bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the weakest point of a secured aortic cannula in central extracorporeal membrane oxygenation?
Authors: Lucas Kayla V. , Stukov Yuriy , Purlee Matthew S. , Delaleu Tatiana , Sharaf Omar M. , Bleiweis Mark S. , Jacobs Jeffrey Phillip , Peek Giles J. 
Published: May 2024

Purpose The purpose of this study was to compare techniques for securing the aortic extracorporeal membrane oxygenation (ECMO) cannula, using in vitro models. Methods Two models were studied: a tissue model using porcine aortas and a stand model replacing the aorta with a metal stand to study the system independent of the tissue. Interventions in each model were divided into three experimental groups: Group 1 (3-0 Prolene® + 20-French Medtronic Arterial Cannula EOPA™), Group 2 (4-0 Prolene® + 16-French Medtronic Arterial Cannula DLP Pediatric), and Group 3 (5-0 Prolene® + 8-French Medtronic Arterial Cannula DLP Pediatric). In separate experiments, both gradual and rapid forces were applied to the cannulas, starting with 9.8 Newtons and increasing exponentially if the cannula remained secured. Additionally, the method of securing the tourniquet and the number of ties securing the tourniquet to the cannula were evaluated. Results In the tissue model, even with a minimum force of 9.8 Newtons, the suture pulled through the aortic tissue, leaving sutures and ties intact. In the stand model, two purse-string sutures secured by two ligaclips held the cannula reliably and withstood higher total force. Dislodgement was prevented at forces close to 60 Newtons with only two hemostatic clips included in cannulation. Conclusions The weakest part of the aortic ECMO cannulation system using in vitro experiments was the tissue. Assuming that these experiments translate in vivo, it is therefore critical to prevent any pull on the cannulas by securing ECMO cannulas and ECMO tubing to both the patient and the patient’s bed. Sutures with a larger diameter withstand more force. Two medium hemostatic clips can secure Prolene® sutures within snares as safely as a mosquito hemostat. Two polypropylene purse-string sutures secured by two hemostatic clips were most reliable at greater forces. The rationale for publishing our experiments in this manuscript is to (1) communicate our quantification of possible contributing factors to this rare and likely catastrophic complication of unintended decannulation, (2) increase awareness about this potential complication, and (3) increase vigilance to assure prevention of this dreaded complication.
Interactive Effects of Racism and Racial Centrality on ADHD Symptoms
Authors: Boyd Kaylee , Ware Maryam , Mekawi Yara 
Published: May 2024

Objective: Although race-related stress is associated with numerous mental health outcomes, no previous research has examined associations with ADHD symptoms. We examine how such associations differ in Black Americans based on racial identity to allow for more nuanced understandings of racial discrimination’s association with ADHD symptoms. Methods: This study asked a sample of Black Americans to answer questionnaires assessing race-related stress, ADHD symptoms, and racial centrality. Results: In predicting ADHD symptoms, we found a positive effect of race-related stress and a negative effect of centrality. At low levels of centrality, the association between ADHD symptoms and race-related stress was stronger than at mean and high levels of centrality. Through additional sub-group analyses we found the interaction effect not replicating in one of our conditions. Conclusion: These results suggest experiences of race-related stress and racial identity are important factors for consideration in the treatment of ADHD symptoms.
Mucopolysaccharidosis type II B complicated by optic disc swelling, pigmentary retinopathy and macular edema
Authors: Olivieri Chiara , Ricardi Federico , Coletto Andrea , Marica Valentina , Serafino Sonia , Marolo Paola , Reibaldi Michele , Borrelli Enrico 
Published: May 2024

Purpose To report clinical and imaging features of optic nerve and retinal involvement in a patient with mucopolysaccharidosis (MPS) type II B. Methods A 27-year-old man, diagnosed with MPS type II B and undergoing enzymatic substitution therapy for the past 19 years, was referred to the retina service. An ophthalmological evaluation, which included multimodal imaging, was conducted to investigate potential retinal and optic disc involvement. Results The eye examination revealed a pigmentary retinopathy with a predominant loss of the outer retinal loss, primarily in the parafoveal and perifoveal regions. Notably, multimodal imaging identified macular edema without any signs of leakage, implying an association between macular edema and retinal neurodegeneration. Additionally, both eyes exhibited an optic disc with blurred margins. Conclusion We herein describe the multimodal imaging findings of retinal and optic disc involvement in a patient with MPS type II B. This report describes for the first-time the presence of macular edema without leakage alongside photoreceptor damage and optic disc swelling.
Identification of Molecular Mechanisms of Ameloblastoma and Drug Repositioning by Integration of Bioinformatics Analysis and Molecular Docking Simulation
Authors: Chujan Suthipong , Vajeethaveesin Nutsira , Satayavivad Jutamaad , Kitkumthorn Nakarin 
Published: May 2024

Background: Ameloblastoma (AM) is a benign tumor locally originated from odontogenic epithelium that is commonly found in the jaw. This tumor makes aggressive invasions and has a high recurrence rate. This study aimed to investigate the differentially expressed genes (DEGs), biological function alterations, disease targets, and existing drugs for AM using bioinformatics analysis. Methods: The data set of AM was retrieved from the GEO database (GSE132474) and identified the DEGs using bioinformatics analysis. The biological alteration analysis was applied to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Protein-protein interaction (PPI) network analysis and hub gene identification were screened through NetworkAnalyst. The transcription factor-protein network was constructed via OmicsNet. We also identified candidate compounds from L1000CDS2 database. The target of AM and candidate compounds were verified using docking simulation. Results: Totally, 611 DEGs were identified. The biological function enrichment analysis revealed glycosaminoglycan and GABA (γ-aminobutyric acid) signaling were most significantly up-regulated and down-regulated in AM, respectively. Subsequently, hub genes and transcription factors were screened via the network and showed FOS protein was found in both networks. Furthermore, we evaluated FOS protein to be a therapeutic target in AMs. Candidate compounds were screened and verified using docking simulation. Tanespimycin showed the greatest affinity binding value to bind FOS protein. Conclusions: This study presented the underlying molecular mechanisms of disease pathogenesis, biological alteration, and important pathways of AMs and provided a candidate compound, Tanespimycin, targeting FOS protein for the treatment of AMs.
Natural weathering degradation studies of the poly (3-hydroxybutyrate-co-3 hydroxyvalerate) (PHBV)/paddy straw powder (PSP) biocomposites
Authors: Yaacob Noorulnajwa Diyana , Sung Ting Sam , Azizul Rashidi Athirah Marsya 
Published: May 2024

The effect of natural weathering exposure time on the poly (3-hydroxybutyrate-co-3 hydroxyvalerate) (PHBV)/paddy straw powder (PSP) biocomposites was studied. These biocomposites were naturally exposed to tropical climate weathering conditions in Perlis, Malaysia for 6 months. Tensile test, Fourier transform infrared (FTIR), and scanning electron microscopy (SEM) were applied to investigate the degradation that happened during natural weathering of the biocomposites. Tensile tests indicated that the weathered PHBV/PSP biocomposites caused lower ultimate strength and elongation to break, but increased the modulus of elasticity. As the exposure time prolonged to 6 months, the concentration of O-H groups became pronounced, indicating severe deterioration of the biocomposites. With a carbonyl chromophoric group in its structure, PHBV can absorb UV radiation directly, which could lead to reactions of Norrish forms I and II. Generally, the addition of PSP has increased the degradability of PHBV. Besides, the exposed PHBV/PSP biocomposite surfaces have undergone surface crazing upon weathering. The surface of the PHBV without the addition of the PSP did not show any crack and fungus colonisation. The higher PSP content loaded in the biocomposites (i.e. 20 wt. %) caused more fungi colonisation, resulting in larger cracks and pores formed on the surface of the samples.
Accelerometry-assessed physical activity and sedentary behavior patterns using single- and multi-component latent class analysis among postmenopausal women
Authors: Evenson Kelly R , Wen Fang , Di Chongzhi , Kebede Michael , LaMonte Michael J , Lee I-Min , Tinker Lesley Fels , LaCroix Andrea Z , Howard Annie Green 
Published: May 2024

Background: Patterns of physical activity and sedentary behavior among postmenopausal women are not well characterized. Objectives: To describe the patterns of accelerometer-assessed physical activity and sedentary behavior among postmenopausal women. Design: Cross-sectional study. Methods: Women 63–97 years (n = 6126) wore an ActiGraph GT3X + accelerometer on their hip for 1 week. Latent class analysis was used to classify women by patterns of percent of wake time in physical activity and sedentary behavior over the week. Results: On average, participants spent two-thirds of their day in sedentary behavior (62.3%), 21.1% in light low, 11.0% in light high, and 5.6% in moderate-to-vigorous physical activity. Five classes emerged for each single-component model for sedentary behavior and light low, light high, and moderate-to-vigorous physical activity. Six classes emerged for the multi-component model that simultaneously considered the four behaviors together. Conclusion: Unique profiles were identified in both single- and multi-component models that can provide new insights into habitual patterns of physical activity and sedentary behavior among postmenopausal women. Implications: The multi-component approach can contribute to refining public health guidelines that integrate recommendations for both enhancing age-appropriate physical activity levels and reducing time spent in sedentary behavior.
Distal Tibiofibular Syndesmosis Injuries in the National Football League (NFL): A Spectrum of Pathology That Correlates With Time to Return to Full Participation
Authors: Kuhn Andrew W. , Coughlin Michael J. , McGonegle Shane J. , Herzog Mackenzie M. , Weir Nate , Meade Spratley E. , O’Cain Cody M. , Anderson Robert B. 
Published: May 2024

Background: Studies routinely evaluate high ankle sprains in isolation, but recent data suggest that these injuries are often associated with concomitant pathology, potentially influencing return to full participation. Hypothesis: In National Football League (NFL) players, isolated high ankle sprains are rare and syndesmosis injuries with concomitant pathology will result in increased time to return to full participation. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Distal tibiofibular syndesmosis injuries sustained by NFL players between 2017 and 2019 were identified through NFL Injury Surveillance Database queries and verified with video analysis. Each injury underwent a comprehensive magnetic resonance imaging (MRI) review. Regression modeling was utilized to explore the influence of numerous imaging findings on time to return to full participation. Results: There were 83 external rotation ankle injuries involving the syndesmosis. Isolated distal tibiofibular syndesmosis injuries were rare (n = 11; 13%) and more often associated with other ligamentous injury (deltoid ligament and lateral ligamentous complex) and/or fractures. Regression modeling resulted in clustering of 3 injury pattern groups for time to return to full participation across numerous imaging findings: syndesmosis injury-fracture combinations (250 days [interquartile range [IQR,] 142-266 days]), syndesmosis injury with complete deep deltoid tear or acute diastasis (175 days [IQR, 20-248 days]), and all other syndesmosis injuries (27 days [IQR, 18-46 days]). Conclusion: In NFL athletes with external rotation ankle injuries, isolated distal tibiofibular syndesmosis injuries were rare and more often associated with concomitant pathology. Time to return to full participation was affected by an associated fracture and complete deep deltoid ligament tear or diastasis but no other relevant MRI variables such as lateral ligament complex involvement or the presence of osteochondral lesions or bone contusions.
Associations between perceived usefulness and willingness to use smart healthcare devices among Chinese older adults: The multiple mediating effect of technology interactivity and technology anxiety
Authors: Sun Sheng , Jiang Lan , Zhou Yue 
Published: May 2024

Objective This study aims to explore the mediating roles of technological interactivity and technological anxiety in the relationship between perceived usefulness and the willingness to use a smart health device to provide insight into the decision-making process of older adults in relation to the adoption of smart devices. Methods A cross-sectional survey was conducted in Jiangsu, China involving 552 older adults. The study utilized structural equation modeling (SEM) to analyze the relationship between the independent variable ‘perceived usefulness’ and the dependent variable ‘willingness to use.’ It also examined the multiple mediating effects of technological interactivity and technological anxiety between the independent and dependent variables. Results The results indicate that the direct effect of perceived usefulness on willingness to use was insignificant. However, technological interactivity completely mediated the relationship between perceived usefulness and willingness to use. Additionally, technological interactivity and technological anxiety were found to have a serial mediating effect on the impact of perceived usefulness on willingness to use smart healthcare devices. Conclusions These findings suggest that increasing older adults’ intention to use smart healthcare devices requires not only raising awareness of their usefulness, but also addressing technological anxiety and enhancing the interactivity of these devices to improve the overall user experience.
Assessment of the online presence and regulatory compliance of dental practice websites in France
Authors: Pollet Aude , Diakonoff Hadrien 
Published: May 2024

Objective The aim of this study was to investigate the online presence of French dental practices that have a professional website. Secondly, the degree of compliance of practices’ websites with the current regulatory framework was assessed. Methods Open data was used to identify a 5% random sample of private dental practices in France ( n = 1370 facilities). Then, a manual search was made on Google to find the website for each practice. When found, the website was analyzed using criteria. Results Only 25.9% of dental practices have a functional and referenced website, allowing 28.9% of the dentists in the sample to have an online presence. Disparities exist depending on the geographical location of the facility and its type. The assessment of website content uncovered a lack of compliance with the existing regulatory framework, exhibiting variations based on the type of facility and the person who designed the website. Hiring a specialized web design provider for dentists enhances compliance with laws and guidelines, though it doesn't guarantee complete adherence. Conclusions The online presence of dental practices and dentists in France is limited. Where they do exist, dental practice websites generally do not comply with legal requirements and guidelines for online communication. Efforts should be made to improve the information provided to patients.
Is information evaluated subjectively? Social media has changed the way users search for medical information
Authors: Yi Shiqi , Guo Yu , Lin Zixuan , Cao Cong 
Published: May 2024

Objective In recent years, social media platforms, such as TikTok and RedBook, have emerged as important channels through which users access and share medical information. Additionally, an increasing number of healthcare professionals have created social media accounts through which to disseminate medical knowledge. This paper explores why users obtain their medical information from social media and how the signals transmitted by social platforms affect use behaviours. Methods We combined the elaboration likelihood model and signal theories to construct a comprehensive model for this study. We used simple random sampling to investigate users’ behaviours related to social media usage. A total of 351 valid questionnaires were completed by people in Mainland China. The participants were enthusiastic about social media platforms and had searched for health-related information on social media in the past three months. We analysed the data using partial least squares structural equation modelling to investigate the influence of two pathways and two signals (objective and subjective judgement pathways and positive and negative signals) on social media use behaviours. Results When seeking medical information on social media, users tend to rely on subjective judgment rather than objective judgment, although both are influential. Furthermore, in the current era, in which marketing methods involving big data algorithms and artificial intelligence prevail, negative signals, such as information overload, have a more pronounced impact than positive signals. Conclusions This study demonstrates that the subjective judgment path has a greater impact on users than the objective judgment path. Platforms are encouraged to focus more on users’ emotional needs. The paper also discusses the negative impact of information overload on users, sounding an alarm for enterprises to control their use of homogeneous information resulting from the excessive use of big data algorithms.
Interrelationship Between Entrepreneurial Alertness and Intention Among University Students: A Moderated Mediation Model
Authors: Zhou (周淑怡) Shuyi , Mei (梅伟惠) Weihui 
Published: May 2024

Purpose Based on the theory of planned behavior and social cognitive theory, this study investigates the relationship between entrepreneurial alertness (EA) and entrepreneurial intention (EI) through the mediating role of entrepreneurial self-efficacy (ESE) and the moderating role of entrepreneurial climate (EC) in the “triple disruptions” of pandemic, Industry 4.0, and innovative technology. Design/Approach/Methods This study collected data from 717 Chinese university students and adopted a moderated mediation model to verify the proposed construct. All data were acquired online via Wenjuanxing software and analyzed with SPSS and SmartPLS. Findings Results show that (1) EA, ESE, and EC are significant predictors of EI; (2) ESE partially mediates the relationship between EA and EI; and (3) EC moderates the relationship between ESE and EI. Originality/Value The originality of this study lies in its use of an inner- and outer-moderator framework to examine student entrepreneurial intentions. The results of this study demonstrate that EA, ESE, and EC are crucial determinants of EI among Chinese university students. These findings of this study have empirical implications for governments, universities, and individuals insofar as they can be used to enhance students’ ability to recognize entrepreneurial opportunities, foster ESE, create ECs, and facilitate EI by offering multiple entrepreneurship-related resources.
Optimal use of antithrombotic agents in recent small subcortical strokes accompanied by atrial fibrillation
Authors: Lee Minwoo , Oh Mi-Sun , Yu Kyung-Ho , Kim Chulho , Sohn Jong-Hee , Mo Hee-Jung , Kim Yerim , Lee Sang-Hwa 
Published: May 2024

Background: This study aimed to evaluate the efficacy and safety of anticoagulants (AC) and antiplatelets (APT) in patients with recent small subcortical infarctions (RSSI) and atrial fibrillation (AF). Methods: We utilized a prospective multicenter stroke registry database to identify patients with RSSI with a concurrent diagnosis of AF. Propensity score matching analysis was used to balance baseline differences among the AC-only, APT-only, and their combination groups. The main outcomes of interest were time to occurrence of minor and major bleeding, stroke recurrence, and all-cause mortality. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for each outcome were calculated using the multivariable Cox proportional hazard regression analysis. Results: Of the 404 eligible patients, 28.2% received APT only, 53.0% received AC only, and 18.9% received a combination of both. Notable differences were observed between these groups in terms of the 1-year stroke recurrence (APT, 32.5%; AC, 5.6%; APT + AC, 9.2%) and all-cause mortality (APT, 21.9%; AC, 6.1%; APT + AC, 14.5%), whereas the rates of bleeding events were comparable. The multivariable analysis indicated a significant association of AC alone with reduced risks of severe bleeding, stroke recurrence, and all-cause mortality compared with APT alone (aHR 0.64, 95% CI 0.41–0.98; aHR 0.11, 95% CI 0.06–0.22; aHR 0.22, 95% CI 0.11–0.44, respectively). The combination group showed a reduced risk of stroke recurrence compared to APT alone (aHR 0.19, 95% CI 0.08–0.46). These findings remained consistent with the propensity score-matched analysis. Conclusion: AC showed better clinical outcomes than APT in patients with RSSI and AF. Additionally, combination therapy with AC and APT was associated with a lower risk of stroke recurrence than APT alone.
“Politics Versus Policy”: Qualitative Insights on Stigma and Overdose Prevention Center Policymaking in the United States
Authors: Koehm Kristin , Rosen Joseph G. , Yedinak Gray Jesse L. , Tardif Jessica , Thompson Erin , Park Ju Nyeong 
Published: May 2024

Background: Federal, state, and municipal governments in the United States have been reluctant to authorize overdose prevention centers (OPCs), which are evidence-based approaches for preventing overdose deaths and blood-borne pathogen transmission. Methods: From July 2022 to February 2023, we explored how stigma manifests in OPC policymaking by conducting in-depth interviews with 17 advocates, legislators, service providers, and researchers involved with OPC advocacy and policymaking in Rhode Island, California, Pennsylvania, and New York. Results: We found that although jurisdictions differed in their OPC policymaking experiences, stigma manifested throughout the process, from planning to authorization. Participants described OPCs as a tool for destigmatizing overdose and substance use, yet confronted institutionalized stigma and discriminatory attitudes toward people who use drugs (PWUD) and harm reduction from multiple sources (eg, politicians, media, and members of the public). Opposition toward OPCs and harm reduction approaches more broadly intersected with public discourse on crime, homelessness, and public disorder. Employed stigma-mitigation strategies included humanizing PWUD, publicizing the benefits of OPCs to the wider community, and strategically engaging media. Conclusion: These findings illustrate the importance of understanding stigma at different stages of the policymaking process to better facilitate authorization and eventual implementation of OPCs in the United States.