bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carbody hunting behaviour of high speed vehicles in low effective conicity of wheel-rail contact
Authors: Zheng Biao , Wei Lai , Zeng Jing , Huang Caihong 
Published: June 2024

In the past, bogie hunting instability garnered more attention due to its potential for causing serious safety issues. However, with the rise in high-speed vehicle speeds and operational mileage, the concerns arising from carbody hunting can no longer be overlooked. This article investigates the causes and solutions for low-frequency carbody swaying under low effective conicity in wheel-rail contact, employing a combination of experimental and numerical techniques. Initially, the study involves an in-depth analysis of time-domain signals from lateral and vertical accelerations of the carbody and bogie frame during a high-speed train field-test. The carbody vibration mode resulting from carbody hunting displays a swaying motion at a frequency of 1.5 Hz. Subsequently, a dynamic system model of the high-speed vehicle was established and the suspension mode of the model were verified. The frequency of the carbody upper sway motion is determined to be 1.39 Hz. Low effective conicity is induced when grinding wheel match with new rail or new wheel match with grinding rail. Under this low effective conicity, the hunting frequency of the vehicle is around 1.5 Hz, close to the frequency of the carbody upper sway motion. The coincidence of the hunting frequency and the upper sway motion frequency leads to the low-frequency swaying of the carbody. At last, the effects of wheel profiles, rail profiles and suspension parameters on the carbody hunting have been studied. The study demonstrates that addressing low-frequency carbody swaying can be achieved through targeted rail grinding. This process involves modifying the rail profile while ensuring careful grinding of the rail inner corner. Furthermore, it has been confirmed in the article that replacing suitable yaw dampers is also effective.
Postpartum Excessive Social Support Scale: A Scale Development and Psychometric Testing Study
Authors: Türkmen Hülya , Tuna Oran Nazan , Gürol Serpil , Aydın İnce Kübra 
Published: June 2024

Introduction: In Turkey and other collectivist cultures, child-rearing is a communal effort provided by multiple family members, especially female relatives such as mothers-in-law, aunts, and sisters. Environments with excessively controlling social factors can adversely affect their maternal roles. This study was conducted to develop a measurement tool for determining postpartum excessive social support. Methods: This is a scale development and psychometric evaluation study. In the study, a draft of the Postpartum Excessive Social Support Scale (PESSS) was created, subsequently submitted to expert opinion, and administered to mothers in the postpartum period of 1 to 6 weeks online between March and December 2023 ( n = 440). A factor analysis (including explanatory factor analysis [EFA] and confirmatory factor analysis) was conducted to determine the construct validity of the scale, while Cronbach’s alpha was examined to establish its reliability. Response bias (Hotelling T2) and additivity (Tukey’s test of additivity) of the scale were also determined in the study. Results: For the content validity of the scale, 10 experts from the field of midwifery were consulted (content validity index [CVI] = 0.80). As a result of the EFA, Kaiser–Meyer–Olkin value was found as 0.916. Through factor analysis using the direct oblimin rotation technique, a four-factor structure was identified for the scale, explaining 64.197% of the total variance (social pressure, effect of environmental factors on paternal role, effect of environmental factors on maternal role, and barriers in mother–infant interaction). The internal reliability coefficient of the scale was highly reliable (Cronbach’s alpha = 0.936). There was no response bias in the scale (Hotelling’s T2 = 433.558, p < .001) and it was additive (Tukey’s Non-additivity = 0.000, p < .001). Discussion: The PESSS is a 20-item scale measuring excessive social support between 1 and 6 weeks postpartum. The PESSS serves as a guiding tool for health care professionals to identify excessive environmental pressure hindering mothers’ maternal role and to provide care accordingly. In this context, health care professionals can readily utilize the PESSS in routine postpartum assessments for mothers.
KRAS, NRAS and BRAF Mutational Profile of Colorectal Cancer in a Series of Moroccan Patients
Authors: El Zaitouni Sara , Laraqui Abdelilah , Ghaouti Meriem , Benzekri Asmae , Kettani Fouad , Bajjou Tahar , Sekhsokh Yassine , Benmokhtar Soukaina , Jafari Meryem , Baba Walid , Oukabli Mohamed , El Annaz Hicham , Abi Rachid , Tagajdid Mohamed Rida , El Kochri Safae , Lahlou Idriss Amine , Ameziane El Hassani Rabii , Ennibi Khalid 
Published: June 2024

Objectives The present study aimed to evaluate the frequencies of KRAS, NRAS, and BRAF mutations and their possible associations with clinicopathological features in 249 Moroccan patients with colorectal cancer (CRC). Methods A retrospective investigation of a cohort of formalin-fixed paraffin-embedded tissues of 249 patients with CRC was screened for KRAS/ NRAS/ BRAF mutations using Idylla™ technology and pyrosequencing. Results KRAS, NRAS, and BRAF mutations were revealed in 46.6% (116/249), 5.6% (14/249), and 2.4% (6/249) of patients. KRAS exon 2 mutations were identified in 87.9% of patients (102/116). KRAS G12D and G12 C were the most frequent, at 32.8% and 12.93%, respectively. Among the patients with KRAS exon 2 wild-type (wt), 27.6% (32/116) harbored additional KRAS mutations. Concurrent KRAS mutations were identified in 9.5% (11/116); including six in codon 146 (A146P/T/V), three in codon 61 (Q61H/L/R), one in codon 12 (G12 A and Q61H), and one in codon 13 (G13D and Q61 L). Among the NRAS exon 2 wt patients, 64.3% (9/14) harbored additional NRAS mutations. Concurrent NRAS mutations were identified in 28.6% (4/14) of NRAS-mutant patients. Since 3.2% wt KRAS were identified with NRAS mutations, concomitant KRAS and NRAS mutations were identified in 2.4% (6/249) of patients. KRAS mutations were higher in the >50-year-old age-group ( P = .031), and the tumor location was revealed to be significantly associated with KRAS mutations ( P = .028) predominantly in left colon (27.5%) and colon (42.2%) locations. NRAS mutations were most prevalent in the left colon (42.8%) and in well-differentiated tumors (64.2%). Conclusion Detection of KRAS mutations, particularly the G12 C subtype, may be significant for patients with CRC and has possible therapeutic implications. However, rare KRAS concomitant mutations in CRC patients suggest that each individual may present distinct therapeutic responses. KRAS testing alongside the identification of other affected genes in the same patient will make the treatments even more personalized by contributing more accurately to the clinical decision process. Overall, early diagnosis using novel molecular techniques may improve the management of CRC by providing the most efficient therapies for Moroccan patients.
Linguistic discreteness and its variable expressions in multilingualism
Authors: Bhatt Rakesh M. , Bolonyai Agnes 
Published: June 2024

Aims and Objectives/Purpose/Research Questions: The aim of this research is to critically examine the concept of linguistic discreteness in multilingual practices, responding to contemporary debates that question the existence of languages as separate entities. We present a range of empirical data to demonstrate the theoretical necessity of maintaining the concept of language as discrete system in understanding multilingual practices. The research questions focus on how linguistic discreteness manifests in multilingual repertoires and the role it plays in the production and comprehension of the complexes of nuances of social-indexical meanings. Data, Methodology, Approach: This paper is a small-scale meta-analysis. The database comprises a diverse collection of empirical examples of code-switching drawn from documented studies, inter-personal interactions, media content, and linguistic landscapes. The research adopts a qualitative methodological approach to show creative, social-indexical uses of languages in multilingual contexts. Data and Analysis: Drawing from a range of empirical sources, this paper provides evidence to claim that multilingual repertoires do indeed exhibit discrete linguistic-epistemic inventories that are recruited routinely in complex ways in the production and comprehension of referential and social- indexical meanings. Findings/Conclusions: The key finding is that mobility of linguistic resources do not erase discreteness; in fact, it is precisely in the movement of various mobile resources where the discreteness of codes, or language “archives,” become significantly relevant in meaning-making. Originality: The paper reinforces the significance of linguistic discreteness through the synthesis of diverse examples to argue for the necessity of discrete linguistic systems in multilingualism studies. Significance/Implications: This paper underscores the persistent relevance of discrete linguistic systems in multilingual practices that facilitates complex meaning-making processes, enabling speakers to navigate and articulate social and referential meanings effectively. Methodologically, the research advocates for a nuanced analysis that recognizes the complexity and specificity of linguistic resources. Limitations: One limitation is the analytic focus, which does not capture the emic perspective of the speakers in multilingual practices.
Valuation and perception of the costs of climate change on health
Authors: Nordeng Zuzana , Kriit Hedi K. , Poltimäe Helen , Aunan Kristin , Dahl Miriam S. , Jevtic Marija , Matkovic Vlatka , Sandanger Gunnell , Orru Hans 
Published: June 2024

Background and aims: Climate change affects our societies and lives through our economies, our livelihoods, and our health. Economic losses of climate change are estimated at $23 trillion, largely through externalities due to premature mortality, healthcare expenditure, and health-related work losses. Even if there are established methods to quantify the health economic burden, there is limited information on how people perceive this information. The current study aimed to examine different health cost evaluation methods and observe perceptions of stakeholders in the climate change context. Method: The participatory research approach of the World Café with 41 participants was applied to explore four topics associated with valuing the costs of climate change. The data were analyzed following an inductive approach. Results: Despite the willingness-to-pay approach being widely applied, many experts see actual healthcare costs as a more explicit indicator of costs; however, this approach might underestimate actual costs. Participants experienced difficulties accepting and understanding cost estimates that indicated very high externalities as a percentage of gross domestic product. The cost-effectiveness of mitigation and adaptation measures was also challenged by a concern that while the costs of such measures are incurred now, the benefits do not come to fruition until later, for example, when building bike lanes or dams. Conclusions: Policies should favor environmentally friendly activities such as making cycling more convenient in cities with the health benefits presented in monetary terms, while limiting car driving. Moreover, the public might better understand the costs of climate change via tools that map how solutions influence different sectors and outlining the costs in evaluating the benefits for health and the environment.
Comparative meta-analysis of endovascular strategies for intracranial dissecting aneurysms: Flow diverters versus stents with or without coiling
Authors: Amoukhteh Melika , Hassankhani Amir , Jannatdoust Payam , Valizadeh Parya , Ghozy Sherief , Bilgin Cem , Kallmes David F 
Published: June 2024

Background Intracranial dissecting aneurysms present a challenging subset linked to considerable morbidity and mortality, necessitating effective therapeutic strategies to prevent complications. Traditional treatments face technical limitations, while emerging endovascular modalities like stent-assisted coiling, multiple stenting, and flow-diverting devices (FDDs) offer promise in reducing periprocedural risks and enhancing patient outcomes. The aim of this study is to compare the safety and efficacy outcomes of endovascular treatment for intracranial dissecting aneurysms using FDDs versus stents (with or without coiling). Methods A systematic review and meta-analysis were conducted following established guidelines. The search included PubMed, Scopus, Web of Science, and Embase databases up to July 30, 2023. Eligible studies reporting outcomes of interest in both FDD and stent-treated groups were included, and the data was extracted and analyzed using STATA software. Results Six studies were analyzed, involving 131 patients in the FDD group and 199 patients in the stent group. The pooled rates for favorable functional outcomes (86.8% vs. 86%), mortality (3.9% vs. 6%), adequate occlusion (79.7% vs. 86.3%), aneurysm recurrence (1.3% vs. 13.3%), in-stent stenosis/thrombosis (7% vs. 6.9%), ischemic events/infarctions (6.7% vs. 7.8%), retreatment (7% vs. 8.6%), and technical success (100% vs. 98.7%) were comparable in individuals treated with FDDs and stents (p > 0.05 in all cases). Additionally, complete occlusion rates were not significantly different between FDD (62.7%) and stent-treated patients (75.2%) (p = 0.06). However, after excluding one study in a leave-one-out analysis of the random effects meta-analysis, a significant difference in the pooled rates of this outcome was observed between the FDD (59.2%) and stent (75.2%) groups (p = 0.034). Conclusion FDDs present a promising approach for the treatment of intracranial dissecting aneurysms, yielding outcomes that are roughly comparable to stent-based methods. However, the absence of randomized trials and data limitations highlight the need for further research to enhance treatment strategies.
The effect of incremental increases in the number of packed red blood cell units transfused on perioperative outcomes in open abdominal aortic aneurysm repair
Authors: Yau Patricia , Liu Bryce , Friedmann Patricia , Lipsitz Evan , Koleilat Issam 
Published: June 2024

Introduction Despite abundant evidence in the surgical and critical care literature demonstrating inferior outcomes in transfused patients, liberal use of blood transfusion, particularly after the initial unit, remains common in vascular surgery. We therefore sought to investigate the incremental risk of each additional unit of blood transfused intraoperatively for patients undergoing elective open repair of abdominal aortic aneurysm (AAA) with regards to postoperative mortality and complications. Methods Patients in the Vascular Quality Initiative registry undergoing elective open infrarenal AAA repair from 2003 to 2020 were included. Exclusion criteria were age greater than 90, prior aortic surgery, concomitant iliac aneurysm, and concomitant additional major procedure. Multivariable logistic regression was used to calculate adjusted odds ratios for in-hospital mortality with incremental increases in packed red blood cells (pRBCs) given intraoperatively. Univariate analysis was performed for secondary outcomes including postoperative cardiac, respiratory, renal, and wound complications. Results Of 4608 patients who underwent elective open AAA repair, 796 patients (16.9%) underwent perioperative transfusion. The overall in-hospital mortality rate was 2.5%. Adjusting for relevant factors, there was an increase in the odds of in-hospital mortality of 24% for each additional unit transfused. Incremental increases in the number of units transfused were associated with significantly higher risk of postoperative myocardial infarction, congestive heart failure, pulmonary complications, renal failure, and wound complications. Discussion There appears to be an important increase in the odds of mortality for each additional unit transfused during infrarenal open AAA repair even when controlling for confounders.
The safety of corticosteroid injection prior to shoulder arthroplasty: A systematic review
Authors: Chowdhury Alex , Islam Saad , Ranaboldo Tom , Shean Katharine , Wilcocks Katharine , Sampalli Sridhar R , Elmorsy Ahmed 
Published: June 2024

Introduction Intra-articular corticosteroid injections are frequently utilised in patients with glenohumeral arthritis for diagnostic and therapeutic purposes. A systematic review was performed to assess the relationship between prior corticosteroid injection and infection following shoulder arthroplasty. Methods A search was performed, using databases Medline, EMBASE and CINAHL. Studies with comparative data of post-arthroplasty infection following previous corticosteroid injection versus controls were included. Results Seven studies fulfilled the inclusion criteria, comprising 87,820 patients. On pooled analysis, previous steroid injection did not increase the overall risk of infection (risk ratio 1.17; confidence interval 1.00–1.37, p = 0.06). On subgroup analysis for timing of injection, one given within 3 months before arthroplasty conferred a greater risk of infection than no injection (risk ratio 2.30; confidence interval 1.13–4.69, p = 0.02) or one given between 3 and 12 months before arthroplasty (risk ratio 3.32; confidence interval 1.43–7.72, p = 0.005). An injection at 3 to 12 months before arthroplasty did not increase the risk of infection over controls (risk ratio 0.89; confidence interval 0.63–1.25, p = 0.50). Conclusions This review has found there to be a time-dependent relationship between prior corticosteroid injection and infection post-arthroplasty, with an increased risk when performed within three months before arthroplasty. Thus, an interval of at least three months is recommended between injection and arthroplasty.
Risk Factors for Atraumatic Medial Patellar Facet Lesions
Authors: Retzky Julia S. , Palhares Guilherme M. , Uppstrom Tyler J. , Hinkley Paige , Fletcher Connor , Gomoll Andreas H. , Strickland Sabrina M. 
Published: June 2024

Background: Medial patellar facet lesions have been well-described in the setting of patellar instability. However, relatively little is known about risk factors for atraumatic medial patellar facet lesions. Purpose/Hypothesis: To identify clinical and radiographic risk factors for medial patellar facet lesions in patients without a history of trauma or patellar instability. It was hypothesized that a posterior tibial tubercle relative to the trochlear groove would be a risk factor for atraumatic medial patellar facet lesions. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 37 patients with atraumatic medial patellar facet lesions were matched by age, sex, and body mass index with 37 control patients without a history of patellofemoral dysplasia. Demographic and imaging characteristics were compared between groups. Plain radiography was used to evaluate Wiberg type, and magnetic resonance imaging was used to calculate Caton-Deschamps index, tibial tubercle-trochlear groove distance, trochlear facet asymmetry ratio, patellotrochlear index, sulcus depth, patellar bisect ratio, and tibial tubercle height. Statistically significant variables from univariate analysis were used as inputs to the multivariate regression model to assess independent risk factors. Results: There were no differences between groups with respect to Wiberg type, Caton-Deschamps index, tibial tubercle-trochlear groove distance, sulcus depth, or patellotrochlear index ( P > .05 for all). The medial facet lesion group had a larger medial trochlear facet (trochlear facet asymmetry ratio, 0.72 ± 0.11 vs 0.60 ± 0.09; P < .001), a more medial-lying patella in the trochlear groove (patellar bisect ratio, 0.57 ± 0.06 vs 0.55 ± 0.07; P = .035), and a more posterior tibial tubercle relative to the trochlear groove (tibial tubercle height, -3.13 ± 5.21 vs -0.23 ± 5.93 mm; P = .030) compared with the control group. Multivariate regression analysis identified trochlear facet asymmetry and tibial tubercle height as independent risk factors for medial patellar facet lesions (relative risk = 97.3 [95% CI, 14.9-635.1], P < .001 and relative risk = 0.95 [95% CI, 0.92-0.98], P = .004, respectively). Conclusion: A relatively larger medial trochlear facet and a more posterior tibial tubercle relative to the trochlear groove were found to be risk factors for medial patellar facet lesions in patients without a history of trauma or patellar instability.
NK cells with adhesion defects and reduced cytotoxic functions are associated with a poor prognosis in multiple myeloma
Authors: Blanquart Eve , Ekren Rüçhan , Rigaud Bineta , Joubert Marie-Véronique , Baylot Virginie , Daunes Hélène , Cuisinier Marine , Villard Marine , Carrié Nadège , Mazzotti Céline , Lucca Liliana E. , Perrot Aurore , Corre Jill , Walzer Thierry , Avet-Loiseau Hervé , Axisa Pierre-Paul , Martinet Ludovic 
Published: June 2024

Abstract
The promising results obtained with immunotherapeutic approaches for multiple myeloma (MM) call for a better stratification of patients based on immune components. The most pressing being cytotoxic lymphocytes such as natural killer (NK) cells that are mandatory for MM surveillance and therapy. Here, we performed a single-cell RNA sequencing analysis of NK cells from 10 patients with MM and 10 age/sex–matched healthy donors that revealed important transcriptomic changes in the NK cell landscape affecting both the bone marrow (BM) and peripheral blood compartment. The frequency of mature cytotoxic CD56dim NK cell subsets was reduced in patients with MM at the advantage of late-stage NK cell subsets expressing NF-κB and interferon-I inflammatory signatures. These NK cell subsets accumulating in patients with MM were characterized by low CD16 and CD226 expression and poor cytotoxic functions. MM CD16/CD226Lo NK cells also had adhesion defects with reduced lymphocyte function-associated antigen 1 (LFA-1) integrin activation and actin polymerization that may account for their limited effector functions in vitro. Finally, analysis of BM-infiltrating NK cells in a retrospective cohort of 177 patients with MM from the Intergroupe Francophone du Myélome (IFM) 2009 trial demonstrated that a high frequency of NK cells and their low CD16 and CD226 expression were associated with a shorter overall survival. Thus, CD16/CD226Lo NK cells with reduced effector functions accumulate along MM development and negatively affect patients’ clinical outcomes. Given the growing interest in harnessing NK cells to treat myeloma, this improved knowledge around MM–associated NK cell dysfunction will stimulate the development of more efficient immunotherapeutic drugs against MM.