bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mission Impossible
Authors: Zamani Masoud , Kiani Amirabbas , Mohammadi Aghil 
Published: December 2024

Abstract
Imagine, as part of its ongoing investigations into the situation in Ukraine, the icc prosecutor finally seizes on the opportunity to make a case for prosecuting the war crime of attacking the environment as formulated under Article 8(2)(b)(iv) and cite, inter alia, the Nova Kakhovka Dam’s destruction as the principal incident triggering the application of the article. In the event of such a possibility, what restraints and difficulties punctuate the application of Article 8(2)(b)(iv), and what do such limits tell us about the juridical value of this provision? This essay argues that many technical nuances such as the meaning of ‘attack’ under international humanitarian law, incomplete information on who is responsible for the attack, and high thresholds of responsibility for environmental damage established under the Rome Statute will create insurmountable barriers to establishing responsibility for even the gravest damage to the environment, such as those witnessed in the destruction of the Nova Kakhovka Dam.
Global Distributions of Atmospheric Turbulence Estimated Using Operational High Vertical-Resolution Radiosonde Data
Authors: Ko Han-Chang , Chun Hye-Yeong , Geller Marvin A. , Ingleby Bruce 
Published: December 2024

Abstract
Atmospheric turbulence plays a key role in the mixing of trace gases and diffusion of heat and momentum, as well as in aircraft operations. Although numerous observational turbulence studies have been conducted using campaign experiments and operational data, understanding the turbulence characteristics particularly in the free atmosphere remains challenging due to its small-scale, intermittent, and sporadic nature, along with limited observational data. To address this, turbulence in the free atmosphere is estimated herein based on the Thorpe method by using operational high vertical-resolution radiosonde data (HVRRD) with vertical resolutions of about 5 or 10 m across near-global regions, provided by the European Centre for Medium-Range Weather Forecasts (ECMWF) via the U.S. National Centers for Environmental Information (NCEI) for 6 years (October 2017–September 2023). Globally, turbulence is stronger in the troposphere than in the stratosphere, with maximum turbulence occurring about 6 km below the tropopause, followed by a sharp decrease above. Seasonal variations show strong tropospheric turbulence in summer and weak turbulence in winter for both hemispheres, while the stratosphere exhibits strong turbulence during spring. Regional analyses identify strong turbulence regions over the South Pacific and South Africa in the troposphere and over East Asia and South Africa in the stratosphere. Notably, turbulence information can be provided in regions and high altitudes that are not covered by commercial aircraft, suggesting its potential utility for both present and future high-altitude aircraft operations.
Efficacy of behavioral cough suppression therapy for refractory chronic cough or unexplained chronic cough: a meta-analysis of randomized controlled trials
Authors: Yi Baiyi , Wang Shengyuan , Xu Xianghuai , Yu Li 
Published: December 2024

Background: The efficacy of behavioral cough suppression therapy (BCST) for refractory chronic cough (RCC) and unexplained chronic cough (UCC) remains unclear due to limited evidence from small-scale single-center studies. Objective: To compile and assess the quality of evidence from randomized controlled trials to evaluate the effectiveness of BCST. Design: This study included randomized controlled studies and self-controlled studies related to BCST involving adult patients with RCC or UCC. Data sources and methods: We conducted an extensive search of various English and Chinese databases (e.g., PubMed, CNKI, CBM, VIP, and Wanfang Data Journal Full-text Database) and the Clinical Trial Registration website up to April 2024. The selected studies underwent meta-analysis to investigate the impact of BCST on the patient’s quality of life and cough frequency. Results: The included 12 studies showed that BCST significantly improved the Leicester Cough Questionnaire scores of the patients (MD = 4.50, 95% CI (4.03, 4.97), p < 0.001) compared to the simple verbal education group. In addition, a significant reduction in objective cough frequency was observed in patients compared to before BCST, with a statistically significant difference (MD = −8.06, 95% CI (−9.71, −6.41), p < 0.001). Other measures of cough symptoms, such as symptom scores, Visual Analog Scale (VAS) scores, and Cough Severity Index (CSI) also showed improvement. Conclusion: This meta-analysis revealed positive therapeutic effects of BCST in patients with RCC/UCC, potentially advancing its application in broader clinical settings. Trial registration: This study was registered on PROSPERO with the registration number CRD42024530746.
Feasibility and Acceptability of a Mobile-Assisted Screening and Brief Intervention for Multiple Health Behaviors in Medical Settings
Authors: Forcier Camille , Constant Aymery , Grisard Florine , Clair Elise , Val-Laillet David , Thibault Ronan , Moirand Romain 
Published: December 2024

Introduction: Leveraging every interaction between patients and healthcare professionals constitutes an opportunity to foster behavior change. We developed a mobile Screening and Brief Intervention (mSBI) designed to screen for and intervene with multiple health behaviors, based on a personalized feedback. The objectives of the present study were to assess its feasibility during consultations for chronic conditions, collect users’ opinions, and to investigate patients’ behaviors and intention to change. Methods: Research counselors provided the mSBI to patients from 2 departments at University Hospital. Socio-demographic, behavioral, and acceptability data were collected from patients together with feasibility data from counselors’ reporting. Results: A total of 259 participants were analyzed, aged 51 ± 17 years, with a majority of women (53%). The m-SBI averaged 20 min and most patients (92%) could complete the screening with minimal assistance. Medical doctors’ involvement facilitated referral to and uptake of the m-SBI, and limited adverse events. On average, patients adhered to 11 of the 18 guidelines screened. A majority of patients rated the personalized feedback as comprehensible and useful. Nearly half of them intended to change behavior. Conclusions: The m-SBI seems well-accepted and useful, but doctor referral, adapting the screening tool to patients with low health literacy, and app’s ability to send the feedback to patients/doctors are essential for feasibility.
Stress by Design: A Scoping Review of Structural Stress of Emergency Telecommunicators
Authors: Oliver Tomeika S. , Flanigan Chelsea , Holmes Megan R. 
Published: December 2024

Background: Most agree that occupational stress is caused by workplace strains, tensions, and demands that originate from characteristics of the work. The accumulation of multiple types of stress has been found to have calamitous effects on health and well-being. One such occupation, emergency telecommunicators, experiences a multitude of stressors within their day-to-day work environment. Structural stressors are the sources of stress that are embedded in the way the work is designed and reinforced through workplace policies, practices, and procedures. This scoping review aimed to analyze occupational stressors directly promulgated by the structure and work design that impact emergency telecommunicators and to identify recommended organizational interventions. Methods: This scoping review utilized the methodological framework of Arksey and O’Malley which examined research literature, identified gaps in the literature, and mapped key concepts. Electronic databases of CINAHL, MEDLINE, PsychINFO, PychNET, PubMed, Social Index, and Academic Search Complete were used to identify relevant literature on occupational stress of emergency telecommunicators. Results: Across 17 included articles, four key themes related to workplace stressors of emergency telecommunicators were identified: (a) staffing problems, (b) poor physical work environment, (c) career development issues, and (d) inequity. The four themes were derived from literature to extract stressors related to workplace policies, procedures, and practices. Implications for stakeholders to reduce stress were interwoven in the themes. This review aimed to expand on existing literature pertaining to structural stressors that have an impact on emergency telecommunicators.
State-Level Structural Racism and Children’s Dental Care Access and Oral Health
Authors: Kranz A.M. , Evans L.A. , Gadwah-Meaden C. , Geissler Kimberley H. 
Published: December 2024

Introduction: Black children in the United States have lower rates of dental visits and higher rates of poor oral health. However, few studies have examined the role of structural racism as a contributor to racial gaps in children’s oral health. This study assessed associations between state-level structural racism and oral health outcomes of children and the related Black–White disparities. Methods: This repeated cross-sectional observational study examined children aged 1 to 17 y in the 2016 to 2021 National Survey of Children’s Health (NSCH). Three outcomes were examined: utilization (dentist visit in past 12 mo), any oral health problem (difficulty in past 12 mo with bleeding gums, cavities, or toothaches), and oral health (teeth in excellent or very good condition). A state-level index was constructed to measure Black–White structural racism composed of 5 dimensions (judicial, educational, economic, political, and neighborhood segregation) and linked to the NSCH. Estimated population-weighted logit regression models were used to assess associations between the outcomes and race and structural racism, adjusting for demographics and socioeconomic status. Results: The dataset consisted of 98,423 Black (11%) or White (88%) children. Black children had relatively worse outcomes than White children did, with the largest difference observed for the children having teeth in excellent or very good condition (73% vs. 83%). State-level structural racism was not statistically significantly associated with a child receiving dental care, having any oral health problem, or having teeth in excellent or very good condition. US Black–White disparities in these outcomes were unchanged after adjustment for state-level structural racism. Conclusions: Expanded efforts are needed to address US Black–White disparities in child oral health outcomes. State-level structural racism was not associated with these outcomes. Future research should explore whether findings change when examining these associations at a different geographic level and whether indices of structural racism should explicitly include items specific to health care access and child-specific institutional domains. Knowledge Transfer Statement: Black children in this US study had relatively worse oral health and were less likely to have a dental visit than White children were. Structural racism did not explain these disparities, which suggests the need for further research to study mechanisms driving these disparities and how to address them. Policy makers should consider policies that expand where care is delivered, who delivers care, and increase dentists’ Medicaid participation, strategies identified previously for reducing disparities.
A phase II study of personalized ultrafractionated stereotactic adaptive radiotherapy for palliative head and neck cancer treatment (PULS-Pal): a single-arm clinical trial protocol
Authors: Courtney P. Travis , L. Santoso Milisuryani , Savjani Ricky R. , K. Reddy Vishruth , Chai-Ho Wanxing , Velez Velez Maria A. , J. Wong Deborah , Palodichuk Christy , Basehart T. Vincent , P. O’Connell Dylan , Cao Minsong , Telesca Donatello , Chin Robert K. 
Published: December 2024

Abstract
Background
Many patients with head and neck cancer are not candidates for standard of care definitive treatments though often require palliative treatments given the frequent symptoms associated with head and neck cancer. While existing palliative radiotherapy regimens can provide adequate symptom control, they have limitations particularly with respect to local control which is becoming more important as advances in systemic therapy are improving survival. Personalized ultrafractionated stereotactic adaptive radiotherapy (PULSAR) is a novel radiotherapy regimen which leverages advances in radiotherapy treatment technology and extended interfraction intervals to enable adaptive radiotherapy and possible synergy with the immune system. Additionally, HyperArc© (Varian Medical Systems, Inc.) radiotherapy planning software allows for safe dose-escalation to head and neck tumors.

Methods
This single-arm phase II study will prospectively evaluate PULSAR with HyperArc© software for palliative treatment of head and neck cancer. Patients with de novo or recurrent, localized or metastatic, head and neck cancer who are ineligible for or decline standard of care definitive treatments are eligible for enrollment. Forty-three patients will receive an 11 Gray fraction of radiation every two weeks for a total of five fractions and dose of 55 Gy. Adaptive radiotherapy planning is permitted. A safety and feasibility evaluation will be performed after enrollment of the first fifteen patients whereby the trial will be closed if five or more patients experience a CTCAEv5.0 grade 3 or 4 or any patient experiences a grade 5 toxicity probably attributable to PULSAR during or within three months after its completion. The primary endpoint is one-year local head and neck tumor control. Secondary endpoints include safety, disease progression-free and overall survival, symptomatic impact, frequency of re-simulation and/or adaptive planning, and radiation dosimetry of PULSAR. Additionally, enrolled patients are permitted to receive cancer-directed systemic therapy, including immunotherapy, during PULSAR which may allow for the analysis of the safety and efficacy of this combination.

Discussion
The PULS-Pal trial is the first prospective study of PULSAR with HyperArc© software for head and neck cancer. We hypothesize that this radiotherapy regimen will lead to improved local tumor control compared with historical controls in patients undergoing palliative radiotherapy for head and neck cancer.

Trial registration
Clinicaltrials.gov identifier: NCT06572423. Date of registration: August 28th, 2024.
Paramedics providing end-of-life care: an online survey of practice and experiences
Authors: Campling Natasha , Turnbull Joanne , Richardson Alison , Voss Sarah , Scott-Green Jennifer , Logan Shane , Latter Sue 
Published: December 2024

Abstract
Background
Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics’ current practice and experiences providing end-of-life care was undertaken.

Methods
A cross-sectional online survey design. Quantitative data were analysed using descriptive statistics and qualitative free text responses using Framework Analysis. The survey link was distributed to registered paramedics employed by all 11 NHS Trusts employing paramedics in England, United Kingdom.

Results
Nine hundred and twenty responses were received. They reported shortfalls in availability of healthcare professionals for advice and/or referral. Respondents often, always or sometimes: lacked patient medical history (91%, 839), access to existing advance care planning documentation (98%, 900) and specific medicines needed (80%, 737); encountered conflicting views (89%, 819); and reported lack of pre-registration training (81%, 743) or continuing professional development (77%, 708) influenced their ability to meet patient needs.

Conclusions
This first national survey of paramedic practice and experiences in delivering end-of-life care provides new evidence and insight into the challenges faced by paramedics and the potential impact of these challenges on their perceived levels of competence and confidence. Respondents reported multiple challenges, which potentially impact their ability to provide good quality end-of-life care and increase the risk of hospital conveyance. Paramedic practice at end-of-life must be supported via improved access to: patient records; anticipatory medicines and authority to administer; 24/7 palliative care advice (for shared decision-making); and paramedic specific palliative and end-of-life care training and education (including via integrative ways of working between palliative care and ambulance services). Action is required to integrate paramedicine within the wider healthcare professional team, with robust education and training to support care delivery.
Enhanced recovery after surgery in Pakistan: a qualitative descriptive analysis of current practices and future directions
Authors: Ahmad Hamza , Arnaert Antonia , Shedio Waqas , Tanoli Omaid , Deckelbaum Dan , Pasha Tayyab 
Published: December 2024

AbstractEnhanced Recovery After Surgery (ERAS) is a cost-effective perioperative approach that has been shown to shorten patients’ hospital length of stay, improve resource utilization, and reduce postoperative costs for both patients and hospitals. While ERAS has the potential to offer even greater benefits in low- and middle-income countries (LMICs) its successful long-term implementation remains incomplete in Pakistan. This study aimed to explore insights and identify opportunities for implementing ERAS within the local socio-environmental context. A qualitative descriptive approach was employed, using convenience sampling to recruit 11 surgical residents from a public tertiary care hospital in Lahore, Pakistan. Individual semi-structured interviews were conducted. The data collected was then thematically analyzed to capture the residents’ experiences regarding the implementation of ERAS. Acknowledging the benefits of ERAS, participants faced several challenges when implementing ERAS in their respective wards. The participants identified several key opportunities for successful implementation, including enhanced teamwork and collaboration amongst medical teams, improved patient education and compliance towards ERAS, strengthening of peripheral healthcare services, and targeted resource allocation. Even though several challenges identified by the participants were like those highlighted in high-income countries (HICs), unique barriers specific to Pakistan’s healthcare structure and culture also emerged. Further research exploring and highlighting these specific challenges is needed to overcome these core barriers and promote a shift towards a standardized healthcare system focused on improving patient outcomes.
The employee’s perception of psychological safety: construct dimensions, scale development and validation
Authors: Wang Canghong , Ning Yuwen 
Published: December 2024

AbstractAlthough organisations can effectively resist risks and enhance organisational performance by creating a Perception of Psychological Safety (PPS) climate, there is a lack of PPS scales developed under a multidimensional integrated interaction perspective. Based on a review of relevant theories, this paper clearly defines the concept of PPS and proposes a three-dimensional model of PPS, including organisational- level PPS, team- level PPS, and dyadic- level PPS. In this paper, we develop and validate a scale for measuring PPS in the workplace using 12 startups in a relatively economically developed region in the southeastern coastal region of China as the empirical target. The results of the empirical analyses show that the scale we developed has a good level of reliability and consistency, as well as good content validity, convergent validity, and discriminant validity.
Advancement in scanning magnetic microscopy utilizing high-sensitivity room-temperature TMR sensors for geological applications
Authors: Oda Hirokuni , Kumagai Seiji , Fujiwara Kosuke , Matsuzaki Hitoshi , Wagatsuma Hiroshi , Oogane Mikihiko , Kubota Hitoshi , Fukuyo Naoto , Tanimoto Akihiro 
Published: December 2024

AbstractScanning magnetic microscopes enable high-sensitivity mapping of magnetic fields in thin geological sections, facilitating submillimeter- to submicrometer-scale studies of paleomagnetism and rock magnetism. Magnetic fields of geological samples have been mapped using various sensors, including Hall-effect devices, magneto-impedance devices, superconducting quantum interference devices (SQUIDs), quantum diamond devices, and tunnel magneto-resistance (TMR) devices. This study proposes magnetic microscopy using high-sensitivity room-temperature TMR sensors developed for biomagnetic applications. The goal was to create high-performance magnetic microscopes that do not require labor-intensive techniques, such as cryogenic technology. An XYZ stage developed for a scanning SQUID microscope (SSM) was used to demonstrate and evaluate magnetic microscopy with TMR sensors. The original TMR sensors developed for biomagnetic sensing composed of serially connected TMR elements with a total length of 2684 μm were shortened to 1073 μm (Sensor #1) and 357 μm length (Sensor #2). Background measurements at 50 Hz show magnetic field sensitivities better than 200 nT/√Hz and 600 nT/√Hz at 1 Hz for Sensor #1 and Sensor #2, respectively. By averaging 10 points of the original 50 Hz sampling, magnetic field sensitivities are better than 30 nT/√Hz and 90 nT/√Hz at 1 Hz for Sensor #1 and Sensor #2, respectively. To demonstrate TMR sensors as magnetic microscopes, a vertically magnetized Hawaii basalt thin section was measured and compared with a SQUID-acquired magnetic field map. Magnetic scanning images obtained with TMR sensors on a 0.1-mm grid were compared with those of SSM after adjusting the lift-off by upward continuation and integrated along the length of the sensors. The results demonstrated that magnetic images for 1073-μm-long (357 μm-long) TMR sensors aligned along the y-axis and x-axis are consistent with those after upward continuation to 0.3 mm (0.25 mm) and 0.4 mm (0.25 mm) and convolution by 1 × 10 (1 × 4) and 10 × 1 (4 × 1) matrix, respectively. Overall, the high-sensitivity TMR sensors exhibited promising performance. Further improvements can be made by optimizing the sensors, preamplifiers, and measurement systems for magnetic microscopy to achieve an optimum target resolution.
Graphical Abstract