bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends of Self-Inflicted Firearm Injuries at a Rural Level 1 Trauma Center
Authors: Burns Aliya G. , Rasarmos Alex P. , Leonard Matthew A. , Collins Hannah W. , Burns J. Bracken 
Published: March 2024

Firearm injuries are a major public health concern with much focus on injuries due to violent crimes in urban areas. Less focus has been on self-inflicted injuries and rural settings. This study included 201 patients, of which 124 (61.7%) were accidental and 77 (38.3%) were intentional self-inflicted gunshot wounds (GSWs) sustained over 6 years at a rural level 1 trauma center. Injury severity scores ( P < .001), hospital days ( P < .001), and mortality ( P < .001) were significantly higher among intentional self-inflicted GSWs. Injuries to the head were the most common injury among patients with intentional self-inflicted GSWs ( P < .001). Accidental and intentional self-inflicted GSWs make up a large portion of firearm injuries seen at our rural level 1 trauma center, and defining these injuries can facilitate the need for targeted gun safety and injury prevention efforts.
The Integrated Prediction of Clinical and Pathological Factors on the Prognosis of Intrahepatic Cholangiocarcinoma
Authors: Chen Guoliang , Li Song , Xia Adong , Xing Yuelong , Liang Wenbo 
Published: March 2024

Objective The primary objective was to construct a high-performing prognostic risk model to accurately forecast the prognosis of patients diagnosed with intrahepatic cholangiocarcinoma (iCCA). Methods We retrospectively collected clinical data from the MSK database on 125 patients diagnosed with iCCA. Random sampling was utilized to divide patients into a training set and a validation set, maintaining a ratio of 7:3. Univariate and multivariate Cox proportional hazards regression models were utilized to identify independent prognostic factors influencing OS. Based on these independent factors, a model nomogram was established. The performance of the prognostic prediction models was assessed through calibration curves and C-index calculations. The Kaplan-Meier method was used to plot survival curves. Time-dependent ROC curve was used to evaluate the accuracy of the model. Results A nomogram was developed, incorporating hepatitis C, CA19, tumor extent, tumor size, LVI, positive lymph nodes, and TMB as predictive factors. The C-index for the training set was .78 and the validation set was .68. Using the riskscore derived from the nomogram, patients were stratified into high- and low-risk groups. The high-risk group exhibited considerably lower OS and RFS compared to the low-risk group in the training set ( P < .05). However, no significant difference was detected in RFS among different risk groups in the validation set ( P > .05). The AUC for 1-year, 3-year, and 5-year survival was .89, .69, and .69, respectively. Conclusion We successfully developed and validated a prognostic nomogram for iCCA, demonstrating its excellent accuracy in predicting patient outcomes and providing clinicians with a potential prognostic tool.
Stage-based Non-price Determinants of Fuel Choice and Its Consumption Decision of Households in Rural India
Authors: Daripa Sanchita , Dinda Soumyananda 
Published: March 2024

This article investigates non-price determinants of fuel choice and consumption decision of households in rural India. Fuel consumption varies at household levels from traditional fuels like firewood and chips to modern fuels such as LPG. Fuel consumption is based on two-stage decisions: (a) whether households participate or not; and (b) how much they consume if they participate. Significant factors might be different in the first stage and the second stage due to certain socio-economic or non-price factors. Applying Cragg’s double hurdle model on NSSO data, this article finds determinants of fuel choice and its consumption at the household level in rural India. Empirical findings indicate that income significantly determines quantity consumption, not choice decision. The role of assets in determining fuel choice and quantity decision is also considered through a comparative study including and excluding landholding, a major asset in rural India. Bottom and top quintile results suggest that advancement of the economic position of the households changes their attitude towards dirty fuel selection and consumption. Firewood fuel consumption decreases with the rising education level of the household head, especially women-headed households. Increased awareness through education and removing social barriers might help to reduce dirty fuel consumption, and India might move towards Sustainable Development Goal. JEL Codes: C20, C13, C34, O13, Q23, Q40, Q56
Self-healing potential of stitched glass/polypropylene/epoxy hybrid composites with various fibers
Authors: Kaya Gaye , Selver Erdem 
Published: March 2024

This study compares the impact damage response and self-healing potential of unstitched and stitched glass/polypropylene (PP) fiber reinforced thermoset composite structures. The novelty of this study is weaving preforms with an intra-ply hybridization of glass and thermoplastic PP fibers and stitching these preforms with a unique stitching pattern by considering the effect of stitching fiber types (PP, Kevlar®, Dyneema®, carbon and silk) on impact damage response and self-healing potential of composites. The mechanical properties of the stitching fiber influenced the composite’s behavior against impact and compressive loads. The unstitched composite deflected more than stitched composites under the same impact energy levels due to delaying of delamination via stitching process. The stitching process reduced the damage areas of composites subjected to 30 J and 60 J impact energies by 57 and 86%, respectively. Structural healing significantly decreased the damaged areas of both unstitched and stitched composite structures up to 87%, while it was more effective on stitched composites. The polypropylene melted and accumulated along the path of the stitch pattern, regardless of whether the stitching fiber was thermoplastic. Due to the reduced impacted area, compression after impact (CAI) strength retention of the stitched composite materials increased by up to 94%.
Influence of foaming-induced crystallization behavior on the structure of poly(butylene adipate-co-terephthalate) supercritical foamed beads
Authors: Luo Haihui , Ou Xuanle , Dong Zhixian , Xu Ruijie , Lei Caihong , Chen Dahua 
Published: March 2024

The crystallization behavior during foaming directly affects the foaming properties. For crystalline polymers, there is no consensus on the influence of the crystallization behavior during foaming process on the stabilization of the cell structure. In this work, PBAT foamed bead and unfoamed pellets were prepared by controlling the saturated temperatures in supercritical CO2, soaking step (one or two) and the depressurization rate, respectively. Double melting peaks were observed in the DSC curve of supercritical CO2 foamed PBAT beads. By comparing the outgassing rates we find that the stretching-induced crystallization caused by the rapid expansion of the gas during foaming plays an important role in the stabilization of the cells. Although the crystalline perfection or crystal size at this time is much smaller than that of the crystalline grains formed during static cooling, the rapid crystallization is effective in stabilizing the cell structure of the foamed pores. Compared to normal supercritical foaming processes, the two-step foaming process of soaking CO2 at high temperatures followed by foaming at low temperatures results in an increase in cell size and expansion ratio. At high temperatures, more CO2 diffuses into the PBAT pellets, increasing the instantaneous gas concentration in the pellets for foaming, and the rapid stretching produces stretching-induced crystallization that raises the average size of the cells, further increasing the expansion multiplicity of individual cells. The average cell size of foam beads rises from 37.8 to 48.8 µm and the expansion ratio also increases to 8.6 with saturated temperature increasing form 95 to 105°C. The two-step soaking foaming method is a more efficient way of manufacturing industrial foamed beads, allowing for the preparation of better foam beads at low temperatures.
Effect of Porcine-Derived Absorbable Patch-Type Atelocollagen for Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Trial
Authors: Kim Hyungsuk , Cho Yong-Soo , Jung Younsung , Song Hyun Seok 
Published: March 2024

Background: Even though arthroscopic rotator cuff repair is recognized as a standard treatment option, the risk of postoperative retear is a major concern. Purpose: To evaluate the effect of porcine-derived absorbable patch-type atelocollagen during arthroscopic rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 64 patients with rotator cuff tears diagnosed on magnetic resonance imaging (MRI) were enrolled prospectively from November 2020 to December 2021. Both groups had repairs using the suture bridge technique. For the atelocollagen group, before securing the lateral anchors, we inserted porcine-derived absorbable patch-type atelocollagen between the footprint and the tendon. On postoperative day 2, the patients underwent MRI to confirm containment of the patch-type atelocollagen. At 6 months and 1 year postoperatively, the signal intensity of the repaired tendon was assessed using MRI. Patients were evaluated using the Constant score as the primary outcome, along with the visual analog scale for pain; range of motion; American Shoulder and Elbow Surgeons score; University of California, Los Angeles, score; and Korean Shoulder Score preoperatively and at 2, 3, 6, and 12 months postoperatively. Results: No significant changes in the Constant score as primary outcome, pain or other functional scores, and range of motion were observed between the groups at 1 year postoperatively. The patch-type atelocollagen was confirmed to be contained by the time-zero MRI scan taken 2 days postoperatively. Among the 55 patients included in final analysis, 12 retear cases were recorded (21.8% retear rate). A significantly lower retear rate was found in the atelocollagen group, as 3 cases were observed in this group (10.3%) and 9 cases were observed in the conventional repair group (34.6%) ( P = .048). Conclusion: The Constant score was not different between the groups. The retear rate after rotator cuff repair was significantly lower in the group that received porcine-derived absorbable patch-type atelocollagen compared with in the conventional group. Registration: KCT0005184 (Clinical Research Information Service [CRIS]; https://cris.nih.go.kr ).
Knowledge and Attitude Towards Traditional, Complementary and Alternative Medicine on Colorectal Cancer Among Northern Malaysians
Authors: Ashruf Ruksana Binti , Seng Tan Boon , Ismail Nahlah Elkudssiah , Parasuraman Subramani , Thamby Sam Aaseer 
Published: March 2024

Background Colorectal cancer (CRC) is the third most common cancer worldwide causing approximately 10% of all cancer cases and is the second most frequent disease which is one of the leading causes of cancer-related fatalities. Traditional, complementary and alternative medicine (TCAM) refers to a broad range of health practices, therapies and products typically not part of the ‘conventional medicine’ system, and its use is substantial among the general population. The knowledge and awareness levels about TCAM and the use of allopathic medications for the treatment of cancer are varied among individuals. The studies were conducted on the knowledge and awareness of the public on cancer, however, no studies specifically addressing the knowledge, attitude and practice of TCAM about CRC were found in Malaysia. Purpose The present study aims to assess the knowledge of CRC and attitude towards TCAM in terms of CRC among a representative sample in Malaysia and identifying the sources of information about CRC and gauging the satisfaction levels with the services of a traditional medicine practitioner. Materials and Methods A validated self-administered questionnaire and educational brochure were utilized for this study. Convenience sampling was employed to recruit respondents ( n = 548) from Kedah and Penang. The calculated sample size was 500. SPSS v25 was used to analyse the data. Results The demographic data were statistically significant ( p < 0.05), the inference could be the sampling technique. Of the 548 respondents, 50.7% ( n = 278) of them were CRC survivors. About 96.2% ( n = 527) understood that CRC occurs in the colon or rectum. The majority were aware that rectal bleeding (75.4%) and blood in the stool (80.7%), are CRC’s signs and symptoms, while only 24.6% identified weakness and fatigue as CRC’s signs and symptoms. The respondents had poor knowledge scores (13.72 out of 31.00) as per Bloom’s cut-off scoring system. In terms of attitude towards TCAM, the majority had a ‘neutral’ (neither agree nor disagree) opinion for all the statements, meaning that the respondents surveyed were very undecided (neither positive nor negative opinion). Conclusion Knowledge of CRC was poor for the cohort, while the attitude towards TCAMs was neutral. The average ‘neutral’ response in the attitude domain could indicate that the respondents had minimal understanding of TCAM about CRC. Further, longitudinal studies can be conducted to better gauge the public’s knowledge, attitude and practice (KAP) towards CRC and TCAM. This highlights the importance of educational interventions which may help to improve the public’s KAP towards CRC and TCAM.
Anatomy of the Lumbrical Muscles: Implications for Mechanical Advantage
Authors: Kooi Kevin , Legerstee Ingmar W.F. , van Vliet Eva , Freundt Liliane A. , Reikersdorfer Kristen , Chen Neal C. , Eberlin Kyle R. 
Published: March 2024

Background: The lumbrical muscles comprise 4 intrinsic muscles of the hand and are involved in flexion of the metacarpophalangeal joint (MCPJ) and extension of the proximal interphalangeal and distal interphalangeal joints. The purpose of this study was to investigate the anatomical mechanics of the lumbrical muscles of the index, middle, ring, and small fingers. Methods: We evaluated 25 cadaver arms and measured the distance between the MCPJ and fingertip, the distance between the MCPJ and lumbrical muscle insertion, and the distance between the MCPJ and the most proximal lumbrical muscle origin. With these measurements we calculated the needed force, insertion ratio (length of the proximal, middle, and distal phalanx divided by the MCPJ to insertion distance), and lumbrical muscle length. Results: We found that the force was significantly different between all fingers, except for the comparison of the index and ring finger ( P = .34). In addition, we found that muscle length was significantly different between most the fingers, except for the comparison between the index and middle fingers ( P = .24), and index and ring fingers ( P = .20). There was no significant difference in insertion ratio. Conclusions: Our study suggests that the anatomical mechanics for the motor function of the lumbrical muscles are similar in all fingers. This could further imply that movements are equally precise in all fingers resulting in coordination with one another and, therefore, adequate hand function. Level of evidence: IV.
Treatment switches of disease-modifying therapies in people with multiple sclerosis: long-term experience from the German MS Registry
Authors: Frahm Niklas , Ellenberger David , Stahmann Alexander , Fneish Firas , Lüftenegger Daniel , Salmen Hans C. , Schirduan Ksenija , Schaak Tom P. A. , Flachenecker Peter , Kleinschnitz Christoph , Paul Friedemann , Krefting Dagmar , Zettl Uwe K. , Peters Melanie , Warnke Clemens 
Published: March 2024

Background: The spectrum of disease-modifying therapies (DMTs) for people with multiple sclerosis (PwMS) has expanded over years, but data on treatment strategies is largely lacking. DMT switches are common clinical practice. Objective: To compare switchers and non-switchers, characterize the first DMT switch and identify reasons and predictors for switching the first DMT. Methods: Data on 2722 PwMS from the German MS Registry were retrospectively analyzed regarding sociodemographic/clinical differences between 1361 switchers (PwMS discontinuing the first DMT) and non-switchers matched according to age, sex, and observation period. Frequencies of first and second DMTs were calculated and switch reasons identified. Predictors for DMT switches were revealed using univariable and multivariable regression models. Results: Switchers and non-switchers differed significantly regarding time to first DMT, education, calendar period of the first DMT start (2014–2017 versus 2018–2021), first DMT class used [mild-to-moderate efficacy (MME) versus high-efficacy (HE) DMT], time on first DMT, and disease activity at first DMT start or cessation/last follow-up. The majority of PwMS started with MME DMTs (77.1%), with the most common being glatiramer acetate, dimethyl/diroximel fumarate, and beta-interferon variants. Switchers changed treatment more often to HE DMTs (39.6%), most commonly sphingosine-1-phosphate receptor modulators, anti-CD20 monoclonal antibodies, and natalizumab. Fewer PwMS switched to MME DMTs (35.9%), with the most common being dimethyl/diroximel fumarate, teriflunomide, or beta-interferon. Among 1045 PwMS with sufficient data (76.8% of 1361 switchers), the most frequent reasons for discontinuing the first DMT were disease activity despite DMT (63.1%), adverse events (17.1%), and patient request (8.3%). Predictors for the first DMT switch were MME DMT as initial treatment [odds ratio (OR) = 2.83 (1.76–4.61), p < 0.001; reference: HE DMT], first DMT initiation between 2014 and 2017 [OR = 11.55 (6.93–19.94), p < 0.001; reference: 2018–2021], and shorter time on first DMT [OR = 0.22 (0.18–0.27), p < 0.001]. Conclusion: The initial use of MME DMTs was among the strongest predictors of DMT discontinuation in a large German retrospective MS cohort, arguing for the need for prospective treatment strategy trials, not only but also on the initial broad use of HE DMTs in PwMS.
Chemical Profile and Assessment of Antioxidant, Anti-Inflammatory, and Antiproliferative Effects of Ammodaucus leucotrichus Coss. & Dur. Fruit Extracts on Human Breast Cancer
Authors: Belbachir Fatima Zohra , Hamdan Ramdani Lamia , Decombat Caroline , Gainche Mael , Chalard Pierre , Djabbou Nassim , Taibi Nadia , Bachari Khaldoun , Dali Yahia Kamel , Delort Laetitia , Caldefie-Chezet Florence 
Published: March 2024

Objective In this study, we analyzed and investigated the antioxidant, anti-inflammatory, and antitumoral properties of methanolic (Met), dichloromethane (Dic), ethyl acetate (Ac), and diethyl ether (Et) fruit extracts of Ammodaucus leucotrichus on the MCF-7 breast cancer cell line. Methods The extracts of Ammodaucus leucotrichus fruits, explored in this study, were obtained by cold maceration and analyzed by LC-MS. 1,1-diphenyl-2-picrylhydrazyl (DPPH), β-Carotene and Bovine Serum Albumin (BSA) assays were used to assess antioxidant and anti-inflammatory activities. The antiproliferative and proapoptotic effects of extracts were determined by the Resazurin test and quantitative real-time polymerase chain reaction (qRT-PCR) analysis. Results Phytochemical screening of Ammodaucus leucotrichus fruit extracts revealed the presence of flavonoids (luteolin and cynaroside), iridoid derivatives, phenolic acids, and identified Rhodojaponin—a major cytoxic compound. The DPPH and BSA assays revealed the most potent radical-scavenging activity (IC50 = 0.16 mg/mL) and anti-inflammatory effect (IC50 = 35.87 μg/mL) in Met extract. Met, Dic, Ac, and Et extracts, at 100 µg/mL, exhibited significant antiproliferative activity against MCF-7 reaching inhibition percentage of 34%, 31%, 28%, and 13%, respectively. qRT-PCR analysis was marked by the inhibition of proliferative and inflammatory markers Proliferating Cell Nuclear Antigen (PCNA) and IL-6 and the up-regulation of antioxidant and proapoptotic genes Nrf2, Bax, and Caspase 3 in Met and Dic extracts, without significant changes to anti-apoptotic gene Bcl-2 expression. Conclusion The study revealed the potential therapeutic effects of Ammodaucus leucotrichus fruit extracts, suggesting they could be used as an adjuvant to breast cancer therapies.
Effect of a Telehealth Navigator Program on Video Visit Scheduling and Completion in Primary Care
Authors: Chen Kevin , Katranji Kenan , Bailey Khera , Rains Michele , Mirzoyan Helena , Zhang Christine , Choxi Shivali , Jackson Hannah B. 
Published: March 2024

Introduction: Patients and clinicians face challenges in participating in video telehealth visits. Patient navigation has been effective in other settings in enhancing patients’ engagement with clinical programs. Our objective was to assess whether implementing a telehealth navigator program to support patients and clinicians affected video visit scheduling, video usage, and non-attendance. Methods: This was a quasi-experimental quality improvement project using difference-in-differences. We included data from 17 adult primary care sites at a large, urban public healthcare system from October 1, 2021 to October 31, 2022. Six sites received telehealth navigators and 11 sites were used as comparators. Navigators contacted patients (by phone) with upcoming video visits to assess and address potential barriers to successful video visit completion. They also provided on-site support to patients and clinicians regarding telehealth visits and usage of an electronic patient portal. The primary outcomes were difference-in-differences for the proportion of telehealth visits scheduled and, separately, completed as video visits and non-attendance for visits scheduled as video visits. Results: There were 65 488 and 71 504 scheduled telehealth appointments at intervention and non-intervention sites, respectively. The adjusted difference-in-differences for the proportion of telehealth visits scheduled as video was −9.1% [95% confidence interval −26.1%, 8.0%], the proportion of telehealth visits completed as video visits 1.3% [−4.9%, 7.4%], and non-attendance for visits scheduled as video visits −3.7% [−6.0%, −1.4%]. Conclusions: Sites with telehealth navigators had comparatively lower video visit non-attendance but did not have comparatively different video visit scheduling or completion rates. Despite this, navigators’ on-the-ground presence can help identify opportunities for improvements in care design.