bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teaching and learning how to make informed health choices: Protocol for a context analysis in Spanish primary schools
Authors: Martínez García Laura , Samsó Jofra Laura , Alonso-Coello Pablo , Ansuategi Eukane , Asso Mistral Laia , Ballesteros Monica , Canelo-Aybar Carlos , Casino Gonzalo , Gallego Iborra Ana , Niño de Guzmán Quispe Ena Pery , Requeijo Carolina , Roqué i Figuls Marta , Salas Karla , Ubeda Mar , Urreta Iratxe , Rosenbaum Sarah 
Published: August 2021

Introduction The Informed Health Choices (IHC) project developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore the educational context for teaching and learning critical thinking about health in Spanish primary schools. Methods During the 2020-2021 school year, we will conduct 1) a systematic assessment of educational documents and resources, and 2) semi-structured interviews with key education and health stakeholders. In the systematic assessment of educational documents and resources, we will include state and autonomous communities’ curriculums, school educational projects, and commonly used textbooks and other health teaching materials. In the semi-structured interviews, we will involve education and health policy makers, developers of learning resources, developers of health promotion and educational interventions, head teachers, teachers, families, and paediatric primary care providers. We will design and pilot a data extraction form and a semi-structured interview guide to collect the data. We will perform a quantitative and a qualitative analysis of the data to explore how critical thinking about health is being taught and learned in Spanish primary schools. Conclusion We will identify opportunities for and barriers to teaching and learning critical thinking about health in Spanish primary schools. We will formulate recommendations—for both practice and research purposes—on how to use, adapt (if needed), and implement the IHC resources in this context.
Development of a legume-enriched feed for treatment of severe acute malnutrition
Authors: Walsh Kevin , Delamare de la Villenaise de Chenevarin Gael , McGurk Joe , Maitland Kathryn , Frost Gary 
Published: August 2021

Background: Outcomes in children hospitalised with severe acute malnutrition (SAM) remain poor. The current milk-based formulations focus on restoring weight-gain but fail to address modification of the integrity of the gut barrier and may exacerbate malabsorption owing to functional lactase, maltase and sucrase deficiency. We hypothesise that nutritional feeds should be designed to promote bacterial diversity and restore gastrointestinal (GI) barrier function. Methods: Our major objective was to develop a lactose-free, fermentable carbohydrate-containing alternative to traditional F75 and F100 formulae for the inpatient treatment of SAM. New target nutritional characteristics were developed and relevant food and infant food specific legislation were reviewed. Suitable certified suppliers of ingredients were identified. Processing and manufacture steps were evaluated and optimised for safety (nutritional, chemical and microbiological), and efficacy at meeting target characteristics (lactose-free, containing resistant starch 0.4-0.5% final product weight). Results: A final validated production process was developed and implemented to produce a novel food product for the inpatient treatment of SAM in children in Africa designed to reduce risk of osmotic diarrhoea and support symbiotic gut microbial populations. The final product matched the macronutrient profile of double-concentrated F100, adhered to all relevant legislation regulating infant foods, was lactose free, and contained 0.6% resistant starch. Chickpeas were selected as the source of resistant starch, since they are widely grown and eaten throughout Africa. Micronutrient content could not be matched in this ready-to-use product, so this was replaced at the point of feeding, as was fluid lost through concentration. Conclusions: The processes and product described illustrate the development steps for a novel nutritional product. The new feed product was ready for evaluation for safety and efficacy in a phase II clinical trial in Ugandan children admitted to hospital with SAM (Modifying Intestinal MicroBiome with Legume-Based feed 2: MIMBLE feed 2 (ISRCTN10309022)).
Sepsis knowledge, skills and attitudes among ward-based nurses
Authors: Edwards Eirian , Jones Lorelei 
Published: August 2021

Background: Nurses are in a prime position to identify sepsis early by screening patients for sepsis, a skill that should be embedded into their daily practice. However, compliance with the sepsis bundle remains low. Aims: To explore the effects of sepsis training on knowledge, skills and attitude among ward-based nurses. Methods: Registered nurses from 16 acute surgical and medical wards were invited to anonymously complete a questionnaire. Findings: Response rate was 39% (98/250). Nurses with sepsis training had better knowledge of the National Early Warning Score 2 for sepsis screening, and the systemic inflammatory response syndrome (SIRS) criteria, demonstrated a more positive attitude towards sepsis screening and management, were more confident in screening patients for sepsis and more likely to have screened a patient for sepsis. Conclusions: Sepsis training improves nurses' attitudes, knowledge and confidence with regards to sepsis screening and management, resulting in adherence to evidence-based care, and should become mandatory for all clinical staff.
Rigorous FM-EDF design with an oversized two-layer erbium ion distribution for C-band DMG mitigation
Authors: Zeng Yan , Fang Yihong , Qin Yuwen , Xu Ou , Li Jianping , Fu Songnian 
Published: August 2021

We present a rigorous design of few-mode erbium doping fiber (FM-EDF) with an oversized two-layer erbium ion distribution at the central region with effective differential modal gain (DMG) mitigation over the C-band. The proposed erbium doping distribution allows for a similar overlapping integral value among the guided modes, leading to a signal gain equalization over the C-band. When the length of the proposed FM-EDF is 8 m under the cladding pumping power of 2.5 W, our calculated results reveal that four linearly polarized (LP)-modes can achieve an average gain per mode of 24.8 dB and a typical DMG of less than 0.64 dB over the C-band. Meanwhile, we carry out numerical simulations to explore the fabrication tolerance of the oversized two-layer erbium doping distribution with respect to the DMG, indicating stable DMG mitigation over the C-band. We believe that such new manipulation of erbium doping distribution is helpful for the multiple-dimensional multiplexing of fiber optical transmission.
Direct measurement of pulse wave propagation in capillaries of the human retina
Authors: Bedggood Phillip , Metha Andrew 
Published: August 2021

With each contraction of the heart’s left ventricle, a pulse pressure wave surges into the aorta and propagates throughout the vascular tree. The pulse wave drives blood flow forward. Its passage is complex, but it passes more quickly through non-compliant, or stiff, vessels, providing an important signpost of cardiovascular disease. The transparent media of the eye allow direct and non-invasive measurement of this phenomenon within the microvasculature of neural tissue. However, previous estimates differ over three orders of magnitude. Here, we used high spatiotemporal resolution adaptive optics imaging to directly track the pulse wave within individual retinal capillaries in three human subjects. Across 74 unique capillary segments, pulse wave velocity averaged

6.4

±

0.5

m
m

/

s
e
c

(

m
e
a
n

±

S
E
M

). There was large variation between vessels; the slowest pulse wave was at most 0.8 mm/sec and the fastest at least 17.6 mm/sec. In 44% of vessels, the pulse wave traveled upstream, in the opposite direction to flow, suggesting wave reflection from downstream collecting junctions.
kW-level monolithic single-mode narrow-linewidth all-solid photonic bandgap fiber amplifier
Authors: Pulford Benjamin , Holten Roger , Matniyaz Turghun , Kalichevsky-Dong Monica T. , Hawkins Thomas W. , Dong Liang 
Published: August 2021

Further power scaling of narrow-linewidth fiber lasers is critical for beam combining. Using all-solid photonic bandgap fibers with large effective mode areas and strong higher-order-mode suppression is an interesting approach. Previously, we demonstrated

∼

400

W

single-frequency single-mode power at 1064 nm from a 50/400 photonic bandgap fiber amplifier, limited only by transverse mode instability (TMI). In this work, we demonstrate a TMI-limited single-mode power of 1.37 kW from a monolithic fiber amplifier with a 25/400 photonic bandgap fiber, the highest output power from a photonic bandgap fiber demonstrated to date, to the best of our knowledge. The spectral linewidth is broadened to

∼

8

G
H
z

to suppress stimulated Brillouin scattering.
Case-area targeted interventions (CATI) for reactive dengue control: Modelling effectiveness of vector control and prophylactic drugs in Singapore
Authors: Brady Oliver J. , Kucharski Adam J. , Funk Sebastian , Jafari Yalda , Loock Marnix Van , Herrera-Taracena Guillermo , Menten Joris , Edmunds W. John , Sim Shuzhen , Ng Lee-Ching , Hué Stéphane , Hibberd Martin L. 
Published: August 2021

Background
Targeting interventions to areas that have recently experienced cases of disease is one strategy to contain outbreaks of infectious disease. Such case-area targeted interventions (CATI) have become an increasingly popular approach for dengue control but there is little evidence to suggest how precisely targeted or how recent cases need to be, to mount an effective response. The growing interest in the development of prophylactic and therapeutic drugs for dengue has also given new relevance for CATI strategies to interrupt transmission or deliver early treatment.

Methods/Principal findings
Here we develop a patch-based mathematical model of spatial dengue spread and fit it to spatiotemporal datasets from Singapore. Simulations from this model suggest CATI strategies could be effective, particularly if used in lower density areas. To maximise effectiveness, increasing the size of the radius around an index case should be prioritised even if it results in delays in the intervention being applied. This is partially because large intervention radii ensure individuals receive multiple and regular rounds of drug dosing or vector control, and thus boost overall coverage. Given equivalent efficacy, CATIs using prophylactic drugs are predicted to be more effective than adult mosquito-killing vector control methods and may even offer the possibility of interrupting individual chains of transmission if rapidly deployed. CATI strategies quickly lose their effectiveness if baseline transmission increases or case detection rates fall.

Conclusions/Significance
These results suggest CATI strategies can play an important role in dengue control but are likely to be most relevant for low transmission areas where high coverage of other non-reactive interventions already exists. Controlled field trials are needed to assess the field efficacy and practical constraints of large operational CATI strategies.
Cancer caregivers unmet needs and emotional states across cancer treatment phases
Authors: Yang Winson Fu Zun , Lee Rachael Zhi Yi , Kuparasundram Sangita , Tan Terina , Chan Yiong Huak , Griva Konstadina , Mahendran Rathi 
Published: August 2021

Study objective
To investigate the association between family cancer caregivers’ unmet daily needs and emotional states of depression, anxiety and stress across their care recipient’s treatment phases.

Method
A cross-sectional study design and self-report questionnaires were used. Family caregivers (N = 237) of cancer patients in ambulatory cancer clinics were recruited from May to December 2017, and completed a sociodemographic and medical questionnaire, the Depression Anxiety Stress Scale and Needs Assessment of Family Caregivers-Cancer Scale. Hierarchical linear regression was conducted to examine the influence of each predictor (sociodemographic variables, unmet personal care and role management needs, cancer treatment phase) on the Depression Anxiety Stress Scale total score, depression subscale, anxiety subscale, and the stress subscale.

Results
Family caregivers’ unmet daily activity needs, in particular higher unmet personal care needs, during the intermediate phase (6–9 months), were significantly associated (ps<0.05) with overall distress (b = 4.93) and stress (b = 2.26). In the chronic treatment phase (>9 months), the significant association of unmet personal care needs was with overall distress (b = 5.91), anxiety (b = 1.97) and stress (b = 2.53). After completing treatment, unmet role management needs were only significantly associated with stress (b = -1.59). Caregivers’ higher depression was also associated with greater unmet role management needs, regardless of treatment phases.

Conclusions
Intermediate and chronic cancer treatment phases were identified as having greatest effect on caregivers’ unmet daily activity needs and emotions. Unmet personal care needs played the major effect on overall negative emotional states in the intermediate treatment phase and stress in the chronic treatment phase. Close attention to caregivers needs in intermediate and chronic treatment phases, would be highly beneficial in alleviating negative emotional disturbances.
Pulmonary tumor embolism: A retrospective study over a 30-year period
Authors: He Xin , Anthony Douglas C. , Catoni Zulmira , Cao Weibiao 
Published: August 2021

BackgroundPulmonary tumor embolism (PTE) is difficult to detect before death, and it is unclear whether the discrepancy between antemortem clinical and postmortem diagnosis improves with the advance of the diagnostic technologies. In this study we determined the incidence of PTE and analyzed the discrepancy between antemortem clinical and postmortem diagnosis.MethodsWe performed a retrospective autopsy study on patients with the history of malignant solid tumors from 1990 to 2020 and reviewed all the slides of the patients with PTE. We also analyzed the discrepancies between antemortem clinical and postmortem diagnosis in 1999, 2009 and 2019 by using the Goldman criteria. Goldman category major 1 refers to cases in which an autopsy diagnosis was the direct cause of death and was not recognized clinically, but if it had been recognized, it may have changed treatment or prolonged survival.ResultsWe found 20 (3%) cases with PTE out of the 658 autopsy cases with solid malignancies. Out of these 20 cases, urothelial carcinoma (30%, 6/20) and invasive ductal carcinoma of the breast (4/20, 20%) were the most common primary malignancies. Seven patients with shortness of breath died within 3–17 days (average 8.4±2.2 days) after onset of the symptoms. Pulmonary embolism was clinically suspected in seven out of twenty (35%, 7/20) patients before death, but only two patients (10, 2/20) were diagnosed by imaging studies before death. The rate of Goldman category major 1 was 13.2% (10/76) in 1999, 7.3% (4/55) in 2009 and 6.9% (8/116) in 2019. Although the rate of Goldman category major 1 appeared decreasing, the difference was not statistically significant. The autopsy rate was significantly higher in 2019 (8.4%, 116/1386) than in 2009 (4.4%, 55/1240).ConclusionsThe incidence of PTE is uncommon. Despite the advances of the radiological techniques, radiological imaging studies did not detect the majority of PTEs. The discrepancy between the antemortem clinical and the postmortem diagnosis has not improved significantly over the past 30 years, emphasizing the value of autopsy.
Testing telediagnostic right upper quadrant abdominal ultrasound in Peru: A new horizon in expanding access to imaging in rural and underserved areas
Authors: Marini Thomas J. , Oppenheimer Daniel C. , Baran Timothy M. , Rubens Deborah J. , Dozier Ann , Garra Brian , Egoavil Miguel S. , Quinn Rosemary A. , Kan Jonah , Ortega Rafael L. , Zhao Yu T. , Tamayo Lorena , Carlotto Claudia , Castaneda Benjamin 
Published: August 2021

Background
Hepatic and biliary diseases are prevalent worldwide, but the majority of people lack access to diagnostic medical imaging for their assessment. The liver and gallbladder are readily amenable to sonographic examination, and ultrasound is a portable, cost-effective imaging modality suitable for use in rural and underserved areas. However, the deployment of ultrasound in these settings is limited by the lack of experienced sonographers to perform the exam. In this study, we tested an asynchronous telediagnostic system for right upper quadrant abdominal ultrasound examination operated by individuals without prior ultrasound experience to facilitate deployment of ultrasound to rural and underserved areas.

Methods
The teleultrasound system utilized in this study employs volume sweep imaging and a telemedicine app installed on a tablet which connects to an ultrasound machine. Volume sweep imaging is an ultrasound technique in which an individual scans the target region utilizing preset ultrasound sweeps demarcated by easily recognized external body landmarks. The sweeps are saved as video clips for later interpretation by an experienced radiologist. Teleultrasound scans from a Peruvian clinic obtained by individuals without prior ultrasound experience were sent to the United States for remote interpretation and quality assessment. Standard of care comparison was made to a same-day ultrasound examination performed by a radiologist.

Results
Individuals without prior ultrasound experience scanned 144 subjects. Image quality was rated “poor” on 36.8% of exams, “acceptable” on 38.9% of exams, and “excellent” on 24.3% of exams. Among telemedicine exams of “acceptable” or “excellent” image quality (n = 91), greater than 80% of the liver and gallbladder were visualized in the majority of cases. In this group, there was 95% agreement between standard of care and teleultrasound on whether an exam was normal or abnormal, with a Cohen’s kappa of 0.84 (95% CI 0.7–0.98, p <0.0001). Finally, among these teleultrasound exams of “acceptable” or “excellent” image quality, the sensitivity for cholelithiasis was 93% (95% CI 68.1%-99.8%), and the specificity was 97% (95% CI 89.5%-99.6%).

Conclusion
This asynchronous telediagnostic system allows individuals without prior ultrasound experience to effectively scan the liver, gallbladder, and right kidney with a high degree of agreement with standard of care ultrasound. This system can be deployed to improve access to diagnostic imaging in low-resource areas.
Elevated plasma free thiols are associated with early and one-year graft function in renal transplant recipients
Authors: Nielsen Marie B. , Jespersen Bente , Birn Henrik , Krogstrup Nicoline V. , Bourgonje Arno R. , Leuvenink Henri G. D. , van Goor Harry , Nørregaard Rikke 
Published: August 2021

Background
Reduced free thiols in plasma are indicative of oxidative stress, which is an important contributor to ischaemia-reperfusion injury (IRI) in kidney transplantation leading to kidney damage and possibly delayed graft function (DGF). In a post-hoc, exploratory analysis of the randomised controlled CONTEXT trial, we investigated whether higher (i.e. less oxidised) plasma levels of free thiols as a biomarker of reduced oxidative stress are associated with a better initial graft function or a higher GFR.

Methods
Free thiol levels were measured in plasma at baseline, 30 and 90 minutes after reperfusion of the kidney as well as at Day 1, Day 5 and twelve months after kidney transplantation in 217 patients from the CONTEXT study. Free thiol levels were compared to the kidney graft function measured as the estimated time to a 50% reduction in plasma creatinine (tCr50), the risk of DGF and measured GFR (mGFR) at Day 5 and twelve months after transplantation.

Results
Higher levels of free thiols at Day 1 and Day 5 are associated with higher mGFR at Day 5 (p<0.001, r2adj. = 0.16; p<0.001, r2adj. = 0.25), as well as with mGFR at twelve months (p<0.001, r2adj. = 0.20; p<0.001, r2adj. = 0.16). However, plasma levels of free thiols at 30 minutes and 90 minutes, but not Day 1, were significantly higher among patients experiencing DGF.

Conclusion
Higher levels of plasma free thiols at Day 1 and Day 5, which are reflective of lower levels of oxidative stress, are associated with better early and late graft function in recipients of a kidney graft from deceased donors.

Trial registration
ClinicalTrials.gov Identifier: NCT01395719.
Experiences of women undergoing assisted reproductive technology in Ghana: A qualitative analysis of their experiences
Authors: Anaman-Torgbor Judith A. , Jonathan Justice Wiston Amstrong , Asare Lily , Osarfo Bernice , Attivor Rita , Bonsu Afia , Fialor Elizabeth A. E. , Tarkang Elvis E. 
Published: August 2021

Objective
The study aimed to explore the experiences of women undergoing Assisted Reproductive Technologies namely; Invitro Fertilization and Intracytoplasmic Sperm Injection at the Finney Hospital and Fertility Centre, New Bortianor, Ghana.

Method
A qualitative research design was employed to analyse and describe the experiences of the women seeking Assisted Reproductive Technologies. A total of 32 women were invited to take part in the interview, 15 of them accepted the invitation. However, saturation was reached before all interviews had been complete.

Results
Three themes emerged from the study: the women’s experiences, challenges and the roles and contributions of significant others. The women were anxious, stressed-up, exhausted and financially burdened. Spouses and health professionals played significant roles by providing social, emotional and financial support for these women. Significant others such as spouses and close relatives were supportive and provided encouragement to the women.

Conclusion
The experiences of women undergoing Assisted Reproductive Technologies are multi-dimensional. Thus, psychosocial interventions as part of ART services with health insurance cover may be client-centered and more appropriate for these group of women.
Naming Atrocity: Theater of Operations: The Gulf Wars 1991–2011, curated by Peter Eleey and Ruba Katrib
Authors: Van de Mieroop Kenan 
Published: August 2021

Naming atrocity: Theater of Operations: The Gulf Wars 1991–2011, curated by Peter Eleey and Ruba Katrib
MoMA PS1, New York, 3 November 2019–1 March 2020
Narrativa transmídia
Authors: Falcão Barbara 
Published: August 2021

No presente artigo, apresentamos os resultados de uma pesquisa-ação que propõe o uso da Narrativa Transmídia para o ensino de língua portuguesa no Ensino Fundamental. A aplicação pedagógica da Narrativa Transmídia pode oferecer estratégias para a criação de atividades que permitam aos estudantes desenvolver habilidades relacionadas aos multiletramentos, conceito proposto pelo Grupo Nova Londres (1996) e preconizados pela BNCC. A análise do processo e do produto final da narrativa transmídia produzida por estudantes de uma escola pública da capital paulista indica que a aplicação pedagógica da Narrativa Transmídia pode mobilizar, de modo coordenado e significativo, conhecimentos acerca da tipologia textual narrativa (ADAM, 2019) e sobre a cultura digital, além de desenvolver habilidades de escrita e leitura sobre os mais variados gêneros textuais (BAKHTIN, 1997), promovendo o protagonismo e a criticidade dos estudantes por meio de atividades coletivas e colaborativas.