bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rethinking marine plastics pollution: Science diplomacy and multi-level governance
Authors: Beltran Macarena , Tjahjono Benny , Suoneto Thomas Noto , Tanjung Rakyan , Julião Jorge 
Published: July 2023

Although science diplomacy has been gaining relevance in foreign policy to solve environmental challenges, critical questions concerning what different instruments mean under the term ‘science diplomacy’ and whether science diplomacy does contribute to the progress in solving environmental issues remain unanswered. We explore those questions by linking science diplomacy salient features through documentary analysis of international instruments addressing the plastics pollution in the ocean. We find that from a science diplomacy and multi-level governance perspective, the responsibilities and capabilities of emergent actors of cross-level governance are also important, leading to more attention being paid to changes in the role of national authorities, away from passive leadership to cross-cutting coalitions supported by the salient features of science diplomacy, and redefining dominant discursive approaches that have framed plastics waste. Points for practitioners As a result of the cost and limitations of the current international mechanisms, there is currently no incentive for individual countries to take action against marine plastic pollution. Science diplomacy and multi-level governance can contribute to international cooperation, foreign policy and national strategies. Leading efforts to engage countries with fewer scientific and technological capabilities could benefit countries’ foreign policy.
MRI characteristics predict BRAF V600E status in gangliogliomas and pleomorphic xanthoastrocytomas and provide survival prognostication
Authors: Jiang Bingqing , Zheng Yingyan , She Dejun , Xing Zhen , Cao Dairong 
Published: July 2023

Background BRAF V600E mutation is a common genomic alteration in gangliogliomas (GGs) and pleomorphic xanthoastrocytomas (PXAs) with prognostic and therapeutic implications. Purpose To investigate the ability of magnetic resonance imaging (MRI) features to predict BRAF V600E status in GGs and PXAs and their prognostic values. Material and Methods A cohort of 44 patients with histologically confirmed GGs and PXAs was reviewed retrospectively. BRAF V600E status was determined by immunohistochemistry (IHC) staining and fluorescence quantitative polymerase chain reaction (PCR). Demographics and MRI characteristics of the two groups were evaluated and compared. Univariate and multivariate Cox regression analyses were performed to identify MRI features that were prognostic for progression-free survival (PFS). Results T1/FLAIR ratio, enhancing margin, and mean relative apparent diffusion coefficient (rADCmea) value showed significant differences between the BRAF V600E-mutant and BRAF V600E-wild groups (all P < 0.05). Binary logistic regression analysis revealed only rADCmea value was the independent predictive factor for BRAF V600E status ( P  = 0.027). Univariate Cox regression analysis showed age at diagnosis ( P = 0.032), WHO grade ( P = 0.020), enhancing margin ( P = 0.029), and rADCmea value ( P = 0.005) were significant prognostic factors for PFS. In multivariate Cox regression analysis, increasing age ( P = 0.040, hazard ratio [HR] = 1.04, 95% confidence interval [CI] = 1.002–1.079) and lower rADCmea values ( P = 0.021, HR = 0.036, 95% CI = 0.002–0.602) were associated with poor PFS in GGs and PXAs. Conclusion Imaging features are potentially predictive of BRAF V600E status in GGs and PXAs. Furthermore, rADCmea value is a valuable prognostic factor for patients with GGs or PXAs.
Exploring the Association of State Policies and the Trajectories of Buprenorphine Prescriber Patient Caseloads
Authors: Griffin Beth Ann , Cabreros Irineo , Saloner Brendan , Gordon Adam J. , Kerber Rose , Stein Bradley D. 
Published: July 2023

Background: Increasing buprenorphine access is critical to facilitating effective opioid use disorder treatment. Buprenorphine prescriber numbers have increased substantially, but most clinicians who start prescribing buprenorphine stop within a year, and most active prescribers treat very few individuals. Little research has examined state policies’ association with the evolution of buprenorphine prescribing clinicians’ patient caseloads. Methods: Our retrospective cohort study design derived from 2006 to 2018 national pharmacy claims identifying buprenorphine prescribers and the number of patients treated monthly. We defined persistent prescribers based on results from a k-clustering approach and were characterized by clinicians who did not quickly stop prescribing and had average monthly caseloads greater than 5 patients for much of the first 6 years after their first dispensed prescription. We examined the association between persistent prescribers (dependent variable) and Medicaid coverage of buprenorphine, prior authorization requirements, and mandated counseling policies (key predictors) that were active within the first 2 years after a prescriber’s first observed dispensed buprenorphine prescription. We used multivariable logistic regression analyses and entropy balancing weights to ensure better comparability of prescribers in states that did and did not implement policies. Results: Medicaid coverage of buprenorphine was associated with a smaller percentage of new prescribers becoming persistent prescribers (OR = 0.72; 95% CI = 0.53, 0.97). There was no evidence that either mandatory counseling or prior authorization was associated with the odds of a clinician being a persistent prescriber with estimated ORs equal to 0.85 (95% CI = 0.63, 1.16) and 1.13 (95% CI = 0.83, 1.55), respectively. Conclusions: Compared to states without coverage, states with Medicaid coverage for buprenorphine had a smaller percentage of new prescribers become persistent prescribers; there was no evidence that the other state policies were associated with changes in the rate of clinicians becoming persistent prescribers. Because buprenorphine treatment is highly concentrated among a small group of clinicians, it is imperative to increase the pool of clinicians providing care to larger numbers of patients for longer periods. Greater efforts are needed to identify and support factors associated with successful persistent prescribing.
Erectile dysfunction prevalence and associated factors in men living with HIV from Western Turkey: A cross-sectional study
Authors: Atalay Sabri , Ucak Hazal Albayrak , Caglayan Derya , Arkali Eren , Abakay Hilal , Koc Gokhan 
Published: July 2023

Background The majority of people living with HIV in our country are younger men. However, limited data exist for the sexual health of these patients. Knowledge of the epidemiology in this population may improve health outcomes across the continuum of HIV care. The aim of this study was to determine the prevalence of erectile dysfunction (ED) and its association with some clinical and laboratory factors. Methods A cross-sectional study was conducted using random sampling in men living with HIV (MLWH) at a tertiary hospital in Turkey. Patients were asked to fill out the five-item International Index of Erectile Function (IIEF-5), and blood was collected for HIV viral load, CD4+ T lymphocyte count, lipids and hormone levels to assess biological aspects at the same clinical visit. Results A total of 107 MLWH were recruited. Mean age was 40.4 ± 12.4 years. ED was found in 73.8% ( n = 79) of the participants. Severe ED was found in 6.3%, moderate in 5.1%, mild-moderate 35.4%, mild 53.2% of the participants, respectively. The mean age of men with erectile dysfunction was 42.5 ± 12.5 years, while those without erectile dysfunction were 34.5 ± 10 years (p:0.00). ED was detected more frequently in cases with high Low Density Lipoprotein (LDL) levels (p:0.003). There was no statistically significant difference between ED presence and having hormone abnormality. There was a moderate, negative correlation between age and ED score (r: −0.440, p < 0.001). A negative and low correlation was found between triglyceride level and ED score (r: −0.233, p:0.02). The only predictive variable was age in the multivariate analysis [B: −0.155 (95% CI -0.232 to −0.078), p: <0.001]. Conclusions Our study revealed a high prevalence of ED in the MLWH cohort. Age was found to be the only factor associated with ED. HIV clinicians should consider routine ED screening with validated measures as a part of the follow-up scheme to improve integrated wellbeing in MLWH.
“On Suggestion” by John Bostock, 1923: A comparison with twenty-first century understandings of the placebo effect
Authors: Clayton Alison 
Published: July 2023

Objectives This paper describes Australian psychiatrist John Bostock’s 1923 concept of suggestion and compares it to our understandings, in 2023, of the placebo effect. Conclusions Bostock’s 1923 article on “suggestion” gives us a glimpse of the history of Australian psychiatry. It also stimulates thought about the current understandings of the placebo effect. Now, as then, placebo effects can play a critical role in patient outcomes. However, careful consideration is required to ensure contemporary ethical standards are met and harm is not done.
Nivolumab-induced immune-related neutropenia in a renal cell carcinoma patient
Authors: Kalaci Ender , Ürün Yüksel 
Published: July 2023

Introduction Immune checkpoint inhibitors (ICIs) have considerably improved the prognosis of solid tumors. However, this class of medications can cause immune-related adverse events, which represent a distinct spectrum of adverse events in cancer treatment. Case Report Here we present a case of immune-related neutropenia (irN) that occurred in a 47-year-old man with metastatic clear cell renal cell carcinoma (ccRCC). During the 18 months of nivolumab monotherapy, severe neutropenia occurred. Buccal mucosal aphthous ulcers and antineutrophil cytoplasmic antibody positivity concurrently emerged with neutropenia. The patient was diagnosed with irN after a comprehensive evaluation ruled out all other likely causes. Management and outcome Neutropenia improved with corticosteroids, but reoccurred with the introduction of nivolumab. During the approximately nine-month follow-up period after nivolumab treatment was permanently discontinued due to neutropenia, there was no disease progression. Discussion IrN associated with nivolumab treatment for metastatic ccRCC is uncommon. The pathophysiology of irN is not entirely understood. Corticosteroids are one of the most commonly used drugs for the treatment of irN. As ICIs become more widely used, medical oncologists will encounter this side effect more frequently.
Supporting tamariki takiwātanga Māori (autistic Māori children): Exploring the experience of early childhood educators
Authors: Tupou Jessica , Ataera Chevelle , Wallace-Watkin Carla , Waddington Hannah 
Published: July 2023

The experience of the many autistic children who attend inclusive early childhood education settings is largely shaped by the knowledge and attitudes of the educators who support them. Autistic children from under-represented ethnic groups, such as autistic Māori, are likely to face additional challenges and educators need to consider strategies to support their cultural development. We conducted in-depth, semi-structured interviews with 12 educators with recent experience supporting tamariki takiwātanga Māori (autistic Māori children) in inclusive early childhood settings. Data were analysed using reflexive thematic analysis resulting in three themes and seven subthemes. Overall, participants’ understandings of autism aligned with the neurodiversity perspective, and there were similarities between neurodiversity and Māori perspectives. Participants wanted more training and resources drawn from a Māori worldview and available in te reo Māori (the Māori language). These findings have important implications for practice and future research. Lay Abstract The knowledge and attitudes of educators can have a strong influence on the experiences of autistic children who attend inclusive early childhood settings. Autistic children from under-represented ethnic groups, for example, tamariki takiwātanga Māori (autistic Māori children), are likely to face extra challenges and educators need to consider ways to support their cultural development. For this study, we interviewed 12 educators with recent experience supporting tamariki takiwātanga Māori in inclusive early childhood settings. We constructed three themes and seven subthemes from the interview data. We found that educators’ understandings of autism were mostly in line with the neurodiversity perspective, which views autism as a difference, not a disorder. We also found similarities between the neurodiversity perspective and Māori perspectives of autism and a need for more training and resources based upon a Māori world view and available in te reo Māori (the Māori language).
Weekly pattern of alcohol-attributable male mortality before and after imposing limits on hours of alcohol sale in Lithuania in 2018
Authors: Stumbrys Daumantas , Štelemėkas Mindaugas , Jasilionis Domantas , Rehm Jürgen 
Published: July 2023

Aims: From 1 January 2018, the number of retail hours for the sale of alcohol was reduced from 14 to 5 hours on Sundays and from 14 to 10 hours on the other days of the week in Lithuania. The significant reduction of hours for the sale of alcohol on Sundays may have affected the distribution of alcohol-attributable deaths during the week. This study aimed to examine the change in the weekly pattern of alcohol-attributable male mortality before and after imposing limits on the hours when alcohol can be sold. Methods: Age-standardised male death rates by days of the week were calculated for four groups according to cause of death: alcohol poisoning (X45), all external causes of death (V01–Y98), diseases of the circulatory system (I00–I99) and all other causes of death. We compared age-standardised death rates for two periods: before (2015–2017) and after (2018–2019) the intervention. Mortality and population data were obtained from the Lithuanian Institute of Hygiene and Human Mortality Database. Results: We found that during 2018–2019, earlier observed peak in age-standardised death rates for external causes of death on Sunday diminished, and this day no longer differed from the weekly average. The same tendency was also observed for the Monday excess mortality due to circulatory diseases. Conclusions: The reduction of the hours when alcohol can be sold from the beginning of 2018 was associated with a change in a weekly pattern of alcohol-attributable male mortality. However, more studies are needed to examine the causes of the change in mortality pattern.
High-resolution computed tomography angiography of the orbit using a photon-counting computed tomography scanner
Authors: Farnsworth Paul J , Campeau Norbert G , Diehn Felix E , Yu Lifeng , Leng Shuai , Zhou Zhongxing , Fletcher Joel G , McCollough Cynthia H 
Published: July 2023

Background and Purpose Recent introduction of photon counting detector (PCD) computed tomography (CT) scanners into clinical practice further improve CT angiography (CTA) depiction of orbital arterial vasculature compared to conventional energy integrating detector (EID) CT scanners. PCD-CTA of the orbit can provide a detailed arterial roadmap of the orbit which can de diagnostic on its own or serve as a helpful planning adjunct for both diagnostic and therapeutic catheter-based angiography of the orbit. Methods For this review, EID and PCD-CT imaging was obtained in 28 volunteers. The volume CT dose index was closely matched. A dual-energy scanning protocol was used on EID-CT. An ultra-high-resolution (UHR) scan mode was used on PCD-CT. Images were reconstructed at 0.6 mm slice thickness using a closely matched medium-sharp standard resolution (SR) kernel. High-resolution (HR) images with the sharpest quantitative kernel were also reconstructed on PCD-CT at the thinnest slice thickness of 0.2 mm. A denoising algorithm was applied to the HR image series. Results The imaging description of the orbital vascular anatomy presented in this work was derived from these patients’ PCD-CTA images in combination with review of the literature. We found that orbital arterial anatomy is much better depicted with PCD-CTA, and this work can serve primarily as an imaging atlas of the normal orbital vascular anatomy. Conclusion With recent advances in technology, arterial anatomy of the orbit is much better depicted with PCD-CTA as opposed to EID-CTA. Current orbital PCD-CTA technology approaches the necessary resolution threshold for reliable evaluation of central retinal artery occlusion.
Multicenter comparison of antiplatelet treatment strategies for urgent/emergent neuroendovascular stenting
Authors: Holden Devin , May Casey C. , Robbins Blake T. , Cook Aaron M. ,   the Neurocritical Care Pharmacy Section Research Group:, Jung Sara , Smetana Keaton S. , Roels Christina , Harlan Sara Schuman , Keegan Shaun , Brophy Gretchen , Al Mohaish Sulaiman , Sandler Melissa , Spetz Samantha , Wohlfarth Kevin , Owusu-Guha Jocelyn , Buschur Pamela , Hetrick Elizabeth , Dombrowski Keith , Glover Jennifer , Levesque Melissa , Dingman Spencer , Hussain Mohammed 
Published: July 2023

Background Emergent neuroendovascular stenting presents challenges for the utilization of antiplatelet agents. Methods This was a multicenter, retrospective cohort of patients who underwent emergent neuroendovascular stenting. The primary endpoints were thrombotic and bleeding events in relation to the timing of antiplatelet administration, route of administration, and choice of intravenous (IV) agent and the study investigated practice variability in antiplatelet utilization. Results Five-hundred and seventy patients were screened across 12 sites. Of those, 167 were included for data analysis. For patients who presented with ischemic stroke, artery dissection and emergent internal carotid artery (ICA) stenting who received an antiplatelet agent prior to or during the procedure, 57% were given an IV antiplatelet agent; for patients who were given an antiplatelet agent after the procedure, 96% were given an oral agent. For patients who presented for aneurysm repair and received an antiplatelet agent prior to or during the procedure, 74% were given an IV agent; patients who were given an antiplatelet agent after the completion of the procedure were given an oral antiplatelet agent 90% of the time. In patients who presented with ischemic stroke, artery dissection and emergent ICA stenting who received oral antiplatelet agents post-procedure were more likely to have thrombotic events compared to those who received oral antiplatelet agents prior to or during the procedure (29% vs 9%; p  =  0.04). There were no differences in the primary outcomes observed when comparing other antiplatelet treatment strategies. Conclusion The optimal timing of antiplatelet administration in relation to stent placement and route of administration of antiplatelet agents is unclear. Timing and route of administration of antiplatelet agents may have an effect on thrombosis in emergent neuroendovascular stenting. Significant practice variation exists in antiplatelet agent utilization in emergent neuroendovascular stenting.
Comaneci stent-angioplasty for the optimization of inadequately deployed flow diverter stents
Authors: Sirakova Kristina , Sirakov Alexander , Ninov Kristian , Minkin Krasimir , Sirakov Stanimir 
Published: July 2023

Background and Purpose In endovascular procedures, inadequate deployment of a flow diverter stent is a highly concerning technical complication that can lead to acute parent vessel occlusion and ischaemic events. This study aimed to assess the off-label use of the Comaneci device in managing technical difficulties associated with flow diversion. Materials and Methods We conducted an analysis of all flow diverter procedures documented in our prospectively collected database. Our objective was to identify patients with inadequately deployed implants who underwent Comaneci stent-angioplasty. Both Comaneci 17 and Comaneci 21 devices were utilized to address and remediate technical complications related to stent deployment. We reviewed anatomical features, technical details, intraprocedural complications, as well as clinical and angiographic outcomes. Results Thirty-one Comaneci devices were employed to remediate 31 inadequately deployed flow diverter stents. Successful resolution of technical complications associated with flow diverter placement was achieved in all attempted cases. No clinically significant complications were attributed to the technique, and no mortality was observed during the study. Conclusion Technical issues arising from flow diverter stent deployment are formidable complications. Familiarity with appropriate corrective manoeuvres is essential to achieve successful outcomes. The Comaneci device can be safely and effectively incorporated into the range of techniques used to rectify inadequately deployed stents.
Outcomes of radialization with ulnar cuff osteotomy for radial longitudinal deficiency: a medium-term follow-up study
Authors: Bhat Anil K. , G. Mithun Pai , Acharya Ashwath M. 
Published: July 2023

Addressing the deforming stresses arising from soft tissue and continued skeletal development is crucial to obtain long-term correction of forearm carpal alignment in Radial longitudinal deficiency. The aim of the present study was to report the medium-term follow-up results of radialization with ulnar cuff osteotomy in children. A total of 17 patients (21 involved limbs) with a mean follow-up of 66 months (range 50 to 96) were reviewed. Mean correction of the hand forearm angle at the final follow-up was 51°. Mean hand forearm position preoperatively and at the final follow-up were −1.1 cm (SD 0.9) and +1.3 cm (SD 0.8), respectively. This metaphyseal osteotomy relaxed the radial structures throughout the original phase of deformity correction. The mean ulnar growth was 62% of the contralateral side at the final follow-up. Our technique may provide a feasible solution to the correction and prevent recurrence of deformity while maintaining ulnar growth in the medium to longer term. Level of evidence: III