bluuebunny/crossref_metadata_2025_split huggingface dataset:
Click and learn: a longitudinal interprofessional case-based sepsis education curriculum
Authors: Heslin Samita M , Qadeer Asem , Kotarba AnnMarie E , Ahmad Sahar , Morley Eric J 
Published: November 2024

BackgroundSepsis is a global healthcare challenge and a leading cause of morbidity and mortality. In the USA, the Centers for Medicare & Medicaid Services has integrated the Severe Sepsis and Septic Shock Management Bundle (SEP-1) into their Core Quality Measures, which has been linked to lower mortality rates. However, SEP-1’s multiple bundle elements present compliance challenges without comprehensive education and a collaborative approach involving nurses and providers (attending physicians, resident physicians, nurse practitioners and physician assistants).MethodsWe developed a virtual longitudinal, case-based curriculum using Kern’s six-step approach to curriculum development and evaluated its effectiveness using the Kirkpatrick model. The curriculum was distributed hospital-wide over a 32-month period.ResultsA total of 3616 responses were received for the Sepsis Case-Based Curriculum modules, with 47% from nurses and 53% from providers. Responses were distributed similarly among medical and surgical specialties, as well as intensive care units. Nurses’ responses were 56% correct, and providers’ responses were 51% correct. Most respondents expressed a likelihood of applying the learning to their practice and reported increased knowledge of sepsis. Themes from participant feedback indicated that they found the activity informative and applicable to real-world cases. Additionally, the hospital’s SEP-1 bundle compliance improved from 71% (Q1 2021) to 80% (Q3 2023) during the study period.ConclusionMeeting SEP-1 bundle elements requires a team-based approach involving providers and nurses. Given the busy hospital environment and diverse care providers, a longitudinal, engaging and concise educational curriculum related to real-life scenarios can enhance sepsis and SEP-1 education.
Randomised trial of Mentored ‘Planning to be Active+Family’ [MPBA+F] for Appalachian youth at risk for diabetes: virtual delivery protocol
Authors: Smith Laureen H , Petosa Rick L , Tan Alai , Shankle Shawnice , Phosri Yoottapichai 
Published: November 2024

IntroductionObesity (OB) in children remains a national epidemic. This trial targets children suffering from overweight (OW) and OB living in rural Appalachia. Rural Appalachia is fraught with unhealthy behaviours, high rates of OB, pre-diabetes and type 2 diabetes among children. Diabetes prevalence in Appalachia is nearly double that of other regions. The prevalence of Appalachian children suffering from OB and extreme obesity (EO) increases the severity of diabetes.Methods and analysisWe will conduct a stratified randomised-controlled trial to evaluateMentored Planning to be Active+Family (MPBA+F) among seventh grade children with OW/OB/EO from rural Appalachian counties. Based on the Social Cognitive Theory,MPBA+Fcurriculum is a self-regulation approach to physical activity (PA) developed at The Ohio State University and successfully tested for feasibility in rural Appalachian middle schools.MPBA+F(a) incorporates active skill-building activities; (b) reinforces self-regulating activities; (c) engages in individual and group PA; (d) builds the link between PA, hydration and physical health and (e) actively supports weekly PA goals. Weekly skills are incorporated into reinforcement assignments verified at the beginning the following week. The primary outcome is the average daily minutes of moderate-vigorous PA. We will stratify by sex assigned at birth and conduct intent-to-treat analysis. We use descriptive statistics to summarise cohort and group (MPBA+F or comparison) baseline characteristics and examine variable distributions. Bivariate tests examine the balance of baseline characteristics by intervention groups. Mixed-effects linear modelling will be our more primary regression strategy. A potential problem is loss of curricular integrity. Our process assessment, structured mentor training and Instructor’s Guide reduce this concern. Another concern may be the lack of reliable broadband access. Participating counties exceed 75% broadband access. Those who lose internet access may have materials mailed to their home or accessed on the study website.Ethics and disseminationThis study was reviewed and approved by the American Diabetes Association Grants Review Committee (Grant number 11-22-ICTSN-30), the host institution’s Social and Behavioral Human Subjects Review Committee (Protocol 2022B0149) and is registered on ClinicalTrials.gov (ProtocolNCT05758441). All data that can be shared without compromising human subject protections will be shared to an approved open data repository within six months of publication or 18 months of the conclusion of the funding period (November 2025) if the study remains unpublished. Dissemination to families and stakeholders is by project newsletters. Public presentation of findings will be shared at the Annual Appalachian Translational Research Network and local health department meetings.Trial registration numberNCT05758441.
Association between perceived discrimination and pulse wave velocity: a scoping review
Authors: Pagan Lassalle Patricia , Paterson Craig , Kerr Zachary Yukio , Barone Gibbs Bethany , Moore Justin B , Meyer Michelle L , Stoner Lee 
Published: November 2024

Racial discrimination is a chronic stressor that may contribute to cardiovascular disease (CVD) disparities in non-Hispanic Black (NHB) adults. NHB adults experience greater perceived discrimination (PD) and CVD risk compared with non-Hispanic White adults. Although the association between PD and some subclinical CVD markers has been examined, the relationship between PD and arterial stiffness has not been established, limiting our understanding of the impact of PD on CVD.ObjectiveThe objective of this review was to summarise the literature on the relationship between PD and arterial stiffness.DesignSystematic scoping review.Data sourcesPubMed, Embase, SPORTDiscus with full text and CINALH+ with full text databases were searched from inception to 10 July 2023.Eligibility criteriaAdults (≥18 years), arterial stiffness measured as pulse wave velocity (PWV), PD assessment, and randomised control trial or observational study designs.Data extraction and synthesisOf 453 articles identified, four studies were included. Two studies were cross-sectional (United States, Brazil), one was longitudinal (United Kingdom), and another was a randomized control trial (United States).ResultsThe age of the study populations ranged from 18 years to 75 years and one study evaluated a clinical population. All studies used different PWV devices and PD assessments. Associations between PD and PWV varied by geographical region, sex, clinical status and study design.ConclusionResearch evaluating the association between PD and PWV is scarce and heterogeneous in PD and PWV assessments. There is an inconclusive association between PD and PWV.
Experiences of family caregivers of children living with thalassaemia-major in Karachi: a phenomenological study
Authors: Baqar Maliha , Ahmed Jawaria Mukhtar , Asim Muhammad , Pradhan Nousheen , Altaf Sadaf 
Published: November 2024

IntroductionThalassaemiamajor, a global health burden, presents a growing challenge in Pakistan’s strained healthcare system. This study explores how caregivers of children with beta-thalassaemia major navigate healthcare services, aiming to identify facilitators and barriers to accessing optimal care.MethodsA qualitative interpretative phenomenological approach was employed. In-depth interviews with 18 purposively sampled caregivers from Karachi thalassaemia centres were conducted. Thematic analysis using a combined inductive-deductive approach identified themes within the interview data.ResultThe study revealed significant challenges for caregivers at individual, interpersonal and organisational levels. Lack of awareness about carrier states, limited disease knowledge, financial constraints and concerns about the child’s future emerged as primary hurdles. Parents felt helpless due to the absence of emotional and social support for their children’s treatment. Obstacles such as complicated registration processes at thalassaemia-care centres, high costs of chelating agents and blood unavailability were major barriers to seeking care and caregiving. Additionally, the study highlighted the absence of guidelines for thalassaemia-carrier detection among mothers during antenatal care.ConclusionThe study emphasised the importance of implementing premarital screening programmes due to the lack of knowledge about the disease and carrier state. To prevent the disease, it is crucial to include thalassaemia-carrier detection for mothers in antenatal guidelines and provide counselling at the primary level. Additionally, caregivers encountered treatment accessibility issues, prompting the establishment of a satellite thalassaemia centre linked to a top-tier tertiary care hospital in the public sector. This initiative addressed treatment challenges and improved overall care for patients with thalassaemia and their caregivers.
Community boat service to promote institutional delivery in the Philippines: a mixed-methods study of a social innovation
Authors: Shan Wenjie , Tucker Joseph D , Ronsmans Carine , Mier-Alpaño Jana Deborah , Ulitin Allan , Cruz Jose Rene Bagani , Abiertas Katerina N , Guinto Renzo , Labarda Meredith 
Published: November 2024

BackgroundRemote islands have limited access to institutional obstetric care, and these challenges are further exacerbated by climatic threats. A Health Service Boat Project was implemented in rural Philippines to provide free boats for pregnant people to deliver at facilities and facilitate prenatal outreach.ObjectiveTo evaluate the impact of the boat project on institutional delivery rates and to explore the underlying mechanism.MethodsA sequential mixed-methods study was conducted in Zumarraga Municipality, Philippines. In the quantitative component, we analysed the data from nationally representative household surveys and governmental data to assess the institutional delivery rate before and after the boat project started in 2012. Linear difference-in-difference regression analysis was used to test the intervention effects of the boat project on institutional delivery. Weather information obtained from the Philippine Atmospheric, Geophysical and Astronomical Services Administration was used to compare the institutional delivery rate between cyclone-affected and non-cyclone-affected periods. In the qualitative component, we conducted two focus group discussions and two semistructured interviews to explore how the boat service may have improved the institutional delivery rate.ResultsThe institutional delivery rate significantly increased the year after the boat project started (B=0.38, p<0.001). The median institutional delivery rate during the cyclone-affected period was significantly lower than that during the non-cyclone-affected period but still remained high at 93.3%. Pregnant women who used the boat service to facilitate institutional delivery reported that they trusted the service, which was available regardless of economic status and political affiliations. The boat project also allowed community health workers to conduct more frequent prenatal check-ups in the community, leading to an improved rapport between health workers and women. The main challenge identified during the implementation was the limited budget for long-term maintenance of the boat.ConclusionThe boat project not only facilitated transportation for pregnant people to the facility but also improved community-based prenatal services. In addition, the boat project may mitigate some of the effects of cyclones on access to health services for pregnant people.
Impact of non-invasive ventilation on microbial colonisation patterns in preterm infants: a single-centre study
Authors: Luo Feixiang , Shi Wei , Fan Xiaoyan , Zhou Mingming , Shen Fei , Zhu Haihong , Zhu Jihua , Chen Zheng 
Published: November 2024

ObjectiveThe objective of this study is to assess the relationship between non-invasive ventilation (NIV) and the colonisation of oral and nasal microbiota in preterm infants within the neonatal intensive care unit (NICU).DesignA prospective cohort study.SettingThe NICU of Zhejiang University Children’s Hospital.PatientsPatients include preterm infants with a gestational age of 28–35 weeks, enrolled within the first 24 hours of life.InterventionsInfants were categorised based on respiratory support: NIV, which included nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation or high-flow nasal cannula; and no respiratory support, defined as room air or low-flow nasal cannula at ≤2 L/min.Main outcome measuresThe primary outcome was the colonisation of oral and nasal microbiota at 5 days post birth, measured by colony-forming units per millilitre (CFU/mL), with colonisation defined as bacterial growth >103 CFU/mL.ResultsThe study included 100 preterm infants, with 50 in each group. Nasal microbial colonisation was observed in 56% (28/50) of the NIV group, significantly higher than the 28% in the no respiratory support group. No significant differences were found in oral colonisation. Adjusted binary logistic regression showed an association between NIV and increased risk of nasal colonisation (adjusted OR=2.91, 95% CI 1.12 to 7.58, p=0.028).ConclusionsNIV in preterm infants was linked to a higher risk of nasal microbial colonisation. This finding suggests the need for further research and consideration of infection control strategies in the NICU.
Impact of patient characteristics on ASDAS disease activity state cut-offs in axial spondyloarthritis: results from nine European rheumatology registries
Authors: Ørnbjerg Lykke M , Georgiadis Stylianos , Kvien Tore K , Michelsen Brigitte , Rasmussen Simon , Pavelka Karel , Zavada Jakub , Loft Anne Gitte , Kenar Gokce , Solmaz Dilek , Glintborg Bente , Rodrigues Ana , Santos Maria Jose , Di Guiseppe Daniela , Wallman Johan K , Ciurea Adrian , Nissen Michael J , Rotar Ziga , Pirkmajer Katja Perdan , Nordström Dan , Hokkanen Anna Mari , Gudbjornsson Bjorn , Palsson Olafur , Hetland Merete Lund , Østergaard Mikkel 
Published: November 2024

ObjectivesTo re-evaluate cut-offs for disease activity states according to the Axial Spondyloarthritis Disease Activity Score (ASDAS), and study the impact of sex, age, calendar time, disease and symptom duration on ASDAS and ASDAS cut-offs in a large contemporary cohort.MethodsData from 2939 patients with axial spondyloarthritis (axSpA) starting their first tumour necrosis factor inhibitor in nine European registries were pooled and analysed. Receiver operating characteristic analyses were performed to identify cut-offs against external criteria. Six-month data including patient and physician global assessments, both ≤1 (0–10 integer scale), and Assessment of SpondyloArthritis International Society partial remission were used for separation of inactive disease (ID) from low disease activity (LDA), while patient and physician global ≤3 were applied as external criteria to separate LDA from high disease activity (HDA). Patient and physician global ≥6 were applied to separate HDA from very high disease activity in baseline data.ResultsThe three ASDAS cut-offs identified to separate the four disease activity states in the overall patient population were <1.3, <2.0 and >3.5. Cut-offs for ID and LDA in women were higher (<1.5 and <2.0, respectively) than in men (<1.3 and <1.9), as were cut-offs in patients ≥45 years (<1.5 and <2.2) versus ≤34 years (<1.2 and <1.9) and 35–44 years (<1.3 and <1.8). Cut-offs were independent of calendar time and disease duration.ConclusionsRe-evaluation of ASDAS cut-offs for disease activity states in a large multi-national axSpA cohort resulted in cut-offs similar to those currently endorsed. Differences in cut-offs between sex and age groups for ID and LDA were observed, but the differences were minor.
Study on the Mechanism of Temperature Effect on SO2 Electrochemical Gas Sensor
Authors: Chen Wei , Liao Dongmei , Wu Shijing 
Published: November 2024

Temperature can affect the measurement values of electrochemical gas sensors, increasing measurement errors. The influence mechanism of temperature on electrochemical gas sensors was studied based on Fick’s first law and the limit diffusion current formula. Temperature affects the sensitive characteristics of a sensor by changing the diffusion coefficient D

l1 of SO2 in air, the Henry’s coefficient K
H of SO2 dissolved in water and the water content of the electrolyte solution. When the temperature increases, the degree of influence of Henry’s coefficient K
H and the reduction of the water content is greater than the degree of influence on the increase in diffusion coefficient, which decreases the sensor measurement value. The results of the temperature experiments show that the optimal temperature range for the sensor is −25 °C to 50 °C, and the average measurement error in this temperature range is less than 20%. When the temperature exceeds 50 °C, it will cause a reduction in the evaporation of water in the electrolyte solution, leading to a rapid increase in the measurement error. The structure of the sensor can be improved by adding a water retention layer inside the sensor to supplement the electrolyte solution with water, so as to reduce the measurement error.
Effective Management of a Fractured Tooth in a Child Using an Aesthetic Pediatric Crown: A Case Report and Review of Literature
Authors: Lampl Stephan , Gurunathan Deepa , Mehta Deepak , Krithikadatta Jogikalmat , Moodley Desigar 
Published: November 2024

Background: Traumatic dental injuries in children present unique challenges, requiring evidence‐based and individualized approaches. Accidental falls are a common cause, resulting in a spectrum of clinical presentations. Managing tooth injuries in mixed dentition adds complexity to treatment decisions.Methods: This case report details the conservative management of an 8‐year‐old with a fractured permanent lateral incisor following a fall. The child’s physical status was assessed, ruling out abuse and associated neurological issues. A novel pediatric full crown fabricated from a hybrid glass material was chosen for its minimally invasive preparation and aesthetic properties.Results: Procedural details, including crown sizing, contouring, and bonding, are outlined. One‐year follow‐up revealed no discoloration, pain, or adverse effects. The hybrid glass material demonstrated longevity in bonding, maintaining both function and esthetics. The discussion encompasses the choice of crown materials and the advantages of hybrid glass material.Conclusion: The case highlights successful conservative restoration in mixed dentition using a pediatric full crown with a hybrid glass material. This approach achieved functional and aesthetic improvements, preserved tooth vitality, and ensured patient satisfaction.
Conspiracionistas e antivacinas: desinformação global nas ruas de Alicante (Espanha)
Authors: Alves Ismael Gonçalves 
Published: November 2024

O conjunto de registros fotográficos, ora apresentado, é resultado parcial de minha estadia como pesquisador visitante no Instituto Universitario de Estudios Sociales de América Latina da Universidade de Alicante, Espanha, realizada entre os meses de janeiro e fevereiro de 2024. A ideia deste trabalho, surgiu a partir da experiência de caminhar por um espaço urbano desconhecido, quando ruas, construções e pessoas, ainda não são familiares, e despertam no transeunte interesse pelos mínimos detalhes do caminho. Durante minhas caminhas pelo centro de Alicante, em direção a universidade, passei a observar que em certas lixeiras, postes e calhas chuva que desciam dos edifícios, havia pequenos adesivos, colados, na altura dos olhos, geralmente em preto e branco, contendo imagens, textos e um pequeno QR Code. Ao me aproximar do primeiro deles, percebi que se tratava de um discurso antivacina, e conforme fui caminhando e lendo os demais, notei que se tratava de uma discussão conspiracionista aliada a desinformação sobre a vacina contra o COVID-19.
Environmentally Induced Human Displacement and Human Rights: Bridging Legal Gaps Through a Human Rights-Based Approach
Authors: Chotouras Dimitris , Fragkou Roxani , Tsadiras Alexandros 
Published: November 2024

Abstract
This article discusses the complex issue of environmentally induced human displacement and emphasises the urgent need for a comprehensive approach to address it effectively. It begins by examining the terminology and underlying causes of environmentally induced human displacement and highlights the interdependence of environmental degradation, climate change and human migration. Next, it stresses the importance of protecting displaced individuals irrespective of terminology and advocates for a human rights-based approach as the most effective means to ensure their legal status and protection. The article calls for a paradigm shift within the human rights regime through the recognition of a right to a healthy environment in a legally binding global instrument. That shift would provide a stronger legal foundation for protecting environmentally induced displaced persons and would bridge the existing gaps in international law. Furthermore, the introduction of this right would empower States to clearly define their obligations and grant displaced individuals access to legal recourse and support systems, ensuring their rights are recognised and upheld.