bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bleeding sites and treatment strategies for cardiac tamponade by catheter ablation requiring thoracotomy: risks of catheter ablation in patients with left atrial diverticulum
Authors: Mitsuishi Atsuyuki , Miura Yujiro , Nomura Yoshinori , Hirota Takayoshi , Arima Naoki , Kitaoka Hiroaki , Tateiwa Hiroki , Katsumata Yoshifumi 
Published: April 2024

Abstract
Background
There is insufficient information regarding the bleeding sites and surgical strategies of cardiac tamponade during catheter ablation for atrial fibrillation (AF).

Case presentation
Of the five patients with cardiac tamponade, three required surgical intervention and two required pericardiocentesis. In the first case of three cardiac tamponades requiring surgical intervention, considering that the peripheral route was used, the catecholamines did not reach the heart, and due to unstable vital signs, venoarterial extracorporeal membrane oxygenation (VA-ECMO) was inserted. No bleeding point was identified, but a thrombus had spread around the left atrium (LA) with diverticulum. Hemostasis was achieved with adhesives placed around the LA under on-pump beating. In the second case, pericardiocentesis was performed, but the patient showed heavy bleeding and unstable vital signs. Thus, VA-ECMO was inserted. Heavy bleeding was expected, and safety was enhanced by attaching a reservoir to the VA-ECMO. The bleeding point was found between the left upper pulmonary artery and LA under cardiac arrest to obtain a good surgical view for suturing repair. In the third case, the LA diverticulum was damaged. Pericardiocentesis resulted in stable vitals, but sustained bleeding was present. A bleeding point was found at the LA diverticulum, and suture repair under on-pump beating was performed.

Conclusions
When cardiac tamponade occured in any patient with LA diverticulum, treatment could not be completed with pericardiocentesis alone, and thoracotomy was likely to be necessary. If the bleeding point could be confirmed, suturing technique is a more reliable surgical strategy than adhesive alone that leads to pseudoaneurysm. If the bleeding point is unclear, it is important to confirm the occurrence of LA diverticulum using a preoperative CT, and if confirmed, cover it with adhesive due to a high possibility of diverticulum bleeding. The necessity of CPB should be determined based on whether these operations can be completed while maintaining vital stability.
Osteoarthritis and hypertension: observational and Mendelian randomization analyses
Authors: Yang Zhi-Jie , Liu Yuan , Liu Yan-Li , Qi Bin , Yuan Xin , Shi Wan-Xin , Miao Liu 
Published: April 2024

Abstract
Background
The association between osteoarthritis (OA) and hypertension is a subject of ongoing debate in observational research, and the underlying causal relationship between them remains elusive.

Methods
This study retrospectively included 24,871 participants in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020. Weighted logistic regression was performed to investigate the connection between OA and hypertension. Additionally, Mendelian randomization (MR) analysis was conducted to explore the potential causal relationship between OA and hypertension.

Results
In the NHANES data, after adjusting for multiple confounding factors, there was no significant relationship between OA and hypertension (OR 1.30, 95% CI, 0.97–1.73, P = 0.089). However, among males, OA appeared to be associated with a higher risk of hypertension (OR 2.25, 95% CI, 1.17–4.32, P = 0.019). Furthermore, MR results indicate no relationship between multiple OA phenotypes and hypertension: knee OA (IVW, OR 1.024, 95% CI: 0.931–1.126, P = 0.626), hip OA (IVW, OR 0.990, 95% CI: 0.941–1.042, P = 0.704), knee or hip OA (IVW, OR 1.005, 95% CI: 0.915–1.105, P = 0.911), and OA from UK Biobank (IVW, OR 0.796, 95% CI: 0.233–2.714, P = 0.715). Importantly, these findings remained consistent across different genders and in reverse MR.

Conclusions
Our study found that OA patients had a higher risk of hypertension only among males in the observational study. However, MR analysis did not uncover any causal relationship between OA and hypertension.
Options for making responsive future strategy to foster sustainability transitions in the German agri-food sector: a Delphi-based approach
Authors: Mangelkramer Delia 
Published: April 2024

AbstractIn response to pressing global challenges, sustainability transitions research has emerged as an interdisciplinary field focused on fundamental changes, necessitating novel approaches for strategy-making from research and innovation. Foresight practitioners need to extend their well-established methodological toolkit, which can inform subsequent planning processes about managing conflicts and shaping futures, to include the articulation of response options for contributing to the creation of more sustainable future systems. This research aims to contribute to this need by exploring future options characterized by discrepancies. Drawing from the Responsible Research and Innovation (RRI) literature to understand discrepancies between “desirability” and “probability” of future options as missed opportunities to secure social desirability in the future or as threats to it, this research argues for the collective identification and anticipation of discrepancies to reflect on options for making more responsive strategies. Thus, informed by RRI, a Delphi exercise was modified to engage experts from the German agri-food sector (n = 21) to assess divergent innovation-driven changes in the German agri-food sector that had been collectively anticipated and reflected upon beforehand. The results speak for a reduction of complexity by revealing specific actions necessary to redirect research and innovation processes away from unsustainable paths, as well as identifying determinants of discrepancies to do good or avoid harm.
The optimal glycemic target in critically ill patients: an updated network meta-analysis
Authors: Tanaka Aiko , Yatabe Tomoaki , Suhara Tomohiro , Egi Moritoki 
Published: April 2024

AbstractAcute glycemic control significantly affects the clinical outcomes of critically ill patients. This updated network meta-analysis examines the benefits and harms of four target blood glucose levels (< 110, 110–144, 144–180, and > 180 mg/dL). Analyzing data of 27,541 patients from 37 trials, the surface under the cumulative ranking curve for mortality and hypoglycemia was highest at a target blood glucose level of 144–180 mg/dL, while for infection and acute kidney injury at 110–144 mg/dL. Further evidence is needed to determine whether 110–144 or 144–180 mg/dL is superior as an optimal glucose target, considering prioritized outcomes.
Genomic Landscape and Clinical Features of Advanced Thyroid Carcinoma: A National Database Study in Japan
Authors: Toda Soji , Hiroshima Yukihiko , Iwasaki Hiroyuki , Masudo Katsuhiko 
Published: April 2024

Abstract

Context
The relationship between the genomic profile and prognosis of advanced thyroid carcinoma requiring drug therapy has not been reported.

Objective
To evaluate the treatment period and overall survival time for each genetic alteration in advanced thyroid carcinoma that requires drug therapy.

Methods
We conducted a retrospective observational study using a national database in Japan, which included 552 cases of thyroid carcinoma out of 53 543 patients in the database.

Results
The database included anaplastic thyroid carcinoma (23.6%), poorly differentiated thyroid carcinoma (10.0%), and differentiated thyroid carcinoma (66.4%). The most common genetic abnormalities were TERT promoter (66.3%), BRAF (56.7%), and TP53 (32.2%). The typical driver genes were BRAF V600E (55.0%), RAS (18.5%), RET fusion (4.7%), NTRK fusion (1.6%), and ALK fusion (0.4%). The most common regimen was lenvatinib, and the time to treatment failure was not different despite the presence of BRAF or RAS mutations. In differentiated thyroid carcinoma and poorly differentiated thyroid carcinoma, TP53 alterations independently predicted worse overall survival (hazard ratio = 2.205, 95% confidence interval: 1.135-4.283). In anaplastic thyroid carcinoma, no genetic alterations were associated with overall survival.

Conclusion
Genetic abnormalities with treatment options were found in 62.7% of advanced thyroid carcinomas. TP53 abnormality was an independent poor prognostic factor for overall survival in differentiated thyroid carcinoma. The time to treatment failure for lenvatinib was not different based on genetic profile.
Effect of Oral Bisphosphonate Drug Holiday on Mortality Following Hip Fracture
Authors: Leung Miriam T Y , Turner Justin P , Marquina Clara , Ilomaki Jenni , Tran Tim , Bell J Simon 
Published: April 2024

Abstract

Context
Current clinical guidelines recommend a drug holiday after extended use of oral bisphosphonates. However, no studies have investigated the effect of drug holidays before hip fractures on postfracture mortality.

Objective
This work aimed to investigate the effect of a drug holiday on postfracture mortality in patients with extended use of oral bisphosphonates.

Methods
This retrospective, population-based cohort study took place among all patients with hip fractures in Victoria, Australia, from 2014 to 2018. Patients were adherent to oral alendronate or risedronate for 5 years or more prior to hip fracture. Group-based trajectory modeling categorized patients into different bisphosphonate usage after 5-year good adherence. The main outcome measure was postfracture mortality.

Results
We identified 365 patients with good adherence (medication possession ratio ≥80%) to oral alendronate/risedronate for 5 years or more. Most patients (69%) continued to use oral bisphosphonates until admission for hip fracture; 17% had discontinued for 1 year and 14% had discontinued for 2 years. Postfracture mortality was higher in patients who had discontinued risedronate for 1 year (hazard ratio [HR] 2.37; 95% CI, 1.24-4.53) and 2 years (HR 3.08; 95% CI, 1.48-6.41) prior to hip fracture. No increase or decrease in postfracture mortality was observed in patients who had discontinued alendronate for 1 year (HR 0.59; 95% CI, 0.29-1.18) or 2 years (HR 1.05; 95% CI, 0.57-1.93) prior to hip fracture.

Conclusion
Postfracture mortality is higher in people who discontinue risedronate, but not alendronate, for 1 or 2 years after being adherent to treatment for at least 5 years. The type of bisphosphonate may be a factor to consider when planning drug holidays.
A rapid return to normal: temporal gene expression patterns following cold exposure in the bumble bee Bombus impatiens
Authors: Verble Kelton M. , Keaveny Ellen C. , Rahman Sarthok Rasique , Jenny Matthew J. , Dillon Michael E. , Lozier Jeffrey D. 
Published: April 2024

ABSTRACT
Bumble bees are common in cooler climates and many species likely experience periodic exposure to very cold temperatures, but little is known about the temporal dynamics of cold response mechanisms following chill exposure, especially how persistent effects of cold exposure may facilitate tolerance of future events. To investigate molecular processes involved in the temporal response by bumble bees to acute cold exposure, we compared mRNA transcript abundance in Bombus impatiens workers exposed to 0°C for 75 min (inducing chill coma) and control bees maintained at a constant ambient temperature (28°C). We sequenced the 3′ end of mRNA transcripts (TagSeq) to quantify gene expression in thoracic tissue of bees at several time points (0, 10, 30, 120 and 720 min) following cold exposure. Significant differences from control bees were only detectable within 30 min after the treatment, with most occurring at the 10 min recovery time point. Genes associated with gluconeogenesis and glycolysis were most notably upregulated, while genes related to lipid and purine metabolism were downregulated. The observed patterns of expression indicate a rapid recovery after chill coma, suggesting an acute differential transcriptional response during recovery from chill coma and return to baseline expression levels within an hour, with no long-term gene expression markers of this cold exposure. Our work highlights the functions and pathways important for acute cold recovery, provides an estimated time frame for recovery from cold exposure in bumble bees, and suggests that cold hardening may be less important for these heterothermic insects.
Friends with Health Benefits: A Field Experiment
Authors: Gershon Rachel , Cryder Cynthia , Milkman Katherine L. 
Published: April 2024

When pursuing goals, we commonly choose between going it alone versus teaming up together. In a field experiment (n = 774), we tested the benefits of rewarding individual versus tandem goal pursuit. In a standard-reward condition, we experimentally offered gym members an individual cash reward each day they visited the gym for four weeks. Participants in a tandem-reward condition could earn the same reward but only if they surmounted an extra logistical hurdle: they had to visit the gym with a friend. Although this additional requirement made it more difficult for participants in the tandem-reward condition to earn equivalent incentives, participants with this extra hurdle visited the gym about 35% more frequently than those earning a standard reward. A follow-up survey suggests that tandem rewards provide nonmonetary incentives that change behavior, including increased accountability and enjoyment. Our findings illustrate the advantages of making desired behaviors social to promote follow-through. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2022.01401 .
Uncertainty among patients with advanced-stage lung cancer
Authors: Wongkalasin Kiratiya , Matchim Yaowarat , Kanhasing Ruankwan , Pimvichai Sirinya 
Published: April 2024

Background: Uncertainty is the inability to define the meaning of illness-related events, which may result in anxiety, depression, poor coping, the self-perception of being a burden and low quality of life. Uncertainty among Thai patients with advanced-stage lung cancer (ASLC) has not been well documented. Aims: To assess uncertainty in patients with ASLC. Methods: A cross-sectional survey design was adopted. Data were collected from 60 patients with ASLC at a university hospital. A demographic data form and the Mishel Uncertainty in Illness Scale (MUIS) were used to collect data. The data were analysed using descriptive statistics. Results: The patients had moderate levels of uncertainty in illness (83.73±15.25). Ambiguity about the illness and unpredictability of the prognosis scored at a moderate level for patients, while complexity of treatment and the system of care and inconsistency or lack of information, about the diagnosis or severity of the illness were at a low level. Conclusion: The results of this study may help healthcare professionals better understand and manage uncertainty in patients with ASLC.
„Am Lëtzebuergesche ginn et esou vill Variatiounen an droleg Ausdréck“.
Authors: Entringer Nathalie 
Published: April 2024

Language experiments have a long tradition in the field of dialectology to investigate phonological, lexical and syntactic variation. Methodologically, the repertoire ranges from written test procedures to standardized language production tests and interviews whereby different types of tasks (e. g. translation, picture-naming, evaluation tasks) are used. In order to investigate the variation and perception of morpho(phono)logical phenomena (e. g. the variation of the superlative dat schéinst/dat schéinsten/dat schéinstent Meedchen ‘the most beautiful girl’) in Luxembourgish, I developed a new test procedure, which is based on test procedures and tasks already used in other dialectological and variationist projects (e. g. Syntax Hessischer Dialekte (SyHD), cf. Fleischer/Lenz/Weiß 2015, Sprachvariation in Norddeutschland (SiN); cf. Elmentaler et al. 2015)). The development of a new method was indispensable, since firstly, it must be adapted to the analysis of morpho(phono)logical phenomena that are not linked to regional variation and secondly this test aims to analyse salience and pertinence, two relevant concepts within the scope of language perception and evaluation (cf. Purschke 2011), separately. This paper thus presents an experiment that aims to investigate the perception of morpho(phono)logical variation and its variants in Luxembourgish. The individual test procedures, a salience test, a specific form of scale-based test, a translation task and a supplementary questionnaire are described, contextualized and discussed in detail. The focus also lies on the special design of the test, which is able to ascertain the salience and pertinence of certain variants and to correlate them directly with the production of the variants and the self-evaluation of the individual participants.
Apprenticeship Reforms in West Africa: An Outcome-Process Evaluation of a Pilot Dual Training Model-Based Apprenticeship Reform Scheme in Ghana
Authors: Nunyonameh Collins , Obinnim Elizabeth , Adzivor Eric Kodzo 
Published: April 2024

Context: Faced with deep challenges with access to formal education, many West African countries are increasingly taking steps to reform their informal apprenticeship systems to make them a quality skills development alternative for their teeming youth. A review of the literature shows that although different countries in the region are deploying different reform strategies, what is emerging as a dominant reform model is the "dual training model" (DTM), a collaborative arrangement in which the task of training apprentices is shared between informal trainers (master craftspersons, under their respective trade associations) and formal vocational training institutions (FVTIs). This paper presents an outcome-process evaluation of a DTM-based apprenticeship reform programme piloted in Ghana.
Methods: Designed as a case study, the paper adopts an interpretivist approach, relying on diverse sources of data, both secondary and primary. Secondary data includes journal articles, attendance registers of participants, memorandums of understanding, relevant media reports, websites, and official reports by all relevant actors. The primary data originated from in-depth interviews with fourteen (14) key informants, as well as from overt and covert observations of respondents.
Results: At the outcome level, the paper shows that the programme has largely failed in transferring new skills or in changing dominant poor practices among trainees, foundational objectives of the programme. At the process level, the paper revealed deep flaws in implementation; these are discussed in detail in an attempt to clarify the programme outcomes.
Conclusion: The paper concludes that although the dual training model remains a potentially viable reform model in informal apprenticeships, its success ultimately depends on the quality of implementation, which in turn depends on the strength and quality of inter-stakeholder collaboration in programme design and implementation.
Resilience and agency in children living with domestic abuse: an alternative interpretation
Authors: Hall Kirsten Ellen 
Published: April 2024

Children’s agency and resilience within situations of domestic abuse has been the focus of recent research, with an emphasis on children’s voices to inform knowledge. This has been underpinned by a move away from the witness model of domestic abuse. This article contributes to this growing understanding of how children react, respond, and interact when living with domestic abuse.
Qualitative interviews were completed with 16 relevant professionals, and 13 adult survivors of childhood domestic abuse. The research overall was conducted through the lens of the home to provide enhanced insight into day-to-day experiences of domestic abuse. Factors associated with resilience were part of an initial research question, whereas agency emerged as a strong theme through the analysis process.
This research has demonstrated that children engage in varying degrees of agency or display behaviours associated with resilience to cope with situations of domestic abuse, prevent or stop escalation of abuse or as protection for themselves and others. This article argues that agency and resilience can occur in contexts where adults – both inside and outside the home – have not prevented children from experiencing domestic abuse and its impacts. This has been conceptualised as children operating in the context of a ‘vacuum of responsibility’.
Be careful what you wish for: why more fragmentation might hurt global cybersecurity
Authors: Hansel Mischa , Silomon Jantje , Neuber Emilia 
Published: April 2024

Governmental representatives often cite security concerns as a reason when justifying policies that contribute to internet fragmentation. Restrictions, such as on the use of foreign soft- and hardware or data localisation requirements, are meant to lessen cybersecurity risks, including disruptive cyberattacks or state-led surveillance campaigns. Intuitively, it seems self-explanatory that these measures translate into cybersecurity gains – the more control a government has over a system, the more secure it should be. Although critics strongly dispute such measures by making an economic case, they hardly ever question the assumption made regarding cybersecurity benefits.
Our article challenges this view, taking public goods theory as our analytical point of departure to criticise notions of ‘weaponized interdependence’. Furthermore, we challenge the idea of secure national controls, which are key building blocks within justifications of governmental fragmentation policies at the application layer. More specifically, we argue that such justifications ignore negative impacts on the availability of key public goods in global cybersecurity, as well as other externalities. For example, while technological decoupling may well lead to less vulnerability to cyberattacks, it may also eliminate important incentives for self-restraint on the part of attackers due to potential blowback effects. It is with a view to such unintended consequences that we call for a more thorough assessment of the security risks and benefits within public policy debates on digital trade restrictions and data localisation.