bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Learning Health System Principles to Embed Patient Experience Data in Primary Care: A Qualitative Investigation
Authors: Ellis Louise A. , Fisher Georgia , Churruca Kate , Saba Maree , Schroeder Tanja , Mahadeva Janani , Vagholkar Sanjyot , Lee Mark Yang , Harrison Reema , Willcock Simon , Braithwaite Jeffrey 
Published: December 2024

ABSTRACTBackgroundThough an important component of high‐quality healthcare, the routine collection of patient experience data is limited in primary care, as is the evidence for how this data is being used for quality improvement. This study used a learning health system (LHS) framework to describe how a university‐affiliated community general practice is integrating patient experience data into service and quality improvement efforts, and to identify barriers and facilitators.MethodsA co‐designed qualitative case study was conducted with academic researchers and staff from a university‐affiliated general practice in Australia. Semi‐structured interviews were conducted in April 2024 with practice staff, and transcripts were deductively coded according to a five‐domain learning health systems framework, and with additional codes capturing barriers and facilitators.ResultsEighteen (53%) practice staff were interviewed, including general practitioners (n = 11), a practice nurse (n = 1), and administrative staff (n = 6). Participants identified multiple methods through which the practice captured the patient experience that spanned all domains of the LHS framework. However, there was less evidence of a coherent quality improvement strategy being employed, with associated barriers identified around staff workloads, training, and existing government funding policies. Key facilitators to the use of patient experience data included: membership of a larger health organisation and university; key dedicated administrative and clinical roles; and effective leadership, governance structures and policies to support continuous learning and drive service improvement.ConclusionThis study presents a case example of how patient experience data is being integrated into general practice and identifies key barriers and facilitators to initiating and translating this data for continuous healthcare improvement. By mapping the use of patient experience data to a LHS framework, this study shows how LHS principles can be applied to primary care to facilitate the capture and use of patient experience data on an ongoing basis.
Serum Level of RIPK1/3 Correlated With the Prognosis in ICU Patients With Acute Ischemic Stroke
Authors: Dong Jianhong , Xiong Xinli 
Published: December 2024

ABSTRACTBackgroundAcute ischemic stroke (AIS) is a common cerebrovascular disease with high mortality. AIS patients in the intensive care unit (ICU) often have severe conditions that require close monitoring and timely treatment. Receptor‐interacting protein kinase 1 (RIPK1) and RIPK3 play important roles in cell apoptosis and inflammation. However, the relevance of serum RIPK1/3 to AIS patients in the ICU has not been clarified.ObjectiveTo explore the correlation of serum RIPK1 and RIPK3 with the prognosis of AIS patients in the ICU.MethodsOne hundred and twenty AIS patients were selected as the research subjects for the retrospective analysis. The subjects were grouped based on the volume of cerebral infarction and the score of the National Institute of Health Stroke Scale (NIHSS) and mRS. The correlation was explored using Pearson analysis. The predictive value was valued using the ROC curve.ResultsThe content of serum RIPK1 and RIPK3 was gradually elevated with increased cerebral infarction volume and the severity of the disease (p < 0.05). Patients with poor prognosis had a higher content of serum RIPK1 and RIPK3 than those with good prognosis (p < 0.05). Serum RIPK1 and RIPK3 levels were positively correlated with infarct volume, NHISS, and mRS scores (p < 0.001). The area under the curve (AUC) of RIPK1 and RIPK3 for predicting the severity of AIS was 0.703, 0.883, and 0.912, respectively. The AUC for predicting poor prognosis of AIS was 0.797, 0.721, and 0.893, respectively. The cooperative detection of RIPK1 and RIPK3 had higher clinical value.ConclusionAIS patients in the ICU had abnormally elevated content of serum RIPK1 and RIPK3, which was closely related to the volume of cerebral infarction, severity, and prognosis. Combined detection of RIPK1 and RIPK3 might help to early identify the severity and evaluate the prognosis, providing a reference basis for clinical doctors to develop treatment strategies.
Laparoscopic ventral mesh uterorectopexy (VMUR) for simultaneously treating rectal prolapse and uterine prolapse: A minimally invasive approach with a single mesh
Authors: Liu Yiran , Hu Pan , Liu Lubin 
Published: December 2024

SynopsisLaparoscopic ventral mesh uterorectopexy (VMUR) is an innovative surgical technique designed to correct both rectal and uterine prolapse simultaneously.
Impact of an intern‐supported antiviral stewardship program for cytomegalovirus prophylaxis and management in high‐risk abdominal solid organ transplant recipients
Authors: Mahn Lindsey , Chandran Mary Moss , Doligalski Christina Teeter , Chargualaf Laura Mincemoyer 
Published: December 2024

AbstractIntroductionCytomegalovirus (CMV) infection is associated with increased graft loss and mortality after solid organ transplantation (SOT). CMV infection risk is highest among seronegative recipients of seropositive donors (D+/R‐). Careful monitoring is imperative to ensure appropriate care.ObjectivesThis study investigates the impact of intern‐supported pharmacist‐driven monitoring on CMV outcomes in D+/R‐ abdominal SOT recipients.MethodsA single‐center retrospective cohort study was conducted in CMV D+/R‐ abdominal SOT recipients transplanted between August 1, 2021, and July 31, 2023 to compare recipients undergoing pharmacy intern review versus standard monitoring. A pharmacy student intern reviewed a list of recipients maintained in the electronic health record weekly to ensure proper CMV prophylaxis and management. Following institutional protocols, the intern identified and recommended interventions to the pharmacists for implementation. Primary outcomes included the incidence of CMV infection within 9 months posttransplant and time to CMV eradication after infection. Secondary outcomes included the incidence of antiviral resistance, viral breakthrough, allograft loss, and recipient death.Results69 D+/R‐ SOT recipients were included (36 control, 33 intervention). Baseline demographics were similar. There was a nonsignificant decrease in CMV infection within 9 months posttransplant in the intervention group. However, the mean time to CMV eradication after infection was significantly shorter in the intervention group (63 days vs. 24 days, p = 0.004). No differences in secondary outcomes were observed.ConclusionsCMV infection rates remained elevated in D+/R‐ SOT recipients after transplant despite frequent reviews of prophylaxis and laboratory monitoring, which is likely a result of seronegative status and global immunosuppression. However, eradication of CMV infection can be significantly impacted by close monitoring, such as that provided by a pharmacy student intern, to reduce the time of active infection. This dramatic reduction in time to eradication has the potential to reduce the risk for negative allograft and recipient outcomes associated with CMV infection.
Exploring how personal and program characteristics inform the experiences of engineering students abroad
Authors: Davis Kirsten A. , Knight David B. 
Published: December 2024

AbstractBackgroundAs more universities seek to offer international experiences for engineering students, it is important to design such programs to effectively support student learning abroad. Previous research on study abroad has focused on a limited number of outcomes and therefore failed to consider the diversity of experiences students may have in the same program and the range of learning outcomes they may develop while abroad.PurposeWe explored student experiences across multiple types of engineering study abroad programs to address the research question: How do the types of significant experiences students highlighted from their time abroad differ based on student and/or program characteristics?MethodWe interviewed 79 engineering students after completing their study abroad programs using the critical incident technique to identify significant experiences from their time abroad. We used multiple rounds of coding to characterize the critical incidents identified by students and then compared the frequency of our main themes across student and program characteristics.ResultsWe found that student experiences differed across both personal and program characteristics, in particular students' prior travel experiences, program duration, and the destination's cultural distance from the United States.ConclusionsOur findings can inform the design of global engineering programs, which should consider the impact of program characteristics on student experiences and employ a variety of pedagogies to accommodate differences in students' needs and prior experiences. We also argue that it is important to consider students' experiences more holistically in research and evaluation of global engineering programs.
Things We Do for No Reason™: Avoiding naltrexone for alcohol use disorder in liver disease
Authors: Kee Dustin P. , Buyske John J. , Calcaterra Susan L. 
Published: December 2024

AbstractHospitalizations related to alcohol use disorder (AUD) are common. Yet, few patients receive pharmacotherapy consistent with guideline recommendations. Previous concerns over the potential hepatotoxicity of naltrexone have been disproven and recent studies have shown its safety and efficacy in patients with cirrhosis. Naltrexone is an effective therapy to reduce heavy alcohol consumption, however, lack of knowledge among prescribers inhibits greater uptake. Hospitalization is an opportune time for change—naltrexone can promote the reduction or cessation of unhealthy alcohol consumption, as well as subsequent readmissions or progression of alcohol‐related liver disease. Hospitalists should stop avoiding naltrexone in the treatment of AUD.
Tibetan Plateau Vortex Activity and Its Relationship With the Tibetan Plateau Summer Monsoon and Precipitation
Authors: Wang Guantian , Hu Zeyong , Yu Haipeng , Sun Genhou , Fan Weiwei , Niu Ruijia , Zhang Bofei 
Published: December 2024

ABSTRACTThe unique topography and location of the Tibetan Plateau (TP) often result in extreme weather events, which have led to disastrous consequences for the TP and its downstream regions. The TP summer monsoon (TPSM) and the TP vortex (TPV) play key roles in the transfer and redistribution of water vapour during the summer months on the TP and are increasingly active in summer and disappear in winter. However, it remains uncertain if a relationship between these systems. Understanding the relationship between these two systems is crucial for uncovering precipitation patterns on the TP, improving weather forecasting accuracy and reducing socioeconomic losses resulting from weather‐related disasters. On the basis of GLDAS and ERA5 reanalysis data from 1996 to 2022, the relationships between TPVs and the TPSM were explored in terms of their intensity and spatial characteristics, and their impacts on the spatial distributions of precipitation across the TP were examined in this study. The results indicated that the monthly mean TPSM index agreed very well with the TPV in terms of the annual number formed, duration and intensity, especially in July and August. The investigation of the movement of the center of the TPSM from May to October revealed that the center of the TPSM moves westward when the TPV is active and moves eastward when the TPV is less active. In years with a strong TPSM, the precipitation location generated by TPVs was biased toward the east. This finding could be attributed to the greater number of TPV events and the fact that the TPVs in years with a stronger TPSM moved eastward across a greater distance than those in years with a weaker TPSM. These findings highlightthe contribution of the joint relationship between the TPSM and TPV to seasonal circulation changes and could provide a new perspective for the study and prediction of precipitation distributions on the TP.
Observed Variability and Future Projections of Urban Heatwaves in Romania
Authors: Cheval Sorin , Amihăesei Vlad Alexandru , Dumitrescu Alexandru , Micu Dana Magdalena , Smău Raluca‐Ioana 
Published: December 2024

ABSTRACTThe crossroad between built‐up areas and extreme heat generates severe consequences on both socio‐ecological systems and the natural environment, and the cities are the most vulnerable. The impact is already significant in the present climate and it will be exacerbated under climate change in many regions, including Romania and especially its southern part. The heatwaves (HWs) are a major risk for our cities as they put constant pressure on population, infrastructure and services for several consecutive days. The urban HWs in 41 Romanian cities are analysed in terms of magnitude, amplitude, duration, number and frequency, as well as the variability of the yearly occurrence of the first and last HW events. The study focuses on the warm season (May–September) and refers to the observed variability (1961–2020) and future projections (2021–2050). The main findings reveal that the occurrence of HWs is not conditioned by geographical and climatic conditions and the cities in any region may experience public health risks associated with extreme heat. This requires permanent monitoring of the phenomena, including the present characteristics and estimating future variations according to different scenarios. Considering the increasing frequency and intensity of extreme heat events expected soon, there is a clear need for region‐specific adaptation, and policymakers should prioritise strategies to protect vulnerable people.
Enhancing Histology Detection in MASH Cirrhosis for Artificial Intelligence Pathology Platform by Expert Pathologist Training
Authors: Goodman Zachary , Akbary Kutbuddin , Noureddin Mazen , Ren Yayun , Chng Elaine , Tai Dean , Boudes Pol , Garcia‐Tsao Guadalupe , Harrison Stephen , Chalasani Naga 
Published: December 2024

ABSTRACTThis study addresses the need for precise histopathological assessment of liver biopsies in Metabolic dysfunction‐Associated Steatohepatitis (MASH) cirrhosis, where assessing nuanced drug effects on fibrosis becomes pivotal. The study describes a framework for the development and validation of an Artificial Intelligence (AI) model, leveraging SHG/TPE microscopy along with insights from an expert hepatopathologist, to precisely annotate fibrous septa and nodules in liver biopsies in MASH cirrhosis. A total of 25 liver biopsies from the Belapectin trial (NCT04365868) were randomly selected for training, and an additional 10 for validation. Each biopsy underwent three sections: Smooth Muscle Actin (SMA) and Sirius Red (SR) staining for septa and nodule annotation by pathologists and an unstained section for SHG/TPE imaging and AI annotation using qSepta and qNodule algorithms. Re‐training of qSepta and qNodule algorithms was executed based on pathologist annotations. Sensitivity and positive predictive value (PPV) were employed to evaluate concordance with pathologist annotations, both pre‐ and post‐training and during validation. Post‐re‐training by pathologist annotations, the AI demonstrated improved sensitivity for qSepta annotations, achieving 91% post‐training (versus 84% pre‐training). Sensitivity for qSepta in the validation cohort also improved to 91%. Additionally, PPV significantly improved from 69% pre‐training to 85% post‐training and reached 94% during validation. For qNodule annotations, sensitivity increased from 82% post‐training to 90% in the validation cohort, while the PPV was consistent at 95% across both training and validation cohorts.This study outlines a strategic framework for developing and validating an AI model tailored for precise histopathological assessment of MASH cirrhosis, using pathologist training and annotations. The outcomes emphasise the crucial role of disease‐specific customisation of AI models, based on expert pathologist training, in improving accuracy and applicability in clinical trials, marking a step forward in understanding and addressing the histopathological evaluation of MASH cirrhosis.
Freeze–Thaw Dynamics in Postindustrial Soil: Implications for Metal Stability and Soil Enzymatic Activity During Phytostabilization
Authors: Klik Barbara , Gusiatin Mariusz Z. , Jachimowicz Piotr , Liniauskiene Ernesta , Brtnicky Martin , Kumar Vinod , Radziemska Maja 
Published: December 2024

ABSTRACTPhytostabilization, a key strategy in addressing heavy metal contamination, faces challenges in regions with frequent temperature fluctuations. The challenges arise from the impact of temperature variations on microbial activity, plant metabolism, and metal bioavailability. Acknowledging the sensitivity of soil dynamics, amendments, and ecological interactions to temperature variations underscores the importance of considering these factors for effective phytostabilization strategies in dynamic environmental conditions. The aim of this study is to explore the effect of phytostabilization assisted with diatomite, halloysite, and biochar with and without freeze–thaw conditions on metal stability (as distribution patterns), and microbial activity (as dehydrogenase activity, DHA). The experiment comprised two variants. In the first, conducted without FTC,
Lolium perenne
seeds were sown in pots filled with soil from a contaminated area, both with and without amendments (3%), lasting for 52 days. The second variant replicated the process with 16 freeze–thaw cycles (FTC) and extended the duration to 116 days. Results revealed that FTC alters the distribution of heavy metals in soil compared to conditions without the FTC cycle. Diatomite reduces Cu mobility but may potentially increase Cd mobility. Halloysite enhances Cu exchangeability, restricts Cd mobility, and increases Pb retention in a stable form. Biochar exhibits mixed effects on Cu and Cd mobility, showcasing the influence of FTC on these soil amendments. As a vital microbial indicator, soil DHA responds dynamically to varying temperatures. The applied amendments seem to mitigate the adverse effects of FTC cycles by supporting DHA. Notably, halloysite exhibits a more favorable influence without FTC, while biochar and diatomite showcase enhanced stimulatory effects post‐FTC. It emphasises the need for a nuanced understanding of temperature–microbe interactions and the role of amendments in enhancing the sustainability of phytostabilization in metal‐contaminated environments.
Soil Polychlorinated Biphenyl Dissipation and Mung Bean Production Influenced by Ryegrass, Nanoscale Zero‐Valent Iron and Arbuscular Mycorrhizal Fungus
Authors: Sun Dongnian , Sun Caiyun , Bai Jianfeng , Qin Hua , Li Minghui , Lin Xiangui , Hu Junli 
Published: December 2024

ABSTRACTA 9‐week greenhouse pot experiment was carried out to study polychlorinated biphenyl (PCB) dissipation and mung bean (
Vigna radiata
(L.) Wilczek) growth in a PCB‐contaminated soil. Besides the control (i.e., monoculture of mung bean), four treatments were tested: intercropping with ryegrass (
Lolium perenne
L.) (IL) and IL treated with arbuscular mycorrhizal (AM) fungus Funneliformis caledonium (+M), nanoscale zero‐valent iron (nZVI) (+N), and both (+NM). Compared with the control, the interspecific competition on soil nutrients besides growth space upon IL tended to decrease the seed yield of mung bean, since the P acquisition by ryegrass, the dominant species, was about 17 times that by mung bean. On the one hand, +N significantly enhanced the dissipation of homologs with three or more chlorine atoms and total PCBs in the soil, consuming a quantity of H+ and increasing soil pH. On the other hand, +N negatively influenced soil available P concentration, mycorrhizal colonization, mung bean seed yield, and ryegrass shoot biomass. In contrast, +M significantly increased mycorrhizal colonization of both plants and ALP activity of the soil, tended to improve plant total P acquisition, and even powerfully enhanced the dissipation of highly chlorinated homologs. In the case of +N, +M again significantly accelerated mycorrhization of both plants and tended to elevate ALP activity of the soil, but the adsorption of soil available P by nZVI debilitated the P benefit from AM fungi. However, +M still tended to improve not only ryegrass shoot biomass but also mung bean seed yield, suggesting that AM fungus had induced detoxification of both host plants against nZVI. In addition, the phytoremediation efficiency of ryegrass associated with AM fungi, which was greatly inhibited by the amendment of nZVI, was reactivated by the newly inoculated AM fungus. These results indicated that when intercropping of edible crops with remedial plants, nZVI and AM fungus played absolutely differential roles during the remediation of PCB‐contaminated soils.
Intelligent summaries: Will Artificial Intelligence mark the finale for biomedical literature reviews?
Authors: Galli Carlo , Moretti Chiara , Calciolari Elena 
Published: December 2024

Key points
LLM has attained generative capabilities similar to human discourse and can effectively summarize documents and extract information from texts.
The development of R.A.G. systems will soon make these systems capable to browse databases such as MEDLINE and extract knowledge, creating summaries of the literature.
These summaries may soon reach a point where they are equivalent to current reviews of the literature, possibly making them irrelevant.
The availability of automated summaries of the literature may raise the bar of what is still worth publishing.
Literature reviews may have to capitalize on human imagination, creativity and abstraction capabilities to survive the A.I. revolution.
Nuclear Magnetic Resonance Spectroscopic Characterization and Determination of the New Psychoactive Substance Benzylone: Application in a Biological Fluid
Authors: Florou D. , Boumba V. A. , Tsiafoulis G. C. 
Published: December 2024

ABSTRACTNew psychoactive substances (NPS)—designed to mimic various legal or illegal substances—are an emerging worldwide health problem. Their identification and quantification in either complex seized samples or powders are critical; moreover, their determination in biological fluids is an intriguing goal in the forensic toxicology field. Synthetic cathinones are one of the most important groups among NPS. The current paper was designed as a pilot study to investigate the application of NMR techniques to identify and quantify unknown NPS compounds in deuterated dimethyl sulfoxide (DMSO‐d6) and in urine using the synthetic cathinone benzylone (3,4‐methylenedioxy‐N‐benzylcathinone, BMDP) as a pilot compound. In the first part of our study, nuclear magnetic resonance (NMR) spectroscopic characterization was performed using 1D and 2D homonuclear and heteronuclear NMR spectroscopic methods as long as diffusion ordered spectroscopy (DOSY). Following the above, the assignment of benzylone in DMSO‐d6 was performed, and a distinct spectroscopic pattern was proposed. In the second part of our study, a NMR spectroscopic approach was applied for benzylone identification and quantification in a spiked with benzylone urine. Following the above, the assignment of benzylone in spiked urine was performed. A distinct pattern of the H11, H14, H15, and H8 signals on the 1H NMR spectra was observed and suggested as a “NMR spectroscopic pattern/signature” enabling the identification of benzylone moieties in urine. On the other hand, the applied NMR techniques showed low sensitivity in quantitating benzylone in spiked urine. Overall, our results are promising in using NMR for structure determination of unknown compounds in urine.