bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two service evaluations of LEAPlets – An early years programme for children in foster care and adoption, based on the BUSS® (Building Underdeveloped Sensorimotor Systems) Model
Authors: Lloyd Sarah , Jones Natalie , Smith Danielle 
Published: December 2024

BUSS® is a relationally based intervention, bringing an appreciation of the role nurture, touch and movement play in the development of bodily regulation in early childhood. Following a neurosequential understanding of development ( Perry and Hambrick, 2008 ), BUSS® works to support foster carers and adoptive parents in understanding both the disruptive impact of trauma on the development of their child’s foundation sensorimotor systems and the critical role they can play in ameliorating this disruption. Good bodily regulation offers children a platform upon which relationships, emotional regulation and learning can grow ( Lloyd, 2023 ). LEAPlets is a group for children and their parents and carers, based on the BUSS® Model. It aims to build attachment relationships, supporting parents and carers in understanding and rebuilding their child’s foundation sensorimotor systems. This paper brings together two service evaluation projects of LEAPlets carried out by clinical psychologists in training. The first evaluation is of LEAPlets as a school readiness programme for children in foster care in Leeds. The second evaluation is the LEAPlets group in One Adoption West Yorkshire (OAWY) for new adoptive parents and their newly adopted children. While more research is needed, both studies showed improvements for the children in bodily and emotional regulation, communication and relationships, as well as positive changes in skill development, understanding of their child, and relationships for foster carers and adoptive parents. Models like LEAPlets, which address both the relational and sensorimotor consequences of early trauma, may usefully form part of early intervention programmes for care-experienced children. Training to run LEAPlets groups has been developed, and groups are now running in England, Wales and the Republic of Ireland. This will be explored and discussed, with reference to school readiness, impact on foster carers and supporting adoptive families early in their life together.
Development and evaluation of a liposome hydrogel system for enhanced delivery of drospirenone at higher doses
Authors: Zhang Xuena , Wang Xuehan , Xu Juan , Wang Ting 
Published: December 2024

Drospirenone (DROP) is a highly effective, low-toxicity, safe new generation progestin that counteracts estrogen-related sodium retention, is well tolerated, and has a positive effect on premenstrual syndrome (PMS). However, the low water solubility of DROP and its chemical instability resulted in low bioavailability. In this study, we developed a two-step delivery system to enhance drospirenone’s solubility and stability. We prepared a drospirenone liposome complex to optimize the encapsulation process and achieve an encapsulation efficiency of (84.9 ± 0.73) %, with an 878-fold increase in solubility under optimal conditions. To address the instability of high drug-loading liposomes, we immobilized the drospirenone liposome inclusion complex using a cellulose-based hydrogel. The system achieved uniform loading of liposomes in the hydrogel, as confirmed by SEM and FTIR analysis. 0.5 g hydrogel can be loaded with up to 96.48 mg drospirenone, and the encapsulation efficiency is (80.4 ± 1.17%). It was indicating the potential for wider application of drospirenone with enhanced water solubility and improved stability. At the same time, it also provides support for sustained-release systems or large dose drug delivery.
“Let’s get PrEP’d” – A pilot service evaluation of the LVNDR health digital pre-exposure prophylaxis pathway for HIV prevention
Authors: Wells Joshua S. , Ching Jennifer , Boyadjian Araxie , El Badaoui Christopher 
Published: December 2024

Background Despite the availability of PrEP, 2023 data have demonstrated an increase in new HIV diagnoses. LGBTQ + individuals are disproportionately affected by HIV. PrEP access is crucial but limited due to high demand on sexual health services. Additional modalities of PrEP access may help to address this unmet need. LVNDR Health, a digital solution for LGBTQ + care, sought to evaluate its PrEP pathway. Methods We conducted a retrospective cross-sectional service evaluation of users accessing the LVNDR digital PrEP pathway between December 2022-April 2023. Operational data (e.g., appointment attendance) were derived from the clinical dashboard. Service-user feedback (e.g., service experience) was sought using a bespoke questionnaire. Descriptive statistics are reported for socio-demographic information. Non-parametric between-group analyses are reported. Results In total, 90 users completed the end-to-end pathway and received PrEP. Average time for pathway completion was 2.7 weeks. A survey response rate of 71.0% was achieved. Users reported significantly higher service satisfaction, inclusivity, and accessibility, compared to their most recent experience accessing PrEP ( p < .01). Up to 89% of users strongly agreed they would switch to a digital PrEP service if made available. Conclusion Digital PrEP shows acceptability among LGBTQ + populations. More research is needed to assess scalability, digital equity, and cost-effectiveness.
Theoretical analyses of the performance parameters of PEM fuel cells at various operating temperatures and pressures
Authors: Atak Nisa Nur , Dogan Battal , Yesilyurt Murat Kadir 
Published: December 2024

In the present study, the performance parameters for a single-cell PEM fuel cell with 50 cm2 active surface area and 0.0178 cm polymer membrane thickness at 4 different operating temperatures (303, 323, 343, and 363 K) and 4 different operating pressures (3, 6, 9, and 12 atm) was investigated by theoretical analysis. Hydrogen and oxygen partial pressures, membrane resistivity, internal resistance, activation, ohmic and concentration losses, cell voltage, power density, and thermal efficiency were calculated using this analysis. It has been observed that the augmentation of temperature and pressure in the fuel cell leads to a favorable increase in cell voltage, power density, and thermal efficiency. The thermal efficiency values were found to be 23% and 39%, respectively at the following conditions: temperatures of 303 K and 363 K, current density of 1 A/cm2, and constant pressure. At the same current density, the thermal efficiency is 29% and 32% at 3 atm and 12 atm operating pressures at a constant temperature. When operated under constant current density and temperature conditions, an increase in the operating pressure of the PEMFC from 3 atm to 12 atm results in a corresponding increase in cell voltage, from 0.4422 V to 0.4755 V, respectively. It was observed that the influence of temperature on the thermal efficiency of the PEM fuel cell was led to be higher than the influence of pressure.
Research on the dynamic response of semi-enclosed sound barrier on viaduct under train pulsating wind and wheel-rail excitation
Authors: Sun Liangming , Liu Shuguang , Wang Wenli , Zhao Hanbing 
Published: December 2024

This study develops a coupled train-viaduct dynamic analysis model to investigate the dynamic response of semi-enclosed sound barriers on viaducts in light rail transit. During the iterative process of this model, fluctuating wind produced by the train is introduced and combined with wheel-rail loads to analyze the dynamic response of sound barriers. Based on the above model, in the time domain, there are significant differences in the vibration displacement and acceleration under combined excitation when the train head enters and the tail exits the sound barrier region. In the frequency domain, the vibration acceleration level under combined excitation increases significantly within the 0–5 Hz frequency. The parameter analysis results indicate that the total vibration acceleration level is higher at the measuring points close to the direction of travel. As the train speed increases, the effect of fluctuating wind becomes more significant in the low-frequency range (1–3.15 Hz). The smaller number of train formations also improved the vibration acceleration level difference between the combined and wheel-rail excitation.
Understanding the barriers to hiring autistic people as perceived by employers in the United Kingdom
Authors: Day Marianne , Wood Chantelle , Corker Elizabeth , Freeth Megan 
Published: December 2024

Supporting more autistic people into employment is a major priority of the United Kingdom’s National Autism Strategy (2021–2026). However, little is known about the barriers employers perceive to hiring autistic people. A pre-registered cross-sectional survey study was conducted on a nationally representative sample of 1212 individuals with recent hiring experience. The Capability, Opportunity, Motivation – Behaviour framework and the Theoretical Domains Framework were used to identify perceived barriers to hiring autistic people. Results indicated that intentions to hire autistic people and to make adjustments to the hiring process were high. However, barriers existed in relation to knowledge about autism and how to make adjustments, as well as perceived limited opportunities to hire autistic people. Intentions to hire autistic people were higher for younger participants, men, people with higher levels of autism knowledge and those with more experience of previously hiring autistic people. Analysis of qualitative responses revealed employer concerns about workplace relationships, productivity and the need for training and adjustments to hiring processes. This study demonstrated that important targets for intervention are improving employer knowledge of autism and building more inclusive hiring practices. Practical suggestions for implementation are provided. These findings are significant for development of policies aimed at improving employment outcomes for autistic people. Lay abstract In the United Kingdom, autistic adults struggle more to find jobs than non-autistic adults, which is a big concern to the government. To help more autistic people get jobs, hiring processes need to be better. By understanding what employers find challenging about hiring autistic people, we can come up with solutions to improve autistic people’s employment chances. A survey of 1212 employers and employees who hire people was conducted to find out what affects employers’ decisions to hire autistic people. Most people said they were open to hiring autistic applicants. This was particularly true for younger employers and men. People who had hired autistic people before were more likely to intend to do so again. However, key barriers to hiring were (1) not knowing enough about autism and (2) problems with how hiring is usually done in organisations. Employers also reported worrying about whether autistic employees would fit in at work, their productivity and the need for better training and changes to hiring methods. Our results indicate that it is important to educate employers about autism and make hiring practices more inclusive.
The association between osteoprotegerin and arterial stiffness in a 10-year longitudinal study of patients with type 2 diabetes
Authors: Low Serena , Pek Sharon , Moh Angela , Liu Jian-Jun , Pandian Bhuvaneswari , Ang Keven , Tang Wern Ee , Lim Ziliang , Subramaniam Tavintharan , Sum Chee Fang , Lim Su Chi 
Published: December 2024

Introduction: Osteoprotegerin (OPG) inhibits vascular calcification which is central to pathogenesis of arterial stiffness. However, it promotes inflammation by upregulating expression of vascular cell adhesion molecule-1(VCAM-1), thereby contributing to arterial stiffness. We investigated longitudinal association between OPG and arterial stiffness in type 2 diabetes (T2D), causality of the association and mediation by VCAM-1. Methods: This was a prospective cohort study of T2D patients ( N = 1877, mean age 57.0 ± 10.8) with 10 years’ follow-up. Baseline plasma OPG was measured using immunoassay. Pulse wave velocity (PWV) was assessed using applanation tonometry. We examined association between OPG and follow-up PWV using linear mixed model. One-sample Mendelian Randomization (MR) was conducted with rs1385492 as OPG-associated single nucleotide polymorphism (SNP). Results: Baseline natural log (Ln)-transformed OPG was positively associated with baseline and follow-up PWV with adjusted coefficients 0.43 (95%CI 0.05, 0.80; p = .026) and 0.51 (95%CI 0.06 to 0.97; p = .028) respectively. Genetically-predicted higher levels of plasma OPG was associated with higher last follow-up PWV with coefficient 10.81 (95%CI 2.97, 18.65; p = .007) per unit increase in LnOPG. Higher VCAM-1 accounted for 10.2% of association between LnOPG and follow-up PWV. Discussion: Baseline plasma OPG was associated with higher follow-up PWV in patients with T2D, with genetic evidence from MR. This association may be mediated, at least in part, by VCAM-1.
Drug-Eluting Stent versus Interwoven Bare-Metal Stent in Clinically Significant Vein-Graft Anastomotic Stenosis of Hemodialysis Arteriovenous Graft
Authors: Hongsakul Keerati , Khantayanuwong Supawut , Sungsiri Jitpreedee , Janjindamai Phurich , Akkakrisee Surasit , Bannangkoon Kittipitch , Rookkapan Sorracha , Boonsrirat Ussanee 
Published: December 2024

Purpose: To date, no direct comparison has been made between the patency rates of drug-eluting stents (DESs) and interwoven stents (IWSs) in addressing hemodialysis access dysfunction. This study aims to directly compare the primary patency rates of DES and IWS in clinically significant vein-graft anastomotic stenosis of arteriovenous grafts (AVGs). Material and methods: Between January 2015 and October 2022, we enrolled all hemodialysis patients with clinically significant vein-graft anastomotic stenosis of AVGs who presented at our institution. Patient demographics, AVG details, lesion characteristics, and primary patency data for each stent group were systemically recorded. Following this, a Kaplan-Meier analysis of the primary stent patency was performed, with statistical significance set at p<0.05. Results: A total of 51 patients (19 men and 32 women; mean age=64 years; range=49–79 years) were enrolled. Among them, 16 were treated with DES and 35 were treated with IWS. Notably, the most common stent placement location in each group was the vein-graft anastomosis of the brachioaxillary grafts, and the primary patency rate was monitored over a follow-up period of 24 months. At 6, 12, and 24 months, the primary patency rates for DES vs IWS were 100% vs 62.7%, 91.7% vs 38.8%, and 62.9% vs 21.4%, respectively (p<0.001). Conclusion: Our findings suggest that DES may be a more effective treatment choice for clinically significant vein-graft anastomotic stenosis in AVGs for hemodialysis access than nondrug-coated IWS. Clinical Impact Drug-eluting stents (DES) have been widely recognized for their efficacy in reducing reintervention rates in coronary and femoropopliteal pathologies. However, their application in managing failing hemodialysis access remains inadequately explored. This study highlights the promising potential of DES in addressing clinically significant vein-graft anastomotic stenosis in hemodialysis arteriovenous grafts (AVG). DES may represent a viable alternative for mitigating substantial immediate recoil stenosis following balloon angioplasty and for preventing early restenosis at the vein-graft anastomosis of AVG, offering a novel therapeutic avenue for future clinical practice.
Medication therapy problems detected at community pharmacy INR checks
Authors: Nagge Jeff , Moussa Michelle , Zerai Amleset , Champigny Joey , Woodill Lisa 
Published: December 2024

Background: Despite the shift towards direct-acting anticoagulants, warfarin remains widely used in Canada and is traditionally managed by family physicians through laboratory-based international normalized ratio (INR) testing. The Community Pharmacy Anticoagulation Management Service (CPAMS) in Nova Scotia represents an innovative approach, enabling community pharmacists to conduct point-of-care (POC) INR testing and manage warfarin therapy. A potential benefit of this approach is the opportunity to identify non-warfarin medication therapy problems (nwMTPs) during routine visits. Method: We conducted a prospective, multicentre, observational study across 40 community pharmacies in Nova Scotia, part of CPAMS’s second phase. Pharmacists documented nwMTPs identified in patients with atrial fibrillation during routine POC INR visits using the Qualtrics Insight Platform, categorizing them by indication, effectiveness, safety, or adherence, alongside corresponding interventions. Results: Over 6 months, 43 nwMTPs were submitted from 13 unique pharmacies. There were 3404 POC INR tests in patients with atrial fibrillation, yielding an estimated nwMTP detection rate of 1.26 (95% CI, 0.69 to 2.32) per 100 INR tests. The most common nwMTP category was “Indication,” primarily requiring additional therapy. Pharmacists frequently intervened by recommending medication adjustments or providing patient education. Discussion: The findings highlight a modest, yet potentially significant role of pharmacists in detecting and managing diverse MTPs during focused warfarin management assessments. The predominance of indication-related problems underscores unmet therapeutic needs in patients on warfarin. Conclusion: This study illustrates the potential of pharmacist-led POC INR testing in community settings to identify and address nwMTPs, contributing to comprehensive patient care.
What Radiographic and Spinopelvic Parameters do Spine Surgeons Consider in Decision-Making for Treatment of Degenerative Lumbar Spondylolisthesis?
Authors: Cabrera Juan P. , Virk Michael S. , Cho Samuel K. , Muthu Sathish , Ambrosio Luca , Yoon S. Tim , Buser Zorica , Wang Jeffrey C. , Diwan Ashish D. , Hsieh Patrick C. , The AO Spine Knowledge Forum Degenerative  
Published: December 2024

Study Design Cross-sectional survey. Objective Surgical treatment of degenerative lumbar spondylolisthesis is remarkably varied due to heterogeneity of clinical-radiological presentations. This study aimed to assess which spinopelvic radiological parameters were considered for decision-making. Methods Survey distributed to International AO Spine members to analyze surgeons’ considerations for treatment. Data collected includes demographics, training background, years of experience, and treatment decisions based on various radiographical findings, including segmental and global spinopelvic parameters. Results From 479 responses, the most frequently radiological parameter considered was slippage on dynamic X-rays (79.1%), followed by disc height (78.9%), global sagittal balance SVA (71.4%), and PI-LL mismatch (69.7%), while the least important was absolute spondylolisthesis on static lateral radiograph (22.8%). Fellowship-trained surgeons were likelier to use SVA (OR = 1.73, 95% CI = 1.02-2.99, P = 0.049), and disc height (2.13, 1.14-3.98, P < 0.05). There was no difference between orthopedics and neurosurgery in applying SVA and PI-LL mismatch. Surgeons from Asia Pacific emphasizes segmental lordosis (2.39, 1.11-5.15, P = 0.026) as from Latin America (2.55, 1.09-5.95, P = 0.030) and Middle East (4.33, 1.66-11.28, P = 0.003). However, surgeons from Latin America and Middle East also significant consider disc height (2.95, 1.07-8.15, P = 0.037) and (3.03, 1.04-8.83, P = 0.043), respectively. Additionally, the surgeons’ age was associated with using angular motion on flexion-extension radiographs, and volume of treated cases yearly with consideration for disc height. Conclusions Treatment of degenerative lumbar spondylolisthesis was influenced by slippage on dynamic radiographs, disc height, global alignment, and PI-LL mismatch. Surgeons’ age and Region, fellowship-trained, and volume of treated cases were significantly associated to apply these radiological parameters.
Characteristics of High-Risk Bipolar Bone Loss Lesions Using 3-Dimensional Imaging
Authors: Golijanin Petar , Arner Justin W. , Ryan Claire B. , Zai Qais , Peebles Liam A. , Peebles Annalise M. , Ganokroj Phob , Whalen Ryan J. , Eble Stephanie K. , Rider Danielle , Ninković Srdjan , Provencher Matthew T. 
Published: December 2024

Background: The concept of on-track versus off-track bone lesions in glenohumeral instability continues to evolve. Although much has been ascertained from an original biomechanical model, bony pathological changes, especially on 3-dimensional (3D) imaging, have not been fully evaluated. Purpose: To compare the differences in on-track versus off-track lesions to characterize glenoid and humeral head bone defects using 3D modeling software. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A consecutive cohort of 75 patients with recurrent anterior instability, with evidence of Hill-Sachs lesions (HSLs) and glenoid bone loss (GBL) and a mean age of 27.1 years (range, 18-48 years), were reviewed. 3D models of unilateral proximal humeri and glenoids were reconstructed. The volume, surface area, width, and depth of identified HSLs were quantified, along with their location (medial, superior) and orientation (Hill-Sachs angle). The percentage, width, and length of GBL as well as the glenoid track status were calculated. The on-track and off-track groups were compared using the Mann-Whitney U test. Results: The off-track group had greater HSL surface area (374.23 vs 272.64 mm2, respectively; P = .001), more HSL medialization (14.96 vs 17.62 mm, respectively; P = .028), greater HSL volume (603.08 vs 433.61 mm3, respectively; P = .007), and a greater mean HSL width (16.06 vs 11.53 mm, respectively; P = .001) than the on-track group. The off-track group also had greater GBL (22.55% vs 17.73%, respectively; P = .037), a greater GBL width (6.92 vs 3.58 mm, respectively; P < .001), and a greater GBL length (21.61 vs 16.1mm, respectively; P = .015) than the on-track group. Further analysis of large off-track lesions revealed a greater Hill-Sachs angle (33.16° vs 26.20°, respectively; P = .035) and a more superior extent of HSLs compared with borderline off-track and on-track lesions. Conclusion: Off-track lesions were found to have larger GBL, a larger HSL width, a more medialized HSL, and greater HSL surface area. This study outlines the specific characteristics of high-risk bipolar bone loss lesions to simplify the identification of patients in a clinical setting and aid in appropriate treatment planning.