bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacists perspectives on challenges and facilitators in initiating medications take-back program in Indonesia: A qualitative study
Authors: Alfian Sofa D , Azzahra Annisa M , Khoiry Qisty A , Griselda Meliana , Puspitasari Irma M , Abdulah Rizky 
Published: October 2024

Objective: The establishment of a medication take-back program is an important intervention to prevent the improper disposal of expired or unused household medications. However, such a program has not been established in Indonesia. A significant step in establishing the program is to gain a better understanding of pharmacists’ perspectives on the associated challenges and facilitators. Therefore, this study aimed to explore pharmacists’ perspectives on the associated challenges and facilitators in initiating medications take-back program in Indonesia. Methods: This qualitative study was conducted through Key Informant Interviews with a purposive sample of nine pharmacists working in community health centers (CHC) in Bandung City, Indonesia. The discussions were transcribed, coded, and analyzed using Atlas.ti9 software. Results: Pharmacists’ perspectives on initiating medications take-back program were categorized into two main themes, including challenges and facilitators. The identified challenges comprised a lack of personnel, financial constraints, geographical constraints, lack of facilities, and inadequate knowledge. Meanwhile, the facilitators included the good responsibility of pharmacists, incentives, and convenient locations. Conclusion: The identified challenges and facilitators should be considered when initiating medication take-back programs in Indonesia.
Infraspinatus muscle necrosis in a cat with primary hyperaldosteronism
Authors: Otani Go , Ohta Hiroshi 
Published: October 2024

Case summary Persistent and progressive weakness secondary to hypokalaemia, that is, hypokalaemic polymyopathy, is one of the most common clinical signs of primary hyperaldosteronism (PHA). Herein, we report a case of PHA with infraspinatus muscle necrosis. A 5-year-old castrated male domestic shorthair cat presented with a history of polyuria and polydipsia, decreased activity, staggering gait, difficulty in jumping and inward rotation of both forelimbs. Blood examination revealed hypokalaemia, increased serum creatinine kinase activity and high serum aldosterone concentration. Abdominal ultrasonography and CT revealed an enlarged right adrenal gland. Post-contrast thoracic CT showed peripheral contrast enhancement and a non-enhanced centre in the bilateral infraspinatus muscles. From the day of initial presentation, the cat was started on oral potassium replacement therapy. On day 17, the right adrenal gland was surgically resected and the left infraspinatus muscle was biopsied. Histopathological examination confirmed the presence of an adrenocortical adenoma in the right adrenal gland and necrosis of the muscle fibres in the left infraspinatus muscle. On day 29, all clinical signs had disappeared, and the serum potassium concentration, creatinine kinase activity and aldosterone concentration had normalised. On day 57, atrophy of the bilateral infraspinatus muscles was noted, but there was no evidence of any posture or gait abnormalities. Relevance and novel information To the authors’ knowledge, this is the first report of possible infraspinatus muscle necrosis in a cat with PHA. It is also possible that the infrinatus muscle necrosis with hypokalaemic polymyopathy secondary to PHA was caused by compartment syndrome in the cat described here.
Transformer-based active learning for multi-class text annotation and classification
Authors: Afzal Muhammad , Hussain Jamil , Abbas Asim , Hussain Maqbool , Attique Muhammad , Lee Sungyoung 
Published: October 2024

Objective Data-driven methodologies in healthcare necessitate labeled data for effective decision-making. However, medical data, particularly in unstructured formats, such as clinical notes, often lack explicit labels, making manual annotation challenging and tedious. Methods This paper introduces a novel deep active learning framework designed to facilitate the annotation process for multiclass text classification, specifically using the SOAP (subjective, objective, assessment, plan) framework, a widely recognized medical protocol. Our methodology leverages transformer-based deep learning techniques to automatically annotate clinical notes, significantly easing the manual labor involved and enhancing classification performance. Transformer-based deep learning models, with their ability to capture complex patterns in large datasets, represent a cutting-edge approach for advancing natural language processing tasks. Results We validate our approach through experiments on a diverse set of clinical notes from publicly available datasets, comprising over 426 documents. Our model demonstrates superior classification accuracy, with an F1 score improvement of 4.8% over existing methods but also provides a practical tool for healthcare professionals, potentially improving clinical documentation practices and patient care. Conclusions The research underscores the synergy between active learning and advanced deep learning, paving the way for future exploration of automatic text annotation and its implications for clinical informatics. Future studies will aim to integrate multimodal data and large language models to enhance the richness and accuracy of clinical text analysis, opening new pathways for comprehensive healthcare insights.
Hip Fracture Patterns, Hospital Course, and Mortality Differ Between Males and Females
Authors: Doxey Stephen A. , Kibble Kendra , Kleinsmith Rebekah M. , Huyke-Hernández Fernando A. , Switzer Julie A. , Cunningham Brian P. 
Published: October 2024

Introduction The purpose of this study was to describe how hip fractures differentially affect male and female patients regarding fracture pattern, hospital course, and postoperative course. Materials and Methods This retrospective case series was performed in a metropolitan healthcare system involving 2996 hip fracture patients >59 years old who underwent surgical management (eg, intramedullary nail, hemiarthroplasty, percutaneous pinning, etc.). Male patients were matched to female patients using 1:2 nearest neighbor matching on the basis of age and Charlson Comorbidity Index. Outcomes of interest included AO/OTA fracture classification, 30- and 90-day readmission, and 30-day and 1-year mortality rates. Results The cohort was predominantly female (64.5%). Female patients were more likely to sustain a type 31A fracture compared to males ( P = .016). The average CCI was higher for males vs females (3.0 ± 2.5 vs 2.6 ± 2.3, P < .001). Males were more likely to be readmitted at 30 ( P < .001) and 90 ( P = .015) days after discharge. The 30-day mortality was higher for males vs females (6.6% vs 4.5%, P = .015). Approximately 19.9% of male patients vs 15.1% of females died within a year of surgery ( P < .001). The average time to surgery was longer for males vs females (23.8 ± 18.8 vs 22.5 ± 21.9 h, P = .048). Males were more likely to die within a year if they underwent surgery >24 h after admission ( P = .029). Discussion Hip fractures have different implications for male and female patients. With age, the incidence of IT fractures increased in females, while it decreased in males. On average, males with hip fractures are sicker than females, which likely contributes to the longer time to surgery as well as increased readmission and mortality rates seen in males. Conclusions Male and female hip fracture patients are not similar in baseline health status, fracture pattern, or postoperative morbidity and mortality. Orthogeriatricians and other providers that care for this patient population should be aware of these differences when implementing treatment strategies to optimize the recovery of their patients, and while educating patients and their families about postoperative expectations.
Cross-Cultural Adaptation and Validation of the Thai Version of the Knee Injury and Osteoarthritis Outcome Score for Patellofemoral Pain and Osteoarthritis (KOOS-PF)
Authors: Reosanguanwong Kongpob , Suphakitchanusan Wasaphon , Lertwanich Pisit 
Published: October 2024

Background: The Knee injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF) is a condition-specific patient-reported outcome measure that is used to evaluate patients with patellofemoral pain. Purpose: To translate the KOOS-PF into the Thai language, to make necessary adaptations to a Thai cultural context, and to assess the measurement properties of the Thai version of the KOOS-PF (TH-KOOS-PF) using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: This study was conducted between December 2021 and May 2023. Language translation of the KOOS-PF was performed according to guidelines for the cross-cultural adaptation of self-report measures. Eligible participants aged 18 to 50 years were asked to complete various patient-reported outcome measures including the TH-KOOS-PF at 3 time points: baseline, 2 weeks after baseline for test-retest reliability analysis, and 2 months after baseline for responsiveness assessment. Results: The KOOS-PF was successfully translated and culturally adapted to create the TH-KOOS-PF. A total of 86 participants (mean age, 37.0 ± 8.1 years; 59.3% female) with patellofemoral pain participated in the validation process. Construct validity of the TH-KOOS-PF was demonstrated by confirmation of all a priori hypotheses. The standardized Cronbach alpha coefficient was 0.88 (95% CI, 0.83-0.91), which indicated good internal consistency. Test-retest reliability was high, with an intraclass correlation coefficient of 0.87 (95% CI, 0.77-0.92). The TH-KOOS-PF demonstrated good responsiveness, as evidenced by all predefined hypotheses’ being confirmed, and there were no floor or ceiling effects. Using an anchor-based approach, the minimal clinically important difference was 11.6 points. Conclusion: The results of this study revealed the TH-KOOS-PF to be a valid, reliable, and responsive tool for assessing Thai patients with patellofemoral pain. The TH-KOOS-PF will be useful in both clinical and research settings.
The Difference in Achilles Tendon Loading within Immobilizing Boots Based on Ankle Angle, Boot Type, and Walking Speed
Authors: Hullfish Todd J. , Woods Madison M. , Kwon Michelle P. , Boakye Lorraine A.T. , Humbyrd Casey Jo , Baxter Josh R. 
Published: October 2024

Background: Achilles tendon rupture is an increasingly common injury treated with progressive rehabilitation in an immobilizing boot. However, it is poorly understood how ankle angle, boot type, and walking speed affect Achilles tendon loading. Hypothesis: These different parameters would affect Achilles tendon loading in terms of (from greatest to least) ankle angle constraint, immobilization style, boot construction, and walking speed. Study Design: Descriptive laboratory study Methods: Ten healthy young adults (8 women and 2 men; age, 21 ± 2 years; body mass index, 21.5 ± 3.0 kg/m2) walked in 3 different immobilizing boots at self-selected slow, medium, and fast walking speeds. The authors estimated Achilles tendon loading using a 3-part instrumented insole within the immobilizing boot. The authors averaged tendon load across every stride for each condition and calculated 2-sided bootstrap confidence intervals. Peak tendon loading was compared across all boots, ankle angles, and walking speeds. Results: All boots and immobilization styles decreased tendon loading with respect to shod walking. Immobilization angle had the largest effect on tendon loading, followed by boot construction, and finally walking speed. Conclusion: Ankle angle, boot type, and walking speed can be modified to change loading progression during rehabilitation. Clinical Relevance: Understanding how immobilization affects tendon loading will enable clinicians to modify rehabilitation to improve functional outcomes.
Changes in Prevalence and Phenotype of Hypertension in Children Suspected of Hypertension Using the 2022 American Heart Association Guidelines
Authors: Nimkarn Norrarath , Pirojsakul Kwanchai , Chantarogh Songkiat , Saisawat Pawaree , Tangnararatchakit Kanchana 
Published: October 2024

Objective The American Heart Association (AHA) launched the 2022 guidelines for the diagnosis of hypertension (HT) by ambulatory blood pressure monitoring (ABPM). The present study aimed to evaluate the impacts of the 2022 AHA guidelines on the changes in the prevalence and phenotype of HT in children suspected of HT. Methods Consecutive 100 children aged 6 to 20 suspected of HT who underwent 24-hour ABPM were recruited. The patients were separated into 3 groups: escalated, de-escalated, and unchanged. Demographic data were compared between the 3 groups. Logistic regression analysis was performed to evaluate the factors associated with the escalation in the diagnosis of HT. Results The present study revealed that the prevalence of HT, including sustained and masked HT, increased from 48% by the 2014 AHA guidelines to 65% by the 2022 AHA guidelines. Patients in the escalated group tended to have a higher proportion of male gender, with an older age and a taller height compared to those in the de-escalated group. Multivariate analysis showed that height was the only factor associated with the escalation in the diagnosis of HT [OR 1.09 (1.01-1.19), P-value .04]. Five out of 6 (83.3%) patients in the escalated group with available echocardiographic results had left ventricular hypertrophy (LVH). Conclusion Using the 2022 AHA guidelines resulted in more detection of patients with HT, and almost 30% of the escalated group had LVH. This finding supports using the 2022 AHA guidelines to detect children at risk of developing cardiovascular diseases early.
Microbial extracellular polymeric substances (EPS) in soil: From interfacial behaviour to ecological multifunctionality
Authors: Zhang Ming , Wu Yichao , Qu Chenchen , Huang Qiaoyun , Cai Peng 
Published: October 2024

Abstract
Extracellular polymeric substances (EPS) are high molecular weight polymers that microorganisms secrete into their extracellular environment. EPS serves as the carrier of the structural integrity of microbial biofilms, determining the physicochemical properties and the functional complexity of biofilms. EPS creates an ideal environment for interfacial reactions and nutrient trapping around microbial cells, while also acting as a buffer zone against environmental stresses. EPS in soil can contribute to soil health through its own properties such as adhesion, hygroscopicity and complexing ability. Here, we first introduce the concept, components, properties and controlled factors of EPS in the soil environment, and outline current advances in extraction methods and characterization techniques for soil EPS. EPS form a dynamic biophysical-chemical interface between microbes and the soil matrix. We explore the role of EPS in the colonization and survival of microorganisms, aggregation and weathering of soil minerals, and cross-linking with soil organic matter. We then summarize the soil ecological functions of microbial EPS: 1) promoting aggregate formation and stabilization; 2) enhancing water retention and holding capacity; 3) mediating nutrient storage and trapping; and 4) regulating contaminant sequestration and transformation. Finally, we propose several future research interests for microbial EPS in soil, thereby calling for more attention and research on microbial EPS and its functions in soil ecosystems, and exploring their potential applications in the development of environment-friendly agriculture.
Lung function during infancy and preschool age
Authors: Carlsen K-H. 
Published: October 2024

Educational aimsTo analyse lung function techniques developed for preschool children and infants.To compare lung function techniques used in adults and children.To discuss the possibility of using equipment from childhood through to adulthood.SummaryMeasurements of pulmonary function are among the most important measurements in respiratory medicine, both in clinical and research work. Despite the rapid technological development during recent decades, we still struggle with a major obstacle in understanding the natural history of the lungs and airways; namely our inability to use one method and one piece of equipment from birth through childhood to adulthood.Thus, various methods measuring, at best, approximations of similar mechanical or physical properties within the lungs and airways will have to be compared at different time-points to the best of our abilities. Recent studies have begun to report extensive work from many research groups addressing the acceptability and reproducibility of spirometry among preschool children.
Suppression of virulence factors of uropathogenic Escherichia coli by Trans-resveratrol and design of nanoemulgel
Authors: ElFeky Dalia Saad , Kassem Abeer Ahmed , Moustafa Mona A. , Assiri Hanan , El-Mahdy Areej M. 
Published: October 2024

Abstract
Background
Development of multidrug resistance in Uropathogenic Escherichia coli (UPEC) makes treatment of Urinary Tract Infections (UTIs) a major challenge. This study was conducted to investigate the effect of trans-resveratrol (t-RSV) at a subinhibitory concentration (sub-MIC-t-RSV) on phenotypic and genotypic expression of virulence factors of clinical isolates of UPEC and develop a nanoformulation of t-RSV. Fifty-five clinical UPEC strains were investigated for the presence of virulence factors by phenotypic methods and PCR detection of virulence genes. The effect of sub-MIC-t-RSV was studied on the phenotypic and genotypic expression of virulence factors. t-RSV-loaded nanoemulgel formulation was prepared and characterized.

Results
Out of the 55 tested isolates, 50.9% were biofilm producers, 23.6% showed both mannose-sensitive and mannose-resistant hemagglutination, 21.8% were serum-resistant, 18.2% were hemolysin producers, while 36.4% showed cytotoxic effect on HEp-2 cells. A total of 25.5% of the isolates harbor one or more of hly-A, cnf-1 and papC genes, while 54.5% were positive for one or more of fimH, iss and BssS genes. A concentration of 100 µg/mL of t-RSV effectively downregulates the phenotypic and genotypic expression of the virulence factors in positive isolates. A stable t-RSV-nanaoemulgel with droplet size of 180.3 nm and Zetapotential of -46.9 mV was obtained.

Conclusion
The study proves the effective role of t-RSV as an antivirulence agent against clinical UPEC isolates in vitro and develops a stable t-RSV-nanoemulgel formulation to be assessed in vivo. The promising antibacterial and antivirulence properties of t-RSV place this natural compound to be a better alternative in the treatment of persistent UTIs.
Collaborative governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector: a synthesis of stakeholder perspectives
Authors: Muntalima Nelly Claire , Silumbwe Adam , Zulu Joseph Mumba , Mweemba Chris , Hangoma Peter 
Published: October 2024

Abstract
Background
Many low-and middle-income countries have adopted social health insurance schemes. However, the collection of contributions from the large informal sector of these economies poses a significant challenge. Employing an integrated system of contribution collection from all relevant institutions may be cost-effective. We used the integrative framework for collaborative governance, to explore and explain factors that may shape the governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector in Zambia.

Methods
We undertook a qualitative case study involving 25 key informants drawn from government ministries and institutions, cooperating partners, non-governmental organizations, and association representatives in the informal sector. Data were analyzed thematically using Emerson’s integrative framework for collaborative governance.

Results
The main drivers of collaboration included a need for comprehensive policies and legislation to oversee the integrated system for contribution collection, prevent redundancy, reduce costs, and enhance organizational effectiveness. However, challenges such as leadership issues and coordination complexities were noted. Factors affecting principled engagement within the collaborative regime consisted of communication gaps, organizational structure disparities, and the adoption of appropriate strategies to engage the informal sector. Additionally, factors influencing shared motivation involved concerns about power dynamics, self-interests, trust issues, corruption, and a lack of common understanding of the informal sector.

Conclusion
This study sheds light on a multitude of factors that may shape collaborative governance of an integrated system for contribution collection for social health insurance, pension, and taxes from the informal sector, providing valuable insights for policymakers and implementers alike. Expanding social health insurance coverage to the large but often excluded informal sector will require leveraging factors identified in this study to enhance collaboration with pension and tax subsystems.
Resilient health care performance in the real world: fixing problems that never happened
Authors: Braithwaite Jeffrey , Churruca Kate , Ellis Louise A. , Leask Elle , Long Janet C. , Sarkies Mitchell , Zurynski Yvonne , Clay-Williams Robyn 
Published: October 2024

Abstract
Background
Staff in health systems everywhere have exhibited flexibility and a capacity for improvisations during, and in response to, the COVID-19 pandemic. Looking to other examples of such resilient behaviours outside of those induced by the pandemic is instructive for those involved with researching or understanding change, or making health systems improvements.

Methods
Here, we synthesise and then assess the value of eight case studies of in situ resilient performance from Canada, Sweden, Japan, Belgium, the United Kingdom, Norway, the United States and Brazil. The cases are divided into four categories: responsiveness to a crisis; adaptiveness over time; local adoption in accommodating to a top down, national policy change; and the consequential outcomes of an intervention.

Results
The cases illuminate the resourcefulness of translational and social researchers in examining such behaviours and practices. More than that, they also foreground the ingenuity and adaptive capacity of staff on-the-ground who continually anticipate, respond and adapt to make systems work and provide continuous care in the face of many challenges, including resource deficiencies, policy misalignments, and new technologies, policies and procedures that need to be integrated into local workflows. Front line clinicians make care systems work, pre-empting issues and sorting out problems before they occur or as they arise.

Conclusions
A key lesson amongst a range of findings is that, rather than focusing on shiny new tools of change (checklists, frameworks, policy mandates), it is much more insightful and satisfying to deeply apprehend care at the sharp end, where clinicians deliver care to patients, understanding how everyday work is executed. This, rather than the Health Ministry, the Boardroom, or the Management Consultant’s office, is where and how change is being enabled, and where street level actors solve problems, thwart issues in advance, and constantly avoid pitfalls.