bluuebunny/crossref_metadata_2025_split huggingface dataset:
Player Experience and Enjoyment: A Preliminary Examination of Differences in Video Game Genre
Authors: Eshuis Sean , Pozzebon Kay , Allen Andrew , Kannis-Dymand Lee 
Published: February 2023

Introduction Player experience is the interaction between individual qualities and game attributes. It is becoming a popular topic to understand why individuals are interested in different video games. The current literature offers a range of different scales that measure similar player experience factors but often lack published validity analysis. The Player Experience Index is an empirically validated measure based on the means-end theory. The current study used this measure to analyse player experience factors and enjoyment among single-player shooter, single-player role-playing, massively multiplayer online shooter, and massively multiplayer online role-playing video games. Methods Analyses were based on a sample of 145 participants who completed an online survey. Results Results indicated that player experience factors were related to enjoyment, with differing results based on video game genre. It was also found that greater levels of enjoyment were reported by participants who preferred single-player mode of play compared to massively multiplayer online play mode, and participants who preferred single-player role-playing games indicated greater levels of enjoyment than the other three groups. Discussion While there was an uneven and small sample size for each video game category, the findings of this exploratory study highlight that further research is warranted. Future research should consider analysing the player experience for currently available and marketed video games to better understand how player experience influences enjoyment in the rapidly evolving gaming industry and its role in gaming design.
Contemplating the Impacts of Canadian Healthcare Institutions That Refuse to Provide Medical Assistance in Dying: A Framework-Based Discussion of Potential Health Access Implications
Authors: Knox Michelle , Wagg Adrian 
Published: February 2023

Introduction Following the historic Canadian legislation on medical assistance in dying (MAiD) in 2016, many implementation challenges and ethical quandaries have formed the focus of further scholarly investigation and policy revisions. Of these, conscientious objections held by some healthcare institutions have involved relatively less scrutiny, despite indicating possible hurdles to the universal availability of MAiD services in Canada. Methods In this paper, we contemplate potential accessibility concerns that pertain specifically to service access, with the hope to trigger further systematic research and policy analysis on this frequently overlooked aspect of MAiD implementation. We organize our discussion using two important health access frameworks: Levesque and colleagues’ Conceptual Framework for Access to Health and the Provisional Framework for MAiD System Information Needs (Canadian Institute for Health Information). Results Our discussion is organized along five framework dimensions through which institutional non-participation may generate or exacerbate inequities in MAiD utilization. Considerable overlaps are revealed across framework domains, indicating the complexity of the problem and the need for further investigation. Conclusion Conscientious dissensions on the part of healthcare institutions form a likely barrier to ethical, equitable, and patient-oriented MAiD service provision. Comprehensive, systematic evidence is urgently needed to understand the nature and scope of resulting impacts. We urge Canadian healthcare professionals, policymakers, ethicists, and legislators to attend to this crucial issue in future research and in policy discussions.
Quetiapine for the Treatment of Pediatric Delirium
Authors: Caballero Alexandra , Bashqoy Ferras , Santos Laura , Herbsman Jodi , Papadopoulos John , Saad Anasemon 
Published: February 2023

Background: Delirium is a common complication of critical illness, with a prevalence of 25% among pediatric intensive care unit (ICU) patients. Pharmacological treatment options for ICU delirium are limited to off-label use of antipsychotics, but their benefit remains uncertain. Objective: The purpose of this study was to evaluate quetiapine effectiveness for the treatment of delirium in critically ill pediatric patients and to describe the safety profile of quetiapine. Methods: A single-center, retrospective review of patients aged ≤ 18 years who screened positive for delirium via the Cornell Assessment of Pediatric Delirium (CAPD ≥ 9) and received ≥ 48 hours of quetiapine therapy was conducted. The relationship between quetiapine and deliriogenic medication doses was evaluated. Results: This study included 37 patients who received quetiapine for the treatment of delirium. The change in sedation requirements before quetiapine initiation to 48 hours after the highest quetiapine dose demonstrated a downward trend; 68% of patients had a decrease in opioid requirements and 43% of patients had a decrease in benzodiazepine requirements. The median CAPD score at baseline was 17 and the median CAPD score at 48 hours after the highest dose was 16. Three patients experienced QTc prolongation (defined as a QTc ≥ 500), although none developed dysrhythmias. Conclusion and relevance: Quetiapine did not have a statistically significant impact on deliriogenic medication doses. There were minimal changes in QTc and dysrhythmias were not identified. Therefore, quetiapine can be safe to use in our pediatric patients but further studies are needed to find an effective dose.
Effect of Anticoagulant Versus Non-Anticoagulant Therapy on Mortality of Sepsis-Induced Disseminated Intravascular Coagulation: A Systematic Review and Meta-Analysis
Authors: Qi Wenqian , Liu Jingyuan , Li Ang 
Published: February 2023

Background Sepsis is a syndrome of severe systemic inflammatory response. When combined with disseminated intravascular coagulation, mortality is increased. The need for anticoagulant therapy is still the focus of debate. Methods PubMed, Embase, Cochrane Library, and Web of Science were searched. Adult patients with sepsis-induced disseminated intravascular coagulation were included in this study. All-cause mortality as efficacy and serious bleeding complications as adverse effect were measured as primary outcomes. Methodological quality of included studies were assessed using the Methodological Index for Non-randomized Studies (MINORS). Meta-analysis was performed using R software (version 3.5.1) and Review Manager (version 5.3.5). Results There were nine eligible studies with 17,968 patients included. There were no significant reductions in mortality between the anticoagulant group and the non-anticoagulant group (RR, 0.89; 95% CI, 0.72–1.10; P = 0.27). The DIC resolution rate in the anticoagulation group has a statistically significant increase compared with the control group [OR: 2.62, 95% CI (1.54–4.45), P < 0.05]. And there was no significant difference in bleeding complications between the two groups (RR, 1.27; 95% CI, 0.77–2.09; P = 0.69). SOFA score reduction did not change significantly between the two groups ( P = 0.13). Conclusions Our study observed no significant benefit of anticoagulant therapy on mortality of sepsis-induced DIC. Anticoagulation therapy can promote DIC resolution in sepsis-induced DIC. In addition, anticoagulant therapy does not increase the risk of bleeding in these patients.
Neuropsychological and Symptom Predictors of Diagnostic Persistence in ADHD: A 25-Year Follow-up Study
Authors: Øie Merete Glenne , Storaas Tor Amund Voll , Egeland Jens 
Published: February 2023

Background: This study extends long-term predictive research on ADHD by including both neuropsychological and symptom measures at baseline in adolescence as predictors of diagnostic persistence 25 years later. Methods: Nineteen males with ADHD and 26 healthy controls (HC; M/F = 13/13), were assessed in adolescence and 25 years later. Measurements at baseline included a comprehensive test battery measuring eight neuropsychological domains, an IQ estimate, the Child Behavior Checklist (CBCL), and the Global Assessment Scale of Symptoms. Differences between ADHD Retainers, Remitters, and HC were calculated with ANOVAs, and potential predictions of differences in the ADHD group by linear regression analyses. Results: Eleven (58%) participants retained their ADHD diagnoses at follow-up. Motor Coordination and Visual perception at baseline predicted diagnosis at follow-up. CBCL Attention problems at baseline in the ADHD group predicted variance in diagnostic status. Conclusion: Lower-order neuropsychological functions related to motor function and perception are important long-time predictors of persistence of ADHD.
Partial retention of the acetabular cement mantle in aseptic revision hip arthroplasty: is it a viable option?
Authors: Swanton Eric , Whitehouse Sarah L , Hubble Matthew JW 
Published: February 2023

Introduction: Choosing the most appropriate reconstruction method when addressing a cemented cup at hip revision surgery can be a difficult decision. The aim of this study is to look into the practice and results of retaining a well-fixed medial acetabular cement mantle while removing loose superolateral cement. This practice goes against a preconceived principle that if some of the cement is loose it must all be removed. So far, no significant series looking at this is available in the literature. Methods: We assessed a cohort of 27 patients in our institution where this practice was carried out and assessed their outcomes clinically and radiographically. Results: Of the 27 patients, 24 had follow-up ⩾2 years (2.9–17.8, mean 9.3 years). There was 1 subsequent revision for aseptic loosening at 11.9 years, 1 first-stage revision of both stem and cup for infection at 1 month, and 2 patients died without a 2-year review. 2 patients did not have radiographs available for review. 2 of the 22 patients with radiographs available had changes in lucent lines, which were not clinically significant. Conclusion: Based on these results we conclude that retaining well-fixed medial cement during socket revision is a viable reconstruction option in carefully selected cases.
Pharmacological Interventions for Primary Psychodermatologic Disorders: An Evidence Mapping and Appraisal of Randomized Controlled Trials
Authors: Turk Tarek , Liu Chaocheng , Fujiwara Esther , Straube Sebastian , Hagtvedt Reidar , Dennett Liz , Abba-Aji Adam , Dytoc Marlene 
Published: February 2023

BackgroundThe lack of clinical guidelines for the treatment of primary psychodermatologic disorders (PPDs) hinders the delivery of optimal care to patients. The review aimed to identify, appraise, and summarize the currently available evidence about the safety and effectiveness of pharmacological management of PPDs through randomized controlled trials (RCTs).MethodsThe Preferred Reporting Items for Systematic Review and Meta-Analyses (PRIMSA) statement and the Global Evidence Mapping Initiative guidance were followed. Medline, Embase, PsycInfo, Cochrane and Scopus were searched, and two reviewers independently completed article review, data extraction, and quality assessment.ResultsAmong 2618 unique studies, full texts of 83 were reviewed and 21 RCTs were included. Five PDDs were identified: trichotillomania ( n = 12), pathologic skin picking ( n = 5), nail biting ( n = 2), delusional parasitosis ( n = 1), and dermatitis from compulsive hand washing ( n = 1). Seven different classes of medications were investigated: SSRIs (i.e., fluoxetine, sertraline, and citalopram), tricyclic antidepressants (i.e., clomipramine and desipramine), antipsychotics (i.e., olanzapine and pimozide), anticonvulsant (i.e., lamotrigine), N-acetylcysteine, inositol, and milk thistle. RCT-derived evidence supports the use of antidepressants in trichotillomania (sertraline and clomipramine), pathologic skin picking (fluoxetine), pathologic nail biting and dermatitis from compulsive hand washing (clomipramine or desipramine); antipsychotics in trichotillomania (olanzapine) and delusional parasitosis (pimozide); N-acetyl cysteine in trichotillomania and skin picking.ConclusionFew pharmacotherapies for primary psychodermatologic disorders are assessed through controlled trials in the literature. This review serves as a roadmap for researchers and clinicians to reach informed decisions with current evidence, and to build on it to establish guidelines in the future.
Genetic regulation of IL-8 influences disease presentation of multiple sclerosis
Authors: Dolcetti Ettore , Bruno Antonio , Azzolini Federica , Gilio Luana , Pavone Luigi , Iezzi Ennio , Galifi Giovanni , Gambardella Stefano , Ferese Rosangela , Buttari Fabio , De Vito Francesca , Colantuono Paola , Furlan Roberto , Finardi Annamaria , Musella Alessandra , Mandolesi Georgia , Centonze Diego , Stampanoni Bassi Mario 
Published: February 2023

Background: Individual genetic variability may influence the course of multiple sclerosis (MS). The interleukin (IL)-8C>T rs2227306 single nucleotide polymorphism (SNP) regulates IL-8 activity in other clinical conditions; however, its role in MS has never been investigated. Objectives: To explore the association between IL-8 SNP rs2227306, cerebrospinal fluid (CSF) IL-8 concentrations, clinical, and radiological characteristics in a group of newly diagnosed MS patients. Methods: In 141 relapsing-remitting (RR)-MS patients, rs2227306 polymorphism, CSF levels of IL-8, clinical, and demographical characteristics were determined. In 50 patients, structural magnetic resonance imaging (MRI) measures were also assessed. Results: An association between CSF IL-8 and Expanded Disability Status Scale (EDSS) at diagnosis was found in our set of patients ( r = 0.207, p = 0.014). CSF IL-8 concentrations were significantly higher in patients carrying the T variant of rs2227306 ( p = 0.004). In the same group, a positive correlation emerged between IL-8 and EDSS ( r = 0.273, p = 0.019). Finally, a negative correlation between CSF levels of IL-8 and cortical thickness emerged in rs2227306T carriers ( r = −0.498, p = 0.005). Conclusion: We describe for the first time a role of SNP rs2227306 of IL-8 gene in regulating the expression and the activity of this inflammatory cytokine in MS.
Associations between executive function and attention abilities and language and social communication skills in young autistic children
Authors: Howard Jill , Herold Brianna , Major Samantha , Leahy Caroline , Ramseur Kevin , Franz Lauren , Deaver Megan , Vermeer Saritha , Carpenter Kimberly LH , Murias Michael , Huang Wei Angel , Dawson Geraldine 
Published: February 2023

Although it has been found that autistic children exhibit delays in executive function abilities and atypical patterns of attention, less is known about the relationship between executive function and attention abilities and social and language skills in early childhood. In this study, 180 autistic children, age 2–8 years, participated in a study examining the relationship between executive function abilities, measured by the Behavior Rating Inventory of Executive Function, and assessments of sustained attention measured via eye-tracking and several language and social communication measures. Results revealed that children with higher caregiver-reported executive function skills, specifically, working memory and planning/organization abilities, demonstrated higher levels of caregiver-reported receptive-expressive social communication abilities measured via the Pervasive Developmental Disorder Behavior Inventory. Higher executive function abilities across all domains were associated with lower levels of social pragmatic problems. Children who were able to sustain their attention for a longer duration demonstrated higher expressive language abilities. These results suggest that executive function and attention skills may play an important role in multiple domains of functioning in autistic children. It will be useful to determine whether therapies that seek to improve executive function skills in autistic individuals also positively influence their social/communication and language abilities. Lay Abstract Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in executive function and attention abilities relate to social abilities and communication/language in 180 young autistic children. Data were gathered via caregiver report (questionnaires/interviews) and an assessment of vocabulary skills. The ability to sustain attention to a dynamic video was measured via eye tracking. We found that children with higher levels of executive function skills demonstrated lower levels of social pragmatic problems, a measure of having difficulties in social contexts. Furthermore, children who were able to sustain their attention longer to the video displayed higher levels of expressive language. Our results emphasize the importance of executive function and attention skills across multiple areas of functioning in autistic children, in particular those that involve language and social communication.
Sound transmission loss of absorber-barrier-absorber structures with kapok fibers as absorption layers
Authors: Xie Xin-Xing , Yang Jin-Bao , Kang Ying-Zi , Shangguan Wen-Bin , Zhang Qu 
Published: February 2023

The sound insulation of the front wall of a car is mainly used to isolate the noise of the engine from being transmitted to the passenger cabin. A front wall is generally a kind of structure of Absorber-Barrier-Absorber (ABA), where A is sound absorption layer and B is sound insulation layer. The sound absorption layer (A) usually consists of porous cotton of superfine fiber or microfiber. In this paper, kapok fiber is used to make the sound-absorbing layer A, and its sound absorption is compared with that of superfine fiber. Microstructure of the two fibers is compared, and it is found that kapok fiber has a large hollow structure. The sound absorbing coefficients of the layer A made with the two fibers are measured and it is concluded that the layer A made of kapok fibers can absorber noise greatly and thus has high sound absorption coefficient. The prototypes of ABA structural are made using two kinds of fibers as layer A, and the sound transmission loss (STL) was measured using reverberation room and anechoic room. The measurement shows that the ABA using kapok fiber as sound absorption layer has better sound insulations, and the STL of ABA using kapok fiber as sound absorption layer is increased by about 3 dB. A model for estimating STL of ABA structure is established and the calculated STL is validated. Using the developed model, the STL of ABA structures with different structural characteristics of Layers A or B is calculated and analyzed.
3D Printing Technology for Chest Wall Reconstruction With a Sternum-Ribs-Cartilage Titanium Implant: From Ideation to Creation
Authors: Goldsmith Ira , Dovgalski Lawrence , Evans Peter Llewelyn 
Published: February 2023

Objective: We describe the use of 3-dimensional (3D) printing technology to plan and reconstruct the sternum, adjoining cartilages, and ribs with a custom-made, anatomically designed, 3D-printed titanium implant for an isolated sternal metastasis complicated with a pathological fracture. Methods: We imported submillimeter slice computed tomography scan data into Mimics Medical 20.0 software and by manual bone threshold segmentation created a 3D virtual model of the patient’s chest wall and tumor. For all-around tumor-free margins, we grew the tumor by 2 cm. The replacement implant was designed in 3D using the anatomical features of the sternum, cartilages, and ribs and manufactured using TiMG 1 powder fusion technology. Physiotherapy was provided prior to and following surgery, and the impact of reconstruction on pulmonary functions was assessed. Results: At surgery, the precise resection, clear margins, and a secure fit were achieved. At follow-up, there was no dislocation, paradoxical movement, change in performance status, or dyspnea. There was a decrease in forced expiratory volume in 1 s (FEV1) from 105% prior to surgery to 82% following surgery and in forced vital capacity (FVC) from 108% to 75%, with no difference in the FEV1/FVC ratio, suggesting a restrictive pattern of impairment. Conclusions: With 3D printing technology, reconstructing a large anterior chest wall defect with a custom-made, anatomical, 3D-printed titanium alloy implant is feasible and safe, and it preserves the shape, structure, and function of the chest wall, albeit with a restrictive pattern of pulmonary function, which can be addressed with physiotherapy.
Hypogastric artery luminal diameter predicts common-external iliac stent patency and major adverse limb events in patients with aortoiliac occlusive disease
Authors: Smith Andrew H , Dash Siddhartha , Steenberge Sean , Quatromoni Jon G , Rowse Jarrad W , Caputo Francis J , Kirksey Levester , Graham Linda M , Lyden Sean P , Smolock Christopher J 
Published: February 2023

Objective Hypogastric coverage may be required for occlusive disease at the iliac arterial bifurcation. In this study, we sought to determine patency rates of common-external iliac artery (C-EIA) bare metal stents (BMS) spanning the hypogastric origin in patients with aortoiliac occlusive disease (AIOD). In addition, we sought to identify predictors of C-EIA BMS patency loss and major adverse limb events (MALE) in patients requiring hypogastric coverage. We hypothesized that worsening stenosis of the hypogastric origin would negatively influence C-EIA stent patency and freedom from MALE. Methods This is a single center, retrospective review of consecutive patients undergoing elective, endovascular treatment of aortoiliac disease (AIOD) between 2010 and 2018. Only patients with C-EIA BMS coverage of a patent IIA origin were included in the study. Hypogastric luminal diameter was determined from preoperative CT angiography. Analysis was performed using Kaplan–Meier survival analysis, univariable and multivariable logistic regression, and receiver operator characteristics (ROC). Results There were 236 patients (318 limbs) who were included in the study. AIOD was TASC C/D in 236/318 (74.2%) of cases. C-EIA stent primary patency was 86.5% (95% confidence interval: 81.1, 91.9) at 2 years and 79.7% (72.8, 86.7) at 4 years. Freedom from ipsilateral MALE was 77.0% (71.1, 82.9) at 2 years and 68.7% (61.3, 76.2) at 4 years. Luminal diameter of the hypogastric origin was most strongly associated with loss of C-EIA BMS primary patency in multivariable analysis (hazard ratio: 0.81, p = .02). Insulin-dependent diabetes, Rutherford’s class IV or above, and stenosis of the hypogastric origin were significantly predictive of MALE in both univariable and multivariable analyses. In ROC analysis, luminal diameter of the hypogastric origin was superior to chance in prediction of C-EIA primary patency loss and MALE. Hypogastric diameter >4.5 mm had a negative predictive value of 0.94 for C-EIA primary patency loss and 0.83 for MALE. Conclusions Patency rates of C-EIA BMS are high. Hypogastric luminal diameter is an important and potentially modifiable predictor of C-EIA BMS patency and MALE in patients with AIOD.