bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding Binge Drinking Quitting Intention and Behaviour Using an Extended TPB
Authors: Machaka-Mare Zivai M. , Mpinganjira Mercy , Maduku Daniel K. 
Published: April 2023

Background Binge drinking is a social problem that is highly prevalent in South Africa, particularly among the youth. The behaviour has negative consequences on the health of individuals and society. Focus of the Article This empirical study drew from the Theory of planned behaviour and decomposed the theory’s determinants of intention into two components each, to investigate intention to quit binge drinking. Social support from the Social cognitive theory was also investigated as a determinant of intention to quit. Furthermore, the study investigates the determinants quitting binge drinking behaviour. Research Hypotheses The study proposed that attitude (affective and instrumental); subjective norms (injunctive and descriptive), perceived behavioural control (self-efficacy and perceived controllability) and social support positively and significantly predict intention to quit binge drinking. Intention, perceived controllability and self-efficacy were hypothesised to predict actual behaviour of quitting binge drinking. Importance to the Social Marketing Field This study contributes theoretical knowledge through the use of an extended TPB model that focuses on the desired behaviour of quitting binge drinking and provides specific determinants that social marketers can use when designing interventions. The two-component TPB used in the study also provides social marketers distinctive and specific knowledge on which aspects from the original one component significantly influence the intention to quit. The implications are discussed from a social marketing perspective. Methods A cross-sectional, quantitative online survey was used to collect data from a convenient sample of 810 respondents. Partial Least Squares Structural equation modelling was used to analyse the data including testing the hypothesis and age group–based multigroup analysis. Results Instrumental attitude, injunctive norms, descriptive norms, self-efficacy and social support were found to significantly and positively predict intention to quit binge drinking explaining 49.2% variance in intention. However, the influence of affective attitude was negative and insignificant. Intention and self-efficacy positively explained 16.2% of variance in behaviour. Recommendations for Research/Practice It is recommended that social marketers focus on instrumental attitude injunctive, descriptive norms, self-efficacy as well as social support when designing interventions to promote quitting binge drinking behaviour. Limitations The main limitation of the study is it provides a broad ranging overview which calls for more experimental efforts to be done on the ground for practitioners promoting positive behaviour change.
Amputation of the Unsalvageable Leg in Vascular Patients with Cancer
Authors: Wafi Arsalan , Kolli Vijay , Azhar Bilal , Poole Grace , Budge James , Moxey Paul , Loftus Ian , Holt Peter 
Published: April 2023

Objectives The aim of this study was to compare outcomes of major lower limb amputation (MLA) in patients with and without cancer and with cancer patients receiving palliation over amputation for their unsalvageable limb. Methods Cancer patients who underwent a major amputation or palliation between 2013 and 2018 were included. Comparison groups were cancer-MLA (active/managed cancers), non-cancer MLA (historic cancer or no cancer history) and cancer-palliation at presentation with unsalvageable limbs. Prospectively collected data was retrospectively analysed for outcomes including survival, postoperative complications, length of stay, suitability for rehabilitation and discharge destination. Results 262 (cancer and non-cancer) patients underwent MLA and 18 patients with cancer received palliation. Of those amputated, 26 (9.9%) had active or managed cancer, of which 12 were diagnosed in the 6 months before MLA. Cancer-MLA patients presented with more acute ischaemia compared to non-cancer patients. Median survival was significantly different between the cancer-MLA (14.1 [9.5 - 29.5, 95% CI] months), non-cancer MLA (57.7 [45 - 73.6, 95% CI] months) and cancer-palliation (.6 [.4 - 2.3, 95% CI] months) groups, P < .001. A significantly higher proportion of cancer-MLA patients (10/26, 38.5%) were deemed unsuitable for rehabilitation in post-operative assessment compared to non-cancer MLA (21/236, 8.9%) patients, P < .001. There was a variation in destinations of discharge, with a greater proportion of cancer-MLA patients (4/26, 15.4%) going to a nursing home compared to non-cancer MLA (10/236, 4.2%) patients, P = .016. Conclusion Cancer is prevalent among vascular amputees, with a large proportion being occult diagnoses. Cancer is associated with poorer outcomes following amputation, but survival remains significantly better compared to palliation in cancer patients presenting with unsalvageable limbs.
More than just noise: Association of pulsatile tinnitus with anxiety, depression, and reduction of quality of life
Authors: Amans Matthew , Mattay Raghav , Hills Nancy K , Smith Eric , McCoy David , Narsinh Kazim , Meisel Karl 
Published: April 2023

Background While many of the causes of pulsatile tinnitus (PT) are treatable with endovascular approaches, the risks of treatment must be balanced with the risks of the underlying cause and the psychological impact of symptoms on patients. While many physicians have anecdotal experience, the comorbid relationship of depression and anxiety with PT is unknown. The objectives of this study are to quantify the prevalence of depression and anxiety, and, to identify the demographic risk factors for impactful depression and anxiety in patients with PT. Methods Subjects recruited from online PT groups filled out secure online questionnaires that included demographic questions, validated Tinnitus Functional Index (TFI) as well as PHQ-9 and GAD-7 questionnaires to assess the prevalence of concurrent depression and anxiety, respectively. Results Sample included 515 surveys (84% female, 65% unemployed, mean(sd) age = 46.4 years (14.2)). Median symptom duration was 1.9 years. Data showed 46% and 37% of patients with moderate to severe depression and anxiety, respectively. Higher TFI scores were associated with moderate to severe depression (OR 1.07; 95% CI 1.06–1.09, p < 0.001) and anxiety (OR 1.05, 95% CI 1.04–1.06, p < 0.001), with TFI subscores also independently being associated in a univariate analysis. Conclusions The prevalence of moderate to severe depression and anxiety in the PT population, which was previously unknown, is estimated in our study to be 46% and 37%, respectively. Significant association of TFI score with increased depression and anxiety scales adds further evidence of the impact of PT on the psychological health of these patients.
Algorithm for evaluating ophthalmic artery pseudo-occlusion during intra-arterial chemotherapy for retinoblastoma
Authors: Maddy Krisna , Luther Evan , Walker Ariel , Hackett Ashia , Lu Victor , Starke Robert 
Published: April 2023

Background and importance Intra-arterial chemotherapy infusion for retinoblastoma is typically performed via selective catheterization of the ophthalmic artery. Anastomoses between the external carotid and the ophthalmic arteries have also been utilized when the ophthalmic artery cannot be catheterized directly. However, these are not present in every patient. Clinical presentation A 10-month-old boy presented with bilateral retinoblastoma and underwent one round of intra-arterial chemotherapy (IAC) via direct catheterization of the ophthalmic arteries. Combined with adjuvant laser therapy, they experienced symptomatic improvement and tumour regression. However, during subsequent treatment sessions both ophthalmic arteries did not have anterograde flow and attempts to catheterize their origin were unsuccessful. Unfortunately, no targetable anastomoses between the external carotid and ophthalmic arteries were identified for drug delivery. Due to the patient's anatomy, balloon occlusion of the ECA was felt to be unsafe. As a salvage technique, a balloon was inflated in the left internal carotid artery (ICA) distal to the ophthalmic take-off to redirect flow into the ophthalmic. Repeat angiography with the distal ICA occluded showed improved flow into the ipsilateral ophthalmic artery. IAC was then successfully delivered through the left ICA. Conclusion This case illustrates the importance of utilizing creative endovascular techniques for targeted intra-arterial drug delivery when other conventional measures fail as these patients often have limited, and potentially higher risk, therapeutic alternatives.
Evaluation of ocular blood flow in the assessment of symptomatic carotid stenosis
Authors: Jones Matthew T , Sanchez Sebastian , Patel Rishi R , Raghuram Ashrita , Miller Jacob M , Hashimoto Ryuya , Kardon Randy , Samaniego Edgar A 
Published: April 2023

Background and Purpose The degree of internal carotid artery (ICA) stenosis determined by criteria from the North American Symptomatic Carotid Endarterectomy Trial (NASCET) is not the most accurate index to assess distal flow compromise. Distal ICA perfusion is also determined by factors such as tandem carotid stenosis and collateral circulation. Quantification of end-organ ocular perfusion using non-invasive laser speckle flowgraphy (LSFG) may provide insights into distal ICA flow. This study prospectively assessed the degree of ICA flow using LSFG. Methods Eighteen patients with symptomatic carotid stenosis underwent LSFG evaluation. LSFG was used to extract ocular blood flow metrics recorded simultaneously in the retina, choroid, and optic nerve head. The following ocular flow parameters were measured with LSFG: mean blur rate (MBR), flow acceleration index (FAI), and rising rate (RR). Syngo iFlow perfusion imaging was used to objectively quantify contrast flow in the ICA and brain parenchyma during digital subtraction angiography. Time to peak (TTP) and contrast delay were extracted from seven different regions of interest (ROIs). Results MBR, FAI, and RR were correlated with NASCET degree of stenosis. FAI and RR also improved after stenting. TTP improved after stenting in three ROIs. A moderate negative correlation was observed between FAI and contrast delay. Conclusions LSFG non-invasively quantifies end-organ blood flow distal to the ICA origin. LSFG metrics have the potential to quantify end-organ perfusion and determine if a proximal carotid stenosis is symptomatic.
Prediction of delayed cerebral ischemia after cerebral aneurysm rupture using explainable machine learning approach*
Authors: Taghavi Reza M , Zhu Guangming , Wintermark Max , Kuraitis Gabriella M , Sussman Eric S , Pulli Benjamin , Biniam Brook , Ostmeier Sophie , Steinberg Gary K , Heit Jeremy J 
Published: April 2023

Background Aneurysmal subarachnoid hemorrhage results in significant mortality and disability, which is worsened by the development of delayed cerebral ischemia. Tests to identify patients with delayed cerebral ischemia prospectively are of high interest. Objective We created a machine learning system based on clinical variables to predict delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage patients. We also determined which variables have the most impact on delayed cerebral ischemia prediction using SHapley Additive exPlanations method. Methods 500 aneurysmal subarachnoid hemorrhage patients were identified and 369 met inclusion criteria: 70 patients developed delayed cerebral ischemia (delayed cerebral ischemia+) and 299 did not (delayed cerebral ischemia−). The algorithm was trained based upon age, sex, hypertension (HTN), diabetes, hyperlipidemia, congestive heart failure, coronary artery disease, smoking history, family history of aneurysm, Fisher Grade, Hunt and Hess score, and external ventricular drain placement. Random Forest was selected for this project, and prediction outcome of the algorithm was delayed cerebral ischemia+. SHapley Additive exPlanations was used to visualize each feature's contribution to the model prediction. Results The Random Forest machine learning algorithm predicted delayed cerebral ischemia: accuracy 80.65% (95% CI: 72.62–88.68), area under the curve 0.780 (95% CI: 0.696–0.864), sensitivity 12.5% (95% CI: −3.7 to 28.7), specificity 94.81% (95% CI: 89.85–99.77), PPV 33.3% (95% CI: −4.39 to 71.05), and NPV 84.1% (95% CI: 76.38–91.82). SHapley Additive exPlanations value demonstrated Age, external ventricular drain placement, Fisher Grade, and Hunt and Hess score, and HTN had the highest predictive values for delayed cerebral ischemia. Lower age, absence of hypertension, higher Hunt and Hess score, higher Fisher Grade, and external ventricular drain placement increased risk of delayed cerebral ischemia. Conclusion Machine learning models based upon clinical variables predict delayed cerebral ischemia with high specificity and good accuracy.
Knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan
Authors: Siddig Emmanuel Edwar , Ahmed Ayman , Ahmed Eiman Siddig , Mohammed Mona Ali , Kunna Ezzan , El-Sadig Sarah M , Ali Yousif , Hassan Rana Alamin , Ali Eman Taha , Mohamed Nouh Saad 
Published: April 2023

Background: Cervical cancer is considered the third leading cause of death among women worldwide, and human papillomavirus was identified as a major causative agent for developing cervical cancer. Objectives: This study aimed to assess the knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan. Design: A community-based cross-sectional study implemented in Khartoum state, Sudan, from 1 August 2020 to 1 September 2020. Methods: We conducted a descriptive cross-sectional community-based study using an electronic questionnaire for data collection. Descriptive statistics, frequency, mean, and percentage were computed. Results: The study included 716 female participants with a mean age of 27.6 + 8.7 years. 580 (81.0%) and 229 (32.0%) had heard about cervical cancer and Pap test, respectively. cervical cancer was assumed related to alcohol consumption 109 (15.2%), giving birth to many children 51 (7.1%), ageing 118 (16.5%), and having many sexual partners 335 (46.8%). In addition, 300 (41.9%) attributed cervical cancer to having human papillomavirus infection, 256 (35.6%) to the prolonged use of contraceptives, and 162 (22.6%) to smoking. Knowledge about the best time to be vaccinated against human papillomavirus, 110 (15.4%) stated it is better after marriage. Regression models to predict the effectors on participants’ knowledge and attitudes showed a low standard deviation of the estimates with higher values of the adjusted R2 [R: 0.041, 0.017, and 0.006; std: 1.527, 0.417, and 0.426]. This indicates the combined influence of occupation, educational level, family income, and marital status on the participant’s knowledge and attitude levels. Conclusion: This study revealed that the participant’s knowledge and attitudes levels are mainly driven by their occupation, educational level, family income, and marital status altogether. This underscores the need for a countrywide community engagement campaign through health education and raising awareness sessions, and massive social media to sensitize the community and healthcare providers about the risk of cervical cancer and the available prevention and control measures.
The incidence of palmaris longus in the heterogeneous Israeli population
Authors: Cohen Joshua , Silver Natan , Steinberg Kobi , Simon Chad , Zinger Gershon 
Published: April 2023

We evaluated the frequency of absence of the palmaris longus tendon in the heterogeneous Israeli population. Nine hundred and fifty wrists were evaluated using a modified Mishra/Schaeffer technique (thumb/little-finger opposition with resisted wrist flexion), which was validated by ultrasound scanning. The geographical and ethnic origin of volunteers was documented. When physical examination was equivocal, any vague, superficial structure was subsequently identified as the median nerve by ultrasound. Physical examination reliably identified palmaris longus only when a structure was clinically obvious (visually or by palpation). There was bilateral absence of the palmaris longus in 21% and unilateral absence in 15% of participants. Frequency of bilateral absence varied between 4.5% and 30%, depending on geographical origin ( p = 0.0007). The incidence of palmaris longus tendon varied significantly by geographical, but not by ethnic origin. Level of evidence: II
A prospective study on the long-term storage of sputum and the recovery of nontuberculous mycobacteria
Authors: Kwon Byoung Soo , Park Jeong Su , Shin Jung-A , Kim Eun Sun , Lim Sung Yoon , Song Myung Jin , Kim Yeon-Wook , Kim Hyung-Jun , Lee Yeon Joo , Park Jong Sun , Cho Young-Jae , Yoon Ho Il , Lee Choon-Taek , Lee Jae Ho 
Published: April 2023

Background: There is little information on the optimal storage conditions for recovery of nontuberculous Mycobacterium spp. (NTM) from refrigerated sputum. Objectives: We investigated the storage duration that could increase the culture-positive rate of NTM isolates. Design: In this prospective study, we collected NTM isolates and clinical data from patients with repeated culture-positive NTM pulmonary disease (NTM-PD). Methods: From June 2020 to July 2021, the participants were instructed to randomly collect six sputum samples and immediately store them in a refrigerator at 4°C until the date of their clinic visit. At the outpatient visits, expectorated spot sputum samples were collected. Results: A total of 226 sputum samples were collected from 35 patients. The median duration of refrigeration was 6 days (maximum duration: 36 days). The overall culture-positive rate was 81.6%. While there was a trend for a higher culture positivity rate when stored for ⩽3 weeks, this was not significant compared with those stored for >3 weeks ( p = 0.610). According to sputum microscopy, smear-positive sputum was 100% isolated, but smear-negative samples had a culture-positive rate of 77.5%. Similarly, there was no significant association between sputum storage duration and culture positivity ( p = 0.511). In addition, the recovery rate of the refrigerated sputum was comparable with the collected spot expectorated sputum (82.6% versus 80.6%, p = 0.795), which is suggestive of the long-term viability of NTM in refrigerated sputum. Conclusion: Our data demonstrated the long-term viability of refrigerated NTM, and the culture positivity rate of these samples was comparable with the spot expectorated sputum. These results suggest that implementing sputum refrigeration would enhance convenience in diagnosing and following patients with NTM-PD. Plain language summary Easy way to diagnose NTM lung diseases Under usual circumstances, most patients with suspected NTM submit spontaneously expectorated sputum rather than induced sputum for the purpose of testing the causative organism. By collecting and storing sputum specimens for a longer period than before, it is expected that more sufficient and adequate collection of sputum specimens will be possible.
Early predictive value of scoring systems and routine laboratory tests in severity and prognosis of acute pancreatitis in pregnancy
Authors: Wang Yu , Qu Guangbo , Wu Zhangbi , Tian Dongmei , Yang Wenbei , Li Hongye , Lu Yu , Meng GuangJun , Zhang Hong 
Published: April 2023

Background: Currently, no guidelines specifically recommend scoring systems and biomarkers for early evaluation of the severity and prognosis of acute pancreatitis in pregnancy (APIP). Objectives: This study aimed to explore the early predictive value of scoring systems and routine laboratory tests on APIP severity and maternofetal prognosis. Design: This study retrospectively analyzed 62 APIP cases in a 6-year period. Methods: The predictive value of scoring systems and routine laboratory tests that were collected 24 h and 48 h after admission, for APIP severity and fetal loss, were analyzed. Results: To detect severe acute pancreatitis (SAP), a 24-h Bedside Index for severity in acute pancreatitis (BISAP) achieved a higher area under the curve (AUC) value of 0.910 than the Acute Physiology and Chronic Health Evaluation II (AUC = 0.898) and Ranson score (AUC = 0.880). The combination of BISAP, glucose, neutrophil-to-lymphocyte ratio (NLR), hematocrit (Hct), and serum creatinine (Scr) provided an AUC value of 0.984, which had greater predictive power than BISAP ( p = 0.015). 24-h BISAP and Hct were independent risk factors for predicting SAP of APIP. The cutoff values of Hct and blood urea nitrogen (BUN) to predict SAP were 35.60% and 3.75 mmol/l in the APIP. Furthermore, 24-h BISAP had the highest predictive power (AUC = 0.958) for fetal loss. Conclusion: BISAP is a convenient and reliable indicator for the early prediction of SAP and fetal loss in APIP. The combination of BISAP, glucose, NLR, Hct and Scr proved to be the optimal early markers for the prediction of SAP in APIP within 24 h after admission. In addition, Hct > 35.60% and BUN > 3.75 mmol/l may be suitable thresholds for predicting SAP in APIP.