bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complexifying Facilitation by Immersing in Lived Experiences of on-the-fly Facilitation
Authors: van Laere Joeri , Lindblom Jessica , de Wijse-van Heeswijk Marieke 
Published: April 2021

Background: Describing the role of a facilitator often results in to-do lists resembling a recipe or a laundry list to follow. Such lists fail to grasp the inherent complexity of facilitation and are not very useful in guiding facilitators when, why and if they should intervene in the unfolding live performance of that day. Aim: To develop a deeper understanding of on-the-fly facilitation by analyzing rich empirical accounts of in-situ facilitation episodes. Intervention: Six facilitation episodes were through purposeful sampling selected from a body of hundreds of interventions in forty-seven performed crisis management training exercises in Swedish municipalities. Each full-day crisis management simulation-game had between fifteen and fifty participants involving politicians, administrative managers and crisis management staff. Method: An auto-hermeneutical phenomenological analysis of six lived experiences of facilitation episodes was conducted to understand what the facilitator observed and how a facilitation intervention was applied. Results: On-the-fly-facilitation is instantaneous, but draws simultaneously on awareness of the past, present and future. Facilitation needs are foreseen during design and they influence current attentiveness and coaching. Unfolding game-play needs to be grasped quickly. Potential future consequences of intervening or not intervening are evaluated within a limited window of opportunity. Due to these circumstances, facilitation is multi-skilled, arbitrary and fallible. Such muddiness of on-the-fly facilitation requires courage from the facilitator. Conclusions: In order to better understand how facilitation skills and roles actually are performed, the facilitation literature desperately needs a larger number of rich empirical accounts of interesting in-situ facilitation. Elaborate analysis of such lived experiences could develop understanding as to how available skills, situational circumstances as well as the unfolding interaction between players and facilitators actually develop into a facilitation intervention. This could generate more complex theoretical understanding of how to apply facilitation skills, in addition to theories that list what skills a facilitator should master.
Design of an Impulse-Debriefing-Spiral for Simulation Game Facilitation
Authors: Schwägele Sebastian , Zürn Birgit , Lukosch Heide K. , Freese Maria 
Published: April 2021

Background. Simulation gaming sessions can be understood as a sequence of briefing, game play, and debriefing - with feedback loops and iterative steps in between. Often, these sessions are supported by a facilitator, who organizes the session, sets learning goals, and guides the players through briefing, game play and debriefing ( Taylor, Backlund & Niklasson, 2012 ), which we call facilitation. Debriefing is a vital part of the facilitation process, as according to Crookall (2010) and Kriz (2010) , it facilitates learning. Contrary to many traditional models that locate the debriefing phase at the very end of a simulation gaming session, we conceptualize debriefing as reflection moments during the whole session, in which participants have the opportunity to reflect on their game play, experiences, and learnings. Facilitation is the process of enabling participants to address challenging situations of the game play, and make connections between the game play and the real environment the game refers to throughout the simulation gaming session. Method & Results. We analysed existing debriefing literature within the Simulation & Gaming journal. This review revealed that many existing approaches do not sufficiently consider changing needs of participants during a simulation gaming session to allow for a direct reflection on what is happening. Instead, a large number of debriefing approaches focus on a post-action reflection only. Moreover, the approaches analysed in our article often are abstract and only provide scarce practical recommendations. In addition to the literature review, we draw conclusions from observations of our own work in and with simulation gaming sessions. Based on the related and our own work, we propose a new model for simulation game facilitation, which better connects moments of reflection with the game play - the Impulse-Debriefing-Spiral. Conclusions. We provide a holistic understanding of debriefing that helps facilitators when implementing simulation games for learning purposes. Our model, called the Impulse-Debriefing-Spiral, conceptualizes the role of facilitation between briefing and debriefing throughout the whole process of a simulation gaming session - starting with its planning to reacting on emerging needs of the participants in between, up to closing the session as last step before transferring new knowledge and competencies into a new context (learning transfer).
Feasibility of preemptive pharmacogenetic testing in colorectal cancer patients within a community oncology setting
Authors: Luczak Tiana S , Schillo Paul J , Renier Colleen M , Waring Stephen C , Friday Bret B 
Published: April 2021

Introduction Pharmacogenetics, in hand with precision medicine in oncology, represents an opportunity to holistically tailor a patient’s treatment regimen using both somatic and germline variants to improve efficacy and decrease toxicity. Colorectal cancer patients represent a population with frequent use of fluoropyrimidine and irinotecan and are an ideal opportunity for implementation of preemptive pharmacogenetics as evidence supports pharmacogenetic testing for DPYD and UGT1A1 to reduce fluoropyrimidine and irinotecan toxicities. Methods This was a single arm proof-of-concept study at a large community-based health system. Participants provided samples for pharmacogenetic testing via an external vendor prior to chemotherapy initiation and an oncology pharmacist was responsible for pharmacogenetic interpretation and pharmacogenetic-guided therapeutic recommendation to the treating provider. Results A total of 24 (60%) participants had a UGT1A1 variant. All participants (100%) were DPYD*1/*1. Results were available and interpreted for 29/40 (72.5%) participants prior to scheduled chemotherapy initiation (p value <0.014). Of the participants whose results were available in 5 weekdays or less (n = 23), 20 (87%) were communicated with the treating provider prior to scheduled chemotherapy administration. A total turnaround time of 5 days or less was significantly associated with PGx feasibility in a community-based oncology clinic (p = 0.03). Conclusions In conclusion, we were able to show that implementation of preemptive pharmacogenetic testing into a community oncology clinic with results interpretation available prior to scheduled initiation of chemotherapy was feasible. As pharmacogenetic testing in oncology expands, pharmacists should be prepared to optimize supportive medication regimens as well as chemotherapy with pharmacogenetic results.
Does Digital Nerve Injury Affect Range of Motion Recovery After Zone 2 Flexor Tendon Repair?
Authors: Keane Grace , Stonner Macyn , Pet Mitchell A. 
Published: April 2021

Background Evidence surrounding the impact of concomitant digital nerve injury on the outcome of zone 2 flexor tendon repair is sparse and conflicting. The purpose of this study is to assess the impact of digital nerve injury on the range of motion recovery after zone 2 flexor tendon repair. We hypothesized that digital nerve injury is independently associated with decreased motion after zone 2 flexor digitorum profundus (FDP) repair. Methods This is a single-institution, multisurgeon retrospective analysis of patients treated with primary zone 2 FDP repair. Patients with or without digital nerve injuries were included. Patients with fracture, extensor tendon injury, dysvascularity, follow-up duration of less than 10 weeks, and younger than 15 years were excluded. The primary outcome measure was Strickland percentage at the last therapy visit. Bivariate analysis was performed using simple linear regression. These results were used to guide backward stepwise multivariable analysis of qualifying exploratory variables. Results Forty-one patients with a total of 54 zone 2 FDP injuries qualified. Mean follow-up duration was 24 ± 10 weeks, and mean age was 38 ± 18 years. Thirty-three digits had a concomitant digital nerve injury, 26 digits had multidigit involvement, and 42 digits had combined FDP and flexor digitorum superficialis (FDS) injuries. Both older age and concomitant FDS injury exhibited independent relationships with poorer range of motion outcomes ( P < .05). Digital nerve injury, follow-up duration, gender, and multidigit involvement did not influence final digital motion. Conclusions In patients undergoing zone 2 FDP repair, concomitant digital nerve injury is not independently associated with poorer postoperative active range of motion.
Acute liver failure following paracetamol overdose
Authors: Arshad Mohammed Asif , Bangash Mansoor Nawaz 
Published: April 2021

Background Acute liver failure is a rare syndrome comprising a coagulopathy of liver origin, jaundice and encephalopathy in a patient with no prior history of liver disease. Paracetamol overdose is the leading cause of acute liver failure in the United Kingdom and often presents with extrahepatic organ dysfunction requiring critical care. Presentation: We present the case of a patient with hyper acute liver failure secondary to paracetamol overdose. Management and discussion: Management focused on ensuring the correct diagnosis had been made, administering N-acetyl cysteine, fluid resuscitation and broad spectrum antimicrobials. Early intubation and transfer to a transplant centre were undertaken following development of hepatic encephalopathy. Neuroprotective measures and hypertonic saline were instituted to reduce the risk of intracranial hypertension. High dose haemofiltration was also started to help reduce ammonia levels. Aggressive critical care therapies with specialised input results in good outcomes for patients admitted with paracetamol induced hyper acute liver failure. Liver transplant is reserved for those patients unlikely to survive with medical treatment alone.
Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis
Authors: Muheim Leander , Signorell Andri , Markun Stefan , Chmiel Corinne , Neuner-Jehle Stefan , Blozik Eva , Ursprung Pascale , Rosemann Thomas , Senn Oliver 
Published: April 2021

Background: Proton-pump inhibitors (PPI) are among the most prescribed drugs worldwide, and a large body of evidence raises concerns about their inappropriate use. Previous estimates of inappropriate use varied due to different definitions and study populations. Aims: We aimed to measure the population-based incidence and time trends of PPI and potentially inappropriate PPI prescriptions (PIPPI) with a novel method, continuously assessing excessive cumulative doses based on clinical practice guidelines. We also assessed association of patient characteristics with PPI prescriptions and PIPPI. Methods: This was an observational study based on a large insurance claims database of persons aged >18 years with continuous claims records of ⩾12 months. The observation period was January 2012 to December 2017. We assessed the incidence and time trends of PPI prescriptions and PIPPI based on doses prescribed, defining ⩾11.5 g of pantoprazole dose equivalents during any consecutive 365 days (average daily dose >31 mg) as inappropriate. Results: Among 1,726,491 eligible persons, the annual incidence of PPI prescriptions increased from 19.7% (2012) to 23.0% (2017), ( p = <0.001), and the incidence of PIPPI increased from 4.8% (2013) to 6.4% (2017), ( p = <0.001). Age, male gender, drugs with bleeding risk and multimorbidity were independent determinants of PIPPI ( p = <0.001 for all). Conclusions: This study provides evidence that one of the most prescribed drug groups is commonly prescribed inappropriately in the general population and that this trend is increasing. Multimorbidity and drugs with bleeding risks were strong determinants of PIPPI. Addressing PPI prescriptions exceeding guideline recommendations could reduce polypharmacy and improve patient safety.
In Vitro and In Vivo Effects of Light Therapy on Cartilage Regeneration for Knee Osteoarthritis: A Systematic Review
Authors: Oliveira Sofia , Andrade Renato , Hinckel Betina B. , Silva Filipe , Espregueira-Mendes João , Carvalho Óscar , Leal Ana 
Published: April 2021

Objective To analyze the effects of light therapy (LT) on cartilage repair for knee osteoarthritis (OA) treatment. Design The PubMed, Embase, Scopus, and Web of Science databases were searched up to August 31, 2020 to identify in vitro and in vivo studies that analyzed the effects of LT on knee cartilage for OA treatment. The study and sample characteristics, LT intervention parameters and posttreatment outcomes were analyzed. Risk of bias was assessed using the Risk of Bias Assessment for Non-randomized Studies (RoBANS) tool. Results Three in vitro and 30 in vivo studies were included. Most studies were judged as high risk of performance and detection bias. Biochemical outcomes were analyzed for both i n vitro and in vivo studies, and histological and behavioral outcomes were analyzed for in vivo studies. LT reduced extracellular matrix (ECM) degradation, inflammation, and OA progression, promoting ECM synthesis. LT improved pain-like behavior in animal models, having no apparent effect on gait performance. There were conflicting findings of some of the biochemical, histological, and behavioral outcomes. Conclusion The included studies presented different strategies and LT parameters. LT resulted in positive effects on cartilage repair and may be an adequate therapy for OA treatment.
Long-term trends of black carbon and particle number concentration in the lower free troposphere in Central Europe
Authors: Sun Jia , Hermann Markus , Yuan Ye , Birmili Wolfram , Collaud Coen Martine , Weinhold Kay , Madueño Leizel , Poulain Laurent , Tuch Thomas , Ries Ludwig , Sohmer Ralf , Couret Cedric , Frank Gabriele , Brem Benjamin Tobias , Gysel-Beer Martin , Ma Nan , Wiedensohler Alfred 
Published: April 2021

Abstract
Background
The implementation of emission mitigation policies in Europe over the last two decades has generally improved the air quality, which resulted in lower aerosol particle mass, particle number, and black carbon mass concentration. However, little is known whether the decreasing particle concentrations at a lower-altitude level can be observed in the free troposphere (FT), an important layer of the atmosphere, where aerosol particles have a longer lifetime and may affect climate dynamics. In this study, we used data from two high-Alpine observatories, Zugspitze-Schneefernerhaus (ZSF) and Jungfraujoch (JFJ), to assess the long-term trends on size-resolved particle number concentrations (PNCs) and equivalent black carbon (eBC) mass concentration separated for undisturbed lower FT conditions and under the influence of air from the planetary boundary layer (PBL) from 2009 to 2018.

Results
The FT and PBL-influenced conditions were segregated for both sites. We found that the FT conditions in cold months were more prevalent than in warm months, while the measured aerosol parameters showed different seasonal patterns for the FT and PBL-influenced conditions. The pollutants in the PBL-influenced condition have a higher chance to be transported to high-altitudes due to the mountainous topography, leading to a higher concentration and more distinct seasonal variation, and vice versa. The long-term trends of the measured aerosol parameters were evaluated and the decreased aerosol concentrations were observed for both FT and PBL-influenced conditions. The observed decreasing trends in eBC concentration in the PBL-influenced condition are well consistent with the reported trends in total BC emission in Germany and Switzerland. The decreased concentrations in the FT condition suggest that the background aerosol concentration in the lower FT over Central Europe has correspondingly decreased. The change of back trajectories in the FT condition at ZSF and JFJ was further evaluated to investigate the other possible drivers for the decreasing trends.

Conclusions
The background aerosol concentration in the lower FT over Central Europe has significantly decreased during 2009–2018. The implementation of emission mitigation policies is the most decisive factor and the decrease of the regional airmass occurrence over Central Europe also has contributed to the decreasing trends.
Increase of blood-brain barrier leakage is related to cognitive decline in vascular mild cognitive impairment
Authors: Li Man , Li Yue , Zuo Long , Hu Wenli , Jiang Tao 
Published: April 2021

Abstract
Background
Blood-brain barrier (BBB) breakdown, as an early biomarker for vascular mild cognitive impairment (vMCI), has only been validated by a few studies. The aim of this study was to investigate whether compromised BBB integrity is involved in vMCI patients, and detect the relationship between BBB breakdown and cognitive function. BBB leakage in vMCI was explored, and the relationship between BBB leakage and cognitive function was discussed in this study.

Methods
This is a cross-sectional study involving 26 vMCI patients and 21 sex- and age-matched healthy controls. Dynamic contrast-enhanced-magnetic resonance imaging was performed for all participants, to determine BBB leakage. Leakage volume, leakage rate, and fractional blood plasma volume (Vp) in the grey and white matter were evaluated. Neuropsychological tests were used to determine cognitive function. Leakage rate, leakage volume, and Vp in different brain locations, including deep grey matter, cortical grey matter, white matter hyperintensity, and normal-appearing white matter were compared between the two groups.

Results
Multivariable linear regression analyses revealed that in all regions of interest, the leakage rate was significantly higher in vMCI patients relative to controls. Leakage volume in normal-appearing white matter and white matter hyperintensity were significantly higher, while Vp in normal-appearing white matter, deep grey matter, and cortical grey matter were significantly lower in vMCI patients. Moreover, Montreal Cognitive Assessment scores decreased with the increase of leakage rate in white matter hyperintensity.

Conclusion
Increased BBB permeability was detected in vMCI patients and was related to cognitive decline, which suggested that BBB breakdown might be involved in cognitive dysfunction pathogenesis.
Time-to-event analysis in economic evaluations: a comparison of modelling methods to assess the cost-effectiveness of transplanting a marginal quality kidney
Authors: Senanayake Sameera , Graves Nicholas , Healy Helen , Baboolal Keshwar , Barnett Adrian , Kularatna Sanjeewa 
Published: April 2021

AbstractBackgroundEconomic-evaluations using decision analytic models such as Markov-models (MM), and discrete-event-simulations (DES) are high value adds in allocating resources. The choice of modelling method is critical because an inappropriate model yields results that could lead to flawed decision making. The aim of this study was to compare cost-effectiveness when MM and DES were used to model results of transplanting a lower-quality kidney versus remaining waitlisted for a kidney.MethodsCost-effectiveness was assessed using MM and DES. We used parametric survival models to estimate the time-dependent transition probabilities of MM and distribution of time-to-event in DES. MMs were simulated in 12 and 6 monthly cycles, out to five and 20-year time horizon.ResultsDES model output had a close fit to the actual data. Irrespective of the modelling method, the cycle length of MM or the time horizon, transplanting a low-quality kidney as compared to remaining waitlisted was the dominant strategy. However, there were discrepancies in costs, effectiveness and net monetary benefit (NMB) among different modelling methods. The incremental NMB of the MM in the 6-months cycle lengths was a closer fit to the incremental NMB of the DES. The gap in the fit of the two cycle lengths to DES output reduced as the time horizon increased.ConclusionDifferent modelling methods were unlikely to influence the decision to accept a lower quality kidney transplant or remain waitlisted on dialysis. Both models produced similar results when time-dependant transition probabilities are used, most notable with shorter cycle lengths and longer time-horizons.
Incorporation of alternative amino acids into cyanophycin by different cyanophycin synthetases heterologously expressed in Corynebacterium glutamicum
Authors: Wördemann Ramona , Wiefel Lars , Wendisch Volker F. , Steinbüchel Alexander 
Published: April 2021

AbstractCyanophycin (multi-l-arginyl-poly-l-aspartic acid; also known as cyanophycin grana peptide [CGP]) is a biopolymer that could be used in various fields, for example, as a potential precursor for the synthesis of polyaspartic acid or for the production of CGP-derived dipeptides. To extend the applications of this polymer, it is therefore of interest to synthesize CGP with different compositions. A recent re-evaluation of the CGP synthesis in C. glutamicum has shown that C. glutamicum is a potentially interesting microorganism for CGP synthesis with a high content of alternative amino acids. This study shows that the amount of alternative amino acids can be increased by using mutants of C. glutamicum with altered amino acid biosynthesis. With the DM1729 mutant, the lysine content in the polymer could be increased up to 33.5 mol%. Furthermore, an ornithine content of up to 12.6 mol% was achieved with ORN2(Pgdh4). How much water-soluble or insoluble CGP is synthesized is strongly related to the used cyanophycin synthetase. CphADh synthesizes soluble CGP exclusively. However, soluble CGP could also be isolated from cells expressing CphA6308Δ1 or CphA6308Δ1_C595S in addition to insoluble CGP in all examined strains. The point mutation in CphA6308Δ1_C595S partially resulted in a higher lysine content. In addition, the CGP content could be increased to 36% of the cell dry weight under optimizing growth conditions in C. glutamicum ATCC13032. All known alternative major amino acids for CGP synthesis (lysine, ornithine, citrulline, and glutamic acid) could be incorporated into CGP in C. glutamicum.