bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid and non-opioid analgesic regimens after fracture and risk of serious opioid-related events
Authors: Hart Kyle , Medvecz Andrew J , Vaidya Avi , Dusetzina Stacie , Leech Ashley A , Wiese Andrew D 
Published: July 2024

BackgroundNon-opioid analgesics are prescribed in combination with opioids among patients with long bone fracture to reduce opioid prescribing needs, yet evidence is limited on whether they reduce the risk of serious opioid-related events (SOREs). We compared the risk of SOREs among hospitalized patients with long bone fracture discharged with filled opioid prescriptions, with and without non-opioid analgesics.DesignWe identified a retrospective cohort of analgesic-naïve adult patients with a long bone fracture hospitalization using the Merative MarketScan Commercial Database (2013–2020). The exposure was opioid and non-opioid analgesic (gabapentinoids, muscle relaxants, non-steroidal anti-inflammatory drugs, acetaminophen) prescriptions filled in the 3 days before through 42 days after discharge. The outcome was the development of new persistent opioid use or opioid use disorder during follow-up (day 43 through day 408 after discharge). We used Cox proportional hazards regression with inverse probability of treatment weighting with overlap trimming to compare outcomes among those that filled an opioid and a non-opioid analgesic to those that filled only an opioid analgesic. In secondary analyses, we used separate models to compare those that filled a prescription for each specific non-opioid analgesic type with opioids to those that filled only opioids.ResultsOf 29 489 patients, most filled an opioid prescription alone (58.4%) or an opioid and non-opioid (22.0%). In the weighted proportional hazards regression model accounting for relevant covariates and total MME, filling both a non-opioid analgesic and an opioid analgesic was associated with 1.63 times increased risk of SOREs compared with filling an opioid analgesic only (95% CI 1.41 to 1.89). Filling a gabapentin prescription in combination with an opioid was associated with an increased risk of SOREs compared with those that filled an opioid only (adjusted HR: 1.84 (95% CI1.48 to 2.27)).ConclusionsFilling a non-opioid analgesic in combination with an opioid was associated with an increased risk of SOREs after long bone fracture.Level of evidenceLevel III, prognostic/epidemiological.Study typeRetrospective cohort study.
Coupled inductor interleaved boost converter with ANN and RNN based MPPT algorithm for PV system
Authors: Kavin K. S. , Karuvelam P. Subha , Kumar Naresh , Kar Siddheswar , Rahiman Riyaz A. , Patwa Sharda 
Published: July 2024

An efficient machine learning approach for accomplishing the maximum power point tracking (MPPT) system for photovoltaic (PV) systems is proposed in this work. PV system is one of the most suitable renewable energy sources (RES) for electric vehicles (EV) based operations due to its ubiquitous availability and speed of installation. The deployment of PV-powered EVs reduces the quantity of carbon dioxide emitted into the atmosphere substantially. The primary objective of this research is to integrate a PV system with an EV load and to provide a constant power supply to the EV load with no distortions. A coupled inductor interleaved boost converter is used to raise voltage level of the PV because it has a wide conversions range with low leakage reaction times. Furthermore, the converter produces a consistent output with no fluctuations and high voltage gain. With the application of artificial neural network (ANN) based MPPT and recurrent neural network (RNN) based MPPT, the converter operational performance enhanced with steady dc link voltage is obtained. Consequently, it is stated that the employment of ANN and RNN-based MPPT controllers in PV-based systems offers improved DC link voltage regulation and lower power losses, thereby boosting system effectiveness. The MATLAB platform is used to test every component of the system's performance, and the findings show that the proposed system is more efficient than alternative approaches.
Magnitude of emergence agitation, its interventions and associated factors among paediatric surgical patients
Authors: Aniley Habtamu Tilahun , Mekuria Samrawit Tassew , Kebede Mebratu Abraha , Gebreanania Alembrhan Hagos , Muleta Mahteme Bekele , Aniley Tafere Tilahun 
Published: July 2024

Abstract
Background
Emergence agitation is a transient confusional state of a child associated with consciousness from general anaesthesia, commonly occurs in the postoperative setting which delays their recovery and exposes them to traumas. The main objective of the current study was to investigate the magnitude of emergence agitation, its interventions and associated factors among paediatric surgical patients at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Methods
Hospital based cross-sectional study with prospective follow-up framework was conducted on a paediatric surgical patients aged 2-14 years who underwent surgery under general anaesthesia between June 1 - October 30 2022. Stratified sampling method followed by simple random sampling technique was employed to reach study participants. Magnitude of emergence agitation and its interventions done at post-anaesthetic care units were recorded. Data analysis was carried out using a descriptive statistics method and the results were summarized using tables and diagrams. Bivariate analysis was done to identify causal relationship and multivariable analysis to assess the confounding effects of factors associated with emergence agitation. A p-value of less than 0.05 was considered statistically significant factor.

Results
A total of 150 participants were included in the current study, where 107 (71.3%) were male and 97 (64.7%) were preschool aged. About 81 (54%) of care givers were female and majority of them have completed primary school. The mean (standard deviation) age of the participants was 6.4 (3.57) years. Around 42.7% of them developed emergence agitation with an average duration of 8.39 ± 4.45 minutes. Factors such as propofol administration at the end of procedure (OR of 0.104 with 95% CI [0.035, 0305]), Ear, nose, throat surgery and oral maxillofacial surgery (OR of 2.341 with 95% CI [1.051, 5.211]) and arrival of patient to recovery awake (OR of 0.456 95% CI [0.209, 0.994]) showed statistically significant association with emergence agitation.

Conclusion
Almost half of the study participants experienced emergence agitation which is high magnitude. Ear, nose, throat surgery and oral maxillofacial surgeries were predictive factors of emergence agitation while propofol administration at the end of procedure and arrival of patient to recovery awake significantly decreased risk of emergence agitation. Therefore, anaesthesia personnel should have essential skills and knowledge to effectively care for children perioperatively including to minimize and treat emergence agitation.
A compartmental model for smoking dynamics in Italy: a pipeline for inference, validation, and forecasting under hypothetical scenarios
Authors: Lachi Alessio , Viscardi Cecilia , Cereda Giulia , Carreras Giulia , Baccini Michela 
Published: July 2024

AbstractWe propose a compartmental model for investigating smoking dynamics in an Italian region (Tuscany). Calibrating the model on local data from 1993 to 2019, we estimate the probabilities of starting and quitting smoking and the probability of smoking relapse. Then, we forecast the evolution of smoking prevalence until 2043 and assess the impact on mortality in terms of attributable deaths. We introduce elements of novelty with respect to previous studies in this field, including a formal definition of the equations governing the model dynamics and a flexible modelling of smoking probabilities based on cubic regression splines. We estimate model parameters by defining a two-step procedure and quantify the sampling variability via a parametric bootstrap. We propose the implementation of cross-validation on a rolling basis and variance-based Global Sensitivity Analysis to check the robustness of the results and support our findings. Our results suggest a decrease in smoking prevalence among males and stability among females, over the next two decades. We estimate that, in 2023, 18% of deaths among males and 8% among females are due to smoking. We test the use of the model in assessing the impact on smoking prevalence and mortality of different tobacco control policies, including the tobacco-free generation ban recently introduced in New Zealand.
Analysis of factors related to recanalization of portal vein thrombosis in liver cirrhosis: a retrospective cohort study
Authors: Shi Yali , Feng Wanlin , Cai Jiaman , Wang Zhonglin , Pu Ying , Mao Weiting , Zhan Ke , Chen Daorong 
Published: July 2024

Abstract
Background
Portal vein thrombosis (PVT) is a common complication of liver cirrhosis, yet there are fewer studies about predictors of PVT recanalization. We aimed to further explore the predictors of recanalization in cirrhotic PVT to facilitate accurate prediction of patients’ clinical status and timely initiation of appropriate treatment and interventions. To further investigate the benefits and risks of anticoagulant therapy in cirrhotic PVT patients.

Methods
A retrospective cohort study of patients with cirrhotic PVT in our hospital between January 2016 and December 2022, The primary endpoint was to analyze predictors of PVT recanalization by COX regression. Others included bleeding rate, liver function, and mortality.

Results
This study included a total of 82 patients, with 30 in the recanalization group and 52 in the non-recanalization group. Anticoagulation therapy was the only independent protective factor for portal vein thrombosis recanalization and the independent risk factors included massive ascites, history of splenectomy, Child-Pugh B/C class, and main trunk width of the portal vein. Anticoagulation therapy was associated with a significantly higher rate of PVT recanalization (75.9% vs. 20%, log-rank P < 0.001) and a lower rate of PVT progression (6.9% vs. 54.7%, log-rank P = 0.002). There was no significant difference between different anticoagulation regimens for PVT recanalization. Anticoagulation therapy did not increase the incidence of bleeding complications(P = 0.407). At the end of the study follow-up, Child-Pugh classification, MELD score, and albumin level were better in the anticoagulation group than in the non-anticoagulation group. There was no significant difference in 2-year survival between the two groups.

Conclusion
Anticoagulation, massive ascites, history of splenectomy, Child-Pugh B/C class, and main portal vein width were associated with portal vein thrombosis recanalization. Anticoagulation may increase the rate of PVT recanalization and decrease the rate of PVT progression without increasing the rate of bleeding. Anticoagulation may be beneficial in improving liver function in patients with PVT in cirrhosis.
The effect of cesarean delivery on the neonatal gut microbiome in an under-resourced population in the Bronx, NY, USA
Authors: Reznik Sandra E. , Akinyemi Ayodele J. , Harary David , Latuga Mariam S. , Fuloria Mamta , Charron Maureen J. 
Published: July 2024

Abstract
Background
Neonatal and early-life gut microbiome changes are associated with altered cardiometabolic and immune development. In this study, we explored Cesarean delivery effects on the gut microbiome in our high-risk, under-resourced Bronx, NY population.

Results
Fecal samples from the Bronx MomBa Health Study (Bronx MomBa Health Study) were categorized by delivery mode (vaginal/Cesarean) and analyzed via 16 S rRNA gene sequencing at four timepoints over the first two years of life. Bacteroidota organisms, which have been linked to decreased risk for obesity and type 2 diabetes, were relatively reduced by Cesarean delivery, while Firmicutes organisms were increased. Organisms belonging to the Enterococcus genus, which have been tied to aberrant immune cell development, were relatively increased in the Cesarean delivery microbiomes.

Conclusion
Due to their far-reaching impact on cardiometabolic and immune functions, Cesarean deliveries in high-risk patient populations should be carefully considered.
Admiration and motivation: key factors in managing PTSD among firefighters
Authors: Pan Yang 
Published: July 2024

AbstractPost-traumatic stress disorder (PTSD) presents a significant challenge for firefighters. While research suggests that admiration may have a positive impact on individual psychological well-being, its specific influence on PTSD among firefighters remains unexplored. This study aims to investigate the association between admiration, motivation (both internal and external), and PTSD in a sample of 2156 firefighters in order to identify effective coping strategies for managing PTSD in this population. The findings indicate a statistically significant inverse relationship between admiration and PTSD, with motivation acting as a mediator. Furthermore, it is noteworthy that internal motivation is negatively correlated with PTSD in the model, while external motivation shows a positive correlation. The results suggest that feelings of admiration are associated with firefighter PTSD via motivation. Specifically, internal motivation stemming from admiration appears to have a mitigating effect on PTSD symptoms, while external motivation is linked to exacerbation of these symptoms. These results have implications for the development of theoretical frameworks and practical interventions aimed at preventing PTSD among firefighters.
Treatment and genetic analysis of multiple supernumerary and impacted teeth in an adolescent patient
Authors: Pu Panjun , Hou Yuxia , Zhang Qing , Hu Xiaoyi , Ding Yi , Jia Peizeng , Zhao Huaxiang 
Published: July 2024

Abstract
Background
Multiple supernumerary teeth, combined with numerous impacted teeth, can lead to various malocclusions, posing significant treatment challenges. While certain genes associated with syndromic cases of multiple supernumerary and impacted teeth have been identified, the etiologies of non-syndromic cases still largely remain elusive.

Case presentation
Here, we report a treatment of a 12-year-old boy who presented with 10 supernumerary teeth and 6 impacted teeth, accompanied by a genetic analysis to explore the underlying etiology. During the treatment, fifteen teeth were extracted, and various skilled techniques, including the closed-eruption technique and the application of by-pass arches, were utilized. Post-treatment, traction was successful for all the impacted teeth, without any tooth mobility or reduction in gingival height. Space closure, well-aligned teeth, and excellent functional occlusion were achieved. Furthermore, comprehensive genetic analysis was conducted through whole-exome sequencing on the patient and his parents, which revealed a potential link between the patient’s numerous supernumerary teeth and abnormal mineralization. Notably, the p.Ser496Pro variant in the TCF7L2 gene was identified as a potential candidate variant in this patient.

Conclusions
Overall, our findings not only report the treatment of a rare case involving multiple supernumerary and impacted teeth but also offer valuable insights into the molecular basis of supernumerary teeth.
Postoperative evaluation of special needs and healthy patients with endodontic treatment under general anesthesia: a retrospective research
Authors: Uysal Busenaz Cemile , Ozkan Hicran Donmez , Kocaturk Ozlem 
Published: July 2024

Abstract
Background
This retrospective clinical study was undertaken to comparatively evaluate the number of restorative treatments, endodontic treatments, and tooth extractions performed for patients under general anesthesia due to dental anxiety or special needs between 2015 and 2022 and to examine the pain, bleeding, nausea, and vomiting data of those patients.

Methods
In total, 1165 patients underwent dental treatment under general anesthesia in the faculty hospital. Those under the age of 15 and with no endodontic procedure planned (n = 918) were excluded, followed by those with incomplete data (n = 25) and those without endodontic treatment (n = 25). Patients who underwent at least one endodontic treatment were finally included in the study (n = 184). Patients were divided into two groups: healthy and with special needs. Dental treatments were recorded as endodontic, restorative, and teeth extractions. Endodontic treatments were classified according to the tooth type (premolar, molar, and incisors). The composite restorations were classified as anterior, occlusal (O), occluso-distal (OD) or occluso-mesial (OM), and mesio-occluso-distal (MOD) restorations and patients’ post-treatment pain, nausea, vomiting, and bleeding were recorded. The data were analyzed statistically.

Results
Among the 184 patients included in the study, 70 (38%) were healthy, and 114 (62%) had special needs. Postoperative bleeding was observed more in patients with special needs (χ2 = 4.189, p < 0.05), whereas pain was observed more in healthy patients (U = 2922.00, p < 0.05). While the number of anterior, O, and MOD restorations was higher in patients with special needs, the number of OD or OM restorations was higher in healthy patients (χ2 = 74.877, p < 0.05).

Conclusions
Patients with special needs undergo a greater number of restorative treatments compared to control patients, which may be associated with the inadequate oral hygiene care of such patients. However, restorative treatment is mostly indicated for such patients in our faculty hospital, which may indicate that a conservative approach is taken. Additionally, the finding that postoperative bleeding was more severe in this group of patients compared to the control group in this study may emphasize the need to consider more possible complications after general anesthesia in these patients.
The effect of detox solution on color stability, roughness, and microhardness of monochromatic universal composite resins
Authors: Nezir Merve , Ahisha Cansu Dağdelen , Özcan Suat , Üçtaşli Mine Betül 
Published: July 2024

Abstract
Background
Currently, the advantages of monochromatic universal composite resin restorative materials have increased their use in dentistry. Accordingly, the optical, surface and mechanical properties of these materials have become more important. This study aimed to evaluate the effect of detox solution on discoloration, surface roughness (SR), and microhardness of different monochromatic universal composite resins (Omnichroma [O], Zenchroma [Z], Vittra [V], and Charisma Diamond One [CDO]). Another aim of this study was to evaluate the monomer conversion degree (DC) of the materials.

Methods
A total of 80 specimens were prepared to evaluate the materials (n = 10). After the initial measurements, the specimens were immersed in a red detox solution for 21 days. Statistical data analysis was performed using one-way ANOVA and Tukey’s multiple comparisons.

Results
The ∆E values of Z were highest on the 21st day. There was an increase in the SR values of the materials immersed in the detox solution. On the 21st day, top surface microhardness of O was lower than the other materials. There was no statistically significant difference at DC values among material groups.

Conclusions
The use of detox solutions for a commercially recommended period of 21 days is suggested. However, this usage period can cause discoloration in restorative materials. Furthermore, especially in the initial one-week period, detox solution may have a negative impact on the microhardness of the materials. In light of all these data, we recommend the cautious use of detox solutions to prevent adverse effects on restorative materials.
Molecular characterization of canine circovirus based on the Capsid gene in Thailand
Authors: Dankaona Wichan , Nooroong Pornpiroon , Poolsawat Napassorn , Srionrod Nitipon , Techangamsuwan Somporn , Anuracpreeda Panat 
Published: July 2024

Abstract
Background
Canine circovirus (CanineCV) is a single-stranded circular DNA virus that infects domestic and wild canids in many countries. CanineCV is associated with gastroenteritis and diarrhea, respiratory disease, and generalized vasculitis leading to a fatal event. The Capsid protein (Cap) is a structural protein of the virus which has high genetic variability and plays a role in the canine immune response. In this study, we cloned the full-length CanineCV Capsid gene (Cap). In-silico analyses were used to explore the genomic and amino acid variability and natural selection acting on the Cap gene. The immune relevance for T-cell and B-cell epitopes was predicted by the immunoinformatic approach.

Results
According to the Cap gene, our results showed that CanineCV was separated into five phylogenetic groups. The obtained CanineCV strain from this study was grouped with the previously discovered Thai strain (MG737385), as supported by a haplotype network. Entropy analyses revealed high nucleotide and amino acid variability of the Capsid region. Selection pressure analysis revealed four codons at positions 24, 50, 103, and 111 in the Cap protein evolved under diversifying selection. Prediction of B-cell epitopes exhibited four consensus sequences based on physiochemical properties, and eleven peptide sequences were predicted as T-cell epitopes. In addition, the positive selection sites were located within T-cell and B-cell epitopes, suggesting the role of the host immune system as a driving force in virus evolution.

Conclusions
Our study provides knowledge of CanineCV genetic diversity, virus evolution, and potential epitopes for host cell immune response.
Factors leading to falls in transfemoral prosthesis users: a case series of prosthesis-side stumble recovery responses
Authors: King Shane T. , Eveld Maura E. , Zelik Karl E. , Goldfarb Michael 
Published: July 2024

Abstract
Background
Falls due to stumbling are prevalent for transfemoral prosthesis users and may lead to increased injury risk. This preliminary case series analyzes the transfemoral prosthesis user stumble recovery response to highlight key deficits in current commercially-available prostheses and proposes potential interventions to improve recovery outcomes.

Methods
Six transfemoral prosthesis users were perturbed on their prosthetic limb at least three times while walking on a treadmill using obstacle perturbations in early, mid and late swing. Kinematic data were collected to characterize the response, while fall rate and key kinematic recovery metrics were used to assess the quality of recovery and highlight functional deficits in current commercially-available prostheses.

Results
Across all participants, 13 (54%) of the 24 trials resulted in a fall (defined as > 50% body-weight support) with all but one participant (83%) falling at least once and two participants (33%) falling every time. In contrast, in a previous study of seven young, unimpaired, non-prosthesis users using the same experimental apparatus, no falls occurred across 190 trials. For the transfemoral prosthesis users, early swing had the highest rate of falling at 64%, followed by mid-swing at 57%, and then late swing at 33%. The trend in falls was mirrored by the kinematic recovery metrics (peak trunk angle, peak trunk angular velocity, forward reach of the perturbed limb, and knee angle at ground contact). In early swing all four metrics were deficient compared to non-prosthesis user controls. In mid swing, all but trunk angular velocity were deficient. In late swing only forward reach was deficient.

Conclusion
Based on the stumble recovery responses, four potential deficiencies were identified in the response of the knee prostheses: (1) insufficient resistance to stance knee flexion upon ground contact; (2) insufficient swing extension after a perturbation; (3) difficulty initiating swing flexion following a perturbation; and (4) excessive impedance against swing flexion in early swing preventing the potential utilization of the elevating strategy. Each of these issues can potentially be addressed by mechanical or mechatronic changes to prosthetic design to improve quality of recovery and reduce the likelihood a fall.