bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of PACK training on the management of asthma and chronic obstructive pulmonary disease by primary care clinicians during 2 years of implementation in Florianópolis, Brazil: extended follow-up after a pragmatic cluster randomised controlled trial with a stepped-wedge design
Authors: Shekar Sameer , Bachmann Max Oscar , Bateman Eric D , Stelmach Rafael , Cruz Alvaro Augusto , Zonta Ronaldo , Pacheco de Andrade Matheus , Zepeda Jorge , Cornick Ruth Vania , Wattrus Camilla , Georgeu-Pepper Daniella , Anderson Lauren Faye , Lombard Carl , Fairall Lara R 
Published: October 2024

BackgroundTraining primary care doctors and nurses to use Practical Approach to Care Kit (PACK) improved management of asthma and chronic obstructive pulmonary disease (COPD) in a previous randomised trial. The present study examined the training effects including a second year of follow-up with expanded coverage of repeated training sessions.MethodsUsing a stepped-wedge cluster randomised trial design, 48 clinics were randomly allocated either to sequence A: (1) no intervention, (2) no intervention, (3) intervention or sequence B: (1) no intervention, (2) intervention, (3) intervention, during three 12-month periods. Primary outcomes were change in treatment and spirometry ordering. Effects of any exposure to the training, and of exposure to the first and second years of training, were estimated with mixed effect logistic regression models.ResultsAny exposure to training was associated with increased changes in treatment (OR adjusted for calendar time (OR) 1.29, 95% CI 1.02 to 1.64) and more spirometry ordering (OR 1.55, (95% CI 1.22 to 1.97)) in asthma patients, and with more spirometry ordering (OR 1.50 (95% CI 1.15 to 1.96)) in patients with COPD. Change in asthma treatment was more likely during the first and second year of exposure to training compared with no exposure (ORs 1.43 (95% CI 1.09 to 1.87); 1.91 (95% CI 1.21 to 3.02)), respectively. Spirometry was more likely during the first and second year of exposure in asthma patients (ORs 1.76 (95% CI 1.34 to 2.30); 2.05 (95% CI 1.32 to 3.19)) and in patients with COPD (ORs 1.57 (95% CI 1.18 to 2.10)); 1.71 (95% CI 1.08 to 2.70)).ConclusionExtended follow-up suggested that PACK training continued to be effective in improving chronic respiratory care and that effective intervention delivery was sustainable for 2 years.Trial registration numberNCT02786030.
Resilience in nursing medication administration practice: a systematic review with narrative synthesis
Authors: Kellett Pollyanna LR , Franklin Bryony Dean , Pearce Susie , Benn Jonathan 
Published: October 2024

Resilience in nursing medication administration practice: a systematic review with narrative synthesis.ObjectiveLittle is known about how nurses adapt medication administration practices to preserve safety. The capacity to adapt and respond before harm occurs has been labelled ‘resilience’. Current evidence examining medication safety largely focuses on errors and what goes wrong. This review aimed to synthesise evidence for the application of resilience principles and practices in nursing medication administration.DesignThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review, which was registered with PROSPERO.Data sourcesMEDLINE, EMBASE, PsychINFO and CINAHL databases were searched from 14 August 2020 to 1 January 2021 for English-language studies.MethodsA systematic review of empirical studies of any design relating to resilience and safety in nursing medication administration in the inpatient setting was conducted. Methodological quality was appraised using the Mixed Methods Appraisal Tool. Data were synthesised thematically.ResultsThirty-two studies with a range of methodologies of mostly good quality met the inclusion criteria. Eleven interventional studies included two that evaluated the effectiveness of education interventions and nine exploratory studies with outcomes showing the impact of an intervention designed or examined to build resilience. Twenty-one non-interventional studies showed how resilience principles are put into practice. Only three studies explicitly named the concept of resilience. Resilient medication administration strategies result from five triggers.ConclusionsNurses’ resilience practices were found to be responses to identified trigers that threaten safety and productivity. These were often short term, real-time proactive adaptations to preserve safety, compensating for and responding to complexities in the modern healthcare setting.PROSPERO registration numberCRD42018087928.
Reducing healthcare waste by eliminating exam table paper in a primary care practice: a sustainable quality improvement initiative
Authors: Hale Ilona , McKenzie Amanda 
Published: October 2024

PurposeClimate change is now the greatest threat to human survival. The healthcare system contributes significantly to global pollution and greenhouse gas emissions. Individual practitioners play an important role in helping to reduce these impacts in day-to-day practice. Deimplementation of unnecessary processes and products, such as exam table paper, in medical offices is one simple approach to incorporating principles of planetary health into practice. All quality improvement (QI) projects must start to consider environmental impacts to fully evaluate change ideas.MethodsWe designed a single Plan-Do-Study-Act cycle using the Institute for Health Improvement Model for Improvement. We removed the exam table paper from our primary care office and measured changes in staff time, laundry, financial costs, paper use and carbon dioxide (CO2) emissions.ResultsEliminating exam table paper in our clinic resulted in modest annual cost savings of $C718 and improved staff efficiency and motivation to introduce other green office practices. In our clinic alone, this change will save 8.2 km of exam table paper, 10 trees and 148 kg of CO2e (equivalent to driving 1233 km) every year. There were no negative consequences or feedback.ConclusionsThis simple QI project demonstrates the feasibility of implementing a small change in a primary care clinic that can improve environmental sustainability with multiple co-benefits. If all family physicians in Canada eliminated exam table paper in their offices, it would result in savings of approximately 95 940 km of paper, 121 680 trees, $C8 400 600 and 3054 T CO2emissions, equivalent to driving around the world 360 times.
Value of the central sensitisation inventory in patients with axial spondyloarthritis
Authors: van der Kraan Yvonne Maria , Paap Davy , Timmerman Hans , Wink Freke , Arends Suzanne , Reneman Michiel , Spoorenberg Anneke 
Published: October 2024

BackgroundIn many patients with axial spondyloarthritis (axSpA), pain persists despite anti-inflammatory medication. Quantitative sensory testing (QST) indirectly assesses altered somatosensory function, though its clinical practicality is limited. The Central Sensitisation Inventory (CSI) could be an alternative in the initial assessment of central sensitisation (CS). This study aimed to investigate the value of the CSI in evaluating CS in patients with axSpA by (1) assessing somatosensory function related to CS with QST and (2) exploring associations between CSI, QST, patient and disease characteristics and pain-related psychosocial factors.MethodsConsecutive outpatients from the Groningen Leeuwarden AxSpA cohort underwent QST, including pressure pain threshold (PPT), temporal summation (TS) and conditioned pain modulation (CPM). Participants completed questionnaires assessing CS (CSI), illness perception (Revised Illness Perception Questionnaire, IPQ-R), pain-related worrying (Pain Catastrophising Scale, PCS), fatigue (Modified Fatigue Impact Scale, MFIS), anxiety/depression (Hospital Anxiety and Depression Scale, HADS) and coping. QST measurements were stratified for CSI≥40.Results201 patients with axSpA were included; 63% male, 64% radiographic axSpA, median symptom duration 12 years (IQR 5–24), mean Axial Spondyloarthritis Disease Activity Score 2.1±1.0. Patients with CSI≥40 had significantly lower PPTs and higher TS than CSI<40 (p<0.004). No significant differences in CPM were observed. In multivariable linear regression, sex, PCS, IPQ-R Identity, MFIS and HADS anxiety were independently associated with CSI (78% explained variance).ConclusionIn this large cross-sectional study in patients with axSpA, the CSI appears as a useful initial CS assessment questionnaire. When CSI scores indicate CS, considering pain-related psychosocial factors is important. These results emphasise the need for a biopsychosocial approach to manage chronic pain in patients with axSpA.
Relative potential for stand persistence of riparian and upland aspen stands of a semi-arid montane landscape of the Southern Rocky Mountains
Authors: Spei Benjamin A. , Goebel Charles , Kashian Daniel M. , Strand Eva , Harley Grant L. 
Published: October 2024

Several studies have predicted a loss of quaking aspen ( Populus tremuloides) from many western landscapes, but other studies have suggested that aspen persistence is driven by local site factors. Increased frequency of acute drought has been implicated as an important factor driving overstory mortality and reduced regeneration densities in the region. We investigated the relationship between aspen regeneration and site moisture availability potential using ecosystem type as a proxy. We hypothesized that aspen stands growing along perennial-flowing streams would support higher aspen regeneration densities than upland aspen stands. We compared stand structure, groundcover composition, and regeneration densities of nine riparian aspen stands with nine paired upland aspen stands in the Caribou–Targhee National Forest. Aspen regeneration densities were significantly higher in the riparian aspen stands (845.3 + 318.7 stems ha−1) compared to the upland aspen stands (249.1 + 74.1 stems ha−1) for regeneration shorter than 1 m ( p = 0.0391). Riparian stands also exhibited significantly higher forb ( p < 0.001) and graminoid ( p < 0.001) cover compared to upland aspen stands, suggesting that riparian sites provided higher site moisture availability. We suggest that riparian areas may provide refugia for aspen in the future considering projections of increased incidence of acute drought.
Egg-shaped sections of fluid structures around black holes
Authors: Tlemissov Abylaikhan , Kovář Jiří 
Published: October 2024

AbstractAstrophysical fluids subjected to the strong gravity of black holes can form rotating toroidal-like structures known as thick accretion discs. In order to facilitate the study of such structures, we introduce approximate empirical formulae for a relatively simple analytical description of their poloidal cross-sections that are usually described only numerically. Our comparisons of the approximate and exact descriptions of the cross-sections of the structures rotating around Schwarzschild and Kerr central black holes, together with the determination of the associated total masses of these structure, indicate a high degree of accuracy for these introduced formulae.
Non-universal SUSY models, $$g_\mu -2$$, $$m_H$$ and dark matter
Authors: Ellis John , Olive Keith A. , Spanos Vassilis C. 
Published: October 2024

AbstractWe study the anomalous magnetic moment of the muon, $$g_\mu - 2 \equiv 2 a_\mu $$

g
μ

-
2
≡
2

a
μ

, in the context of supersymmetric models beyond the CMSSM, where the unification of either the gaugino masses $$M_{1,2,3}$$

M

1
,
2
,
3

or sfermion and Higgs masses is relaxed, taking into account the measured mass of the Higgs boson, $$m_H$$

m
H

, the cosmological dark matter density and the direct detection rate. We find that the model with non-unified gaugino masses can make a contribution $$\Delta a_\mu \sim 20 \times 10^{-10}$$

Δ

a
μ

∼
20
×

10

-
10

to the anomalous magnetic moment of the muon, for example if $$M_{1,2} \sim 600\; \textrm{GeV}$$

M

1
,
2

∼
600

GeV

and $$M_3\sim 8 \; \textrm{TeV}$$

M
3

∼
8

TeV

. The model with non-universal sfermion and Higgs masses can provide even larger $$\Delta a_\mu \sim 24 \times 10^{-10}$$

Δ

a
μ

∼
24
×

10

-
10

if the sfermion masses for the first and the second generations are $$ \sim 400 \; \textrm{GeV}$$

∼
400

GeV

and that of the third is $$ \sim 8 \; \textrm{TeV}$$

∼
8

TeV

. We discuss the prospects for collider searches for supersymmetric particles in specific benchmark scenarios illustrating these possibilities, focusing in particular on the prospects for detecting the lighter smuon and the lightest neutralino.
Application of LIBS and LA-ICP-MS analysis to Hellenistic tableware
Authors: Charlton Michael , Miše Maja 
Published: October 2024

AbstractGreek and Hellenistic painted vases have attracted scholars of classical archaeology for centuries, either because of the artistic value of the painted decorations or because of the depicted scenes of ancient everyday life. Due to the application of thin slips on the surface, different methods are used for the chemical characterisation of the slips and the body of the same vase. The slips are commonly analysed by X-ray microanalysis, offering point-by-point analysis of mostly major elements, while different tools, such as X-ray fluorescence (XRF), inductively coupled mass spectrometry (ICP-MS), and instrumental neutron activation analysis (INAA), are used for bulk body analysis. This can cause difficulties in comparing the bulk composition and thus in determining the similarities and differences in the preparation process of the clay paste for the slips and bodies of an object. Given the artistic value of these objects, museum curators tend to be reluctant to provide samples for invasive characterisation. Micro-destructive laser ablation methods offer a robust solution to addressing both the relationships between ceramic body and surface treatment chemistry and destructive sampling. To provide a proof-of concept, we analysed slips and bodies of a small sample of Hellenistic fine wares from the Greek colony of Issa in modern Croatia with Laser-Induced Breakdown Spectroscopy (LIBS) and Laser ablation-ICP-MS. Results show remarkable diversity in the use of clay types and processing techniques.
Multiple Function Merging for Code Size Reduction
Authors: Saito Yuta , Sakamoto Kazunori , Washizaki Hironori , Fukazawa Yoshiaki 
Published: October 2024

Resource-constrained environments, such as embedded devices, have limited amounts of memory and storage. Practical programming languages such as C++ and Rust tend to output multiple similar functions by monomorphizing polymorphic functions. An optimization technique called Function Merging, which merges similar functions into a single function, has been studied. However, in the state-of-the-art approach, the number of functions that can be merged at once is limited to two; thus, efficiently merging three or more functions, which are often generated from polymorphic functions, has been impossible.
In this study, we propose Multiple Function Merging optimization, which targets merging three or more similar functions into a single function using a multiple sequence alignment algorithm. With multiple aligned information, Multiple Function Merging can increase merge opportunities and reduce extra branching overheads at the code generation stage. We evaluated it using the SPEC CPU benchmark suite and some large-scale C/C++ programs, and the results show that it reduces code size by as much as 7.61% compared with the state-of-the-art approach.
Assessing the Malaria Burden and Community Response to the Malaria Control and Management Programs in Omoro District, Northern Uganda
Authors: Soyekwo Divas , Opiyo Elizabeth A. , Austin Reiginald , Ochaya Stephen 
Published: October 2024

Background: Malaria remains the leading cause of hospitalization and death in the healthcare system. This study explored the malaria burden and community response to government malaria control programs in Omoro district.Method: This retrospective study involved 576 patient results from purposely selected health facilities data from health center III (HCIII) of Odek, Bobi, and Lapainat and health center IV (HCIV) of Lalogi. And prospective random section study involved 288 participants from Lutori and Lagude cells and Atyang A and Lagwaya villages who consented to answer the pretested questionnaire.Results: The prevalence of malaria in Omoro district in 2018 and 2019 was 81.6% and 97.2% for hospital record positivity and community surveys, respectively. The participants had 100% knowledge of malaria signs, symptoms, and cause. The average number of malaria attacks an individual received in the district from the health facility and community data was three. Nonadherence to government control programs was associated with an increased incidence of malaria infections. From questionnaire, the proportion of people that used local herbal remedies for treatment and prevention of malaria were 21.2% of the sampled 288 participants.Conclusion: The high rate of malaria attacks indicates that the area has a high prevalence of malaria‐carrying mosquitoes. The increase in the proportion of malaria attacks in 2019 suggests that the burden of malaria increased compared with that in the previous year, with approximately 21% of local herbal remedies for malaria treatment and management. The findings of this study suggest that malaria attacks are associated with household size, age, sex, occupation, and the household head. Participants who did not respond positively to government programs experienced more malaria attacks. These findings can be used to develop interventions to reduce the incidence of malaria in this population.
Preclinical Development of SGN-CD47M: Protease-Activated Antibody Technology Enables Selective Tumor Targeting of the Innate Immune Checkpoint Receptor CD47
Authors: Levengood Matthew R. , Carosino Christopher M. , Zhang Xinqun , Lucas Sasha , Ortiz David J. , Westendorf Lori , Chin Alice P. , Martin Arlan D. , Wong Abbie , Hengel Shawna M. , Sun Hao , Zeng Weiping , Yumul Roma , Dominguez Melissa M.C. , Chen Yufei , Zheng Janet H. , Karlsson Courtney A.B. , Trang Vivian H. , Senter Peter D. , Gardai Shyra J. 
Published: October 2024

Abstract
CD47 is a cell-surface glycoprotein that is expressed on normal human tissues and plays a key role as a marker of self. Tumor cells have co-opted CD47 overexpression to evade immune surveillance, and thus blockade of CD47 is a highly active area of clinical exploration in oncology. However, clinical development of CD47-targeted agents has been complicated by its robust expression in normal tissues and the toxicities that arise from blocking this inhibitory signal. Furthermore, pro-phagocytic signals are not uniformly expressed in tumors, and antibody blockade alone is often not sufficient to drive antitumor activity. The inclusion of an IgG1 antibody backbone into therapeutic design has been shown to not only serve as an additional pro-phagocytic signal but also exacerbate toxicities in normal tissues. Therefore, a need persists for more selective therapeutic modalities targeting CD47. To address these challenges, we developed SGN-CD47M, a humanized anti–CD47 IgG1 mAb linked to novel masking peptides through linkers designed to be cleaved by active proteases enriched in the tumor microenvironment (TME). Masking technology has the potential to increase the amount of drug that reaches the TME while concomitantly reducing systemic toxicities. We demonstrate that SGN-CD47M is well tolerated in cynomolgus monkeys and displays a 20-fold improvement in tolerability to hematologic toxicities when compared with the unmasked antibody. SGN-CD47M also displays preferential activation in the TME that leads to robust single-agent antitumor activity. For these reasons, SGN-CD47M may have enhanced antitumor activity and improved tolerability relative to existing therapies that target the CD47–signal regulatory protein α interaction.
Association Between Delay to First Shock and Successful First-Shock Ventricular Fibrillation Termination in Patients With Witnessed Out-of-Hospital Cardiac Arrest
Authors: Stieglis Remy , Verkaik Bas J. , Tan Hanno L. , Koster Rudolph W. , van Schuppen Hans , van der Werf Christian 
Published: October 2024

BACKGROUND:
In patients with out-of-hospital cardiac arrest who present with an initial shockable rhythm, a longer delay to the first shock decreases the probability of survival, often attributed to cerebral damage. The mechanisms of this decreased survival have not yet been elucidated. Estimating the probability of successful defibrillation and other factors in relation to the time to first shock may guide prehospital care systems to implement policies that improve patient survival by decreasing time to first shock.

METHODS:
Patients with a witnessed out-of-hospital cardiac arrest and ventricular fibrillation (VF) as an initial rhythm were included using the prospective ARREST registry (Amsterdam Resuscitation Studies). Patient and resuscitation data, including time-synchronized automated external defibrillator and manual defibrillator data, were analyzed to determine VF termination at 5 seconds after the first shock. Delay to first shock was defined as the time from initial emergency call until the first shock by any defibrillator. Outcomes were the proportion of VF termination, return of organized rhythm, and survival to discharge, all in relation to the delay to first shock. A Poisson regression model with robust standard errors was used to estimate the association between delay to first shock and outcomes.

RESULTS:

Among 3723 patients, the proportion of VF termination declined from 93% when the delay to first shock was <6 minutes to 75% when that delay was >16 minutes (
P
trend
<0.001). Every additional minute in VF from emergency call was associated with 6% higher probability of failure to terminate VF (adjusted relative risk, 1.06 [95% CI, 1.04–1.07]), 4% lower probability of return of organized rhythm (adjusted relative risk, 0.96 [95% CI, 0.95–0.98]), and 6% lower probability of surviving to discharge (adjusted relative risk, 0.94 [95% CI, 0.93–0.95]).

CONCLUSIONS:
Every minute of delay to first shock was associated with a significantly lower proportion of VF termination and return of organized rhythm. This may explain the worse outcomes in patients with a long delay to defibrillation. Reducing the time interval from emergency call to first shock to ≤6 minutes could be considered a key performance indicator of the chain of survival.
The European Energy Crisis and the Consequences for the Global Natural Gas Market
Authors: Emiliozzi Simone , Ferriani Fabrizio , Gazzani Andrea 
Published: October 2024

The Russian invasion of Ukraine in February 2022 led to severe disruptions in the European gas market with significant repercussions on a global scale. The conflict caused a surge in energy prices, a major reshuffling of global natural gas flows, and a shift in the policy-makers’ agendas toward energy supply security. This paper provides a comprehensive review of the developments in the global gas market in the aftermath of the war in Ukraine, focusing in particular on the European gas market and on global LNG trade flows. We first review the characteristics of the gas market in terms of both pricing benchmarks and contractual terms. Next, we analyze the changes to LNG and natural gas production, consumption, and trade flows throughout the European energy crisis. Finally, we review the main policy response to the energy crisis and present some considerations on the gas market outlook. JEL Classification: L95, P28, Q35