bluuebunny/crossref_metadata_2025_split huggingface dataset:
The essential-use concept: a valuable tool to guide decision-making on applications for authorisation under REACH?
Authors: Figuière Romain , Borchert Flora , Cousins Ian T. , Ågerstrand Marlene 
Published: January 2023

Abstract
Background
In 2020, the European Commission published the Chemical Strategy for Sustainability (CSS) in which it aims to increase the level of protection for human health and the environment from hazardous chemicals. Part of the implementation of the CSS will involve a reform of the REACH authorisation and restriction processes. One option for the reform of the authorisation process is to implement the essential-use concept as a tool to guide decision-making on applications for authorisation to make the process more efficient and to align it with societal needs. The purpose of this study is to investigate whether changes in the legal text that defines the authorisation process, and of the amount and type of information that applicants should provide in an application for authorisation, are needed to enable an implementation of the essential-use concept.

Results
The results suggest that no fundamental changes in the regulatory requirements are needed and that applicants should already provide sufficient and relevant information to the authorities to determine if the use(s) applied for is (are) essential.

Conclusions
Although the REACH authorisation already provides a legal and practical basis for an implementation of the essential-use concept, the feasibility of the essentiality assessment and its potential to make the decision-making on applications more efficient are highly dependent on the quality of the information provided and the clearness of decision criteria. However, if an applicant successfully demonstrates that the risk related to the use(s) applied for is adequately controlled, it could not be legally justified for the European Commission to refuse an authorisation by arguing that the use(s) applied for is (are) non-essential.
Agreement between Capillary Refill Time measured at Finger and Earlobe sites in different positions: a pilot prospective study on healthy volunteers
Authors: La Via Luigi , Sanfilippo Filippo , Continella Carlotta , Triolo Tania , Messina Antonio , Robba Chiara , Astuto Marinella , Hernandez Glenn , Noto Alberto 
Published: January 2023

Abstract
Background
Capillary Refill Time (CRT) is a marker of peripheral perfusion usually performed at fingertip; however, its evaluation at other sites/position may be advantageous. Moreover, arm position during CRT assessment has not been fully standardized.

Methods
We performed a pilot prospective observational study in 82 healthy volunteers. CRT was assessed: a) in standard position with participants in semi-recumbent position; b) at 30° forearm elevation, c and d) at earlobe site in semi-recumbent and supine position. Bland–Altman analysis was performed to calculate bias and limits of agreement (LoA). Correlation was investigated with Pearson test.

Results
Standard finger CRT values (1.04 s [0.80;1.39]) were similar to the earlobe semi-recumbent ones (1.10 s [0.90;1.26]; p = 0.52), with Bias 0.02 ± 0.18 s (LoA -0.33;0.37); correlation was weak but significant (r = 0.28 [0.7;0.47]; p = 0.01). Conversely, standard finger CRT was significantly longer than earlobe supine CRT (0.88 s [0.75;1.06]; p < 0.001) with Bias 0.22 ± 0.4 s (LoA -0.56;1.0), and no correlation (r = 0,12 [-0,09;0,33]; p = 0.27]. As compared with standard finger CRT, measurement with 30° forearm elevation was significantly longer (1.17 s [0.93;1.41] p = 0.03), with Bias -0.07 ± 0.3 s (LoA -0.61;0.47) and with a significant correlation of moderate degree (r = 0.67 [0.53;0.77]; p < 0.001).

Conclusions
In healthy volunteers, the elevation of the forearm significantly prolongs CRT values. CRT measured at the earlobe in semi-recumbent position may represent a valid surrogate when access to the finger is not feasible, whilst earlobe CRT measured in supine position yields different results. Research is needed in critically ill patients to evaluate accuracy and precision at different sites/positions.
The impact of intrahepatic cholestasis on pregnancy outcomes: a retrospective cohort study
Authors: Chen Yiming , Zhang Huimin , Ning Wenwen , Chen Yijie , Wen Caihe 
Published: January 2023

AbstractBackgroundThis study analyzed the pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy (ICP) in Hangzhou, China.MethodsCases of pregnant women monitored by antepartum testing at Hangzhou Women’s Hospital from January 2018 to December 2020 were reviewed. Subjects were classified into two groups according to whether they had ICP: 688 cases of ICP were assigned to an exposure group while 38,556 cases of non-ICP were assigned to a non-exposed group. Univariate analysis was performed on qualitative or quantitative data using the Chi-Squared test or Mann–WhitneyUtest, and the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the two groups of related variables were calculated by multivariate binary logistic regression analysis.ResultsThe incidence rate of ICP was 1.75%. Pregnant women with hepatitis B virus were correlated with ICP. Hepatitis B carriers (aOR = 3.873), preeclampsia (PE, aOR = 3.712), thrombocytopenia (aOR = 1.992), gestational hypertension (GH, aOR = 1.627), hyperlipidemia (aOR = 1.602) and gestational diabetes mellitus (GDM, aOR = 1.265) were all risk factors for ICP. In contrast, Body Mass Index (BMI) ≥ 30 kg/m2(aOR = 0.446), 25 m2< maternal BMI < 29.9 kg/m2(aOR = 0.699) and parity ≥ 1 (aOR = 0.722) were protective factors for ICP. Pregnant women in the ICP group had an increased risk of gestation days < 259 days (aOR = 4.574) and cesarean delivery (aOR = 1.930) after ICP, and a decreased risk of longer gestational days (aOR = 0.105), premature rupture of membranes (aOR = 0.384) and fetal macrosomia (aOR = 0.551).ConclusionsBy analyzing a Chinese population with ICP, we identified that pregnant women who are hepatitis B carriers or with PE, thrombocytopenia, GH, hyperlipidemia, and GDM are at higher risk of ICP. Moreover, ICP is associated with adverse pregnancy outcomes; in particular, ICP may increase the incidence of shorter gestational days and non-vaginal delivery methods such as cesarean section but reduce the incidence of premature rupture of membranes and fetal macrosomia.
A high neutrophil-to-platelet ratio is associated with hematoma expansion in patients with spontaneous intracerebral hemorrhage: a retrospective study
Authors: Li Yujian , Yang Xiang , Zhou Huiqing , Hui Xuhui , Li Hao , Zheng Jun 
Published: January 2023

Abstract
Background
Early hematoma expansion (HE) occurs in 20 to 40% of spontaneous intracerebral hemorrhage (ICH) patients and is a primary determinant of early deterioration and poor prognosis. Previous studies have shown that inflammation is a major pathological feature of ICH, and the neutrophil-to-platelet ratio (NPR) is a marker of systemic inflammation. Therefore, we aimed to assess the association between the NPR and HE in ICH patients.

Methods
We retrospectively collected and analyzed data from ICH patients who received treatment at our institution from January 2018 to November 2019. The NPR was calculated from the admission blood test. Brain computed tomography (CT) scans were performed at admission and repeated within 24 h. Hematoma growth was defined as relative growth > 33% or absolute growth > 6 ml.

Results
A total of 317 patients were enrolled in our study. Multivariate logistic regression analysis indicated that the NPR was an independent predictor of HE [odds ratio (OR) = 1.742; 95% CI: 1.508–2.012, p < 0.001]. Receiver operating characteristic (ROC) curve analysis revealed that the NPR could predict HE, with an area under the curve of 0.838 (95% CI, 0.788–0.888, p < 0.001). The best predictive cut-off of the NPR for HE was 5.47 (sensitivity, 75.3%; specificity, 77.6%).

Conclusions
A high NPR was associated with an increased risk of HE in patients with ICH.
DUPAN-II normalisation as a biological indicator during preoperative chemoradiation therapy for resectable and borderline resectable pancreatic cancer
Authors: Hasegawa Shinichiro , Takahashi Hidenori , Akita Hirofumi , Mukai Yosuke , Mikamori Manabu , Asukai Kei , Yamada Daisaku , Wada Hiroshi , Fujii Yoshiaki , Sugase Takahito , Yamamoto Masaaki , Takeoka Tomohira , Shinno Naoki , Hara Hisashi , Kanemura Takashi , Haraguchi Naotsugu , Nishimura Junichi , Matsuda Chu , Yasui Masayoshi , Omori Takeshi , Miyata Hiroshi , Ohue Masayuki , Ishikawa Osamu , Sakon Masato 
Published: January 2023

Abstract
Background
Duke pancreatic mono-clonal antigen type 2 (DUPAN-II) is a famous tumour maker for pancreatic cancer (PC) as well as carbohydrate antigen 19–9 (CA19-9). We evaluated the clinical implications of DUPAN-II levels as a biological indicator for PC during preoperative chemoradiation therapy (CRT).

Methods
This retrospective analysis included data from 221 consecutive patients with resectable and borderline resectable PC at diagnosis who underwent preoperative CRT between 2008 and 2017. We focused on 73 patients with elevated pre-CRT DUPAN-II levels (> 230 U/mL; more than 1.5 times the cut-off value for the normal range). Pre- and post-CRT DUPAN-II levels and the changes in DUPAN-II ratio were measured.

Results
Univariate analysis identified normalisation of DUPAN-II levels after CRT as a significant prognostic factor (hazard ratio [HR] = 2.06, confidence interval [CI] = 1.03–4.24, p = 0.042). Total normalisation ratio was 49% (n = 36). Overall survival (OS) in patients with normalised DUPAN-II levels was significantly longer than that in 73 patients with elevated levels (5-year survival, 55% vs. 21%, p = 0.032) and in 60 patients who underwent tumour resection (5-year survival, 59% vs. 26%, p = 0.039).

Conclusion
Normalisation of DUPAN-II levels during preoperative CRT was a significant prognostic factor and could be an indicator to monitor treatment efficacy and predict patient prognosis.
Instability of emotional relationships and suicide among youth: a qualitative study
Authors: Fallahi-Khoshknab Masoud , Amirian Zainab , Maddah Sadat Seyed Bagher , Khankeh Hamid Reza , Dalvandi Asghar 
Published: January 2023

Abstract
Background
Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults.

Method
This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis.

Results
The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide.

Conclusion
The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.
Suicidal ideation in men during COVID-19: an examination of protective factors
Authors: Seidler Zac E. , Wilson Michael J. , Oliffe John L. , Fisher Krista , O’Connor Rory , Pirkis Jane , Rice Simon M. 
Published: January 2023

Abstract
Background
Men account for three-quarters of all suicide deaths in many Western nations including Australia. Whilst extensive research has examined risk factors for suicidal ideation and behaviour in men, protective factors remain underexplored, particularly social support, resilience and coping behaviours. Such factors are important to examine particularly in the context of COVID-19, where enforced isolation (among other negative lifestyle effects) has created widespread risk for the development of suicidal ideation. This mixed-methods study aimed to examine associations of various protective factors with suicidal ideation in men, using data from an online survey conducted during the COVID-19 pandemic. In addition, we aimed to qualitatively investigate men’s self-reported protective strategies when experiencing suicidal thoughts and behaviour.

Methods
A convenience sample of 700 men (age M = 50.3 years; SD = 15.2 years) responded to an online survey including quantitative measures of suicidal ideation, planning and attempt, alongside employment and relationship status, coping, social support, resilience, and a qualitative free-text item gauging men’s self-reported protective strategies. Multinomial logistic regression was applied to compare odds of sub-categories of suicide risk (ideation; planning) according to protective factors. Qualitative responses were analysed via thematic analysis.

Results
Men in a relationship, and those lower in emotion-focused and avoidant coping reported lower odds of suicidal ideation. Maintaining employment throughout the pandemic was protective against suicidal ideation and planning; as was greater perceived social support from friends. Greater self-reported resilience was protective against suicidal ideation and planning. Qualitative analyses led to the development of two themes: coping and connecting, reflecting men’s intra- and interpersonal management strategies; and sustaining selflessness, where men’s imaginings of the collateral damage of their suicidal behaviour was protective against action on suicidal thoughts or plans.

Conclusions
Findings of this study speak to the nuanced roles of interpersonal connections, resilience and coping behaviours in protecting against suicidal ideation and planning in men. In addition, qualitative insights further cement men’s identification with familial protector and/or provider roles as protective against suicidal action.
Participative epidemiology and prevention pathway of health risks associated with artisanal mines in Luhihi area, DR Congo
Authors: Irenge Christian Ahadi , Bushenyula Parfait Kaningu , Irenge Emmannuel Bayubasire , Coppieters Yves 
Published: January 2023

Abstract
Background
Health issues are associated with artisanal mining in the DR Congo. The scenario is worst when artisanal mining is done informally or with limited material and technical resources.
This paper argues that the adoption of healthy practices by artisanal miners might be limited given that it involves unrealistic socio-economic, and administrative aspects and access to health risk prevention means.
Making a conceptual framework on the feasibility of revolutionizing artisanal mining practices linked to health risks in the DR Congo requires trans-disciplinary interventions and researches. This case study aims at co-analyzing with actors in the Luhihi artisanal gold mine, the epidemiology of health issues. It also aims at describing the dynamics of resources that mining actors mobilize or think they can mobilize in order to prevent health risks.

Methods
A “socio-anthropological” qualitative study with “transdisciplinary methods” was carried out the Luhihi artisanal mining. Data collection tools and methods included an exploratory survey, semi-structured interviews. Focus groups (FG) mixed with proportional piling were used to support the open-ended interview discussions. The actors interviewed were selected by “convenience sampling” and the saturation principle indicated the size of the sampling. In total, 67 persons were interviewed and 5 FG each consisting of 5 to 10 mining actors were organized. Data were triangulated among respondents to ensure their veracity and an “inductive thematic data analysis” was applied.

Results
Key findings are the role of actors involved the organization system at the Luhihi artisanal mining site; a description of a participative epidemiology and determinants of health issues; presentation of the importance of health risks as perceived by mining actors; the constraints in the common illenesses treatment; and opportunities of collective actions for gathering resources required for the organization of healthcare services.

Conclusion
The results are translated into a grid of powers and interests in relation to the mobilization of resources for the prevention and treatment of health issues. The dialogue for change regarding the ignorance of the actors to exposure to chemical risks such as to exposure mercury, silica, carbon monoxide, and cyanide also entailed the translation of the results. In addition, an analysis of the ability of artisanal mining actors to implement health risk prevention services was made.
Relationship of sleep duration with incident cardiovascular outcomes: a prospective study of 33,883 adults in a general population
Authors: Cui Hui , Xu Rong , Wan Yiming , Ling Yong , Jiang Yonggen , Wu Yiling , Guan Ying , Zhao Qi , Zhao Genming , Zaid Maryam 
Published: January 2023

Abstract
Background
Studies on the effect of sleep duration on cardiovascular health have contradictory findings. Underlying health issues may have led to inconsistent results and warrant consideration. We aim to assess the relationship of night sleep duration with incident cardiovascular disease (CVD) in a general population, taking into consideration underlying chronic diseases.

Methods
Data from Shanghai Suburban Adult Cohort and Biobank with a median follow-up of 5.1 years was used, including 33,883 adults aged 20–74 years old. Incident CVD cases were reported and recorded by the Center for Disease Prevention and Control in Songjiang, Shanghai. We used Cox proportional hazard regression models and restricted cubic spline (RCS) analysis to explore the relationship between different sleep groups and sleep duration with incident CVD outcomes, through stratification by gender and age, as well as different health conditions, with adjustments for potential confounders.

Results
Long sleep duration (> 9 h) compared to > 7 to ≤ 8 h was associated with overall incident CVD in participants aged ≥ 50 years old: HR(95%CI) = 2.07 (1.15, 3.74) for 50-59y and 1.43 (1.04, 1.93) for 60-74y. RCS analysis showed a J-shaped relationship between sleep and CVD risk in those ≥ 50y, which was confirmed only in those with a chronic health condition. Non-linear relationships between sleep and CVD risk factors, such as BMI, blood glucose and glycated haemoglobin, were observed.

Conclusions
Long sleep duration is associated with increased risk of CVD in people ≥ 50y. However, CVD risk factors and underlying health conditions such as hypertension, and diabetes, may play a driving role in the relationship.
Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention
Authors: You Hua , Wang Yuan-Yuan , Zhang Chi , Walker Anita Nyarkoa , Ge Jin-Jin , Zhao Shi-Qi , Peng Xue-Qing 
Published: January 2023

Abstract
Background
Unhealthy gestational weight gain is a modifiable risk factor for adverse maternal and child health. Appropriate and effective intervention strategies that focus on behavioral change or maintenance are critical in weight management during pregnancy. Our aim was to uncover the influencing factors and psychosocial mechanisms of gestational weight control behavior, and to construct a behavioral model suitable for intervention based on Information-Motivation-Behavioral skills (IMB) model.

Methods
A sample of 559 pregnant women from a municipal maternal and child healthcare facility in Jiangsu Province, China was enrolled in this cross-sectional empirical study. Partial least square structural equation modelling was used to verify the hypothesized model, and post hoc analyses was used to test the effect of parity and pre-pregnancy BMI on the model.

Results
The IMB model elements can predict gestational weight management (GWM) behavior well, with information being the most influential factor. As predicted, information affects GWM directly (β = 0.325, p < 0.05) and indirectly (β = 0.054, p < 0.05) through behavioral skills. Likewise, motivation has direct (β = 0.461, p < 0.05) effects on GWM, and has indirect (β = 0.071, p < 0.05) effects through behavioral skills. Behavioral skills have a direct impact (β = 0.154, p < 0.05). The model had a goodness of fit (GOF = 0.421) and was robust when tested in subgroups of different parity or pre-pregnancy BMI.

Conclusion
Findings from this study supported the predictions of the IMB model for GWM behavior, and identified its modifiable determinants. The tested behavior model for GWM can serve as a new validated intervention strategy in weight management among pregnant women.
Cyanoacrylate glue foreign body after CT-guided localization of a pulmonary nodule during video-assisted thoracoscopic surgery: a case report
Authors: Deng Jingdan , Zeng Zhiwen , Liao Yilin , Zhong Haihui , Zhang Huanrong 
Published: January 2023

Abstract
Background
A tracheal foreign body is a common airway aspiration that creates an emergency, which often causes unobserved respiratory problems and requires management. Iatrogenic tracheal foreign bodies are rarely observed, which results in tracheal obstruction. If the foreign body were removed from the tracheobronchial system, it would save lives. A similar case of a tracheal foreign body was focused on, which was caused by medical glue used during preoperative computed tomography localization of pulmonary nodules.

Case presentation
The foreign body was deposited in the right upper bronchi, accidentally discovered after anesthesia when a double-lumen tube was located by fiber bronchoscopy. Following a video-assisted thoracoscopic surgery, the foreign body was removed using a respiratory endoscopy without subsequent adverse consequences for the patient.

Conclusions
There is a risk of complications from iatrogenic airway foreign bodies for preoperative localization of pulmonary nodules by injecting cyanoacrylate glue.