bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of the Adoption of the National Accreditation Program for Rectal Cancer Process on Compliance Standards at a Single Institution
Authors: Peters Garrett W. , Thomas Gregory , Applegarth Jacob A. , Wasvary Joanna , Bohler Forrest , Callahan Rose E. , Bergeron Shelli , Wasvary Harry J. 
Published: October 2024

Background: The National Accreditation Program for Rectal Cancer (NAPRC) was developed to enhance the quality of rectal cancer care in the United States. This project compared NAPRC compliance at a single tertiary care academic hospital before and after the institution adopted these standards in 2019. Methods: Rectal cancer patients from 2016 to 2023 who met NAPRC eligibility criteria were retrospectively reviewed for compliance with pre-selected patient care standards. Patients diagnosed prior to August 1, 2019 (pre-NAPRC) were compared with those diagnosed afterward (post-NAPRC) to determine whether compliance with these standards differed following the institution’s adoption of new guidelines. Results: This study included 353 patients, 146 pre-NAPRC and 207 post-NAPRC. The post-NAPRC group demonstrated significantly higher compliance with pretreatment standards compared to the pre-NAPRC group, including attaining magnetic resonance imaging (MRI) ( P = .015), computed tomography (CT) ( P < .001), and a carcinoembryonic antigen (CEA) level ( P < .001). Postoperative standards were more frequently met in the post-NAPRC group regarding the photographing of surgical specimens ( P < .001). No significant differences were observed in confirming a tissue diagnosis, starting treatment within a 60-day timeframe, or completing surgical pathology reports. Prior to initiation of the NAPRC process, the institution had achieved accreditation-level compliance in 2 of the 7 standards. Within 2 years of adopting NAPRC standards, complete compliance was met in 6 of the 7 measures. Conclusions: A single institution’s adoption of NAPRC standards improved compliance with multiple rectal cancer care standards, achieving near-complete accreditation level compliance within 2 years.
The contribution of Tanzania library association in enhancing the librarianship profession: Views from the under 40-year-Olds - a quantitative study
Authors: Mubofu Christian , Malekani Andrew 
Published: October 2024

This study assessed the contribution of the Tanzania Library Association in Enhancing the Librarianship Profession: Views from Under 40-Year-Olds librarians were gathered. The study adopted a quantitative approach with a case study design. Thirty-six respondents purposively selected from the Tanzania Librarian Forum and the Tanzania Library Association were involved in this study. Data were collected through a questionnaire created using a Google form. The questionnaire was shared with respondents and remained active for 2 weeks to allow them to fill it in. Data were analysed using the Statistical Package for Service Solutions (SPSS) Version 23 computer programme. The study found that 47.2% of participants were very familiar with TLA, which suggests that a substantial portion of the participants strongly understand the Tanzania Library and Information Association (TLA) and its objectives. Regarding the perceived contribution of TLA in advancing professional development opportunities for librarians under 40, results demonstrated that a majority, comprising 24 respondents (66.7%), agreed that TLA indeed fosters such opportunities. Furthermore, 41.7% reported that TLA enhances networking platforms for librarians under 40. However, another 30.6% said that TLA was essential in addressing the ever-evolving needs and issues faced by librarians under 40. Professional associations are vital for the career development of their members, and TLA is not left behind. From the findings, the study recommends that TLA continues to foster development in its members by utilising different strategies like preparation and conducting continuous professional training courses for its members and the library profession at large, publicity among different institutions within and outside the country and forging links with other international information professional associations.
Comparing results of midline catheter and peripherally inserted central catheter in cancer patients under chemotherapy
Authors: Faccini Beatrice , Aula Federico , Fontana Vincenzo , Rosa Alessandra , Consoli Damiano , Bondielli Filippo , Bertoglio Sergio 
Published: October 2024

Background and objectives: Peripherally inserted central catheters (PICC), and peripherally inserted midlines (MC) represent a possible less invasive alternative option to totally implantable vascular access devices (TIVAD) in cancer patients. This study aims to investigate the outcomes of PICC, and MC devices in patients undergoing chemotherapy. Methods: A prospective non-concurrent observational study was conducted at the IRCCS Ospedale Policlinico San Martino, Genova (Italy) on 559 cancer patients candidate to chemotherapy bearing PICC, and MC during the period 2019–2022. The primary endpoint was the comparative analysis for failure of the different types of peripheral insertion accesses requiring removal. Secondary outcome measures were age at diagnosis, gender, period of diagnosis, cancer site and type of chemotherapy. The negative binomial regression analysis was applied to estimate catheter removal rate ratios (RR), along with 95% confidence limits (95% CL), in each category of the risk factors. Results: The median follow-up time was 2.6 months (IQR = 1.4–4.6; min-max = 0.03–12.7), and at the end of the study period, a total of 45 catheter failures were detected. A risk reduction of approximately 75% (RR = 0.24; 95% CL = 0.11–0.51) was emphasized for patients with PICC when compared with those with MLC. Type of chemotherapy and cancer site appeared to be important predictive factors for catheter removal risk. Conclusions: For cancer patients undergoing chemotherapy by a non TIVAD, PICC must be preferred to MC because of higher safety and efficacy.
Unveiling connections between venous disruption and cerebral small vessel disease using diffusion tensor image analysis along perivascular space (DTI-ALPS): A 7-T MRI study
Authors: Zhang Xue , Pei Xun , Shi Yulu , Yang Yingying , Bai Xiaoyan , Chen Tong , Zhao Yuanbin , Yang Qianqian , Ye Jinyi , Leng Xinyi , Yang Qi , Bai Ruiliang , Wang Yilong , Sui Binbin 
Published: October 2024

Background: Cerebral venous disruption is one of the characteristic findings in cerebral small vessel disease (CSVD), and its disruption may impede perivascular glymphatic drainage. And lower diffusivity along perivascular space (DTI-ALPS) index has been suggested to be with the presence and severity of CSVD. However, the relationships between venous disruption, DTI-ALPS index, and CSVD neuroimaging features remain unclear. Aims: To investigate the association between venous integrity and perivascular diffusion activity, and explore the mediating role of DTI-ALPS index between venous disruption and CSVD imaging features. Methods: In this cross-sectional study, 31 patients (mean age, 59.0 ± 9.9 years) were prospectively enrolled and underwent 7-T magnetic resonance (MR) imaging. DTI-ALPS index was measured to quantify the perivascular diffusivity. The visibility and continuity of deep medullary veins (DMVs) were evaluated based on a brain region–based visual score on high-resolution susceptibility-weighted imaging. White matter hyperintensity (WMH) and perivascular space (PVS) were assessed using qualitative and quantitative methods. Linear regression and mediation analysis were performed to analyze the relationships among DMV scores, DTI-ALPS index, and CSVD features. Results: The DTI-ALPS index was significantly associated with the parietal DMV score ( β = −0.573, p corrected = 0.004). Parietal DMV score was associated with WMH volume ( β = 0.463, p corrected = 0.013) and PVS volume in basal ganglia ( β = 0.415, p corrected = 0.028). Mediation analyses showed that DTI-ALPS index manifested a full mediating effect on the association between parietal DMV score and WMH (indirect effect = 0.115, Pm = 43.1%), as well as between parietal DMV score and PVS volume in basal ganglia (indirect effect = 0.161, Pm = 42.8%). Conclusion: Cerebral venous disruption is associated with glymphatic activity, and with WMH and PVS volumes. Our results suggest cerebral venous integrity may play a critical role in preserving perivascular glymphatic activity; while disruption of small veins may impair the perivascular diffusivity, thereby contributing to the development of WMH and PVS enlargement.
The implementation of smart continence care for people with disabilities: A qualitative study of key stakeholders’ first-hand experiences
Authors: van Calis Julia FE , van Cooten Vivette JC , Smeets Odile , Naaldenberg Jenneken , Boon Brigitte , Leusink Geraline L , Bevelander Kirsten E 
Published: October 2024

Introduction Innovative technological applications like smart continence care (SCC) offer potential benefits in healthcare delivery, particularly for individuals with profound intellectual and multiple disabilities (PIMD). SCC aims to prompt caregivers to change continence materials, potentially improving clients’ quality of life and reducing caregivers’ workload. Although the use of SCC in PIMD care is promising, research is needed to improve its use in these complex settings. The aim of this study was to reflect on the SCC implementation process in care organizations for people with PIMD. Methods Fifteen semi-structured interviews were conducted with key stakeholders, caregivers, and SCC project leaders, across four care organizations. Interviews utilized an integrated framework drawing from the centre for eHealth research roadmap and the nonadoption, abandonment, scale-up, spread, and sustainability framework, both addressing eHealth implementation. Thematic analysis and open coding were employed to identify key themes and sub-themes in the implementation process. Results Four main themes emerged as crucial for successful SCC implementation: creating support, communication between stakeholders, problem-solving, and willingness to adopt SCC. The first three themes were perceived as contributors to the success of SCC implementation, whereas the last theme showed factors impacting willingness to adopt SCC. Early involvement of key stakeholders and clear communication about expectations of their roles was perceived as crucial and created clarity. Adequate problem-solving was identified as influential in SCC utilization and willingness to adopt person-centred continence care. Conclusion Implementation of SCC requires changes in the work routines of those involved, and key stakeholders’ early involvement appears to improve support for these changes. Fostering communication between key stakeholders and adequate problem-solving contributes to positive experiences and the perceived success of sustainable implementation. This study offered a rich understanding of day-to-day practices around implementing SCC in disability care organizations. The findings may also be relevant for the implementation of technologies in other care settings.
Planning of a Single Flow Channel in Valve Blocks Based on Additive Manufacturing and the Ant Colony Algorithm
Authors: Zhang Jin , Li Ziyang , Zhang Yuying , Liu Yandong , Li Ying , Kong Xiangdong 
Published: October 2024

AbstractAs electro-hydrostatic actuator (EHA) technology advances towards lightweight and integration, the demand for enhanced internal flow pathways in hydraulic valve blocks intensifies. However, owing to the constraints imposed by traditional manufacturing processes, conventional hydraulic integrated valve blocks fail to satisfy the demands of a more compact channel layout and lower energy dissipation. Notably, the subjectivity in the arrangement of internal passages results in a time-consuming and labor-intensive process. This study employed additive manufacturing technology and the ant colony algorithm and B-spline curves for the meticulous design of internal passages within an aviation EHA valve block. The layout environment for the valve block passages was established, and path optimization was achieved using the ant colony algorithm, complemented by smoothing using B-spline curves. Three-dimensional modeling was performed using SolidWorks software, revealing a 10.03% reduction in volume for the optimized passages compared with the original passages. Computational fluid dynamics (CFD) simulations were performed using Fluent software, demonstrating that the algorithmically optimized passages effectively prevented the occurrence of vortices at right-angled locations, exhibited superior flow characteristics, and concurrently reduced pressure losses by 34.09%–36.36%. The small discrepancy between the experimental and simulation results validated the efficacy of the ant colony algorithm and B-spline curves in optimizing the passage design, offering a viable solution for channel design in additive manufacturing.
Interplay between cannabinoids and the neuroimmune system in migraine
Authors: Zorrilla Erik , Della Pietra Adriana , Russo Andrew F. 
Published: October 2024

AbstractMigraine is a common and complex neurological disorder that has a high impact on quality of life. Recent advances with drugs that target the neuropeptide calcitonin gene-related peptide (CGRP) have helped, but treatment options remain insufficient. CGRP is released from trigeminal sensory fibers and contributes to peripheral sensitization, perhaps in part due to actions on immune cells in the trigeminovascular system. In this review, we will discuss the potential of cannabinoid targeting of immune cells as an innovative therapeutic target for migraine treatment. We will cover endogenous endocannabinoids, plant-derived phytocannabinoids and synthetically derived cannabinoids. The focus will be on six types of immune cells known to express multiple cannabinoid receptors: macrophages, monocytes, mast cells, dendritic cells, B cells, and T cells. These cells also contain receptors for CGRP and as such, cannabinoids might potentially modulate the efficacy of current CGRP-targeting drugs. Unfortunately, to date most studies on cannabinoids and immune cells have relied on cell cultures and only a single preclinical study has tested cannabinoid actions on immune cells in a migraine model. Encouragingly, in that study a synthetically created stable chiral analog of an endocannabinoid reduced meningeal mast cell degranulation. Likewise, clinical trials evaluating the safety and efficacy of cannabinoid-based therapies for migraine patients have been limited but are encouraging. Thus, the field is at its infancy and there are significant gaps in our understanding of the impact of cannabinoids on immune cells in migraine. Future research exploring the interactions between cannabinoids and immune cells could lead to more targeted and effective migraine treatments.
Effectiveness of intraosseous access during resuscitation: a retrospective cohort study
Authors: Rijnhout Tim W.H. , Kieft Marin , Klein Willemijn M. , Tan Edward C.T.H. 
Published: October 2024

Abstract
Purpose
During resuscitation in emergency situations, establishing intravascular access is crucial for promptly initiating delivery of fluids, blood, blood products, and medications. In cases of emergency, when intravenous (IV) access proves unsuccessful, intraosseous (IO) access serves as a viable alternative. However, there is a notable lack of information concerning the frequency and efficacy of IO access in acute care settings. This study aims to assess the efficacy of intraosseous (IO) access in acute care settings, especially focusing on children in a level 1 trauma center.

Methods
This retrospective study included patients with IO access presented in a level 1 trauma center emergency department (ED) between January 2015 and April 2020. Data regarding medication and fluid infusion was documented, and the clinical success rate was calculated.

Results
Of the 109,548 patients that were admitted to the ED, 25,686 IV lines were inserted. Documentation of 188 patients of which 73 (38.8%) children was complete and used for analysis. In these 188 patients, a total of 232 IO accesses were placed. Overall, 182 patients had a functional IO access (204 needles) (88%). In children (age < 18 years) success rate was lower as compared to adults, 71–84% as compared to 94%. However, univariate regression showed no association between the percentage of functional IO access and gender, age, weight, health care location (prehospital and in hospital), anatomical position (tibia as compared to humerus) or type of injury.

Conclusion
Intraosseous access demonstrates a high success rate for infusion, independent of gender, age, weight, anatomical positioning, or healthcare setting, with minimal complication rates. Caution is especially warranted for children under the age of six months, since success rate was lower.
The effect of diet quality and body mass index on depression in older adults: a growth curve analysis
Authors: Wang Yun-Lin , Wang Yun-Han , Leung Dara Kiu Yi , Wong Gloria Hoi Yan , Lum Terry Yat Sang 
Published: October 2024

Abstract
Background
Nutrition not only plays an important role in one’s physical health, but also mental health. The causal association between nutrition and mental health remains unclear. While a healthy dietary pattern may protect one against mental illness, it is also possible that poor mental health could lead to unhealthy eating habits or choices. Furthermore, emerging studies suggest that a higher body mass index (BMI) is associated with a lower risk of depressive symptoms in older adults, contrasting the effect observed in other populations. With an ageing population, this study aimed to investigate the long-term impact of a healthy dietary pattern, BMI, and other covariates on depressive symptoms in older adults.

Methods
We conducted a cohort study between 2014 and 2017, with each follow-up assessment being one year apart. A total of 2081 participants above 65 years old (M = 79.65, SD = 7.94) completed the baseline assessment in 2014, which included basic demographics, self-reported eating habits, depressive symptoms, and the measurement of height and weight. Distance to supermarkets and fast food was calculated based on participants’ residential addresses. Two growth models were performed to assess the trajectory of change in depressive symptoms over time.

Results
Older adults experienced a significant decrease in depressive symptoms over time (intercept = 2.68, p < .001; slope = -0.25, p < .001). At baseline, a higher diet quality (B = -0.95, p < .001), higher BMI (B = -0.09, p < .001), younger age (B = 0.40, p = .001), being a male (B = 0.76, p < .001), and having fewer chronic diseases (B = 0.39, p < .001) were associated with lower levels of depressive symptoms. Over time, a higher diet quality (B = 0.14, p = .05), higher BMI (B = 0.02, p = .04), and fewer chronic diseases (B = -0.08, p < .001) predicted lower levels of depressive symptoms over time.

Conclusions
A higher diet quality and higher BMI may serve as protective factors for depressive symptoms in older adults. Potential implications are being discussed.
High-risk human papillomavirus diversity among indigenous women of western Botswana with normal cervical cytology and dysplasia
Authors: Rantshabeng Patricia S. , Tsima Billy M. , Ndlovu Andrew K. , Motlhatlhedi Keneilwe , Sharma Kirthana , Masole Carol B. , Moraka Natasha O. , Motsumi Kesego , Maoto-Mokote Angela K. T. , Eshetu Alemayehu B. , Tawe Leabaneng , Gaolathe Tendani , Moyo Sikhulile , Kyokunda Lynnette T. 
Published: October 2024

Abstract
Background
Cervical cancer remains a public health problem despite heavy global investment in health systems especially in low-and-middle-income countries (LMIC). Prophylactic vaccines against the most commonly detected human papillomavirus (HPV) types in cervical cancers are available and decisions on the selection of vaccine design depends on the prevalence of high-risk (hr) HPV genotypes for a particular region. In 2015, Botswana adopted the use of a quadrivalent HPV vaccine as a primary prevention strategy. Secondary prevention includes cervical smear screening whose uptake remains notably low among indigenous and marginalized communities despite efforts to improve access.

Aim
To determine the prevalence of hrHPV genotypes and cervical lesions’ burden in women from the indigenous and marginalized communities of Botswana.

Methods
This prospective survey enrolled 171 non-HPV vaccinated women aged 21 years and older. Face-to-face interviews, Pap smear screening, hr-HPV and Human Immuno-deficiency virus (HIV) testing were carried out. Conventional Papanicolau smears were analyzed and cervical brushes were preserved for hrHPV testing using the Ampfire Multiplex HR-HPV protocol which detects the following genotypes: HPV 16, 18, 31, 35, 39, 45, 51, 52, 53, 56, 58, 59 and 68.

Results
In this study, 168/171 (98.6%) of the women consented to HIV testing; 53/171 (31%) were living with HIV and self-reported enrolment on antiretroviral therapy. Among the women examined, 23/171 (13.5%) had cervical dysplasia with most presenting with Atypical Squamous Cells of Undetermined Significance 8/23 (35%), Low-Grade Squamous Intraepithelial Lesions 8/23 (35%), Atypical Squamous Cells-High Grade 4/23 (17%), Atypical Endocervical Cells 2/23 (9%) and Atypical Endocervical Cell favoring neoplasia 1/23(4%). However, no High-Grade Squamous Intraepithelial Lesions (HSIL) or squamous cell carcinoma (SCC) were detected. Overall hrHPV prevalence in this study was at 56/171 (32.7%). The most commonly detected hrHPV genotypes in women with cervical dysplasia were HPV39 (6.25%), HPV51 (14.5%), HPV52 (12.5%) and HPV56 (4%). Notably, HPV 16 and 18 were not found in women with cervical dysplasia.

Conclusions
Our study provides valuable insights into the prevalence and distribution of hrHPV genotypes in indigenous and marginalized communities in Botswana, and the need for further investigation of their potential role in cervical carcinogenesis in this population. These results may also serve as baseline data to facilitate future evaluation of the HPV vaccine needs.
Dynamics of osteopontin levels and correlation with parasitemia in acute malaria in Uganda and Sweden
Authors: Mortazavi Susanne E. , Lugaajju Allan , Danielsson Lena , Wu Bingyan , Norrgren Hans , Persson Kristina E. M. 
Published: October 2024

Abstract
Background
Malaria remains a significant public health concern, especially for the deadliest parasite, Plasmodium falciparum. During acute malaria, various cytokines, including osteopontin (OPN), regulate the immune response. OPN has been shown to be protective against malaria in mice. Nonetheless, its precise function and potential ability to control parasites during acute malaria in humans remain poorly understood.

Results
Blood samples were collected from Swedish adults with imported malaria, Ugandan children and adults with symptomatic malaria (including follow-up after 42 days), Ugandans with non-malarial fever and healthy individuals from both Uganda and Sweden. Parasitemia was determined by microscopy. Malaria-negative samples were verified by LAMP. OPN and interferon-γ (IFN- γ) levels were measured using ELISA. In children, OPN levels were significantly higher during acute infection compared to levels after 42 days, whereas Ugandan adults showed no difference. Swedish adults with imported malaria had elevated OPN levels compared to both Swedish controls and Ugandan adults with malaria. Parasitemia was significantly correlated with both OPN and IFN-γ levels across the entire cohort. While a significant correlation between OPN and IFN-γ was evident overall, it remained statistically significant only in Ugandan adults when analyzed by subgroups. This suggests that OPN is not just a general marker of inflammation but may be regulated differently during the development of malaria immunity.

Conclusions
In acute malaria, elevated OPN levels showed a stronger correlation with lack of immunity than age. These findings underscore the potential importance of OPN in malaria, particularly in non-immune individuals.