bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Transition Paths for AMOC Collapse and Recovery in a Stochastic Box Model
Authors: Soons Jelle , Grafke Tobias , Dijkstra Henk A. 
Published: October 2024

Abstract
There is strong evidence that the present-day Atlantic meridional overturning circulation (AMOC) is in a bistable regime, and hence, it is important to determine probabilities and pathways for noise-induced transitions between its equilibrium states. Here, using large deviation theory (LDT), the most probable transition pathways for the noise-induced collapse and recovery of the AMOC are computed in a stochastic box model of the World Ocean. This allows us to determine the physical mechanisms of noise-induced AMOC transitions. We show that the most likely path of an AMOC collapse starts paradoxically with a strengthening of the AMOC followed by an immediate drop within a couple of years due to a short but relatively strong freshwater pulse. The recovery on the other hand is a slow process, where the North Atlantic needs to be gradually salinified over the course of 20 years. The proposed method provides several benefits, including an estimate of probability ratios of collapse between various freshwater noise scenarios, showing that the AMOC is most vulnerable to freshwater forcing into the Atlantic thermocline region. Moreover, a comparison with a quasi-equilibrium approach reveals the contrasts in the behavior of a bifurcation- and noise-induced collapse of the AMOC.
Training the Future: Themes From a Content Analysis of Psychology Research Lab Manuals
Authors: Lilley Malin K. , Castellanos Isabella , Wicks Anastacia , Raya Alena , Weatherford Dawn R. , Huynh Ho Phi 
Published: October 2024

Background Lab manuals help researchers and students share a common understanding of the rules, guidelines, and expectations related to being involved with a research laboratory. However, no formal guidelines direct the creation of lab manuals in psychology. Objective In this study, we conducted qualitative analyses of 10 psychology lab manuals to provide some broad guidelines for crafting a lab manual that would improve the research experience for undergraduate students. Method Taking an inductive approach, a team of researchers created codes from the contents of the manuals, and then derived themes from those codes. Results Themes included lab philosophy and direction, expectations and roles in the lab, communication inside and outside the lab, ethics, preparing for research, conducting research, presenting research, networking, and benefits of undergraduate research. Conclusion We defined and provided specific examples of each theme for consideration by educators and discussed limitations of our approach. Teaching Implications Ultimately, these themes could serve as a modest outline from which teacher-scholars can create their lab manuals from scratch or to revise/expand current manuals.
Evaluation of lymphovascular space invasion in endometrial carcinoma by APTw and mDixon-Quant
Authors: Meng Xing , Zhang Xiaowen , Tian Shifeng , Lin Liangjie , Chen Lihua , Wang Nan , Liu Ailian 
Published: October 2024

Background Lymphovascular space invasion (LVSI) is a strong and independent risk factor that increases the probability of endometrial carcinoma (EC) recurrence and reduces the survival rate of patients. Purpose To investigate the value of amide proton transfer weighted (APTw) and mDixon-Quant techniques in evaluating EC lymphovascular space invasion (LVSI). Material and Methods Data of 50 EC patients (18 LVSI+ and 32 LVSI–) confirmed by surgery and pathology were retrospectively analyzed. Preoperative magnetic resonance imaging (MRI) scans included APTw and mDixon-Quant imaging. APT, transverse relaxation rate (R2*), and fat fraction (FF) plots were obtained by postprocessing. The APT, R2*, and FF values of the two groups of cases were measured by two observers. Results The agreement between the two observers was good. The mean APT, R2*, and FF values of LVSI+ EC were 2.947% ± 0.399%, 20.605 /s (range = 18.525–27.953), and 2.234% ± 1.047%, respectively, while the parameters of LVSI– EC were 2.628% ± 0.307%, 18.968 /s (range = 16.225–20.544), and 2.103% ± 1.070%, respectively. The APT and R2* values of LVSI+ EC were higher than those of LVSI– EC ( P < 0.05). There was no significant difference in FF value between the two groups. The AUC values of APT, R2*, and APT + R2* for LVSI were 0.751, 0.713, and 0.781, respectively (all P > 0.05). APT value was moderately correlated with R2* value (r = 0.528, P < 0.001) and weakly correlated with FF value ( r = 0.312, P = 0.027). Conclusion APTw and mDixon-Quant techniques could evaluate the LVSI status of EC, and their combined application could improve diagnostic efficiency.
Abscesses in different body sites among children: a single-center prospective study
Authors: Ajaj Omar Abdulqader , Hashim Hashim Talib , Hussein Zainab Ali 
Published: October 2024

Objectives An abscess is a localized collection of pus contained within a fibrous capsule. In this study, we aimed to determine the demographic pattern, common anatomical sites, risk factors, and the microbial profile of abscesses in different body sites among children. Methods We conducted a prospective study in our pediatric surgical department among children with abscesses in different body sites between January 2019 and December 2022. Results During the study period, 85 children were included. The participant age range was 0 to 14 years old, and 66% of participants were boys. The most common anatomical sites where abscesses formed were the pelvis (n = 29, 34%), abdomen (n = 22, 26%), neck (n = 14, 16%), and extremities (n = 12, 14%). Risk factors of abscesses in different body sites included cannulation, lymphadenitis, mastitis, perforated appendix, and perianal fistula. We observed that 74% of abscesses were of a polymicrobial nature. Conclusion The most common anatomical sites for abscesses in children included the pelvis, abdomen, neck, and extremities. Most abscesses in these sites were polymicrobial in nature.
Impact of renality-CASE training on knowledge, skills, and practices in peritoneal dialysis catheter placement among nephrologists
Authors: Sahutoglu Tuncay , Kazancioglu Rumeyza , Ozkan Mehmet Kemal , Erkasap Pelin Çelikbilek , Ates Kenan 
Published: October 2024

Introduction Despite being an effective home-based kidney replacement therapy, peritoneal dialysis (PD) remains underutilized. The aim of the Renality-CASE training program was to assess its impact on nephrologists by expanding their knowledge of PD therapy and enhancing their catheter placement skills to better offer the PD option. Methods The Renality-CASE program provided two days of training, including theoretical lectures, virtual reality sessions, and hands-on practice of PD catheter placement on live pigs. Eighty-eight participants attended four sessions. An anonymized online questionnaire collected demographic data, self-assessments of knowledge and skills, and feedback. Pre- and post-training comparisons were analyzed using paired samples t-tests and the Wilcoxon signed-rank test, with significance at p < 0.05. Results Fifty-seven out of 88 participants responded to the survey one-year post-training. Post-training, 94.7% felt at least moderately knowledgeable compared to 61.4% pre-training ( p < 0.001). Confidence in skills increased to 73.6% post-training from 26% pre-training ( p < 0.001). The number of PD catheters placed by participants also rose significantly ( p = 0.012). The program received positive feedback and high satisfaction rates. Conclusions The Renality-CASE program significantly improved nephrologists’ PD catheter placement skills through comprehensive training. Despite limitations such as sample size and response bias, the study highlights the need for standardized PD training to enhance clinical practice and increase PD utilization in CKD management.
Investigation of 5-fluorouracil cardiotoxicity in combinational therapy: Influence of risk factors and demographics in a Pakistani population
Authors: Raza Hina , Javaid Mariyam , Rehman Wajiha , Rafiq Sana , Rashid Zermina , Shamim Rahat , Jaradat Abdolelah , Yousif Mohamed Deifallah 
Published: October 2024

Introduction 5-Fluorouracil (5-FU) is a chemotherapeutic agent used to treat various types of cancers. Although widely used, it has consistently been attributed to cardiotoxicities after administration. The purpose of this study was to assess the parameters and predictors of cardiotoxicities associated with various 5-FU-based chemotherapeutic protocols in patients with GI/colorectal cancer, as well as the correlation of these cardiotoxic events with age, sex, cumulative dose, and risk factors such as obesity, hypertension, and family history of cardiac diseases. Methods A prospective study consisting of 396 patients of both sexes was conducted in the oncology ward of Nishtar Hospital in Multan, Pakistan. Patients were grouped according to the therapeutic protocol they received (5-FU monotherapy or in combination, with different dosing regimens). Electrocardiography and serum troponin levels were used to assess 5-FU-induced cardiotoxicity. In cases where cardiotoxicity was detected, 5-FU treatment was interrupted; nitroglycerin, nitrates, and calcium channel blockers were administered; and cardiac monitoring was initiated. 5-FU was discontinued in all cases of acute myocardial infarction. Results Of the 396 patients, 28.5% reported different cardiotoxic symptoms after receiving various 5-FU-containing protocols. 35% had anginal pain, 13% suffered a myocardial infarction, 11% developed hypertension, and 10% presented heart failure. Patients receiving 5-FU combination therapy showed cardiotoxic events that were significantly different from those on 5-FU monotherapy. Based on the ECG results, only the QTc-d interval increased significantly (p < 0.001) after therapy. 68% of the patients had troponin levels > 2 ng/mL at the end of treatment. Conclusions Pre-existing cardiac diseases, treatment duration, smoking, and obesity were found to be influential components in the development of cardiotoxicity, and patients with cancer should be closely monitored during 5-FU chemotherapy.
Longitudinal structural changes in central serous chorioretinopathy: A multimodal imaging-based study
Authors: Sahoo Niroj Kumar , Ong Joshua , Selvam Amrish , Maltsev Dmitri , Sacconi Riccardo , Venkatesh Ramesh , Reddy Nikitha Gurram , Madan Shivam , Tombolini Beatrice , Lima Luiz H , Pramil Varsha , Anantharaman Giridhar , Casella Antonio Marcelo , Ledesma-Gil Gerardo , Waheed Nadia , Borrelli Enrico , Querques Giuseppe , Chhablani Jay 
Published: October 2024

Purpose To analyse the longitudinal changes in imaging parameters in eyes with acute or chronic central serous chorioretinopathy (CSCR). Methods This was a multicentric, retrospective, longitudinal, observational study in patients with a diagnosis of CSCR and having at least 4 years of follow-up. Trend in choroidal thickness (CT), area of double layer sign (DLS), area of retinal pigment epithelium (RPE) alterations, and area of hyper-autofluorescence were analysed. Results A total of 175 eyes of 146 patients with a mean age of 52.9 ± 12.5 years were included. Fifty-two eyes had acute and 123 had chronic CSCR at baseline. There was an overall decreasing trend of CT values during follow up (from 354.4 ± 74.8 at baseline to 343.2 ± 109.4 at final visit). There was a steady rise in DLS width and RPE alteration in the overall cohort (from 811.7 ± 760.6 microns and 3.5 ± 3.3 disc areas respectively at baseline to 1209.1 ± 1113.18 microns, 4.1 ± 3.6 disc areas at final visit). An initial rise in hyper-autofluorescent area followed by steady fall was seen in chronic CSCR. A significant positive correlation (r = 0.54, p = 0.004) was seen between change in DLS width and change in area of hyper-autofluorescence. On linear regression analysis, lower CMT and absence of intraretinal fluid at baseline were associated with greater increase in RPE abnormalities. Conclusion Acute and chronic CSCR had different pattern of change in imaging parameters with area of RPE alterations in acute CSCR not reaching values close to that of chronic CSCR eyes even after long follow up.
Identifying pseudo-resistant hypertension and optimizing diuretic therapy for confirmed resistant cases in primary care
Authors: Champigny Joey , Nagge Jeff 
Published: October 2024

Background: Approximately 10% of individuals with hypertension are expected to have resistant hypertension (RH). Many have pseudo-resistant hypertension (p-RH) due to a variety of factors. To date, the prevalence of p-RH and optimal diuretic therapy in primary care have not been studied. Methods: A retrospective chart review was conducted, including patients referred to the hypertension clinic at the Centre for Family Medicine (CFFM) Family Health Team in Kitchener, ON, from January 2010 to September 2020. Individuals ≥18 years old referred to clinic by their family physician or other health care provider with 2 consecutive blood pressure (BP) readings of ≥140/90 mmHg despite using ≥3 antihypertensive agents were included. Results: Fifty-one patients taking ≥3 antihypertensive agents were referred during the study timeframe. Forty-one patients had ≥2 consecutive BP readings of ≥140/90 and were classified as having presumed RH. Of these, 24 patients (59%) had p-RH after BP was measured systematically in the hypertension clinic. Of the 17 with RH, 5 (29%) were prescribed optimal diuretic therapy upon referral. Most common clinic interventions included initiating or adjusting the dose of a diuretic (47%), adding a different antihypertensive agent (27%) or discontinuing an antihypertensive agent due to side effects (24%). Discussion: To our knowledge, this is the first time that the prevalence of p-RH and optimal diuretic therapy have been studied in primary care. p-RH was common and diuretic therapy was underused in RH. Conclusion: This study suggests that p-RH is prevalent and diuretic therapy underused in primary care. Systematic BP measurement and optimization of diuretic therapy should be prioritized prior to specialist referral.
Co-creation and evaluation of an app to support reminiscence therapy interventions for older people with dementia
Authors: De-Rosende-Celeiro Iván , Francisco-Gilmartín Virginia , Bautista-Blasco Susana , Ávila-Álvarez Adriana 
Published: October 2024

Objective The objectives encompassed (1) the creation of Recuerdame, a digital app specifically designed for occupational therapists, aiming to support these professionals in the processes of planning, organizing, developing, and documenting reminiscence therapies for older people with dementia, and (2) the evaluation of the designed prototype through a participatory and user-centered design approach, exploring the perceptions of end-users. Methods This exploratory research used a mixed-methods design. The app was developed in two phases. In the first phase, the research team identified the requirements and designed a prototype. In the second phase, experienced occupational therapists evaluated the prototype. Results The research team determined the app's required functionalities, grouped into eight major themes: register related persons and caregivers; record the patient's life story memories; prepare a reminiscence therapy session; conduct a session; end a session; assess the patient; automatically generate a life story; other requirements. The first phase ended with the development of a prototype. In the second phase, eight occupational therapists performed a series of tasks using all the application's functionalities. Most of these tasks were very easy (Single Ease Question). The level of usability was considered excellent (System Usability Scale). Participants believed that the app would save practitioners time, enrich therapy sessions and improve their effectiveness. The qualitative results were summarized in two broad themes: (a) acceptability of the app; and (b) areas for improvement. Conclusions Participating occupational therapists generally agreed that the co-designed app appears to be a versatile tool that empowers these professionals to manage reminiscence interventions.
Construction of the whole-process nursing service system for day surgery patient based on the Kano model: A pilot cluster randomized controlled trial
Authors: Sun Weige , Wu Fei , Du Yue , Luo Jie , Wang Xin , Li Aman , Zhang Ran , Cai Weixin 
Published: October 2024

Objective The types and number of day surgeries have significantly increased, but the construction of the whole process nursing service system (WPNSS) for preoperative education, intraoperative cooperation, postoperative knowledge, and follow-up for day surgery patients is still in the exploratory stage. The aim of this study is to establish the WPNSS for day surgery patients using the Kano model and to preliminarily assess its efficacy. Methods WPNSS for day surgery was devised leveraging Internet hospital information systems and patient mobile terminals (WeChat), guided by the World Health Organization's conceptual framework for scaling-up strategies. The system was methodically developed, progressing from defining the overall framework to delineating modular functions and developing specific educational materials and tools. A pilot test was conducted in a hospital in China. Results WPNSS, a patient-centric remote education and monitoring system, seamlessly amalgamates health education, online consultations, and follow-up functionalities; offering semi-automated surgical consultations, inquiry services, and postoperative follow-ups, as well as autonomously disseminating perioperative health education content. Comprising both client and server components, patients utilizing the system are inclined to recommend day surgery at the hospital to others Conclusions WPNSS delivers personalized and precise health education, consultation, and postoperative follow-up services for day surgery patients. Current results suggest that the WPNSS may improve patients’ experience. Trial Registration Chinese Clinical Trial Register (ChiCTR2200066782).
How is digital health suitability measured for communities? A systematic review
Authors: Geracitano John , Barron Luke , McSwain David , Khairat Saif 
Published: October 2024

Background Digital health services continue growing in usage and popularity, with patients and healthcare organizations benefiting from their use. Despite this, no mechanism exists to measure a patient's and community's suitability to leverage these services. Objective This systematic review aims to evaluate the extent and nature of measuring the overall suitability of individuals and communities within the digital health landscape. Methods Database searches in February 2024 across PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, and IEEE Xplore yielded 1044 unique references. Two screening stages resulted in 10 articles that met all evaluation criteria for review inclusion. Results This systematic review found a gap in the ability to holistically assess a patient's and community's suitability to access digital health services. Myriad indices and tools identify isolated factors contributing to digital health accessibility (e.g., broadband availability); however, no comprehensive mechanism adequately informs providers, policymakers, and researchers. Conclusion A comprehensive index that accurately reflects suitability for digital health services is needed. Index factors should include a combination of indicators related to socioeconomic status, digital accessibility, such as device and internet access, and social determinants of health. Together, these form the predominant driving factors related to one's ability to participate in digital health services.
Home and workforce reintegration one year after thrombectomy in acute stroke patients
Authors: Bode Felix J , Zadon Nina A , Asperger Hannah , Beckonert Niklas M , Ebrahimi Taraneh , Nitsch Louisa , Nordsiek Julia , Meissner Julius N , Shirvani Omid , Stösser Sebastian , Thielscher Christian , Dorn Franziska , Lehnen Nils C , Petzold Gabor C , Weller Johannes M 
Published: October 2024

Introduction: Endovascular thrombectomy (EVT) combined with intravenous thrombolysis is the current standard treatment for acute large-vessel occlusion stroke. Beyond clear clinical benefits in the acute and post-acute phases, comprehensive evaluations of long-term outcomes, including home and workforce reintegration, remain limited. This study aimed to assess home and workforce reintegration 1 year post-EVT in a cohort of acute stroke patients and explore their association with health-related quality of life (HRQoL). Patients and methods: We conducted a prospective observational study of 404 patients undergoing EVT at a tertiary university medical center between October 2019 and December 2021. Patients’ functional outcomes were evaluated using the modified Rankin Scale (mRS), and HRQoL was assessed via the European Quality of Life Five Dimension Scale (EQ-5D). Data on occupational and living status were collected through standardized telephone interviews at 3- and 12-months post-treatment. Results: Of 357 patients with 12-month follow-up data, 33.6% had a favorable outcome (mRS 0–2). Among stroke survivors, the rate of home reintegration without nursing care was 42.1%, and workforce reintegration among previously employed patients was 43.3% at 12 months. Both outcomes were significantly associated with improved HRQoL. Lower neurological deficits and younger age were predictive of successful home and workforce reintegration. Discussion and conclusion: One year post-EVT, approximately 40%–50% of acute stroke patients successfully reintegrate into home and work settings. These findings underscore the need for ongoing support tailored to improving long-term reintegration and quality of life for stroke survivors. Data access statement: The data supporting the findings of the study are available from the corresponding author upon reasonable request and in accordance to European data privacy obligations.