bluuebunny/crossref_metadata_2025_split huggingface dataset:
Centre-level fluid management practices in the BISTRO trial and their lack of association with participant fluid status and blood pressure in non-anuric haemodialysis patients
Authors: Johal Neena , Sharma Radha , Belcher John , Coyle David , Lindley Elizabeth J. , Keane David , Caskey Fergus J. , Dasgupta Indranil , Davenport Andrew , Farrington Ken , Mitra Sandip , Ormandy Paula , Wilkie Martin , Macdonald Jamie , Solis-Trapala Ivonne , Sim Julius , Davies Simon J. 
Published: November 2024

Abstract
Introduction
Fluid assessment and management is a key aspect of good dialysis care and is affected by patient-level characteristics and potentially centre-level practices. In this secondary analysis of the BISTRO trial we wished to establish whether centre-level practices with the potential to affect fluid status were stable over the course of the trial and explore if they had any residual associations with participant’s fluid status.

Methods
Two surveys (S) of fluid management practices were conducted in 32 participating centres during the trial, (S1: 2017–18 and S2: 2021–22). Domains interrogated included: dialysate sodium concentration, (D-[Na+]), fluid and salt intake, residual kidney function, use of diuretics, incremental start, approaches to fluid assessment, management and dialysate temperature, (D-oC). Associations of these practices with the closeness of the participant’s post-dialysis target weight to their normally hydrated weight, pre- and post-dialysis systolic (SBP) and diastolic blood pressure, (DBP), were analysed using intra-class correlations and multilevel modelling with adjustment for visit, age, sex and comorbidity burden.

Results
Variations in centre practices were reported but did not change during the trial, apart from some relaxation in salt and fluid restriction in S2. For our measures of fluid status, measured 2501 times in 439 non-anuric incident haemodialysis patients, centre-level intraclass correlations were extremely low, whereas patient-level correlations ranged between 0.12 and 0.47, strongest for pre- and post-dialysis-SBP, less so for post-dialysis-DBP. Multi-level analysis found no associations between D-[Na+], or assessment methods of fluid status. In S2, one centre, routinely using a D-Co of 35°C had more divergence between the target and normally hydrated weight, but this was not observed in S1, and no other associations were found.

Conclusions
Centre-level fluid management practices were stable over the course of the BISTRO trial, and in contrast to patient-level factors, no centre-level associations were detected with fluid status or blood pressure. This may be because the trial imposed a standardised approach to fluid assessment in all trial participants who at least initially had residual kidney function, potentially over-riding the effects of other centre practices. Survey responses revealed substantial scope for developing and evaluating standardised protocols to optimise fluid management.
High anaemia and iron deficiency prevalence among pregnant women living in low groundwater iron areas of Bangladesh
Authors: Hasan Mohammed Imrul , Ahmed Shamim , McLean Alistair R. D. , M Quaiyum Rahman A. , Bhuiyan Mohammad Saiful Alam , Tipu S. M. Mulk Uddin , Braat Sabine , Arifeen Shams El , Hamadani Jena D. , Pasricha Sant-Rayn , Davidson Eliza M. 
Published: November 2024

Abstract
Background
Anaemia is a significant public health concern in Bangladesh, yet data on the prevalence of anaemia in pregnancy and the contribution of iron deficiency are limited. Given the reliance on groundwater for drinking, a better understanding of the role of drinking water iron in anaemia aetiology is also required to inform anaemia prevention strategies.

Methods
This cross-sectional study enrolled 1500 pregnant women from Narayanganj district, Bangladesh, during their second or third trimester. Anaemia and iron status were described and their relationship with drinking water iron assessed using regression analyses.

Results
The prevalence of anaemia was 38% (95% confidence interval, CI: 35%, 40%), with 10% (95% CI: 9%, 12%) experiencing moderate-to-severe anaemia. Iron deficiency affected 48% (95% CI: 45%, 50%) of participants. Although drinking water iron concentrations were generally low (median: 0 mg/L; interquartile range: 0–1), high concentrations (≥ 2 mg/L) were associated with increased ferritin levels but did not significantly impact iron deficiency (95% CI: 0·73, 1·02) or anaemia (95% CI: 0·79, 1·17) prevalence. Iron deficient women had a 1·86 (95% CI: 1·61, 2·15) adjusted prevalence ratio for anaemia and a 4·22 (95% CI: 2·89, 6·17) adjusted prevalence ratio for moderate-to-severe anaemia, compared to iron replete women.

Conclusions
Anaemia and iron deficiency are highly prevalent among pregnant women in Narayanganj. These findings challenge the assumption of low iron deficiency prevalence throughout Bangladesh and highlight iron deficiency in pregnancy as a potentially underrecognized public health problem, particularly in regions with low drinking water iron. Further research is needed to clarify the contribution of drinking water iron to iron deficiency and anaemia in Bangladesh.

Trial registration
The study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000982819, registered 26/07/2021)
Medical students‘ leadership competence in health care: development of a self-assessment scale
Authors: Ogurek Barbara , Harendza Sigrid 
Published: November 2024

Abstract
Background
Medical leadership plays an increasing role already in early career stages. Undergraduate medical students in the transition to postgraduate education feel not well prepared for their leadership roles. While leadership curricula have been developed, instruments for students’ self-assessment of leadership competences as part of their professional development are still missing. The aim of our study was to develop a self-assessment scale for undergraduate medical students’ leadership competences.

Methods
The medical leadership competence scale (MeLeCoS) for undergraduate medical students was developed in twelve steps. For item generation, we employed the Medical Leadership Competence Framework (MLCF), which is also used as a framework for many leadership curricula and includes five leadership domains for three fields of education: undergraduate education, postgraduate education, and continuing practice. In a pretest, 67 items were tested with n = 88 undergraduate medical students. For content validation we performed group discussions with a total of 17 students. After item reduction a test-version with 45 items and a 5-point Likert scale (1: ‘never’, 2: ‘rarely’, 3: ‘sometimes’, 4: ‘often’, 5: ‘always’) was used in a test-sample of final-year students (n = 129). Descriptive statistics and factor analyses were performed.

Results
The final version of the MeLeCoS includes 37 items and the scale’s Cronbach’s alpha was 0.87. Six factors could be identified and two of them, respectively, represent leadership aspects from the following three areas: (1) the medical students themselves, (2) the interrelation of the medical students with a healthcare organisation regarding general management and improvement, and (3) general leadership aspects of medical students within undergraduate medical studies and the healthcare system. The overall mean of the MeLeCoS was 3.50 ± 0.39. Factor 2 (‘Demonstrating responsible behaviour and shaping relations’) reached the highest mean (4,36 ± 0.37) and factor 5 (‘Promoting improvement and innovation in undergraduate medical education’ the lowest (1.91 ± 0.87).

Conclusions
The medical leadership competence self-assessment scale (MeLeCoS) is a reliable instrument for undergraduate medical students’ self-assessment of leadership competence with good content validity. It could be used for students’ self-reflection on leadership competences in addition to rater-based assessments in leadership curricula and for longitudinal development of students’ professional identity.
“If government is saying the regulations are important, they should be putting in funding to back it up.”- An in-depth analysis of local authority officers’ perspectives of the Food (Promotion and Placement) (England) Regulations 2021
Authors: Dhuria Preeti , Muir Sarah , Jenner Sarah , Roe Emma , Lawrence Wendy , Baird Janis , Vogel Christina 
Published: November 2024

Abstract
Background
As part of the UK government’s obesity strategy, the Food (Promotion and Placement) (England) Regulations 2021 were implemented in October 2022 to restrict the prominent placement of products high in fat, sugar, or salt (HFSS) in most retail settings. Local authority (LA) officers have been tasked with enforcement of these regulations. This qualitative study examined the perspectives of LA officers including, trading standards, environmental health, and public health officers to understand enforcement approaches and requirements to optimise business compliance with the regulations.

Methods
Semi-structured interviews were conducted via MS Teams with a purposive sample of LA officers across England. Data were analysed using inductive thematic analysis.

Results
The 22 participants comprised 13 officers from Trading Standards, six from Environmental Health, and three from Public Health teams. The key messages include the following: (i) the regulations are complex and do not align with existing enforcement approaches, (ii) officers’ professional background will result in variable enforcement practices, and (iii) compliance assessment is an arduous task. LAs are facing resource and workforce constraints and have to prioritise regulations addressing high health risks (e.g., allergens). Therefore, officers will mostly apply a light touch approach to enforcement, raising awareness and engaging with businesses rather than issuing notices. To develop a consistent enforcement approach across LAs, officers asked for (i) further leadership from central government in the form of funding, training, and tools to determine in-scope businesses and products, (ii) cross-departmental collaboration to raise the regulations’ priority at local and regional levels, and (iii) greater consumer demand for healthier retail environments.

Conclusion
It is crucial to address both structural challenges such as resource allocation, workforce, and prioritisation issues as well as the inherent complexity of the regulations to strengthen enforcement efforts. Our findings highlight the necessity of supporting enforcement activities at national and regional government levels to avoid potential false conclusions about ineffectiveness of regulations.
Lost in translation: the lack of agreement between surgeons and scientists regarding biomaterials research and innovation for treating bone defects
Authors: Laubach Markus , Whyte Stephen , Chan Ho Fai , Frankenbach-Désor Tina , Mayer-Wagner Susanne , Hildebrand Frank , Holzapfel Boris M. , Kneser Ulrich , Dulleck Uwe , Hutmacher Dietmar W. 
Published: November 2024

Abstract

Background

With over 2 million grafts performed annually, bone ranks second only to blood in the frequency of transplants. This high demand is primarily driven by the persistent challenges posed by bone defects, particularly following trauma or surgical interventions such as tumour excision. The demand for effective and efficient treatments has increased exponentially in the twenty-first century. Limitations associated with autologous bone grafts drive exploration into replacements, including allografts, synthetic substitutes, and 3D-printed scaffolds. This research aimed to unravel disparities in the knowledge and evaluation of current and future bone defect treatments between surgeons and biomaterial scientists.

Methods
A prospective cross-sectional survey, pre-registered with the OSF (https://osf.io/y837m/?view_only=fab29e24df4f4adf897353ac70aa3361) and conducted online from October 2022 to March 2023, collected data on surgeons’ views (n = 337) and scientists (n = 99) on bone defect treatments.

Results
Scientists were significantly more optimistic than surgeons regarding the future replacement of autologous bone grafts with synthetic or tissue-engineered substitutes (p < 0.001). Accordingly, scientists foresee a paradigm shift from autologous bone grafts to biomaterial and tissue-engineered solutions, reflecting their confidence in the ongoing advancements within this field.
Furthermore, regulatory trepidations for 3D-printed bone scaffolds were acknowledged, with scientists emphasizing the need for a more significant focus on clinical relevance in preclinical studies and regulatory clarity. In a ranked categorical assessment, witnessing the technology in action was deemed most influential in adopting new bone regeneration methods by both scientists and surgeons.

Conclusions
To conclude, this study was conducted through a web-based survey, highlighting a substantial translational gap. It underscores the immediate need (“call to action”) for meaningful interdisciplinary collaboration between surgeons and scientists, often referred to as the need to “walk the talk”. The findings underscore the critical importance of aligning clinical needs, research outcomes, and regulatory frameworks to improve the development and implementation of biomaterial-based bone graft substitutes that demonstrate efficacy and efficiency in bone defect treatment.
Recombinant characterization and pathogenicity of a novel L1C RFLP-1-4-4 variant of porcine reproductive and respiratory syndrome virus in China
Authors: Huang Xinyi , Liu Guoqing , Chang Tong , Yang Yongbo , Wang Tao , Xia Dasong , Qi Xinyu , Zhu Xulong , Wei Ziyi , Tian Xiaoxiao , Wang Haiwei , Tian Zhijun , Cai Xuehui , An Tongqing 
Published: November 2024

AbstractPorcine reproductive and respiratory syndrome (PRRS) is one of the most significant diseases affecting the pig industry worldwide and is caused by the PRRS virus (PRRSV), which has complex genetic variation due to frequent mutations, indels, and recombination. The emergence of PRRSV L1C.5 in 2020 in the United States has raised worldwide concerns about PRRSV with the RFLP 1-4-4 pattern and lineage 1C. However, studies on the pathogenic characteristics, epidemiological distribution, and effectiveness of vaccines against PRRSV with L1C and RFLP1-4-4 pattern in China are still insufficient. In this study, a novel recombinant variant of PRRSV with RFLP 1-4-4 and lineage 1C features, different from L1C.5 in the United States, was isolated in China in 2021. In pathogenicity experiments in specific pathogen-free piglets or farm piglets, 60–100% of artificially infected experimental piglets died with high fever and respiratory symptoms. Inflammatory cytokine and chemokine levels were upregulated in infected piglets. A commercially modified live vaccine against highly pathogenic PRRSV did not provide effective protection when the vaccinated piglets were challenged with the novel L1C-1-4-4 variant. Therefore, this strain merits special attention when devising control and vaccine strategies. These findings suggest that extensive joint surveillance is urgently needed and that vaccine strategies should be updated to prevent the disease from spreading further.
Comparative analysis of active period and oxidative stress of DDVP and ginger (Zingiber officinale) oil on Indian meal moth (Plodia interpunctella Hübner) infesting maize grain
Authors: Olufemi-salami Folasade Kemisola , Akinneye Joseph Onaolapo , Adeyemi Joseph Adewuyi 
Published: November 2024

Abstract
Background
Indian meal moth (Plodia interpunctella) is a significant pest infesting stored grains, particularly maize. Over time, synthetic insecticides have been employed to control insect. The residual effects posed on non-target organisms have called for replacement of synthetic insecticides with botanicals. This study therefore aimed at comparing the insecticidal consistency and oxidative stress invoked by dichlorvos (DDVP) and the oil extract of ginger (Zingiber officinale) on Indian meal moth infesting maize. Disinfested maize grains were treated with DDVP and ginger oil extract separately. Adults P. interpunctella were introduced to the treated grains daily using complete replacement method. The percentage mortality was calculated daily for 10 d. Furthermore, the oxidative stress caused by DDVP and ginger oil extract on the moth was evaluated by measuring the level of some oxidative stress biomarkers such as glutathione S-transferase, superoxide dismutase, glutathione peroxidase (GPx), and catalase (CAT) activity in the exposed insects.

Results
Preliminary results indicated that both DDVP and ginger oil extract exhibited insecticidal properties against Indian meal moth infesting maize. However, the insecticidal (active) period of ginger oil extract was found to be longer than that of DDVP. Nevertheless, DDVP provoked greater oxidative stress in the exposed moth.

Conclusions
Ginger oil extract and DDVP show potential for controlling Indian meal moth infestations in stored maize. Yet, ginger oil offers a longer-lasting effect on pest suppression and control. Consequently, it could be a replacement or synergistic insecticide with DDVP to provide ecofriendly insecticide application.
Relationship between global warming and autism spectrum disorder from 1990 to 2019
Authors: Zhou Qinfeng , Chen Junjun , Ma Junxiong , Jiao Wangteng , Liang Zhisheng , Du Runming , Pan Yuhang , Liu Lu , Qian Qiujin , Sun Shengzhi , Ji Yuelong , Zhang Zhenyu 
Published: November 2024

Background
Despite mounting evidence linking neurological diseases with climate change, the link between autism spectrum disorder (ASD) and global warming has yet to be explored.

Aims
To examine the relationship between the incidence of ASD and global warming from 1990 to 2019 and estimate the trajectory of ASD incidence from 2020 to 2100 globally.

Method
We extracted meteorological data from TerraClimate between 1990 and 2019. To estimate the association between global ASD incidence and temperature variation, we adopted a two-stage analysis strategy using a generalised additive regression model. Additionally, we projected future ASD incidence under four representative shared socioeconomic pathways (SSPs: 126, 245, 370 and 585) by bootstrapping.

Results
Between 1990 and 2019, the global mean incidence of ASD in children under 5 years old was 96.9 per 100 000. The incidence was higher in males (147.5) than in females (46.3). A 1.0 °C increase in the temperature variation was associated with a 3.0% increased risk of ASD incidence. The association was stronger in boys and children living in a low/low-middle sociodemographic index region, as well as in low-latitude areas. According to the SSP585 scenario, by 2100, the children living in regions between 10 and 20° latitude, particularly in Africa, will experience a 68.6% increase in ASD incidence if the association remains. However, the SSP126 scenario is expected to mitigate this increase, with a less than 10% increase in incidence across all latitudes.

Conclusions
Our study highlights the association between climate change and ASD incidence worldwide. Prospective studies are warranted to confirm the association.
School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review
Authors: Wong Rosa S. , Chan Bianca N. K. , Lai Sok Ian , Tung Keith T. S. 
Published: November 2024

Background
Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation.

Aims
This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health.

Method
We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023. Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies.

Results
After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853). Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes. Among these programmes, seven (41%) employed dissonance-based approaches. Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping. Ten (59%) of the programmes were effective in improving adolescent mental health. Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality.

Conclusions
The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students. Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.
Investigating changes in mental illness stigma and discrimination after the Time to Change programme in England
Authors: Ronaldson Amy , Henderson Claire 
Published: November 2024

Background
Between 2008 and 2019, we reported positive change relating to mental health stigma and discrimination among the adult population of England, supporting the effectiveness of the Time to Change campaign.

Aims
Using data from the Attitudes to Mental Illness survey (2008/2009 to 2023), we investigated the extent to which positive changes in stigma were sustained by 2023, 2 years after the programme's end in 2021.

Method
We used regression analyses to evaluate trends in outcomes. Measures were of stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes toward the Mentally Ill scale (CAMI)) and desire for social distance (Reported and Intended Behaviour Scale (RIBS)). We also examined willingness to interact with people based on vignettes of depression and schizophrenia, and attitudes toward workplace discrimination, using data from the British Social Attitudes Survey for comparison.

Results
CAMI scores improved between 2008 and 2023 (s.d. 0.24, 95% CI 0.16–0.31), but decreased since 2019 (P = 0.015). After improvements between 2009 and 2019, 2023 MAKS and RIBS scores no longer differed from 2009 scores, indicating decreases in stigma-related knowledge (MAKS scores declined 7.8%; P < 0.001) and willingness to interact (RIBS scores declined by 10.2%; P < 0.001) since 2019. Conversely, comparison with British Social Attitudes Survey data indicated that willingness to interact with people with depression and schizophrenia increased gradually between 2007, 2015 and 2023, and attitudes to workplace discrimination also improved.

Conclusions
The lasting positive changes reflect support for non-discrimination and willingness to interact with someone after a sense of familiarity is evoked. Besides the end of Time to Change, interpretations for declines in other outcomes include the COVID-19 pandemic and economic stress.