bluuebunny/crossref_metadata_2025_split huggingface dataset:
World Stroke Organization and World Hypertension League position statement on hypertension control strategies in prevention and management of stroke
Authors: Pandian Jeyaraj Durai , Sylaja PN , Lackland Daniel T , Babu Veena , Kumar Paramasivan Naveen , Sebastian Ivy , Parati Gianfranco , Anderson Craig S , Ovbiagele Bruce , Fisher Marc , Martins Sheila , Whelton Paul 
Published: December 2024

Background and purpose: The goal of this consensus is to provide a comprehensive set of recommendations in regard to hypertension control strategies for the prevention and management of stroke. This document is intended for prehospital care providers, physicians, allied health professionals, and hospital administrators and healthcare policymakers. Methods: Members of the writing group were representatives of the World Stroke Organization and World Hypertension League. The writing group reviewed articles searched from PubMed and Google Scholar using selected search strings. The document was sent to 12 peer reviewers. The writing group considered the feedback from peer reviewers and made revisions accordingly. Every member of the writing group gave their approval of the final document. Results: This article details the various techniques for blood pressure (BP) measurement, BP classification, BP and stroke risk, antihypertensive drug therapy for the primary and secondary prevention of stroke, choice of antihypertensive drug therapy, optimal BP targets, non-drug approaches to the prevention of stroke through BP lowering, BP management separately for acute ischemic stroke and spontaneous intracerebral hemorrhage, and the implementation of BP prevention, treatment, and control in the community. Conclusion: This article provides general recommendations based on currently available evidence to guide healthcare practitioners caring for adults with hypertension for the prevention and management of stroke. Future studies are needed to better define approaches to hypertension control in the community and high-risk groups.
Proximal interphalangeal surface replacement in patients with severe longitudinal joint axis deviation
Authors: Bandzaite Laima , Marks Miriam , Schindele Stephan , Herren Daniel B. 
Published: December 2024

We compared the 2 year outcomes after proximal interphalangeal joint surface replacement in 68 joints with severe (>15°) preoperative longitudinal axis deviation and 50 joints without (<5°) preoperative deviation. Patients in both groups had a mean preoperative brief Michigan Hand Outcomes Questionnaire score of 47 and had similar 2 year scores of 72 (95% CI 68–77) (severe deviation) and 70 (95% CI 65–76) (no deviation). Pain, proximal interphalangeal joint range of motion, grip strength and complications did not differ between the groups at 2 years. Ninety per cent of the severely deviated joints had a deviation of less than 15° at follow-up. The revision rates were 5.9% and 1.8% for deviated and non-deviated joints, respectively. We recommend a surface replacing implant to correct severe preoperative axis deviations of the proximal interphalangeal joint, but the risk of revision surgery needs to be considered. Level of evidence: IV
Stakeholder Perspectives on Research Consent and Reconsent for Procedures Involving Biological Samples and Biobanking of Children and Adolescents Living With HIV in Kenya
Authors: Aluoch Josephine , Chory Ashley , Scanlon Michael , Gillette Emma , Koros Hillary , Munyoro Dennis , Ashimosi Celestine , Beigon Whitney , Lidweye Janet , Nyagaya Jack , DeLong Allison , Kantor Rami , Vreeman Rachel Christine , Naanyu Violet , Nyandiko Winstone M. 
Published: December 2024

Objective To explore the perspectives of stakeholders on consenting and reconsenting children and adolescents living with HIV (CALWH) to participate in research involving biological sampling and biobanking. Stakeholders included CALWH, their caregivers, subject matter experts (SMEs) such as Institutional Review Board (IRB) members, Community Advisory Board (CAB) members, Healthcare Providers, researchers, and community leaders. Study design This qualitative study was conducted at the Academic Model Providing Access to Healthcare (AMPATH) in Kenya. Semi-structured interviews were conducted with CALWH, their caregivers, and SMEs. Audio recordings were transcribed, thematically analyzed, and emerging themes derived. Results In total, 99 participants were interviewed, of which the majority (52%) were female; 50% of CALWH were female with a median age of 17.5 years (range 11-24); 70% of caregivers and 44% of SMEs were female. All SMEs, CALWH, and caregivers emphasized that recontacting and reconsenting were their strong preferences for the use of biospecimens and also an essential procedure to address legal and ethical considerations and confidentiality. All CALWH wanted consent to detail how they will be informed about research findings and emphasized making their results available to them. Caregivers highlighted the importance of trust in the use of the stored samples to be maintained as per the consents. Conclusion Our findings revealed that CALWH and their caregivers want researchers to go beyond the typical information provided about biospecimen storage and use. They desire to be recontacted and reconsented as well as maintain ongoing communication with the research team about the research findings.
Experiences of Nurse Educators Regarding the R171 Nursing Curriculum in North-West Province, South Africa
Authors: Botlhoko Katlego Patronellah , Zenani Nombulelo Esme , Sehularo Leepile Alfred 
Published: December 2024

Background Nurse educators must seek innovative frameworks for their curricula to prepare nursing students to meet evolving healthcare needs. The South African National Department of Health introduced the new nursing curriculum (R171) in 2013 with the aim of producing generalist nurses who can meet the health care needs of the patients and to align the nursing program with the relevant Higher Education Qualification Framework. R171 was implemented in the North-West Province in 2021.Therefore, the main purpose of this study was to explore and describe the experiences of nurse educators regarding the three-year R171 nursing curriculum in North-West Province, South Africa. Methodology The researcher used a descriptive phenomenology research design to achieve the aim and objectives. A nonprobability sampling approach was adopted for the study with use of a purposive sampling technique to select participants with insight and experience on the phenomenon in question. Semi-structured individual interviews, through Microsoft Teams, collected the data, with analysis using thematic analysis. Results Three themes emerged from the findings of this study, namely inadequate resources to implement the R171 nursing curriculum, teaching and learning challenges in implementing the R171 nursing curriculum, and the possible solutions for effective implementation of the R171 nursing curriculum. Conclusion To implement the R171 nursing curriculum effectively, it is necessary to include nurse educators in the development of the curriculum. There is also a need for comprehensive support that comprises all available essential resources.
Belongingness in Medical Student Placements: Validation and Pilot Study of the Use of the Exeter Belongingness Assessment Tool in Belgian and English Medical Students
Authors: Daniels Rob , Pattyn Thomas , Schoenmakers Birgitte , Buramba Eric , Denis Kato 
Published: December 2024

BACKGROUND Belongingness is an important factor in the social development of medical students, and the ability to quantify belongingness in medical students may provide additional metrics by which we can compare different learning environments to help explore differential attainment. Previous studies looking at the measurement of belongingness have demonstrated good internal and external validity for tools designed to measure this facet of student experience. This study aimed to explore the use of the Exeter Belongingness Assessment Tool (EBAT) as one potential source of evidence in the study of student learning experience on clinical placements, which could be used to support quality assurance of clinical learning. This study sought to validate the use of the EBAT and carry out an initial pilot study to compare levels of belongingness in medical students in Belgium and the United Kingdom. METHODS This study used a validated assessment tool self-administered via an online survey platform in undergraduate medical students in all years studying in Belgium and the United Kingdom. RESULTS The EBAT described here demonstrated good internal validity in undergraduate medical students in the United Kingdom and Belgium and identified statistically significant differences between these medical student populations. CONCLUSIONS These results suggest that belongingness in undergraduate medical students varies between different demographic groups and provides further evidence that the EBAT described here is a valid tool to study this. It also supports the proposal that this may be a useful tool to monitor teaching environments.
Biomechanical Evaluation of Different Fixation Methods for Percutaneous Extracapsular Transverse Cervical Metatarsal Osteotomy in a Hallux Valgus Sawbone Model
Authors: Wagner Pablo , Wagner Emilio , Pinochet Miguel , Salinas David , Lam Peter 
Published: December 2024

Background: There is limited literature available that provide information about fixation methods for minimally invasive hallux valgus osteotomies. Our objective was to evaluate the strength of different fixation methods for a percutaneous extracapsular transverse cervical metatarsal (PTCM) osteotomy in a sawbone model. Methods: Thirty solid foam sawbone foot models were used. Percutaneous extracapsular transverse cervical metatarsal osteotomies were performed and fixed in a standardized fashion in 6 different groups: (1) one 4.0-mm screw; (2) 2 (one 4.0-mm and one 3.0-mm) parallel screws; (3) 2 (one 4.0-mm and one 3.0-mm) divergent screws; (4) same as group 3, but with lateral metatarsal head cortex purchase with the 4.0-mm screw; (5) same as group 4, but with two 4.0-mm screws; (6) same as group 5, but with two 3.5-mm screws. Cyclic and load to failure testing were performed applying a plantar load to the metatarsal head. The measured variables were stiffness and force needed to create deformity using a Zwick Roell Universal Testing Machine. Results: Group 1 failed as a result of rotational instability in cyclic testing. In load to failure testing, group 3 did not achieve difference compared with group 2 ( P = .09) (181 vs 131 N). Group 4 was stronger ( P = .02) (250 N) than groups 1-3. Group 5 did not show differences relative to group 4 ( P = .1) (223 N). Group 6 was stronger only than groups 1 and 2 ( P = .01) (193 N). Conclusion: In this sawbones-based study, we found that the use of two 4.0-mm screws or use of a 3.0-mm screw and a 4.0-mm screw with lateral first metatarsal head cortical purchase was superior to other screw configurations.
Understanding the emergency medical service response to patients who are at imminent risk of out-of-hospital cardiac arrest
Authors: Kirby Kim , White Paul , Voss Sarah , Benger Jonathan 
Published: December 2024

Study Aim To understand the survival and emergency medical service call triage and response to patients who suffer an out-of-hospital cardiac arrest after the emergency medical service call is connected. Methods: A descriptive retrospective data analysis of two years’ of out-of-hospital cardiac arrest registry data, 2018-2019, linked to computer aided dispatch data was completed in a single system emergency medical service in the South West of the United Kingdom. Data analysis included descriptive statistics and chi squared analysis for association. Results: There were 4245 out-of-hospital cardiac arrest patients included for analysis. Patients who suffer an out-of-hospital cardiac arrest after the emergency call is connected receive a lower priority response, have a significantly longer response time and where the cardiac arrest is not witnessed by the emergency medical service have poorer outcomes than those patients who have already suffered a cardiac arrest at the time of the emergency call. Conclusion: Emergency medical service response times were significantly shorter for patients who had already suffered a cardiac arrest at the time of the call for help in comparison to those patients who continued to suffer a cardiac arrest after the call for help was connected. Patients who suffer a cardiac arrest after the connection of the emergency call and where the out-of-hospital cardiac arrest is not emergency medical service witnessed have the poorest outcomes.
Membrane-bound model of the ternary complex between factor VIIa/tissue factor and factor X
Authors: Muller Melanie P. , Mortenson Alex , Sedzro Josepha C. , Wen Po-Chao , Morrissey James H. , Tajkhorshid Emad 
Published: December 2024

Abstract
Formation of the extrinsic complex (EC) on cell surfaces is the event that triggers the coagulation cascade. Tissue factor (TF) and factor VIIa (FVIIa) form the EC together with FX on phosphatidylserine-containing membranes, leading to FX activation by TF:FVIIa. This lipid dependence has made experimental characterization of the EC structure challenging. Using a novel computational methodology combining rigid-body protein-protein docking and extensive nonequilibrium molecular dynamics simulations in the explicit presence of a membrane, we developed, to our knowledge, the first atomic-level model of the EC, taking full account of the role of the membrane. Rigid-body docking generated 1 000 000 protein-only structures that predict the binding of key EC domains. Residue-residue contact information was then used in nonequilibrium simulations to drive the formation of the EC on a phosphatidylserine/phosphatidylcholine membrane surface, providing, to our knowledge, the first membrane-bound model for the EC. Strikingly, in our model, FX makes contact with TF:FVIIa chiefly via its γ-carboxyglutamate–rich (GLA) domain and protease domain, with the majority of the FX light chain (ie, its 2 epidermal growth factor–like domains) out in the solvent, making no direct contact with TF:FVIIa. The TF exosite makes substantial contacts with both the FX- and FVIIa-GLA domains, in which TF residue K165 engages directly with the FVIIa-GLA domain, whereas K166 plays a central role in binding to the FX-GLA domain. These findings underscore the substrate-binding exosite of TF as being pivotal in the formation of the EC, serving as a critical interface linking the GLA domains of both FVIIa and FX.
Impact of Positive Airway Pressure on Right Ventricular Afterload in Pulmonary Arterial Hypertension
Authors: Bentley Robert F. , Yo Shaun W. , Mok K.H. , Valle Felipe H. , Goligher Ewan C. , Carvalho Carolina Gonzaga , Granton John T. , Mak Susanna S , Ryan Clodagh M. 
Published: December 2024

RationaleThe impact of continuous positive airway pressure (CPAP) is currently unknown in patients with pulmonary arterial hypertension (PAH).ObjectiveTo investigate the effect of CPAP on cardiopulmonary hemodynamics in patients with (PAH) compared to healthy volunteers.MethodsAll participants underwent an esophageal catheter insertion followed by right heart catherization with and without the application of CPAP at 10 cm H20. The primary outcome was the effect of CPAP on cardiopulmonary hemodynamics and intrapleural pressures within and between groups.ResultsIn both PAH (n= 18) and healthy (n=5) participants the acute application of CPAP increased the esophageal pressure significantly from baseline (all p<0.007). There was a decline in cardiac output in both groups from baseline (p=0.047), which was due to a reduction in heart rate (p=0.027) rather than stroke volume (p=0.8). CPAP significantly reduced right ventricular end diastolic pressure (p=0.02), without a significant impact on resistive right ventricular afterload. CPAP did not significantly change pulmonary artery or pulmonary vascular resistance in either group. The calculated dynamic pulmonary arterial compliance was increased in both groups.ConclusionsIn PAH and healthy participants, CPAP had a modest effect on intrapleural pressures. The transmural hemodynamic changes of CPAP were modest with a net increase in pulmonary vascular compliance in both groups, but no change in resistive right ventricular afterload in the PAH group. The current study did not demonstrate any deleterious effects of CPAP on pulmonary hemodynamics.
Multiple-breath washout is more sensitive than spirometry to detect lung function impairment in children and adults with bronchiectasis
Authors: Ziegahn Niklas , Roehmel Jobst F. , Pioch Charlotte O. , Busack Leonie M. , Allomba Christine , Fuhlrott Bent R. , Meinus Carolin , Schnabel Olaf , Moridani Mehrak Yoosefi , Thee Stephanie , Lau Susanne , Mall Marcus A. , Stahl Mirjam 
Published: December 2024

BackgroundMultiple-breath washout (MBW) is an established outcome measure of lung disease in cystic fibrosis (CF). However, data on its sensitivity to detect lung function impairment in bronchiectasis across age groups remain limited. The aim of this study was therefore to determine the feasibility, validity, and sensitivity of MBW compared with spirometry in people with bronchiectasis.MethodsWe performed MBW and spirometry in 94 people with bronchiectasis (aged 0.2 to 79.3 years), 168 healthy controls, and 128 people with CF and 76 with asthma as disease controls.ResultsThe overall success rate of MBW in all 466 participants was 96.1%. People with bronchiectasis had an elevated lung clearance index (LCI) and a reduced forced expiratory volume in 1 s (FEV1) compared with healthy controls and people with asthma (all p<0.001). Comparing bronchiectasis and CF, there was no difference in LCI, but FEV1was reduced in bronchiectasis (p=0.032). Within the bronchiectasis group, LCI correlated strongly with FEV1(r=−0.69, p<0.001). However, 34.3% of people with bronchiectasis presented with an elevated LCI but normal FEV1while none had a reduced FEV1combined with a normal LCI (p<0.001). LCI was superior to FEV1in detecting lung function impairment in bronchiectasis (AUC: 0.95versus0.86).ConclusionLCI is more sensitive than FEV1to detect lung function impairment in bronchiectasis. These findings support further evaluation of LCI for clinical monitoring and as a sensitive outcome measure in clinical trials in people with bronchiectasis.
Exploring the carbon footprint of severe asthma and change after biologic therapy initiation: an analysis of Northern Irish data
Authors: Busby John , Khezrian Mina , Patel Soram , Tran Trung N , Rhodes Kirsty , Heaney Liam G 
Published: December 2024

IntroductionThe carbon footprint of severe asthma (SA) and the impact of biologic therapy in this population is unknown.MethodsThis was a retrospective cohort study in adults with SA, using data from the Northern Ireland Regional Severe Asthma Service (September 2015-November 2021). We calculated annual greenhouse gas emissions (GHGs; carbon dioxide equivalent) for asthma-related medications and healthcare resource utilisation, compared patient characteristics by GHG-quartile, calculated GHG change post-biologic initiation and explored the relationship between GHG change and clinical response.ResultsAmong 303 patients with SA, mean GHGs was 474 kg (sd:431), largely driven by SABA-use (50.7%) and ED/hospitalizations (21.0%). Those with highest-quartile GHGs were more likely to have uncontrolled disease (ACQ 3.5versus2.5; p<0.001), be more deprived (46.1%versus25.0%, p=0.029) and have depression/anxiety (35.5%versus14.7%, p=0.002)versusthose with lowest-quartile GHGs. Among patients who received a biologic (n=213), modest GHG reductions (−28.0 kg [sd:286], p=0.15) were observed, largely driven by reduction in ED/hospitalization-related GHGs (−59.3 [sd:224], p<0.001). SABA-related GHG emissions were relatively unchanged (−6.1 kg [sd:138]), p=0.518). Total GHGs were 72.4 kg (sd:352, p=0.044) lower than baseline 4-years post-biologic-initiation. Although there was substantial clinical improvement post-biologic-initiation, this was not associated with GHG reductions.ConclusionsSA is associated with substantial GHGs, primarily driven by SABA use and emergency care utilisation. Although GHG emissions were lower post-biologic, largely due to a reduction in emergency care, the changes in GHGs were modest and SABA-use was relatively unchanged. An improved understanding of the factors driving elevated GHGs is required.
Bioconversion efficiency and chemical composition of Hermetia illucens larvae fed spent mushroom substrates
Authors: Nayak Anjani , Rühl Martin , Klüber Patrick 
Published: December 2024

AbstractSpent mushroom substrate (SMS) is a by-product remaining after harvesting mushrooms. We evaluated the effect of substituting chicken feed with 0–100% of Pleurotus eryngii and Lentinula edodes SMS at different stocking densities (200–1000 larvae/box) on development, composition, and substrate reduction of black soldier fly (Hermetia illucens) larvae. Although the survival rate was not significantly different, feeding pure SMS led to a low growth rate. The substitution level of SMS negatively correlated with individual larval weight, total harvested biomass, larval growth rate (LGR), feed conversion ratio (FCR), substrate reduction, and waste reduction index (WRI) except for the 20% substitution. Feeding 40% SMS resulted in the highest number of prepupae. In the density experiment, the heaviest larvae (220–239 mg fresh weight) were obtained at 200 larvae/box in the 0% SMS group. The frass residue and FCR decreased with increased density. Remarkably, when feeding 20% SMS at 250 larvae/box, the harvested biomass, LGR, and FCR did not differ significantly from the 0% SMS control, whereas some of the higher densities led to a deterioration. In fact, the frass residue, substrate reduction, and WRI were even improved at 250 larvae/box in the 20% SMS group. The chemical analyses of larvae reared on 20% SMS at 250 larvae/box showed comparable ash and fat contents and a higher protein content compared to the 0% SMS group. Accordingly, up to 20% of a standard diet such as chicken feed can be replaced by low-cost SMS without disadvantages for breeding.