bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans
Authors: Totzkay Daniel , Fraustino Julia Daisy , Smith Brittany T. , Jarrett Traci , Dino Geri A. , Costello Lisa M. , Kristjansson Alfgeir L. 
Published: April 2024

Purpose Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination. Design Cross-sectional survey administered by Research America, Inc. Setting West Virginia (WV). Sample 756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers). Measures Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control. Analysis Multivariate linear regression for intention and logistic regression for behavior. Results Intention was positively predicted by affective attitude, β = .30, P < .05, instrumental attitude, β = .19, P < .05, response efficacy, β = .19, P < .05, negative affect, β = .16, P < .05, self-efficacy, β = .13, P < .05, and subjective norm, β = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp( B) = 2.09, and subjective norm, exp( B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71. Conclusion COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination’s effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.
Comparative Safety and Effectiveness of Urea and Tolvaptan for the Management of Hyponatremia
Authors: Scalla Paolo A , Palma Stephanie M , Dittmar Erika , Zamora Francis J , Trimino Estela 
Published: April 2024

Background: The optimal management of euvolemic and hypervolemic hyponatremia remains controversial. The effectiveness of the vasopressin receptor antagonist tolvaptan on serum sodium normalization has been well described in the literature, although the associated risk of serum sodium overcorrection limits its use. Urea has been proposed as an alternative treatment option due to its milder serum sodium raising effects and adverse event profile. Objective: This study aimed to compare urea and tolvaptan for their serum sodium raising effects and potential for overcorrection. Methods: In a multicenter retrospective review, 46 hospitalized patients who received either urea or tolvaptan for the management of hyponatremia were evaluated for the rate of serum sodium normalization and overcorrection. Results: Mean serum sodium concentrations at baseline were 125.91 mEq/L and 123.83 mEq/L for patients treated with urea and tolvaptan, respectively. After 12 hours, tolvaptan was associated with a significantly higher rate of serum sodium increase compared with urea (5.05 mEq/L vs 1.10 mEq/L; P = .001). However, no statistically significant differences were observed in the mean change in serum sodium concentrations at 24 hours, 48 hours, or with the proportion of patients who reached a serum sodium concentration of 135 mEq/L. Overcorrection rates were significantly higher with tolvaptan compared with urea at 43% and 9%, respectively. Conclusion: The results of this study suggest that urea has a comparable effectiveness profile to tolvaptan for the management of hyponatremia with a significantly reduced risk of overcorrection.
A study of angle parametric optimization of the composite honeycomb on turbine blade tip
Authors: Kong Qingguo , Ning Jiaxin , Sun Xiaopeng , Pan Xiande , Sun Shuang , Lu Lehan , Si Haixu 
Published: April 2024

To reduce the secondary flow loss of the high-pressure turbine caused by the tip leakage flow, the design of the composite honeycomb tip has been experimentally and numerically examined in this study. The arrangement angle of the composite honeycomb is defined and optimized using the radial basis function and genetic algorithm. The tip flow field of the high-pressure turbine blade with a 2.128 mm clearance is simulated by CFX 18.0, and the arrangement angle of the composite honeycomb is optimized to obtain a lower loss. Moreover, the flat tip, basic honeycomb tip, and optimized honeycomb tip are tested in a low-speed cascade test facility. The results show that the vortices and radial velocity induced by the honeycomb structure cavity increase the kinetic energy loss of the leakage flow and reduce the leakage flow rate. Compared with the basic honeycomb, the optimized honeycomb has a supplemental blocking effect on the tip leakage flow by reducing the crosswise pressure gradient in the blade tip. The optimized honeycomb also changes the outlet angle of the leakage flow in the tip clearance, reduces the leakage vortex, and the total pressure loss is further reduced by 2.5%.
Evaluation of colitis induced by immune-checkpoint inhibitors therapy in melanoma patients by an overall grading scale
Authors: Nguyen Trang L. , Tew Alice , Kirton Laura , Steven Neil 
Published: April 2024

Background Colitis was the third most common immune-related adverse effect in melanoma patients treated with immune-checkpoint inhibitor (ICI). With the limitation of real-world data in the UK population, this study was conducted in a UK hospital where a fresh colitis guidance was introduced to evaluate the overall grading (OG) to assess colitis severity and guide the treatment. Aims This study aimed to investigate colitis severity by Common Terminology Criteria for Adverse Events (CTCAE) grade and overall grade at time of presentation. Colitis treatment and outcome were evaluated to compare the impact of these two categories. Methods A single-center, retrospective observational study was performed in melanoma patient developing colitis symptoms. Results A total of 44 advanced melanoma patient with colitis symptoms were included. Median time to colitis onset was 67 days (range 4–890). Majority of patients developed G1/ G2 of CTCAE scale (70.4%) but moderate or severe overall grade (84.1%). There were 65.9% of patients treated with steroids, and 38.2% with infliximab and 4.5% with vedolizumab. The median time of colitis resolution was 28 days (range 0–282). Both treatment modality and time to resolution were associated with severity of colitis assessed by complete OG(p&lt;0.0001) rather than CTCAE grading (p&gt;0.05). Conclusions This study provided a comprehensive description about ICI-induced colitis management in a single center of the UK. The more completed OG was proposed to stratify colitis patient and guide the investigation and treatment decision at presenting time, replacing the old CTCAE grading.
Pararenal Aortic Thrombus in Patients Undergoing Aortic Aneurysm Repair With Chimney Technique
Authors: Benedetto Filippo , Spinelli Domenico , Barillà Chiara , Fittipaldi Alessandra , Maria Castellana Federica , De Caridi Giovanni 
Published: April 2024

Introduction: Chimney technique (chimney graft in abdominal aortic aneurysm repair [ChEVAR]) can be used to treat patients with pararenal aortic aneurysm unfit for open surgery and not suitable for custom-made fenestrated endograft. Since almost 1 in 5 patients undergo a reintervention within 3 years, features associated with higher risk of complications need to be investigated to tailor the follow-up schedule to each patient. The aim of our study was to assess the impact of mural thrombus in the pararenal aorta on perioperative and follow-up complications after ChEVAR. Methods: All consecutive patients undergoing ChEVAR at our center from 2015 to 2022 were included in this retrospective study. Collected variables included number of target vessels, stent graft size, presence, and severity of mural thrombus in pararenal aorta, which was reported with a scoring system from 0 to 10 based on thrombus type, thickness area, and circumference Analyzed outcomes included perioperative and follow-up complications. Results: Thirty-one patients underwent ChEVAR during the study period. In 4 patients the indication for ChEVAR was type 1A endoleak after a previous endovascular aneurysm repair (EVAR). The number of target vessels was 1 in 17 patients (55%), 2 in 12 (39%), 3 in 1 (3%), and 4 in 1 (%). The mean mural thrombus score was 5.9. Complications were the following: type 1A endoleak in 4 cases (13%), chimney stent complications in 7 cases (23%) (including partial or total thrombosis, intrastent stenosis, displacement), renal function worsening during follow-up in 8 cases (26%). Overall survival was 90% at 2 years. Patients with severe mural thrombus showed lower freedom from ChEVAR-related complications (28% vs 59% at 2 years, p=0.023). Conclusions: The presence of severe pararenal aortic mural thrombus was associated with lower freedom from ChEVAR-related complications in patients undergoing ChEVAR for pararenal aortic aneurysm repair. Further research with a larger number of patients is required to confirm these results. Clinical Impact The analysis of severity of mural thrombus in pararenal aorta, which was reported with a scoring system from 0 to 10 based on thrombus type, thickness area and circumference, can be useful and can be represent an important predictor element for complications in patient submitted to Chimney tecnique; in fact the presence of severe pararenal aortic mural thrombus was associated with lower freedom from ChEVAR-related complications in patients undergoing ChEVAR for pararenal aortic aneurysm repair. Then, in patient with pararenal aortic aneurysm, a preoperative evaluation could be focused on severity of mural thrombus to minimize the complications in ChEVAR tecnique or to change the surgical strategy.
Differences in In-Hospital and Follow-Up Outcomes Between Non-A Non-B Aortic Dissection and Type B Aortic Dissection Treated by Endovascular Based Treatment
Authors: Li Gen , Li Jun , Deng Hongping , Wei Xiang , Li Na 
Published: April 2024

Objectives Non-A non-B aortic dissection (AD) is a rare and life-threatening medical emergency, and it has been controversial whether it should be managed as type B aortic dissection (TBAD). The study aims to compare in-hospital and follow-up outcomes between patients with non-A non-B AD and those with TBAD treated by endovascular based treatment (EBT). Methods From January 2017 to December 2021, 96 consecutive patients with non-A non-B AD met the inclusion criteria and underwent EBT. Patients with TBAD were matched to patients with non-A non-B AD at a 1:1 ratio using propensity score matching analysis to correct for baseline confounding factors. The primary endpoint was all-cause mortality. Aortic-related events were defined as dissection-related death, aortic rupture, retrograde type A aortic dissection, reintervention, and type Ia endoleak. Results Patients with non-A non-B AD required more TEVAR-related adjunctive procedures compared to TBAD patients during EBT and they required a longer ICU length of stay (36.0 vs 24.0 hours, P < .05) as well as a longer hospitalization (8.0 vs 7.0 days, P < .05) after EBT. There was no statistical difference in overall survival after EBT for patients with TBAD and non-A non-B AD. However, compared to patients with TBAD, non-A non-B AD patients had a higher rate of reintervention and experienced more aortic-related late events during follow-up. Conclusion Patients with non-A non-B acute AD who are treated with EBT do not have higher in-hospital or follow-up mortality rates compared to patients with type B AD. However, there is an increased risk of reintervention and aortic-related late events after the intervention during follow-up.
Impact of the economic crisis on the health-related quality of life of adults in Lebanon: An observational cross-sectional study
Authors: Sukarieh Rand , Hatem Georges , Hajar Nisrine , Al-Hajje Amal , Chehabeddine Mouna , Sukarieh Mohamad Bassam , Awada Sanaa 
Published: April 2024

Background: The economic crisis imposed changes to afford necessities like food, housing, and healthcare, leading to a decline in the physical and mental health of the population. Objectives: This study assessed the impact of the economic crisis on Lebanese adults’ health-related Quality of Life (QoL) and the predictors of lower scores. Methods: A cross-sectional study targeted 561 adults using a uniform questionnaire for data collection and a Short Form 8-item survey. Results: The sample comprised 77.9% females and 22.1% males. More than half of the sample reported a decrease in their income compared to the period before the crisis, and most participants reported that the economic turmoil highly impacted their access to healthcare services (63.0%), medication (51.5%), and food (56.5%) in addition to other necessities. Participants had lower Mental Component (MC) than Physical Component (PC) scores (55.5 and 69.0, respectively). Those highly impacted by the economic crisis in accessing medication had 1.76 times higher odds of lower PC scores than others (OR 1.76, 95% CI: 1.07–3.21). As regards the impact of the economic crisis on the MC scores, significantly higher odds of a lower MC score were noted among those highly impacted by the economic crisis in terms of access to medication (OR 2.12, 95% CI: 1.14–3.95), to food (OR 1.79, 95% CI: 1.1.12–2.87), and encountering water shortage (OR 1.65, 95% CI: 1.01–2.71). Conclusion: Lebanese adults’ QoL suffered physically and psychologically amid the economic crisis. The study underscores the need for accessible and affordable essential healthcare services and necessities.
The sequential antifracturative treatment: a meta-analysis of randomized clinical trials
Authors: Fassio Angelo , Gatti Davide , Biffi Annalisa , Ronco Raffaella , Porcu Gloria , Adami Giovanni , Alvaro Rosaria , Bogini Riccardo , Caputi Achille P. , Cianferotti Luisella , Frediani Bruno , Gonnelli Stefano , Iolascon Giovanni , Lenzi Andrea , Leone Salvatore , Michieli Raffaella , Migliaccio Silvia , Nicoletti Tiziana , Paoletta Marco , Pennini Annalisa , Piccirilli Eleonora , Rossini Maurizio , Brandi Maria Luisa , Corrao Giovanni , Tarantino Umberto 
Published: April 2024

Background: Subjects with a fragility fracture have an increased risk of a new fracture and should receive effective strategies to prevent new events. The medium-term to long-term strategy should be scheduled by considering the mechanisms of action in therapy and the estimated fracture risk. Objective: A systematic review was conducted to evaluate the sequential strategy in patients with or at risk of a fragility fracture in the context of the development of the Italian Guidelines. Design: Systematic review and meta-analysis. Data sources and methods: PubMed, Embase, and the Cochrane Library were investigated up to February 2021 to update the search of a recent systematic review. Randomized clinical trials (RCTs) that analyzed the sequential therapy of antiresorptive, anabolic treatment, or placebo in patients with or at risk of a fragility fracture were eligible. Three authors independently extracted data and appraised the risk of bias in the included studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Effect sizes were pooled in a meta-analysis using fixed-effects models. The primary outcome was the risk of refracture, while the secondary outcome was the bone mineral density (BMD) change. Results: In all, 17 RCTs, ranging from low to high quality, met our inclusion criteria. A significantly reduced risk of fracture was detected at (i) 12 or 24 months after the switch from romosozumab to denosumab versus placebo to denosumab; (ii) 30 months from teriparatide to bisphosphonates versus placebo to bisphosphonates; and (iii) 12 months from romosozumab to alendronate versus the only alendronate therapy (specifically for vertebral fractures). In general, at 2 years after the switch from anabolic to antiresorptive drugs, a weighted BMD was increased at the lumbar spine, total hip, and femoral neck site. Conclusion: The Task Force formulated recommendations on sequential therapy, which is the first treatment with anabolic drugs or ‘bone builders’ in patients with very high or imminent risk of fracture.
Colorimetric Barium Detection of Gunshot Residues on Cadaveric Human Skin: A Pilot Application for Forensic Purposes
Authors: Tambuzzi Stefano , Gentile Guendalina , Boracchi Michele , Andreola Salvatore , Zoja Riccardo 
Published: April 2024

Introduction: In this study we microscopically investigated, for the first time ever, the colorimetric detectability of barium of gunshot residues (GSR) on cadaveric human skin with gunshot wounds. Methods: For this purpose we used two different colorimetric techniques known in the literature, namely 0.2% sodium rhodizonate (Na-R-Ba 0.2%) and sodium rhodizonate in alcoholic environment (Na-R-Ba OH 0.2%). At the same time, we have also coupled it with scanning electron microscopy with energy dispersive X-ray (SEM/EDX) analysis and the colorimetric study for the detection of lead of GSR. These techniques were applied to 16 victims who died from gunshot injuries, as well as to a control group. Results: SEM/EDX demonstrated the presence of lead in all cases and barium in 11 of the 16 cases. The subsequent colorimetric technique with Na-R-Ba 0.2% did not show the barium of GSR in any case, unlike the Na-R-Ba OH 0.2% technique. This latter, in fact, has demonstrated the presence of this metal in 2 cases (18%). No microscopic case of false positive was recorded. Conclusion: The evidence obtained with Na-R-Ba OH 0.2% makes this method, applied here for the first time ever, worthy of further study. Meanwhile, although this technique can certainly be applied, it cannot be separated from the contextual colorimetric investigation for lead and the use of more sophisticated techniques.
Intermediate-Term Clinical Outcomes of High-Density Autologous Chondrocyte Implantation in Patients with Concomitant Anterior Cruciate Ligament Reconstruction and Focal Chondral Lesions
Authors: Guillén-Vicente Isabel , Herros-García Ramón , Guillén-Vicente Marta , Ruiz Borja , Lopez-Alcorocho Juan Manuel , Rodríguez-Iñigo Elena , Barrera Adrián , Fernández-Jaén Tomás F. , Abelow Steve , Guillén-García Pedro 
Published: April 2024

Objective To investigate intermediate-term clinical results in patients with concomitant anterior cruciate ligament (ACL) reconstruction and chondral defect treated with high-density autologous chondrocyte implantation (HD-ACI) compared to patients without ACL tear but with a chondral lesion and HD-ACI treatment. Design Forty-eight patients with focal chondral lesions underwent HD-ACI (24 with ACL reconstruction after an ACL injury and 24 with an intact ACL). Follow-up assessments occurred at 6, 12, and 24 months. Patient-reported knee function and symptoms were assessed using the International Knee Documentation Committee (IKDC) questionnaire, pain was measured using the Visual Analog Scale (VAS), and adverse events were monitored. Physical activity was assessed using the Tegner Activity Level Scale, and cartilage healing was evaluated with the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Results No significant adverse events occurred during follow-up. Both groups showed significant improvements at 2 years compared to baseline (VAS: 8.0 ± 1.3 to 1.4 ± 2.0 [normal ACL]; 7.4 ± 2.3 to 2.1 ± 2.3 [ACL reconstruction]; IKDC: 39.2 ± 10.6 to 76.1 ± 22.0 [intact ACL]; 35.6 ± 12.1 to 74.6 ± 20.9 [ACL reconstruction]). Patients in both groups exceeded the minimal clinically important difference (MCID) for IKDC scores. The Tegner Activity Level Scale decreased immediately after surgery and increased after 2 years, with 70.6% (normal ACL) and 89.5% (ACL reconstruction) returning to their preinjury activity levels. No significant differences in the MOCART score were observed between the groups. Conclusions ACL reconstruction does not appear to reduce the outcomes (at 2 years) of HD-ACI.
Autogenous structural bone graft reconstruction of ≥ 10-mm-deep uncontained medial proximal tibial defects in primary total knee arthroplasty
Authors: Dewidar Ahmed Abdel-Monem , Mesregah Mohamed Kamal , Mesriga Mustafa Mohamed , El-Behiry Ahmed Mohamed 
Published: April 2024

Abstract
Background
Management of uncontained medial proximal tibial defects during primary total knee arthroplasty (TKA) can be challenging, especially for defects ≥ 10 mm in depth. This study sought to assess the outcomes of autogenous structural bone grafts to address these defects.

Materials and methods
In this prospective study, patients with uncontained medial proximal tibial defects ≥ 10 mm in depth undergoing TKA were managed by autogenous structural bone grafts fixed by screws and were followed up for at least 36 months. Patients were followed-up clinically with Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, radiological follow-up was done to assess bone graft union and implant stability.

Results
The study included 48 patients with a mean age of 69.2 ± 4.5 years. The mean body mass index (BMI) was 31.4 ± 3.7 kg/m2. The mean defect depth was 17 ± 3.6 mm. With a mean follow-up period of 52.2 ± 12.3 months, the median KSS improved significantly from 30 preoperatively to 89, P < 0.001. The median WOMAC score reduced significantly from 85 preoperatively to 30.5, P < 0.001. The mean ROM increased significantly from 73 ± 12.4 preoperatively to 124 ± 8.4 degrees, P < 0.001. The mean graft union time was 4.9 ± 1 months. No significant complications were reported.

Conclusions
Autogenous bone graft reconstruction is a safe and effective method of addressing uncontained medial proximal tibial defects in primary TKA.

Level of evidence
Level IV.
Targeted inhibition of the PI3K/AKT/mTOR pathway by (+)-anthrabenzoxocinone induces cell cycle arrest, apoptosis, and autophagy in non-small cell lung cancer
Authors: Li Xiao-Qian , Cheng Xiao-Ju , Wu Jie , Wu Kai-Feng , Liu Tie 
Published: April 2024

AbstractNon-small cell lung cancer (NSCLC), characterized by low survival rates and a high recurrence rate, is a major cause of cancer-related mortality. Aberrant activation of the PI3K/AKT/mTOR signaling pathway is a common driver of NSCLC. Within this study, the inhibitory activity of (+)-anthrabenzoxocinone ((+)-ABX), an oxygenated anthrabenzoxocinone compound derived from Streptomyces, against NSCLC is demonstrated for the first time both in vitro and in vivo. Mechanistically, it is confirmed that the PI3K/AKT/mTOR signaling pathway is targeted and suppressed by (+)-ABX, resulting in the induction of S and G2/M phase arrest, apoptosis, and autophagy in NSCLC cells. Additionally, the augmentation of intracellular ROS levels by (+)-ABX is revealed, further contributing to the inhibition of the signaling pathway and exerting inhibitory effects on tumor growth. The findings presented in this study suggest that (+)-ABX possesses the potential to serve as a lead compound for the treatment of NSCLC.
Graphical abstract