bluuebunny/crossref_metadata_2025_split huggingface dataset:
Illuminating a Path Forward for Tobacco Nation: Projected Impacts of Recommended Policies on Geographic Disparities
Authors: Maciosek Michael V. , Donovan Emily M. , LaFrance Amy B. , Schillo Barbara A. 
Published: September 2023

Introduction This study quantifies the impacts of strengthening 2 tobacco control policies in “Tobacco Nation,” a region of the United States (U.S.) with persistently higher smoking rates and weaker tobacco control policies than the rest of the US, despite high levels of support for tobacco control policies. Methods We used a microsimulation model, ModelHealthTM:Tobacco, to project smoking-attributable (SA) outcomes in Tobacco Nation states and the U.S. from 2022 to 2041 under 2 scenarios: (1) no policy change and (2) a simultaneous increase in cigarette taxes by $1.50 and in tobacco control expenditures to the CDC-recommended level for each state. The simulation uses state-specific data to simulate changes in cigarette smoking as individuals age and the health and economic consequences of current or former smoking. We simulated 500 000 individuals for each Tobacco Nation state and the U.S. overall, representative of each population. Results Over the next 20 years, without policy changes, disparities in cigarette smoking will persist between Tobacco Nation and other U.S. states. However, compared to a scenario with no policy change, the simulated policies would lead to a 3.5% greater reduction in adult smoking prevalence, 2361 fewer SA deaths per million persons, and $334M saved in healthcare expenditures per million persons in Tobacco Nation. State-level findings demonstrate similar impacts. Conclusions The simulations indicate that the simulated policies could substantially reduce cigarette smoking disparities between Tobacco Nation and other U.S. states. These findings can inform tobacco control advocacy and policy efforts to advance policies that align with evidence and Tobacco Nation residents’ wishes.
Environmental justice for whom? Citizen participation and brownfield redevelopment in downtown Birmingham, Alabama
Authors: Cutts Sandra , Fricano Russell , Peters Robert 
Published: September 2023

Environmental legislation promotes citizen participation in the environmental review process through public hearings, community meetings, and advisory groups. However, environmental justice literature advocates higher levels of grassroots citizen empowerment through education and involvement in the decision-making process. Numerous research studies indicated that although the federal government supports community involvement in environmental restoration projects, such involvement has never been implemented to its fullest potential. This case study examines citizen participation and empowerment in the environmental review process in the redevelopment of three brownfields in underserved neighborhoods in downtown Birmingham, Alabama. This study quantifies empowerment leveraging Arnstein's ladder of participation in a novel approach. Utilizing a survey questionnaire, this analysis was conducted in three ways: a comparison of actual citizen participation methods used in the process with those providing a higher level of empowerment; compilation of open-ended responses of citizen dissatisfaction with the environmental review process; and utilizing Arnstein's Ladder to measure perceived levels of empowerment of citizen, public official, and developer stakeholders. Findings suggest that the types of participation methods used were at lower levels of citizen empowerment removed from decision-making; in responses to open-ended questions, citizens expressed shortcomings in the participatory process compared with their opinion on how it should be conducted, and perceived levels of empowerment differed among the categories of stakeholders. Citizens reported perceptions of empowerment at levels of tokenism removed from decision-making, while developers and public officials reported higher levels of empowerment. This study concludes that more innovative citizen participation techniques, university/community partnerships, and collaborative compact models are needed for more equitable participation.Statement of Problem—The purpose of this case study is to analyze how well citizen participation in the environmental review process as specified by legislation corresponds to normative guidelines prescribed in the environmental justice literature.
Psychometric Properties of LUN-MS: A New Questionnaire to Identify the Unmet Needs of People With Multiple Sclerosis
Authors: Mohamed Abu Baker Amin , Moore Harriet , Baster Kathleen , Hobson Esther , Paling David , Sharrack Basil , Nair Krishnan Padmakumari Sivaraman 
Published: September 2023

Background: We developed a 29-item Questionnaire, Long-term Unmet Needs in MS (LUN-MS) to identify the unmet needs of people with multiple sclerosis (pwMS). Objective: To assess acceptability, test-retest reliability, internal consistency, and validity of the LUN-MS. Methods: Participants completed the LUN-MS and MSIS-29 twice, four weeks apart. Acceptability was assessed by looking at the response rate in each time point. Reliability was calculated by comparing the response during the two time points using Cohen’s weighted kappa. Using principal component analysis, the dimensionality of the questionnaire’s items was reduced, to five domains and the internal consistency of each domain was assessed using Cronbach’s alpha. Concurrent validity was tested by comparing the total LUN-MS score against MSIS-29 and EQ-5D-3L using Pearson’s product-moment correlation coefficient. Results: Among 88 participants, rate of completion at time points-1 and 2 was 96 and 80% respectively. Test-retest reliability for individual items was between fair to near-perfect (weighted Cohen’s kappa 0.39-0.81). The unmet needs could be divided into five internally consistent domains (Cronbach’s alpha 0.83-0.74): neuropsychological, ambulation, physical, interpersonal relationship and informational. Concurrent validity with MSIS-29 ( r = 0.705, P < .001) and EQ-5D-3L ( r = 0.617, P < .001) were good. Conclusion: LUN-MS is a reliable, valid, and acceptable tool to identify the unmet needs of pwMS.
Sleep duration in schooldays is associated with health-related quality of life in norwegian adolescents: a cross-sectional study
Authors: Grasaas Erik , Rohde Gudrun , Haraldstad Kristin , Helseth Sølvi , Småstuen Milada Cvancarova , Skarstein Siv , Mikkelsen Hilde Timenes 
Published: September 2023

Abstract
Background
Insufficient sleep is commonly reported in adolescence and is negatively associated with a wide range of health outcomes. A way to grasp the complicated challenge of how sleep impact different aspects of the adolescents´ everyday life is by examining the relationship between sleep duration in schooldays and weekends on different health-related quality of life (HRQOL) subscales. Furthermore, to expand the understanding of possible underlying mechanisms between sleep and HRQOL, testing for self-efficacy as a possible mediator is of importance.

Methods
A cross-sectional study was performed among 696 adolescents aged 13–15 years from a school-based setting. All participants completed an electronic survey in their respective classrooms. The survey included demographic data, the School Sleep Habits Survey, the KIDSCREEN-27 questionnaire measuring HRQOL, and the General Perceived Self-Efficacy Scale. Statistical analyses were conducted using SPSS Statistics software including PROCESS macro by Andrew Hayes.

Results
Our findings revealed overall similar sleep patterns in boys and girls including longer sleep duration in the study sample during weekends (10:09 h) than in schooldays (08:36 h). Regression analyses revealed that sleep duration in schooldays was positively and statistically associated with HRQOL subscales psychological well-being (95% CI [0.44 to 1.33]), autonomy and parents (95% CI [0.12 to 1.06]), school environment (95% CI [0.47 to 1.40]), and self-efficacy (95% CI [0.01 to 0.47]). Sleep duration in weekends revealed no associations with the HRQOL subscales, except for the HRQOL subscale psychological well-being (95% CI [0.09 to 0.85]). Mediation analyses revealed that sleep duration in schooldays explained most of the associations (64 − 75%) in 4 out 5 HRQOL subscales, except in the association with the HRQOL subscale physical well-being revealing an indirect effect of 71.9%.

Conclusions
This cross-sectional study described sleep among Norwegian adolescents and demonstrated that sleep durations in weekends and schooldays impact HRQOL and self-efficacy, revealing overall better outcome in HRQOL and self-efficacy with sufficient sleep during schooldays. These findings support the regularity of sleep and highlight the importance of sufficient sleep during schooldays, especially in a school-based sample of adolescents.
The prevalence of elongated styloid process in the population of Barcelona: a cross-sectional study & review of literature
Authors: Assiri Ahmed Hassan , Estrugo-Devesa Albert , Roselló Llabrés Xavier , Egido-Moreno Sonia , López-López José 
Published: September 2023

Abstract
Background
Styloid process (SP) is a cylindrical bony projection that originates from the inferior part of the petrous temporal bone just anteriorly to the stylomastoid foramen. Several nerves, muscles, and ligaments are related closely to the (SP). It is considered elongated when the measurement exceeds 30 mm. The overall prevalence of the styloid process is between 3.3% to 84.4%. The elongation of the styloid process (ESP) is associated with the manifestation of Eagle’s Syndrome (ES) which is characterized by various types of pain in the head and neck region such as headache, tinnitus, otalgia, and trigeminal neuralgia. Eagle’s syndrome occurs in 4–10.3% of individuals with an elongated styloid process (ESP). The objective of the study is to determine the prevalence of (ESP) in the patients who were treated in the Dental Hospital University of Barcelona (HOUB), to review the literature to spot the light on the different demographic data worldwide.

Methods
The archived panoramic image in the University of Barcelona dental Hospital were consecutively retrieved to investigate the prevalence of (ESP). Of all digital panoramic radiographs (OPG), 400 met the inclusion criteria and were furtherly analyzed. The results are correlated with the participant’s gender, age, and occurrence. Age is subcategorized into three groups. A chi-square test is used to measure the significant differences and the P-value is set at < 0.05 for the level of significance.

Results
Among the included 400, we found 291 demonstrating (ESP). The prevalence of (ESP) which exceeds 30 mm is 72.75%. It is found that the most common morphological type is type 1 which is regarded as the uninterrupted (ESP) regardless of gender and age group. Concerning the calcification pattern, the most prevalent is the partial calcified (ESP) despite genders and age groups.

Conclusion
(OPG) is a sufficient tool for the screening of the elongated styloid process. Regarding the prevalence, our results are considered higher than previously reported prevalence in different populations using (OPG) radiography tool. A study on a wider spectrum of the Spanish population is recommended to further investigate the correlation between the elongated styloid process and the occurrence of Eagle’s syndrome.
How to assess hypercoagulability in heparin-induced thrombocytopenia? Biomarkers of potential value to support therapeutic intensity of non-heparin anticoagulation
Authors: Barocas Antoine , Savard Philippe , Carlo Audrey , Lecompte Thomas , de Maistre Emmanuel 
Published: September 2023

Abstract
Background
In case of heparin-induced thrombocytopenia (HIT), the switch to a non-heparin anticoagulant is mandatory, at a therapeutic dose. Such a treatment has limitations though, especially for patients with renal and/or hepatic failure. Candidate laboratory tests could detect the more coagulable HIT patients, for whom therapeutic anticoagulation would be the more justified.

Patients and methods
This was a monocentre observational prospective study in which 111 patients with suspected HIT were included. Nineteen were diagnosed with HIT (ELISA and platelet activation assay), among whom 10 were classified as HITT + when a thrombotic event was present at diagnosis or during the first following week. Two plasma prethrombotic biomarkers of in vivo activation of the haemostasis system, procoagulant phospholipids (ProcoagPPL) associated with extracellular vesicles and fibrin monomers (FM test), as well as in vitro thrombin potential (ST Genesia; low picomolar tissue factor) after heparin neutralization (heparinase), were studied. The results were primarily compared between HITT + and HITT- patients.

Results
Those HIT + patients with thrombotic events in acute phase or shortly after (referred as HITT+) had a more coagulable phenotype than HIT + patients without thrombotic events since: (i) clotting times related to plasma procoagulant phospholipids tended to be shorter; (ii) fibrin monomers levels were statistically significantly higher (p = 0.0483); (iii) thrombin potential values were statistically significantly higher (p = 0.0404). Of note, among all patients suspected of suffering from HIT, we did not evidence a hypercoagulable phenotype in patients diagnosed with HIT compared to patients for whom the diagnosis of HIT was ruled out.

Conclusion
The three tests could help identify those HIT patients the most prone to thrombosis.
A pediatric case series of catastrophic gastrointestinal complications of posttransplant lymphoproliferative disease with increasing incidence, high association with coronavirus disease 2019, higher mortality, and a plea for early endoscopy to prevent late fatal outcome
Authors: Keshtkar Alireza , Karbasian Fereshteh , Reihani Hamid , Atighi Farnaz , Hedayati Seyyed-Bozorgmehr , Ataollahi Maryam , Geramizadeh Bita , Dehghani Seyed Mohsen 
Published: September 2023

Abstract
Background
Posttransplant lymphoproliferative disorder is one of the most severe complications after transplantation, caused by uncontrolled proliferation of Epstein–Barr virus-positive B-cells in the setting of chronic immunosuppression. As one of the biggest transplant centers worldwide, we observed a potential increase in the number of patients with posttransplant lymphoproliferative disorder presenting with gastrointestinal symptoms in 1 year, during the coronavirus disease 2019 pandemic. There is limited information about dysregulation of the immune system following coronavirus disease 2019 infection, which may lead to Epstein–Barr virus reactivation in Epstein–Barr virus-positive B-cells and development of posttransplant lymphoproliferative disorder. Furthermore, there is no consensus in literature on a modality that can help in early diagnosis of posttransplant lymphoproliferative disorder with nonspecific gastrointestinal presentations before late and fatal complications occur.

Case presentation
Our case series includes five Iranian (Persian) patients, three female (2, 2.5, and 5 years old) and two male (2 and 2.5 years old), who developed gastrointestinal posttransplant lymphoproliferative disorder after liver transplantation. All of our patients were on a similar immunosuppressant regimen and had similar Epstein–Barr virus serologic status (seronegative at time of transplantation but seropositive at time of posttransplant lymphoproliferative disorder diagnosis). Four patients had either a positive coronavirus disease 2019 polymerase chain reaction test or exposure within the family. Although all of our patients presented with nonspecific gastrointestinal symptoms, four patients developed late posttransplant lymphoproliferative disorder complications such as bowel perforation and obstruction. All five patients with gastrointestinal posttransplant lymphoproliferative disorder received chemotherapy, but only two survived and currently are continuing the therapy. In one of the surviving patients, prompt endoscopic investigation resulted in early diagnosis of posttransplant lymphoproliferative disorder and a better outcome.

Conclusion
Since 80% of our patients had exposure to coronavirus, a potential relationship might be suggested between the two. Furthermore, as we witnessed in one case, urgent endoscopic investigation in immunocompromised patients presenting with gastrointestinal symptoms can improve the clinical outcomes and therefore should be considered for early diagnosis of posttransplant lymphoproliferative disorder.
Factors influencing entrepreneurial intention to initiate new ventures: evidence from university students
Authors: Martins José Moleiro , Shahzad Muhammad Farrukh , Xu Shuo 
Published: September 2023

AbstractAs worldwide unemployment is an extensive problem with the increasing population every day, job opportunities did not increase with a similar ratio. Unemployment is increasing, affecting developing countries’ economies like Pakistan. This attempt to solve this problem is commonly acknowledged by creating new opportunities and starting new business ventures. Considering this aspect, this study inspects the aspects that create and affect entrepreneurial intention in young entrepreneurs to start entrepreneurial projects. This study explores the effect of self-efficacy, family, institutional, and peer support on entrepreneurial intention. These factors are expected to create entrepreneurial intention in young graduates to start their business ventures. All these factors and the mediating role of knowledge of entrepreneurial skills, ability to take risks, and entrepreneurial innovativeness motivate young entrepreneurs to take startups. For results, a survey method with a questionnaire has been utilized to gather data. The collected data were evaluated through descriptive and inferential statistics. SPSS and SMART-PLS 3.3 were used for the analysis of results. 716 respondents participated in the data collection process. Data have been gathered from the master's students who registered in Pakistan's top business sector universities. The results of this study showed that self-efficacy, peers support, institutional support, and family support positively impact entrepreneurial intention. Additionally, knowledge of entrepreneurial skills, the ability to take risks, and entrepreneurial innovativeness also significantly affect entrepreneurial intention. In this study, all these results have been discussed. This study also discusses various theoretical and practical factors with substantial policy-making significance.
Effects of long-term consumption of two plant-based dietary supplements on cardiovascular health and low-grade inflammation in middle-aged and elderly people: study protocol for a randomised, controlled trial
Authors: Tsiountsioura Melina , Cvirn Gerhard , Meixner-Goetz Lisa , Ziegler Tobias , Lamprecht Manfred 
Published: September 2023

Abstract
Background
Ageing is a process characterised by chronic low-grade inflammation and oxidative stress which could lead to increased prevalence of both physical and mental age-related chronic conditions. A healthy balanced diet, rich in fruit and vegetables as well as omega-3 polyunsaturated fatty acids (n3 PUFA), could reduce oxidative stress and improve markers of low-grade inflammation. Nonetheless, considering that a large part of the population struggles to meet current guidelines on fruit and vegetable and n3 PUFA recommendations, fruit and vegetable concentrate supplements and mixed omega fatty acid supplements could be an effective strategy to bridge the gap between actual and recommended intakes.

Methods
In this randomised, controlled, open-labelled, parallel-grouped clinical trial, 112 participants will be allocated to one of four arms (n = 28 on each arm): an encapsulated juice powder concentrate, a plant-based omega fatty acid supplement, both or a control group. We aim to investigate whether long-term separate or combined ingestion of the two can affect biomarkers of cardiovascular health, low-grade inflammation and indicators of ageing, including cognitive function, in middle-aged and elderly people. We will additionally explore the effect of the different supplementations on plasma levels of vitamins, carotenoids and fatty acids. Intervention will last 2 years and participants will be assessed at baseline and at follow-up visits at 6, 12, 18 and 24 months.

Discussion
This study will provide evidence whether long-term, plant-based dietary supplementation can support cardiovascular health, anti-inflammatory processes, immunity and nutritional status in ageing.
Trial registration This trial was registered at ClinicalTrials.gov (NCT04763291) on February 21, 2021.
Pericardial agenesis - the wandering heart
Authors: Kalekar Tushar , Reddy Latha P. , Koganti Deepak , Soman Nikhith 
Published: September 2023

Abstract
Background
Congenital pericardial absence is an uncommon cardiac anomaly that is typically asymptomatic and commonly misdiagnosed due to a lack of symptoms or atypical symptoms. Pericardial agenesis (PA) should be considered one of the differential diagnoses when the patient presents with chest pain. This case shows how the diagnosis of pericardial agenesis is made exclusively using multi-modality imaging, starting from findings in a basic chest radiograph to cardiac MRI, while also demonstrating the classic signs seen in this condition. Magnetic resonance imaging of the heart is the gold standard for determining the absence of pericardium in the prognosis.

Case presentation
A 32-year-old male who presented with chest discomfort and radiating pain to his back and left shoulder mimicking myocardial infarction with normal ECG and enzyme markers. A chest radiograph (taken 24 h apart) demonstrates the left lateral position of the heart and the bulging contour of the left heart border, a lucent area between the aorta and pulmonary artery. Subsequently, cardiac MRI reveals left pericardial agenesis.

Conclusions
This article provides insight into a rare differential to consider in a young patient presenting with chest discomfort. This case shows how the diagnosis of pericardial agenesis is made exclusively using multi-modality imaging, starting from findings in a basic chest radiograph to cardiac MRI, while also demonstrating the classic signs seen in this condition.