bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes of undergraduate medical students toward patients’ safety in Jordan: a multi-center cross-sectional study
Authors: Al-Sawalha Ibrahim , Jaloudi Nebras , Zaben Shaima’ , Hamamreh Rawan , Awamleh Hala , Al-Abbadi Sondos , Abuzaid Leen , Abu-Ekteish Faisal 
Published: September 2023

Abstract
Background
Patient safety practices are crucial in healthcare as they aim to reduce harm, medical errors, and ensure favorable outcomes for patients. Therefore, this study aims to examine the attitudes towards patient safety among undergraduate medical students in Jordanian medical schools.

Methods
A descriptive cross-sectional study was conducted among undergraduate medical students. Participants completed the Attitudes to Patient Safety Questionnaire- III (APSQ-III), which examines students’ attitudes in 26 items distributed in nine domains. Results are represented as mean ± standard deviation for all participants and subgroups.

Results
Our study included 1226 medical students. They reported positive attitudes toward patient safety with a mean score of 4.9 (SD ± 0.65). Participants scored the highest score in “Working hours as error cause” followed by “Team functioning”. Gender, academic-year, and first-generation student status had a significant association with certain patient safety domains. Females scored significantly higher than males in four domains, while males scored higher in one domain. First-generation medical students had a significantly lower score for “Professional incompetence as error cause”. Interestingly, pre-clinical students recorded more positive attitudes in “Patient safety training received” and “Disclosure responsibility” domains.

Conclusion
Undergraduate medical students in Jordan demonstrated positive attitudes towards patient safety concepts. Our study provides baseline data to improve current educational programs and enhance the patient safety culture among medical students. Additional studies are needed to delve into actual attitudes toward patient safety and to assess how educational programs contribute to the cultivation of this culture.
Hip circumference has independent association with the risk of hyperuricemia in middle-aged but not in older male patients with type 2 diabetes mellitus
Authors: Lu Wenyi , Zhao Xuan , Sheng Jinye , Zhao Xuelin , Tang Qingya , Zhang Hongmei , Feng Yi , Niu Yang 
Published: September 2023

Abstract
Background
Obesity and type 2 diabetes mellitus (T2DM) are risk factors for hyperuricemia. However, which anthropometric indices can better predict incident hyperuricemia in patients with T2DM remains inconsistent. This study aimed to examine the associations between hyperuricemia and different anthropometric indices in middle-aged and older male patients with T2DM.

Methods
In this retrospective study, a total of 1447 middle-aged (45—65 years, n = 791) and older (≥ 65 years, n = 656) male patients with T2DM were collected from December 2015 to January 2020 at Shanghai Xinhua Hospital. Hyperuricemia was defined as a serum uric acid level above 7.0 mg/dL. Weight, height, waist circumference (WC) and hip circumference (HC) were measured by trained nurses at visit.

Results
The median uric acid level of subjects was 5.6 (interquartile ranges: 4.7—6.7) mg/dl, and 279 (19.3%) were hyperuricemia, with 146 (18.5%) in the middle-aged group, and 133 (20.3%) in the older group. After adjusting for age, duration of T2DM, fasting plasma glucose and insulin, homeostasis model assessment-β, aspartate aminotransferase, triglycerides, high-density lipoprotein cholesterol and estimated glomerular filtration rate, body mass index (BMI), WC, HC, and waist-to-height ratio (WHtR) were associated with a higher risk of hyperuricemia in both middle-aged and older group (P < 0.05). After further adjusting for BMI and WC, HC still showed a positive relationship with the risk of hyperuricemia (Odds Ratio = 1.51, 95% confidence intervals: 1.06—2.14) in the middle-aged group, but such relationship was not found in the older group. Moreover, according to receiver operating characteristic analysis, the optimal cutoff value was 101.3 cm of HC for hyperuricemia screening in the middle-aged male patients with T2DM.

Conclusion
In middle-aged male patients with T2DM, more attention should be paid to HC with the cutoff value of 101.3 cm in clinical practice for early recognition of individuals with a high risk of hyperuricemia for targeted guidance on disease prevention, such as community screening.
Plan robustness analysis for threshold determination of SGRT-based intrafraction motion control in 3DCRT breast cancer radiation therapy
Authors: Sauer Tim-Oliver , Stillkrieg Wilhelm , Ott Oliver J. , Fietkau Rainer , Bert Christoph 
Published: September 2023

Abstract
Purpose
The goal of this study was to obtain maximum allowed shift deviations from planning position in six degrees of freedom (DOF), that can serve as threshold values in surface guided radiation therapy (SGRT) of breast cancer patients.

Methods
The robustness of conformal treatment plans of 50 breast cancer patients against 6DOF shifts was investigated. For that, new dose distributions were calculated on shifted computed tomography scans and evaluated with respect to target volume and spinal cord dose. Maximum allowed shift values were identified by imposing dose constraints on the target volume dose coverage for 1DOF, and consecutively, for 6DOF shifts using an iterative approach and random sampling.

Results
Substantial decreases in target dose coverage and increases of spinal cord dose were observed. Treatment plans showed highly differing robustness for different DOFs or treated area. The sensitivity was particularly high if clavicular lymph nodes were irradiated, for shifts in lateral, vertical, roll or yaw direction, and showed partly pronounced asymmetries. Threshold values showed similar properties with an absolute value range of 0.8 mm to 5 mm and 1.4° to 5°.

Conclusion
The robustness analysis emphasized the necessity of taking differences between DOFs and asymmetrical sensitivities into account when evaluating the dosimetric impact of position deviations. It also highlighted the importance of rotational shifts, especially if clavicular lymph nodes were irradiated. A practical approach of determining 6DOF shift limits was introduced and a set of threshold values applicable for SGRT based patient motion control was identified.
Patient-related risk factors of prosthetic joint infections following total hip and knee arthroplasty at King Abdulaziz Medical City, a 10-year retrospective study
Authors: Aljuhani Wazzan S. , Alanazi Abdullah M. , Saeed Abdullah I. , Alhadlaq Khalid H. , Alhoshan Yazeed S. , Aljaafri Ziad A. 
Published: September 2023

Abstract
Background
Total joint arthroplasty (TJA) can be associated with the development of periprosthetic joint infection (PJI). It is necessary to determine the modifiable and non-modifiable risk factors of PJI to provide optimum healthcare to TJA candidates.

Methods
This single-center retrospective review investigated 1198 patients who underwent TJA from 2012 to 2022. The data analysis comprised two stages. The first stage was a descriptive analysis, while the second stage was a bivariate analysis. The sociodemographic data, medical history, operative details, and presence of PJI postoperatively were evaluated.

Results
The study sample consisted of 1198 patients who underwent TJA. The mean patient age was 63 years. Among the patients, only 1.3% had PJI. No comorbidity was significantly related to PJI. General anesthesia was used in almost 21% of the patients and was significantly associated with a higher risk of infection (p = 0.049). An increased operative time was also significantly related to PJI (p = 0.012). Conversely, tranexamic acid (TXA) administration was a protective factor against PJI (p = 0.017).

Conclusion
Although PJI is not a common complication of TJA, multiple risk factors such as general anesthesia and prolonged operative time play a significant role in its development. In contrast, TXA administration is thought to reduce the risk of PJI effectively.
Innovative thinking of clinical investigation for rare disease drug development
Authors: Wang Peijin , Chow Shein-Chung 
Published: September 2023

AbstractFor the development of a test treatment or drug product, it is necessary to conduct composite hypothesis testing to test for effectiveness and safety simultaneously, since some approved drug products have been recalled due to safety concerns. One of the major issues in conducting a composite hypothesis testing for effectiveness and safety is the requirement of a huge sample size to achieve the desired power for detecting clinically meaningful differences in both safety and effectiveness. Situation can be much difficult in orphan drug development. In this article, a generalized two-stage innovative approach to test for effectiveness and safety simultaneously is proposed. Additionally, to alleviate the requirement of a large randomized clinical trial (RCT) and revealing effectiveness, real-world data is suggested to use in conjunction with RCT data for orphan drug development. The proposed approach can help investigators test for effectiveness and safety at the same time without worrying about the sample size. It also helps reduce the probability of approving a drug product with safety concerns.
Sclerosing angiomatoid nodular transformation of the spleen in a child with anemia: a case report and review of the literature
Authors: Soleimani Neda , Geramizadeh Bita , Anbardar Mohammad Hossein , Bahador Ali , Safavi Dornaz , Mohammadzadeh Sahand , Kasaee S. Saeed , Ayoub Abbas 
Published: September 2023

AbstractBackgroundSclerosing angiomatoid nodular transformation of the spleen is a relatively rare benign vascular lesion in both adult and pediatric age groups with unclear etiopathogenesis and variable clinical presentations. Many benign and also malignant splenic masses could mimic sclerosing angiomatoid nodular transformation, both clinically and radiologically. Herein, we report our experience with a case of sclerosing angiomatoid nodular transformation in a 3-year-old girl.Case reportA 3-year-old Iranian girl presented with abdominal pain, back pain, and constipation for 2 weeks. She was being followed up by a pediatrician due to her short stature and persistent anemia. Physical examination showed stable vital signs, short stature, pallor, and a puffy face. Laboratory evaluation showed normochromic normocytic anemia with a normal reticulocyte count, ferritin, and hemoglobin electrophoresis. Radiologic assessments revealed a hypoechoic lesion in the spleen with high vascularity, clinically suspected to be lymphoma. She was operated on, and after partial splenectomy, pathologic evaluation of the spleen showed a solitary, well-demarcated, and unencapsulated dark mass. Microscopic examination revealed micronodular appearance composed of irregular-shaped vascular spaces lined by plump endothelial cells and surrounded by concentric collagen fibers, features in keeping with sclerosing angiomatoid nodular transformation. The patient’s anemia was resolved after surgery, and no clinical or radiologic deficits were noted during the 10-month follow-up visits.ConclusionAlthough sclerosing angiomatoid nodular transformation is exceedingly rare in children, it should be considered a differential diagnosis in pediatric splenic neoplasms with concurrent hematologic manifestations, such as anemia.
Will we ever eradicate animal tuberculosis?
Authors: Gortázar Christian , de la Fuente José , Perelló Alberto , Domínguez Lucas 
Published: September 2023

AbstractTwo characteristics of the Mycobacterium tuberculosis complex (MTC) are particularly relevant for tuberculosis (TB) epidemiology and control, namely the ability of this group of pathogens to survive in the environment and thereby facilitate indirect transmission via water or feed, and the capacity to infect multiple host species including human beings, cattle, wildlife, and domestic animals other than cattle. As a consequence, rather than keeping the focus on certain animal species regarded as maintenance hosts, we postulate that it is time to think of complex and dynamic multi-host MTC maintenance communities where several wild and domestic species and the environment contribute to pathogen maintenance. Regarding the global situation of animal TB, many industrialized countries have reached the Officially Tuberculosis Free status. However, infection of cattle with M. bovis still occurs in most countries around the world. In low- and middle-income countries, human and animal TB infection is endemic and bovine TB control programs are often not implemented because standard TB control through testing and culling, movement control and slaughterhouse inspection is too expensive or ethically unacceptable. In facing increasingly complex epidemiological scenarios, modern integrated disease control should rely on three main pillars: (1) a close involvement of farmers including collaborative decision making, (2) expanding the surveillance and control targets to all three host categories, the environment, and their interactions, and (3) setting up new control schemes or upgrading established ones switching from single tool test and cull approaches to integrated ones including farm biosafety and vaccination.
Hermite–Hadamard type inequalities for multiplicatively harmonic convex functions
Authors: Özcan Serap , Butt Saad Ihsan 
Published: September 2023

AbstractIn this work, the notion of a multiplicative harmonic convex function is examined, and Hermite–Hadamard inequalities for this class of functions are established. Many inequalities of Hermite–Hadamard type are also taken into account for the product and quotient of multiplicative harmonic convex functions. In addition, new multiplicative integral-based inequalities are found for the quotient and product of multiplicative harmonic convex and harmonic convex functions. In addition, we provide certain upper limits for such classes of functions. The obtained results have been verified by providing examples with included graphs. The findings of this study may encourage more research in several scientific areas.
Establishment of a Zimbabwe National SME sector: a major priority to enhance the performance of the national economy
Authors: Musabayana Godfrey Tambudzayi , Mutambara Emmanuel , Ngwenya Tony 
Published: September 2023

AbstractA sound administration strategy is an effective tool to improve the performance SMEs. The establishment of a national SME sector will assist in the implementation, monitoring and evaluation of programmes that aim to improve the performance of SMEs. The administration of the SMEs by the Ministry of Women affairs, Community and Small and Medium Enterprises Development has failed to improve the performance of SMEs. This study established that the administration of SMEs by the ministry lacks value addition and value creation, technological innovation and research and development and it is disjointed from the implementers, hence the need to establish a new Zimbabwe National SME sector which can improve the performance of SMEs. The mixed method research was used in the study following the sequential exploratory strategy which employed both qualitative and quantitative data collection methods. The study followed the dominant sequential mixed strategy which collected data in two phases. The findings of the study will assist the government to establish a new SME sector that will address the plight of the SMEs. From the study, the researcher deduces that the ministry responsible for SMEs is overwhelmed with responsibilities and is not reaching out to the SMEs. The researcher proposed the structure of a new Zimbabwe National SME sector that focusses on the improvement of SME performance.
High return to sports rates after operative treatment of patella fractures
Authors: Pesch Sebastian , Greve Frederik , Zyskowski Michael , Müller Michael , Crönlein Moritz , Biberthaler Peter , Kirchhoff Chlodwig , Wurm Markus 
Published: September 2023

Abstract
Background
Patella fractures are relatively rare fractures and only little is known about the postoperative return to sports after patella fractures.

Methods
This retrospective study presents information on functional outcome after operative treatment of patella fractures as well as time until return to sports and patients’ complaints after open-reduction internal-fixation (ORIF) of patella fractures.

Results
Overall, 39 patients after ORIF of patella fractures were evaluated at our Level-I trauma center with a mean follow-up of 42 months. The mean time until return to sports was 7 ± 3.9 months. No significant difference was found for functional outcome with respect to body mass index (BMI) or age. Fracture consolidation was accomplished after a mean of 6.9 ± 2.9 months besides a relatively low complication rate of 5.1% (n = 2).

Conclusion
The results demonstrate a high return to sports rate of 90.3%. However, only 51.6% were able to perform sports on their pre-injury level or above.
Trial Registration The study was retrospectively registered at DRKS (No: DRKS00031146).
Influence of perioperative blood pressure regulation on postoperative delirium in patients undergoing head and neck free flap reconstruction
Authors: Ooms Mark , Schooß Ruth , Winnand Philipp , Heitzer Marius , Hölzle Frank , Bickenbach Johannes , Rieg Annette , Modabber Ali 
Published: September 2023

Abstract
Background
Postoperative delirium (POD) is a serious complication in patients undergoing microvascular head and neck reconstruction. Whether intraoperative and postoperative blood pressure regulation are risk factors for POD remains unclear. This study aimed to highlight the relationships between intraoperative and postoperative blood pressure regulation and POD in microvascular head and neck reconstruction.

Methods
Data from 433 patients who underwent microvascular head and neck reconstruction at our department of oral and maxillofacial surgery between 2011 and 2019 were retrospectively analyzed. The 55 patients with POD were matched with 55 patients without POD in terms of tracheotomy, flap type, and flap location, and the intraoperative and postoperative systolic and mean blood pressure values were compared between the two groups.

Results
Patients with POD showed lower intraoperative and postoperative minimum mean arterial pressure (MAP) values than patients without POD (60.0 mmHg vs. 65.0 mmHg, p < 0.001; and 56.0 mmHg vs. 62.0 mmHg, p < 0.001; respectively). A lower intraoperative minimum MAP value was identified as predictor for POD (odds ratio [OR] 1.246, 95% confidence interval [CI] 1.057–1.472, p = 0.009). The cut-off value for intraoperative MAP for predicting POD was  ≤ 62.5 mmHg (area under the curve [AUC] 0.822, 95% CI 0.744–0.900, p < 0.001).

Conclusions
Maintaining a stable intraoperative minimum MAP of  > 62.5 mmHg could help to reduce the incidence of POD in microvascular head and neck reconstruction.
Understanding the phenomenon of food waste valorisation from the perspective of supply chain actors engaged in it
Authors: Rao Madhura , Bast Aalt , de Boer Alie 
Published: September 2023

AbstractThe repurposing of surplus food and food processing by-products is a key aspect of the shift towards a circular bioeconomy. In the Netherlands, food supply chain actors are already working towards making better use of agri-food surpluses to improve food security and resource efficiency. By analysing the experiences of these actors, this study aims to identify the current state of the sector and highlight barriers and enablers of successful food waste valorisation. Based on a phenomenological analysis of 16 in-depth unstructured interviews with participants from the Netherlands, we empirically demonstrate that supply chain actors involved in food waste valorisation consider local embedding, societal perception, and food safety to be important aspects of their work. They often grapple with legislative and logistical uncertainties and face various ethical dilemmas such as having to pay for products that were once considered waste. Building on these findings, we propose that experienced professionals with a penchant for sustainability can play the role of ‘transition brokers’ as the food system moves towards a circular way of operating. We also posit that private standards and voluntary agreements could be a way for the sector to better manage the various bottlenecks that are characteristic of food waste valorisation endeavours.
Modelling acquired resistance to DOT1L inhibition exhibits the adaptive potential of KMT2A-rearranged acute lymphoblastic leukemia
Authors: Schneider Pauline , Crump Nicholas T. , Arentsen-Peters Susan T.C.J.M. , Smith Alastair L. , Hagelaar Rico , Adriaanse Fabienne R.S. , Bos Romy S. , de Jong Anja , Nierkens Stefan , Koopmans Bianca , Milne Thomas A. , Pieters Rob , Stam Ronald W. 
Published: September 2023

AbstractIn KMT2A-rearranged acute lymphoblastic leukemia (ALL), an aggressive malignancy, oncogenic KMT2A-fusion proteins inappropriately recruit DOT1L to promote leukemogenesis, highlighting DOT1L as an attractive therapeutic target. Unfortunately, treatment with the first-in-class DOT1L inhibitor pinometostat eventually leads to non-responsiveness. To understand this we established acquired pinometostat resistance in pediatric KMT2A::AFF1+ B-ALL cells. Interestingly, these cells became mostly independent of DOT1L-mediated H3K79 methylation, but still relied on the physical presence of DOT1L, HOXA9 and the KMT2A::AFF1 fusion. Moreover, these cells selectively lost the epigenetic regulation and expression of various KMT2A-fusion target genes such as PROM1/CD133, while other KMT2A::AFF1 target genes, including HOXA9 and CDK6 remained unaffected. Concomitantly, these pinometostat-resistant cells showed upregulation of several myeloid-associated genes, including CD33 and LILRB4/CD85k. Taken together, this model comprehensively shows the adaptive potential of KMT2A-rearranged ALL cells upon losing dependency on one of its main oncogenic properties.