bluuebunny/crossref_metadata_2025_split huggingface dataset:
More than a feeling: emotional regulation strategies for simulation-based education
Authors: LeBlanc Vicki R. , Brazil Victoria , Posner Glenn D. 
Published: December 2024

AbstractSimulation-based education often involves learners or teams attempting to manage situations at the limits of their abilities. As a result, it can elicit emotional reactions in participants. These emotions are not good or bad, they simply are. Their value at any given moment is determined by their utility in meeting the goals of a particular situation. When emotions are particularly intense, or a given emotion is not aligned with the situation, they can impede learners’ ability to engage in a simulation activity or debriefing session, as well as their ability to retain knowledge and skills learned during the session. Building on existing guidance for simulation educators seeking to optimize the learning state/readiness in learners, this paper explores the theory and research that underpins the practical application of how to recognize and support learners’ emotions during simulation sessions. Specifically, we describe the impact of various emotions on the cognitive processes involved in learning and performance, to inform practical guidance for simulation practitioners: (1) how to recognize and identify emotions experienced by others, (2) how to determine whether those emotional reactions are problematic or helpful for a given situation, and (3) how to mitigate unhelpful emotional reactions and leverage those that are beneficial in achieving the goals of a simulation session.
An Egyptian child with Wolman disease presenting with hemophagocytic lymphohistiocytosis
Authors: El Hawary Rabab , Meshaal Safa , Eldash Alia S. , Lotfy Sohilla , Abd Elaziz Dalia , Alkady Radwa , Darwish Rania , Erfan Aya , Saad Mai , Chohayeb Engy , Galal Nermeen , Elmarsafy Aisha M. 
Published: December 2024

Abstract
Background
Lysosomal acid lipase (LAL) deficiency is hyperinflammatory disease caused by the deficiency of the enzyme which hydrolyzes cholesterol esters and triglycerides; thus, there is pathologic accumulation of cholesterol in various tissues. Wolman disease (WD) and cholesteryl ester storage disease (CESD) are two phenotypes of the same disorder with low or absent LAL activity. CESD has lower mortality and presents by hyperlipidemia, atherosclerosis, and hepatic fibrosis, while WD classic presentations include hepatosplenomegaly, malabsorption, failure to thrive, and organ-specific symptoms such as hepatic damage or adrenal calcification.

Case presentation
Herein, we describe a 3-month-old female patient with an unusual presentation of Wolman disease in the form of secondary hemophagocytic lymphohistiocytosis (HLH). The patient presented with severe diarrhea, dehydration, metabolic acidosis, and sepsis. Laboratory workup revealed anemia and thrombocytopenia. Bone marrow aspirate showed hypocellular marrow with few macrophage cells showing phagocytosis. The patient had elevated levels of ferritin, triglycerides, fibrinogen, and soluble CD25, and thus, the diagnosis of HLH was suspected. Next-generation sequencing was performed, and it revealed one homozygous previously reported pathogenic variant in LIPA gene: c.398del; p. (Ser133Ter); thus, the diagnosis of Wolman disease was confirmed.

Conclusions
Wolman disease should be suspected in infants with HLH criteria, as the early diagnosis will improve outcomes in these patients especially if enzyme replacement therapy is available.
The Discourse on the Difference Between Audacity and Real Fortitude in De bellis by Procopius of Caesarea
Authors: Stachura Michał 
Published: December 2024

In De bellis by Procopius of Caesarea, there are multiple, though quite dispersed, instances of a discourse concentrated thematically on the distinction between true fortitude and audacity, with the latter being a mere semblance of the former, and actually a vice that is just the opposite of fortitude. The weight of this discourse comes from the role played by the virtue of fortitude in Procopius’ vision of history – being, on the one hand, the proper motive for preserving the remembrance of martial deeds and, on the other hand, the human-related factor that makes the greatest impact on the course of history. To understand this discourse properly, we need to abandon modern insights (with the mediaeval origin) expressed by concepts such as ‘courage’ and ‘bravery’ that blurred the boundary between virtue and emotion. Analysis of this discourse points to a relationship between real fortitude and prudence/integrity, while audacity is related to cowardice in the sense that it turns into the latter instantly in the face of danger (a stereotypical characteristic of villains in Antiquity). Likewise, seeking a certain death would be an act of audacity, not fortitude. However, a closer analysis of individual cases within this discourse shows a surprising rule: nearly all of them are examples of the moral philosophy applied in a perverse manner, to justify often disgraceful acts. Procopius himself, even though considering the reckless risking of one’s life as unworthy of fortitude, looks with admiration on all those who choose fighting until the end over accepting the shame of surrender (including also the opponents of Rome such as Vandals, Goths, and Persians). It appears then that the Late-Antique historiographer had already viewed the Platonic-Aristotelean distinction of fortitude and audacitywith some reserve, being closer in spirit to a new conception of fortitude, later on to be expressed by the term ‘courage’.
Effects of brief mindfulness intervention on mental fatigue and recovery in basketball tactical performance
Authors: Cao Shudian , Liu Jia , Geok Soh Kim , Sun He , Wang Xiaopeng 
Published: December 2024

Objective
The detrimental effects of mental fatigue (MF) have been established in sports, such as soccer, volleyball, and basketball. Mindfulness interventions are considered a promising method to help players counteract MF, but whether it could improve basketball tactical performance after MF in competition is not clear. This study aims to investigate the effect of brief mindfulness intervention on basketball tactical performance under MF.

Method
This study employed a cluster randomized controlled trial (cRCT) design. It involved 54 male basketball players aged 18 to 24 from three universities. The participants were randomly assigned to one of three groups: control group (CG), mental fatigue group (MFG), and mental fatigue-mindfulness group (MF-MG). Players in the MFG and MF-MG underwent a 30-minute Stroop task to induce MF. Subsequently, players in the MF-MG engaged in a 30-minute audio mindfulness intervention. Basketball tactical performance was assessed in the small side games (SSG).

Results
There were no significant differences in total tactics observed across groups and over time. However, when examining specific tactical sub-variables, significant differences were found in ball reversal, dribble penetration into the key area, and off-ball screen between the CG and MFG in the post-test. Furthermore, significant differences were noted in ball reversal, dribble penetration into the key area, on-ball screen, and off-ball screen between the MFG and MF-MG in the post-test.

Conclusion
The basketball tactical performances, particularly in areas such as ball reversal, dribble penetration into the key area, on-ball screen, and off-ball screen, were negatively impacted by MF. Notably, the brief mindfulness intervention effectively restored these performance aspects. This suggests that coaches and trainers should place increased emphasis on players’ mental well-being and consider incorporating brief mindfulness interventions into their training programs. More studies that investigate mindfulness intervention on the comprehensive aspects of basketball performance should be focused on in the future.
The effects of secretome of umbilical cord mesenchymal stem cells on regeneration of sciatic nerve defects in Sprague dawley rats
Authors: Kurniawan Aryadi , Dilogo Ismail Hadisoebroto , Pawitan Jeanne Adiwinata , Widodo Wahyu , Oesman Ihsan , Martinus Ade 
Published: December 2024

Background and purpose
Current treatments for peripheral nerve defects are suboptimal. Mesenchymal stem cell (MSC) implantation holds promise, with studies indicating their efficacy through the secretome. This study aims to assess the secretome’s potency in regenerating peripheral nerve defects.

Animals and methods
Twenty-eight spraque dawley (SD) rats were divided into four groups, with a 10mm segmental sciatic nerve defect created. Group I received autografts, while Groups II, III, and IV had proximal and distal nerve stumps fixed with a conduit. Group II received MSC implantation, Group III received umbilical cord MSC secretome, and Group IV was treated with silicone conduits. Motoric recovery was assessed using the Sciatic Functional Index (SFI) at 6, 9, and 12 weeks. After 12 weeks, rats were sacrificed for measurements of gastrocnemius muscle weight ratio and sciatic nerve histomorphometry.

Result
The highest ratio of the gastrocnemius muscle were found in groups 1 and 3, namely 0.7 ± 0.06 and 0.7 ± 0.2 (p <0.001). The highest number of myelinated axons was found in group 1 and 3, namely 175.1 ± 15.9 and 168.9 ± 11.7 (p <0.001). The secretome had the similar effectiveness with autograft in promoting regeneration of the sciatic nerve defect.

Interpretation
The secretome of the umbilical cord MSC can be a novel therapy in replacing autografts for the management of peripheral nerve defects.
Evaluation of the impact of COVID-19 pandemic on hospital admission related to common infections: Risk prediction models to tackle antimicrobial resistance in primary care
Authors: Fahmi Ali , Palin Victoria , Zhong Xiaomin , Yang Ya-Ting , Watts Simon , Ashcroft Darren M. , Goldacre Ben , MacKenna Brian , Fisher Louis , Massey Jon , Mehrkar Amir , Bacon Seb ,   the OpenSAFELY Collaborative, Hand Kieran , van Staa Tjeerd Pieter 
Published: December 2024

Background
Antimicrobial resistance (AMR) is a multifaceted global challenge, partly driven by inappropriate antibiotic prescribing. The objectives of this study were to evaluate the impact of the COVID-19 pandemic on treatment of common infections, develop risk prediction models and examine the effects of antibiotics on infection-related hospital admissions.

Methods
With the approval of NHS England, we accessed electronic health records from The Phoenix Partnership (TPP) through OpenSAFELY platform. We included adult patients with primary care diagnosis of common infections, including lower respiratory tract infection (LRTI), upper respiratory tract infections (URTI), and lower urinary tract infection (UTI), from 1 January 2019 to 31 August 2022. We excluded patients with a COVID-19 record in the 90 days before to 30 days after the infection diagnosis. Risk prediction models using Cox proportional-hazard regression were developed for infection-related hospital admission in the 30 days after the common infection diagnosis.

Results
We found 12,745,165 infection diagnoses from 1 January 2019 to 31 August 2022. Of them, 80,395 (2.05%) cases were admitted to the hospital during follow-up. Counts of hospital admission for infections dropped during COVID-19, for example LRTI from 3,950 in December 2019 to 520 in April 2020. Comparing those prescribed an antibiotic to those without, reduction in risk of hospital admission were largest with LRTI (adjusted hazard ratio (aHR) of 0.35; 95% confidence interval (CI), 0.35–0.36) and UTI (aHR 0.45; 95% CI, 0.44–0.46), compared to URTI (aHR 1.04; 95% CI, 1.03–1.06).

Conclusions
A substantial variation in hospital admission risks between infections and patient groups was found. Antibiotics appeared more effective in preventing infection-related complications with LRTI and UTI, but not URTI. While this study has several limitations, the results indicate that a focus on risk-based antibiotic prescribing could help tackle AMR in primary care.
Primary healthcare provider-perceived barriers to implementing an evidence-based pathway for undifferentiated lower gastrointestinal tract symptoms: A qualitative inquiry
Authors: Sharma Sowmya , Stewart Michael J. , Mathias Holly , Novak Kerri , Veldhuyzen Van Zanten Sander , Heisler Courtney , Richard Sharon , Neil Emily , Burge Frederick , Smith Aaron , Peltekian Kevork , Patel Sunil , Jones Jennifer L. 
Published: December 2024

Background
Primary healthcare providers play a critical role in diagnosing and managing digestive disorders. Standardized clinical care guidelines have been developed, but with limited and inconsistent implementation. An evidence-based gastroenterology clinical care pathway (GUTLINK) has been proposed in one region of Canada; however, little is known in the medical literature about potential barriers to pathway implementation within primary care. We aimed to identify behavioral and environmental barriers and facilitators to implementation of evidence-based care pathways for undifferentiated lower gastrointestinal tract symptoms in primary care.

Methods
One-on-one semi-structured interviews were conducted with primary healthcare providers between September 2021 and May 2022. Interview script development was guided by the COM-B framework. Interviews were transcribed and data were analyzed using an inductive thematic analysis approach.

Results
A total of 15 primary healthcare provider interviews were conducted. Several key barriers to GUTLINK implementation were identified in all three domains of the COM-B framework. Key barriers included Capability (e.g., Physician Knowledge and Access to Allied Health), Opportunity (e.g., Access to diagnostic tools), and Motivation (e.g., Comfort with managing cases and optimism). Some of these barriers have not previously been identified in medical literature.

Conclusions
Evidence-based clinical care pathways have the potential to support access to quality gastroenterology care, yet primary healthcare providers in this study identified several barriers to implementation. Potential solutions exist at the individual and clinic levels (e.g., greater education, improved provider-specialist communication), but must be supported with systems-level changes (e.g., increased funding for gastrointestinal care and e-Health platforms) to support pathway implementation and improve quality of care.
Relative abrasive potential of silica-based conventional and tablet dentifrices on enamel and dentin
Authors: Kasi Shaira R. , Pilecco Rafaela Oliveira , Saldanha da Rosa Lucas , Tribst João Paulo Mendes , Kleverlaan Cornelis Johannes , Özcan Mutlu , Feilzer Albert J. 
Published: December 2024

Objectives
This in vitro study aimed to investigate the toothbrushing wear on both enamel and dentin surfaces of reference and commercially available dentifrices.

Methods
Bovine enamel and dentin blocks were initially polished and embedded within a resin composite in square shapes (10×8×6 mm3). Employing toothbrushes equipped with nylon bristles, a toothbrushing machine was utilized, subjecting dentin specimens (n = 36) to 500 brush cycles and enamel samples to 5000 brush cycles (n = 36). Before and after the brushing simulation (2.45-N, 180 strokes per minute), an advanced contact profilometer was employed to measure the abraded depth. The wear rates were analyzed by using One-way ANOVA with two-sided Dunnett’s multiple comparisons with a control (water).

Results
Significant variations were observed among the tested toothpaste formulations, particularly in dentin wear, where Sident and Prodent showed notably higher values (7.30 μm and 9.67 μm, respectively) compared to the water control group (0.79 μm). Prodent also induced the highest enamel wear (2.64 μm) among the toothpaste formulations, while water, Zendium, and Denttabs exhibited comparatively lower enamel wear values. Statistical analysis using One-way ANOVA with two-sided Dunnett’s multiple comparisons against the control (water) confirmed these differences.

Significance
Toothbrushing with water causes minimal wear on enamel and dentin tissues, suggesting the predominant effect of three-body wear when using an abrasive medium. Comparing the standard references for dentifrice abrasives, Sident and Sylodent exhibit similar wear rates, making them reliable choices for in-vitro tests. When employed in a similar frequency, the wear rate of commercial toothpaste depends more on its composition than its form (paste or tablets).
Facilitators and barriers for the implementation of a transmural fall-prevention care pathway for older adults in the emergency department
Authors: Charmant W. M. , Snoeker B. A. M. , van Hout H. P. J. , Nauta I. N. , Boonstra F. , Geleijn E. , Veenhof C. , Nanayakkara P. W. B. 
Published: December 2024

Background
Older adults at the emergency department (ED) with fall-related injuries are at risk of repeated falls. National guidelines state that the ED is responsible for initiating fall preventive care. A transmural fall-prevention care pathway (TFCP) at the ED can guide patients to tailored interventions. In this study, we investigated the facilitators and barriers for the implementation of the TFCP for older adults following a fall-related ED visit from the perspectives of patients and healthcare professionals.

Methods
In this qualitative study, we used semi-structured interviews with ten older adults who had a recent ED visit due to a fall. Furthermore, we organised focus groups with 13 healthcare professionals involved in TFCP. Two researchers independently coded the transcripts using inductive thematic analysis.

Results
We revealed facilitators and barriers on three key themes: 1) Communication, 2) organisation & execution, and 3) personal factors, and thereunder 12 subthemes. Our specific finding were 1a) communication between healthcare professionals and patients, 1b) interprofessional communication and 1c) communication between patients and their family or friends can have both positive and negative impact on the implementation of a TFCP. For the organisation & execution, facilitators and barriers were mentioned for 2a) processes at the ED, 2b) the fall risk assessment, 2c) patient engagement, 2d) finances, 2e) time, and 2f) responsibilities. Personal factors such as 3a) emotions and behaviour, 3b) knowledge, and 3c) motivation play a crucial role in the success of patient participation. The competence of healthcare professionals in geriatric care facilitate the process of tailoring of care to patients’ needs.

Conclusion
When implementing a TFCP, it is crucial to be aware that facilitators and barriers from the perspective of patients and healthcare professionals exist in the processes of communication, organisation & execution, and personal factors. These factors guide the development of tailored implementation strategies in ED and primary care settings.
Study protocol for COVID-19 breakthrough infections and vaccine-induced immune response among a cohort of healthcare workers, Bangladesh
Authors: Hassan Md. Zakiul , Basher Ahamed Khairul , Rahman Mohammed Ziaur , Bhuiyan Taufiqur Rahman , Chowdhury Fahmida , Hossain Md. Kamal , Rahman Aninda , Islam Md. Nazmul , M. Duca Lindsey , Kaydos-Daniels Susan Cornelia , A. Dahl Benjamin , Qadri Firdausi , Ortiz Nancy 
Published: December 2024

Background
To optimize vaccination strategies, it is useful to detect breakthrough infections and assess vaccine effectiveness in programmatic use. Monitoring emerging SARS-CoV-2 variants and vaccine effectiveness against them is also essential to determine the most effective vaccine options. This study aims to monitor SARS-CoV-2 breakthrough infections, the emergence of new SARS-CoV-2 variants, and host immune response during the peri-infection period of COVID-19. The study will also assess the uptake of the COVID-19 vaccine booster doses, and associated barriers or motivations among healthcare workers (HCWs).

Methods
Leveraging an existing HCW cohort in Bangladesh, HCWs will be enrolled from purposively selected health facilities from four different administrative divisions across Bangladesh. We captured cohort data on HCW’s demographic information, clinical information, COVID-19 illness, and exposure, and vaccination histories for COVID-19. However, no biological specimens were collected for testing during the first phase of the cohort. In the current study, we plan to follow enrolled HCWs biweekly for suspected COVID-19 illness and capture relevant data including illness outcomes. Respiratory swab samples from symptomatic and a subset of asymptomatic HCWs will be tested for SARS-CoV-2 by rRT-PCR and positive samples will undergo Sanger sequencing to identify the SARS-CoV-2 variants of concern (VOCs). We will also perform Whole Genome Sequencing on a subset of SARS-CoV-2 positive samples with low CT values (Ct ≤ 30) to identify emerging SARS-CoV-2 variants. To examine the antibody response, we will collect blood samples from the participants at 12-week intervals for one year. We will use the EUROIMMUN kit and will also perform in-house ELISA to assess host immune factors with Luminex platform.

Discussion
This proposed study will generate useful data on COVID-19 breakthrough infection and the durability of anti-SARS-CoV-2 antibodies among HCWs following vaccination. The findings on booster vaccination intention and uptake will inform government COVID-19 vaccination strategies. Information on circulating and emerging strains of SARS-CoV-2 and vaccine performance against those strains will help understand population-level risks of COVID-19 infection. The study will generate data on facilitators and barriers to COVID-19 booster uptake among HCWs which can inform health communication messaging to improve booster acceptance in this population.
Impact of varying accelerometer epoch length on physical activity patterns in adults: Considerations for public health
Authors: Haddadj Rayane , Verdot Charlotte , Salanave Benoît , Deschamps Valérie , Vanhelst Jérémy 
Published: December 2024

Background
To process wearables sensors data, end-users face a wide variety of choices influencing physical activity (PA) patterns estimation. This study investigated the impact of varying epoch length on PA patterns in adults and World Health Organization (WHO) PA guidelines prevalence, assessed by accelerometer.

Methods
The study included 181 adults (18–74 years) from the Esteban Study (2014–2016). Participants wore an accelerometer for 7 consecutive days. Data were processed with ActiLife® software using epoch lengths from 1 to 60 seconds to assess PA patterns. Difference of PA patterns between epoch length was assessed using repeated measures ANOVA. Difference in meeting WHO PA guidelines was assesses using Fisher’s exact test.

Results
Significant changes were observed in sedentary behaviour and PA intensities with epoch length variation (p<0.001). Longer epochs led to reduced moderate and vigorous PA, increased light PA, and less sedentary time, affecting adherence to WHO PA guidelines.

Conclusion
Result underline the importance of careful epoch length selection when processing accelerometer data to accurately assess sedentary behaviour and PA in adults. Shorter epochs seem preferable to capture short and spontaneous PA bouts and preventing underestimation of MVPA along with prolonged PA bouts. Further investigation including a PA reference measure is needed to confirm these findings and their implications for adult health.