseline (0.25%, p < 0.001) compared with M-DMT. Conclusions: Applying a rebaselining concept significantly improves differentiation of DMT effects on retinal layer thinning by avoiding carry-over confounding from previous disease activity.
Therapeutic Effect of Stem Cells from Different Sources on Diabetic Foot Ulcers: Systematic Review and Network Meta-Analysis
Authors: Tao Yuqi , Yu Yang , He Chengdong , Guo Weiguang 
Published: August 2024

Aim To evaluate the efficacy of stem cell therapy from different sources on the ankle-brachial index, wound closure percentage, and wound closure time in the treatment of diabetic foot ulcers (DFUs). Methods A literature search was conducted in PubMed, Embase, Cochrane Library's Central Register of Controlled Trials, and Web of Science, extending through June 29, 2023. Quality evaluation was done using the Cochrane's bias risk assessment tool (RoB 2.0). Employing a Bayesian approach, the statistical computations was executed with the JAGS software, leveraging the gemtc 0.8-2 and rjags 4-10 libraries, within the R environment 4.1.2. The included interventions came from peripheral blood, bone marrow, placenta, umbilical cord blood, adipose tissue, or others. Result A preliminary search identified 2286 articles, of which 23 randomized controlled trials met the inclusion criteria and were ultimately included. The analysis findings indicated that mesenchymal stem cells derived from the umbilical cord (HUCMSCs) led to a notable enhanced the ankle-brachial index in patients with DFUs compared to standard treatment (MD: 0.2; 95% CI [0.01, 0.36]). HUCMSCs were found to be the optimal therapeutic approach for enhancing the ankle-brachial index (SUCRA = 82.7%). Research on the wound closure percentage revealed that compared to platelet-rich plasma (PRP), processed microvascular tissue (PMVT), peripheral blood stem cells (PBSCs), microfragmented adipose tissue (MFAT), autologous bone marrow-derived stem cell therapy (ABMSCT), adipose-derived stem cells (ASCs), and dehydrated human umbilical cord allograft (EpiCord), Huoxue Shengji Decoction (HXSJD) + ABMSCT (H_Group_hematopoietic) significantly increased the wound closure percentage in DFU patients ( P < 0.05). According to the SUCRA ranking, HXSJD + ABMSCT was the best therapeutic method to increase the percentage of wound closure (SUCRA = 93.8%). Conclusion This study employed a network meta-analysis method, combining direct and indirect comparisons, to analyze the latest clinical data and concluded that umbilical cord mesenchymal stem cells and the combination of HXSJD + autologous bone marrow hematopoietic stem cell treatment as adjunctive therapies for DFUs may have beneficial effects. Future research needs to focus on this.