bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the impact of a multicomponent positive participatory organisational intervention on burnout in New Zealand emergency department staff: a prospective, multisite, before and after, mixed methods study
Authors: Nicholls Mike , Anderson Natalie , Jarden Rebecca , Selak Vanessa , Frampton Chris , Dalziel Stuart R 
Published: October 2024

IntroductionThe well-being of healthcare workers (HCWs) is critical to providing excellent care. Recent evidence concerns the well-being of emergency department (ED) HCWs in New Zealand, with high levels of burnout found in a 2020 survey. This threat to providing high-quality acute care warrants improvement interventions. The causes of burnout are complex and multifactorial, the solutions are not straightforward.Methods and analysisA prospective, multisite, before and after, mixed methods study assessing a multicomponent intervention, adaptable to local context, that targets three organisation levels (the individual, the group and the system levels) and meaningfully involves frontline HCWs may reduce HCW burnout and improve HCW well-being. Individual HCWs will choose from three individual-level psychological interventions and participate in those most appropriate for them. Local champions will decide which group-level intervention their ED will use. The system-level intervention will build capacity and capability for quality improvement (QI) with QI training and the establishment of a Quality Improvement Learning System. This system-level intervention has several important features that may ultimately empower HCWs to contribute to improving the quality of ED healthcare.We will enrol nine EDs, from which there will be at least 900 HCW participants. EDs will be enrolled in three waves from March 2023 to April 2024, with interventions taking place in each ED over 12 months.Methods of assessment will include baseline and repeat survey measures of burnout and well-being. Process evaluation at each ED will provide details of context, the intervention and the fidelity of the implementation.Ethics and disseminationEthics committee approval was provided, with locality approval at each site.Individual site feedback will be provided to each ED and executive leadership. Dissemination of findings will be through publication in peer-reviewed journals, presentation at national and international scientific meetings and through national healthcare quality bodies.Trial registration numberAustralia New Zealand Clinical Trials Registry (ACTRN12623000342617).
Safety and efficacy of personalised versus standard dosing of linezolid in patients with sepsis (SePkLin): a pragmatic, multicentre, randomised, controlled and superiority clinical trial protocol
Authors: Bandín-Vilar Enrique , Estany-Gestal Ana , Cabaleiro Teresa , Rial-Pensado Eva , Castro-Balado Ana , Varela-Rey Iria , Mondelo-García Cristina , Cajade-Pascual Francisco , Rodríguez-Jato María Teresa , Zarra-Ferro Irene , Rey-Rilo María Teresa , Arca-Suárez Jorge , Albiñana-Pérez María Sandra , Rascado-Sedes Pedro , Pose-Reino Antonio , Valdés Luis , Taboada-Muñiz Manuel , Barbeito-Castiñeiras Gema , Mena de Cea Álvaro , Alemparte-Pardavila Enrique , Fernández-Ferreiro Anxo , Study Group SePkLin 
Published: October 2024

IntroductionLinezolid is a broadly used antibiotic to treat complicated infections caused by gram-positive bacteria. Therapeutic drug monitoring of linezolid concentrations is recommended to maximise its efficacy and safety, mainly haematological toxicity. Different pharmacokinetic/pharmacodynamic targets have been proposed to improve linezolid exposure: the ratio of the area under the concentration–time curve during a 24-hour period to minimum inhibitory concentration (MIC) between 80 and 120; percentage of time that the drug concentration remains above the MIC during a dosing interval greater than 85% and the trough concentration between 2 and 7 mg/L. This clinical trial aims to evaluate the safety, efficacy and the clinical and economic utility of personalised dosing of linezolid using Bayesian forecasting methods to attain pharmacokinetic/pharmacodynamic targets, known as model-informed precision dosing.Methods and analysisThis is a pragmatic, multicentre, randomised, parallel, controlled, phase IV and low intervention trial. Participants will be randomly assigned 1:1 to each group (n=346 per group). Control group will receive the standard dose of linezolid. Intervention group will receive personalised dosage of linezolid based on pharmacokinetic–pharmacodynamic adjustments. The primary outcome will be the incidence of thrombocytopenia in both groups.Ethics and disseminationThis protocol was approved by the Ethical Committee of the Investigation with Medicines of Galicia (code 2022/140) and authorised by the Spanish Agency for Medicines and Medical Devices. The trial is implemented in accordance with the Declaration of Helsinki and the international ethical and scientific quality standard, the Good Clinical Practice. The results will be published in peer-reviewed journals.Trial registration numberEudraCT registration code: 2022-000144-30.
Knowledge, attitude and practice towards chemotherapy-related neutropenia and febrile neutropenia among breast cancer patients
Authors: Chen Yilin , Zhou Huanhao , Jiang Junzhen 
Published: October 2024

ObjectivesThis study aimed to investigate the knowledge, attitude and practice (KAP) towards chemotherapy-related neutropenia and febrile neutropenia (FN) among breast cancer patients. The major hypothesis was that demographic characteristics influence patients’ KAP regarding chemotherapy-related neutropenia and FN.DesignA multi-centre cross-sectional study.SettingConducted in four secondary care hospitals between April and June 2023.ParticipantsThe study enrolled 246 breast cancer patients undergoing chemotherapy. Participants were aged 18 years or older, currently on chemotherapy and willing to complete the questionnaire. Exclusion criteria included significant cognitive impairments.Primary and secondary outcome measuresPrimary outcome measures were KAP scores regarding chemotherapy-related neutropenia and FN. Secondary outcomes included factors associated with adequate knowledge and positive attitudes.ResultsA total of 246 patients completed the questionnaire. The mean knowledge score was 12.46±6.21 (range: 0–26), and the mean attitude score was 30.00±2.58 (range: 7–35). Less than half of the patients (45.95%) knew whether their chemotherapy protocol was high risk for FN, while 79.67% were aware of the need for prophylactic administration of leukocyte-raising agents. Multivariate logistic regression analysis revealed that having a junior college education or higher was significantly associated with knowledge scores (OR=4.69, 95% CI 2.23 to 9.89, p<0.001). Living in urban areas was associated with attitude scores (OR=0.58, 95% CI 0.34 to 0.97, p=0.037). Structural equation modelling analysis indicated that experience with chemotherapy-related neutropenia or FN influenced knowledge to some degree (β=1.77, p=0.029).ConclusionsThe study found inadequate knowledge, a positive attitude and suboptimal practice towards chemotherapy-related neutropenia and FN among breast cancer patients undergoing chemotherapy. Tailored education programmes are needed to improve KAP in this patient population. Further research should explore additional demographic and psychosocial factors influencing KAP to develop comprehensive educational interventions.
Community breast pain clinics can provide safe, quality care for women presenting with breast pain
Authors: Sibbering Mark , Rogers Veronica , Merriman Louise , Azmy Iman , Stafford Denise , Clifton Kevin , Pickard Jennifer , Bartholomeuz Thilan , Robertson John 
Published: October 2024

IntroductionBreast pain is not typically a symptom of breast cancer, yet nationally 20% of 2-week wait (2WW) breast referrals are breast pain alone. The East Midlands Breast Pain Pathway improves patient experience and frees capacity in secondary care diagnostic breast clinics, managing women with breast pain only in a community setting. We report the results of implementation of community breast pain clinics (CBPCs) at sites in Derbyshire (catchment population ~1 million), with 12 months follow-up data.Results1036 patients were seen at CBPCs between June 2021 and February 2023. The median patient age was 49 (range 16–88) years. 993 patients (95.8%) were discharged from the clinic with breast pain management advice. 43 (4.2%) patients were referred for further assessment at a 2WW breast diagnostic clinic. Objective family history risk assessment identified 124 patients (12.3%) above population risk of breast cancer, who were offered referral to familial cancer services for ongoing management.DiscussionSeven patients were diagnosed with breast cancer at or within 12 months of CBPC attendance. Five patients were diagnosed through attending the CBPC, one patient was subsequently referred to 2WW clinic with a new symptom and had a mammographically occult tumour and one was diagnosed following a subsequent routine breast screening invitation. Two of the five patients had a personal history of breast cancer which was a stated exclusion criterion for the CBPC. Breast cancer incidence in women with breast pain only and fulfilling CBPC referral criteria was 4.8/1000, confirming that this population is at low risk of developing breast cancer.Patient service satisfaction was high with 99% (n=1022) ‘extremely likely or likely’ to recommend the service.ConclusionThe results confirm the pathway is the first to demonstrate women can be safely managed with breast pain alone in a community setting with high levels of patient satisfaction.
Frequency and mechanism of injury for unintentional paediatric femoral fractures associated with consumer products over a 10-year period in the USA
Authors: Peace Andrew , Dandamudi Siddartha , Ozdemir Sevil , Ostrander James , Atkinson Theresa 
Published: October 2024

BackgroundFemoral shaft fractures tend to be rare among children; however, these injuries are the most common major paediatric injuries treated by orthopaedic surgeons. The purpose of this study is to characterise the demographics and mechanisms of femoral injury associated with consumer products in the age group treated with spica casting, children 6 months to 6 years, to identify areas for injury prevention.MethodsData from 2012 to 2021 were obtained from the National Electronic Injury Surveillance System maintained by the Consumer Products Safety Commission, documenting emergency department visits for unintentional injuries associated with consumer products. Narrative descriptions were analysed to identify common factors in the injury events such as location, products and mechanisms of action.ResultsFrom 2012 to 2021, the estimated incidence of femur fractures was 23.5 cases per 100 000 children with no significant difference in yearly frequency. The most common mechanism of injury was a fall with the most frequent fracture sources being bed/bunk beds (16.1%), floor (slips/falls, 9.7%) and trampolines (9.7%). Most fractures occurred at the patient’s home (58.4%). The incidence of injury outside of the home and frequency of fractures involving play structures/trampolines increased with age.ConclusionsThe incidence and demographic characteristics of paediatric femur fractures associated with consumer products have remained consistent over the past 10 years. As home was the most common location of fracture, prevention of femur fractures should focus on caregiver education around high-risk sources of fracture (bed, stairs and trampolines) and manufacturers should consider design alternatives that discourage potential misuse.
System-level interventions for fall risk assessment, fall prevention and fall injury prevention in long-term care facilities: a scoping review
Authors: Wi Dahee , Ustach Andrew , Jung Wonkyung , Lim Sungwon , Thompson Hilaire J 
Published: October 2024

ObjectivesOlder adults living in long-term care facilities (LTCFs) are at high risk for falls. Interventions to prevent falls and fall-related injury in this population may be individual-level or system-focused interventions. However, relatively little attention has been given to research on system-focused interventions. This scoping review seeks to synthesise previous studies on the effects of system-focused interventions for fall prevention in LTCFs.MethodsWe searched Ovid-Medline, CINAHL and Embase databases from 2007 to 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. We conducted a narrative synthesis to summarise findings from the included studies.ResultsIn the initial search, 403 studies were identified and underwent title and abstract screening resulting in 116 articles retrieved for full-text review. 20 studies were included in the final data extraction. System-level fall prevention interventions evaluated in LTCFs include (1) multicomponent and multidisciplinary programmes, (2) environmental adaptations, (3) technological adaptations, and (4) staff education and training programmes. 11 out of 17 included quantitative studies reported significant effects of system-focused interventions to reduce falls in LTCFs.ConclusionsThis scoping review reveals the effectiveness of system-level fall prevention strategies in LTCFs. Enhancing training, customising tools and fostering a supportive leadership culture are vital for improving fall prevention practices in LTCFs.
Evaluating the financial case for investing in, or divesting from, tobacco investments
Authors: Evans Timothy , Sayed Ayesha , Van Walbeek Corné 
Published: October 2024

BackgroundTobacco Free Portfolios urges institutions to pledge against investing in, and to withhold financial services from, tobacco companies. Their goal is to create a ‘tobacco-free world’. They argue that without financial and investor support, these companies’ operations will become less sustainable.ObjectiveTo assess the financial rationale for investing in, or divesting from, tobacco companies.MethodsUsing data sourced from Bloomberg from 2008 to 2023, we evaluate historical sales volumes, real revenue, real gross profit per cigarette, stock performance and price-to-earnings trends for nine leading listed global tobacco companies.ResultsCigarette sales volumes have steadily declined from 2008 to 2023. Despite efforts to diversify towards novel products, revenues from these products remain small, and cigarettes remain the primary revenue source. Excluding inorganic growth, six of the nine companies experienced real revenue declines from 2008 to 2023. Since 2016, many companies experienced declines in real gross profit per cigarette, indicating that they find it increasingly difficult to offset reduced cigarette sales through net-of-tax price increases. Since 2016, all nine tobacco companies’ stocks have substantially underperformed the market. This stands in contrast to the 2008–2016 period, during which all nine companies’ stocks substantially outperformed the market.ConclusionsTobacco companies have experienced deteriorating financial performance since 2016, amidst ever-escalating regulation. It remains unclear whether the growth in novel products will be rapid enough to mitigate the decline in cigarette sales. This uncertainty poses heightened risks for investors, and there is a real possibility of continued poor stock performance.
Analytical design of fourth and fifth harmonic generations of an elliptically polarized Bessel-Gauss beam by using the concept of guided wave optics and TIR-QPM technique in a biaxial material
Authors: Saha Jaya , Deb Sumita 
Published: October 2024

This paper demonstrates the analytical design of an Elliptically polarized Bessel-Gauss beam-based frequency converter by using the guided wave optics concept and Total Internal Reflection Quasi phase matching technique. An anisotropic positive biaxial crystal featuring a rectangular structure of Rubidium Titanyle Phosphate has been used to carry out this analysis. The efficiency of the fourth and fifth harmonic conversion in the projected scheme is 7.05% and 4.3%, respectively, which is approximately three times greater than in a crystal length of approximately 1.4[Formula: see text]mm and 3.4[Formula: see text]mm, as provided by the scheme illuminated by a linearly polarized Bessel-Gauss beam at a wavelength of 735[Formula: see text]nm and 588[Formula: see text]nm, respectively. The influence of limiting factors, viz Goos Hänchen Shift, surface roughness, absorption, and the diffraction effect rooted in the basic law of nonlinear reflection, has also been taken care of in this analysis. The dependence of conversion efficiency on the length, thickness and angle of incidence of the slab has also been studied.
RGO-g-C3N4-Co3O4 Composite Modified Platinum Electrode for Electrochemical Detection of Dopamine
Authors: Madhavan Arya S. , Rajith Leena 
Published: October 2024

A novel RGO-g-C3N4-Co3O4 composite modified platinum electrode with significant sensing performance for dopamine was fabricated. Herein, RGO-g-C3N4-Co3O4 hybrid nanostructure could boost the electrocatalytic performance of nanoparticles by avoiding the clustering of nanoparticles. These spinel-based composites are stable and affordable materials. Electrochemical impedance spectroscopy revealed enhanced electron transfer at the modified electrode, as evidenced by the lowest charge transfer resistance (Rct) for the RGO-g-C₃N₄-Co₃O₄/Pt electrode. An increased electroactive surface area compared to bare and other modified Pt electrodes was obtained. Several experimental parameters were optimized to maximize sensitivity, including the choice of supporting electrolyte and pH. Cyclic voltammetry conducted at varying scan rates confirmed that the oxidation of dopamine followed a diffusion-controlled process. The modified electrode exhibits outstanding electrocatalytic activity, with a detection limit as low as 8.10 × 10−7 M, demonstrating a wide linear range between 2.00 × 10−6 M to 4 × 10−4 M. Selectivity tests indicated that the sensor could reliably detect dopamine in the presence of common interfering substances such as NaCl, KCl, glucose and urea, ascorbic acid, uric acid and L-dopa. This enhanced sensitivity and selectivity were validated in both synthetic blood and urine samples, providing the electrode’s potential for real-world applications in the diagnosis of neurodegenerative diseases.
Rate Capability of Fluorinated Catholyte-Based Li Primary Batteries Governed by Interfacial and Bulk Li+ Transport
Authors: Sevilla Alejandro R. , Gao Haining , Steinberg Katherine , Gallant Betar M. 
Published: October 2024

Fluorinated catholytes based on fluoro–organosulfur reactants have recently been shown to offer a compelling design space for high-energy lithium (Li) primary batteries with ability to compete with carbon monofluoride (CFx) at low rates and moderate cell temperatures. However, rate capability is hindered as the operating temperature is lowered to room temperature, warranting further investigation. Here, we examined the origin of such loss in detail via impedance spectroscopy and 3–electrode cells. As temperature decreases, the Li anode disproportionately contributes to discharge overpotentials at moderate to high rates (0.3–1 mA cm−2), indicating that the Li solid electrolyte interphase (SEI) plays a pivotal role in governing performance. Despite a modest temperature change, the chemical composition of the SEI is significantly different at 25 °C than at 50 °C, with a lower oxygen/fluorine ratio at room temperature that impedes SEI Li+ transport. Furthermore, continuous growth in ionic resistance/viscosity of the catholyte throughout discharge are found to be the cause of cell “sudden death” at lower temperature and higher rates. This analysis indicates that development of these energy–dense primary battery chemistries for moderate-to-high–rate applications must focus on enhancing SEI Li+ conductivity and maximizing diffusivity of reactant species under solvent–lean conditions.
Perceptual Health and Wellbeing, Self‐Reported Sleep, and Hydration Status in Youth Soccer Players During Competition
Authors: King Michael , Kimble Rachel , Brown Matthew , McCafferty Seamus , Lithgow Hannah 
Published: October 2024

Introduction: The aim of this study was to assess match time courses on hydration, wellness, and sleep as well as the interrelationship between these variables in youth national soccer players.Materials and Methods: Under‐17 and under‐19 youth national soccer players (age range: 16.96 ± 1.17 years) completed a perceptual wellness questionnaire, self‐reported their sleep, and carried out hydration assessments each morning during a period of competitive match play.Results: Players reported having significantly more sleep leading into the day of a match (MD) compared to both the evening after a match (MD‐2; p < 0.001; CI = 7.972 and 8.212) and the evening before a match (MD‐1; p < 0.001; CI = 7.996 and 8.174). Furthermore, players reported better health and wellbeing scores on MD compared to both MD‐1 (p < 0.001; CI = 19.231 and 19.692) and MD‐2 (p < 0.001; CI = 18.911 and 19.489). When self‐reported sleep was correlated with the individual components of health and wellbeing, it was highlighted that there were significant effects for fatigue (r = 0.304, p < 0.001; CI = 0.250 and 0.383), mood (r = 0.170, p < 0.001; CI = 0.112 and 0.243), general muscle soreness (r = 0.225, p < 0.001; CI = 0.162 and 0.306), and stress (r = 0.203, p < 0.001; CI = 0.147 and 0.274).Conclusion: It is important to consider sleep strategies to mitigate the potential impact of lack of sleep following match play. Self‐reported sleep seems to be appropriate for estimating individual components of health and wellbeing, and therefore may be a suitable replacement for perceptual wellness questionnaires.
Increased Incidence of Rhinovirus Pneumonia in Children During the COVID‐19 Pandemic in Mexico
Authors: Ortega-Vargas Fanny Yasmin , Herrera-González Aldo Agustin , Díaz-Torres Ilen Adriana , Cabrera-Takane Isamu Daniel , Bautista-Carbajal Patricia , García-León Miguel Leonardo , Noyola Daniel E. , Juárez-Tobías María Susana , Tabla-Orozco Verónica , Martínez-Arce Pedro Antonio , Espinosa-Sotero María del Carmen , Martínez-Aguilar Gerardo , Rojas-Larios Fabian , Salazar-Soto Luis Alfonso , Wong-Chew Rosa María 
Published: October 2024

Background: Human rhinovirus (HRV), traditionally recognized as the primary etiological agent of the common cold, has become the second most important viral agent in bronchopulmonary conditions, such as pneumonia and asthma exacerbations. During the COVID‐19 pandemic, several viruses exhibited changes in their epidemiological behavior. This study aims to evaluate the clinical and epidemiological characteristics of children with HRV pneumonia before and during the pandemic in Mexico.Methods: A comparative ambispective longitudinal epidemiological study of two cohorts (prepandemic and pandemic periods) was carried out. Two databases were compared: one from 2010 to 2013 and the other from 2021 to 2023. Children under 5 years of age diagnosed with HRV pneumonia were included. Student’s t‐test, χ2 tests, and logistic regression were used to assess risk factors associated with severe pneumonia. Incidence density was calculated as HRV cases per 10 new cases of pneumonia per month for each year.Results: During the pandemic, the age of presentation shifted from 5 months to 16 months. There was a higher incidence of HRV pneumonia in children during the pandemic, particularly in the second half of 2021, with a peak in July and August. In addition, there was an increase in severity (53% vs. 63%, p = 0.006) and coinfections (51.3% vs. 76% p < 0.001). A higher prevalence of all risk factors was observed in the second cohort.Conclusions: During the pandemic, a shift toward older age, a higher percentage of coinfections, and increased severity associated to HRV pneumonia were observed. These findings highlight the need for the development and implementation of targeted prevention and treatment measures for HRV.