bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Econometric Analysis of Revenue Diversification Among Selected Indian States
Authors: Darshini J.S. , Gayithri K. 
Published: May 2023

The key objective of this article is to empirically examine the trends and determinants of revenue diversification with respect to 14 major Indian states. The findings highlight a gradual decrease in the level of revenue diversification, which has become more visible in recent years. This indicates an erratic pattern of growth in tax and non-tax revenue sources. The panel cross-sectional–autoregressive distributed lag model test results reveal a positive contribution of economic and institutional factors, as compared to political factors, toward the process of revenue diversification. Overall, it is evident that cyclical fluctuations in the major tax revenue sources, coupled with a lessened emphasis on rationalising the structure of non-tax revenue sources, seem to have had an adverse impact on the process of revenue diversification on the part of states. JEL Classifications: H0, H1, H2, H7
First-in-human trial of Center Wire for neuroendovascular therapy to avoid guidewire-related complications
Authors: Matsumoto Shirabe , Imamura Hirotoshi , Takayanagi Ariel , Fukumitsu Ryu , Goto Masanori , Sunohara Tadashi , Fukui Nobuyuki , Omura Yoshihiro , Akiyama Tomoaki , Fukuda Tatsumaru , Go Koichi , Kajiura Shinji , Shigeyasu Masashi , Asakura Kento , Horii Ryo , Naramoto Yuji , Nishii Rikuo , Yamamoto Yasuhiro , Sakai Chiaki , Imahori Taichiro , Kaneko Naoki , Tateshima Satoshi , Sakai Nobuyuki 
Published: May 2023

Background An exchange maneuver is useful for the delivery of devices to target vessels. However, hemorrhagic complications can occur due to vessel perforation during an exchange maneuver. In addition, the exchange is often challenging due to unfavorable anatomy. Center Wire is an exchange-length wire with a nondetachable stent that was developed to improve navigation and stability during exchange maneuvers. The aim of this study is to investigate the safety and efficacy of Center Wire of the anchor wire technique during neuroendovascular treatment. Methods Ten patients with intracranial aneurysms were treated after signing a Certified Review Board-approved consent. Anchor wire technique was used in all patients to navigate catheters to the target vessel for aneurysm treatment. Results Anchor wire technique was successfully applied in all 10 cases using Center Wire. One device-related incident of vasospasm occurred which was asymptomatic. No device-related dissection, perforation, or thromboembolic events occurred. One patient had intraoperative aneurysm rupture during coil placement which was treated immediately without clinical consequences. Two patients had postoperative ischemic strokes due to thrombotic occlusion of branches originating from the aneurysm which were unrelated to the device. Conclusions This first-in-human trial of Center Wire demonstrated the safety and efficacy of the anchor wire technique for neuroendovascular treatment in a strictly regulated prospective registry trial.
Recruitment and Retention of Recreational Runners in Prospective Injury Research: A Qualitative Study
Authors: Lacey Aisling , Whyte Enda , O’Keeffe Sinéad , O’Connor Siobhán , Moran Kieran 
Published: May 2023

Purpose Continuous and long-term prospective monitoring of athletes in natural training environments is essential to provide further clarity on the risk factors for running-related injuries. However, participant recruitment and retention can be problematic. This study aimed to identify factors for facilitating the recruitment and retention of recreational runners in prospective, longitudinal running-related injury research involving running technologies. Methods Twenty-seven recreational runners (14 female, 13 male) participated across nine semi-structured focus groups. Focus groups were audio and video recorded and transcribed verbatim. A reflexive thematic analysis was undertaken, with a critical friend approach taken to enhance reliability. Results Incentives, recruiting suitable participants, ease of use of running technologies, an appropriate research design, and good communication practices will facilitate recruitment and retention. Conclusion Receiving study outputs, evidence-based information and undergoing laboratory testing were identified as incentives, however, researchers need to consider whether these may influence participant behaviour and adversely bias the findings of their study. Researchers should offer participants an option with regard to the type, content, frequency and mode of delivery of incentives and communication. Appealing to potential participants’ personal interests will facilitate initial recruitment, while attempts to ‘feed’ this interest throughout the course of a study will enhance retention. Employing a user-friendly smartphone app and unobtrusive sensor(s), and a research study that can work with runners’ training schedules and technology usage habits, will further facilitate their recruitment and retention.
A prospective study on varicose veins surgery impact on systemic endothelial function evaluated by arterial brachial flow mediated dilation
Authors: Nóbrega Leandro , Cardoso Rita , Leite-Moreira Adelino , Castro-Ferreira Ricardo 
Published: May 2023

Objectives Chronic venous disease (CVD) is a prevalent pathology, and endothelial dysfunction is recognized as a core of its physiopathology. Flow-mediated dilation (FMD) is one of the most widely used tests for evaluating endothelial function. The aim of this study is to evaluate the influence of varicose vein (VV) surgery on FMD. Methods A prospective study with patients with superficial CVD and saphenous incompetence on Doppler ultrasonography that were proposed for VV surgery. The FMD test was performed before and 6 months after the procedure. The operator performing the post-operative evaluation was blinded to the pre-operative result. Results A total of 42 patients were included in the analysis. The median pre-operative percent change of FMD was 4.20% (±1.30) and the post-operative was 4.56% (±1.25) ( p = 0.819). Conclusions Our findings do not corroborate the presence of an overall endothelial dysfunction prone to modulation by surgery. Nevertheless, further studies are needed to confirm our findings.
Determination of high-sensitivity C-reactive protein reference intervals for apparently healthy children in Addis Ababa, Ethiopia
Authors: Mohammed Ousman , Kassaw Melkitu , Befekadu Endalkachew , G/Egzeabher Letebrhan , Mekonen Abebaye , Bikila Demiraw , Challa Feyissa , Belay Abiy , Wolde Mistire , Desta Kassu , Tsegaye Aster 
Published: May 2023

Objective: Since then, the reference intervals of serum hsCRP in apparently healthy Ethiopian children are unknown. Therefore, this study aimed to determine the reference intervals of serum hsCRP for apparently healthy children. Methods: In this cross-sectional study, a total of 492 apparently healthy children aged 5–17 years were recruited from residents of Addis Ababa. Well-trained professionals took anthropometric measurements. The biochemical analysis was performed with the automatic biochemical analyzer Cobas Integra 400 Plus from Roche. The 2.5th and 97.5th percentile limits were calculated using a non-parametric method as per the Clinical Laboratory Standard Institute (CLSI) guide. A box plot was used to show the distribution of hsCRP by age and gender. Furthermore, bivariate and multivariable logistic regression analyses were carried out to evaluate factors associated with elevated hsCRP levels. Percentiles were displayed by age subgroup and sex. p-values <0.05 were considered statistically significant. Results: The study included 245 boys and 247 girls. For the age group of 5–11 years, the combined 2.5th and 97.5th percentiles, which can be used as a reference interval for children in Addis Ababa, were 0.15–6.78 mg/L, while for the older age group (12–17 years), the determined percentile was 0.14–4.40 mg/L. Likewise, the current study shows that never or occasionally eating vegetables and/or fruits (AOR = 2.28, 95% CI, 0.84–4.97), and being obese (AOR = 3.63, 95% CI, 1.14–11.53) were independent risk factors for elevated serum hsCRP concentrations. Conclusion: This study is the first to determine the reference intervals of hsCRP concentrations among apparently healthy Ethiopian children. Notable differences were observed in the established percentiles of hsCRP in comparison with published literature.
User experiences of an American-adapted moderated online social media platform for first-episode psychosis: Qualitative analysis
Authors: Pokowitz Elena L , Stiles Bryan J , Thomas Riya , Bullard Katherine , Ludwig Kelsey A , Gleeson John F , Alvarez-Jimenez Mario , Perkins Diana O , Penn David L 
Published: May 2023

Objectives The current study sought to qualitatively characterize the experiences of American users in a recent open trial of the Horyzons digital platform. Methods In total, 20 users on Horyzons USA completed semistructured interviews 12 weeks after their orientation to the platform and addressed questions related to (1) the platform, (2) their online therapist, and (3) the peer workers and community space. A hybrid inductive-deductive coding strategy was used to conduct a thematic analysis of the data (NCT04673851). Results The authors identified seven prominent themes that mapped onto the three components of self-determination theory. Features of the platform itself as well as inter- and intra-personal factors supported the autonomous use of Horyzons. Users also reflected that their perceived competence in social settings and in managing mental health was increased by the familiarity, privacy, and perceived safety of the platform and an emphasis on personalized therapeutic content. The behaviors or traits of online therapists as perceived by users and regular contact with peers and peer support specialists satisfied users’ need for relatedness and promoted confidence in social settings. Users also described aspects of Horyzons USA that challenged their satisfaction of autonomy, competence, and relatedness, highlighting potential areas for future iterations of the platform's content and interface. Conclusions Horyzons USA is a promising digital tool that provides young adults with psychosis with the means to access tailored therapy material on demand and a supportive digital community to aid in the recovery process.
Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study
Authors: Straube Andreas , Broessner Gregor , Gaul Charly , Hamann Xenia , Hipp Joachim , Kraya Torsten , Neeb Lars 
Published: May 2023

Abstract
Background
Monoclonal antibodies targeting the CGRP pathway are effective and safe for prophylactic treatment of episodic (EM) and chronic migraine (CM). In case of treatment failure of a CGRP pathway targeting mAb, physician has to decide whether using another anti-CGRP pathway mAb is useful. This interim analysis of Finesse Study evaluates effectiveness of the anti-CGRP mAb fremanezumab in patients with a history of other prior anti-CGRP pathway mAb treatments (switch patients).

Methods
Finesse, a non-interventional, prospective, multicentre, two-country (Germany-Austria) study observing migraine patients receiving fremanezumab in clinical routine. This subgroup analysis presents data on documented effectiveness over 3 months after the first dose of fremanezumab in switch patients. Effectiveness was evaluated based on reduction in average number of migraine days per month (MMDs), MIDAS and HIT-6 scores changes as well as in number of monthly days with acute migraine medication use.

Results
One hundred fifty-three out of 867 patients with a history of anti-CGRP pathway mAb treatment prior to initiation of fremanezumab were analysed. Switch to fremanezumab led to ≥ 50% MMD reduction in 42.8% of migraine patients, with higher response rate in EM (48.0%) than in CM patients (36.5%). A ≥ 30% MMD reduction was achieved by 58.7% in CM patients. After three months, monthly number of migraine days decreased by 6.4 ± 5.87 (baseline: 13.6 ± 6.5; p < 0.0001) in all patients, 5.2 ± 4.04 in EM and 7.7 ± 7.45 in CM patients. MIDAS scores decreased from 73.3 ± 56.8 (baseline) to 50.3 ± 52.9 (after 3 months; p = 0.0014), HIT-6 scores decreased from 65.9 ± 5.0 to 60.9 ± 7.2 (p < 0.0001). Concomitant use of acute migraine medication had decreased from 9.7 ± 4.98 (baseline) to 4.9 ± 3.66 (3 months) (p < 0.0001).

Conclusions
Our results show that about 42.8% of anti-CGRP pathway mAb-non-responder benefit from switching to fremanezumab. These results suggest that switching to fremanezumab may be a promising option for patients experiencing poor tolerability or inadequate efficacy with prior other anti-CGRP pathway mAb use.

Trial registration
Finesse Study is registered on the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (EUPAS44606).

Graphical Abstract
Synergistic action of phages and lytic proteins with antibiotics: a combination strategy to target bacteria and biofilms
Authors: Lu Han , Li Zong , Elbaz Amro , Ni Shou-Qing 
Published: May 2023

Abstract
Background
Multidrug-resistant bacteria continue to emerge owing to the abuse of antibiotics and have a considerable negative impact on people and the environment. Bacteria can easily form biofilms to improve their survival, which reduces the efficacy of antibacterial drugs. Proteins such as endolysins and holins have been shown to have good antibacterial activity and effectively removal bacterial biofilms and reduce the production of drug-resistant bacteria. Recently, phages and their encoded lytic proteins have attracted attention as potential alternative antimicrobial agents. The aim of the present study was to investigate the sterilising efficacy of phages (SSE1, SGF2, and SGF3) and their encoded lytic proteins (lysozyme and holin), and to further explore their potential in combination with antibiotics. To the ultimate aim is to reduce or replace the use of antibiotics and provide more materials and options for sterilisation.

Results
Phages and their encoded lytic proteins were confirmed to have great advantages in sterilisation, and all exhibited significant potential for reducing bacterial resistance. Previous studies on the host spectrum demonstrated the bactericidal efficacy of three Shigella phages (SSE1, SGF2, and SGF3) and two lytic proteins (LysSSE1 and HolSSE1). In this study, we investigated the bactericidal effects on planktonic bacteria and bacterial biofilms. A combined sterilisation application of antibiotics, phages, and lytic proteins was performed. The results showed that phages and lytic proteins had better sterilisation effects than antibiotics with 1/2 minimum inhibitory concentrations (MIC) and their effect was further improved when used together with antibiotics. The best synergy was shown when combined with β- lactam antibiotics, which might be related to their mechanism of sterilising action. This approach ensures a bactericidal effect at low antibiotic concentrations.

Conclusions
This study strengthens the idea that phages and lytic proteins can significantly sterilise bacteria in vitro and achieve synergistic sterilisation effects with specific antibiotics. Therefore, a suitable combination strategy may decrease the risk of drug resistance.
Type I Kounis syndrome induced by COVID-19 vaccination in China: a case report
Authors: Deng Yubing , Peng Zhujun , Peng Xiaoping 
Published: May 2023

Abstract
Background
Kounis syndrome is a rare clinical condition characterized by the occurrence of an acute coronary event induced by an acute allergic episode. The ongoing pandemic of coronavirus disease 2019 (COVID-19) has contributed to an increase in the incidence of allergic reactions to a certain extent, thereby increasing the incidence of Kounis syndrome. Timely diagnosis and effective management of this disease are important in clinical practice.

Case presentation
We report a 43-year-old woman who developed generalized pruritus, breathlessness, paroxysmal precordial crushing pain, and dyspnea after receiving the third dose of the COVID-19 vaccine. After anti-allergic treatment and therapy for acute myocardial ischemia, her symptoms resolved with improvement in cardiac function and resolution of ST-segment changes. The prognosis was satisfactory, and the final diagnosis was type I Kounis syndrome.

Conclusion
This patient with type I Kounis syndrome rapidly developed acute coronary syndrome (ACS) after an acute allergic reaction to the COVID-19 vaccine. ​Timely diagnosis of acute allergic reaction and ACS, and targeted treatment based on the relevant guidelines are the key to successful treatment of the syndrome.​
Cervical cancer screening utilization and its predictors among women in bench Sheko Zone, Southwest Ethiopia: using health belief model
Authors: Belay Alemayehu Sayih , Asmare Wondwossen Niguse , Kassie Aychew 
Published: May 2023

Abstract
Background
Cervical cancer is the fourth most frequently diagnosed and found to be the leading cause of cancer death in women, especially in low and middle-income countries. Even though cervical cancer is a preventable disease, its preventive measures have not been equitably implemented across and within different countries; especially in low and middle-income countries, due to different contributing factors.

Objective
This study aimed to assess cervical cancer screening utilization and its’ predictors among Women in Bench Sheko Zone, Southwest Ethiopia.

Method
A community-based cross-sectional study design was employed in Bench Sheko Zone from February 2021 to April 2021. Using a multi-stage stratified sampling method, a total of 690 women in the age range of 30–49 years were included in the study. The logistic regression analysis was used considering a 95% confidence interval and a P-value of < 0.05.

Results
Ninety-six (14.2%) of the participants have utilized cervical cancer screening. Predictors like; age between 40–49 years (AOR = 5.35, 95% CI = [2.89, 9.90]), partner educational status of certificate and above (AOR = 4.36, 95% CI = [1.65, 11.51]), first sexual intercourse before eighteen years (AOR = 4.85, 95% CI = [2.29, 10.26]), ever used of alcohol (AOR = 3.99, 95% CI = [1.23, 12.89]), good knowledge (AOR = 8.98, 95% CI = [4.06, 19.89]), favorable attitude (AOR = 3.56, 95% CI = [1.78, 7.09]), and high perceived benefit (AOR = 2.94, 95% CI = [1.48, 5.84]) were strongly associated with cervical cancer screening utilization.

Conclusion
In this study, cervical cancer screening utilization was relatively low. Therefore, promotion of the perception of women towards cervical cancer screening, and provision of health-related information towards different behavioral-related factors should have to be addressed at each level of health care.
Incidence and geographic distribution of retinoblastoma in Ethiopia
Authors: Sherief Sadik Taju , Asfaw Gadisa , Abateneh Aemero , Takewe Solomon , Fufa Diriba , Wondale Teshager , Takele Temesgen , Dimaras Helen 
Published: May 2023

Abstract
Introduction
Retinoblastoma is the most frequent intraocular malignancy of the eye in children, occurring in early childhood. Based on global estimates, Ethiopia is expected to observe over 200 new retinoblastoma cases per year, however without a cancer registry, this number is difficult to confirm. Therefore, the goal of the study was to determine the incidence and geographic distribution of retinoblastoma in Ethiopia.

Methods
A retrospective medical chart review of clinically diagnosed new retinoblastoma patients between January 1, 2017 - December 31, 2020, in four public Ethiopian tertiary hospitals was performed. The incidence of retinoblastoma was calculated by a birth-cohort analysis.

Results
There were 221 retinoblastoma patients observed in the study period. The incidence of retinoblastoma was found to be 1 in 52,156 live births. Incidence varied among different regions of Ethiopia.

Conclusion
The incidence of retinoblastoma observed in this study is likely an underestimate. It is possible that patients were undercounted because they were seen outside of the 4 main retinoblastoma treatment facilities included in this facility, or they experienced barriers to accessing care. Our study suggests a need for a nationwide retinoblastoma registry and more retinoblastoma treatment centers in the country.
Progression of pulmonary cysts in Birt-Hogg-Dubé syndrome: longitudinal thoracic computed tomography study with quantitative assessment
Authors: Cho Su Min , Chae Eun Jin , Choe Jooae , Lee Sang Min , Song Jin Woo , Do Kyung-Hyun 
Published: May 2023

Abstract
Background
Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal dominant disorder characterized by fibrofolliculomas, renal tumors, pulmonary cysts, and recurrent pneumothorax. Pulmonary cysts are the cause of recurrent pneumothorax, which is one of the most important factors influencing patient quality of life. It is unknown whether pulmonary cysts progress with time or influence pulmonary function in patients with BHD syndrome. This study investigated whether pulmonary cysts progress during long-term follow-up (FU) by using thoracic computed tomography (CT) and whether pulmonary function declines during FU. We also evaluated risk factors for pneumothorax in patients with BHD during FU.

Methods
Our retrospective cohort included 43 patients with BHD (25 women; mean age, 54.2 ± 11.7 years). We evaluated whether cysts progress by visual assessment and quantitative volume analysis using initial and serial thoracic CT. The visual assessment included the size, location, number, shape, distribution, presence of a visible wall, fissural or subpleural cysts, and air-cuff signs. In CT data obtained from a 1-mm section from 17 patients, the quantitative assessment was performed by measuring the volume of the low attenuation area using in-house software. We evaluated whether the pulmonary function declined with time on serial pulmonary function tests (PFT). Risk factors for pneumothorax were analyzed using multiple regression analysis.

Results
On visual assessment, the largest cyst in the right lung showed a significant interval increase in size (1.0 mm/year, p = 0.0015; 95% confidence interval [CI], 0.42–1.64) between the initial and final CT, and the largest cyst in the left lung also showed significant interval increase in size (0.8 mm/year, p < 0.001, 95% CI; -0.49–1.09). On quantitative assessment, cysts had a tendency to gradually increase in size. In 33 patients with available PFT data, FEV1pred%, FEV1/FVC, and VCpred% showed a statistically significant decrease with time (p < 0.0001 for each). A family history of pneumothorax was a risk factor for the development of pneumothorax.

Conclusions
The size of pulmonary cysts progressed over time in longitudinal follow-up thoracic CT in patients with BHD, and pulmonary function had slightly deteriorated by longitudinal follow-up PFT.
Brain-lung crosstalk: how should we manage the breathing brain?
Authors: Wahlster Sarah , Town James A. , Battaglini Denise , Robba Chiara 
Published: May 2023

AbstractRecent studies have drawn increasing attention to brain-lung crosstalk in critically ill patients. However, further research is needed to investigate the pathophysiological interactions between the brain and lungs, establish neuroprotective ventilatory strategies for brain-injured patients, provide guidance on potentially conflicting treatment priorities in patients with concomitant brain and lung injury, and enhance prognostic models to inform extubation and tracheostomy decisions. To bring together such research, BMC Pulmonary Medicine welcomes submissions to its new Collection on ‘Brain-lung crosstalk’.