bluuebunny/crossref_metadata_2025_split huggingface dataset:
Provisions Related to Health, Nutrition, and Healthy Beverage Promotion in University Pouring Rights Contracts: A Content Analysis
Authors: Greenthal Eva , Marx Katherine , Grossman Elyse R. , Ruffin Martha , Lucas Stephanie A. , Benjamin-Neelon Sara E. 
Published: August 2024

Purpose Many universities maintain pouring rights contracts (PRCs) with beverage companies wherein one company exchanges sponsorship payments for exclusive beverage marketing rights. Separately, universities may have healthy beverage initiatives (HBIs) to encourage healthier choices on campus. This study aimed to assess how and how frequently PRCs included provisions related to health and nutrition to examine how PRCs may support or undermine HBIs. Design Cross-sectional. Setting U.S. public universities with >20,000 students. Sample 131 PRCs obtained from 124 of 143 universities in 2019-2020. Measures Primary outcomes were the presence of provisions that could encourage or discourage promotion of healthy beverages (water, diet soda, unsweetened coffee or tea, and 100% juice), and any other provisions explicitly or implicitly referencing health or nutrition. Analysis Descriptive statistics. Results Twelve contracts (9%) had explicit commitments from the company or university to promote healthy beverages or adhere to nutrition standards, including five committing to support HBIs, four committing to healthy vending policies, and three describing activities to promote healthy beverage brands. Ten (8%) had provisions explicitly inhibiting water promotion and 55 (42%) had provisions that could be interpreted that way. Eleven (8%) included other health and nutrition provisions, such as funding for unspecified wellness activities. Conclusion Most university beverage contracts did not expressly aim to support healthy choices, and more than half had provisions potentially limiting universities’ ability to implement HBIs. When present, nutrition standards were weak.
Linking the UN SDGs and Sustainable Development Progress: The Case of China
Authors: Kang Sung Jin , Lee Seon Ju , Cao Shijun 
Published: August 2024

This study examines China’s progress in sustainable development (SD) from 1990 to 2019 toward the 2030 Agenda and 2030 carbon peak target. Through extended factor analysis with principal component analysis, the sustainable development index (SDI), including each economy, society, and environment subclass SDI, was derived, and the contribution and weight of each Sustainable Development Goal (SDG) to the SDI calculated. The main findings are: (a) A progressively improving SDI is derived, supporting the considerate achievement of China’s SD policies; (b) the SDI trend aligns with per capita GDP, implying that the state of economic development measured by per capita GDP well approximates the degree of SD; (c) most goals, especially those in the economy and society subclasses, show sustained improvement and contribute to the improvement of China’s SDI. However, it is still relatively fragile in the environment subclass and requires further strengthening. Therefore, China should continue strengthening ecological civilization construction to achieve the 2030 Agenda and 2030 carbon peak target. JEL Classification C43, O10, O53
Utilization of Antibiotics for the Treatment of Urinary Tract Infections in End-of-Life Patients
Authors: Thomas Abigail , Davis Lacey , Dolan Allie , Prewett Rebecca 
Published: August 2024

Purpose The use of antibiotics for end-of-life patients is controversial; currently there is limited guidance on the use of antibiotics in hospice patients. The threat of antibiotic resistance, risk of adverse events, variable efficacy, and time to benefit in hospice patients makes their use divisive. Patients’ potential care needs are estimated using the palliative performance scale (PPS) with lower scores indicating more care is required. The purpose of this project is to examine the utilization of antibiotics for urinary tract infections (UTIs) in hospice patients. Methods This multi-center retrospective observational cohort study evaluated the prescribing of antibiotics in symptomatic vs asymptomatic hospice patients being treated for UTIs and assessed antibiotic initiation based on PPS of ≥30% or <30%. Patients included in this study were adults initiated on oral antibiotics for UTI. Exclusion criteria included antibiotics initiated prior to admission, prophylactic antibiotics, non-oral antibiotics, or if the patient revoked election of hospice. Results A total of 56 patients were prescribed antibiotics for UTIs during the 1-year study period. Half of the antibiotics were prescribed appropriately based on documented symptoms when starting the antibiotics. There was not a statistically significant difference between appropriate utilization based on PPS ≥30% or <30% using the Mann-Whitney U test ( P = 0.255). Conclusion The prescribing of antibiotics in end-of-life patients is not always appropriate regardless of the PPS. This may indicate that antibiotics are initiated in asymptomatic hospice patients, and the utilization of unnecessary medications presents the risk of adverse effects.
Development and Validation of a Predictive Model for Intracranial Haemorrhage in Patients on Direct Oral Anticoagulants
Authors: Liu Yuanyuan , Li Linjie , Li Jingge , Liu Hangkuan , Geru A , Wang Yulong , Li Yongle , Sia Ching-Hui , Lip Gregory Y. H. , Yang Qing , Zhou Xin 
Published: August 2024

Background Intracranial haemorrhage (ICH) poses a significant threat to patients on Direct Oral Anticoagulants (DOACs), with existing risk scores inadequately predicting ICH risk in these patients. We aim to develop and validate a predictive model for ICH risk in DOAC-treated patients. Methods 24,794 patients treated with a DOAC were identified in a province-wide electronic medical and health data platform in Tianjin, China. The cohort was randomly split into a 4:1 ratio for model development and validation. We utilized forward stepwise selection, Least Absolute Shrinkage and Selection Operator (LASSO), and eXtreme Gradient Boosting (XGBoost) to select predictors. Model performance was compared using the area under the curve (AUC) and net reclassification index (NRI). The optimal model was stratified and compared with the DOAC model. Results The median age is 68.0 years, and 50.4% of participants are male. The XGBoost model, incorporating six independent factors (history of hemorrhagic stroke, peripheral artery disease, venous thromboembolism, hypertension, age, low-density lipoprotein cholesterol levels), demonstrated superior performance in the development dateset. It showed moderate discrimination (AUC: 0.68, 95% CI: 0.64–0.73), outperforming existing DOAC scores (ΔAUC = 0.063, P = 0.003; NRI = 0.374, P < 0.001). Risk categories significantly stratified ICH risk (low risk: 0.26%, moderate risk: 0.74%, high risk: 5.51%). Finally, the model demonstrated consistent predictive performance in the internal validation. Conclusion In a real-world Chinese population using DOAC therapy, this study presents a reliable predictive model for ICH risk. The XGBoost model, integrating six key risk factors, offers a valuable tool for individualized risk assessment in the context of oral anticoagulation therapy.
Lorlatinib experience in a patient with ALK + non-small cell lung cancer on hemodialysis: A case report
Authors: Gürbüz Ali Fuat , Eryılmaz Melek Karakurt , Yıldız Oğuzhan , Kaya Bahattin Engin , Araz Murat , Artaç Mehmet 
Published: August 2024

Introduction Lorlatinib is a potent third-generation anaplastic lymphoma kinase/c-ros oncogene 1 (ALK)/ROS1 oral tyrosine kinase inhibitor that has broad coverage of acquired resistance mutations and is currently indicated for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are ALK-positive. Case report In this case, we aimed to present the safety and effectiveness of lorlatinib use in a patient diagnosed with ALK-positive metastatic NSCLC who underwent hemodialysis 3 days a week. Management & Outcome A 76-year-old female patient has been undergoing regular hemodialysis for about 2 years. A brain magnetic resonance imaging (MRI) was taken due to headache and a mass was detected. She was diagnosed with lung adenocarcinoma as a result of excisional biopsy. Positron emission tomography/ computed tomography (PET/CT) showed a mass in the hilar region of the left lung and multiple lymphadenopathy in the mediastinum. In February 2023, 100 mg lorlatinib was started daily. There was no significant regression in PET-CT and no brain MRI residue during follow-up. The patient has been continuing lorlatinib for approximately 1 year with almost complete response, with no side effects other than hypercholesterolemia. Discussion We presented our experience using lorlatinib in a patient with metastatic ALK + NSCLC undergoing hemodialysis. Although the dosage of lorlatinib in hemodialysis patients is still controversial, our case report indicates that 100 mg lorlatinib was safe in this patient.
Concussion Awareness Training Tool for Youth: Impact on Concussion Knowledge, Beliefs, and Reporting Intentions
Authors: Shepherd Heather A. , Galarneau Jean-Michel , Neill Matthew , Karmali Shazya , Turcotte Kate , Williamson Rylen A. , Cowle Stephanie , Macpherson Alison , Reed Nick , Schneider Kathryn J. , Belton Kathy L. , Gagnon Isabelle , Black Amanda M. , Emery Carolyn A. , Babul Shelina 
Published: August 2024

Background Concussion education is recommended to increase concussion knowledge, beliefs, and reporting intentions. The Concussion Awareness Training Tool for Youth (CATT-Youth) is a 40-minute e-Learning module developed for high school–aged youth. Aim The aim of the study was to evaluate changes in concussion knowledge, beliefs, and reporting intentions in high school youth from Calgary, Canada, following completion of the CATT-Youth Methods This study used a modified stepped-wedge trial design. High school classes were randomly assigned to an intervention (Ix) or delayed intervention (DIx) group. Ix group participants completed a pre-CATT survey immediately followed by the CATT-Youth, then a post-CATT survey 2 to 6 weeks later. DIx group participants completed two pre-CATT surveys 2 to 6 weeks apart, with the CATT-Youth completed immediately following the second pre-CATT, then a post-CATT survey 2 to 6 weeks later. The pre-/post-CATT survey encompassed 11 subtests evaluating concussion knowledge, beliefs, and reporting intentions. Independent mixed linear regression models were conducted to examine changes in scores for each subtest. Results Participants included 454 high school students: five Ix schools (16 classes, n = 323) and two DIx schools (six classes, n = 131). The CATT-Youth significantly increased general concussion knowledge, Ix δ = 0.546/8 (95% confidence interval [CI] = [0.243, 0.849]), DIx δ = 0.728/8 (95% CI = [0.389, 1.106]), and beliefs about capabilities, Ix δ = 2.462/28 (95% CI = [1.086, 3.838]), DIx δ = 3.219/28 (95% CI = [1.594, 4.844]) for both groups. For some subtests, improvements were noted in the DIx group only. Conclusion The CATT-Youth module improved concussion knowledge and beliefs about capabilities for students in both groups. Future studies should explore the utility of the CATT-Youth in changing knowledge, beliefs, and reporting intentions in high school students.
Use of a silicone shield to protect the optical cylinder following osteo- and osteo-odonto-keratoprosthesis (O/OKP) procedures
Authors: Goren Lee , Yassur Iftach , Goldblum David , Achiron Asaf , Bahar Irit , Livny Eitan 
Published: August 2024

Purpose To describe the placement of a silicone shield to protect the optical cylinder following osteo-keratoprosthesis or osteo-odonto-keratoprosthesis (O/OKP) procedures in four patients. Methods In this retrospective observational study, we reviewed all patients who underwent O/OKP in our tertiary medical centre. We found four patients in whom a protective cellphone silicone shield (VisionGuard+, Zagg, Utah, USA) was cut with a 3 mm dermal punch and placed on the polymethyl methacrylate (PMMA) optical cylinder of an O/OKP 3–4 months after implantation to either correct or prevent abrasions. Results The first patient presented with a severely abraded OOKP optic that reduced BCVA from 6/6 to 6/20. The shield smoothed the optical surface and filled minor scratches, leading to BCVA improvement to 6/9. In the subsequent three patients, the optic was relatively clear, and the shield was used as a preventive measure. In two patients, the shield fell off after a few weeks and was replaced. Conclusions Placing a protective silicone shield on the optical cylinder of an O/OKP can prevent permanent abrasions and, in an already scratched polymethyl methacrylate (PMMA) optic cylinder, improve vision by smoothing the surface. This intervention can be clinically significant, considering that the optical cylinder cannot be removed after implantation.
Retinal Reactive Astrocytic Tumor and Astrocytic hamartomas in patient with Neurofibromatosis type 1: Case Report and Literature review
Authors: Hadjistilianou Theodora , Carnicci Alberto , D’Alessandro Carlo , De Francesco Sonia , Fruschelli Mario 
Published: August 2024

Introduction Neurofibromatosis type I, also known as Von Recklinghausen disease, is a common phakomatosis affecting 1 in 2500–3000 live births; it may be associated with several common ocular findings, including Lisch nodules, plexiform neurofibromas, optic pathway gliomas, retinal astrocytic hamartomas and choroidal nodules. Case description This report illustrates clinical evidence of simultaneous presence of retinal reactive astrocytic tumor (RRAT) and two retinal astrocytic hamartomas (RAH) in a 15 y/o patient with NF1, referred to our attention because of an asymptomatic fundus mass in his right eye of recent onset. Conclusion This case, in addition to considering NF1 as one of the ocular conditions associated with secondary RRAT, underlines the importance of early referral and continuous ophthalmological follow-up in preventing possible complications that could cause significant visual impairment in patients with NF1.
Study on sporty exhaust sound of economical vehicle under acceleration
Authors: Yang Liang , Jia Xiaoli , Liao Xiangning , Zhang Jiangsheng , Chu Zhigang 
Published: August 2024

Exhaust sound quality is an important part of vehicle performance. In this paper, the sporty exhaust sound quality of an economical vehicle equipped with a 4-cylinder and 4-stroke engine is evaluated, analyzed, and improved under acceleration. Firstly, a sporty feeling evaluation method with engine speed divided is proposed, and the influence of exhaust sound order components on sporty exhaust sound is analyzed. The results show that while the A-weighted sound pressure level (ASPL) of Order 2 is lower and the ASPLs of Orders 4 and 6 are higher, the exhaust sound is sportier. Then, a hybrid predicted model of vehicle sporty exhaust sound under acceleration is established based on convolutional neural network (CNN) and support vector regression (SVR) algorithm. The relative errors between the predicted results of CNN-SVR hybrid model and the subjective evaluation results are limited within 2%, which indicates that the CNN-SVR hybrid prediction model achieves a high accuracy in assessing the sporty feeling of exhaust sound. Finally, considering the frequency ranges corresponding with the above order components under the practical accelerating condition, a strategy is proposed to enhance the sporty feeling of exhaust sound by reducing the sound energy within 100 Hz and increasing the sound energy within 100–450 Hz. Based on this strategy, a muffler with different structure is selected and installed on the economical vehicle, and the sporty feeling of exhaust sound is 0.63 points higher than before.
A Mixed Method Study in Young Children Participating in Clinical Research During A Kidney Transplantation Trajectory
Authors: Voet Marieke , Lucker Guusje , Malagon Ignacio , Schaaijk Nienke Maas-van , Cornelissen Elisabeth A.M. , Engels Yvonne 
Published: August 2024

Introduction Regulations designed to protect children participating in clinical research often restrict the availability of research data necessary for the development of age-specific therapies and drug dosing. Few data exist on how children experience participation in clinical research, and studies investigating young children undergoing an intensive medical treatment are lacking. Methods Mixed methods with semi-structured interviews and DISCO-RC questionnaires were used to explore young children's and their parents’ experiences in clinical research participation during a kidney transplantation trajectory. Findings Nine children and their parents were interviewed. Children's median age at kidney transplantation was 4 years (IQR 4,7); age at interview was 7 years (IQR 6,9). Thematic content analysis of interviews revealed that most children were unaware of having participated in a study. Both children and their parents frequently were unaware whether procedures were standard care or research related. The additional burden attributed to study participation varied from not at all to heavy in combination with intensive medical treatment. Positive experiences included kind healthcare professionals, effective distraction techniques, educational aspects, contributing to science and extra check-ups. Most reported negative experiences were conflicting communication, spending much time in the hospital, missing school and suboptimal planning. Venous puncture was stressful for all children, whereas the discomfort of other procedures varied. Conclusion Pediatric clinical research design should focus on education and fun during research procedures, smart planning, consistent communication, close collaboration between clinical and research team and age appropriate distraction techniques.
Mean Pressure Gradient and Fractional Flow Reserve at A Superficial Femoral Artery Dissection after Drug-Coated Balloon Angioplasty
Authors: Kobayashi Taira , Fujiwara Takashi , Hamamoto Masaki , Okazaki Takanobu , Okusako Ryo , Yamaguchi Tomokazu , Sugawara Naohide , Tomota Mayu , Takahashi Shinya 
Published: August 2024

Objectives Residual dissection is a concern in endovascular treatment with a DCB, and there is limited knowledge of hemodynamics at a dissection lesion. Therefore, the objective of this study is to evaluate the mean pressure gradient (MPG) and fractional flow reserve (FFR) at a residual dissection after DCB angioplasty for the superficial femoral artery (SFA). Methods A total of 59 cases with residual SFA dissection treated with DCB angioplasty at a single center were analyzed retrospectively. The dissection was classified into 6 types (A-F). The primary endpoints were MPG and FFR at a residual dissection lesion after DCB angioplasty, using evaluation with a pressure wire. Results The median lesion length was 70 (40-130) mm with 24% popliteal involvement, and 11 cases (18%) had chronic total occlusion. A completion angiogram revealed dissection of types A (n = 33, 56%), B (n = 18, 31%), C (n = 7, 12%), and D (n = 1, 2%). The median MPGs in type A, B, and C cases were 0 (0-2), 0 (0-4), and 3 (0-6) mmHg, with a significant lower in type C cases than in type A cases (A vs C, P = .021). The median FFRs in type A, B, and C cases of 1.0 (.98-1.00), 1.0 (.96-1.00), and .98 (.95-1.00) did not differ significantly among dissection types (A vs B, P = .86; A vs C, P = .055; B vs C, P = .15). Conclusions This is the first report of hemodynamics at a SFA dissection. The results suggest that low-grade dissection (types A or B) does not affect MPG and FFR at a SFA lesion. This indicates that a bailout stent may be unnecessary for patients with dissection of types A or B. A further investigation is needed to determine whether a scaffold is required for a SFA lesion with type C dissection.
Decoding Radiology Reports: Artificial Intelligence-Large Language Models Can Improve the Readability of Hand and Wrist Orthopedic Radiology Reports
Authors: Butler James J. , Acosta Ernesto , Kuna Michael C. , Harrington Michael C. , Rosenbaum Andrew J. , Mulligan Michael T. , Kennedy John G. 
Published: August 2024

Background: The purpose of this study was to assess the effectiveness of an Artificial Intelligence-Large Language Model (AI-LLM) at improving the readability of hand and wrist radiology reports. Methods: The radiology reports of 100 hand and/or wrist radiographs, 100 hand and/or wrist computed tomography (CT) scans, and 100 hand and/or wrist magnetic resonance imaging (MRI) scans were extracted. The following prompt command was inserted into the AI-LLM: “Explain this radiology report to a patient in layman’s terms in the second person: [Report Text].” The report length, Flesch reading ease score (FRES), and Flesch-Kincaid reading level (FKRL) were calculated for the original radiology report and the AI-LLM–generated report. The accuracy of the AI-LLM report was assessed via a 5-point Likert scale. Any “hallucination” produced by the AI-LLM–generated report was recorded. Results: There was a statistically significant improvement in mean FRES scores and FKRL scores in the AI-LLM–generated radiograph report, CT report, and MRI report. For all AI-LLM–generated reports, the mean reading level improved to below an eighth-grade reading level. The mean Likert score for the AI-LLM–generated radiograph report, CT report, and MRI report was 4.1 ± 0.6, 3.9 ± 0.6, and 3.9 ± 0.7, respectively. The hallucination rate in the AI-LLM–generated radiograph report, CT report, and MRI report was 3%, 6%, and 6%, respectively. Conclusions: This study demonstrates that AI-LLM effectively improves the readability of hand and wrist radiology reports, underscoring the potential application of AI-LLM as a promising and innovative patient-centric strategy to improve patient comprehension of their imaging reports. Level of Evidence: IV.
Predictors for thoracic aortic growth in patients with type B aortic dissection after thoracic endovascular aortic repair
Authors: Chen Yonghui , Ren Jianli , Liu Zongwei , Cui Dongsheng , Wang Shuaishuai , Bi Jiaxue , Dai Xiangchen 
Published: August 2024

Objective To identify independent predictors of thoracic aortic growth in patients with type B aortic dissection (TBAD) undergoing thoracic endovascular aortic repair (TEVAR). Methods A retrospective analysis of the patients undergoing TEVAR for TBAD or intramural hematoma (IMH) from April 2014 to April 2023 was performed. The baseline morphological data of TBAD was established through computed tomography angiography (CTA) before discharge. Patients were divided into two groups based on aortic growth: growth and no growth. Aortic growth defined as an increase ≥5 mm in thoracic maximal aortic diameter during any serial follow-up CTA measurement. Logistic regression following propensity score matching (PSM) was used to identify independent predictors for aortic growth. Receiver operating characteristic curve and cutoff value of independent predictors were calculated. Linear regression was used to establish a correlation between anatomical variables and follow-up aortic diameter. Results A total of 145 patients with TBAD ( n = 122) or IMH ( n = 23) undergoing TEVAR were included, with a male of 83.4% and a mean age of 56 ± 14.1 years. Patients in growth group and no growth group was 26 (17.9%) and 119 (80.1%), respectively. After using PSM method, matched regression analysis showed residual maximal tear diameter (OR = 0.889, 95% CI 0.830-0.952, p = 0.001) and follow-up aortic diameter (OR = 0.977, 95% CI 0.965-0.989, p < 0.001) were independent predictors for aortic growth. The cutoff value was 8.55 mm for residual tear diameter and 40.65 mm for follow-up maximal aortic diameter. The residual maximal tear diameter showed a linear correlation with follow-up aortic diameter (DW = 1.74, R2 = 6.2%, p = 0.033). Conclusions This study suggested that residual maximal tear diameter >8.55 mm and follow-up aortic diameter >40.65 mm could predict aortic growth in patients with TBAD undergoing TEVAR.