bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of clinical internship experience on nursing students' attitudes towards death and choices of end‐of‐life care: A self‐control study
Authors: Jiang Jingyuan , Zhou Jing , Chen Xiaoli , Zhu Xiaolin , Zhang Hao , Zhang Qin , Zhang Jianna 
Published: June 2024

AbstractAimThis study aims to explore the impact of emergency department internships on the attitudes towards death among undergraduate nursing students and their preferences for end‐of‐life care settings. Additionally, the study analyzes the reasons behind nursing students' choices of end‐of‐life care settings and provides insights for improving undergraduate education on attitudes towards death and end‐of‐life care, and provide reference for the development of emergency hospice care.DesignThis study adopts an observational design with a self‐controlled before‐and‐after approach.MethodsA questionnaire survey was conducted with 96 nursing interns between July 2021 to June 2022. Demographic information and data on attitudes towards death, and preferences for end‐oflife care location were collected by online questionnaire. Paired test were conducted to compare differences between groups.ResultsThe study included a total of 96 nursing students with an average age of 21.11 years. The scores for the avoidance‐acceptance dimension of death attitudes before and after the internship were 2.40 (1.80, 3.00) and 2.20 (1.60, 3.00), respectively, showing a significant difference (Z = −2.084, p = 0.037). Factors such as gender, experience in caring for critically ill or dying patients, knowledge of death education, and discussions about death at home were found to influence nursing students' attitudes towards death. Nursing students expressed a preference for receiving end‐of‐life care and treatment in their homes or in hospice/palliative care wards, while the intensive care unit, emergency department, and nursing homes were the least preferred settings. There were significant differences in nursing students' preferences for end‐of‐life care settings before and after the internship (p = 0.000). Importantly, the number of nursing students expressing a desire to receive end‐of‐life care in the emergency department increased from 2 to 7 after the internship, while the number of students not wanting end‐of‐life care in the emergency department decreased by 5.
Anti‐PD‐(L)1‐Based Neoadjuvant Therapy in Head and Neck Carcinoma: a Meta‐analysis of Prospective Clinical Trials
Authors: Yu Yaner , Chen Haiyan , Huang Zhifei , Yuan Zhijun , Liu Lihong , Zhao Jian , Wei Qichun 
Published: June 2024

AbstractObjectiveThis meta‐analysis aims to evaluate the efficacy and safety of antiprogressive disease (PD)‐(L)1‐based neoadjuvant therapy in head and neck squamous cell carcinoma (HNSCC) patients and identify potential prognostic biomarkers.Data SourcesDatabases were systematically searched for prospective clinical trials evaluating the efficacy and safety of anti‐PD‐(L)1‐based neoadjuvant therapy for HNSCC before January 12, 2024.Review MethodsWe estimated the efficacy and safety of neoadjuvant immune checkpoint inhibitors. Subgroup and sensitivity analyses were further performed.ResultsA total of 570 patients from 20 studies were included. The pooled major pathological response (MPR), pathological complete response (pCR), and partial pathological response (PPR) rates were 30.7%, 15.3%, and 68.2%, respectively. Surgical complications, surgical delayed rate, all grade treatment‐related adverse effects (TRAEs) and ≥Grade 3 TRAEs were 0.6%, 0.3%, 82.6%, and 9.7%, respectively. Best MPR or pCR rate was detected in patients receiving neoadjuvant anti‐PD‐(L)1 therapy + radiotherapy (with MPR rate of 75.5% and pCR rate of 51.1%) and neoadjuvant anti‐PD‐(L)1 therapy + chemotherapy groups (with MPR rate of 57.5% and pCR rate of 26.7%). No differences were detected in subgroups stratified by neoadjuvant treatment cycles, human papillomavirus (HPV) status, and tumor location. Patients with baseline Combined Positive Score (CPS) ≥ 20 have higher MPR and pCR rates compared to patients with CPS < 20. High Tumor Cell Proportion Score was also associated with MPR and pCR. Objective response rate is a strong predictor of MPR (odds ratio [OR] = 7.78, 95% confidence interval [CI] = 3.20%‐18.91%) and pCR (OR = 3.24, 95% CI = 1.40%‐7.48%).ConclusionAnti‐PD‐(L)1‐based neoadjuvant therapy was effective and safe for HNSCC patients.
Is Preoperative Chemoprophylaxis Safe for Venous Thromboembolism Prevention in Patients With Head and Neck Cancer?
Authors: Isaac Heba , Arnold Mark A. , Pagedar Nitin A. , Buchakjian Marisa R. , Arnold Kiranya E. 
Published: June 2024

AbstractObjectiveTo assess the safety of preoperative chemoprophylaxis (PEC) in head and neck cancer (HNC) patients undergoing oncologic procedures.Study DesignRetrospective cohort study.SettingTertiary academic center.MethodsHNC patients with Caprini risk score (CRS) ≥5 who underwent inpatient surgery ≥3 hours between 2015 and 2020 were included. Patients were divided into 2 cohorts, PEC and control, based on whether or not they received a single dose of low molecular weight heparin or unfractionated heparin prior to surgery. The primary endpoint was the 30‐day rate of major bleeding events.ResultsA total of 539 patients were included; 427 patients received PEC prior to surgery. The rate of major bleeding was 6.7%. The PEC cohort was more likely to have received concurrent aspirin or ketorolac (225 of 427 patients vs 36 of 112 patients; P = .0002), greater duration of chemoprophylaxis (7.8 vs 5.0 days; P < .0001), have higher CRS (7.2 vs 6.6; P < .0001), longer operative times (596 vs 512 minutes; P < .0001), higher blood loss (265 vs 214 ml; P = .02), and higher bleeding rates when compared to the control (34 of 427 patients; P = .03). On multivariate analysis, only PEC was associated with bleeding (odds ratio, 8.74; 95% confidence interval, 1.15‐66.5). The rate of VTE was 1.3% and was not significantly different between cohorts.ConclusionPEC was associated with an increase in bleeding and did not result in lower rates of VTE in patients with HNC. This study highlights the need to determine the optimal regimen of chemoprophylaxis in this patient cohort.Level of Evidence3
Decreasing the Size of Bottle Caps: Helping or Hurting Children?
Authors: DiNardo Lauren A. , Vijay Arunima , Reese Alyssa D. , Alzouhayli Suma , Carr Michele M. 
Published: June 2024

AbstractObjectiveOur study aims to assess if decreasing bottle cap size was associated with more ingestions and injuries nationally.Study DesignRetrospective chart review.SettingThe National Electronic Injury Surveillance System (NEISS) database.MethodsThe NEISS was queried for bottle cap ingestions in children 0 to 18 years old between 2002 and 2021. Demographic factors including age, race, and sex of the patient were recorded. The location where the ingestion took place and the disposition of the patient were also analyzed. Data were excluded if the narrative did not specify the ingestion of a cap of a drinking bottle.ResultsA total of 415 bottle cap ingestion injuries were identified, for a national estimate of 11,683 injuries. The mean age at the time of ingestion was 10.3 ± 5.2 years and the majority of the injuries occurred in males (N = 9129, 78.4%). 46.4% (N = 5398) were Caucasian, 17.6% (N = 2046) were Black or African American, and 2.7% (N = 311) were Hispanic. 55.0% (N = 6405) of injuries occurred at an unknown location, 41.4% (N = 4781) occurred at home, and 2.8% (N = 326) occurred at school. 82.3% (N = 9584) of patients were treated in the emergency department and released, 6.9% (N = 808) were treated and admitted, 6.7% (N = 783) were treated and transferred, and 0.9% (N = 110) were held for observation. From 2002 (N = 6) to 2021 (N = 2291), there was a statistically significant increase in bottle cap ingestions (P < .001).ConclusionPlastic bottle cap ingestions have increased in children over the last 20 years, coincident with the change to smaller bottle caps.
Preparation of poly(butyl acrylate)‐grafted‐poly(styrene‐co‐acrylonitrile) particles for toughening poly(styrene‐co‐acrylonitrile) resin
Authors: Liu Mengen , Tang Qianyi , Liu Baijun , Zhang Mingyao 
Published: July 2024

AbstractHerein, the impact modifier of poly(butyl acrylate) grafted poly(styrene‐co‐acrylonitrile) (PBA‐g‐SAN) with 60% rubber content was prepared by emulsion grafting polymerization and subsequently blended with styrene–acrylonitrile copolymer (SAN) resin to construct acrylate styrene acrylonitrile (ASA) resins. The effects of acrylonitrile content of PBA‐g‐SAN copolymer and PBA size on the ASA resins' mechanical properties were investigated. Experimental results revealed that ASA resin's highest impact strength reached 27.75 kJ/m2. The lap shear adhesion test suggested that the PBA‐g‐SAN copolymer with 21% AN content exhibited excellent interfacial adhesion with SAN resin. The PBA‐g‐SAN particles with 100 and 400 nm poly (butyl acrylate) as core rubbers demonstrated a synergistic toughening effect for SAN resin. The high blackness ASA resin with excellent impact resistance was obtained when the 100 nm and the 400 nm poly (butyl acrylate) particle mass ratio reached 8/2.Highlights
The ASA resin with 27.75KJ/m2 impact strength was prepared.
The synergistic toughening mechanisms were investigated.
The high blackness ASA resin was constructed.
Außerhäusliche Mobilität von Personen ab 75 Jahren im ländlichen Raum. Ergebnisse aus einer GPS-Studie
Authors: Haeger Christine , Mümken Sandra A. , Spang Robert P. , Brauer Max , Voigt-Antons Jan-Niklas , Gellert Paul 
Published: July 2024

Zusammenfassung
Hintergrund
Außerhäusliche Mobilität, definiert als aktives und passives Bewegen durch außerhäusliche Umwelten, ist eine Ressource für Autonomie, Lebensqualität und Selbstverwirklichung im Alter. Beeinflusst wird diese multifaktoriell, was bisher vor allem im urbanen Raum untersucht wurde. Ziel der Studie ist es, assoziierte Faktoren in einer ländlichen Studienpopulation ab 75 Jahren zu untersuchen.

Methoden
Baseline-Daten der MOBILE-Studie von 212 Personen ab 75 Jahren erhoben zwischen Juni 2021 und Oktober 2022 gingen in die Analysen ein. Außerhäusliche Mobilität (GPS-basiert an 7 aufeinanderfolgenden Tagen) wurde zeitlich als Time out of Home (TOH) sowie räumlich als Convex Hull (CHull) gemessen. Gemischte Modelle berücksichtigten neben ambulanten Versorgungsparametern persönliche, soziale und umweltbezogene Faktoren sowie Kovariaten wie Alter und Geschlecht.

Ergebnisse
Die Teilnehmenden der MOBILE-Studie (MAlter 81,5, SD: 4,1, davon 56,1 % weiblich) zeigten eine tägliche außerhäusliche Mobilität von MTOH: 319,3 min; SD: 196,3 und MCHull: 41,3; SD: 132,8. Signifikante Assoziationen wurden für Alter (TOH: ß = −0,039; p < 0,001), soziales Netzwerk (TOH: ß = 0,123; p < 0,001), Zusammenleben (CHull: ß = 0,689; p = 0,035), Gesundheitskompetenz (CHull: ß = 0,077; p = 0,008), Gehwegqualität (ß = 0,366; p = 0,003), Grünflächenanteil (TOH: ß = 0,005; p = 0,047), ambulante Versorgungsinanspruchnahme (TOH: ß = −0,637; p < 0,001, CHull: ß = 1,532; p = 0,025) und aktives Autofahren (TOH: ß = −0,361; p = 0,004) gefunden.

Diskussion
Bereits bekannte multifaktorielle Assoziationen mit objektiv gemessener außerhäuslicher Mobilität konnten im ländlichen Raum bestätigt werden. Neuartig und für Forschung und Praxis relevant ist der signifikante Zusammenhang außerhäuslicher Mobilität mit der Versorgungsinanspruchnahme.
Real-time temperature control in rubber extrusion lines: a neural network approach
Authors: Lukas Marco , Leineweber Sebastian , Reitz Birger , Overmeyer Ludger 
Published: July 2024

AbstractIn rubber extrusion, precise temperature control is critical due to the process’s sensitivity to fluctuating parameters like compound behavior and batch-specific material variations. Rapid adjustments to temperature deviations are essential to ensure stable throughput and extrudate surface integrity. Based on our previous research, which initiated the development of a feedforward neural network (FNN) without real-world empirical application, we now present a real-time control system using artificial neural networks (ANNs) for dynamic temperature regulation. The underlying FNN was trained on a dataset comprising different ethylene propylene diene monomer (EPDM) rubber compounds, totaling 14,923 measurement points for each temperature value. After training, the FNN achieves remarkable precision, evidenced by a mean absolute percentage error (MAPE) of 0.68% and a mean squared error (MSE) of 0.63°C2 in predicting temperature variations. Its integration into the control system enables real-time responsiveness, allowing for adjustments to temperature deviations within an average timeframe of 68 ms. A key advantage over proportional-integral-derivative (PID) controllers is the ability to continuously learn and adjust to complex, non-linear, and batch-specific process dynamics. This adaptability results in enhanced process stability, as evidenced by inline manufacturing validation. Our paper presents the first ANN-based rubber extrusion control, demonstrating how machine learning techniques can be effectively leveraged for real-time, adaptive temperature control. Beyond rubber extrusion, this strategy has potential applications in various polymer processing and other industries requiring precise temperature control. Future trends may involve the integration of online learning techniques and the expansion of interconnected manufacturing processes.
Resolution of extravascular hemolysis with oral iptacopan monotherapy in a patient with treatment experienced paroxysmal nocturnal hemoglobinuria (PNH)
Authors: Füreder Wolfgang , Thalhammer Renate , Valent Peter 
Published: July 2024

SummaryParoxysmal nocturnal hemoglobinuria (PNH) is an acquired hematologic disorder characterized by a loss of glycosyl-phosphatidyl-inositol-linked (GPI) proteins on various hematopoietic cells. Some GPI proteins are involved in the regulation of the complement system, and their absence renders erythrocytes susceptible to complement-mediated lysis. Current standard of care in PNH is to block the complement system at the level of C5 using ravulizumab or eculizumab; however, some patients with PNH may develop extravascular hemolysis (EVH) during treatment with C5 inhibitors. The proximal complement inhibitor iptacopan has recently been shown to be efficacious in patients with PNH. This article reports on a 43-year-old female patient with PNH who was successfully treated with iptacopan. The patient had received ravulizumab for several years and developed a clinically relevant EVH. After obtaining informed consent, the patient received oral iptacopan 200 mg twice daily and ravulizumab was discontinued. Over the next few weeks hemoglobin levels and reticulocyte counts normalized. The patient reported mild flushes with erythema, chills, and mild muscle pain, all of which resolved during follow-up. No breakthrough hemolysis occurred, and no severe adverse events were recorded.
Management of external ventricular drain: to wean or not to wean?
Authors: Hallenberger Tim Jonas , Tharmagulasingam Thavena , Licci Maria , Mariani Luigi , Guzman Raphael , Soleman Jehuda 
Published: July 2024

Abstract

Purpose
External ventricular drain (EVD) is one of the most frequent procedures in neurosurgery and around 15 to 30% of these patients require a permanent cerebrospinal fluid (CSF) diversion. The optimal EVD weaning strategy is still unclear. Whether gradual weaning compared to rapid closure, reduces the rate of permanent CSF diversion remains controversial. The aim of this trial is to compare the rates of permanent CSF diversion between gradual weaning and rapid closure of an EVD.

Methods
This was a single-center, retrospective cohort study including patients between 2010 to 2020. Patients were divided into a weaning (WG) and non-weaning (NWG) group. The primary outcome was permanent CSF diversion rates, secondary outcomes included hospitalization time, EVD-related morbidity, and clinical outcome.

Results
Out of 412 patients, 123 (29.9%) patients were excluded due to early death or palliative treatment. We registered 178 (61.6%) patients in the WG and 111 (38.4%) in the NWG. Baseline characteristics were comparable between groups. The VPS rate was comparable in both groups (NWG 37.8%; WG 39.9%, p = 0.728). EVD related infection (13.5% vs 1.8%, p < 0.001), as well as non-EVD related infection rates (2.8% vs 0%, p < 0.001), were significantly higher in the WG. Hospitalization time was significantly shorter in the NWG (WG 24.93 ± 9.50 days; NWG 23.66 ± 14.51 days, p = 0.039).

Conclusion
Gradual EVD weaning does not seem to reduce the need for permanent CSF diversion, while infection rates and hospitalization time were significantly higher/longer. Therefore, direct closure should be considered in the clinical setting.
Artificial Intelligence Application in Skull Bone Fracture with Segmentation Approach
Authors: Lu Chia-Yin , Wang Yu-Hsin , Chen Hsiu-Ling , Goh Yu-Xin , Chiu I-Min , Hou Ya-Yuan , Kuo Kuei-Hong , Lin Wei-Che 
Published: July 2024

Abstract
This study aims to evaluate an AI model designed to automatically classify skull fractures and visualize segmentation on emergent CT scans. The model’s goal is to boost diagnostic accuracy, alleviate radiologists’ workload, and hasten diagnosis, thereby enhancing patient outcomes. Unique to this research, both pediatric and post-operative patients were not excluded, and diagnostic durations were analyzed. Our testing dataset for the observer studies involved 671 patients, with a mean age of 58.88 years and fairly balanced gender representation. Model 1 of our AI algorithm, trained with 1499 fracture-positive cases, showed a sensitivity of 0.94 and specificity of 0.87, with a DICE score of 0.65. Implementing post-processing rules (specifically Rule B) improved the model’s performance, resulting in a sensitivity of 0.94, specificity of 0.99, and a DICE score of 0.63. AI-assisted diagnosis resulted in significantly enhanced performance for all participants, with sensitivity almost doubling for junior radiology residents and other specialists. Additionally, diagnostic durations were significantly reduced (p < 0.01) with AI assistance across all participant categories. Our skull fracture detection model, employing a segmentation approach, demonstrated high performance, enhancing diagnostic accuracy and efficiency for radiologists and clinical physicians. This underlines the potential of AI integration in medical imaging analysis to improve patient care.
Science or scientism? On the momentum illusion
Authors: Grobys Klaus 
Published: July 2024

AbstractThis study explores the risk of the traditional momentum strategy in terms of its realized variance using various data frequencies. It is shown that momentum risk is infinite regardless of the data frequency, implying that (a) t-statistics for this strategy do not exist, (b) correlation-based metrics such as Sharpe ratios do not exist either, and (c) the momentum premium is not observable in reality. It is further shown that the time-honored lognormal distribution is unable to accurately model extreme events observed at various variance data frequencies. Finally, it is shown that the well-known effect of time aggregation does not work for this investment vehicle. Hence, the study is forced to conclude that momentum stories have no valid foundation for their claims.
The performance of transmission pipelines on February 6th, 2023 Kahramanmaras earthquake: a series of case studies
Authors: Uckan E. , Aksel M. , Atas O. , Toprak S. , Kaya E. S. 
Published: July 2024

AbstractThe Mw 7.8 earthquake that struck Kahramanmaras on February 6, 2023, caused significant damage to hydrocarbon and water transmission lines due to permanent ground deformations. Explosions occurred in the Kahramanmaras–Gaziantep Natural Gas transmission pipeline causing disruption of gas in the cities of Gaziantep and Hatay Fault Displacement Hazard. Water transmission pipelines were also damaged due to extreme fault offsets. This paper presents the findings from the earthquake affected zones. Particular attention was given to the performance of the 2600 mm diameter Duzbag–Gaziantep water transmission pipeline due to three reported challenges: (#1) The behavior of the pipe in the Duzbag tunnel, (#2) The pipe bend behavior at the fault crossing, and (#3) The pull-out of the pipe at valve room. Based on field observations, extreme damage forms at pipes were presented. A three-dimensional nonlinear numerical analysis was performed to simulate the observed damage of the reoriented water pipe at the fault crossing for Case #2. The nonlinear finite element model was able to capture the complex nature of the post-yield behavior of steel pipe as well as the damage locations along the pipe and their sequence of occurrences. As a mitigation measure for new pipes, the need for using flexible connections at critical crossings was highlighted. For existing pipes, the importance of developing secondary (by-pass) lines was emphasized.
Orbit determination from one position vector and a very short arc of optical observations
Authors: Scantamburlo Erica , Gronchi Giovanni F. , Baù Giulio 
Published: July 2024

AbstractIn this paper, we address the problem of computing a preliminary orbit of a celestial body from one topocentric position vector $$\mathcal{P}_1$$

P
1

and a very short arc (VSA) of optical observations $$\mathcal{A}_2$$

A
2

. Using the conservation laws of the two-body dynamics, we write the problem as a system of 8 polynomial equations in 6 unknowns. We prove that this system is generically consistent, namely, for a generic choice of the data $$\mathcal{P}_1, \mathcal{A}_2$$

P
1

,

A
2

, it always admits solutions in the complex field, even when $$\mathcal{P}_1, \mathcal{A}_2$$

P
1

,

A
2

do not correspond to the same celestial body. The consistency of the system is shown by deriving a univariate polynomial $$\mathfrak {v}$$
v
of degree 8 in the unknown topocentric distance at the mean epoch of the observations of the VSA. Through Gröbner bases theory, we also show that the degree of $$\mathfrak {v}$$
v
is minimum among the degrees of all the univariate polynomials solving this problem. Even though we can find solutions to our problem for a generic choice of $$\mathcal{P}_1, \mathcal{A}_2$$

P
1

,

A
2

, most of these solutions are meaningless. In fact, acceptable solutions must be real and have to fulfill other constraints, including compatibility with Keplerian dynamics. We also propose a way to select or discard solutions taking into account the uncertainty in the data, if present. The proposed orbit determination method is relevant for different purposes, e.g., the computation of a preliminary orbit of an Earth satellite with radar and optical observations, the detection of maneuvres of an Earth satellite, and the recovery of asteroids which are lost due to a planetary close encounter. We conclude by showing some numerical tests in the case of asteroids undergoing a close encounter with the Earth.