bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperacute stenting and angioplasty for acute extracranial non-tandem internal carotid artery strokes within the first 48 h: A 20-year experience and a systematic review and meta-analysis
Authors: Baig Ammad A , Lai Pui Man Rosalind , Turner Ryan C , Donnelly Brianna M , Kuo Cathleen C , Lim Jaims , Raygor Kunal P , Bouslama Mehdi , Prasad Shefalika , Fayyaz Najya , Snyder Kenneth V , Davies Jason M , Siddiqui Adnan H , Levy Elad I 
Published: May 2023

Background Acute strokes involving complete, isolated occlusion of the extracranial cervical internal carotid artery (EC-ICA) with no intracranial clot burden account for a minority of stroke cases that are managed variably. Here we present our two-decade experience and a systematic review of endovascular management of acute isolated EC-ICA strokes in the hyperacute phase (<48 h) and attempt to evaluate clinical effectiveness and safety. Methods Our prospectively maintained database was retrospectively searched for patients who presented between January 1, 2003 and December 31, 2022 with acute cervical ICA stroke confirmed on angiography. Only patients who had an isolated 100% occlusion of the cervical ICA segment and attempted acute stenting with/without angioplasty within the first 48 h of time since last known well were included. Demographics, procedural details, and outcomes were recorded. For the systematic review, a search of PubMed and Embase databases was conducted. Results Forty-six patients with acute, isolated EC-ICA occlusive stroke were included. Median presenting National Institutes of Health Stroke Scale (NIHSS) score was 8 (interquartile range 3–10) with a perfusion deficit in 78.3% of the 40 cases assessed with computed tomography perfusion imaging. Median time from symptom onset to intra-arterial puncture was 14.4 h. Immediate recanalization was achieved in 82.6% cases. Two cases (4.3%) of symptomatic intracranial hemorrhage (sICH) occurred postprocedure. Outcome measures were stable or improved discharge NIHSS score in 86.9% of cases, functional independence at 90 days (modified Rankin scale score ≤2) in 78.3%, and mortality in 6.5%. The systematic review included 167 patients from four articles. The estimated rate of immediate recanalization was 92.7% (95% confidence interval (CI), 88.77–96.77%), favorable outcome was 62.01% (95% CI, 55.04–69.87%), and sICH was 6.2% (95% CI, 3.41–11.32%). Conclusion Stenting and angioplasty for acute cervical ICA occlusive strokes during the hyperacute phase can be performed successfully with favorable clinical outcomes and an acceptable recanalization rate.
Reduction in Thrombolytic Usage in Hemodialysis Patients Following a Quality Assurance Review: A Research Letter
Authors: Bau Jason T. , Younis Kokab , Gallagher Nathen , Harrison Tyrone G. , Leung Kelvin , Hemmett Juliya , Qirjazi Elena 
Published: May 2023

Background: Catheter malfunction in hemodialysis (HD) is increasingly managed with recombinant tissue plasminogen activator (rt-PA, alteplase), though evidence of improved catheter function is lacking. Objective: To evaluate the effect of a standardized rt-PA administration protocol on rt-PA usage, catheter function, and adverse events. Design: Observational quality improvement study. Setting: Single, urban, community HD unit in Calgary, Alberta. Patients: Patients treated with maintenance in-center HD through central venous catheter. Outcomes: Incidence of rt-PA usage, catheter interventions, hospitalizations, and measures of dialysis efficacy. Methods: The rt-PA protocol was designed following a consultative and iterative design period with dialysis shareholders, which included focusing on standard objective criteria before use and targeting use to the problematic lumen. Protocol implementation occurred over a 6-month period in 2021. Patient and dialysis data were collected through our regional dialysis electronic health record. Results: Implementation of the rt-PA protocol resulted in decreased rt-PA use (standardized per 100 dialysis sessions) compared to the preprotocol period (incidence rate ratio [IRR] of 0.57, 95% confidence interval [CI]: [0.34, 0.94]). Line procedures were also less frequent (IRR = 0.42, 95% CI: [0.18, 0.89]). Hospitalization rates and measures of dialysis efficacy were similar in both periods. Limitations: Small sample size with single dialysis center and short duration of follow-up. Conclusions: Implementation of a multidisciplinary designed rt-PA administration protocol decreased incident rt-PA usage
The effectiveness of wearable activity trackers for increasing physical activity and reducing sedentary time in older adults: A systematic review and meta-analysis
Authors: Wu Shuang , Li Guangkai , Du Litao , Chen Si , Zhang Xianliang , He Qiang 
Published: May 2023

Background Traditional interventions such as education and counseling are successful in increasing physical activity (PA) participation, but are usually labor and resource intensive. Wearable activity trackers can objectively record PA and provide feedback to help users to achieve activity goals and are an increasingly popular tool among adults used to facilitate self-monitoring of PA. However, no reviews systematically explored the roles of wearable activity trackers in older populations. Methods We searched PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and Scopus from inception to September 10, 2022. Randomized controlled trials were included. Two reviewers independently conducted study selection, data extraction, risk of bias, and certainty of evidence assessment. A random-effects model was used to evaluate the effect size. Results A total of 45 studies with 7144 participants were included. A wearable activity tracker was effective in increasing daily steps (standard mean differences (SMD) = 0.59, 95% confidence interval (CI) (0.44, 0.75)), weekly moderate-to-vigorous PA (MVPA) (SMD = 0.54, 95% CI (0.36, 0.72)), and total daily PA (SMD = 0.21, 95% CI (0.01, 0.40)) and reducing sedentary time (SMD = −0.10, 95% CI (−0.19, −0.01)). Subgroup analysis showed that the effectiveness of wearable activity trackers for daily steps was not influenced by participants and intervention features. However, wearable activity trackers seemed more effective in promoting MVPA of participant's age <70 than participant's age ≥70. In addition, wearable activity trackers incorporated with traditional intervention components (e.g. telephone counseling, goal setting, and self-monitoring) could better promote MVPA than alone use. Short-term interventions potentially achieve better MVPA increase than long-term. Conclusion This review showed that wearable activity trackers are an effective tool to increase PA for the old population and also favor reducing sedentary time. When used together with other interventions, wearable activity trackers can achieve better MVPA increase, especially in the short term. However, how to more effectively improve the effectiveness of wearable activity trackers is an important direction of future research.
Undergraduate Students’ Knowledge, Attitudes and Willingness to Receive COVID-19 Vaccines: A Survey of Convenience Sample in Namibia
Authors: Tomas Nestor , Munangatire Takaedza , Nampila Stefanus 
Published: May 2023

Introduction The global consequences of the COVID-19 pandemic cannot be overstated. Vaccinations are one of the leading strategies to protect against the virus, and it is likely that students’ understanding and desire to be vaccinated can be major factors in helping contain the pandemic. Nonetheless, no studies looked into the vaccine attitude, knowledge and willingness in Namibia. Objectives To assess and describe the association between knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines in the school of education, nursing and economics and management science at the university campus in Namibia. Methods The study employed a cross-sectional descriptive study from 203 undergraduate university students using a convenience sampling. Data analysis was done using SPSSv28 and descriptive statistics were used to depict trends in data while a Pearson's correlation determined the relationship between the study variables. Results The data showed that 54.2% (1.54  ±  0.49) of the participants had adequate knowledge concerning the vaccine, while 57.1% and 58.6% had a negative outlook and were unwilling to get vaccinated. A moderate positive correlation was observed between attitudes and willingness to take COVID-19 vaccines ( r  =  .546, P  =<.001), while a negative relation existed between knowledge and attitudes ( r  =  −.017, P  =>.001). Conclusions This study has provided valuable insight into the knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines. Despite more than half of the participants having appropriate knowledge, they had an unfavourable outlook toward COVID-19 vaccination. It is recommended that further studies focus on how factors such as incentives, religion and cultural values affect their desires to be vaccinated.
Retrospective Analysis of Management of Zygomatic Complex Fractures
Authors: Kambalimath Deepashri H. , Kambalimath Halaswamy V. , M.V.V. Satyanarayan , V. Ashok kumar , T.G. Ravikumar , Deepak R.M. 
Published: May 2023

Introduction Zygomatic bone and its surrounding bony anatomy are essential for maintaining facial contour—cheek prominence and orbital integrity. Management of the zygomatic complex (ZMC) fractures are important in the maintenance of function and facial integrity. Aim and Objectives To analyze the incidence, aetiology, surgical management, and complications encountered in the treatment of ZMC fractures in our super-specialty hospital, and to compare the number and location of fixation points and surgical access in our patient cohort with the literature. Materials and Method Retrospective analysis of all operative cases (Open Reduction and Internal Fixation) of ZMC fractures over a 3-year period (2017-2021) were reviewed. Craniofacial maxillofacial trauma patient’s medical records were collected and out which only the ZMC fracture cases were reviewed. Only the medical records from the period from 2017 to 2021 were included. The parameters such as etiology, site of the ZMC fracture, type of fracture, associated injuries, clinical findings, treated with conservative or surgical intervention, type of incisions used, number of fixation used, and any complications encountered were reviewed and analyzed. Results Out of 428 cases of craniofacial injury, 96 cases were ZMC fractures, isolated ZMC fractures accounted for 43%, 33% with associated injuries, 13% isolated arch, while 11% accounted isolated infraorbital rim fracture. Most common clinical findings were subconjunctival ecchymosis (71%), flattening of cheek (39%), malocclusion (22%), and so on. Buccal sulcus incision (66%) was mainly used, followed by upper blepharoplasty incision (59%). Depending on degree of displacement of fracture 1-point fixation (8%), 2-point fixation (30%), or 3-point fixation (27%) was performed. About 33% of cases were conservatively managed and followed up on regular intervals. Lymph edema, infra orbital paresthesia, temporary blindness, diplopia, hemianopsia were some of the complications encountered which were managed successfully and followed up. Conclusion ZMC fractures are most commonly occurring midface fractures with variable etiologies. The most common ZMC fracture pattern was tripod type of fracture. Greater portion of the patient were treated with 2-point fixation. Most of the complications were due to the impact and velocity of trauma.
Cross-disciplinary Prevalence and Associated Factors for Work-Related Discomfort in Users of Ultrasonography: Implications for Sonography Professionals and Health Care Administrators
Authors: Roll Shawn C. , Fukumura Yoko E. , Sommerich Carolyn M. , Stigall-Weikle A. Nicole , Evans Kevin D. 
Published: May 2023

Objective: Work-related discomfort is a pervasive issue among ultrasonography users. The Sonography Work Systems (SWS) framework was constructed as a means of examining relationships within and across components of the sonography work systems, work processes, and work/worker outcomes. A database of ultrasonography users was established as a foundation for a longitudinal survey study to examine worker health and well-being and explore the most salient work systems and process factors associated with work-related discomfort. Materials and Methods: An estimated 100 000 unique ultrasonography users were invited to complete the online questionnaire through an e-mail campaign. Snowball sampling occurred through social media posts and encouragement for respondents to share the survey link with colleagues. The questionnaire included items that examined participant demographics, selected constructs from the SWS, and the prevalence of work-related musculoskeletal discomfort, visual discomfort, and headaches. Individual and multi-factorial regression models were conducted to examine SWS factors associated with the likelihood of experiencing the three types of work-related discomfort. Results: A total of 3659 valid responses were included in the analysis, with 86% of respondents reporting that they regularly experienced musculoskeletal discomfort that they directly attributed to their work. About half (54.2%) of the respondents have engaged in sonography-related ergonomics training, and respondents indicated using adjustable equipment approximately 74% of the time. Workplace culture was rated as primarily positive, but respondents indicated that employers implement only two of seven commonly recommended ergonomic policies and procedures. Working in an organization with more policies, using adjustable equipment more frequently, taking more work breaks, engaging in a positive work culture, and minimizing interruptions to workflow were key factors associated with reduced likelihood of work-related discomfort. Conclusion: This study provides a new framework for examining and addressing factors that contribute to ultrasonography users’ experience of work-related discomfort. Despite increased participation in ergonomics training and the use of adjustable equipment, the prevalence of work-related discomfort remains high among ultrasonography users. The findings highlight the need for attention to be directed at organizational factors and work processes to identify and implement evidence-based solutions to improve the health and well-being of medical ultrasound users.
Litter mixing promoted decomposition and altered microbial community in common bean root litter
Authors: Zhang Linlin , Li Jiawei , Wang Zhilin , Zhang Dinghong , Liu Hui , Wang Jia , Wu Fengzhi , Wang Xue , Zhou Xingang 
Published: May 2023

Abstract
Background
Decomposition of plant litter is a key driver of carbon and nutrient cycling in terrestrial ecosystems. Mixing litters of different plant species may alter the decomposition rate, but its effect on the microbial decomposer community in plant litter is not fully understood. Here, we tested the effects of mixing with maize (Zea mays L.) and soybean [Glycine max (Linn.) Merr.] stalk litters on the decomposition and microbial decomposer communities of common bean (Phaseolus vulgaris L.) root litter at the early decomposition stage in a litterbag experiment.

Results
Mixing with maize stalk litter, soybean stalk litter, and both of these litters increased the decomposition rate of common bean root litter at 56 day but not 14 day after incubation. Litter mixing also increased the decomposition rate of the whole liter mixture at 56 day after incubation. Amplicon sequencing found that litter mixing altered the composition of bacterial (at 56 day after incubation) and fungal communities (at both 14 and 56 day after incubation) in common bean root litter. Litter mixing increased the abundance and alpha diversity of fungal communities in common bean root litter at 56 day after incubation. Particularly, litter mixing stimulated certain microbial taxa, such as Fusarium, Aspergillus and Stachybotrys spp. In addition, a pot experiment with adding litters in the soil showed that litter mixing promoted growth of common bean seedlings and increased soil nitrogen and phosphorus contents.

Conclusions
This study showed that litter mixing can promote the decomposition rate and cause shifts in microbial decomposer communities, which may positively affect crop growth.
The upper airway parameters: the potential diagnostic clues for congenital intrathoracic lesions
Authors: Song Shijing , Wang Jingjing , Wang Li , Hou Chenxiao , Wu Qingqing 
Published: May 2023

AbstractBackgroundThe diagnosis of congenital intrathoracic lesions still has limitations. The airway development was influenced by intrathoracic factors. Whether the diagnostic value of the upper airway parameters in congenital intrathoracic lesions has not been confirmed.ObjectivesWe aimed to compare fetal upper airway parameters between normal fetuses and fetuses with intrathoracic lesions, and we tried to verify its diagnostic value in intrathoracic lesions.MethodsThis was an observational case–control study. In the control group, 77 women were screened at 20–24 weeks’ gestational age, 23 were screened at 24–28 weeks’ gestational age, and 27 were screened at 28–34 weeks’ gestational age. In the case group, 41 cases were enrolled (6 cases of intrathoracic bronchopulmonary sequestration, 22 of congenital pulmonary airway malformations, and 13 of congenital diaphragmatic hernia). Fetal upper airway parameters (tracheal width, the narrowest lumen width, and width of the subglottic cavity and laryngeal vestibule) were measured using ultrasound equipment. The correlations between fetal upper airway parameters and gestational age, and the differences in fetal upper airway parameters between cases and controls, were analyzed. The standardized airway paraments were acquired, and their potential diagnostic value for congenital intrathoracic lesions were analyzed.ResultsThe fetal upper airway parameters of both groups were positively correlated with the gestational age: The control group, tracheal width (R2 = 0.569,p < 0.001), narrowest lumen width (R2 = 0.429,p < 0.001), subglottic cavity width (R2 = 0.551,p < 0.001), laryngeal vestibule width (R2 = 0.349,p < 0.001). The case group (tracheal widthR2 = 0.474,p < 0.001) narrowest lumen width (R2 = 0.425,p < 0.001), subglottic cavity width (R2 = 0.623,p < 0.001), laryngeal vestibule width (R2 = 0.347,p < 0.001). Fetal upper airway parameters of the cases group were smaller than those of the controls group. The tracheal width in fetuses with congenital diaphragmatic hernia was the smallest among the other case groups studied. The standardized tracheal width has the best diagnostic value for congenital intrathoracic lesions in the standardized airway paraments (the area under the ROC curve was 0.894), and has a high diagnostic value for congenital pulmonary airway malformations and congenital diaphragmatic hernia (the area under the ROC curve was 0.911 and 0.992, respectively).ConclusionFetal upper airway parameters differ between normal fetuses and fetuses with intrathoracic lesions, and might offer potential diagnostic clues for congenital intrathoracic lesions.
Repetitive and restricted behaviors and interests in autism spectrum disorder: relation to individual characteristics and mental health problems
Authors: Jasim Sara , Perry Adrienne 
Published: May 2023

Abstract
Background
Although repetitive and restricted behaviors and interests (RRBIs) may interfere with well-being and functioning in autistic individuals, research on their relation to sex, age, cognitive level, and mental health problems remains unclear. Much of the research to date has used broad categorizations rather than specific categorizations of RRBIs to examine the difference in RRBIs between individuals. The purpose of this study was to explore, in different groups of individuals, the presence of specific RRBI subtypes, and to examine the association of specific RRBI subtypes with symptoms of internalizing and externalizing behaviors.

Methods
Secondary data analyses were conducted using the Simons Simplex Collection dataset, which included 2,758 participants (aged 4 to 18). Families of autistic children completed the Repetitive Behavior Scale–Revised (RBS-R) and the Child Behavior Checklist.

Results
Across all RBS-R subtypes, results revealed no sex differences. Older children showed higher rates of Ritualistic/Sameness behaviors than younger children and adolescents, whereas younger and older children showed more Stereotypy than adolescents. Additionally, lower cognitive level groups showed higher rates of RBS-R subtypes except for Ritualistic/Sameness. After controlling for age and cognitive level, RBS-R subtypes accounted for a substantial amount of variance in internalizing and externalizing behaviors (23% and 25%, respectively). Specifically, Ritualistic/Sameness and Self-Injurious Behavior both predicted internalizing and externalizing behaviors, whereas Stereotypy only predicted internalizing behavior.

Conclusions
These findings have key clinical implications that emphasize not only the consideration of sex, age, and cognitive level, but also specific RRBIs and co-occurring mental health problems, when assessing for ASD and designing individualized interventions.
Unintended consequences of communicating rapid COVID-19 vaccine policy changes– a qualitative study of health policy communication in Ontario, Canada
Authors: Vernon-Wilson Elizabeth , Tetui Moses , Nanyonjo Agnes , Adil Maisha , Bala Arthi , Nelson David , Sayers Emma , Waite Nancy , Grindrod Kelly 
Published: May 2023

Abstract
Background
The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature.

Methods
Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes.

Results
Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities.

Conclusions
Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities’ access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.