bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiotensin-II for vasoplegia following cardiac surgery
Authors: Johnson Andrew J , Tidwell William , McRae Andrew , Henson C Patrick , Hernandez Antonio 
Published: November 2023

Introduction The objective of this study was to describe the implementation and outcomes of a protocol outlining angiotensin-II utilization for vasoplegia following cardiac surgery. Methods This was a retrospective chart review at a single-center university hospital. Included patients received angiotensin-II for vasoplegia refractory to standard interventions, including norepinephrine 20 mcg/min and vasopressin 0.04 units/min, following cardiac surgery between April 2021 and April 2022. Results 30 patients received angiotensin-II for refractory vasoplegia. Adjunctive agents at angiotensin-II initiation included corticosteroids (26 patients; 87%), epinephrine (26 patients; 87%), dobutamine (17 patients; 57%), dopamine (9 patients; 30%), milrinone (2 patients; 7%), and hydroxocobalamin (4 patients; 13%). At 3 hours, the median mean arterial pressure increased from baseline (70 vs 61.5 mmHg, p = .0006). Median norepinephrine doses at angiotensin-II initiation, 1 hour, 3 hours, and angiotensin-II discontinuation were 0.22, 0.16 ( p = .0023), 0.10 ( p < .0001), and 0.07 ( p < .0001) mcg/kg/min. Median dobutamine doses decreased throughout angiotensin-II infusion from eight to six mcg/kg/min ( p = .0313). Other vasoactive medication doses were unchanged. Three patients (10%) subsequently received hydroxocobalamin. Thirteen (43.3%) and five (16.7%) patients experienced mortality by day 28 and venous or arterial thrombosis events, respectively. Conclusions The administration of angiotensin-II to vasoplegic patients following cardiac surgery was associated with increased mean arterial pressure, reduced norepinephrine dosages, and reduced dobutamine dosages.
Potential Adverse Outcomes of Shared Decision Making about Palliative Cancer Treatment: A Secondary Analysis of a Randomized Trial
Authors: van de Water Loïs F. , Bos–van den Hoek Danique W. , Kuijper Steven C. , van Laarhoven Hanneke W. M. , Creemers Geert-Jan , Dohmen Serge E. , Fiebrich Helle-Brit , Ottevanger Petronella B. , Sommeijer Dirkje W. , de Vos Filip Y. F. , Smets Ellen M. A. , Henselmans Inge 
Published: November 2023

Background While shared decision making (SDM) is advocated for ethical reasons and beneficial outcomes, SDM might also negatively affect patients with incurable cancer. The current study explored whether SDM, and an oncologist training in SDM, are associated with adverse outcomes (i.e., patient anxiety, tension, helplessness/hopelessness, decisional uncertainty, and reduced fighting spirit). Design A secondary analysis of a randomized clinical trial investigating the effects of SDM interventions in the context of advanced cancer. The relations between observed SDM (OPTION12), specific SDM elements (4SDM), oncologist SDM training, and adverse outcomes were analyzed. We modeled adverse outcomes as a multivariate phenomenon, followed by univariate regressions if significant. Results In total, 194 patients consulted by 31 oncologists were included. In a multivariate analysis, observed SDM and adverse outcomes were significantly related. More specifically, more observed SDM in the consultation was related to patients reporting more tension ( P = 0.002) and more decisional uncertainty ( P = 0.004) at 1 wk after the consultation. The SDM element “informing about the options” was especially found to be related to adverse outcomes, specifically to more helplessness/hopelessness ( P = 0.002) and more tension ( P = 0.016) at 1 wk after the consultation. Whether the patient consulted an oncologist who had received SDM training or not was not significantly related to adverse outcomes. No relations with long-term adverse outcomes were found. Conclusions It is important for oncologists to realize that for some patients, SDM may temporarily be associated with negative emotions. Further research is needed to untangle which, when, and how adverse outcomes might occur and whether and how burden may be minimized for patients. Highlights Observed shared decision making was related to more tension and uncertainty postconsultation in advanced cancer patients However, training oncologists in SDM did not affect adverse outcomes. Further research is needed to untangle which, when, and how adverse outcomes might occur and how burden may be minimized
Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population
Authors: Monahan Katie , Paiva Andrea , Blissmer Bryan , Sacco Allegra , Robbins Mark 
Published: November 2023

Purpose To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). Design Cross-sectional, split-half measure development. Setting Online survey in the US. Subjects 450 Black and/or Hispanic/Latinx adults. Measures Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. Analysis Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. Results EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. Conclusion This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.
Experimental study on high-temperature resistance of alkali-activated slag concrete block masonry
Authors: Huang Wenxuan , Zheng Wenzhong , Wang Ying 
Published: November 2023

The use of blast furnace slag improves resource utilization and supports the achievement of sustainable development goals. The use of alkali-activated slag cementitious material (AASCM) provides a new direction for improving the fire resistance of masonry structures. The masonry investigated in this study was alkali-activated slag crushed aggregate concrete masonry (ASCCM) in which aggregates of blocks and mortars were crushed and screened using AASCM paste specimens. The compression behavior of 12 specimens during and after exposure to high temperatures, specifically 300, 500, 600, 700, 800, and 900°C was investigated. The specimens were maintained under the target temperature for 2 h. The compressive strength and axial deformation of the specimen were recorded. The compressive strength losses during exposure to 300, 500, 600, 700, 800, and 900°C are 15.9, 20.3, 38.3, 43.9, 63.3 and 73.8%, respectively. The compressive strength losses after exposure to 300, 500, 600, 700, 800, and 900°C are 10.6, 15.8, 34.0, 37.2, 58.6 and 72.2%, respectively. The rate of loss in elastic modulus is greater than that in compressive strength. During exposure to 300, 500, 600, 700, 800, and 900°C, the loss rates of elastic modulus are 56.5, 74.4, 83.3, 86.3, 92.9 and 93.9%, respectively. After exposure to 300, 500, 600, 700, 800, and 900°C, the loss rates of elastic modulus are 49.6, 67.3, 77.5, 82.0, 90.7 and 94.5%, respectively. The peak compressive strain values are 9.9 and 11.1 times that at room temperature. Equations for calculating the compressive strength, elastic modulus, peak compressive strain, and ascending section curve of the stress–strain relationship with temperature were derived. The research results provide a new choice for high temperature resistant masonry materials, and provide theoretical basis and data support for the application of AASCM in masonry structures in high-temperature environments.
Access to Rehabilitation After Hospitalization for Traumatic Brain Injury: A National Longitudinal Cohort Study in Sweden
Authors: Klang Andrea , Molero Yasmina , Lichtenstein Paul , Larsson Henrik , D’Onofrio Brian Matthew , Marklund Niklas , Oldenburg Christian , Rostami Elham 
Published: November 2023

Background Rehabilitation is suggested to improve outcomes following traumatic brain injury (TBI), however, the extent of access to rehabilitation among TBI patients remains unclear. Objective To examine the level of access to rehabilitation after TBI, and its association with health and sociodemographic factors. Method We conducted a longitudinal cohort study using Swedish nationwide healthcare and sociodemographic registers. We identified 15 880 TBI patients ≥18 years hospitalized ≥3 days from 2008 to 2012 who were stratified into 3 severity groups; grade I (n = 1366; most severe), grade II (n = 5228), and grade III (n = 9268; least severe). We examined registered contacts with specialized rehabilitation or geriatric care (for patients ≥65 years) during the hospital stay, and/or within 1 year post-discharge. We performed a generalized linear model analysis to estimate the risk ratio (RR) for receiving specialized rehabilitation or geriatric care after a TBI based on sociodemographic and health factors. Results Among TBI patients, 46/35% (grade I), 14/40% (grade II), and 5/18% (grade III) received specialized rehabilitation or geriatric care, respectively. Being currently employed or studying was positively associated (RR 1.7, 2.3), while living outside of a city area was negatively associated (RR 0.36, 0.79) with receiving specialized rehabilitation or geriatric care. Older age and a prior substance use disorder were negatively associated with receiving specialized rehabilitation (RR 0.51 and 0.81). Conclusion Our results suggest insufficient and unequal access to rehabilitation for TBI patients, highlighting the importance of organizing and standardizing post-TBI rehabilitation to meet the needs of patients, regardless of their age, socioeconomic status, or living area.
Factors associated with short birth interval among reproductive-age women in East Africa
Authors: Tesema Getayeneh Antehunegn , Wolde Maereg , Tamirat Koku Sisay , Worku Misganaw Gebrie , Fente Bezawit Melak , Tsega Sintayehu Simie , Tadesse Aster , Teshale Achamyeleh Birhanu 
Published: November 2023

Background: Child and maternal mortality continue as a major public health concern in East African countries. Optimal birth interval is a key strategy to curve the huge burden of maternal, neonatal, infant, and child mortality. To reduce the incidence of adverse pregnancy outcomes, the World Health Organization recommends a minimum of 33 months between two consecutive births. Even though short birth interval is most common in many East African countries, as to our search of literature there is limited study published on factors associated with short birth interval. Therefore, this study investigated factors associated with short birth intervals among women in East Africa. Objective: To identify factors associated with short birth intervals among reproductive-age women in East Africa based on the most recent demographic and health survey data Design: A community-based cross-sectional study was conducted based on the most recent demographic and health survey data of 12 East African countries. A two-stage stratified cluster sampling technique was employed to recruit the study participants. Methods and analysis: A total weighted sample of 105,782 reproductive-age women who had two or more births were included. A multilevel binary logistic regression model was fitted to identify factors associated with short birth interval. Four nested models were fitted and a model with the lowest deviance value (–2log-likelihood ratio) was chosen. In the multivariable multilevel binary logistic regression analysis, the adjusted odds ratio with the 95% confidence interval was reported to declare the statistical significance and strength of association between short birth interval and independent variables. Results: The prevalence of short birth interval in East Africa was 16.99% (95% confidence interval: 16.76%, 17.21%). Women aged 25–34 years, who completed their primary education, and did not perceive the distance to the health facility as a major problem had lower odds of short birth interval. On the contrary, women who belonged to the poorest household, made their own decisions with their husbands/partners or by their husbands or parents alone, lived in households headed by men, had unmet family planning needs, and were multiparous had higher odds of having short birth interval. Conclusion: Nearly one-fifth of births in East Africa had short birth interval. Therefore, it is essential to promote family planning coverage, improve maternal education, and empower women to decrease the incidence of short birth intervals and their effects.
Different associations between organ-specific immune-related adverse event and survival in non-small cell lung cancer patients treated with programmed death-1 inhibitors-based combination therapy
Authors: Chen Yuzhong , Shi Yuanjian , Ding Hanlin , Feng Yipeng , Zhang Te , Liang Yingkuan , Wang Hui , Song Xuming , Chen Bing , Xia Wenjie , Mao Qixing , Shen Bo , Xu Lin , Dong Gaochao , Jiang Feng 
Published: November 2023

Background: The profile of immune-related adverse events (irAEs) due to programmed death-1 (PD-1) inhibitors-based combination therapy in advanced non-small cell lung cancer (NSCLC) and its relationship with survival have not been fully described. Objective: Designed to capture the spectrum of irAEs and explore the association between irAEs and clinical outcomes in patients with NSCLC. Design: This retrospective single-center study included patients with advanced NSCLC treated with PD-1 inhibitors (mainly in combination with chemotherapy) at Jiangsu Cancer Hospital. Methods: The relationship between irAEs and survival was explored using landmark analysis and time-dependent Cox regression. The subgroup analyses focused on investigating the effects of organ-specific irAE, irAE grade, and steroid dose used to treat irAE. Results: This study included 301 patients, 199 of whom received PD-1 inhibitors plus chemotherapy. The most common irAEs were skin toxicity (19.3%), endocrinopathy (21.3%), and pneumonitis (17.6%). In the entire cohort, the median progression-free survival (PFS) for patients developing and not developing irAE was 12.3 and 10.7 months ( p < 0.001), and the median overall survival (OS) was 23.5 months and 20.1 months ( p = 0.137), respectively. Subgroup analyses indicated that grade 3 or higher irAE, high steroid dose, and immune-related pneumonitis were detrimental to OS, whereas skin toxicity was beneficial to survival. These findings were further corroborated by both landmark analyses and Cox regression models conducted over four time points (1, 3, 6, and 12 months). Conclusion: In the real world, NSCLC patients receiving PD-1 inhibitor-based combination therapy (particularly combined with chemotherapy) experience longer PFS with irAE, though not necessarily OS. Immune-related skin toxicity is associated with a better prognosis, whereas pneumonitis grade ⩾3 irAE and high steroid dose compromise survival. Clinicians should remain cognizant of the organ-specific manifestations of irAE and take proactive measures to mitigate the progression of irAE.
Bimbowrieite, NaMgFe3+5(PO4)4 (OH)6⋅2H2O, a new dufrénite-group mineral from the White Rock No.2 quarry, South Australia, Australia
Authors: Elliott Peter , Kampf Anthony R. 
Published: November 2023

AbstractBimbowrieite, NaMgFe3+5(PO4)4(OH)6⋅2H2O, is a new mineral found in a mineralogically zoned rare-element bearing pegmatite at the White Rock No.2 quarry, Bimbowrie Conservation Park, South Australia, Australia. Crystals are dark olive green to greenish brown and are bladed with dimensions of up to 150 μm. Crystals occur as aggregates up to 0.4 mm across associated with ushkovite, bermanite, leucophosphite and sellaite. Bimbowrieite is pleochroic, biaxial (+), with α = 1.785(5), β = 1.795(5), γ = 1.805(5) and 2V(meas.) = 89.4(5)°. The average of 28 chemical analyses gave the empirical formula: (Na0.81Ca0.19)Σ1.00(Mg0.75Mn2+0.19Fe2+0.05)Σ0.99(Fe3+4.99Al0.01)Σ5.00(PO4)3.97(OH)5.88⋅2.05 H2O based on 24 oxygen atoms. Bimbowrieite is monoclinic, space group C2/c with a = 25.944(5), b = 5.1426(10), c = 13.870(3 Å, β = 111.60(3)°, V = 1720.4(7) Å3 and Z = 4. The crystal structure was refined to R1 = 1.97% for 1060 observed reflections with F0 > 4σ(F0). Bimbowrieite is isostructural with dufrénite. The structure is based on a trimer of face-sharing octahedra in which an M2 octahedra shares two trans faces with two M4 octahedra. Trimers link in the c-direction by sharing corners with two M3 octahedra and with T1 and T2 tetrahedra. Linkage in the a-direction is via corner-sharing M1 octahedra and linkage in the b-direction is via corner-sharing T1 and T2 tetrahedra.
How I diagnose and treat thrombocytopenia in geriatric patients
Authors: Foy Patrick , Friedman Kenneth D. , Michaelis Laura C. 
Published: November 2023

Abstract
Thrombocytopenia in older individuals is a common but diagnostically challenging condition that has variable clinical impact to those who are affected. Diagnostic approach requires evaluation of the preexisting clinical conditions, detailed review of medications, and assessment for disorders that warrant urgent treatment. In this article, we describe a systematic approach to diagnosis of thrombocytopenia and present a schematic review for management strategies. Three clinical scenarios are presented that are relevant for their prevalence and management challenges in an older adult population. The first scenario addresses primary immune thrombocytopenia (ITP) and reviews different treatment options. The second one addresses complications of thrombocytopenia in management of the myelodysplastic syndrome. The last one reviews diagnostic challenges of drug-induced ITP.
A mouse model of ATRX deficiency with cognitive deficits and autistic traits
Authors: Quesnel Katherine M. , Martin-Kenny Nicole , Bérubé Nathalie G. 
Published: November 2023

AbstractBackgroundATRX is an ATP-dependent chromatin remodeling protein with essential roles in safeguarding genome integrity and modulating gene expression. Deficiencies in this protein cause ATR-X syndrome, a condition characterized by intellectual disability and an array of developmental abnormalities, including features of autism. Previous studies demonstrated that deleting ATRX in mouse forebrain excitatory neurons postnatally resulted in male-specific memory deficits, but no apparent autistic-like behaviours.MethodsWe generated mice with an earlier embryonic deletion of ATRX in forebrain excitatory neurons and characterized their behaviour using a series of memory and autistic-related paradigms.ResultsWe found that mutant mice displayed a broader spectrum of impairments, including fear memory, decreased anxiety-like behaviour, hyperactivity, as well as self-injurious and repetitive grooming. Sex-specific alterations were also observed, including male-specific aggression, sensory gating impairments, and decreased social memory.ConclusionsCollectively, the findings indicate that early developmental abnormalities arising from ATRX deficiency in forebrain excitatory neurons contribute to the presentation of fear memory deficits as well as autistic-like behaviours.
Enhanced cancer immunotherapy through synergistic ferroptosis and immune checkpoint blockade using cell membrane-coated nanoparticles
Authors: Mu Yeteng , Fan Yuxin , He Lianping , Hu Nannan , Xue Han , Guan Xingang , Zheng Zhijian 
Published: November 2023

Abstract
Background
Immune checkpoint blockade (ICB) has achieved unprecedented success in inhibiting the progression and metastasis of many cancers. However, ICB regents as a single treatment have a relatively low overall response rate due to the tumor’s low immunogenicity and immunosuppressive microenvironment. Herein, we report a PD-1 cellular membrane-coated ferroptosis nanoinducer to potentiate cancer immunotherapy toward triple-negative breast cancer.

Results
This study demonstrates that PD-1 membrane-coated RSL3 nanoparticles (PD-1@RSL3 NPs) have the ability to disrupt the PD-1/PD-L1 axis, leading to the activation of antitumor immunity in breast cancer. In addition, the nanoparticles promote the induction of tumor cell ferroptosis through GPX4 inhibition, enhanced infiltration of CD8+ T cells, and maturation of dendritic cells. The potentiated antitumor immune response induced by PD-1@RSL3 NPs significantly delayed tumor progression and extended the survival rate of mice with breast cancer xenografts.

Conclusions
Our study suggest the potential of PD-1@RSL3 NPs as an effective therapeutic approach for breast cancer by promoting tumor cell ferroptosis and inducing antitumor immunity.
Optimizing diabetes classification with a machine learning-based framework
Authors: Feng Xin , Cai Yihuai , Xin Ruihao 
Published: November 2023

Abstract
Background
Diabetes is a metabolic disorder usually caused by insufficient secretion of insulin from the pancreas or insensitivity of cells to insulin, resulting in long-term elevated blood sugar levels in patients. Patients usually present with frequent urination, thirst, and hunger. If left untreated, it can lead to various complications that can affect essential organs and even endanger life. Therefore, developing an intelligent diagnosis framework for diabetes is necessary.

Result
This paper proposes a machine learning-based diabetes classification framework machine learning optimized GAN. The framework encompasses several methodological approaches to address the diverse challenges encountered during the analysis. These approaches encompass the implementation of the mean and median joint filling method for handling missing values, the application of the cap method for outlier processing, and the utilization of SMOTEENN to mitigate sample imbalance. Additionally, the framework incorporates the employment of the proposed Diabetes Classification Model based on Generative Adversarial Network and employs logistic regression for detailed feature analysis. The effectiveness of the framework is evaluated using both the PIMA dataset and the diabetes dataset obtained from the GEO database. The experimental findings showcase our model achieved exceptional results, including a binary classification accuracy of 96.27%, tertiary classification accuracy of 99.31%, precision and f1 score of 0.9698, recall of 0.9698, and an AUC of 0.9702.

Conclusion
The experimental results show that the framework proposed in this paper can accurately classify diabetes and provide new ideas for intelligent diagnosis of diabetes.