bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should Patients with Traumatic Brain Injury with Significant Contusions be Treated with Different Neurointensive Care Targets?
Authors: Svedung Wettervik Teodor , Hånell Anders , Lewén Anders , Enblad Per 
Published: March 2024

Abstract
Background
Patients with traumatic brain injury (TBI) with large contusions make up a specific TBI subtype. Because of the risk of brain edema worsening, elevated cerebral perfusion pressure (CPP) may be particularly dangerous. The pressure reactivity index (PRx) and optimal cerebral perfusion pressure (CPPopt) are new promising perfusion targets based on cerebral autoregulation, but they reflect the global brain state and may be less valid in patients with predominant focal lesions. In this study, we aimed to investigate if patients with TBI with significant contusions exhibited a different association between PRx, CPP, and CPPopt in relation to functional outcome compared to those with small/no contusions.

Methods
This observational study included 385 patients with moderate to severe TBI treated at a neurointensive care unit in Uppsala, Sweden. The patients were classified into two groups: (1) significant contusions (> 10 mL) and (2) small/no contusions (but with extra-axial or diffuse injuries). The percentage of good monitoring time (%GMT) with intracranial pressure > 20 mm Hg; PRx > 0.30; CPP < 60 mm Hg, within 60–70 mm Hg, or > 70 mm Hg; and ΔCPPopt less than − 5 mm Hg, ± 5 mm Hg, or > 5 mm Hg was calculated. Outcome (Glasgow Outcome Scale-Extended) was assessed after 6 months.

Results
Among the 120 (31%) patients with significant contusions, a lower %GMT with CPP between 60 and 70 mm Hg was independently associated with unfavorable outcome. The %GMTs with PRx and ΔCPPopt ± 5 mm Hg were not independently associated with outcome. Among the 265 (69%) patients with small/no contusions, a higher %GMT of PRx > 0.30 and a lower %GMT of ΔCPPopt ± 5 mm Hg were independently associated with unfavorable outcome.

Conclusions
In patients with TBI with significant contusions, CPP within 60–70 mm Hg may improve outcome. PRx and CPPopt, which reflect global cerebral pressure autoregulation, may be useful in patients with TBI without significant focal brain lesions but seem less valid for those with large contusions. However, this was an observational, hypothesis-generating study; our findings need to be validated in prospective studies before translating them into clinical practice.
Cerebral Microbleeds in Critically Ill Patients with Respiratory Failure or Sepsis: A Scoping Review
Authors: Chen Bing Yu , Dang Johnny , Cho Sung-Min , Harnegie Mary Pat , Uchino Ken 
Published: March 2024

Abstract
Background
Cerebral microbleeds (CMBs) have been described in critically ill patients with respiratory failure, acute respiratory distress syndrome (ARDS), or sepsis. This scoping review aimed to systematically summarize existing literature on critical illness–associated CMBs.

Methods
Studies reporting on adults admitted to the intensive care unit for respiratory failure, ARDS, or sepsis with evidence of CMBs on magnetic resonance imaging were included for review following a systematic search across five databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science) and a two-stage screening process. Studies were excluded if patients’ CMBs were clearly explained by another process of neurological injury.

Results
Forty-eight studies reporting on 216 critically ill patients (mean age 57.9, 18.4% female) with CMBs were included. Of 216, 197 (91.2%) patients developed respiratory failure or ARDS, five (2.3%) patients developed sepsis, and 14 (6.5%) patients developed both respiratory failure and sepsis. Of 211 patients with respiratory failure, 160 (75.8%) patients had coronavirus disease 2019. The prevalence of CMBs among critically ill patients with respiratory failure or ARDS was 30.0% (111 of 370 patients in cohort studies). The corpus callosum and juxtacortical area were the most frequently involved sites for CMBs (64.8% and 41.7% of all 216 patients, respectively). Functional outcomes were only reported in 48 patients, among whom 31 (64.6%) were independent at discharge, four (8.3%) were dependent at discharge, and 13 (27.1%) did not survive until discharge. Cognitive outcomes were only reported in 11 of 216 patients (5.1%), all of whom showed cognitive deficits (nine patients with executive dysfunction and two patients with memory deficits).

Conclusions
Cerebral microbleeds are commonly reported in patients with critical illness due to respiratory failure, ARDS, or sepsis. CMBs had a predilection for the corpus callosum and juxtacortical area, which may be specific to critical illness–associated CMBs. Functional and cognitive outcomes of these lesions are largely unknown.
The inscrutable baseline and the problem of attribution
Authors: Waite Stephen P. 
Published: March 2024

AbstractThis paper examines the problem of attribution in the evaluation of energy efficiency program impact. The methodological problem concerns the observability of consumer behavior under the baseline condition of no program intervention. The statistical solution to the problem, which entails randomized exposure of targeted individuals to program influence, is not a viable alternative in most applications. Randomized opt-in and randomized encouragement designs do not conform to this requirement because all targeted individuals are encouraged to participate in the program, resulting in negative exposure bias. Quasi-experimental methods which utilize non-targeted individuals or targeted nonparticipants as baseline surrogates are further subject to selection bias of unknown magnitude and direction. Valid attribution in the general case of unrestricted eligibility depends on prior knowledge of the determinants of measure adoption and program participation. In default of such knowledge, evaluators must rely upon structural assumptions that have no foundation in empirical science. On the other hand, established measurement and verification methods which exploit scientific knowledge of the determinants of end-use energy consumption should be utilized to obtain unbiased estimates of individual measure and gross program energy savings.
Omission of adjuvant radiotherapy in low-risk elderly males with breast cancer
Authors: Vo Kim , Ladbury Colton , Yoon Stephanie , Bazan Jose , Glaser Scott , Amini Arya 
Published: March 2024

Abstract
Purpose
Randomized clinical trials demonstrate that lumpectomy + hormone therapy (HT) without radiation therapy (RT) yields equivalent survival and acceptable local–regional outcomes in elderly women with early-stage, node-negative, hormone-receptor positive (HR +) breast cancer. Whether these data apply to men with the same inclusion criteria remains unknown.

Methods
The National Cancer Database was queried for male patients ≥ 65 years with pathologic T1-2N0 (≤ 3 cm) HR + breast cancer treated with breast-conserving surgery with negative margins from 2004 to 2019. Adjuvant treatment was classified as HT alone, RT alone, or HT + RT. Male patients were matched with female patients for OS comparison. Survival analysis was performed using Cox regression and Kaplan − Meier method. Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding.

Results
A total of 523 patients met the inclusion criteria, with 24.4% receiving HT, 16.3% receiving RT, and 59.2% receiving HT + RT. The median follow-up was 6.9 years (IQR: 5.0–9.4 years). IPTW-adjusted 5-yr OS rates in the HT, RT, and HT + RT cohorts were 84.0% (95% CI 77.1–91.5%), 81.1% (95% CI 71.1–92.5%), and 93.0% (95% CI 90.0–96.2%), respectively. On IPTW-adjusted MVA, relative to HT, receipt of HT + RT was associated with improvements in OS (HR: 0.641; p = 0.042). RT alone was not associated with improved OS (HR: 1.264; p = 0.420).

Conclusion
Among men ≥ 65 years old with T1-2N0 HR + breast cancer, RT alone did not confer an OS benefit over HT alone. Combination of RT + HT demonstrated significant improvements in OS. De-escalation of treatment through omission of either RT or HT at this point should be done with caution.
Microfluidic-based systems for the management of diabetes
Authors: Zhang Shuyu , Staples Anne E. 
Published: March 2024

AbstractDiabetes currently affects approximately 500 million people worldwide and is one of the most common causes of mortality in the United States. To diagnose and monitor diabetes, finger-prick blood glucose testing has long been used as the clinical gold standard. For diabetes treatment, insulin is typically delivered subcutaneously through cannula-based syringes, pens, or pumps in almost all type 1 diabetic (T1D) patients and some type 2 diabetic (T2D) patients. These painful, invasive approaches can cause non-adherence to glucose testing and insulin therapy. To address these problems, researchers have developed miniaturized blood glucose testing devices as well as microfluidic platforms for non-invasive glucose testing through other body fluids. In addition, glycated hemoglobin (HbA1c), insulin levels, and cellular biomechanics-related metrics have also been considered for microfluidic-based diabetes diagnosis. For the treatment of diabetes, insulin has been delivered transdermally through microdevices, mostly through microneedle array-based, minimally invasive injections. Researchers have also developed microfluidic platforms for oral, intraperitoneal, and inhalation-based delivery of insulin. For T2D patients, metformin, glucagon-like peptide 1 (GLP-1), and GLP-1 receptor agonists have also been delivered using microfluidic technologies. Thus far, clinical studies have been widely performed on microfluidic-based diabetes monitoring, especially glucose sensing, yet technologies for the delivery of insulin and other drugs to diabetic patients with microfluidics are still mostly in the preclinical stage. This article provides a concise review of the role of microfluidic devices in the diagnosis and monitoring of diabetes, as well as the delivery of pharmaceuticals to treat diabetes using microfluidic technologies in the recent literature.
Graphical abstract
Rich phenomenology of the solutions in a fractional Duffing equation
Authors: Hamaizia Sara , Jiménez Salvador , Velasco M. Pilar 
Published: March 2024

AbstractIn this paper, we characterize the chaos in the Duffing equation with negative linear stiffness and a fractional damping term given by a Caputo fractional derivative of order $$\alpha $$
α
ranging from 0 to 2. We use two different numerical methods to compute the solutions, one of them new. We discriminate between regular and chaotic solutions by means of the attractor in the phase space and the values of the Lyapunov Characteristic Exponents. For this, we have extended a linear approximation method to this equation. The system is very rich with distinct behaviours. In the limits $$\alpha $$
α
to 0 or $$\alpha $$
α
to 2, the system tends to basically the same undamped system with a behaviour clearly different from the classical Duffing equation.
Trade-offs and Trait Integration in Tree Phenotypes: Consequences for the Sustainable Use of Genetic Resources
Authors: Climent Jose , Alía Ricardo , Karkkainen Katri , Bastien Catherine , Benito-Garzon Marta , Bouffier Laurent , De Dato Giovanbattista , Delzon Sylvain , Dowkiw Arnaud , Elvira-Recuenco Margarita , Grivet Delphine , González-Martínez Santiago C. , Hayatgheibi Haleh , Kujala Sonja , Leplé Jean-Charles , Martín-Sanz Ruth C. , de Miguel Marina , Monteverdi M. Cristina , Mutke Sven , Plomion Christophe , Ramírez-Valiente José Alberto , Sanchez Leopoldo , Solé-Medina Aida , Soularue Jean-Paul , Steffenrem Arne , Teani Angela , Westin Johan , Whittet Richard , Wu Harry , Zas Rafael , Cavers Stephen 
Published: March 2024

Abstract
Purpose of Review
In this review, we synthesise current knowledge on trade-offs among traits in key fitness dimensions and identify major research gaps with the intention of laying the groundwork for a rapid advance in tree breeding for multiple objectives as a key contribution to the sustainability of planted forests in the future.

Recent Findings
Trade-offs among growth, reproduction, defence, stress tolerance and product quality predicted theoretically have been reported experimentally in many breeding programmes. Among these trade-offs, the genetic linkage between resistance against biotic threats and growth (or other relevant traits) is particularly critical for the current and future management of forest genetic resources. Maintaining tree growth and wood quality in the novel environments of the future requires the assessment of genetic correlations of target traits with phenology, closely linked to survival to temperature extremes. Improving our current knowledge on the genetic trade-offs of drought tolerance as a breeding objective in forest trees obligates a more precise definition of both the specific traits and the experimental conditions. Published evidence suggests that common target traits in breeding programmes may trade-off with reproductive success and fire-adaptation, and the simultaneous improvement of growth and wood quality traits still remains as a constraint in traditional tree breeding.

Summary
Changing environments combined with pests and diseases are challenging plantation forestry worldwide, which implies an urgent need to develop new improvement strategies to build the resilience of forestry for our future environments. It is essential to have a better understanding of how traits interact, especially those important for production, climate and biotic threat resilience, but much of the information is still missing. Since many key trade-offs are affected by the environment, we need new studies under novel environments to forecast levels of multi-trait integration in breeding populations.
Understanding Heterogeneous Passenger Route Choice in Municipal Rail Transit with Express and Local Trains: An Empirical Study in Shanghai
Authors: Peng Wei , Teng Jing , Wang Hui 
Published: March 2024

AbstractThe express/local mode of municipal rail transit provides passengers with multiple alternatives to achieve more efficient and superior travel, in contrast to the conventional all-stop operation mode. However, the various route choices (including direct express trains, direct local trains, or transfers) covering different passenger groups pose a significant challenge to passenger flow assignment. To understand route choice behavior, it is crucial to measure the passenger heterogeneity (variability in individual and trip attributes) in order to propose targeted solutions for operation schemes and service planning. This paper proposes a hybrid model by integrating structural equation modeling and the mixed logit model under express/local mode to estimate the impact of passenger heterogeneity on route choice. An empirical study with revealed preference and stated preference surveys carried out in Shanghai revealed how individual and trip attributes quantitatively impact the sensitivity of factors in route choice. The results show that age and trip purpose are more significant factors. Compared to the control group, the probability of express trains is reduced by 10.22% for the elderly and by 11.36% for non-commuters. Our findings can provide support for more reasonable operation schemes and more targeted services.
Effectiveness of research ethics and integrity competence development – what do learning diaries tell us about learning?
Authors: Tammeleht Anu , Löfström Erika , Rajando Kertu 
Published: March 2024

AbstractDue to the variety of research ethics and integrity training formats it may be challenging to use a common instrument to monitor and evaluate the development of competencies and learning progress as well as determine the effectiveness of the training. The present study scrutinises the use of learning diaries as one possible measure to evaluate the development of ethics competencies. The aim of the study was to increase understanding about how learning diaries capture development of research ethics and integrity competencies of participants and explore the use of diaries as a measure of training effectiveness. In the evaluative case study, a micro-credential programme was used as the context of the study and data was analysed using deductive content analysis. As a result, we outline criteria for analysis to be used in ethics training programmes for learning diaries. Results indicated that learning diaries submitted in the forum format (compared to individual submissions) provide peer support, so learners display more content knowledge on high levels of reflection and understanding. Submitting learning diaries over a longer period and making submissions repeatedly can improve writing and reflection competencies. The quality of learning diary entries may also depend on learner characteristics, such as commitment and motivation. Keeping a learning diary can help retain obtained competencies over a longer period. The article ends with a set of recommendations for implementing learning diaries as one measure of evaluation.
Algorithmically-driven writing and academic integrity: exploring educators' practices, perceptions, and policies in AI era
Authors: Gustilo Leah , Ong Ethel , Lapinid Minie Rose 
Published: March 2024

AbstractBackgroundDespite global interest in the interface of Algorithmically-driven writing tools (ADWTs) and academic integrity, empirical data considering educators' perspectives on the challenges, benefits, and policies of ADWTs use remain scarce.AimThis study responds to calls for empirical investigation concerning the affordances and encumbrances of ADWTs, and their implications for academic integrity.MethodsUsing a cross-sectional survey research design, we recruited through snowball sampling 100 graduate students and faculty members representing ten disciplines. Participants completed an online survey on perceptions, practices, and policies in the utilization of ADWTs in education. The Technology Acceptance Model (TAM) helped us understand the factors influencing the acceptance and use of ADWTs.ResultsThe study found that teacher respondents highly value the diverse ways ADWTs can support their educational goals (perceived usefulness). However, they must overcome their barrier threshold such as limited access to these tools (perception of external control), a perceived lack of knowledge on their use (computer self-efficacy), and concerns about ADWTs' impact on academic integrity, creativity, and more (output quality).ConclusionAI technologies are making headway in more educational institutions because of their proven and potential benefits for teaching, learning, assessment, and research. However, AI in education, particularly ADWTs, demands critical awareness of ethical protocols and entails collaboration and empowerment of all stakeholders by introducing innovations that showcase human intelligence over AI or partnership with AI.
Helping School Students Deal with Peer Provocations and Avoid Hostile Attribution Bias with the CATZ Cross-Age Teaching Zone Intervention
Authors: Boulton Michael J. , Macaulay Peter J. R. 
Published: March 2024

AbstractCross-age tutoring and co-operative group work have been shown to help student tutors and tutees acquire academic and non-academic skills and knowledge. A novel intervention (Cross-Age Teaching Zone, CATZ) that combined them was tested for its effects on student tutors’ thinking skills associated with (i) dealing pro-socially with peer provocations and (ii) avoiding hostile attribution bias. Small co-operative groups of 11- and 15-year-old students (N = 228) designed a CATZ lesson on these themes and delivered it to younger students. The CATZ tutors, but not matched controls (N = 189), showed significant improvements on both outcome measures. Participants aged 9 to 15 years (N = 469) were also asked about: (1) their willingness to act as CATZ tutors/tutees, (2) how effective they think such CATZ activities would be, (3) how much they valued autonomy in how they might deliver CATZ, and (4) their relative preference for being taught by older students versus teachers. Overall, participants expressed positive views of CATZ, which also helped students learn patterns of thinking that can help them avoid aggressive and conflict behavior. This initial evidence on the effectiveness of CATZ calls for further research to use CATZ across a range of social, emotional, and behavioral domains to support its wider uptake in schools.
Improved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh
Authors: Contreras Jesse D. , Islam Mahfuza , Mertens Andrew , Pickering Amy J. , Arnold Benjamin F. , Benjamin-Chung Jade , Hubbard Alan E. , Rahman Mahbubur , Unicomb Leanne , Luby Stephen P. , Colford John M. , Ercumen Ayse 
Published: March 2024

Abstract
Background
The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.

Methods
We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention’s effect on diarrhea through its effect on the mediator.

Results
The intervention improved all indicators compared to controls. We found significant mediation through multiple latrine use and feces management practice indicators. The strongest mediators during monsoon seasons were reduced open defecation among children aged < 3 and 3–8 years, and increased disposal of child feces into latrines. The strongest mediators during dry seasons were access to a flush/pour-flush latrine, reduced open defecation among children aged 3–8 years, and increased disposal of child feces into latrines. Individual mediation effects were small (PD = 0.5–2 percentage points) compared to the overall intervention effect but collectively describe significant mediation pathways.

Discussion
The effect of the WASH Benefits Bangladesh sanitation intervention on diarrheal disease was mediated through improved child feces management and reduced child open defecation. Although the intervention significantly improved latrine quality, relatively high latrine quality at baseline may have limited benefits from additional improvements. Targeting safe child feces management may increase the health benefits of rural sanitation interventions.