bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compression-Only or Standard Cardiopulmonary Resuscitation for Trained Laypersons in Out-of-Hospital Cardiac Arrest: A Nationwide Randomized Trial in Sweden
Authors: Riva Gabriel , Boberg Erik , Ringh Mattias , Jonsson Martin , Claesson Andreas , Nord Anette , Rubertsson Sten , Blomberg Hans , Nordberg Per , Forsberg Sune , Rosenqvist Mårten , Svensson Leif , Andréll Cecilia , Herlitz Johan , Hollenberg Jacob 
Published: March 2024

BACKGROUND:
The ongoing TANGO2 (Telephone Assisted CPR. AN evaluation of efficacy amonGst cOmpression only and standard CPR) trial is designed to evaluate whether compression-only cardiopulmonary resuscitation (CPR) by trained laypersons is noninferior to standard CPR in adult out-of-hospital cardiac arrest. This pilot study assesses feasibility, safety, and intermediate clinical outcomes as part of the larger TANGO2 survival trial.

METHODS:
Emergency medical dispatch calls of suspected out-of-hospital cardiac arrest were screened for inclusion at 18 dispatch centers in Sweden between January 1, 2017, and March 12, 2020. Inclusion criteria were witnessed event, bystander on the scene with previous CPR training, age above 18 years of age, and no signs of trauma, pregnancy, or intoxication. Cases were randomized 1:1 at the dispatch center to either instructions to perform compression-only CPR (intervention) or instructions to perform standard CPR (control). Feasibility included evaluation of inclusion, randomization, and adherence to protocol. Safety measures were time to emergency medical service dispatch CPR instructions, and to start of CPR, intermediate clinical outcome was defined as 1-day survival.

RESULTS:

Of 11 838 calls of suspected out-of-hospital cardiac arrest screened for inclusion, 2168 were randomized and 1250 (57.7%) were out-of-hospital cardiac arrests treated by the emergency medical service. Of these, 640 were assigned to intervention and 610 to control. Crossover from intervention to control occurred in 16.3% and from control to intervention in 18.5%. The median time from emergency call to ambulance dispatch was 1 minute and 36 s (interquartile range, 1.1–2.2) in the intervention group and 1 minute and 30 s (interquartile range, 1.1–2.2) in the control group. Survival to 1 day was 28.6% versus 28.4% (
P
=0.984) for intervention and control, respectively.

CONCLUSIONS:
In this national randomized pilot trial, compression-only CPR versus standard CPR by trained laypersons was feasible. No differences in safety measures or short-term survival were found between the 2 strategies. Efforts to reduce crossover are important and may strengthen the ongoing main trial that will assess differences in long-term survival.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02401633.
Radar Outage Costs and the Value of Alternate Datasets
Authors: Rudlosky Scott D. , Patton Joseph , Palagonia Eric , Cho John Y. N. , Kurdzo James M. 
Published: March 2024

Abstract
Quantifying the costs of radar outages allows value to be attributed to the alternate datasets that help mitigate outages. When radars are offline, forecasters rely more heavily on nearby radars, surface reports, numerical weather prediction models, and satellite observations. Monetized radar benefit models allow value to be attributed to individual radars for mitigating the threat to life from tornadoes, flash floods, and severe winds. Eighteen radars exceed $20 million in annual benefits for mitigating the threat to life from these convective hazards. The Jackson, Mississippi, radar (KDGX) provides the most value ($41.4 million), with the vast majority related to tornado risk mitigation ($29.4 million). During 2020–23, the average radar is offline for 2.57% of minutes or 9.27 days per year and experiences an average of 58.9 outages per year lasting 4.32 h on average. Radar outage cost estimates vary by location and convective hazard. Outage cost estimates concentrate at the top, with 8, 2, 4, and 5 radars exceeding $1 million in outage costs during 2020, 2021, 2022, and 2023, respectively. The KDGX radar experiences outage frequencies of 4.92% and 5.50% during 2020 and 2023, resulting in outage cost estimates > $2 million in both years. Combining outage cost estimates for all radars suggests that approximately $29.1 million in annual radar outage costs may be attributable as value to alternative datasets for helping mitigate radar outage impacts.

Significance Statement
This study combines information on radar status and monetized radar benefit models to attribute value to individual radars, estimate radar outage costs, and quantify the potential value of alternative datasets during outage-induced gaps in coverage. Eighteen radars exceed $20 million in annual benefits for mitigating the combined threat to life from tornadoes, flash floods, and severe winds. The first and third most valuable radars, both in Mississippi, experience outage frequencies twice the national average, accounting for a disproportionate share of the overall outage costs. Our findings suggest that characterizing and mitigating these outages might provide a near-term solution to better protect these communities from convective hazards. Combining outage cost estimates for all radars suggests that approximately $29.1 million in annual radar outage costs may be attributable as value to alternative datasets for helping mitigate the impacts of radar outages.
Effects of Fibular Plate Fixation on Ankle Stability in a Weber B Fracture Model With Partial Deltoid Ligament Sectioning
Authors: Gregersen Martin G. , Dalen Andreas F. , Skrede Aleksander L. , Bjelland Øystein , Nilsen Fredrik A. , Molund Marius 
Published: March 2024

Background: Weber B fractures with concomitant deltoid ligament injury have traditionally been operated with open reduction and internal fixation of the fibular fracture. More recently, clinical studies have suggested that some fractures have concomitant partial deltoid ligament injury with the deep posterior tibiotalar ligament intact (SER4a), allowing for nonoperative treatment in this subgroup. This study explores whether plate fixation of the fibula improves ankle stability in an SER4a injury model. And if so, does it restore native ankle stability? Methods Fifteen cadaver ankle specimens were tested in 3 states using an industrial robot: intact joint, SER4a models without plate fixation of the fibula, and SER4a models with plate fixation of the fibula. The robot measured ankle stability in lateral translation, valgus, and internal and external rotation in 3 talocrural joint positions: 10 degrees dorsiflexion, neutral, and 20 degrees plantar flexion. Furthermore, fluoroscopic mortise view radiographs were taken to measure isolated talar shift and talar tilt. Results: The talar shift and tilt tests showed no differences between the SER4a injury model with and without fibular plate fixation at neutral ankle position with a mean difference of −0.16 mm (95% CI −0.33 to 0.01 mm, P = .071) for talar shift and −0.15 degrees (95% CI −0.01 to 0.30 degrees, P = .068) for talar tilt. However, plate fixation increased external rotation stability, with mean improvements ranging from −7.43 to −9.52 degrees ( P < .001 for all comparisons), but did not restore intact ankle stability. For internal rotation, plate fixation resulted in minor differences. Conclusion: The results of this suggest that plate fixation of the fibular fracture primarily improves external rotation stability but does not substantially improve lateral translation, valgus, or internal rotation stability in SER4a injury models. In this robotic cadaver model, fibular plate fixation did not fully restore intact ankle stability after simulated SER4a injury. Clinical Relevance: This study offers insights into the effects of fibular plate fixation on Weber B/SER4a injury models and may assist informed decisions when selecting treatments for these types of fractures.
Generative artificial intelligence chatbots may provide appropriate informational responses to common vascular surgery questions by patients
Authors: Chervonski Ethan , Harish Keerthi B. , Rockman Caron B. , Sadek Mikel , Teter Katherine A. , Jacobowitz Glenn R. , Berland Todd L. , Lohr Joann , Moore Colleen , Maldonado Thomas S. 
Published: March 2024

Objectives Generative artificial intelligence (AI) has emerged as a promising tool to engage with patients. The objective of this study was to assess the quality of AI responses to common patient questions regarding vascular surgery disease processes. Methods OpenAI’s ChatGPT-3.5 and Google Bard were queried with 24 mock patient questions spanning seven vascular surgery disease domains. Six experienced vascular surgery faculty at a tertiary academic center independently graded AI responses on their accuracy (rated 1–4 from completely inaccurate to completely accurate), completeness (rated 1–4 from totally incomplete to totally complete), and appropriateness (binary). Responses were also evaluated with three readability scales. Results ChatGPT responses were rated, on average, more accurate than Bard responses (3.08 ± 0.33 vs 2.82 ± 0.40, p < .01). ChatGPT responses were scored, on average, more complete than Bard responses (2.98 ± 0.34 vs 2.62 ± 0.36, p < .01). Most ChatGPT responses (75.0%, n = 18) and almost half of Bard responses (45.8%, n = 11) were unanimously deemed appropriate. Almost one-third of Bard responses (29.2%, n = 7) were deemed inappropriate by at least two reviewers (29.2%), and two Bard responses (8.4%) were considered inappropriate by the majority. The mean Flesch Reading Ease, Flesch–Kincaid Grade Level, and Gunning Fog Index of ChatGPT responses were 29.4 ± 10.8, 14.5 ± 2.2, and 17.7 ± 3.1, respectively, indicating that responses were readable with a post-secondary education. Bard’s mean readability scores were 58.9 ± 10.5, 8.2 ± 1.7, and 11.0 ± 2.0, respectively, indicating that responses were readable with a high-school education ( p < .0001 for three metrics). ChatGPT’s mean response length (332 ± 79 words) was higher than Bard’s mean response length (183 ± 53 words, p < .001). There was no difference in the accuracy, completeness, readability, or response length of ChatGPT or Bard between disease domains ( p > .05 for all analyses). Conclusions AI offers a novel means of educating patients that avoids the inundation of information from “Dr Google” and the time barriers of physician-patient encounters. ChatGPT provides largely valid, though imperfect, responses to myriad patient questions at the expense of readability. While Bard responses are more readable and concise, their quality is poorer. Further research is warranted to better understand failure points for large language models in vascular surgery patient education.
Evaluation of Costs Associated With Acute Achilles Tendon Repair
Authors: Wagers Kade , Ofori-Atta Blessing S. , Tucker William , Presson Angela P. , Nixon Devon 
Published: March 2024

Background: Increasing attention is being paid to the costs associated with various orthopaedic surgeries. Here, we studied the factors that influence costs associated with surgically treated acute Achilles tendon tears. Methods: We retrospectively identified patients with surgically repaired acute Achilles tendon tears, excluding insertional ruptures or chronic tendon issues. Using the Value Driven Outcome (VDO) tool from our institution, we assessed total direct costs as well as facility costs. Briefly, the VDO tool includes an item-level database that can capture detailed cost data—costs are then reported as relative mean data. Cost variables were adjusted to 2022 US dollars, and total direct cost was compared with patient characteristics using gamma regressions to report cost ratios with 95% CIs. Results: Our cohort consisted of 224 patients with Achilles tendon tears surgically repaired by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographics, total direct costs, or facility costs based on surgical positioning (prone n = 156, supine n = 68). Open repairs (n = 215), compared with percutaneous techniques (n = 9) that used commercially available instrumentation, had 37% less total direct costs ( P < .001, 95% CI 0.55-0.72). Compared with surgery at a main academic hospital (n = 15), procedures at an ambulatory care center (n = 207) had 19% lower total direct costs ( P = .040, 95% CI 0.66-0.99) and 41% lower facility costs ( P < .001, 95% CI 0.5-0.7). Conclusion: Improving cost-effective orthopaedic care remains an increasingly important goal. Patient positioning for Achilles tendon repair does not appear to have meaningful impacts on cost. When clinically appropriate, considering surgery location at an ambulatory center appears to reduce surgical costs. Level of Evidence: Level III, retrospective comparative study.
Exploring sustainable management by using green nano-silver to combat three post-harvest pathogenic fungi in crops
Authors: Shende Sudhir S. , Gade Aniket K. , Minkina Tatiana M. , Ingle Pramod U. , Rajput Vishnu D. , Sushkova Svetlana N. , Mandzhieva Saglara S. , Rai Mahendra , Wong Ming H. 
Published: March 2024

AbstractGlobal crop protection and food security have become critical issues to achieve the ‘Zero Hunger’ goal in recent years, as significant crop damage is primarily caused by biotic factors. Applying nanoparticles in agriculture could enhance crop yield. Nano-silver, or AgNPs, have colossal importance in many fields like biomedical, agriculture, and the environment due to their antimicrobial potential. In this context, nano-silver was fabricated by Citrus medica L. (Cm) fruit juice, detected visually and by UV–Vis spectrophotometric analysis. Further, AgNPs were characterized by advanced techniques. UV–Vis spectroscopic analysis revealed absorbance spectra at around 487 nm. The zeta potential measurement value was noted as -23.7 mV. Spectral analysis by FT-IR proved the capping of the acidic groups. In contrast, the XRD analysis showed the Miller indices like the face-centered cubic (fcc) crystalline structure. NTA revealed a mean size of 35 nm for nano-silver with a 2.4 × 108 particles mL−1 concentration. TEM analysis demonstrated spherical Cm-AgNPs with 20–30 nm sizes. The focus of this research was to evaluate the antifungal activity of biogenic AgNPs against post-harvest pathogenic fungi, including Aspergillus niger, A. flavus, and Alternaria alternata. The Cm-AgNPs showed significant antifungal activity in the order of A. niger > A. flavus > A. alternata. The biogenic Cm-AgNPs can be used for the inhibition of toxigenic fungi.
Post-discharge nutritional management for patients with coronary heart disease and frailty: a qualitative study
Authors: Yang Yifei , Gong Jing , Yang Binxu , Chen Chan , Deng Xintong , Chen Kejun , Zhao Yingying , Cai Xusihong , Li Jingjing , Zhou Jing 
Published: March 2024

Abstract
Background
Frail elderly patients experience physiological function and reserve depletion, leading to imbalances in their internal environment, which increases the risk of coronary heart disease recurrence and malnutrition. However, the majority of these patients, who primarily have a low level of education and lack self-management skills, face difficulties actively dealing with obstacles during the transition period after their discharge from hospitalization. Therefore, it is necessary to understand and discuss in depth the nutrition management experience of discharged elderly patients with coronary heart disease and frailty (ages 65-80 years old) and to analyze the promoting and hindering factors that affect scientific diet behavior during the discharge transition period.

Methods
Fifteen elderly patients with coronary heart disease and frailty who had been discharged from the hospital for 6 months were interviewed using a semistructured method. The directed content analysis approach to descriptive research was used to extract topics from the interview content.

Results
All participants discussed the problems in health nutrition management experience of discharged. Five topics and ten subtopics were extracted, such as ①Weak perceptions and behaviors towards healthy eating (personal habit solidification, negative attitudes towards nutrition management), ②Lack of objective factors for independently adjusting dietary conditions (reliance on subjective feelings, times of appetite change), ③Personal hindrance factors (memory impairment, deficiencies in self-nutrition management), ④Expected external support (assistance care support, ways to obtain nutritional information), ⑤Lack of continuous nutrition management (interruption of professional guidance, avoidance of medical treatment behavior).

Conclusions
Nutrition management after discharge places a burden on elderly patients with coronary heart disease and frailty. According to the patients' physical conditions, we should develop a diet support system that is coordinated by individuals, families and society.
Immune response to the recombinant herpes zoster vaccine in people living with HIV over 50 years of age compared to non-HIV age-/gender-matched controls (SHINGR’HIV): a multicenter, international, non-randomized clinical trial study protocol
Authors: Hentzien Maxime , Bonnet Fabrice , Bernasconi Enos , Biver Emmanuel , Braun Dominique L. , Munting Aline , Leuzinger Karoline , Leleux Olivier , Musardo Stefano , Prendki Virginie , Schmid Patrick , Staehelin Cornelia , Stoeckle Marcel , Walti Carla S. , Wittkop Linda , Appay Victor , Didierlaurent Arnaud M. , Calmy Alexandra 
Published: March 2024

Abstract
Background
The burden of herpes zoster (shingles) virus and associated complications, such as post-herpetic neuralgia, is higher in older adults and has a significant impact on quality of life. The incidence of herpes zoster and post-herpetic neuralgia is increased in people living with HIV (PLWH) compared to an age-matched general population, including PLWH on long-term antiretroviral therapy (ART) with no detectable viremia and normal CD4 counts. PLWH – even on effective ART may- exhibit sustained immune dysfunction, as well as defects in cells involved in the response to vaccines. In the context of herpes zoster, it is therefore important to assess the immune response to varicella zoster virus vaccination in older PLWH and to determine whether it significantly differs to that of HIV-uninfected healthy adults or younger PLWH. We aim at bridging these knowledge gaps by conducting a multicentric, international, non-randomised clinical study (SHINGR’HIV) with prospective data collection after vaccination with an adjuvant recombinant zoster vaccine (RZV) in two distinct populations: in PLWH on long-term ART (> 10 years) over 50 years of and age/gender matched controls.

Methods
We will recruit participants from two large established HIV cohorts in Switzerland and in France in addition to age-/gender-matched HIV-uninfected controls. Participants will receive two doses of RZV two months apart. In depth-evaluation of the humoral, cellular, and innate immune responses and safety profile of the RZV will be performed to address the combined effect of aging and potential immune deficiencies due to chronic HIV infection. The primary study outcome will compare the geometric mean titer (GMT) of gE-specific total IgG measured 1 month after the second dose of RZV between different age groups of PLWH and between PLWH and age-/gender-matched HIV-uninfected controls.

Discussion
The SHINGR’HIV trial will provide robust data on the immunogenicity and safety profile of RZV in older PLWH to support vaccination guidelines in this population.

Trial registration
ClinicalTrials.gov NCT05575830. Registered on 12 October 2022. Eu Clinical Trial Register (EUCT number 2023-504482-23-00).
Attitudes towards risk-stratified breast cancer screening: a population-based survey among 5,001 Danish women
Authors: Loft Louise Hougaard , Pedersen Line Hjøllund , Bigaard Janne , Bojesen Stig Egil 
Published: March 2024

Abstract
Background
The individual woman’s risk of being diagnosed with breast cancer can now be estimated more precisely, and screening can be stratified accordingly. The risk assessment requires that women are willing to provide a blood test, additional personal information, to know their risk, and alter screening intervals. This study aimed to investigate Danish women’s attitudes towards risk-stratified breast cancer screening.

Methods
An online, cross-sectional survey was conducted among Danish women aged 52–67 years. We used logistic regression analyses to assess how personal characteristics were associated with the women’s attitudes.

Results
5,001 women completed the survey (response rate 44%) of which 74% approved of risk estimation to potentially alter their screening intervals. However, only 42% would accept an extended screening interval if found to have low breast cancer risk, while 89% would accept a reduced interval if at high risk. The main determinants of these attitudes were age, education, screening participation, history of breast cancer, perceived breast cancer risk and to some extent breast cancer worry.

Conclusion
This study indicates that women are positive towards risk-stratified breast cancer screening. However, reservations and knowledge among subgroups of women must be carefully considered and addressed before wider implementation of risk-stratified breast cancer screening in a national program.
Effect of educational intervention on the knowledge, attitude and practice of breast self-examination among female students at a private university in Southern Nigeria
Authors: Uruntie Rejoice Oritsemoyowa , Oputa Chime Helen , Peters Esegbue , Otovwe Agofure 
Published: March 2024

AbstractIntroductionIn Nigeria, breast cancer (BC), a disorder marked by the unchecked growth of breast cells, has been the commonest cancer among women in Nigeria. Breast self-examination (BSE) is one of the suggested methods for screening for the early diagnosis of breast cancer. However, studies have reported inadequate knowledge, negative attitudes and poor practices of BSE among undergraduate female students. The study was designed as an interventional study to examine the effect of educational intervention on knowledge, attitude and practice of breast self-examination among female students in a private university in southern Nigeria.MethodsThis pretest posttest design study was carried out on 103 students of Novena University at baseline in 2022, which were chosen through the use of simple random sampling. A validated questionnaire with components on demographics, knowledge, attitude, and BSE practice was used to gather the data. After that, the students participated in three hourly sessions of an educational intervention for two weeks. A month later, the students’ data were once again collected, and SPSS 20 software was used to evaluate the results using the mean, paired t test, and logistic regression at theP < 0.05 level of significance.ResultsThe mean age of the respondents was 22.37 ± 1.92 years. Only 53 (51.3%) were aware of BSE. The mean knowledge, attitude and practice of BSE at pretest significantly increased at posttest after the educational intervention (1.58 ± 1.48 vs. 4.31 ± 1.15, 2.37 ± 1.27 vs. 4.80 ± 0.49 and 1.97 ± 0.09 vs. 5.81 ± 3.26, respectively). Furthermore, age and family history of BC were predictors of knowledge (OR = 4.00 95% CI = 0.29–41.99, OR = 141, 95% CI = 0.15–13.18), attitude (OR = 2.39, 95% CI = 0.28–12.32, OR = 1.15, 95% CI = 0.24–8.34) and practice of BSE (OR = 2.66, 95% CI = 0.38–18.41, OR = 1.44, 95% CI = 0.24–8.34) respectively.ConclusionThe findings showed that using an educational intervention strategy will improve the knowledge, attitude and practice of BSE among undergraduate students.