bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying potential outcomes of patient engagement in primary care quality improvement: a modified Delphi study
Authors: Pandhi Nancy , Jacobson Nora , Crowder Madison , Quanbeck Andrew , Davis Sarah 
Published: October 2024

AbstractRationaleA barrier to dedicating resources towards patient engagement in primary care quality improvement is the lack of clearly identified outcomes that might result from these initiatives.Aims and objectivesWe sought to identify these potential outcomes at three healthcare levels as defined by the Institute of Medicine: 1) Micro/Direct Care; 2) Meso/Microsystem; and 3) Macro/Clinic/System using a Modified Delphi technique.MethodTwo focus groups of patients and primary care clinician leaders generated a first set of outcomes. These outcomes were then vetted and expanded through three web‐based surveys sent to twelve national experts. Experts indicated the level of agreement with prior elicited outcomes and generated potential new outcomes.ResultsIncluded outcomes achieved at least 80% agreement. The final list of 46 consensus‐derived outcomes was categorized across levels. 22 were at the Micro‐level, 9 were at the Meso‐level, and 15 were at the Macro‐level.ConclusionOur findings suggest outcomes across all health system levels have the potential for progress when patients are engaged in primary care quality improvement initiatives. Future programs should consider validating and measuring these outcomes as part of their interventions.
Response to tigilanol tiglate in dogs with mast cell tumors
Authors: Musser Margaret L. , Jones Pamela D. , Goodson Teresa L. , Roof Erin , Johannes Chad M. 
Published: October 2024

AbstractBackgroundInformation regarding response rate to tigilanol tiglate for mast cell tumors in dogs is limited.ObjectivesReport the response rate and durability of tigilanol tiglate intratumoral treatment in dogs with mast cell tumors presented to veterinary oncologists.AnimalsOne hundred forty‐nine dogs; 151 individual tumors.MethodsMulticenter, retrospective survey‐based study. Veterinary oncologists subscribed to the American College of Veterinary Internal Medicine (ACVIM) oncology listserv were solicited for information from dogs treated with tigilanol tiglate. An electronic survey was used to collect information at initial treatment, 1 month and 1 year after treatment.ResultsMost tumors were cutaneous, occurred on the limbs and were cytologically low grade. Seventy‐five percent of dogs achieved a complete response after 1 dose of tigilanol tiglate 1 month after treatment. This response was durable at 1 year in 64% of dogs for which data were available (n = 88). Wound formation, an expectation after treatment, occurred after a median of 7 days (range, 1‐91 days), with a median wound area of 4.71 cm2 (range, 0.09‐100 cm2). Wounds took a median of 30 days to heal completely (range, 14‐154 days). A moderate association between tumor volume and wound size was confirmed.Conclusions and Clinical ImportanceTigilanol tiglate is an effective local treatment option for mast cell tumors in dogs with a predictable clinical course and response. Because of the unique mode of action and clinical course, client education and careful case selection is necessary before electing tigilanol tiglate for local treatment.
Do investors gain by selling the tails of return distributions?
Authors: Bakshi Gurdip , Crosby John , Gao Xiaohui 
Published: October 2024

AbstractThis paper examines whether investors gain by selling the tails of return distributions. To address this, we develop a way of ranking and scoring actively managed funds and investment strategies, which accounts for ambiguity aversion and risk aversion in decision‐making. Using data relating to options on the S&P 500 equity index and Treasury bond futures and to hedge funds, we provide evidence that suggests a negative answer to this question. We reinforce this evidence with data from options on the STOXX 50, FTSE, and Nikkei equity indices.
The Mediating Role of Depressive Symptoms and Treatment Burden on Health‐Related Quality of Life Among Multimorbid Patients With Hypertension: A Multi‐Group Analysis
Authors: Lee Jihyang , Kim Su‐Young , Lee Kyoung Suk 
Published: October 2024

ABSTRACTMultimorbidity negatively affects health‐related quality of life (HRQoL), though the underlying mechanism remained unclear. This study aims to investigate the mediating role of depressive symptoms and multimorbidity treatment burden (MTB) in the association between disease burden and HRQoL in multimorbid patients with hypertension and to determine differences in mediating effects between and within age groups (< 60 years vs. 60 and above). Disease burden, depressive symptoms, MTB, and HRQoL were assessed by self‐reported questionnaires. We conducted path analysis with all subjects and multi‐group path analyses with two age groups. Results from the path analysis with all subjects (n = 498) showed a significant direct effect of disease burden on HRQoL and a significant indirect effect via depressive symptoms and MTB. No significant differences in mediating effects were found between age groups. However, in the older patients, depressive symptoms had a greater indirect effect than MTB. Our results underscore the importance of addressing both depressive symptoms and MTB in interventions tailored to the patient's age.
Effect of Oral Frailty on Postoperative Infection in Patients Undergoing Abdominal Visceral Surgery
Authors: Ikuno Tamao , Ida Mitsuru , Momota Yoshihiro , Kawaguchi Masahiko 
Published: October 2024

ABSTRACTObjectivesTo assess effects of the oral frailty index‐8 (OFI‐8) on the incidence of postoperative infection.Subjects and MethodsThis retrospective study included patients aged ≥ 65 years who underwent elective abdominal visceral surgery under general anaesthesia. Oral frailty was assessed using OFI‐8 (total score, 0–11), with higher scores indicating poorer oral health. The primary outcome measure was incidence of postoperative infection. The association between incidence of postoperative infection and OFI‐8 score was evaluated using multiple logistic regression analysis adjusted for clinically relevant preoperative and intraoperative covariates.ResultsData of 791 patients (mean age, 74 years; mean OFI‐8 score, 3.4) were analysed. The OFI‐8 score had a linear association (P for nonlinear effect on postoperative infection = 0.43) with a composite postoperative infection at a rate of 14.2% (95% confidence interval: 11.8–16.7). The adjusted odds ratio of the OFI‐8 score for the primary outcome was 1.10 (95% confidence interval: 1.00–1.21), indicating that patients with higher OFI‐8 scores tended to have postoperative infections.ConclusionThis study's findings suggest that patients with higher OFI‐8 scores were more likely to develop postoperative infection after undergoing elective abdominal visceral surgery.
Comparing the effectiveness of individual occupation‐based reminiscence therapy at home and in a dementia care centre on cognitive function in older adults with mild dementia: a pilot randomised controlled trial
Authors: Jung Ha Yeong , Kwon Jae Sung 
Published: October 2024

ABSTRACTBackgroundThe need for research on individual home therapies to promote continued community‐dwelling among older adults with mild dementia is growing. This study aimed to compare the effects of individual occupation‐based reminiscence therapy at home (IOBRT‐H) and individual occupation‐based reminiscence therapy in a dementia care centre (IOBRT‐DCC) on cognitive function, depression, and instrumental activities of daily living (IADL) among community‐dwelling older adults with mild dementia.MethodsThis study was a randomised controlled trial. Twenty‐six community‐dwelling older adults with mild dementia were randomised to the IOBRT‐H (n = 13) and IOBRT‐DCC (n = 13) groups. The intervention was conducted for 10 weeks, with one session a week and each session lasting 60 min for both groups. Cognitive function was assessed using the Allen Cognitive Level Screen (ACLS), depression with the short form of the Geriatric Depression Scale Korean version (SGDS‐K), and IADL using the Seoul‐Instrumental Activities of Daily Living (S‐IADL).ResultsBoth the IOBRT‐H and IOBRT‐DCC groups showed significant improvements in ACLS scores (P < 0.01 and P < 0.01, respectively). The SGDS‐K score decreased only in the IOBRT‐H group (P < 0.01). Between the groups, the IOBRT‐H group had significantly greater improvements in both ACLS and SGDS‐K scores than the IOBRT‐DCC group (P < 0.05 and P < 0.05, respectively).ConclusionThis study's results indicated the potential for applying IBORT‐H as an intervention to improve cognitive function and reduce depression in community‐dwelling older adults with mild dementia. We expect the findings of this study to serve as useful foundational data for developing home‐visiting cognitive programs.
Taiwan Strait: An ocean‐current‐dominated shallow‐water setting with a river‐fed detached muddy contourite deposit
Authors: Shan Xin , Dalrymple Robert W. , Shi Xuefa , Qiao Shuqing , Liu Chenguang , Yao Zhengquan , Jin Lina , Hua Qingfeng , Feng Han , Liu Shan , Liu Shihao , Liu Char‐Shine , Liu Paul 
Published: October 2024

ABSTRACTContourites (contour‐current deposits) are commonly associated with deep‐water environments, but this study documents a shallow‐water, muddy contourite drift in the centre of Taiwan Strait. The drift body (water depths of 30 to 70 m, 220 km long, 50 to 70 km wide, 0 to 30 m thick), with its long axis approximately colinear with the Taiwan Strait Current, is flanked on both sides by moats. Compositional data show that the drift is composed of sediment carried northward by the Taiwan Strait Current from the Choshui River draining Taiwan. The coast‐normal Changyun Ridge directly offshore of the Choshui River splits the Taiwan Strait Current into two branches that occupy the moats. Oblique cross‐drift flow from west to east contributes to drift growth. The dispersal system shows a down‐current fining from sands on the Changyun Ridge (ca 100 km long, 25 to 45 km wide) to the fine‐grained elongate drift; these together represent the asymmetrical subaqueous portion of the Choshui delta. Cores show that the drift is <8 kyr old, with sedimentation rates up to 7.8 m/ka. It coarsens upward during the initial phase of drift growth, perhaps due to an increase in current strength, with smaller‐scale textural bedding attributed to fluctuating current strengths or variations in wave energy depending on the location. Seismic data show that the southern end of the drift is migrating westward, due to elongation of the Changyun Ridge, whereas the middle and distal end are migrating eastward because of cross‐drift flow. Erosion by the eastern branch of the Taiwan Strait Current detached the drift from the coeval coastal mud belt. The influence of tidal currents is small because of the destructive interference of tidal waves entering from the two ends, creating weak rotary tidal currents over the drift. Wave energy is small within the Strait but larger waves arriving from the East China Sea are thought to be responsible for upward coarsening of the more exposed northern end. Taiwan Strait serves as a starting point for developing a facies model for ocean‐current‐dominated straits and seaways.
DEVELOPMENT OF MACHINE-LEARNT TURBULENCE CLOSURES FOR WAKE MIXING PREDICTIONS IN LOW-PRESSURE TURBINES
Authors: Frey Marioni Yuri , Adami Paolo , Vazquez Diaz Raul , Cassinelli Andrea , Sherwin Spencer J. , Montomoli Francesco 
Published: October 2024

Abstract
In this work, a DNS – Machine Learning (ML) framework is developed for low-pressure turbine (LPT) profiles to inform turbulence closures in Reynolds-Averaged Navier–Stokes (RANS) calculations. This is done by training the coefficients of Explicit Algebraic Reynolds Stress Models (EARSM) with shallow artificial neural networks (ANN). DNS data are generated with the incompressible Navier–Stokes solver in Nektar++ and validated against experiments. All calculations include moving bars upstream of the profile to capture the effect of incoming wakes. The resulting formulations are then implemented in the Rolls-Royce solver HYDRA and tested. The aim is to improve mixing predictions in LPT wakes, compared to the baseline k-ω SST, in terms of velocity profiles, turbulent kinetic energy production and mixing losses. LPT calculations are run at Reynolds numbers spanning from ≈ 80k to ≈ 300k, to cover the range of aircraft engine applications. Models for the low and high Reynolds datasets are trained separately and a method is developed to merge the two together. The resulting model is tested on an intermediate Reynolds case. This process is followed for two computational domains: one starting downstream of the profile trailing edge and one including the last portion of the profile. Finally, the developed closures are tested on the entire profile, including transition in the simulation. This work explains the methodology used to develop ML-driven closures and shows how it is possible to combine models trained on different datasets.
The British Preschool Children’s Play Survey: When, Where, and How Adventurously Do British Preschool-Aged Children Play?
Authors: Dodd Helen F. , Hesketh Kathryn 
Published: October 2024

Background: Outdoor, adventurous play supports physical activity and might help to prevent mental health problems, yet data on preschool-aged children’s outdoor play are scarce. Method: Data were collected from a nationally representative sample of 1166 parents/caregivers of children aged 2–4 years (52% male; 88% white) living in Britain. Caregivers reported time children spent playing in 7 locations and corresponding adventure level. Responses were used to derive: total play time, outdoor play time, and adventurous play time (in hours per year). Associations between sociodemographic characteristics and play outcomes were examined, controlling for relevant confounding variables. Results: Outside of childcare, preschool-aged children spent approximately 4 hours per day playing, with 1 hour 45 minutes spent playing outdoors. Most outdoor play happened in gardens at home. Away from home, children most often played in playgrounds and green spaces. Levels of adventurous play were reported to be highest at indoor play centers, followed by playgrounds and green spaces. Total play differed significantly by location, with children in rural areas spending more time playing (vs urban areas). Child ethnicity was associated with play and outdoor play, with children belonging to minority ethnic groups (vs white) playing less. Child sex was also a significant predictor of outdoor play time: boys (vs girls) spent more time playing outdoors, driven primarily by time spent in green spaces. No associations were found for adventurous play. Conclusions: These results highlight how inequalities in access to outdoor space at home and good quality local play spaces may impact young children’s play opportunities and, in turn, exacerbate health inequalities.
Examination of Transition Shock and Colleague Violence Among Newly Graduated Nurses: A Cross‐Sectional Study
Authors: Berşe Soner , Ağar Ali , Di̇rgar Ezgi , Tosun Betül 
Published: October 2024

Background: The adaptation process for new nursing graduates is challenging, with transition shock and colleague violence impacting both individuals and institutions.Objective: This study investigates transition shock and colleague violence among newly graduated nurses in Turkey during their adaptation process.Methods: The study involved 235 newly graduated nurses from a state university in Turkey with at least six months of clinical experience. Data were collected using the Nursing Transition Shock Scale and the Exposure to Colleague Violence Scale.Results: Among the participants, 27.23% experienced colleague violence and 56.17% witnessed it. The mean score on the Nursing Transition Shock Scale was 53.62 ± 15.39. Female nurses and younger age groups faced more challenges.Conclusion: Supportive work environments, mentorship programs, and collaborative teamwork are crucial for newly graduated nurses. Updating nursing education programs to prepare students for these challenges is essential. This study underscores the need for targeted interventions.
Spatial Dynamics of T- and B-Cell Responses Predicts Clinical Outcome of Resectable and Unresectable Hepatocellular Carcinoma
Authors: Kurebayashi Yutaka , Sugimoto Katsutoshi , Tsujikawa Hanako , Matsuda Kosuke , Nomura Rui , Ueno Akihisa , Masugi Yohei , Yamazaki Ken , Effendi Kathryn , Takeuchi Hirohito , Itoi Takao , Hasegawa Yasushi , Abe Yuta , Kitago Minoru , Ojima Hidenori , Sakamoto Michiie 
Published: October 2024

Abstract

Purpose:
Immunotherapies have led to a paradigm shift in the treatment of hepatocellular carcinoma (HCC). Studies have revealed the single-cell catalogs of tumor-infiltrating immune cells and the trajectories of their differentiation. Nevertheless, the spatial distribution of these immune cells with distinct phenotypes in the tumor microenvironment and their clinicopathologic significance in resectable and unresectable HCCs are still largely unclear.

Experimental Design:
We analyzed the spatial dynamics of intratumoral CD4 and CD8 T cells and their association with B and plasma cells using 283 surgically resected HCC samples, 58 unresectable HCC samples before combined immunotherapy [atezolizumab plus bevacizumab (Atezo + Bev)], and autopsy specimens from 50 cases of advanced-stage HCC through multiplex IHC combined with transcriptomic and driver gene mutation analyses. Classification based on the spatial dynamics of T- and B-cell responses (refined immunosubtype) was developed, and its clinicopathologic significance was analyzed.

Results:
We found that stem-like CD4 and CD8 T cells were mainly observed in T-cell aggregates and T-cell zone of tertiary lymphoid structure (TLS). The differentiation of T follicular helper cells was associated with the development of TLS, whereas the differentiation of CXCL13-expressing CD4 TCXCL13 cells with a phenotype resembling T peripheral helper cells was associated with the development of the lymphoplasmacytic microenvironment. The refined immunosubtype could predict clinical outcomes of resectable HCC after surgery and unresectable HCC after Atezo + Bev therapy. The immune microenvironment of metastatic lesions tended to reflect those of primary lesions.

Conclusions:
We revealed the spatial dynamics of T- and B-cell responses in HCC, which is closely associated with the clinical outcome after surgical resection or Atezo + Bev therapy.
Benzodiazepine Utilization in Ischemic Stroke Survivors: Analyzing Initial Excess Supply and Longitudinal Trends
Authors: Lomachinsky Torres Victor , Brooks Julianne D. , Donahue Maria A. , Sun Shuo , Hsu John , Price Mary , Blacker Deborah , Schwamm Lee H. , Newhouse Joseph P. , Haneuse Sebastien , Moura Lidia M.V.R. 
Published: October 2024

BACKGROUND:
Benzodiazepines are commonly prescribed for post-acute ischemic stroke for anxiety, insomnia, and agitation. While guidelines discourage use in those aged ≥65 years, little is known about prescription patterns at the national level.

METHODS:
We analyzed a 20% sample of US Medicare claims from April 1, 2013, to September 30, 2021. We selected beneficiaries aged ≥65 years discharged alive following an acute ischemic stroke who had traditional Medicare coverage and 6 months’ prior enrollment in Parts A (hospital insurance), B (Medical insurance), and D (drug coverage). We excluded those with prior benzodiazepine prescriptions, self-discharges, or discharge to skilled nursing facilities. We examined demographics, comorbidities, first prescription days’ supply, cumulative incidences of benzodiazepine first prescription fills within 90 days after discharge, and geographic and yearly trends.

RESULTS:
We included 126 050 beneficiaries with a mean age of 78 years (SD, 8); 54% were female and 82% were White. Within 90 days, 6127 (4.9%) initiated a benzodiazepine. Among new prescriptions, lorazepam (40%) and alprazolam (33%) were the most prescribed. Most (76%) of first fills had a day’s supply over 7 days and 55% between 15 and 30 days. Female initiation rates were higher (5.5% [95% CI, 5.3–5.7]) than male initiation rates (3.8% [95% CI, 3.6%–3.9%]). Rates were highest in the southeast (5.1% [95% CI, 4.8%–5.3%]) and lowest in the midwest (4.0% [95% CI, 3.8%–4.3%]), with a modest nationwide initiation decline from 2013 to 2021 (cumulative incidence difference, 1.6%).

CONCLUSIONS:
Despite a gradual decline in benzodiazepine initiation from 2013 to 2021, we noted excessive supplies in prescriptions post-acute ischemic stroke discharge, underscoring the need for improved policies.
Successful adoption of non-orphaned infant by a parous, nursing female in yaki (Sulawesi crested macaque)
Authors: Graham Kirsty E. , Holden Eve , Engelhardt Antje , Perwitasari-Farajallah Dyah , Slocombe Katie E. 
Published: October 2024

Abstract
Adoption is an unusual behaviour across taxa, and for adoption to be successful, with the infant surviving to independence, the adoptive parent must be able to provide appropriate nutrition and care. Successful adoption has now been reported in several nonhuman primate species and here we add a case in wild yaki (Sulawesi crested macaque, Macaca nigra). We observed the adoption of an approx. 2-week-old infant by a female with her own approx. 3-week-old infant who went on to carry, nurse, and care for both infants until they both became independent. The adoptive and biological mother had each previously raised the same number of offspring (5). There was no evidence of aggressive transfer and we did not observe any attempts by the adopted infant’s biological mother to retrieve her. The biological mother went on to have another infant 8 months later while the adoptive mother was still caring for her other infant. This case may reflect some of the health costs and reproductive benefits of adoption for nonhuman primates.
Diagnostic accuracy of bone marrow blood evaluation in haemophagocytic lymphohistiocytosis paediatric patients
Authors: Caravaggi Elisa , Serana Federico , Carini Mattia , Ferrari Fabiana , Tregambe Daniela , Micheletti Moira , Martellosio Giovanni , Brugnoni Duilio , Bresciani Roberto , Biasiotto Giorgio 
Published: October 2024

Introduction Haemophagocytic lymphohistiocytosis (HLH) is a rare and serious immunological syndrome that involves a strong activation of cytotoxic T lymphocytes and macrophages. HLH determines a cytokine-mediated tissue injury with a contemporary multi-organ failure and a high fatality rate. Material and methods A retrospective study was performed considering the medical records of paediatric patients who underwent a bone marrow aspirate for suspect HLH. The biomarkers evaluated were among those included in the HLH-2004. Lactate dehydrogenase (LD) was also evaluated. Haemophagocytosis was evaluated in bone marrow blood smear slides. Results Enrolled were 11 patients included in the HLH group and 8 patients as controls. Haemoglobin and fibrinogen resulted lower in HLH patients than in controls, while blood triglycerides, serum ferritin and LD resulted increased. Blood triglycerides and fibrinogen discriminated HLH cases perfectly, with a sensitivity and specificity of 100%. Ferritin had a sensitivity of 100% and a specificity of 83% (cut off ≥3,721 µg/L) and LD of 73% and of 100% (the cut off ≥1,903 U/L). Haemoglobin was found to have a sensitivity of 75% and a specificity of 100% (cut off ≤ 96 g/L). Total haemophagocytes cell counts were not different between patients and controls. Only the increased number of phagocytized nucleated red blood cells (NRBC) was found to be significantly increased in the patients. Erythrocytes phagocytosis (≥4/1,000 cells) only tended towards significance. Conclusions The blood biomarkers showed better diagnostic performance than the morphological evaluation. Among the different cell lineages engulfed by haemophagocytes, the best diagnostic performance was obtained by phagocytosed mature erythrocytes and immature nucleated erythrocytes.