bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness and Perceptions of US Food and Drug Administration’s JUUL Marketing Denial Order: A National Study of US Adolescents
Authors: Rams Alissa , D. Kowitt Sarah , Ritchie Caroline , Sutfin Erin L , Sheeran Paschal , Noar Seth M 
Published: October 2023

Abstract

Introduction
We examined awareness and perceptions of the US Food and Drug Administration (FDA) JUUL marketing denial order (MDO) that occurred in June 2022 among a nationally representative sample of US adolescents.

Aims and Methods
Data were collected in August 2022 via an online survey (n = 1603). Adolescents were asked whether they had heard about the JUUL MDO, and, if yes, where they heard the news. Those who had heard were asked about the MDO’s impact on their harm beliefs about JUUL and vape products in general. We examined correlates of awareness of the MDO and of increased JUUL and vape harm perceptions.

Results
Twenty-seven percent of adolescents had heard about the MDO. Older adolescents (adjusted odds ratio [aOR] = 1.13) and LGBTQ+ adolescents (aOR = 2.05) had significantly higher odds of having heard the news, while those who identified as Black or African American had significantly lower odds of having heard (aOR = 0.56). Most participants who were aware of the MDO indicated that they had higher harm perceptions about JUUL itself (77.9%) and vapes in general (79.6%). Youths susceptible to vaping and current users were less likely to report increased harm perceptions about JUUL (B = −0.34 and −0.46, respectively) and vapes in general (B = −0.27 and −0.43) compared with youth not susceptible to vaping.

Conclusions
The results of this nationally representative survey demonstrate that over one-quarter of US youth heard about the JUUL MDO and the vast majority of those indicated increased harm perceptions about vapes. Large-scale news events about vaping can reach youth audiences and may impact what youth think about the harms of vaping.

Implications
Analysis of a nationally representative survey of adolescents aged 13–17 revealed that more than 25% had heard about the marketing denial order issued to JUUL Labs by the FDA in June of 2022. We also found that the vast majority of adolescents reported increased JUUL and vape harm perceptions in response to hearing about the MDO. This indicates that news coverage about vaping—including coverage of regulatory actions—can reach and potentially impact adolescents. It is therefore important to monitor news coverage about vaping, how it is framed and discussed across media platforms, and its reach among priority populations.
Baseline micronucleus frequencies and 60Co cytokinesis-block micronucleus assay dose–response curve for biodosimetry in Vietnam
Authors: Pham Ngoc Duy , Tran Thanh Mai , Anderson Donovan , Che Quang Tuan , Pham Ho Thuat Khoa 
Published: October 2023

Abstract
This study aims to establish baseline micronucleus (MN) frequencies from various populations of residents in Vietnam and develop a 60Co dose–response curve for the cytokinesis-block micronucleus (CBMN) assay. Blood samples were exposed in vitro to a 60Co source at a dose rate of 275 mGy per min in a range of 0.1 to 4.0 Gy. MN background frequencies were 4.5 ± 3.2, 7.3 ± 4.6, 7.0 ± 3.8 and 13.1 ± 6.7 in 1000 binucleated (BN) cells for 96 healthy donors, 22 male radiation workers and 12 breast cancer patients, respectively. Blood samples from three healthy donors were used to generate the MN dose–response curve: y = C + (0.0496 ± 0.0069)D + (0.0143 ± 0.0026)D2. This curve was verified through an inter-laboratory comparison (RENEB ILC 2021). Our findings highlight the significance of the CBMN assay as an additional essential tool for biodosimetry in Vietnam.
Cerebrospinal fluid tumor necrosis factor-alpha (TNF-α) levels in children with cerebral malaria
Authors: Prasad Rajniti , Patel Raghvendra Singh , Mishra S P , Singh Ankur , Abhinay Abhishek , Singh Tej Bali 
Published: October 2023

Abstract
This prospective cross-sectional study evaluated the diagnostic and prognostic role of cerebrospinal fluid (CSF) tumor necrosis factor-alpha (TNF-α) in children with cerebral malaria (CM) and its role in the differentiation of CM from non-cerebral severe malaria. CSF TNF-α was measured using a human TNF-α enzyme-linked immunosorbent assay kit of 39 cases of CM and 19 cases of non-cerebral severe malaria. CSF TNF-α levels were significantly higher in CM (p &lt; 0.001). Based on the receiver operating characteristics curve, a cutoff value of CSF TNF-α was 5.7 pg/ml for diagnosis of CM with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 87.2%, 94.7%, 97.1% and 78.3% respectively. The cutoff value of CSF TNF-α was 13.7 pg/ml for predicting adverse outcomes in CM with sensitivity, specificity, PPV and NPV of 100%, 96.8%, 88.9% and 100%, respectively. However, the cutoff value of CSF TNF-α was 4.96 pg/ml for predicting adverse outcomes in non-cerebral severe malaria with a sensitivity, specificity, PPV and NPV of 100%, 94.1%, 88.9% and 100% respectively. So, CSF TNF-α is an excellent biomarker and can be used as a diagnostic and prognostic tool. More studies are needed to establish CSF TNF-α as a predictor of neurological sequelae.
Effect of Propofol on Heart Rate and Its Coupling to Cortical Slow Waves in Humans
Authors: Fabus Marco S. , Sleigh Jamie W. , Warnaby Catherine E. 
Published: October 2023

Background
Propofol causes significant cardiovascular depression and a slowing of neurophysiological activity. However, literature on its effect on the heart rate remains mixed, and it is not known whether cortical slow waves are related to cardiac activity in propofol anesthesia.

Methods
The authors performed a secondary analysis of electrocardiographic and electroencephalographic data collected as part of a previously published study where n = 16 healthy volunteers underwent a slow infusion of propofol up to an estimated effect-site concentration of 4 µg/ml. Heart rate, heart rate variability, and individual slow electroencephalographic waves were extracted for each subject. Timing between slow-wave start and the preceding R-wave was tested against a uniform random surrogate. Heart rate data were further examined as a post hoc analysis in n = 96 members of an American Society of Anesthesiologists Physical Status II/III older clinical population collected as part of the AlphaMax trial.

Results
The slow propofol infusion increased the heart rate in a dose-dependent manner (mean ± SD, increase of +4.2 ± 1.5 beats/min/[μg ml−1]; P < 0.001). The effect was smaller but still significant in the older clinical population. In healthy volunteers, propofol decreased the electrocardiogram R-wave amplitude (median [25th to 75th percentile], decrease of –83 [–245 to –28] μV; P < 0.001). Heart rate variability showed a loss of high-frequency parasympathetic activity. Individual cortical slow waves were coupled to the heartbeat. Heartbeat incidence peaked about 450 ms before slow-wave onset, and mean slow-wave frequency correlated with mean heart rate.

Conclusions
The authors observed a robust increase in heart rate with increasing propofol concentrations in healthy volunteers and patients. This was likely due to decreased parasympathetic cardioinhibition. Similar to non-rapid eye movement sleep, cortical slow waves are coupled to the cardiac rhythm, perhaps due to a common brainstem generator.

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Reinvestigating the Perceptions of Annual Skin Cancer Screening Scale: a suitable measure for older adults
Authors: Howard Matt C 
Published: October 2023

Objectives
The Perceptions of Annual Skin Cancer Screening Scale (PASCSS) explains significant variance in whether people undergo annual clinical skin cancer screening beyond other relevant predictors. When developing the PASCSS, the author only tested its psychometric properties and validity with participants representative of the general USA population, despite the particular relevance of annual clinical skin cancer screenings to at-risk populations, namely, older adults. We reanalyze the PASCSS using a sample of older adults.

Methods
We conducted a three-wave survey study (n = 237) with each wave separated by one week. Demographic information was recorded at Time 1. The PASCSS was administered at Time 2. Outcomes were measured at Time 3.

Results
The model fit of our confirmatory factor analysis met or closely approached traditional cutoffs, and each item loaded very strongly onto its respective latent factor. These PASCSS’s dimensions together explained an additional 38% of variance in dermatologist screening and 37% of variance in any medical professional screening beyond our control variables (both P < 0.01). The dimension of Unknowledgeable was statistically significant in predicting dermatologist screening (P = 0.03), whereas the three dimensions of Forget, Recommended, and Unknowledgeable were statistically significant in predicting any medical professional screening (all P < 0.05).

Conclusion
Our results supported the psychometric properties and validity of the PASCSS, and we showed that the dimensions significantly relate to whether participants received a clinical skin cancer screening in the past year. The current investigation supports that the PASCSS is appropriate to administer to older adults.
The illness perceptions of patients with percutaneous coronary intervention compared to patients with no percutaneous intervention, for acute myocardial infarction, in cardiac rehabilitation
Authors: McCallum Craig J. , Stewart Katy , MacIntyre Paul D. 
Published: October 2023

Purpose
Patients who receive percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have been found to have low attendance at cardiac rehabilitation (CR). It has been suggested that this is because PCI patients have a benign perception of their coronary disease; however, this has never been quantitatively investigated. The aim of this prospective study was to evaluate the illness perceptions (IP) of patients with AMI treated with PCI.

Methods
The Heart Health Illness Perception Questionnaire (modified version of the Brief Illness Perception Questionnaire) and the Cardiac Beliefs Questionnaire were used to assess patients’ IP and cardiac disease misconceptions, respectively. Patients in phase 2 of CR were recruited from the Royal Alexandria Hospital, Paisley, UK. One hundred two patients were identified from the cardiac unit database over a 16-week period and sent questionnaires.

Results
Fifty-six patients returned questionnaires suitable for analysis (54.9% response rate). There was a significant difference in the IP scores of the 3 groups [primary-PCI (pPCI) = 0.18 ± 1.44, elective-PCI = 5.27 ± 15.65, non-PCI = 9.94 ± 11.19; P = 0.046]. PCI patients had a significantly lower IP score than non-PCI patients (PCI = 1.62 ± 12.76, non-PCI = 9.94 ± 11.19; P = 0.027). pPCI patients had a significantly lower IP score than non-pPCI patients (pPCI = 0.18 ± 11.44, non-pPCI = 8.04 ± 13.11; P = 0.021). Of the PCI patients 22.9% agreed they were ‘fixed for life’ and a lower IP score was found to predict this opinion (P = 0.032).

Conclusion
PCI patients, particularly pPCI patients, perceive their coronary disease to be relatively benign. Further research is required to investigate if this predicts poor attendance at CR.
Naples score is associated with SYNTAX Score in patients with ST-segment elevation myocardial infarction
Authors: Oner Ender , Kahraman Serkan , Agus Hicaz Zencirkiran , Guner Ahmet , Dogan Arda Can , Yildiz Muhammed Mustafa , Erturk Mehmet 
Published: October 2023

Objective
The Naples Score (NS) predicts adverse outcomes in ST-elevation myocardial infarction (STEMI) patients, but the relationship between NS and the severity of coronary artery disease (CAD) in patients with STEMI has not been studied. In this study, we aimed to evaluate the role of NS at admission in predicting SYNTAX Score (SS).

Method
We gathered the data from 499 consecutive STEMI patients who underwent percutaneous coronary intervention between January 2018 and September 2020. Patients were divided into two groups: low SS group (≤22) and intermediate to high SS group (>22). NS was calculated for both groups besides baseline clinical and demographic variables.

Results
NS was higher in the intermediate to high SS group and the SS was increasing as the NS escalates. In multivariate logistic regression analysis, the NS was an independent predictor of intermediate to high SS. Additionally, there was a positive correlation between SS and NS.

Conclusion
Presentation NS predicts CAD complexity in patients with STEMI.
Root canal treatment of a six-canal first mandibular molar with extensive periapical lesion: A case report
Authors: Li Xin , Sun Shuyu , Zheng Tengyi 
Published: October 2023

Rationale:
There is an increasing tendency for case reports to reveal anatomical aberrances in mandibular first molars, such as the lateral and accessory canals. Thus, clinicians should pay special attention to anatomic variances when dealing with mandibular first molars requiring endodontic treatment to prevent reinfection within the root canal system, which is responsible for the failure of root canal treatment.

Patient concerns:
This article presents the clinical report and successful root canal treatment of a 24-year-old healthy female patient with an extensive periapical lesion in a 6-canal first mandibular molar. The patient was admitted to the endodontic department because of a periapical abscess found 1 month ago in her left mandibular first molar.

Diagnosis:
Chronic apical periodontitis was diagnosed based on clinical examination coupled with radiographic and cone-beam computed tomography images.

Interventions:
The treatment plan was to first perform root canal therapy and then perform clinical observation.

Outcomes:
During 1-year follow-up period, the treated tooth was asymptomatic, and complete resolution of the extensive apical lesion was eventually achieved, as shown in the postoperative cone-beam computed tomography images and clinical examination.

Lessons:
The present case emphasizes the importance of a comprehensive understanding of root canal morphology, especially rare anatomical variations, to ensure successful root canal treatment. Additionally, the case report adds to the library of previously reported cases of extensive periapical lesions with a direct connection to the root canal system, which demonstrates the potential clinical advantages of root canal therapy as a conservative nonsurgical approach in these cases.
Metachronous double primary malignant tumors with nasopharyngeal carcinoma and diffuse malignant peritoneal mesothelioma accompanied with paraneoplastic syndromes treated with nivolumab: A case report
Authors: Tang Liang-Ke , Li Zhi-Ke , Xiang Ya-Lang , Ma Dai-Yuan , Du Guo-Bo 
Published: October 2023

Rationale:
Multiple primary malignant tumors are rare and challenging to diagnose. Diffuse malignant peritoneal mesothelioma (DMPM) originate from the peritoneum, which lacks specific clinical manifestations and is difficult to diagnose, with a short survival about 10 to 13 months for inoperable ones. This is the first report of metachronous double primary malignant tumors in nasopharyngeal carcinoma and DMPM accompanied with paraneoplastic syndromes.

Patient concerns:
A 61-year-old man presented with abdominal discomfort with a history of nasopharyngeal carcinoma 5 years ago.

Diagnoses:
The diagnosis of DMPM was finally confirmed by laparoscopic mesenteric biopsies. Paraneoplastic syndromes including increased platelets were present when diagnosis, followed by increased neutrophils after disease progression.

Interventions:
Due to intolerable for surgery, he was treated with pemetrexed combined with nivolumab, intraperitoneal infusion of nivolumab, radiotherapy, anlotinib and maintenance treatment of nivolumab.

Outcomes:
Progression-free survival in first line is 12 months, overall survival is 23 months.

Lessons:
This indicate that comprehensive treatment including immunotherapy may be helpful for inoperable DMPM patients with nasopharyngeal carcinoma accompanied with paraneoplastic syndromes.
The level of ratio between matrix metalloproteinase-1 (MMP-1) and tissue inhibitor matrix metalloproteinase-1 (TIMP-1) after prolotherapy intervention and the functional outcome in patient with frozen shoulder: A randomized controlled trial
Authors: Sam Nuralam , Yusuf Irawan , Idris Irfan , Adnan Endy , Haryadi Ratna Darjanti , Hamid Firdaus , Usman Andry , Johan Muhammad Phetrus , Zainuddin Andi Alfian , Bukhari Agussalim 
Published: October 2023

Objective:
To determine the effect of prolotherapy on functional outcome changes, along with ratio of matrix metalloproteinase-1 (MMP-1)/tissue inhibitor matrix metalloproteinase-1 (TIMP-1) as an indicator of tissue repair in the glenohumeral joint in frozen shoulder patients.

Design:
Single-blinded randomized controlled trial.

Subjects/Patients:
Participants with frozen shoulder.

Methods:
The prolotherapy group is the study group, and the normal saline (NS) group is the control group. Each group was given injections at weeks 0, 2, 4, and 6. Level of biomarker levels was measured at week 6 and week 12 after there. Functional outcomes were measured at weeks 0, 6, and 12.

Results:
A significant difference in week 6 and week 12 was demonstrated in the ratio of MMP-1/TIMP-1 level between the prolotherapy group and the normal saline group (P value = .002). Both groups performed well regarding the Numerical Rating Scale score and functional outcome. Compared to the normal saline group, prolotherapy changed the mean range of motion in flexion and internal rotation.

Conclusion:
Prolotherapy is considered to play a role in repairing cartilage based on biomarker assessment, particularly the ratio of MMP-1/TIMP-1—prolotherapy effectiveness in improving functional outcome and Numerical Rating Scale score.
Severe hemolytic disease of the newborn caused by JKb antibody: Two case reports and literature review
Authors: Jiang Liang-Liang , Bi Shao-Hua , Yu Jing , Zhao Feng-Xia , Teng Maggie , Teng Ru-Jeng 
Published: October 2023

Background:
JKb antibody rarely causes severe hemolytic disease in the newborn except in 1 case, required blood exchange transfusion but later died of intractable seizure and renal failure. Here we describe 2 cases of JKb-induced severe neonatal jaundice requiring blood exchange transfusion with good neurological outcome.

Case presentation:
Two female Chinese, ethnic Han, term infants with severe jaundice were transferred to us at the age of 5- and 4-day with a total bilirubin of 30.9 and 25.9 mg/dL while reticulocyte counts were 3.2% and 2.2%, respectively. Both infants were not the firstborn to their corresponding mothers. Direct and indirect Coombs’ tests were positive, and JKb antibody titers were 1:64 (+) for both mothers. Phototherapy was immediately administered, and a blood exchange transfusion was performed within 5 hours of admission. Magnet resonance image showed no evidence of bilirubin-induced brain damage, and no abnormal neurological finding was detected at 6 months of life.

Conclusion:
JKb antibody-induced hemolytic disease of the newborn usually leads to a benign course, but severe jaundice requiring blood exchange transfusion may occur. Our cases suggest good outcomes can be achieved in this minor blood group-induced hemolytic disease of the newborn if identified and managed early enough.
A case report of heterotopic gastric mucosa in the rectum treated by endoscopic submucosal dissection and a systematic review
Authors: Peng Dunhuang , Qiu Ting , Chen Shaohua , Hu Weitao , Fang Taiyong 
Published: October 2023

Rationale:
Heterotopic gastric mucosa (HGM) can occur in all segments of the gastrointestinal tract, but rectal is very rare. In recent years, rectal HGM is more often treated by endoscopic resection (ER).

Patient concerns:
A 28-year-old female was admitted to the hospital with the chief complaint of “a rectal lesion found on physical examination”.

Diagnoses:
Heterotopic gastric mucosa (HGM).

Interventions:
An endoscopic submucosal dissection (ESD) was performed to completely dissect the lesion.

Outcomes:
The patient recovered well at 1 month of follow-up and did not suffer from further blood in the stool.

Lessons:
Rectal HGM has acid secretion function and HP can be colonized, causing a variety of symptoms such as abdominal pain, bloody stool, and anal pain and has the potential risk of malignant transformation; resection is the best treatment method, and ESD has its unique advantages and can be promoted in the clinic.
Comparison of Confirmed Cytology Smears and Cell Blocks for Epidermal Growth Factor Receptor Mutation Testing in Non–Small Cell Lung Cancer
Authors: Liu Chia-Hsing , Chang Shu-Jyuan , Tsai Min-Jan , Yang Sheau-Fang 
Published: October 2023

Introduction:
Various cytologic specimens have been used to diagnose epidermal growth factor receptor (EGFR) gene mutations in non–small cell lung cancer (NSCLC). However, insufficient samples and lengthy DNA extraction procedures have led to inconsistent diagnostic results. To reduce manipulation losses and improve DNA extraction quality, we provide an improved procedure for DNA extraction from smear samples containing rare tumor cells in NSCLC.

Patients and Methods:
The effectiveness of this new method for DNA extraction and diagnosis was validated in 8 patients with pleural effusion smears and formalin-fixed paraffin-embedded cell blocks, and another with 2 smears. Smear samples with <5% tumor cells were collected, and visible particles were selected for DNA extraction after centrifugation. Qiagen formalin-fixed paraffin-embedded DNA extraction kit (Qiagen) was used for DNA extraction and the procedure was modified. The EGFR mutation analysis in both types of material used the EGFR mutation analysis kit (Therascreen EGFR RGQ PCR) and real-time polymerase chain reaction (Rotor-Gene Q).

Results:
The DNA extraction amount of the smear was 2.6 to 258.8 ng/μL, and that of the cell block was 1.4 to 139.9 ng/μL. The DNA quantity and purity of DNA extracts isolated from both sample sources were sufficient for subsequent EGFR mutation detection, where mutation rates were similar and diagnostic results were consistent when smears or cell blocks were used.

Conclusion:
This improved method demonstrates that cytology smears can be used as a test material for the detection of EGFR mutations in patients with NSCLC with sparse cells.
Amniotic Band Syndrome: Head-to-Toe Manifestations and Clinical Management Guidelines
Authors: Inglesby Dani C. , Janssen Pierce L. , Graziano Francis D. , Gopman Jared M. , Rutland John W. , Taub Peter J. 
Published: October 2023

Learning Objectives:
After studying this article, the participant should be able to: 1. Understand and describe the basic principles underlying the intrinsic versus extrinsic proposed mechanisms for the development of amniotic band syndrome (ABS). 2. Discuss risk factors and conditions that are associated with the development of ABS. 3. Understand the various presentations and associated clinical implications of ABS by anatomic location. 4. Describe the basic tenets underlying various repair technique options for ABS of the extremities. 5. Discuss the common manifestations of ABS in the face and trunk. 6. Understand clinical implications of fetoscopic surgery as it relates to ABS treatment as a novel method for limb salvage in utero.

Summary:
Amniotic band syndrome (ABS) refers to the development of constrictive bands of fibrotic tissue in utero. It can lead to a variety of clinical manifestations after delivery. There is much debate in the plastic surgery community regarding the exact pathophysiologic mechanism for the development of ABS, and the most appropriate management. This CME article aims to provide an overview of ABS manifestations throughout the body, and to expound on the most recent advances in anticipatory and definitive management of the condition.