bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression and anxiety among multiethnic middle school students: Age, gender, and sociocultural environment
Authors: Jenkins Janis H , Sanchez Giselle , Miller Eric A , Santillanes Allande Nadia Irina , Urano Grace , Pryor Alexandra J 
Published: December 2022

Background: Depression and anxiety-related disorders are common among adolescents. Research attention to early adolescence and low-income ethnically diverse populations is limited. Aim: To conduct screening for depression and anxiety at an early age with attention to gender and socioenvironmental context within a low-income setting. Method: Mixed methods included the PHQ-9A and GAD-10 screening instruments and ethnographic interviews. Results: 75 ethnically diverse middle school students were included. Mean years age was 11.2 (0.74). Females had higher PHQ-9A sum scores than males ( p = .002, Mann-Whitney test) and higher GAD-10 sum scores than males ( p = .016, Mann-Whitney test). After controlling for multiple comparisons, girls had higher mean responses on three PHQ-9A items ( p < .006, two-sided t-test) and only one GAD-10 item ( p < .005, two-sided t-test). Ethnographic interviews revealed contexts associated with girls’ experiences of depression and anxiety, including gender-based violence in both school and home environments. Salient for girls and boys alike were worries about consequences of COVID-19 for family with respect to illness, death, job loss, economic hardship. Fears over student perceptions of intensified discrimination and racism in school and community were prominent. These problems were experienced by students as barriers to educational engagement. Conclusion: Specific attention to early adolescence is needed to identify emergence of subsyndromal conditions which may benefit from therapeutic attention to reduce symptom severity, identify sociocultural, structural, and gender-specific stressors, and to enhance educational engagement.
Identification of mechanical properties of a braided alfa stem (Stipa tenacissima L.) by an inverse method
Authors: Helaili Sofiene , Chafra Moez 
Published: December 2022

The aging of buildings and structures, accompanied by an increase in the prices of conventional building materials, has pushed the scientific community to explore new techniques and materials to rehabilitate existing buildings. Rehabilitation aims to extend the service life of a structure while maintaining its strength and stability. Among these techniques, composite materials based on synthetic fibers, such as carbon fibers, have been developed. However, materials with low carbon footprints that are bio-sourced and eco-friendly are of interest to the scientific community. The use of Alfa plant natural stems in a braided form is the focus of this study. This study is the first to use geometric shapes to improve the performance of a natural fiber-reinforced composite. Epoxy was used as the matrix, which is the material used most often in composite designed for reinforced concrete structures. This study aims to determine the equivalent mechanical properties of the Alfa braided stem using the reverse method. Test specimens of the epoxy/Alfa composites were manufactured and tested on a tensile machine. The epoxy was tested, and its properties were determined. Subsequently, a finite element numerical model of the specimen was constructed, and the properties of the braided Alfa stem were varied until identical results were obtained. The mechanical properties of the Alfa braided stem were thus identified. The results showed that the braided Alfa stem had a stiffness modulus of 23.243 GPa.
Physical–mechanical properties of multifunctional thermoplastic elastomers based on polyolefins and styrene-butadiene elastomer
Authors: Kakhramanov Najaf , Allahverdiyeva Khayala , Gahramanli Yunis , Mustafayeva Fatima , Martynova Galina 
Published: December 2022

The article presents the results of a study of the effect of the content of styrene-butadiene elastomer on the change in ultimate tensile stress, tensile yield strength, elongation at break, flexural strength, enthalpy and melting temperature, Vicat softening temperature, and melt flow rate of polymer blends based on a wide range of thermoplastic polyolefins: high-density polyethylene, low-density polyethylene, polypropylene, ethylene-hexene-1 copolymer, polypropylene random copolymer, and block copolymer of ethylene with propylene. Nanoparticles of technical carbon (TC), aluminum, and calcium stearate were used as fillers. It has been shown that, depending on the type of polyolefin used and the specific concentration of elastomer, the polymer mixture can acquire the properties of a thermoplastic elastomer (TPE). In high-density polyethylene and an ethylene-hexene-1 copolymer, the properties of TPE appear at an elastomer concentration of 30 wt %; in low-density polyethylene, this effect occurs at its 20 wt % content. In polypropylene, polypropylene random copolymer, and ethylene-propylene block copolymer, TPE properties appear at 40 wt % concentration of the elastomeric component. This was confirmed by the results of scanning electron microscopy, X-ray diffraction analysis, differential scanning calorimetry, as well as the “stress–strain” dependence of polymer mixtures. To achieve technological compatibility and miscibility of non-polar polyolefins with polar elastomer, compatibilizers based on high-density polyethylene and polypropylene modified with maleic anhydride were used. It is shown that the equality of the values of the ultimate tensile stress and the tensile yield strength is a consequence of the occurrence of phase inversion in the polymer mixture, that is, change of the dispersed medium to the dispersed phase and vice versa.
Design and mechanical properties of cervical fusion cage based on porous entangled metal rubber material
Authors: Ren Zhiying , Li Linlin , Xu Fangqi , Xu Jie , Lai Fuqiang 
Published: December 2022

Titanium and its alloys are one of the mainstream materials for the manufacture of intervertebral cages. With the application on clinical, the problems of elastic modulus is relatively high, subsidence of adjacent vertebral implants and stress shielding after surgery have gradually exposed. In this paper, metal rubber made from titanium alloy wire was used to prepare cervical fusion cage (CFC), which was a porous material with buffering and vibration damping properties. The C5/C6 segment of the goat cervical vertebra was used as the research object. The shape parameters of the CFC were determined by combining the three-dimensional model data of the cervical vertebra and the structural characteristics of the natural intervertebral disc. The force of CFC under different working conditions were simulated and analyzed by finite element simulation. Then three kinds of metal rubber core (MRC) were prepared by medical titanium alloy wire (TC4), and their mechanical properties and fatigue strength were experimentally studied. With the increases of density, the mechanical properties of MRC improved. The variation range of the loss factor η under different amplitudes and frequencies were 20% and 16.3%, respectively. After one million vibrations, the wear rate was 0.131 g/MC; after five million vibrations, the wear rate was 0.158 g/MC, which was similar to the existing clinical prosthesis wear rate. The MRC has sufficient mechanical strength. Compared with the existing clinical prostheses, it has a longer service life and has broad application prospects.
Relationship between raltegravir trough plasma concentration and virologic response and the impact of therapeutic drug monitoring during pregnancy
Authors: Carvalho Sabrina , Sheehan Nancy L. , Valois Silvie , Kakkar Fatima , Boucher Marc , Ferreira Ema , Boucoiran Isabelle 
Published: December 2022

Background Limited data is available on raltegravir (RAL) pharmacokinetics during pregnancy and the value of therapeutic drug monitoring (TDM) in pregnancy is unknown. This study aims to describe RAL trough plasma concentrations (Ctrough) during pregnancy and review the impact of RAL TDM on outcomes. Methods Women from the prospective mother-infant HIV cohort of Mother and Children’s Infectious Diseases Center who received RAL during their pregnancy between 2011-2020 were included. TDM reports were reviewed and Ctrough values estimated when possible, using historical RAL half-lives. Results We included 76 pregnant women of which 47 underwent TDM. We observed a significant association between virological response and Ctrough ( p-value .034) with an increase of 0.1 mg/L corresponding to a 2.96 reduction in the risk of having a detectable viral load. The results indicated that in pregnant women a RAL Ctrough threshold of 0.04 mg/L has a higher specificity (75%) as compared to our current Ctrough target value of 0.02 mg/L (25%) and an acceptable sensitivity (77%). No significant differences were observed between Ctrough at each trimester. When comparing pregnancies with and without TDM, no statistically significant differences were observed in the virologic response during pregnancy and at delivery, or with the need for triple antiretroviral prophylaxis in newborns. Conclusions An association between RAL Ctrough and viral load was observed and achieving a RAL Ctrough of 0.04 mg/L or greater is a predictor of virologic response in pregnant women. The impact of TDM in pregnancy, however, could not be demonstrated.
Association between periodontitis and blood-ocular barrier disruption
Authors: Karesvuo Minna , Häyry Sam , Karesvuo Petteri , Kanclerz Piotr , Tuuminen Raimo 
Published: December 2022

PurposePeriodontitis causes low-grade systemic inflammation e.g., through circulatory periodontal endotoxins, and it has been associated with cardiovascular morbidity and wet age-related macular degeneration.MethodsTo assess the association between clinical severity of periodontitis and aqueous flare levels in the eyes. Patients with periodontitis (N = 15) who underwent periodontal treatment by a specialized dentist between the years 2020 and 2021 at the Chin and Mouth Disease Unit, Kymenlaakso Central Hospital, Kotka, Finland were enrolled. Aqueous flare levels, a surrogate marker for blood-aqueous and blood-retinal-barrier disruption, were measured using Laser Flare Meter (FM-600, Kowa Company, Ltd., Nagoya, Japan) before and right after the periodontal treatment and at 3 months. The number of teeth, periodontal probing depth (PPD), periodontal pathogens and antimicrobial treatment were recorded.ResultsAt baseline, aqueous flare levels correlated with the number of clinically-relevant PPD (>5 mm) pockets (R = 0.789, P < 0.001) and inversely correlated with the number of teeth (R = −0.587, P = 0.035). At baseline, aqueous flare levels were 15.39 ± 13.24 photon units (pu)/ms among patients with periodontal pathogens, compared with 3.29 ± 1.67 pu/ms among those without any peridontal pathogens in PCR ( P = 0.018). At 3 months compared to baseline values, aqueous flare levels were reduced to <50% from baseline among 6 patients (40%), whereas the levels increased to >200% from baseline in 1 patient (7%) (repeated measures ANOVA, P < 0.026).ConclusionsPoor periodontal status was associated with blood-ocular-barrier breakdown. These findings could expand our understanding of the potential mechanisms and therapeutic targets against retinal vascular diseases and systemic comorbidities in patients with periodontitis.
Wait times and patient throughput after the implementation of a novel model of virtual care in an outpatient neurology clinic: A retrospective analysis
Authors: Rabinovitch Brenden Samuel , Diaz Patrick L , Langleben Amanda C , Katz Talia M , Gordon Tatyana , Le Kevin , Chen Frank Yizhao , Lewis Evan Cole 
Published: December 2022

Introduction Neurology wait times — from referral to consultation — continue to grow, leading to various adverse effects on patient outcomes. Key elements of virtual care can be leveraged to improve efficiency. This study examines the implementation of a novel virtual care model – Virtual Rapid Access Clinics – at the Neurology Centre of Toronto. The model employs a patient-centred care workflow, involving multidisciplinary staff and online administrative tools that are synthesized to expedite care and maintain quality. Methods Virtual Rapid Access Clinic efficacy was studied by determining average wait times and patient throughput, calculated from anonymous data that was extracted from the clinic patient database (n  =  1542). Comparative analysis focused on new patient consultations during the 12-month periods prior to (pre-Virtual Rapid Access Clinic, n  =  456) and following (post-Virtual Rapid Access Clinic, n  =  1086) Virtual Rapid Access Clinic implementation. Results After Virtual Rapid Access Clinic implementation, there was a mean 15-day wait time reduction, and a monthly average 52-patient increase in patient throughput. Wait time reductions and increased patient throughput were observed in all three Virtual Rapid Access Clinic sub-clinics – epilepsy, headache and concussion. Respectively, average wait times reduced significantly by 26.4 and 18.9 days and insignificantly by 1.1 days; monthly average patient throughputs increased by 235%, 95% and 161%. Discussion These findings demonstrated that the Virtual Rapid Access Clinic model of care is effective at reducing patient wait times and increasing patient throughput. While the Virtual Rapid Access Clinic presents a feasible model both during and after pandemic restrictions, further research exploring its scalability in other care contexts, potential changes in care quality and efficiency outside of pandemic restrictions must be performed.
Transcarotid Revascularization Timing and Early Postoperative Outcomes in Symptomatic Patients
Authors: Pineau Sylvestre , Fajardo Andres , Saqib Naveed U. , Tanaka Akiko , Motaganahalli Raghu L. , Keyhani Arash , Keyhani Kourosh , Wang Keisin S. 
Published: December 2022

Objective Carotid endarterectomy (CEA) performed several days after onset of symptoms has been shown to be optimal in preventing procedure-related stroke. Transcarotid artery revascularization (TCAR) is an alternative hybrid procedure to treat high-risk for CEA patients. In this investigation, our aim is to determine the effect of timing of TCAR in symptomatic patients. Methods Procedures were captured prospectively at 2 independent health systems from 2016-2022 within a carotid intervention database. A retrospective analysis of this database was performed to generate cohorts by time to revascularization from onset of symptoms, with the short-interval revascularization (SIR) group defined as having a time to revascularization between 2-5 days; and long-interval revascularization (LIR) group having a time to revascularization of 6-180 days. Univariate analysis was performed comparing the cohorts at an α of .05. Results During the study period, 875 TCARs were captured, including 321 procedures performed in symptomatic patients. Of these, 84 had revascularization performed within 6 days after onset of symptoms (SIR) while 237 additional cases were completed 6 or more days after onset of symptoms (LIR). Baseline comorbidities were grossly similar between cohorts. Intraoperatively, SIR patients were less likely to develop bradycardia (4.8% vs 22.2%, P = .01) and experienced a shorter operative time (58 minutes vs 65 minutes, P = .02). Estimated blood loss, flow reversal time, radiation exposure, fluoroscopic time and contrast volume were identical between the groups. Length of stay in SIR patients was longer (1, IQR [1-3] vs 1, IQR [1-2] days, P < .01). Additionally, SIR patients seemed to trend toward a higher rate of reinterventions (3.6% vs .4%, P = .06). The incidence of ipsilateral or contralateral stroke, cranial nerve palsy, myocardial infarction, hematoma, stent thrombosis and death were statistically identical between the 2 groups. Conclusion Like the previous results established for CEA, symptomatic patients undergoing TCAR demonstrate similar outcomes if the procedure is performed 48 hours after the neurologic event.
A scoping review on early inflammatory bowel disease: definitions, pathogenesis, and impact on clinical outcomes
Authors: Estevinho Maria Manuela , Leão Moreira Paula , Silva Isabel , Laranjeira Correia João , Santiago Mafalda , Magro Fernando 
Published: December 2022

Background: Crohn’s disease (CD) and ulcerative colitis (UC) arise from a dysregulation of the balance between commensal microbiota and mucosal-associated immune system, in patients with genetic and environmental predisposition. Different pathophysiological mechanisms have been reported to influence disease history, with impact on disease phenotype and risk of complications. Objectives: This review aims to summarize the definitions of early CD and UC, analyze the underlying immunological mechanisms, and evaluate the impact of recognizing and treating early inflammatory bowel disease (IBD) on patients’ prognosis (short- and long-term outcomes). Design: To address this issue, we have performed a scoping review. Data sources and methods: Three online databases (MEDLINE, Web of Science, and ScienceDirect) were searched and the results were independently screened by two reviewers. Results: From 683 records identified, 42 manuscripts evaluating early IBD in adult patients were included. The ‘early CD’ concept was first described in 2008. Four years later, an international consensus proposed the definition of diagnosis up to 18 months, in patients without previous or current need for disease-modifying therapies. Several other definitions have been proposed; the ‘2 years since diagnosis’ is the most used, regardless of disease characteristics or medication. The amount of evidence on early UC is lower and more recent. Regarding early disease pathogenesis, most theories emphasize the prominent role of innate immunity, followed by early-Th1 adaptive response. Conclusion: The treatment of early CD seems to be crucial for the management of CD patients, impacting short-, medium-, and long-term outcomes. On the other hand, the early treatment of UC appears to be less advantageous, yet evidence comes from only a few retrospective studies.
Comparative effectiveness of natalizumab versus ocrelizumab in multiple sclerosis: a real-world propensity score–matched study
Authors: Pape Katrin , Rolfes Leoni , Steffen Falk , Muthuraman Muthuraman , Korsen Melanie , Meuth Sven G. , Zipp Frauke , Bittner Stefan 
Published: December 2022

Background: For treatment of relapsing-remitting multiple sclerosis (RRMS), a broad range of disease-modifying therapies (DMT) is available. However, few comparative effectiveness studies between different drugs have been performed. Objectives: This study aimed to compare the efficacy and treatment continuation of natalizumab and ocrelizumab in a real-world cohort of patients with relapsing-remitting multiple sclerosis (RRMS) from two German university hospitals. Methods: We performed a retrospective analysis of RRMS patients who initiated treatment with natalizumab or ocrelizumab between January 2016 and April 2019 at the German university hospitals of Mainz and Düsseldorf. Bayesian propensity score matching was conducted to correct for differences in baseline characteristics. Our primary outcome was no evidence of disease activity [NEDA-3: no relapses, no confirmed disability progression, and no magnetic resonance imaging (MRI) activity] and its subcomponents. Secondary outcomes included measurement of neurofilament light chain (NfL) in serum, analysis of premature discontinuation, and evidence of rebound activity in patients switching from natalizumab to ocrelizumab. Results: We identified 63 patients starting treatment with natalizumab and 76 patients starting with ocrelizumab. Binary logistic regression showed that treatment with natalizumab or a higher number of relapses in the previous year were independently associated with a higher risk for relapses. Patients receiving natalizumab had a higher probability of premature discontinuation of therapy ( p = 0.002). After propensity score matching of the two treatment arms, 55 patients remained per group. NEDA-3 after 30 months of follow-up was reached by 53.1% in the ocrelizumab group and 36.1% in the natalizumab group ( p = 0.177). Ocrelizumab was superior to natalizumab concerning the occurrence of relapses in log-rank test ( p = 0.019). NfL levels in serum were low under both treatments. Patients who switched from natalizumab to ocrelizumab showed no increased rebound activity. Discussion: This study provides class IV evidence that treatment of RRMS patients with ocrelizumab and natalizumab show comparable effectiveness in combined endpoints, while ocrelizumab might be more effective in preventing the occurrence of relapses.
Real-world outcomes from use of CDK4/6 inhibitors in the management of advanced/metastatic breast cancer in Asia
Authors: Low Jia Li , Lim Elaine , Bharwani Lavina , Wong Andrea , Wong Karmen , Ow Samuel , Lim Siew Eng , Lee Matilda , Choo Joan , Lim Joline , Chan Gloria , Walsh Robert John , Muthu Vaishnavi , Ngoi Natalie , Chong Wanqin , Tan Sing Huang , Lee Soo Chin 
Published: December 2022

Background: Oestrogen receptor positive, human epidermal growth factor receptor-2 (HER2) negative breast cancer (BC) is the most frequently diagnosed BC subtype. Combinations of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with anti-oestrogen therapy have led to improved survival compared with anti-oestrogen therapy alone for advanced/metastatic BC. The evaluation of CDK4/6i in the real-world facilitates treatment planning, insights into the incidence of drug toxicities, dose modifications including dose delays (DDs) and dose reductions (DRs) and improves prognostic accuracy in subgroups, for example geriatric patients, who are under-represented in clinical trials. Methods: This multi-centre study analysed retrospective and prospective data from 456 patients treated with CDK4/6i between January 2015 and December 2020. We examined patient characteristics, variation in prescribing practices, efficacy and toxicity outcomes. Results: In all, 456 patients were included in this study. The median age was 59 (range: 24–92). In total, 85 (19%) were ⩾70 years old. In all, 122 (27%) and 119 (26%) of patients were treated in the first-line and second-line settings, respectively. In total, 25 (5%), 31 (7%) and 145 (32%) of patients had brain, peritoneum and liver metastasis, respectively, at the time of CDK4/6i initiation. On univariate analysis, heavily pre-treated patients and those with distant metastases, involving the liver, brain or peritoneum, had significantly shorter progression-free survival (PFS) and 24-month overall survival (OS). Elderly patients (⩾70) had a shorter PFS; OS results were not mature. Majority of patients ( n = 362, 80%) initiated treatment with the United States FDA-approved starting dose of CDK4/6i. In all, 330 (72%) had at least one DD and 217 (48%) patients required at least one DR, but these dose modifications were not associated with poorer survival outcomes. Patients age ⩾70 were more likely to require dose modifications leading to a lower treatment dose. The most common reason for DD/DR was neutropenia (60%) and the incidence of febrile neutropenia was only 2%. Conclusions: Our study indicates CDK4/6i is effective and safe. Age ⩾ 70, distant metastases to liver, peritoneal or brain were negative prognostic factors. Age ⩾ 70 was associated with significantly increased requirement for dose modification; however, this did not impact survival outcomes. These findings provide reassurance that survival outcomes are not adversely affected in elderly patients when DD/DR is indicated.