bluuebunny/crossref_metadata_2025_split huggingface dataset:
Philip Morris International’s Formula 1 Sponsorship-Linked Marketing: Transformation From Marlboro to Mission Winnow
Authors: Dewhirst Timothy , Lee Wonkyong Beth , Czaplicki Lauren 
Published: September 2023

Abstract

Introduction
Transformation describes a dramatic modification in appearance or character. Philip Morris International (PMI)’s sponsorship-linked marketing of Formula 1 auto racing is illustrative of transformation. The company’s flagship cigarette brand, Marlboro has been replaced as the identified partner by their newly developed brand, Mission Winnow. This study examines the tobacco company’s marketing objectives for transforming the brand identity of its Formula 1 Ferrari race team partnership.

Aims and Methods
We provide a case study, and our method of qualitative enquiry is textual analysis. We review marketing planning documents from Philip Morris, which would normally be proprietary, but are publicly accessible because of litigation. Additionally, we review Mission Winnow’s social media posts, over a 3-year span, from the brand’s Facebook, Instagram, and Twitter accounts.

Results
PMI initiated its Formula 1 sponsorship in 1972. Through Marlboro, the company’s sponsorship-linked marketing was largely centered on building brand image and reinforcing Marlboro’s brand identity of rugged masculinity, independence, heroism, and adventure. When Mission Winnow replaced Marlboro as the identified brand sponsor in 2018, the company’s marketing communication shifted to highlighting transformation, progress, open dialogue, teamwork, innovation, technology, and science.

Conclusions
Despite Article 5.3 of the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) calling for Parties to protect public health policies from the commercial and vested interests of tobacco companies, PMI still seeks to be an important stakeholder in such consultations, including those pertaining to harm reduction. Mission Winnow’s sponsorship-linked marketing points to a larger company narrative about trying to gain or reclaim legitimacy and credibility.

Implications
PMI’s continued sponsorship of Formula 1 is a strategic means of drawing attention to the company’s “next-generation products” and communicating their supposed “transformation.” The company’s sponsorship-linked marketing initiatives point to a need for Parties to enforce Article 13 of the WHO FCTC, which calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship.
How much disease risk is due to old age and established risk factors?
Authors: Webster A J 
Published: September 2023

Abstract
Improved healthcare is leading to older populations and increasing numbers of individuals experiencing multiple diseases, possibly concurrently (multimorbidity). This article asks whether the observed number of new diseases is more than expected based on age and established risk factors alone, assuming that disease risk is unchanged by prior or pre-existing disease. This is accomplished by designing a new epidemiological approach, where the expected number of disease types are estimated for individuals without prior disease, by combining individual risk predictions with a “Poisson-Binomial” model to estimate the expected number of new diseases and its confidence interval. For 123 diseases in men and 99 diseases in women, the expected number of new diseases based on age and established risk factors was approximately 2/3 of that observed, with the observed number of new diseases approximately 1.5 times that predicted. The differences could not be explained by natural statistical variation, and provide a rigorous statistical demonstration of lower disease risk for individuals without any previous disease. The multiple of 1.5 was sufficiently consistent across different diseases to prevent its use for classification of disease types, but there were differences for subgroups such as smokers with high body mass index, and for some classes of disease (as defined by the International Classification of Diseases, version 10). The results suggest that empirical modeling might allow reliable predictions of future hospital admissions, and confirm the value of conventional epidemiological approaches that study disease risk in healthy individuals. The implications and future possibilities of this new approach are discussed.
Understanding the Interplay Between Paraspinal Muscle Atrophy and Lumbar Endplate Degeneration
Authors: Schönnagel Lukas , Zhu Jiaqi , Guven Ali E. , Camino-Willhuber Gaston , Tani Soji , Caffard Thomas , Haffer Henryk , Muellner Maximilian , Chiapparelli Erika , Amoroso Krizia , Arzani Artine , Moser Manuel , Shue Jennifer , Tan Ek T. , Carrino John A. , Jöns Thomas , Sama Andrew A. , Girardi Federico P. , Cammisa Frank P. , Hughes Alexander P. 
Published: September 2023

Study Design.
Retrospective analysis of longitudinal data.

Objective.
To assess the association between the paraspinal musculature (PM) and lumbar endplate degeneration.

Background.
The PM is essential for spinal stability, while the vertebral endplate is pivotal for nutrient transport and force distribution. The clinical importance of both has been highlighted in recent literature, though little is known about their interaction.

Methods.
We identified patients with lumbar MRI scans due to low back pain, with a 3-year interval between MRI scans. Endplate damage was assessed by the total endplate score (TEPS) at each lumbar level. The PM was evaluated for its functional cross-sectional area and fatty infiltration (FI) at the L4 level. We used a generalized mixed model to analyze the association between PM parameters and TEPS at timepoint one, adjusting for age, sex, BMI, diabetes, hypertension, and smoking status. The association with the progression of endplate damage was analyzed through an ordinal regression model, additionally adjusted for TEPS at baseline.

Results.
In all, 329 patients were included, with a median follow-up time of 3.4 years. Participants had a median age of 59 and a BMI of 25.8 kg/m2. In the univariate analysis, FI of the posterior PM was significantly associated with TEPS at baseline (β: 0.08, P<0.001) and progression of TEPS [Odds Ratio (OR): 1.03, P=0.020] after adjustment for confounders. The β and OR in this analysis are per percent of FI. In a binary analysis, patients with FI≥40% had an OR of 1.92 (P=0.006) for the progression of TEPS.

Conclusions.
This is the first longitudinal study assessing the relationship between PM and endplate degeneration, demonstrating the association between PM atrophy and the progression of endplate degeneration. This insight may aid in identifying patients at risk for degenerative lumbar conditions and guide research into preventive measures.
Outcomes of Pre-Descemet Endothelial Keratoplasty for Failed Therapeutic Penetrating Keratoplasty
Authors: Narang Priya , Ashok Kumar Dhivya , Narang Rhea , Agarwal Amar 
Published: September 2023

Purpose:
The aim of this study was to analyze the outcomes of pre-Descemet endothelial keratoplasty (PDEK) for failed therapeutic penetrating keratoplasty.

Methods:
This was a retrospective, interventional study that involved 12 eyes of 12 patients with failed therapeutic penetrating keratoplasty that underwent PDEK. All cases had a minimum follow-up of 12 months. The main outcome measures were best-corrected visual acuity, graft clarity, endothelial cell density loss, and graft survival. Corneal clarity was graded on a scale from 0 to 4, where grade 4 denoted an absolutely clear cornea and grade 0 denoted a totally opaque cornea. Three cases underwent PDEK, 6 cases PDEK with phacoemulsification, and 3 cases underwent PDEK with pupilloplasty.

Results:
The mean follow-up period for all cases was 18.5 ± 4.9 months. The mean preoperative and postoperative best-corrected visual acuity (in Snellen decimal equivalent) was 0.02 ± 0.01 and 0.54 ± 0.17, respectively, at the last follow-up. Postoperatively, corneal clarity grade 4 was present in 9 eyes, grade 3 in 2 eyes, and grade 2 in 1 eye. Mild subepithelial haze was noted in 2 eyes. The percentage of endothelial cell density loss was 28.2% ± 10.6%. No correlation was observed between the postoperative graft clarity and preoperative specular count (r = −0.021, P = 0.512). Rebubbling was performed for 1 eye that developed partial graft detachment in the first postoperative week. One patient had an episode of rejection that was managed with systemic and topical steroids.

Conclusions:
In patients with failed therapeutic penetrating keratoplasty, PDEK can be a useful alternative for visual rehabilitation as it demonstrates favorable visual outcomes with a good graft survival rate.
Toxidrome of an Easily Obtainable Nootropic
Authors: Martin Robin , Buffenstein Ilana , Cho Daniel , Kiyokawa Miki 
Published: September 2023

Abstract

Purpose/Background
Phenibut (4-amino-3-phenyl-butyric acid) is a structural analog of GABA with central nervous system depressant and anxiolytic properties, developed in the former Soviet Union for anxiety, insomnia, and alcohol withdrawal. Its primary mechanism of action is believed to be a GABA-B receptor agonist—with high affinity at the α2δ subunit-containing voltage-dependent calcium channels and therefore gabapentinoid activity—as well as, to a lesser extent, GABA-A agonist activity. While not approved or regulated by the FDA, phenibut is easily obtainable online, where it is marketed as a nootropic, or cognitive enhancer. However, phenibut can lead to problems related to intoxication, dependency, and withdrawal, similar to other sedatives.

Methods/Procedures
We present a case of phenibut intoxication and withdrawal delirium that provided diagnostic and management challenges because of a patient that was initially not forthcoming about his phenibut use which resulted in five presentations to the hospital including two admissions.

Findings/Results
Initial differential including adrenergic, serotonergic or anticholinergic toxidrome based on clinical picture and history reported at that time, however phenibut use of 50 g daily was eventually revealed, an amount exceeding the highest reported cases in our review of the English literature.

Implications/Conclusions
High-dose phenibut intoxication and withdrawal can appear as dramatic and dangerous as high-dose sedative withdrawal, however given its specified receptor affinity and binding profile we found that a pharmacotherapeutic approach targeting GABA-B, GABA-A, and gabapentenoid receptors were effective in stabilizing this patient, eventually leading to the patient's full and sustained recovery.
Comparing Longitudinal Measures of Cholinesterase as Biomarkers for Insecticide Exposure Among Latinx Children in Rural Farmworker and Urban Nonfarmworker Communities in North Carolina
Authors: Quandt Sara A. , Smith Sydney A. , Arcury Thomas A. , Chen Haiying , Hester Kirstin , Pope Carey N. , Anderson Kim A. , Laurienti Paul J. 
Published: September 2023

Objective
In a 2-group prospective design, this study compared seasonal cholinesterase levels of Latinx children in rural farmworker families and comparable urban children to assess the impact of environmental exposure to cholinesterase-inhibiting insecticides.

Methods
Quarterly blood samples and passive dosimeter wristbands were collected over 2 years in 8-year-old children (74 rural, 62 urban). Laboratory analysis assessed total cholinesterase, acetylcholinesterase, and butyrylcholinesterase from blood samples, and insecticides from wristbands.

Results
In spring and summer, total cholinesterase and acetylcholinesterase levels were depressed in rural children compared with winter and fall. Butyrylcholinesterase was depressed in rural children in fall compared with spring and summer. Adjustment for insecticide exposure did not affect these associations.

Conclusions
Environmental exposures to cholinesterase-inhibiting insecticides have measurable biochemical effects on blood cholinesterases in rural children from farmworker families.
Artificial intelligence-based prediction of molecular and genetic markers for hepatitis C–related hepatocellular carcinoma
Authors: Colak Cemil , Kucukakcali Zeynep , Akbulut Sami 
Published: September 2023

Background:Hepatocellular carcinoma (HCC) is the main cause of mortality from cancer globally. This paper intends to classify public gene expression data of patients with Hepatitis C virus-related HCC (HCV+HCC) and chronic HCV without HCC (HCV alone) through the XGboost approach and to identify key genes that may be responsible for HCC.Methods:The current research is a retrospective case–control study. Public data from 17 patients with HCV+HCC and 35 patients with HCV-alone samples were used in this study. An XGboost model was established for the classification by 10-fold cross-validation. Accuracy (AC), balanced accuracy (BAC), sensitivity, specificity, positive predictive value, negative predictive value, and F1 score were utilized for performance assessment.Results:AC, BAC, sensitivity, specificity, positive predictive value, negative predictive value, and F1 scores from the XGboost model were 98.1, 97.1, 100, 94.1, 97.2, 100, and 98.6%, respectively. According to the variable importance values from the XGboost, the HAO2, TOMM20, GPC3, and PSMB4 genes can be considered potential biomarkers for HCV-related HCC.Conclusion:A machine learning-based prediction method discovered genes that potentially serve as biomarkers for HCV-related HCC. After clinical confirmation of the acquired genes in the following medical study, their therapeutic use can be established. Additionally, more detailed clinical works are needed to substantiate the significant conclusions in the current study.
Self-esteem and optimism in patients with major depression disorder: a cross-sectional study
Authors: Yavari Saeed , Radfar Moloud , Faraji Navid , Goli Rasoul , Bagherzadi Aynaz , Atharifar Reza , Kazemi Sahar , Dadashi Maryam 
Published: September 2023

Background:Depressive disorders are common mental illnesses characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities. Self-esteem refers to the appraisal of one’s worth and personality, whereas optimism reflects a positive attitude and the expectation of positive outcomes. Therefore, the present study aims to determine the average self-esteem and optimism of patients with depression in 2022.Methods:The present study is a single center and prospective descriptive-analytical study in which 121 patients out of 154 participants with major depression using convenience sampling were studied. Recruitment started on 10 June 2022 and ended on 12 July 2022. Data were collected using a demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Revised Life Orientation Test (LOT -R). Data analysis was performed using statistical tests and the Pearson correlation coefficient with SPSS software version 21.Results:The mean and SD of patients’ self-esteem scores were 14.68±1.30, and the mean and SD for optimism scores were 9.90±1.68. Pearson correlation analysis showed that educational level had a significant inverse relationship with patients’ self-esteem scores (r=−0.009,P=0.03), and sex had a significant relationship with patients’ optimism scores (r=0.175,P=0.008).Conclusion:Considering the importance of self-esteem and optimism in the recovery and return to society of patients with major depression, it is necessary to take measures to strengthen and increase self-esteem and optimism in these patients.
Serum and Tissue Lipocalin-2 Expression in Chronic Kidney Disease Pruritic Patients
Authors: Bazid Heba A. S. , Sakr Hanaa G. , Abdallah Rania A. , Arafat Eman S. , Ragheb Ahmed , Seleit Iman 
Published: September 2023

Background:
Uremic pruritus is an irritating symptom for patients with end-stage kidney disease. Lipocalin-2 (LCN2) has relevant importance in several biological cellular processes and immunity. It is also a major player in the progression of many disorders, such as renal injury.

Aim:
To evaluate LCN2 expression in chronic kidney disease (CKD) pruritic patients in serum together with immunohistochemical expression in skin samples and further correlation of their results with the studied clinicopathologic parameters.

Materials and Methods:
Serum level of LCN2 (assessed by enzyme-linked immunosorbent assay) and skin immunohistochemical expression were investigated in 25 CKD patients and 25 healthy controls. Ten patients were subjected to narrowband ultraviolet B phototherapy for 12 weeks then re-evaluated for serum and tissue LCN2 after therapy.

Results:
LCN2 expression was increased significantly in both the epidermis and dermal adnexa in CKD patients over controls. Also, serum LCN2 level was higher in patients than in healthy subjects and was significantly associated with itching severity, grades of CKD, urea, and creatinine serum level. Tissue and serum levels of LCN2 were significantly diminished in CKD patients following narrowband therapy along with improvement of the severity of pruritus.

Conclusions:
The increased serum and tissue LCN2 expression in CKD pruritic patients and its pronounced decrease, in addition to the improvement of pruritus after treatment, suggest a major pathogenic role of LCN2 in uremic pruritus.
Prepectoral Direct-to-Implant versus Staged Tissue Expander Breast Reconstruction: A Comparison of Complications
Authors: Finkelstein Emily R. , Laureano Natalia Vidal , Azizi Armina , Smartz Taylor , Zheng Caiwei , Lessard Anne-Sophie , Panthaki Zubin , Oeltjen John , Kassira Wrood 
Published: September 2023

Background:
Direct-to-implant (DTI) reconstruction has multiple advantages over a staged tissue expander (TE) approach. However, its use may be limited by concerns of increased complications. This study is the largest series to date comparing postoperative outcomes for DTI versus TE reconstruction in the prepectoral plane.

Methods:
The authors retrospectively reviewed 348 patients who underwent 536 total immediate, prepectoral implant-based breast reconstructions between January of 2018 and December of 2021. The authors compared the presence of risk factors and the rate of six separate complications between patients who underwent DTI versus TE reconstruction up to 1 year after surgery.

Results:
Of 348 patients, 147 (42%) and 201 (58%) underwent TE and DTI reconstruction (P = 0.1813), respectively. The overall infection rate was 16.4% (n = 57). DTI patients had a significantly greater incidence of wounds (P < 0.0001), including minor (P < 0.0011) and major wounds (P < 0.0053). Significantly greater mastectomy resection weights were found for DTI patients who experienced any complication (P < 0.0076), postoperative wounds (P < 0.0001), and major wounds specifically (P < 0.0035). Compared with medium-thickness acellular dermal matrix (ADM), extra thick ADM was associated with significantly increased rates of infection (P < 0.0408) and wounds (P < 0.0001).

Conclusions:
Prepectoral DTI reconstruction in patients with adequate flap perfusion may have complication rates comparable to staged TE reconstruction, apart from a higher incidence of postoperative wounds. Greater mastectomy resection weights and thickness of ADM may specifically contribute to infection and wound-healing complications. Prepectoral DTI reconstruction is encouraged in the patients with adequate flap perfusion and moderate to low mastectomy resection weights who desire comparable or smaller implant volumes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Bacterial Lipoteichoic Acid Induces Capsular Contracture by Activating Innate Immune Response
Authors: Ahmad Ikram , Xuan Tianfan , Wang Qiang , Zhang Simin , Wang Lu , Gu Jianying , Qi Fazhi , Luan Wenjie 
Published: September 2023

Background:
Capsular contracture is attributed to an exaggerated fibrosis response within the capsule and is partly associated with bacterial contamination in situ. However, the cellular mechanisms that initiate this response are unclear.

Methods:
The authors developed a mouse model of capsular contracture by repeated injection of 10 μg/mL lipoteichoic acid (LTA). The histological changes in the capsule tissue were measured by hematoxylin and eosin, Masson trichrome, and immunohistochemical staining. The expression of cytokines was measured by quantitative reverse transcription polymerase chain reaction. The authors also used pharmacological methods to verify the roles of macrophages and toll-like receptor 2 (TLR2) signaling in this pathological process.

Results:
The authors discovered that repeated LTA injection, at a low concentration, could induce thickening of the capsule tissue. Macrophage infiltration and TLR2/nuclear factor-κB signaling activated in this process could be suppressed by macrophage depletion or TLR2 receptor inhibition.

Conclusion:
As TLR2 signal activation was found to cause capsular contracture by inducing macrophage infiltration as a consequence of trace amounts of LTA contamination in situ, this target is helpful for understanding that chronic or repeated subclinical infection can activate capsular contracture.

Clinical Relevance Statement:
This finding is of significant importance for understanding that chronic or repeated subclinical infection could activate a persistent immune response and capsular contracture, and provides novel strategies to interfere with the formation of capsular contracture.
Speech Outcomes and Rates of Secondary Speech Surgery from Childhood to Skeletal Maturity following Modified Furlow Palatoplasty
Authors: Salinero Lauren K. , Wagner Connor S. , Barrero Carlos E. , Valenzuela Zachary D. , McCormack Susan M. , Solot Cynthia , Cohen Marilyn , Kirschner Richard E. , Low David W. , Jackson Oksana A. 
Published: September 2023

Background:
This study updates the authors’ institutional experience with modified Furlow palatoplasty, evaluating speech outcomes and incidence of secondary speech surgery throughout development and at skeletal maturity.

Methods:
Nonsyndromic patients undergoing primary modified Furlow palatoplasty between 1985 and 2005 with postoperative speech evaluations were reviewed retrospectively. Secondary speech surgery and Pittsburgh Weighted Speech Scale (PWSS) scores before secondary speech or orthognathic operations were assessed in the groups aged 5 to 7 years, 8 to 11 years, 12 to 14 years, and older than 15 years and analyzed by Veau cleft type.

Results:
A total of 551 patients with 895 total speech assessments were analyzed. Of 364 patients followed up to age 15 years or older, 19.8% underwent secondary speech surgery. Speech assessment of patients aged 15 years or older without prior secondary speech surgery showed competent velopharyngeal mechanisms in 77% of patients. PWSS nasal emission scores were worse in the 5- to 7-year age range (P = 0.02), whereas resonance scores remained stable throughout development (P = 0.2). Patients with Veau type I or II clefts had worse overall PWSS classifications in the groups aged 5 to 7 years and 8 to 11 years (P = 0.01 and P = 0.03), with greater odds of secondary speech surgery relative to those with Veau type III (OR, 2.9; P < 0.001) or IV clefts (OR, 3.6; P = 0.001).

Conclusions:
Most patients undergoing primary modified Furlow palatoplasty do not require secondary speech surgery and achieve socially acceptable speech at skeletal maturity. However, Veau type I and II clefts are associated with increased risk for early velopharyngeal dysfunction and secondary speech surgery. The incidence of secondary speech surgery was 19.8%, an increase from our previously reported rate of 8%.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.