bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in Delirium after Coronary Artery Bypass Graft Surgery and Perioperative Neuropsychiatric Conditions: A Secondary Analysis of a Cohort Study
Authors: Oldham Mark A. , Kukla Bennett , Walsh Patrick , Lee Hochang B 
Published: April 2024

Background Biological sex influences the risk of depression and cognitive impairment, but its role in relation to postoperative delirium is unclear. This analysis investigates sex differences in delirium risk after coronary artery bypass graft (CABG) surgery and sex-related differences in relation to affective and cognitive symptoms. Methods This is a secondary analysis of the Neuropsychiatric Outcomes After Heart Surgery (NOAHS) study, a single-site, observational study of a CABG surgery cohort (n = 149). Preoperative characteristics are stratified by sex, and baseline variables that differ by sex are evaluated to understand whether sex modifies their relationships with delirium. We also evaluate sex differences in one-month depression and cognition. Results Female sex is associated with several delirium risk factors, including higher risk of preoperative depression and middle cerebral artery (MCA) stenosis. MCA stenosis was statistically associated with delirium only among women (OR 15.6, 95% CI 1.5, 164.4); mild cognitive impairment (MCI) was associated with delirium only in men (OR 4.6, 95% CI 1.2, 17.9). Other sex-based differences failed to reach statistical significance. Depression remained commoner among women 1 month post-CABG. Conclusions Women in this CABG cohort were more likely to have depression at baseline and 1 month postoperatively, as well as MCA stenosis and postoperative delirium. Sex might modify the relationship between post-CABG delirium and its risk factors including MCA stenosis and MCI. Cerebrovascular disease deserves study as a potential explanation linking female sex and a range of poor outcomes among women with coronary heart disease.
Identification of Epstein-Barr virus after topical treatment for oral hairy leukoplakia: A preliminary study
Authors: Nobre Daniel Augusto Barnabé , Moura Mariela Dutra Gontijo , de Arruda José Alcides Almeida , Felix Fernanda Aragão , Diniz Priscilla Barbosa , Duarte Eliza Carla Barroso , Abreu Lucas Guimarães , Gomez Ricardo Santiago , Mesquita Ricardo Alves 
Published: April 2024

Background This study evaluated the presence of Epstein-Barr virus type 1 (EBV-1) DNA in patients living with HIV, before and after three different topical therapy protocols for oral hairy leukoplakia (OHL). Methods The sample consisted of five patients treated with topical solution of 25% podophyllin resin; six with 25% podophyllin resin plus 5% acyclovir cream; and four with 25% podophyllin resin plus 1% penciclovir cream. DNA was extracted from OHL scrapings and amplified by the PCR using specific primers for EBV-1 (EBNA-1). Results Clinical healing of OHL lesions was observed across all treatment groups over time. At baseline, EBNA-1 was detected in all OHL lesions. After treatment, OHL samples from three patients treated with 25% podophyllin resin plus 5% acyclovir cream and from one patient treated with 25% podophyllin resin plus 1% penciclovir cream exhibited negative EBNA-1 viral gene encoding. Despite the clinical resolution of OHL, 11 patients (73.3%) showed EBNA-1 positivity immediately after the lesion disappeared. Three patients (20%) treated with podophyllin resin displayed both EBNA-1 positivity and a recurrence of OHL, in contrast to no recurrence in the other two groups. Conclusions These findings suggest potential associations between treatment formulations, EBNA-1 persistence, and the recurrence of OHL lesions.
Oral streptococcal susceptibility to azithromycin may be associated with doxycycline use: A post-hoc analysis with implications for doxycycline post exposure prophylaxis
Authors: Vanbaelen Thibaut , De Baetselier Irith , Manoharan-Basil Sheeba Santhini , Kenyon Chris 
Published: April 2024

Objective Tetracycline and macrolide resistance are frequently linked in streptococci and other species. We aimed to assess the association between doxycycline use and azithromycin MICs in oral streptococci. Methods Linear regression was used to assess the association between doxycycline use in the prior year and the median MIC per participant of oral streptococcal colonies isolated at the baseline visit of the ResistAZM study. The analysis controlled for receipt of other antimicrobials as well as time since antimicrobial consumption. Results Fifty-six individual colonies confirmed to be streptococci were isolated from 19 individuals at baseline. The azithromycin MICs of these isolates varied considerably between 0.25 mg/L and >256 mg/L (median 28 mg/L; IQR 1-192 mg/L). The consumption of doxycycline in the preceding 12 months was positively associated with median streptococcal azithromycin MIC (coef. 151.6 [95% CI 10.6-292.7]; p = .037). Conclusion This post-hoc analysis found that doxycycline use was associated with streptococcal azithromycin susceptibility. Numerous limitations of the study design mean that this study is best considered hypothesis generating. Prospective studies are required to assess if the use of doxycycline could select for macrolide resistance in oral streptococci.
Micromechanical modeling and experimental characterization of thermoplastic cork filler composites
Authors: Benabdallah Faiza , Safra Imen , Ghachem Kaouther , Alwadai Norah , Kolsi Lioua 
Published: April 2024

This study focuses on the experimental characterization and micromechanical modeling of thermoplastic cork filler composites. The research investigates the influence of granule size on the mechanical properties of composites made with a polypropylene matrix and cork granulates. Tensile, compressive, flexural, and Charpy impact tests are conducted according to ASTM standards to assess the mechanical behavior of the Cork/Polypropylene composites with different size of cork granulates (2 mm, 0.5 mm and 50 μm). Additionally, a micromechanical model is developed to provide numerical insights into the composite’s mechanical properties. Results indicate that the use of smaller cork granules (50 μm) significantly enhances tensile, compressive, and flexural properties, while maintaining Charpy impact resistance comparable to the matrix material. The Young’s Modulus exhibits an augmentation of approximately 28%, the flexural modulus demonstrates a 10% increase, and the compressive modulus manifests a notable rise of 47.7%. One-way ANOVA analysis is employed to establish the statistical significance of granule size on the modulus. Numerical simulations reveal that the spherical morphology of fillers induces isotropic characteristics in cork composite materials.
Seizure and Intracranial Hemorrhage: An Early Complication of Bee Sting – A Case Report
Authors: Kaur Amandeep , Gupta Monica , Ahuja Ishreen , Kak Kapil 
Published: April 2024

Background: Bee sting is a common entity during the summer season and is rarely associated with devastating complications such as myocardial infarction, pulmonary edema, bleeding, and rhabdomyolysis, neurological complications can occur after multiple stings. However, single bee venom infestation resulting in such complications is rare. Patient’s Concern: Here, we are describing a young male, who presented to us with a seizure episode, soon after bitten by a bee sting around his lips. The patient did not have hypertension, diabetes, other risk factors for seizure, or any history of trauma but the patient’s computed tomography head showed cerebral hematoma. Intervention: The patient was managed immediately with an injection of antiepileptics with intravenous (IV) fluids, antihistaminics, and IV steroids. The patient had gross improvement in the sensorium and was seizure free for 48 h under observation. The patient was discharged on the 4th day of admission with 100% recovery. Conclusion: This case report emphasizes the potential for severe neurological complications following bee stings in the form of cerebral hematoma which is clinically important to recognize early and further research is required to better understand the mechanism and management strategies.
Patient clinical and demographic factors associated with involuntary psychiatric admission in the northern territory top end
Authors: Lowes Jessica , Ferguson Nicholas , Bressington Daniel , Mitchell David 
Published: April 2024

Objective Australia has inadequate publicly available data regarding the use of involuntary psychiatric care. This study examined the association between patient clinical/demographic factors and involuntary psychiatric admission following initial psychiatric assessment in Royal Darwin Hospital. Method Retrospective review of 638 psychiatric assessments followed by covariate analysis of patient variables associated with involuntary psychiatric admission. Results Most of the 225 psychiatric admissions were involuntary (92%). Male patients and those with a preferred language other than English had the highest risk of being admitted involuntarily (RR 1.09, χ2 [1] = 3.9, p = .048, and RR 1.11, p = .036, respectively). Conclusions Further research regarding the influence of patient demographics and clinical factors on rates of involuntary admissions, particularly for Aboriginal patients, is recommended. The findings prompt discussion on strategies to improve monitoring of involuntary care and barriers to voluntary treatment.
Troponin Elevation in Patients Undergoing Percutaneous Hepatic Perfusion for Metastatic Uveal Melanoma
Authors: Chandrasekhar Sanjay , Perez Matthew , Niaz Zurain , Ekram Jahanzaib , Lal Neelam , Koly Sarah , Cao Biwei , Zager Jonathan S. , Alomar Mohammed 
Published: April 2024

Background Percutaneous Hepatic Perfusion (PHP) is a liver directed regional therapy recently FDA approved for metastatic uveal melanoma to the liver involving percutaneous isolation of liver, saturation of the entire liver with high-dose chemotherapy and filtration extracorporeally though in line filters and veno-venous bypass. The procedure is associated with hemodynamic shifts requiring hemodynamic support and blood product resuscitation due to coagulopathy. Objective To assess the cardiac safety and subsequent clinically significant sequalae of this therapy. Methods Consecutive PHP procedures done at our center between 2010-2022 were assessed retrospectively. Cardiac risk factors, post procedural cardiac enzymes, electrocardiograms, and transthoracic echocardiograms along with 90-day cardiac outcomes were reviewed. All data were reviewed by cardio-oncologists at our institution. Results Of 37 patients reviewed, mean age was 63 years and 57% were women. 132 procedures were performed with an average of 3.57 procedures per patient. 68.6% of patients had elevated troponin during at least 1 procedure. No patients were found to have acute coronary syndrome, heart failure, unstable arrhythmias, or cardiac death. No patients had notable echocardiographic changes. 10.8% of patients with positive troponin had asymptomatic transient electrocardiographic changes not meeting criteria for myocardial infarction. One patient had non-sustained ventricular tachycardiac intra-operatively which did not recur subsequently. Three patients died from non-cardiac causes within 90-days. There was no oncology treatment interruption, even in those with troponin elevation. In multivariable analysis, a history of hyperlipidemia was a predictor of postoperative troponin elevation. ( P = .042). Conclusion Percutaneous Hepatic Perfusion is safe and associated with a transient, asymptomatic troponin elevation peri-operatively without major adverse cardiac events at 90 days. The observed troponin elevation is likely secondary to coronary demand-supply mismatch related to procedural hemodynamic shifts, hypotension, and anemia.
Propelling precision of longitudinal vibration mitigation in ship propeller shafts through advanced nonlinear intelligent semi-active control leveraging adaptive neuro-fuzzy inference system with linear quadratic regulator
Authors: Sharma Sunil Kumar , Sharma Rakesh Chandmal , Lee Jaesun 
Published: April 2024

This study presents a pioneering method to address longitudinal vibrations in ship propeller shafts by integrating an intelligent semi-active control system. By leveraging Adaptive Neuro-Fuzzy Inference System (ANFIS) and Linear Quadratic Regulator (LQR) techniques, the proposed system offers a novel solution to a longstanding challenge in maritime engineering. The efficacy of the semi-active control system is assessed through two complementary analyses: frequency domain analyses and Percentage Reduction Index (PRI) values. The investigation reveals substantial PRI values, ranging from 24.68% to 46.87%, indicating notable enhancements in vibration control with the adoption of semi-active technology. Furthermore, frequency domain analyses demonstrate significant advantages, with a peak reduction of 68.21% observed at 750 r/min. To rigorously evaluate the statistical significance of these improvements, paired t-tests were conducted between the semi-active control system and passive strategies. The results confirm a statistically significant difference in vibration reduction ( p < .05) between the two systems. Specifically, for Percentage Reduction Index Values, the t test yielded a p-value of .023, while for Frequency Domain Analyses, the t-statistic significantly exceeded the critical value (t ≈ 8.09, tcritical ≈ 2.571). Both data sets provide compelling evidence to reject the null hypothesis, indicating a significant difference in vibration reduction between the semi-active control system and passive strategies. The PRI values consistently demonstrate superior performance for the semi-active control system, highlighting its effectiveness in mitigating vibrations. These findings validate the effective ness of the system. These results show the practical implications of implementing semi-active control systems in maritime engineering, offering enhanced safety, fuel efficiency, and operational reliability in ship propeller shaft applications.
Driving simulator: Analysing the impact of mechanical latency on the perception of lateral dynamics
Authors: Melzi Stefano , Previati Giorgio 
Published: April 2024

Mechanical latency is the time elapsed between the driver’s input and the subsequent movement of a driving simulator. Large latencies may overlap with the time constants of a vehicle, thus altering its dynamics. As latency introduces inconsistencies between the driver’s input and the vehicle’s response, it may also result in motion sickness. The paper describes the design and the results of a test campaign conceived to understand how mechanical latency impacts the perception of lateral dynamics. In particular, the research aimed at identifying the minimal variation of latency perceived by ordinary drivers. Tests were performed with an innovative cable-driven simulator moving over a 6 × 6 metre platform. A rigorous test procedure was designed while several volunteers of different ages and driving experiences were required to perform a specific manoeuvre with different latencies. The results showed that 20% of the population can perceive latency variations below 40 ms.
Urinary vanin-1 as a novel biomarker for survival in peripheral artery disease
Authors: Zierfuss Bernhard , Karlinger Anna , Bojic Marija , Koppensteiner Renate , Schernthaner Gerit-Holger , Höbaus Clemens 
Published: April 2024

Background: Chronic kidney disease is associated with increased rates of incidence, morbidity, and mortality in lower-extremity peripheral artery disease (PAD). No specific marker for a functional risk assessment of kidney disease in PAD is known, especially at the early stages. Thus, we speculated that urinary vanin-1 (uVNN1), a marker of oxidative stress even in early kidney injury, could further stratify outcome assessment in patients with PAD. Methods: Patients with stable PAD ( n = 304) of the Vienna medical cohort were followed up for up to 10 years and the outcome was assessed by central death database queries. uVNN1 was measured by enzyme-linked immunosorbent assay (ELISA) at study inclusion and normalized to urinary creatinine (uVNN1/Cr). During the observation time (9.3, 7.0–9.8 years), 104 patients died, 54.8% of which were due to cardiovascular causes. Results: uVNN1/Cr was associated with a urine albumin–creatinine ratio (UACR) ( R = 0.166, p = 0.004) but not with an estimated glomerular filtration rate ( R = 0.102, p = 0.077). Levels of uVNN1/Cr did not differ between asymptomatic and symptomatic PAD ( p = 0.406). Kaplan–Meier curves showed a clear-cut association with higher all-cause (log-rank p = 0.034) and cardiovascular mortality (log-rank p = 0.032) with higher uVNN1/Cr levels. Similarly, significant associations for all-cause (hazard ratio [HR] 1.34, 95% CI [1.08–1.67], p = 0.009) and cardiovascular mortality (HR 1.45, 95% CI [1.06–1.99], p = 0.020) could be seen in multivariable Cox regression models. Conclusions: uVNN1/Cr showed an independent association with both all-cause and cardiovascular mortality in patients with PAD and was associated with early kidney disease. Thus, uVNN1 could be a useful marker for risk stratification of kidney disease in PAD.
Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury
Authors: Levy Adam S , Berger Connor , Kumar Vignessh , Badami Abbasali , Côté Ian 
Published: April 2024

Introduction Penetrating spinal cord injuries present unique clinical scenarios with high variability in presentation and management. These injuries are rare, accounting for 0.8% of annual penetrating spine injuries in the United States, with knives being the most common penetrating object. Retention of the knife blade further complicates management, with greater risk of infection and progressive neurologic injury. Given the rarity and variability of such injuries, preferred management for penetrating-knife spinal cord injuries (PKSCI), especially those with retained knife blades, remains contested. Furthermore, the management of PKSCI with concurrent lung injury is poorly described within the literature. Case Report Here we discuss a unique case of a neurologically intact adult male who suffered a large lower thoracic PKSCI with complete dural transection and lung involvement. The patient arrived with the blade in situ while maintaining full neurologic function. Emergent imaging revealed the blade trajectory passing through the T8 lamina exiting the spinal canal at the costovertebral junction with involvement of the lung parenchyma and associated pneumorrhachis and pneumothorax. The patient was brought to the operating room where the blade was removed under direct visualization, the dura was repaired, and pneumothorax was stabilized. Conclusion We describe in this case the choice of imaging, method of blade removal, cerebrospinal fluid leak management, dural repair, and concurrent lung injury management that afforded a favorable, ASIA class E outcome with complete preservation of neurologic function.
Cost and Activity Analysis of Patient Navigation for Persons With HIV: Comparing Health Department and Health Clinic Delivered Interventions
Authors: Lightner Joseph S. , Moore Erik , Barnhart Travis , Rajabiun Serena 
Published: April 2024

Background Housing and employment are key factors in the health and well-being of people with HIV (PWH). Patient navigation programs to improve housing and employment show success in achieving viral suppression. Replicating patient navigation interventions to improve population health is needed. Understanding costs associated with patient navigation is a key next step. Therefore, the purpose of this study is to describe the costs associated with delivering patient navigator interventions in two different organizations to improve housing and employment for PWH. Methods We conducted a cost analysis of two models of patient navigation. Costs were collected from two sites’ payroll, invoices, contracts, and receipts. Pre-implementation and implementation costs and utilization of service costs are presented. Potential reimbursement costs were calculated based on salaries from the Department of Labor. Results The health clinic’s pre-implementation costs were higher ($169,133) than the health department’s ($22,018). However, costs of patient navigation during the 2-year intervention were similar between health clinic and health department ($264,985 and $232,923, respectively). The health clinic reported more total time spent with clients (16,013.7 hours) than the health department (1,883.8 hours). The costs per additional person suppressed were $20,632 versus $37,810 for the health department and health clinic, respectively, which are lower than the average lifetime cost of HIV treatment. Discussion Replicability and scalability of a patient navigation intervention are possible in both health clinic and health department settings. Each site had specific costs, client needs, and other factors that required adaptations to successfully implement the intervention. Future programs should consider tailoring costs to site-specific factors to improve outcomes. Policymakers and public health officials should consider using these results to improve planning and investment in HIV treatment and prevention interventions.
Long-term Outcomes of Endovascular Repair for Blunt Thoracic Aortic Injury: A 10 Year Multi-center Experience
Authors: Wu Mingwei , Zeng Zhaoxiang , Bao Xianhao , Ren Luxia , Feng Jiaxuan , Feng Rui , Xiong Jiang 
Published: April 2024

Objective: This study aimed to assess the long-term outcomes in patients treated by thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injuries (BTAI). Materials and methods: From January 2010 to December 2019, this retrospective observational study was conducted at 3 centers, involving 62 consecutive BTAI patients who underwent TEVAR. Computed tomography angiography scans were planned to be conducted at 6 months post-procedure, and annually thereafter. Results: Technical success was achieved in all 62 procedures (100%), which included cases of dissection (n=35, 56.45%), pseudoaneurysm (n=20, 32.26%), and rupture (n=7, 11.29%). Mean injury severity score was 31.66±8.30. A total of 21 supra-arch branches were revascularized by chimney technique, with 12 cases involving the left subclavian artery (LSA) and 9 cases involving the left common carotid artery. In addition, 11 LSAs were covered during the procedure. The in-hospital mortality rate was 1.61% (n=1). The mean follow-up time was 86.82±30.58 months. The all-cause follow-up mortality rate was 3.28% (n=2). Stenosis or occlusion of 3 supra-arch branches (4.92%) was identified at follow-up, with 2 cases (3.28%) requiring re-intervention. No spinal cord ischemia, endoleak, or migration was observed. Conclusions: Despite only including patients with long-term follow-up, this study confirms the long-term safety and effectiveness of TEVAR for BTAI. For young BTAI patients, as the thoracic aorta increases with age, longer follow-up is needed to observe the potential mismatch between the endograft and the aorta. Clinical Impact This study confirms the long-term safety and effectiveness of endovascular treatment for blunt thoracic aortic injury (BTAI). For young BTAI patients, as the thoracic aorta increases with age, longer follow-up is needed to observe the potential mismatch between the endograft and the aorta. Through a remarkably extended follow-up period (86.82±30.58 months) conducted at multiple centers in China, this study confirms the long-term safety and effectiveness of endovascular treatment for BTAI.