bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stabilizing Civil Wars without Peacekeeping: Evidence from South Asia
Authors: Bastaki Basil , Staniland Paul , Popoola Bryan 
Published: August 2024

Abstract
Peacekeeping is helpful in resolving civil wars, but there is little chance of peacekeeping operations or other international peace-building interventions for many conflicts. How do internal wars stabilize in the absence of meaningful international involvement? Two key factors, the government's political space for bargaining and the relative power of armed groups, help to explain when it is possible to reach either stable cooperation between states and armed groups or negotiated settlements. We analyze three conflict trajectories—“long-term limited cooperation” arrangements, state incorporation or disarmament, and ongoing conflict—to show that the paths to stabilization are often ethically fraught and empirically complicated but exist even when international involvement is off the table. We use quantitative and qualitative data to study the relationships between armed groups and governments in much of post-colonial South Asia, including during periods of little or no violence. Understanding these trajectories provides policymakers, analysts, and scholars with useful tools for identifying policy options and political trade-offs as they seek to reduce the human costs of war.
Experiences of Family Members With Visitation Prohibition for Critically Ill Patients
Authors: Kim Sunjung , Tak Sunghee H. 
Published: August 2024

Background: Visitation plays a number of positive roles for critically ill patients and their families. It reduces the physical and mental stress of intensive care unit (ICU) patients and their families and allows family members to participate in patient care. Visit prohibition during the COVID-19 pandemic has raised unprecedented challenges to patients, family members, and health care providers. Objective: This qualitative study aimed to explore the experiences of families of patients in the ICU with no-visitor policies due to COVID-19. Methods: Data collection was conducted through 8 individual in-depth semi-structured interviews conducted between October 2021 and March 2022. Data analysis was performed following the qualitative method proposed by Colaizzi. The researchers independently analyzed the data, checked the findings, derived subthemes, and categorized them into overarching themes. Results: Four themes emerged from the data analysis: ( a) experiencing emotional distress, ( b) being fearful of in-person patient contact, ( c) being dissatisfied with the access control policy in the ICU, and ( d) making efforts to reach the patient. Conclusions: It is critical to provide support and develop interventions for families denied visitation with loved ones in ICUs. Since in-person visits are crucial for families, hospitals should establish clear and reasonable visitation guidelines, communicate effectively with families, and offer alternative methods for them to connect with loved ones in the ICU.
Exploring gastrointestinal manifestations in childhood onset systemic lupus erythematosus - Insights from a multicenter study
Authors: Sönmez Hafize Emine , Batu Ezgi Deniz , İşgüder Rana , Şahin Nihal , Aliyev Emil , Aslan Esma , Çoban Sümeyra , Güngörer Vildan , Karadağ Şerife Gül , Karaçayır Nihal , Kısaoğlu Hakan , Yekedüz Bülbül Aydan , Garip Sevinç , Karalı Yasin , Ayduran Semra , Demir Selcan , Kaya Akça Ümmüşen , Başaran Özge , Şahin Sezgin , Kasap Belde , Kilic Sara Sebnem , Kışla Ekinci Rabia Miray , Kısaarslan Ayşenur Paç , Kalyoncu Mukaddes , Bakkaloğlu Sevcan , Yüksel Selçuk , Aktay Ayaz Nuray , Çelikel Acar Banu , Sözeri Betül , Kasapçopur Özgür , Ünsal Erbil , Özen Seza 
Published: August 2024

Objective Systemic lupus erythematosus (SLE) constitutes an autoimmune disorder with potential involvement of the gastrointestinal system (GIS). Our objective was to assess the gastrointestinal (GI) manifestations in patients diagnosed with childhood onset SLE. Methods The study cohort consisted of 123 patients with childhood onset-SLE and GIS involvement from 16 referral departments of pediatric rheumatology. All participants met the Systemic Lupus International Collaborating Clinics criteria. Results Out of 123 patients, 78 (63.4%) exhibited GIS involvement at the initial SLE diagnosis, whereas the remaining 45 (36.6%) developed GI symptoms after a median duration of 12 (3–140) months. Eighty-two (66.7%) individuals experienced symptoms related to the GI tract, whereas the remaining patients received a diagnosis of GI involvement through laboratory assessments. The predominant initial GIS involvement symptom was abdominal pain, observed in 77 (62.6%) patients, followed by elevated hepatic transaminases in 70 (56.9%), hepatomegaly in 40 (32.5%), diarrhea in 26 (21.1%), and jaundice in 11 (8.9%) patients. The GIS involvement was associated with SLE in 82 (78.6%), while it resulted from drug-related adverse events in 35 (28.5%) patients or comorbidities in 6 (0.5%) patients. Conclusion GIS involvement should be considered in all childhood onset-SLE patients, especially in the presence of suggestive symptoms or elevated hepatic transaminases. It is also crucial to consider SLE in the differential diagnosis of GIS manifestations in children. Apart from GIS involvement directly associated with SLE, adverse events of drugs should be kept in mind.
A Twin Case Report of Xanthogranulomatous Oophoritis: A Rare Histological Finding
Authors: Somani Kavita , Singh Pretty 
Published: August 2024

Introduction: Xanthogranulomatous oophoritis is a rare ovarian inflammatory disorder characterised by the extensive infiltration of foamy macrophages and chronic inflammation in the ovarian stroma. Background: We report two cases of xanthogranulomatous oophoritis, both of 34 years of age with complaints of chronic pelvic pain with infertility and with abnormal uterine bleeding. Aim: This case study aims to explore the clinical and pathological features of this rare condition while highlighting the challenges in diagnosis and management.
Utilization of a Novel Scoring System in Predicting 30-day Mortality in Acute Pulmonary Embolism, the CLOT-5 Pilot Study
Authors: Marginean Alexandru , Arora Punit , Walsh Kevin , Bruno Elizabeth , Sawalski Cathryn , Gupta Riya , Greathouse Frances , Clarke Jacob , Mallery Quinn , Choi Myoung Hyun , Malas Waddah , Shah Parth , Sutherland David , Kumar Amudha , Wroblewski Igor , Elkaryoni Ahmed , Desai Parth , Brailovsky Yevgeniy , Darki Amir 
Published: August 2024

Objectives To construct a new scoring system utilizing biomarkers, vitals, and imaging data to predict 30-day mortality in acute pulmonary embolism (PE). Background Acute PE, a well-known manifestation of venous thromboembolic disease, is responsible for over 100,000 deaths worldwide yearly. Contemporary management algorithms rely on a multidisciplinary approach to care via PE response teams (PERT) in the identification of low, intermediate, and high-risk patients. The PESI and sPESI scores have been used as cornerstones of the triage process in assigning risk of 30-day mortality for patients presenting with acute PE; however, the specificity of these scoring systems has often come into question. Methods This study retrospectively analyzed 488 patients with acute PE who were managed at a tertiary care institution with either conservative therapy consisting of low molecular weight or unfractionated heparin, advanced therapies consisting of catheter directed therapies, aspiration thrombectomy, or a combination of these therapies, or surgical embolectomy. The CLOT-5 score was designed to include vital signs, biomarkers, and imaging data to predict 30-day mortality in patients presenting with acute PE. Results The CLOT-5 score had an area under the curve (AUC) of 0.901 with a standard error of 0.29, while the PESI and sPESI scores had an AUC and standard errors of 0.793 ±­ 0.43 and 0.728 ± 0.55, respectively. Conclusions When incorporated into the management algorithms of national PERT programs, the CLOT-5 score may allow for rapid and comprehensive assessment of patients with acute PE at high risk for clinical decompensation, leading to early escalation of care where appropriate.
Lateral femoral wall thickness in trochanteric hip fractures: a systematic review
Authors: Selim Amr , Ponugoti Nikhil , Daoub Ahmed , Johnson-Lynn Sarah , Rhee Shin Jae 
Published: August 2024

Background: Thin lateral femoral wall has been investigated as a sign of instability in trochanteric hip fractures, necessitating lateral wall reconstruction or the use of a cephalomedullary nail (CMN). Various cut-off values have been proposed to guide implant choice. This review aims to determine the clinical significance of the lateral femoral wall thickness (LWT) in trochanteric hip fractures and identify an optimal cut-off value for increased risk of lateral wall (LW) fracture when using Dynamic Hip Screw (DHS). Methods: A comprehensive search was conducted in databases including Medline, Embase, and the Cochrane library up to July 2023. A predefined strategy was employed, with 5 eligible studies critically appraised using the methodological index for non-randomized studies (MINORS) criteria. Outcomes assessed encompassed the standardised mean difference (SMD) of LWT between the LW fracture and non LW fracture groups, aggregate LWT mean in LW fracture group, and the relation between AO/OTA fracture type with LW fracture utilising the chi-square test. Results: Among 481 patients from 5 studies, 112 experienced LW fractures, while 369 did not postoperatively. Analysis indicated a significantly lower LWT in the LW fracture group (SMD −1.13, I² = 41.3%, p = 0.146). The mean LWT in the LW fracture group was 18.2 mm, with a 95% confidence interval of 17.29–19.10 mm. Conclusions: A preoperative thin lateral femoral wall is a critical predictor of fixation failure and suboptimal functional outcomes when using a DHS. Thorough evaluation of pre- and intraoperative x-rays is essential. CMN is recommended over DHS in cases with LWT measurements <19 mm.
Physical and Psychosocial Correlates of Occupational Physical Injury in the Global Construction Industry: A Scoping Review
Authors: Howe Aaron S , Tan Jeremy , Yuen Beatrice , Saini Harseerat , Saade-Cleves Natalia , Obeidat Donia , Shahzad Maryam , Chattu Vijay Kumar , Fatemi Ali-Bani , Nowrouzi-Kia Behdin 
Published: August 2024

Purpose: The construction industry is a diverse sector with exposure to multiple psychosocial and environmental workplace hazards that increase the risk of injury. This scoping review aims to consolidate the existing literature on the physical and psychosocial determinants influencing the risk of occupational physical injuries among construction workers globally. Methods: A scoping review was conducted using the PRISMA extension checklist guided. Literature searches were performed between June and October 2023 in electronic academic databases. Results: A total of 77 studies were identified, encompassing various geographical regions, including North America (n = 29), Africa (n = 18), Europe (n = 12), Asia (n = 9), the Middle East (n = 5), and Oceania (n = 4). The review identified physical and psychosocial factors in 3 domains influencing occupational physical injuries: workplace physical environment (eg, exposure to physical hazards, availability and utilization of personal protective equipment, company size, and job type), workplace culture (eg, psychosocial stressors, gender-related barriers, migrant and ethnic disparities, educational background), and physical wellbeing, health and aging (eg, age, obesity, sleep quality, marital stats, and physical health status). Notably, workers from social minority groups (eg, women, ethnic and migrant workers) of young (<25 years old) or older ages (45-55 years old) employed in smaller construction companies are vulnerable to increased injury risk and exposure to physical and psychosocial hazards in the workplace. Conclusion: The review emphasizes a global paucity of research examining the implications of physical and psychosocial factors on injury risk within the construction industry. Future research should prioritize investigating the impact of psychosocial hazards on younger and older workers to detect age-related differences in injury rate, treatment access, and work-related health outcomes.
Adolescent E-Cigarette Expectancies: Measure Development and Preliminary Validity of the Electronic Nicotine Vaping Outcomes Measure for Youth
Authors: Harrell Paul T. , England Kelli J. , Barnett Tracey E. , Simmons Vani N. , Handel Richard W. , Paulson Amy C. 
Published: August 2024

Background Electronic nicotine delivery systems (“e-cigarettes”) are the nicotine product most commonly used by adolescents. Research, treatment, and policy could benefit from measures of adolescent e-cigarette beliefs about outcomes of use (ie, expectancies). In the current study, we developed and tested an adolescent electronic nicotine vaping expectancy measure. Methods A focus group with adolescents evaluated potential e-cigarette expectancy items. A panel of national experts assisted in revision of these items. Finally, items were administered to a sample of adolescents 14-17 years old (N = 267, Mean age 15.6, SD = 1.1, 50.9% Female, 50.2% Non-Hispanic White, 22.5% Non-Hispanic Black, 14.2% Hispanic) in a large Southeastern metropolitan area in the United States. Results Exploratory Factor Analysis revealed a four factor solution: Negative Consequences (Cronbach’s α = .92); Positive Reinforcement (α = .83); Negative Affect Reduction (α = .95); and Weight Control (α = .89). Subscales were significantly correlated with vaping susceptibility and lifetime vaping. Subscales successfully differentiated susceptible adolescents from confirmed non-susceptible adolescents, with susceptible adolescents reporting more positive expectancies, eg, Positive Reinforcement, M = 5.0, SD = 2.0 vs M = 3.0, SD = 2.1, P < .001, η2 = 0.19, and less negative expectancies, M = 5.5, SD = 2.3 vs M = 6.5, SD = 2.6, P = .001, η2 = 0.04. Similar results were found comparing adolescents who have never vaped nicotine with those who have vaped nicotine. Hierarchical linear regression demonstrated subscales were significant predictors of lifetime vaping after controlling for demographics, vaping ad exposure, and peer/family vaping. Conclusions A preliminary version of an adolescent expectancy measure appears reliable and valid based on expert input and pilot testing with adolescents. Promising results were found in the domains of concurrent validity, discriminant validity, and incremental validity. Future research and evaluation efforts will be able to use this tool to further prevention and treatment goals.
Isolated Pulmonic Valve Endocarditis: A Rare Clinical Entity
Authors: Gizaw Abera Wondie , Tadesse Abilo , Alemu Hailemaryam , Worku Abebe , Chanie Samuel Dereje , Muluken Getasew 
Published: August 2024

Background: Isolated pulmonic valve endocarditis is a rare heart valve infection, and constitutes about 1% to 2% of all infective endocarditis cases. Modified Duke’s criteria were used to diagnose culture negative pulmonic valve endocarditis. Case presentation: A 52-year-old male patient presented with generalized body swelling of 1 month duration associated with prolonged fever, malaise, fatigue, and lassitude. He had productive cough, dyspnea on mild exertion, and reddish discoloration of urine. Upon physical examination, blood pressure (BP) = 140/90 mmHg, pulse rate (PR) = 104 beats per minute, respiratory rate (RR) = 26 breaths per minute, temperature (T0) = 38.3°C, and Sp02 = 90% at ambient air. He had signs of bilateral pleural effusion. Cardiovascular examination revealed tachycardia, raised jugular venous pressure, murmurs of pulmonic regurgitation, and tricuspid regurgitation. There was grade 2 ascites and bilateral leg edema. On laboratory investigation, there were normochromic, normocytic anemia; raised ESR; positive Rheumatoid factor, elevated serum creatinine; and active urinary sediments on urinalysis. Two sets of blood culture were negative on days 1, 5, and 7. Chest-X-ray showed cardiomegaly with bilateral pleural effusion. ECG revealed sinus tachycardia with regular P-waves and QRS complexes. 2D Transthoracic echo showed vegetation on pulmonic valves, pulmonary valve lesions, dilated right atrium and right ventricle, and elevated right ventricular systolic pressure. Abdominal ultrasound revealed enlarged and echogenic kidneys, and ascites. Definitive diagnosis of PVE was made using modified Duke’s criteria which was evidenced by 1 major (echo-proven vegetation on pulmonic valve), and 3 minors (suspected congenital pulmonic stenosis, fever, and immunologic phenomena [acute glomerulonephritis, positive rheumatoid factor]). The patient’s clinical condition markedly improved after 2 weeks of intravenous antibiotics and loop diuretics, and discharged home after completing 6 weeks of parenteral antibiotics. Conclusion: Modified Duke’s criteria could play a major role in the management decision about diagnosis and empiric treatment of infective endocarditis in the absence of positive bacterial cultures.
The influence of selective mortality on poverty rates in later life: evidence from a Swedish cohort born in 1926
Authors: Rehnberg Johan , Östergren Olof , Almquist Ylva B , Fritzell Johan , Fors Stefan 
Published: August 2024

Aims: Mortality influences the composition of the surviving population. Higher mortality among low-income individuals than high-income individuals may result in lower poverty rates in the surviving population. The objective of this study was to describe poverty rates for both survivors and deceased individuals in a cohort born in 1926. Methods: We used Swedish total population data on the 1926 birth cohort ( n = 83,382), calculating annual poverty rates from 1991 to 2016. We compared poverty rates for the entire cohort, those who died the next year, and those who survived for 5, 10, or 20+ years, measuring the impact of selective mortality as the differences in poverty rates between the cohort and these subgroups. Results: Individuals who died the following year had higher poverty rates than the cohort at ages 65–90. Conversely, individuals who survived 5, 10, or 20+ years had lower poverty rates, with relatively small differences (1.1% to 6.9% lower) for survivors of 5 years or longer, and larger differences (26.4% to 32.8% lower) for those who survived 20+ years. Conclusions: Despite differences in mortality rates by income, selective mortality had only a modest impact on poverty rates. If life expectancy rises for all, and a more diverse population reaches old age, our findings indicate a potential slight increase in poverty rates due to reduced mortality as a selective factor. These findings emphasise the need to consider mortality selection when addressing future poverty rates in older adults.
One-year Outcomes of Drug-Eluting Stent Versus Drug-Coated Balloon for Femoropopliteal Artery Lesions: BEASTARS Study Results
Authors: Nakama Tatsuya , Takahara Mitsuyoshi , Iwata Yo , Suzuki Kenji , Tobita Kazuki , Hayakawa Naoki , Horie Kazunori , Mori Shinsuke , Obunai Kotaro , Ohki Takao 
Published: August 2024

Background: Previous reports have shown comparable outcomes between drug-eluting stents (DESs) and drug-coated balloons (DCBs) for treating femoropopliteal artery (FPA) lesions; however, DCB outcomes include approximately 10% to 50% bailout stents. Therefore, comparing DESs and DCBs is not simple. The aim of this study was to compare the clinical outcomes of DESs and DCBs in patients with symptomatic FPA disease. Materials and Methods: Using the registries of 7 institutions, we retrospectively reviewed the records of 1356 patients who underwent endovascular therapy for FPA with DESs (n=333; Eluvia, 74.0%; Zilver PTX stent, 26.0%) or DCBs without bailout stents (n=1023; IN.PACT, 67.6%; Lutonix, 32.4%). The primary outcome was the 1-year primary patency comparison between DESs and DCBs, using propensity score matching. The severity of the dissection pattern after predilatation (none or grades A-C) was included as an explanatory variable for matching. Patients with grade D dissections were excluded from the main analysis and assessed independently. Results: After matching, the 1-year primary patency between DESs and DCBs was similar (88.8% vs 85.2%, p=0.31). By contrast, perioperative complications were frequent with DES, compared with DCB (5.1% vs 2.2%, p=0.005), and the intravascular ultrasound-evaluated minimum luminal area was significantly larger with DES than with DCB (19 mm2 vs 14 mm2, p<0.001). In the supplemental analysis of lesions with grade D dissection, the 1-year primary patency was significantly higher with DES than with DCB (86.1% vs 55.1%, p=0.014). Conclusion: In FPA lesions without severe dissection (ie, no dissection or grade A-C dissection), DESs and DCBs showed comparable 1-year primary patency in matched populations. However, DCBs did not perform well with severe dissection (ie, grade D or more). Clinical Impact The results of this study clearly define the appropriate boundaries for the “leaving nothing behind” strategy. Clinicians can now more clearly differentiate between the use of DES and DCB, based on the results of lesion preparation. Further prospective investigations with well-designed trials and larger populations are necessary to confirm these findings.