bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and Acceptance of a Remotely Supervised Home-Based Group Mobility Exercise for Older Adults Using a Mobile Robotic Telepresence: A Pilot Study
Authors: Robin Louise , Borel Benoit , Mandigout Stéphane , De Serres-Lafontaine Annabelle , Batcho Charles Sebiyo 
Published: December 2024

Background/Objectives: Mobile robotic telepresence could be used to remotely supervise physical activity programs. Our study aims to explore the feasibility, acceptance, and usability of a physical activity program offered synchronously via a mobile robotic telepresence platform. Methods: For this interventional study, five Cutii robots were made available in two residences for older adults in Quebec. Participants received the exercise program, two sessions per week for 4–6 weeks, delivered remotely via the robot. The following feasibility indicators were collected during the study, as recommended by Thabane et al.: process, resources, management, and intervention. Acceptance and usability of the technology were measured using the extended version of the Unified Theory of Acceptance and Use of Technology-based questionnaire and the System Usability Scale, respectively. Results: Eighty percent of participants completed the protocol, and 58% of participants attended 80% of the sessions. Various technical problems (internet connection and technology issues) limited the usability and acceptance of the technology. Conclusion: The results revealed that the program was feasible according to the process, management, and intervention indicators but unsatisfactory in terms of resources. For some participants, minor modifications were needed to improve technology support and facilitate connection to the mobile robotic telepresence. Further studies will need to focus on the evaluation of the effectiveness of this type of intervention. Implications: These results emphasize the importance of continuing research evaluating the opportunities provided by new technologies to enhance older adults’ engagement in physical activity and inform clinicians and policymakers to improve future services in this domain.
Geochemical transition from Miocene–Pliocene to Quaternary arc volcanism in the northern Sierra Nevada, California
Authors: Stoffers Albert J. , Clarke Christopher A.L. , Cousens Brian L. , Henry Christopher D. , Timmermans Ann C. 
Published: December 2024

ABSTRACT
Miocene–Pliocene volcanism around Lake Tahoe, California/Nevada, USA, part of the Southern Ancestral Cascades arc, ceased at around 3 Ma as the southern edge of the subducting Juan de Fuca plate migrated north of the region. Post–3 Ma, arc volcanism continued north of Lake Tahoe, but modern subduction and arc volcanism now occur only north of the Lassen volcanic center. Miocene–Pliocene Tahoe arc lavas appear to include an older mantle source component that is not common in Quaternary Lassen arc rocks. The goal of this work was to investigate how magma sources and/or volcanic processes transitioned in the northern Sierra Nevada between Lake Tahoe and Lassen. The Sierra Nevada between Lake Tahoe and Lassen, or the North Sierra segment of the Ancestral Cascades, includes eroded remnants of Ancestral Cascades volcanic rocks, including lava flow complexes, intrusions, and landslide/debris-flow deposits. Lava samples from the North Sierra segment include calc-alkaline basalts to dacites, with rare rhyolites. All North Sierra segment lavas exhibit normalized incompatible-element patterns with negative Nb, Ta, and Ti anomalies and positive Pb, Sr, and Ba anomalies. The North Sierra segment is geochemically split into two parts: a northern group including lavas from the Susanville area, and a southern group consisting of arc rocks from the Portola, Sierraville, Henness Pass, and Sagehen areas. With the exception of the Sagehen area, the North Sierra segment shows little variation in radiogenic isotope ratios with SiO2, indicating that assimilation of crustal rocks was outweighed by liquid-crystal crystallization during magma evolution. Trace-element and isotopic ratios in mafic rocks of the northern group are more typical of Lassen area Quaternary volcanic rocks, whereas those of southern group mafic rocks are more typical of Miocene–Pliocene arc lavas of the Lake Tahoe area. The isotopic distinction between Lassen-like and Tahoe-like arc lavas is likely controlled by basement age and lithology, where Lassen-like magmas were derived largely by mantle wedge melting and Tahoe-like magmas were primarily partial melts of metasomatized Sierran lithospheric mantle. The Susanville area represents the “transition zone” between these two geochemically distinct primary magma sources.
Optimising fatigue, abdominal pain and faecal incontinence in people with inflammatory bowel disease (IBD-BOOST Optimise): feasibility study of a checklist and algorithm for initial nurse-led management
Authors: Stagg Imogen , Hart Ailsa , Cléirigh Büttner Fionn , Fikree Asma , McLaughlin John , LeBlanc Jean-Frederic , Bouri Sonia , Hamborg Thomas , Miller Laura , Norton Christine 
Published: December 2024

ObjectiveMany people with inflammatory bowel disease (IBD) experience fatigue, pain and faecal incontinence that some feel are inadequately addressed. It is unknown how many have potentially reversible medical issues underlying these symptoms.MethodsWe conducted a study testing the feasibility of a patient-reported symptom checklist and nurse-administered management algorithm (‘Optimise’) to manage common medical causes of IBD-related fatigue, pain and faecal incontinence. We conducted qualitative interviews with nurses implementing the algorithm.Results515 individuals reporting IBD-related symptoms were invited to participate, of whom 201 (39%) consented. 194/201 (97%) returned the symptom checklist, of whom 157 (81%) returned a postal faecal calprotectin sample. Five (3%) participants reported ‘red flags’ and 31/157 (20%) participants had a faecal calprotectin result ≥200 µg/g, of whom 12 (8%) were judged to have likely active inflammation when clinical symptoms and disease history were reviewed. The algorithm suggested at least one clinical test or intervention for fatigue, pain or faecal incontinence in 67 (43%) participants, of whom 25 (37%) declined. Among 87 participants for whom clinical actions were indicated, 57 (66%) completed follow-up outcomes 3 months after algorithm implementation. Three nurses interviewed found the Optimise algorithm easy to administer.ConclusionImplementing the Optimise checklist and algorithm appears feasible in UK clinical practice, with adjustments needed to minimise missing items. Not all patients accepted algorithm-indicated interventions, but a yield of 43% with symptoms having potentially reversible causes detected is clinically useful. Nurses endorsed ease and utility of the implementation process. Optimise now needs clinical effectiveness to be assessed.
Effectiveness of potent topical corticosteroids versus mild ones in primary care for children with moderate flare-ups of atopic dermatitis; results of a randomised controlled trial
Authors: van Halewijn Karlijn F , Elshout Gijs , Bohnen Arthur M , Bindels Patrick J E , Pasmans Suzanne G M A 
Published: December 2024

ObjectiveTo assess the effectiveness of a potent topical corticosteroid (TCS) as an initial treatment in primary care for children with moderate flare-ups of atopic dermatitis (AD), compared to starting on a mild TCS.DesignAn observational prospective cohort study with an embedded pragmatic multicentre open-label randomised controlled trial.SettingA total of 53 general practices in the southwest of the Netherlands took part in the study.Participants209 children aged 3 months to 17 years diagnosed with AD (International Classification of Primary Care codes S87 or S88) who visited their general practitioner (GP) for AD or received repeat prescriptions for AD in the previous 12 months were included in the cohort study through the general practices. Finally, 32 patients (15%) were randomised and assigned to the trial (13 girls; 19 boys; median age 4.0 years).InterventionsIf cohort participants experienced a moderate flare-up (ie, need to intensify topical treatment from the child’s and/or parents’ point of view of AD and a three-item severity score from three to<6 scored by their GP) during cohort follow-up, they were randomised to either the intervention group, a strong TCS (class III, fluticasone propionate 0.05%), or the control group, a mild TCS (class I, hydrocortisone acetate 1%).Primary and secondary outcome measuresWe measured outcomes at baseline and at 1, 4 and 24 weeks. The primary outcome was AD-related symptoms (Patient-Oriented Eczema Measure (POEM) score) measured over 24 weeks of follow-up. Secondary outcomes included the Eczema Area and Severity Index, the Investigators Global Assessment, quality of life (QoL), Patient Global Assessment, Numeric Itch Intensity Score and TCS use.ResultsThe primary outcome showed a significant difference in the POEM scores over 24 weeks of follow-up between the intervention group (n=17) and the control group (n=15) (3.3 vs 9.4, p=0.023). The potent TCS also significantly improved the POEM at 1 week (5.5 vs 12.0, p=0.042) and 4 weeks (4.3 vs 12.7, p=0.030). Improvement in the QoL was significant at 4 weeks (1.0 vs 4.5, p=0.014) and 24 weeks (0.0 vs 2.0, p=<0.000).ConclusionDespite the small sample size, the data suggests a clinical benefit from starting with a potent TCS rather than a mild TCS when a flare-up of AD is moderate.Trial registrationThe Netherlands National Trial Register: NTR6679.
Impact of mindfulness-based tri-modal prehabilitation on functional recovery and selected surgical outcomes of patients with colorectal cancer admitted to surgical hospital wards: the first international randomised control trial for mindfulness-based tri-modal prehabilitation
Authors: Gamage Bawantha , Gamage Manori Nayanakantha , Perera Nilushika Madushani , Kodikara Chadani Samararatna , Wijeratne Jayamina Udhara Munasinghe , Seneviratne Alles S M D P , Kumaran Thavendra , Jeewandara J M Chandima , Mahawithanage Sanath Thushara Chamakara 
Published: December 2024

IntroductionColorectal cancer (CRC) is the third most common and second most deadly cancer worldwide, with significant morbidity and mortality risks. Despite advancements in surgical care, postoperative complications and recovery challenges persist. The severity of these issues is linked to preoperative functional capacity and emotional distress. Mindfulness, known for enhancing emotional well-being, is being considered as a promising intervention in cancer care. This study investigates the effectiveness of mindfulness-based tri-modal prehabilitation in improving functional recovery and surgical outcomes for patients with CRC.Methods and analysisThe sample size of this prospective, randomised controlled trial was calculated based on the primary outcome, which is the detection of the clinically significant difference in a 6 min walk test (6MWT). With our population variables, the size of the sample was estimated for an α level of 0·05 (two-sided) and 80% power to detect a clinically meaningful difference between groups at postsurgical follow-up of 32 m, with an estimated variability of 64 m based on previous studies. The final sample size is 72 patients, in both arms. Both groups will receive a 4-week standard tri-modal prehabilitation. The intervention group will receive a mindfulness practice module. Outcomes will be measured at four different time intervals for each patient. Secondary outcome measures cover nutritional status, psychological status and selected biomarker status. Patient recruitment to the study started in April 2022.Ethics and disseminationThis study was approved by the Ethics Review Committee of the Faculty of the Medical Sciences University of Sri Jayewardenepura (Registration No: FMC/ USJP ERC 29/19) and the Ethics Review Committee of Colombo South Teaching Hospital (Reference number 915). The research results will be published in peer-reviewed publications and presented at international conferences.Trial registration numberSLCTR/2020/022.
Scope of work and contributions of female community health volunteers in Nepal’s healthcare sector: a qualitative study
Authors: Joshi Anjali , Marasini Sabina , Sharma Sudim , Paneru Bandana , Kunwar Surakshya , Shrestha Archana , Shrestha Akina , Karmacharya Biraj Man 
Published: December 2024

ObjectivesTo determine the perception of female community health volunteers (FCHVs) in terms of their scope of work, impact of work on their professional experiences and their coping strategies and stakeholders’ perception of FCHVs programme, their contribution to the health sector and its sustainability.DesignA qualitative study involving in-depth interviews (IDIs) with FCHVs and key informant interviews (KIIs) with local stakeholders. All the interviews were conducted through telephone.SettingSix municipalities in Kavre district, Nepal.Participants16 FCHVs participated in IDIs and 12 local stakeholders involving members of mother’s group, health workers and local ward representatives of the selected municipalities were involved in KIIs from May to August 2021.ResultsThe FCHVs perceived a sense of workload because of their wide scope of work. The major challenges faced by FCHVs were limited allowances and incentives for their contribution, negative and judgemental attitudes, geographical challenges, multitasking, inadequate supply of health commodities and limited infrastructures for service delivery. Both the FCHVs and the stakeholders perceived the FCHV programme as one of the most effective programmes supporting the health system. However, they seem concerned about the sustainability of FCHVs programme. In addition, they indicated that the FCHVs could possibly alleviate the shortage of health workforce by providing preventive and promotive healthcare services at the grassroot level.ConclusionOur study showed a need for systematic and integrated health programme delivery packages thereby reducing additional workload and burden among FCHVs.
Conceptualising Centres of Clinical Excellence: A Scoping Review
Authors: Kandasamy Thoshenthri , Stockley Rachel C , Hendriks Jeroen M , Fini Natalie Ann , Bulto Lemma N , Lynch Elizabeth A 
Published: December 2024

ObjectivesCentres of clinical excellence (CoCE) are healthcare facilities that provide excellent healthcare. However, despite their increasing prevalence, it is unclear how CoCE are identified and monitored. This paper explores how CoCE has been described in the literature, including its defining characteristics and selection and monitoring processes.DesignWe conducted a scoping review following Arksey and O’Malley’s framework, enhanced by Levacet al. Additionally, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Data sourcesA comprehensive search using MEDLINE Ovid, PubMed, Web of Science, CINAHL and Scopus was conducted to identify relevant literature from January 2010 to June 2022.Eligibility criteria for selecting studiesWe included published studies and grey literature that described how a CoCE was defined, established, monitored or evaluated.Data extraction and synthesisTwo independent reviewers completed the title and abstract screening, reviewed the full texts and extracted data.Results50 records describing 45 initiatives were included. More than half were published in the USA (n=25, 56%). All but one initiative focused on one clinical condition/population, most commonly cardiovascular disease (n=8, 17%), spinal surgeries (n=4, 9%) and pituitary tumours (n=4, 9%). Most initiatives (n=30, 67%) described a structured process to establish CoCE. The definitions of CoCE were not uniform. Common defining features included the volume of patients treated, medical expertise, a highly skilled multidisciplinary team, high-quality care and excellent patient outcomes. Identification as a CoCE varied from self-identification with no explicit criteria to application and assessment by an approval panel.ConclusionDespite a growing prevalence of CoCE, there are inconsistencies in how CoCE are established, identified, monitored and evaluated. Common (but not uniform) features of CoCE are highly skilled staff, high-quality care delivery and optimal patient outcomes.
Equity of intensive care unit bed resource allocation in ethnic minority areas of China—an empirical analysis based on geographical and population dimensions
Authors: Zhou Junxu , Peng Rong , Feng Jun , Kang Jing , Deng Meng , Meng Shanshan , Qin Xianjing , Lu Decheng 
Published: December 2024

ObjectiveThe purpose of this study is to analyse the changes in the equity of intensive care unit (ICU) bed allocation in 14 cities in China’s Guangxi Zhuang Autonomous Region from 2018 to 2021, to identify the problems in the process of ICU bed allocation in China’s ethnic minority regions.DesignThe Gini coefficient, Theil index, health resource density index, and spatial correlation analysis were used to analyse the current status of ICU bed resource allocation and allocation equity in Guangxi, China, on two dimensions: geography, and population.SettingThe Guangxi Zhuang Autonomous Region.ResultsThe number of ICU beds configured by geographic and population dimensions in Guangxi basically showed a growing trend. The ICU bed allocation by population dimensions was in a state of absolute equity, and the equity of geographic dimension was in a state of basic reasonableness. The contribution rate of intraregional differences is higher than that of inter-regional differences. There is a localised spatial aggregation of ICU bed resource allocation, with a low health resource density index and a higher proportion of lack of ICU beds in cities with a high concentration of ethnic minority populations, such as Hechi, Chongzuo, Baise, Hezhou, and Laibin.ConclusionsThe total amount of ICU bed resources increased, but the regional distribution was not balanced. The equity of ICU beds allocated by population and economy was better than that by geography, the unfairness of ICU bed allocation was mainly caused by intraregional differences, and the lack of the number of ICU beds was greater in the economically underdeveloped ethnic minority areas. Exchanges and cooperation between regions should be strengthened to promote the coordinated development of ICU bed resources between regions.
Improving the accUracy of Referrals to the emerGency departmEnt of patieNts with chesT pain using the modified HEART score in Emergency Medical Transport (URGENT 2.0): protocol for a multicentre randomised controlled trial
Authors: Frenk Lisa D S , Rahel Braim M , de Vos Cees B , van Osch Frits H M , Prestigiacomo Fabiana G , Janssen Marcel J W , Willemsen Robert T A , van 't Hof Arnoud W , Meeder Joan G 
Published: December 2024

IntroductionIschaemic heart disease is the single most common cause of death worldwide. Traditionally, distinguishing patients with cardiac ischaemia from patients with less alarming disease, in prehospital triage of chest pain, is challenging for both general practitioners and ambulance paramedics. Less than 20% of patients with chest pain, transferred to the emergency department (ED), have an acute coronary syndrome (ACS) and the transportation and analysis at the ED of non-ACS patients result in substantial healthcare costs and a great patient burden. Advanced risk stratification, with the help of cardiac troponin measurements, seems crucial to improve prehospital diagnostic accuracy.Methods and analysisThe URGENT 2.0 trial is a randomised controlled trial in which the primary objective is to reduce the referral of non-cardiac chest pain (NCCP) patients, using a modified HEART score including a high-sensitivity capillary point-of-care high-sensitivity cardiac troponin I measurement. Patients are included by ambulance paramedics and 1:1 randomised for (1) regular care (control group) or (2) modified HEART score analysis (intervention group) and non-referral in case of a low modified HEART score (0–3). In total, 852 patients will be included. Follow-up will be performed at 30 days, 6 months and 12 months. Both referral rates of NCCP patients and the occurrence of major adverse cardiac events are defined as primary outcome measures.Ethics and disseminationThe medical ethics committee Zuyderland-Zuyd Hogeschool (Netherlands) has approved this trial (reference numbers NL71820.096.19 and METCZ20190139). Written informed consent will be obtained from all participating patients. The results of this trial will be disseminated in one main paper and in additional papers with subgroup analyses.Trial registrationClinicalTrials.gov,NCT04904107.
Cross-sectional evaluation of medical reversals among National Institute of Health guideline practices implemented during the COVID-19 pandemic: how often did experts err in a time of crisis?
Authors: Kacew Alec J , Haslam Alyson , Prasad Vinay , Cifu Adam S 
Published: December 2024

ObjectiveThe COVID-19 pandemic required the rapid and often widespread implementation of medical practices without robust data. Many of these practices have since been tested in large, randomised trials and were found to be in error. We sought to identify incorrect recommendations, or reversals, among National Institute of Health COVID-19 guidelines and Food and Drug Administration (FDA) approvals and authorisations.DesignRetrospective cross-sectional study.ParticipantsRecommended medical practices and FDA authorisations or approvals for COVID-19 prevention, treatment and/or management.Main outcome measuresThe frequency and characteristics of COVID-19 medical reversals, defined as practices that were implemented and/or recommended during the pandemic, but were later tested in randomised trials that failed to find benefit.ResultsWe found 332 COVID-19 recommendations. 85 (25.6%) opposed a medical practice, 23 (6.9%) were to continue a pre-COVID standard of care without deviation and 224 (67.5%) reccommended a new medical practice. We found randomised trials assessing 72 of these practices (32.1%), among which 25 (35%) were found to be in error and deemed medical reversals. Among medical reversals, 21 (84%) were prescription medications and 1 (4%) was convalescent plasma. 17 (68%) were repurposed medications. Two (8%) were procedures or mechanical interventions and one (4%) was a device. 16 (64%) reversals pertained to the hospital setting (4 to intensive care units), 4 (16%) were non-specific (ie, applicable to any setting), 4 (16%) pertained to a non-hospital setting and 1 pertained to healthcare workers.ConclusionWhen faced with a novel pandemic, policymakers rapidly made hundreds of specific medical recommendations. More than two out of three were never robustly tested. Among practices tested in a randomised fashion, one in three was made in error. Pandemic recommendation errors were substantial. Early and coordinated efforts to initiate randomised trials, even during dire situations, may mitigate the perpetuation of ineffective practices.