bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undergraduate Nursing Students’ Attitude and Perception Toward High-Fidelity Simulation-Based Education in a Middle Eastern Country
Authors: Raman Savithri , Arulappan Judie , Zaabi Omar Al , Hashmi Iman Al , Cyril Vincent Sophia , Raghavan Divya , Panchatcharam Sathiyamurthi 
Published: September 2024

Introduction Rapid use of technologically driven simulation environment in teaching–learning has caused mixed feelings among students. High-fidelity simulation-based education is superior in cultivating the knowledge, skills, caring, learning interest, and collaboration among nursing students. However, the nursing students’ attitudes and perceptions toward high-fidelity simulation-based education are unexplored. Objectives The present study aims to explore the attitude and perception of undergraduate nursing students toward high-fidelity simulation-based education. Methods Cross-sectional survey research design was adopted. We used self-administered Education Practices Questionnaire (student version) and Attitude Scale toward Simulation-Based Education to collect the data. A total of 109 nursing students were recruited. Results Nursing student's attitude shows (mean = 68.26); perception on educational practices of high-fidelity simulation-based education demonstrates ( M = 39.33 ± 7.87) and the importance of high-fidelity simulation-based education shows ( M = 37.73 ± 7.45). However, no significant difference observed between the male and female student's attitude ( t = −0.286 [0.78]) and perception ( t [107] = 0.960 [0.34]). Similarly, no significant difference was observed among the different levels of students p > .005 on perception and attitude toward high-fidelity simulation-based education. Conclusion The study proposed to have high-fidelity simulation-based education as an integral part of teaching in clinical training of students at all levels of nursing program.
Descriptive Analysis of Student Diagnostic and Documentation Skill Development in a low Fidelity Simulation in Psychiatric Nurse Practitioner Education
Authors: Guenzel Nicholas , Dai Hongying , Dean Lyndsay 
Published: September 2024

Introduction Nursing educators face challenges in helping registered nurses prepare to be psychiatric nurse practitioners. Nursing educators must consider the variation of students’ skill sets, experience levels, and the shortage of preceptors. Simulations can help overcome limited clinical sites and standardize skill acquisition. High-fidelity simulations can be helpful but are labor-intensive and expensive. Low-fidelity simulations are adaptable to fit the learning needs of psychiatric nurse practitioner students but little research has evaluated these simulations. Objective This paper evaluates a series of low-fidelity interventions used to help students learn diagnostic criteria, treatment decisions, and documentation. Methods A retrospective descriptive analysis was performed on the results of all students in five cohorts in a psychiatric nurse practitioner course ( n=68) on 45 low-fidelity online simulations over five years during the course on advanced psychiatric nursing of adults. Diagnostic notes were graded on four criteria by a psychologist or a psychiatric nurse practitioner. A representative sample of grades on eight notes were analyzed for this manuscript. Survey responses from the students in one cohort were obtained to evaluate their confidence levels and perceptions of simulation utility and responses were analyzed using descriptive and qualitative methods. Results The overall mean of description, detail, completeness, and professionalism increased from 7.6 (out of 10) to 9 over the semester with statistically significant improvements in all four areas. The strongest correlation was between detail and completeness and the weakest correlation was between professionalism and description. Students reported that they found significant value in the low-fidelity simulation exercises. Conclusion This analysis demonstrates one of the first efforts to analyze low-fidelity simulations for psychiatric nurse practitioner students. The data indicate these simulations can help students improve their confidence and skills in several areas.
Case Study: First Ever Visualization of Esophagogastric Junction Following Endoscopic Fundoplication in an Awake Patient Using Magnetically Controlled Capsule Endoscopy
Authors: Fanous Medhat , Lorenson David 
Published: September 2024

Background: Endoscopic retroflexion evaluates the gastroesophageal junction (GEJ) which is traversed by the gastroscope in a sedated patient. Magnetically Controlled Capsule Endoscopy (MCCE) examines the GEJ in a collapsed natural state in awake patients. This report is the first-ever visualization of endoscopic fundoplication status post transoral incisionless fundoplication (TIF) without gastroscope or sedation. Case Description: This patient is a 69-year-old female with recurrent antral gastritis. She underwent laparoscopic hiatal hernia repair and concomitant TIF (cTIF) in 2019. She tolerated swallowing the MCCE capsule well. As we guided the MCCE to evaluate the cardia, we observed the first visualization of a collapsed postoperative TIF valve. She had no adverse events and was discharged 30 minutes post-procedure. Discussion: MCCE has the advantage of avoiding sedation and its risks. There is no need to stop critical medications, including anticoagulants. MCCE has a short duration, enabling the physician to show high-resolution images and discuss the plan with an awake patient who can drive after the procedure. The use of MCCE in evaluating the reconstructed postoperative valve is promising. It enables visualization of the valve in its natural position, can measure the length of the valve, and has the potential to perform dynamic evaluation of the GEJ in an awake patient. Conclusion: The Magnetically Controlled Capsule Endoscopy system evaluates the original and reconstructed gastroesophageal valve in its natural status without sedation. It can potentially enhance the understanding of GERD and its surgical treatment.
Influence of crystal shape and orientation on the magnetic microstructure of bullet-shaped magnetosomes synthesized by magnetotactic bacteria
Authors: Kovács András , Pósfai Mihály , Zingsem Benjamin , Li Zi-An , Pekker Péter , Caron Jan , Prévéral Sandra , Lefèvre Christopher T. , Bazylinski Dennis A. , Frankel Richard B. , Dunin-Borkowski Rafal E. 
Published: September 2024

Abstract
Cells of magnetotactic bacteria are used as model systems for studying the magnetic properties of ferrimagnetic nanocrystals. Each individual bacterial strain produces magnetosomes (membrane-bounded magnetic crystals) that have distinct sizes, shapes, crystallographic orientations and spatial arrangements, thereby providing nanoparticle systems whose unique magnetic properties are unmatched by synthetic chemically-produced crystals. Here, we use off-axis electron holography in the transmission electron microscope to study the magnetic properties of isolated and closely-spaced bullet-shaped magnetite (Fe3O4) magnetosomes biomineralized by the following magnetotactic bacterial strains: the cultured Desulfovibrio magneticus RS-1 and the uncultured strains LO-1 and HSMV-1. These bacteria biomineralize magnetite crystals whose crystallographic axes of elongation are parallel to <100> (RS-1 and LO-1) or <110> (HSMV-1). We show that the individual magnetosome crystals are single magnetic domains and measure their projected in-plane magnetization distributions and magnetic dipole moments. We use analytical modelling to assess the interplay between shape anisotropy and the magnetically preferred <111> magneto-crystalline easy axis of magnetite.
Rates of strokes in Californians with sickle cell disease in the post-STOP era
Authors: Oluwole Olubusola , Brunson Ann M. , Adesina Oyebimpe O. , Willen Shaina M. , Keegan Theresa H. M. , Fertrin Kleber Yotsumoto , Wun Ted 
Published: September 2024

Abstract
Neurovascular complications, including strokes and transient ischemic attacks (TIAs), are common and cause significant morbidity in individuals with sickle cell disease (SCD). The Stroke Prevention Trial in Sickle Cell Anemia (STOP) (1998) established chronic transfusions as the standard of care for children with SCD at high risk for stroke. Using statewide data from the California Department of Health Care Access and Innovation (1991-2019), we determined the cumulative incidence (CMI) and rates of primary and recurrent strokes/TIAs in people with SCD pre- and post-STOP trial. For the 7636 patients included in our SCD cohort, the cumulative incidence of the first ischemic stroke was 2.1% by the age of 20 years and 13.5% by the age of 60 years. The CMI of the first intracranial hemorrhage (ICH) was 0.5% and 6.8% by the age of 20 and 60 years, respectively. Ischemic stroke rates increased in children (age &lt;18 years; 234.9 vs 165.1 per 100 000 patient years [PY]; P = .012) and adults (age 31-50 years; 431.1 vs 303.2 per 100 000 PY; P = .031) in 2010 to 2019 when compared with the preceding decade. There was an increase in the rates of ICH in those aged 18 to 30 years and TIA in children &lt;18 years from 2010 to 2019 when compared with the previous decade. Risk factors for strokes included increasing age, hypertension, and hyperlipidemia. These findings underscore the need for stroke prevention in adults with SCD, suggesting an emphasis on management of modifiable cerebrovascular risk factors that have been proven to be effective in the general population.
Design and Optimization Analysis of an Adaptive Knee Exoskeleton
Authors: Yang Xinhua , Guo Sheng , Wang Peiyi , Wu Yifan , Niu Lianzheng , Liu Duxin 
Published: September 2024

AbstractTo solve the problem of undesired relative motion of human-machine interaction positions caused by misalignment of the human-machine joints rotation axis of the knee exoskeleton, this study designed an adaptive knee exoskeleton based on a gear-link mechanism (GLM) by considering the human body as a component of the exoskeleton mechanism. Simultaneously, the concept of the wearable area (WA) was proposed, which transformed the operation of aligning the exoskeleton rotation axis with the human knee joint rotation axis into a "face alignment point" in the sagittal plane, reducing the difficulty of aligning the human-machine joint rotation axis. In the kinematic analysis of GLM, the phenomenon of instantaneous movement of the central axis of the human knee joint was considered. Based on the kinematic model, the WA, velocity transfer ratio, and initial position static stiffness of GLM were analyzed. The NSGA-II optimization algorithm was used to optimize the size parameters of GLM, which increased the WA by 18.4%, the average velocity transfer ratio by 4.98%, and the average initial position static stiffness by 6.01%. Finally, the ability of the exoskeleton to absorb movement displacement (MD) was verified through simulation, and the good human-machine kinematic compatibility of the exoskeleton was verified through wearable tests conducted on the initial mechanism principle prototype.
High abundance of butyrate-producing bacteria in the naso-oropharynx of SARS-CoV-2-infected persons in an African population: implications for low disease severity
Authors: Akorli Jewelna , Opoku Millicent , Appiah-Twum Francis , Akpo Margaret Sena , Ismail Rahmat Yusif , Boamah Georgina Yaa Kwartemaa , Obeng-Aboagye Elizabeth , Adu-Asamoah Dina , Donkor Irene Owusu 
Published: September 2024

Abstract
Background
The association of the oral microbiome with SARS-CoV-2 infections and disease progression has been documented in European, Asian, and American populations but not in Africa.

Methods
We conducted a study in Ghana to evaluate and compare the naso-oropharyngeal microbiome in SARS-CoV-2-infected and uninfected persons before (pre-vaccine) and after vaccine availability (post-vaccine) in the country. 16S rRNA V3-V4 variable region was sequenced and analysed from DNA extracted from naso-oropharyngeal swabs.

Results
Considering only the infection status, infected and uninfected groups had no difference in their within-group diversity and was evident in the study population pre- and post-vaccine availability. The introduction of vaccines reduced the diversity of the naso-oropharyngeal microbiome particularly among SARS-CoV-2 positive persons and, vaccinated individuals (both infected and uninfected) had higher microbial diversity compared to their unvaccinated counterparts. SARS-CoV-2-positive and -negative individuals were largely compositionally similar varying by 4–7% but considering vaccination*infection statuses, the genetic distance increased to 12% (P = 0.003) and was mainly influenced by vaccination. Common among the pre- and post-vaccine samples, Atopobium and Finegoldia were abundant in infected and uninfected individuals, respectively. Bacteria belonging to major butyrate-producing phyla, Bacillota (particularly class Clostridia) and Bacteroidota showed increased abundance more strikingly in infected individuals before vaccines were available. They reduced significantly after vaccines were introduced into the country with Fusobacterium and Lachnoanaerobaculum being the only common bacteria between pre-vaccine infected persons and vaccinated individuals, suggesting that natural infection and vaccination correlate with high abundance of short-chain fatty acids.

Conclusion
Our results show, in an African cohort, the abundance of bacteria taxa known for their protective pathophysiological processes, especially during infection, suggesting that this population is protected against severe COVID-19. The immune-related roles of the members of Bacillota and Bacteroidota that were found associated with infection and vaccination require further studies, and how these may be linked to ethnicity, diet and age. We also recommend expansion of microbiome–disease association studies across Africa to identify possible bacterial-mediated therapeutics for emerging infections.
Key stakeholders’ perspectives of illicit drug use and associated harms in the Northern Territory of Australia
Authors: Brickley Bryce , Moore Samuel , Tari-Keresztes Noemi , Brand Anthea , Bower Madeleine , Bonson Jason G. , McEntee Alice , Bartram Ashlea J. , Bovopoulos Nataly , McPhie Skye , Martin Craig , Wright Cassandra , Bowden Jacqueline , Smith James A. 
Published: September 2024

Abstract
Background
In the Northern Territory (NT) of Australia, there are significant evidence gaps about illicit drug use and harms, despite having established monitoring and reporting systems. This paper reports on illicit drug use, associated harms, contributing factors, service needs and priorities in the NT from the perspective and experiences of key stakeholders engaged in providing services for, or advocating on behalf of, people who use illicit drugs in the NT.

Methods
Face-to-face and online qualitative interviews were conducted with stakeholders across urban and remote locations in the NT. Key stakeholders were service providers, including acute and primary care clinicians, representatives of Aboriginal community controlled health organisations, lived experience advocates, peak body representatives and public health executives. Qualitative data were analysed thematically.

Results
Four researchers interviewed 21 participants across urban (62%), and remote areas (38%) of the NT. Themes identified were: (1) Illicit drug use and harms are diverse and distinct; (2) Client support needs are complex and influenced by co-morbidities, socio-demographic and cultural factors; (3) Priority population sub-groups need targeted strategies; (4) Local service strengths can be further developed and enhanced; (5) Local services need better resourcing; (6) Invest in progressive legislative and policy reforms; and (7) Improve routine monitoring and evaluation.

Conclusions
Key stakeholders described illicit drug use, harms and contributing factors, which provided insights into the local challenges. Participants emphasised that clients have complex care needs, and further investment into targeted strategies are required to improve service engagement with priority groups. Service needs included greater understanding the role of dual diagnosis and its implementation and enhancing integrated and collaborative care in both primary health and acute care contexts. The voices of people with lived experience captured in this paper must inform local strategy and policy development relating to illicit drug use, in alignment with national strategy.
Effects of high-definition tDCS targeting individual motor hotspot with EMG-driven robotic hand training on upper extremity motor function: a pilot randomized controlled trial
Authors: Hu Chengpeng , Ti Chun Hang Eden , Yuan Kai , Chen Cheng , Khan Ahsan , Shi Xiangqian , Chu Winnie Chiu-wing , Tong Raymond Kai-yu 
Published: September 2024

Abstract
Background
Delivering HD-tDCS on individual motor hotspot with optimal electric fields could overcome challenges of stroke heterogeneity, potentially facilitating neural activation and improving motor function for stroke survivors. However, the intervention effect of this personalized HD-tDCS has not been explored on post-stroke motor recovery. In this study, we aim to evaluate whether targeting individual motor hotspot with HD-tDCS followed by EMG-driven robotic hand training could further facilitate the upper extremity motor function for chronic stroke survivors.

Methods
In this pilot randomized controlled trial, eighteen chronic stroke survivors were randomly allocated into two groups. The HDtDCS-group (n = 8) received personalized HD-tDCS using task-based fMRI to guide the stimulation on individual motor hotspot. The Sham-group (n = 10) received only sham stimulation. Both groups underwent 20 sessions of training, each session began with 20 min of HD-tDCS and was then followed by 60 min of robotic hand training. Clinical scales (Fugl-meyer Upper Extremity scale, FMAUE; Modified Ashworth Scale, MAS), and neuroimaging modalities (fMRI and EEG-EMG) were conducted before, after intervention, and at 6-month follow-up. Two-way repeated measures analysis of variance was used to compare the training effect between HDtDCS- and Sham-group.

Results
HDtDCS-group demonstrated significantly better motor improvement than the Sham-group in terms of greater changes of FMAUE scores (F = 6.5, P = 0.004) and MASf (F = 3.6, P = 0.038) immediately and 6 months after the 20-session intervention. The task-based fMRI activation significantly shifted to the ipsilesional motor area in the HDtDCS-group, and this activation pattern increasingly concentrated on the motor hotspot being stimulated 6 months after training within the HDtDCS-group, whereas the increased activation is not sustainable in the Sham-group. The neuroimaging results indicate that neural plastic changes of the HDtDCS-group were guided specifically and sustained as an add-on effect of the stimulation.

Conclusions
Stimulating the individual motor hotspot before robotic hand training could further enhance brain activation in motor-related regions that promote better motor recovery for chronic stroke.

Trial registration
This study was retrospectively registered in ClinicalTrials.gov (ID NCT05638464).
WHO-recommended levels of physical activity in relation to mammographic breast density, mammographic tumor appearance, and mode of detection of breast cancer
Authors: Boraka Öykü , Sartor Hanna , Sturesdotter Li , Hall Per , Borgquist Signe , Zackrisson Sophia , Rosendahl Ann H. 
Published: September 2024

Abstract
Background
Despite known benefits of physical activity in reducing breast cancer risk, its impact on mammographic characteristics remain unclear and understudied. This study aimed to investigate associations between pre-diagnostic physical activity and mammographic features at breast cancer diagnosis, specifically mammographic breast density (MBD) and mammographic tumor appearance (MA), as well as mode of cancer detection (MoD).

Methods
Physical activity levels from study baseline (1991–1996) and mammographic information from the time of invasive breast cancer diagnosis (1991–2014) of 1116 women enrolled in the Malmö Diet and Cancer Study cohort were used. Duration and intensity of physical activity were assessed according to metabolic equivalent of task hours (MET-h) per week, or World Health Organization (WHO) guideline recommendations. MBD was dichotomized into low-moderate or high, MA into spiculated or non-spiculated tumors, and MoD into clinical or screening detection. Associations were investigated through logistic regression analyses providing odds ratios (OR) with 95% confidence intervals (CI) in crude and multivariable-adjusted models.

Results
In total, 32% of participants had high MBD at diagnosis, 37% had non-spiculated MA and 50% had clinical MoD. Overall, no association between physical activity and MBD was found with increasing MET-h/week or when comparing women who exceeded WHO guidelines to those subceeding recommendations (ORadj 1.24, 95% CI 0.78–1.98). Likewise, no differences in MA or MoD were observed across categories of physical activity.

Conclusions
No associations were observed between pre-diagnostic physical activity and MBD, MA, or MoD at breast cancer diagnosis. While physical activity is an established breast cancer prevention strategy, it does not appear to modify mammographic characteristics or screening detection.
The effect of cessation of drinking water fluoridation on dental restorations and crowns in children aged 3–5 years in Israel – a retrospective study
Authors: Nezihovski Shiran Shemesh , Findler Mordechai , Chackartchi Tali , Mann Jonathan , Haim Doron , Tobias Guy 
Published: September 2024

Abstract
Background
Community water fluoridation began in the 1945 as a public health measure to prevent and control caries and was implemented in Israel in 1981. Community water fluoridation reduced caries significantly, but in 2014, the Ministry of Health decided to stop Community water fluoridation in Israel. The aim of our study was to examine the effect of fluoridation cessation on the dental health of children aged 3–5, treated in “Assuta Tel Aviv” dental clinics, under general anesthesia or deep sedation.

Methods
The computerized Maccabi-Dent database provided data for this retrospective study. Records from the years 2014–2019 including treatment codes for procedures relevant to the study, the number of stainless-steel crowns and restorations of all types were examined. Kruskal-Wallis test was performed to compare the results from before and after fluoridation cessation.

Results
A statistically significant increase in the mean number of treatments in the years after fluoridation cessation (P < 0.05) was found. There was approximately a two-fold increase in the number of all treatments for all ages.

Conclusion
The results of the study emphasize the advantages of water fluoridation and are further proof of the need to restore community water fluoridation in Israel.