bluuebunny/crossref_metadata_2025_split huggingface dataset:
Crew Autonomy During Simulated Medical Event Management on Long Duration Space Exploration Missions
Authors: Yule Steven , Robertson Jamie M. , Mormann Benjamin , Smink Douglas S. , Lipsitz Stuart , Abahuje Egide , Kennedy-Metz Lauren , Park Sandra , Miccile Christian , Pozner Charles N. , Doyle Thomas , Musson David , Dias Roger D. 
Published: April 2022

Objective Our primary aim was to investigate crew performance during medical emergencies with and without ground-support from a flight surgeon located at mission control. Background There are gaps in knowledge regarding the potential for unanticipated in-flight medical events to affect crew health and capacity, and potentially compromise mission success. Additionally, ground support may be impaired or periodically absent during long duration missions. Method We reviewed video recordings of 16 three-person flight crews each managing four unique medical events in a fully immersive spacecraft simulator. Crews were randomized to two conditions: with and without telemedical flight surgeon (FS) support. We assessed differences in technical performance, behavioral skills, and cognitive load between groups. Results Crews with FS support performed better clinically, were rated higher on technical skills, and completed more clinical tasks from the medical checklists than crews without FS support. Crews with FS support also had better behavioral/non-technical skills (information exchange) and reported significantly lower cognitive demand during the medical event scenarios on the NASA-TLX scale, particularly in mental demand and temporal demand. There was no significant difference between groups in time to treat or in objective measures of cognitive demand derived from heart rate variability and electroencephalography. Conclusion Medical checklists are necessary but not sufficient to support high levels of autonomous crew performance in the absence of real-time flight surgeon support Application Potential applications of this research include developing ground-based and in-flight training countermeasures; informing policy regarding autonomous spaceflight, and design of autonomous clinical decision support systems.
The Development and Initial Validation of the Youth Sexual Intention Scale: Indonesian Version
Authors: Lubis Rahmi , Hinduan Zahrotur R. , Jatnika Ratna , Baydhowi Baydhowi , Agustiani Hendriati 
Published: April 2022

Interventions for the early sexual problem in adolescents require proper measurement of sexual intentions. The adolescent sexual intention scales have been widely used by researchers in the West. However, those scales are not very suitable for adolescents in eastern cultures such as Indonesia. As a religious society, Indonesian people have different sexual expectations from liberal western society. Religious teachings and societal norms shape sexual beliefs that reflect semi-restrictive sexual socialization. Thus, sexual intention measurement that represents the sexual beliefs of the subject under study becomes important. Therefore, this two-steps study aims to develop and validate the Youth Sexual Intention Scale (YSIS). In the first step, qualitative elaboration resulted in 27 themes of adolescent sexual beliefs, which turned into 31 items according to the Theory of Planned Behavior (TPB). In the second step, we selected 396 students using the cluster random sampling technique. We investigated 2 methods of validity, content validity using CVI and construct validity using confirmatory factor analysis (CFA). The content validity examination proved that all scale items had high validity (CVI = .93). Meanwhile, the CFA showed that the data was fit for the model (Chi-square 819,420, P <.001, RMSEA = .056, CFI = .978, TLI = .972). The CFA groups items into 4 dimensions, namely, sexual attitudes, subjective norms, perceived behavioral control, and sexual intentions. The reliability test shows an Alpha coefficient of .854. We conclude that 26-items YSIS is a valid and reliable instrument to measure belief-based youth sexual intentions (15–18 years) in religious culture.
Primary Aneurysmal Bone Cyst of Nasal Cavity and Sinuses in a Child: Case Report and Literature Review
Authors: Han Yang , Yang Xiaojian , Tang Lixing , Wang Pengpeng , Zhang Jie , Ge Wentong , Ni Xin 
Published: April 2022

Introduction Aneurysmal bone cysts (ABCs) are a rare benign bone lesion, which are divided into primary and secondary categories, and occur mainly in the vertebra and the long tubular bones. Primary ABCs in the nasal cavity and the sinuses are rare. Case presentation We reported on a one-year-old boy who suffered from progressive nasal obstruction and intermittent nosebleeds over a period of approximately 1 month. The patient had no history of trauma or surgery. Physical examination showed a red tumor in his right nasal cavity. A magnetic resonance imaging scan showed a multicystic lesion arising from the ethmoid sinus. The lesion was resected under a nasal endoscope without any complications. Histological evaluation confirmed that the lesion was an aneurysmal bone cyst. Because an osteoma was found during the surgery on the cyst, the lesion was considered secondary clinically. However, fluorescence in situ hybridization testing showed a rearrangement of the USP6 (ubiquitin-specific protease 6) oncogene on chromosome 17. No recurrence was observed after 1 year. Conclusion An ABC of the nasal cavity and sinuses in such a young child is very rare and needs to be further analyzed according to postoperative pathology and combined with a genetic examination to make a diagnosis. Endoscopic sinus surgery is an effective method of treatment for this kind of disease.
Evaluating Impact of Implementing Order Questions on Appropriate Prescribing of Tolvaptan
Authors: VanDyke Ashton D. , Wolters Nicholas 
Published: April 2022

Background Tolvaptan poses a significant risk to patient safety due to its risk of overcorrection of hyponatremia, and its cost-effectiveness is not well established. Kettering Health implemented order questions into Epic in 2019 to drive appropriate use of tolvaptan. Objective: The primary objective was to determine the impact of implementing order questions on appropriate use of tolvaptan. The secondary objectives were to determine if providers are adhering to the order questions meant to ensure appropriate use, to identify if there is provider variance across the network constituting a higher proportion of use outside of network recommendations, and to look at patients with multiple orders for tolvaptan and discern if dose titration was appropriate based on sodium levels. Methods: This study was a retrospective chart review of all patients who received a dose of tolvaptan from 7/3/2019 to 10/15/2020. Results: From July 2019 to October 2020, 211 patients received tolvaptan for hyponatremia, resulting in 598 administrations. Use of urea powder or fluid restriction preceded 248/586 (42.3%) tolvaptan administrations and the patient’s sodium level was < 125 mEq/L or 125–135 mEq/L with documentation of symptoms for 261/586 (44.5%) of the administrations. Medication safety concerns related to monitoring sodium levels were also identified. Conclusions: While tolvaptan use did significantly decrease in Kettering Health since the implementation of order questions, the answers to the questions displayed substantial variability. Further opportunity exists for directing appropriate use of tolvaptan within Kettering Health and additional emphasis should be placed on safe use of this medication.
Numerical simulation and prototype experiment of integrated electrohydraulic pump
Authors: Fei Sun , Hong Ji , Yanbo Peng , Chen Li 
Published: April 2022

Integrated electrohydraulic pump (IEHP) is conceived as an innovative design concept to achieve the higher power density, lower noise level, and leakage-free with respect to the traditional hydraulic power units. Nevertheless, the complex cooling circuit may increase the flow resistance, reducing the effective delivery flow rate of IEHP, which will be more serious at high rotational speed. In this context, a novel centrifugal charging pump (CCP) integrated on the hollow drive shaft is arranged on the suction path of positive-displacement vane pump (main pump) to boost its inlet pressure, thus efficiently improving the suction capability of IEHP. The contribution of this study is to develop a full flow field CFD model of IEHP, in which the fluid domain of main pump and CCP are connected in series. Based on the CFD model validated subsequently by prototype experiment in terms of volumetric efficiency, the charging effect of CCP modeled with different geometric parameters, at 1,500 r/min, has been investigated. Finally, combined with experiment and simulation, the delivery flow rate of IEHP, in the speed range 600–6,000 r/min, are also analyzed by means of comparing with a standard vane pump. The results show that the CCP makes an outstanding contribution to the filling of main pump, especially when the rotational speed exceeds 3,000 r/min; Since then, the flow rate saturation of standard vane pump tends to occur due to serious incomplete filling, while the IEHP still maintains valid output. It can be concluded that, with the help of charging effect of CCP, the IEHP can keep the same volume efficiency as the vane pump under rated speed, and there is a certain potential for the application of IEHP in a wide speed range.
Machining characteristics investigations of duplex stainless steel by considering dual effect of chip breaker and cooling conditions
Authors: Aşcıoğlu Mümin , Boy Mehmet 
Published: April 2022

Duplex stainless steels (DSSs) use in many applications because of their superior properties like high corrosion, good strength, and low cost. On the other hand, machinability of DSSs is very low due to its superior ductility. This study investigates optimization of cutting parameters, cutting environments (dry and cold air), and chip breaker forms by Taguchi–Grey relational analysis in turning of 2205 grade DSS. The turning tests were conducted using Taguchi’s L16 mixed design by measuring and evaluating the cutting force components and surface roughness criteria (Ra and Rz). When turning of DSS2205 material in medium cutting condition, it is suitable to use low feed rate and high cutting speed for reducing of cutting force and surface roughness. In addition, it was shown that the chip breaker form is as important as the cooling medium in terms of minimizing Built-Up-Edge (BUE), which negatively affects the machinability outputs. Grey relational grade (GRG) indicated that the optimum results for all cutting conditions were the cutting speed of 160 m/min, the feed rate of 0.15 mm/rev, GM chip breaker, and cold air cutting environment. Experimental and ANOVA results indicated that the feed rate is the most important parameter on turning of DSS2205, followed by chip breaker, and cutting environment.
Genetic and Neurophysiological Biomarkers of Neuroplasticity Inform Post-Stroke Language Recovery
Authors: Dresang Haley C. , Harvey Denise Y. , Xie Sharon X. , Shah-Basak Priyanka P. , DeLoretta Laura , Wurzman Rachel , Parchure Shreya Y. , Sacchetti Daniela , Faseyitan Olufunsho , Lohoff Falk W. , Hamilton Roy H. 
Published: April 2022

Background There is high variability in post-stroke aphasia severity and predicting recovery remains imprecise. Standard prognostics do not include neurophysiological indicators or genetic biomarkers of neuroplasticity, which may be critical sources of variability. Objective To evaluate whether a common polymorphism (Val66Met) in the gene for brain-derived neurotrophic factor (BDNF) contributes to variability in post-stroke aphasia, and to assess whether BDNF polymorphism interacts with neurophysiological indicators of neuroplasticity (cortical excitability and stimulation-induced neuroplasticity) to improve estimates of aphasia severity. Methods Saliva samples and motor-evoked potentials (MEPs) were collected from participants with chronic aphasia subsequent to left-hemisphere stroke. MEPs were collected prior to continuous theta burst stimulation (cTBS; index for cortical excitability) and 10 minutes following cTBS (index for stimulation-induced neuroplasticity) to the right primary motor cortex. Analyses assessed the extent to which BDNF polymorphism interacted with cortical excitability and stimulation-induced neuroplasticity to predict aphasia severity beyond established predictors. Results Val66Val carriers showed less aphasia severity than Val66Met carriers, after controlling for lesion volume and time post-stroke. Furthermore, Val66Val carriers showed expected effects of age on aphasia severity, and positive associations between severity and both cortical excitability and stimulation-induced neuroplasticity. In contrast, Val66Met carriers showed weaker effects of age and negative associations between cortical excitability, stimulation-induced neuroplasticity and aphasia severity. Conclusions Neurophysiological indicators and genetic biomarkers of neuroplasticity improved aphasia severity predictions. Furthermore, BDNF polymorphism interacted with cortical excitability and stimulation-induced neuroplasticity to improve predictions. These findings provide novel insights into mechanisms of variability in stroke recovery and may improve aphasia prognostics.
Photodynamic Therapy for Colorectal Cancer: A Systematic Review of Clinical Research
Authors: Guidolin Keegan , Ding Lili , Yan Han , Englesakis HBA Marina , Chadi Sami , Quereshy Fayez , Zheng Gang 
Published: April 2022

Background Photodynamic therapy (PDT) is a therapeutic modality that can be used to ablate tumors using the localized generation of reactive oxygen species by combining a photosensitizer, light, and molecular oxygen. This modality holds promise as an adjunctive therapy in the management of colorectal cancer and could be incorporated into neoadjuvant treatment plans under the auspices of prospective clinical trials. Methods We conducted a search of primary literature published until January 2021, based on PRISMA guidelines. Primary clinical studies of PDT for the management of colorectal cancer were included. Screening, inclusion, quality assessment, and data collection were performed in duplicate. Analyses were descriptive or thematic. Results Nineteen studies were included, most of which were case series. The total number of patients reported to have received PDT for colorectal cancer was 137, almost all of whom received PDT with palliative intent. The most common photosensitizer was hematoporphyin derivative or Photofrin. The light dose used varied from 32 J/cm2 to 500 J/cm2. Complete tumor response (cure) was reported in 40%, with partial response reported in 43.2%. Symptomatic improvement was reported in 51.9% of patients. In total, 32 complications were reported, the most common of which was a skin photosensitivity reaction. Conclusions PDT for the management of colorectal cancer has not been well studied, despite promising results in early clinical case series. New, well designed, prospective clinical trials are required to establish and define the role of PDT in the management of colorectal cancer.
A new opportunity for enhancing trial efficiency: Can we investigate intervention implementation processes within trials using SWAT (study within a trial) methodology?
Authors: Ahmed Sadia , Airlie Jennifer , Clegg Andrew , Copsey Bethan , Cundill Bonnie , Forster Anne , Heaven Anne , Johansson Jessica F , Kime Nicola , Moreau Lauren , Ozer Seline , Parker Catriona , Richards Suzanne H , Thompson Ellen , Farrin Amanda J 
Published: April 2022

Background A study within a trial (SWAT) is a self-contained research study embedded within one or more host trials to evaluate or explore alternative ways of delivering or organising a particular trial process. There is limited evidence of SWATs evaluating trial processes other than recruitment and retention. Purpose Embedding a SWAT into a host trial provides a potential method of evaluating an aspect of intervention implementation, such as engagement or compliance with the intervention. Research Design This paper presents two case studies of SWATs which aim to test the use of video animations to improve intervention implementation, with particular focus on enhancing understanding, engagement and compliance. These are important aspects of intervention implementation as they are directly linked to intervention effectiveness and therefore, important to study. Results In this paper, we present the potential benefits of conducting SWATs of intervention implementation processes as well as discussing the methodological considerations for embedding a SWAT of this nature within a host trial. Benefits include the opportunity to test minor refinements to intervention implementation within trials through robust randomised SWATs, and the possibility of increasing trial efficiency by maximising the quality or quantity of intervention implementation. Methodological considerations surrounding the design and conduct of the SWAT as well as statistical and health economics considerations are discussed in this paper. Conclusions This paper presents a novel application of SWAT methodology in investigating intervention implementation processes within trial conduct.
Differential regulation of intramuscular fat and abdominal fat deposition in chickens
Authors: Luo Na , Shu Jingting , Yuan Xiaoya , Jin Yuxi , Cui Huanxian , Zhao Guiping , Wen Jie 
Published: April 2022

Abstract
Background
Chicken intramuscular fat (IMF) content is closely related to meat quality and performance, such as tenderness and flavor. Abdominal fat (AF) in chickens is one of the main waste products at slaughter. Excessive AF reduces feed efficiency and carcass quality.

Results
To analyze the differential deposition of IMF and AF in chickens, gene expression profiles in the breast muscle (BM) and AF tissues of 18 animals were analyzed by differential expression analysis and weighted co-expression network analysis. The results showed that IMF deposition in BM was associated with pyruvate and citric acid metabolism through GAPDH, LDHA, GPX1, GBE1, and other genes. In contrast, AF deposition was related to acetyl CoA and glycerol metabolism through FABP1, ELOVL6, SCD, ADIPOQ, and other genes. Carbohydrate metabolism plays an essential role in IMF deposition, and fatty acid and glycerol metabolism regulate AF deposition.

Conclusion
This study elucidated the molecular mechanism governing IMF and AF deposition through crucial genes and signaling pathways and provided a theoretical basis for producing high-quality broilers.
Wellens’ syndrome: incidence, characteristics, and long-term clinical outcomes
Authors: Zhou Li , Gong Xuhe , Dong Tianhui , Cui He-he , Chen Hui , Li Hongwei 
Published: April 2022

Abstract
Background
Few studies with large sample sizes are available regarding patients with Wellens’ syndrome. Therefore, we sought to assess the current incidence, risk factors, clinical presentation and long-term outcomes of this population.

Methods
Among a total of 3528 patients with ACS who underwent angioplasty from 2017 to 2019 in our centre, 2127 NSTE-ACS patients with culprit LAD vessels were enrolled in this study. According to electrocardiographic criteria, the patients were divided into a Wellens’ group (n = 200) and non-Wellens’ group (n = 1927). The primary endpoint was cardiac death; the secondary endpoint was MACCE, a composite of all-cause death, cardiac death, recurrent myocardial infarction, target lesion revascularization, heart failure and stroke.

Results
The incidence of Wellens’ syndrome was 5.7% (200 of 3528) of all ACS patients. Wellens’ syndrome more often manifested as NSTEMI (69% vs. 17.5%, P < 0.001). The percentages of preexisting coronary heart disease (39.6% vs. 23%) and previous PCI (19.5% vs. 9%) were significantly higher in the non-Wellens’ group than in the Wellens’ group (all P < 0.001). More importantly, the proportion of early PCI was higher in the Wellens’ group (68% vs. 59.3%, P = 0.017). At a median follow-up of 24 months, Wellens’ syndrome was not associated with an increased risk of MACCE (P = 0.05) or cardiac death (P = 0.188).

Conclusions
The presence of Wellens’ syndrome is not definitively associated with adverse prognosis in patients with NSTE-ACS. Age ≥ 65 years, diabetes, NSTEMI, eGFR < 60 ml/min and left main disease are associated with the incidence of cardiac death. Early recognition and aggressive intervention are critical, as they may help to attenuate adverse outcomes.
Relevance of presenting risks of frailty, sarcopaenia and osteopaenia to outcomes from aneurysmal subarachnoid haemorrhage
Authors: Lim Jia Xu , Lim Yuan Guang , Kumar Aravin , Cheong Tien Meng , Han Julian Xinguang , Chen Min Wei , Wen David , Lim Winston , Ng Ivan Hua Bak , Ng Vincent Yew Poh , Kirollos Ramez Wadie , Keong Nicole Chwee Har 
Published: April 2022

Abstract
Introduction
Aneurysmal subarachnoid haemorrhage (aSAH) is a condition with significant morbidity and mortality. Traditional markers of aSAH have established their utility in the prediction of aSAH outcomes while frailty markers have been validated in other surgical specialties. We aimed to compare the predictive value of frailty indices and markers of sarcopaenia and osteopaenia, against the traditional markers for aSAH outcomes.

Methods
An observational study in a tertiary neurosurgical unit on 51 consecutive patients with ruptured aSAH was performed. The best performing marker in predicting the modified Rankin scale (mRS) on discharge was selected and an appropriate threshold for the definition of frail and non-frail was derived. We compared various frailty indices (modified frailty index 11, and 5, and the National Surgical Quality Improvement Program score [NSQIP]) and markers of sarcopaenia and osteopaenia (temporalis [TMT] and zygoma thickness), against traditional markers (age, World Federation of Neurological Surgery and modified Fisher scale [MFS]) for aSAH outcomes. Univariable and multivariable analysis was then performed for various inpatient and long-term outcomes.

Results
TMT was the best performing marker in our cohort with an AUC of 0.82, Somers’ D statistic of 0.63 and Tau statistic 0.25. Of the frailty scores, the NSQIP performed the best (AUC 0.69), at levels comparable to traditional markers of aSAH, such as MFS (AUC 0.68). The threshold of 5.5 mm in TMT thickness was found to have a specificity of 0.93, sensitivity of 0.51, positive predictive value of 0.95 and negative predictive value of 0.42. After multivariate analysis, patients with TMT ≥ 5.5 mm (defined as non-frail), were less likely to experience delayed cerebral ischaemia (OR 0.11 [0.01 – 0.93], p = 0.042), any complications (OR 0.20 [0.06 – 0.069], p = 0.011), and had a larger proportion of favourable mRS on discharge (95.0% vs. 58.1%, p = 0.024) and at 3-months (95.0% vs. 64.5%, p = 0.048). However, the gap between unfavourable and favourable mRS was insignificant at the comparison of 1-year outcomes.

Conclusion
TMT, as a marker of sarcopaenia, correlated well with the presenting status, and outcomes of aSAH. Frailty, as defined by NSQIP, performed at levels equivalent to aSAH scores of clinical relevance, suggesting that, in patients presenting with acute brain injury, both non-neurological and neurological factors were complementary in the determination of eventual clinical outcomes. Further validation of these markers, in addition to exploration of other relevant frailty indices, may help to better prognosticate aSAH outcomes and allow for a precision medicine approach to decision making and optimization of best outcomes.