bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physicians’ training and patient education initiative to improve quality of care decision communication at the emergency department
Authors: Briedé Saskia , van Charldorp Tessa C , Peerden Joppe P , Kaasjager Karin AH 
Published: September 2024

BackgroundDiscussions about care decisions, including code status documentation and advance care planning, are crucial components of patient-centred care. However, due to numerous barriers, these discussions are often avoided by both physicians and patients. As a result, these discussions often take place at the emergency department (ED). We aimed to improve the quality of care decision conversations in the internal medicine ED.MethodsThis pre–post intervention study was conducted at the internal medicine ED of a tertiary hospital in the Netherlands. Two interventions were implemented simultaneously: physician training and patient education. Physician training included an e-learning module and simulated patient sessions. Patients received a leaflet providing information about care decisions. Primary outcome was patient satisfaction with the care decision discussions, assessed using the Quality of Communication questionnaire. Secondary outcomes included the percentage of patients recalling a care decision discussion, initiator of the discussion, leaflet recall, leaflet evaluation, prior care decision discussions and perceived appropriate timing for discussions.Results333 patients participated, 149 before and 184 after the interventions. Postintervention, there were significant improvements in patient-reported quality of care decision communication (p<0.001) and more patients recalled having care decision discussions (63.7% vs 45.9%, p=0.001). However, only 12% of patients recalled receiving the leaflet.ConclusionsImplementation of physician training and patient education significantly improved the quality of care decision conversations in our internal medicine ED. Despite low leaflet recall, the interventions demonstrated a notable impact on patient satisfaction with care decision discussions. Future research could explore alternative patient education methods and involve other healthcare professionals in initiating discussions. These findings underscore the importance of ongoing efforts to enhance communication in healthcare settings, particularly in emergency care.
Prevention in adults of transmission of infection with multidrug-resistant organisms: an updated systematic review from Making Healthcare Safer IV
Authors: McCarthy Sean , Motala Aneesa , Shekelle Paul G 
Published: September 2024

BackgroundHealthcare-associated infections due to multidrug-resistant organisms (MDROs) remain a high priority patient safety topic, despite broad acceptance as standard-of-care safety practices to prevent central line-associated bloodstream infection, catheter-associated urinary tract infection and ventilator-associated pneumonia. Prior editions of Making Healthcare Safer have mixed certainty evidence for various other patient safety practices.ObjectivesAs part of Making Healthcare Safer IV, we performed an updated systematic review on the certainty of evidence for the following safety practices at reducing in-facility MDRO infections in adult patients: universal gloving, contact precautions, cohorting, environmental decontamination, patient decolonisation and the adverse effects of isolation.MethodsWe searched PubMed and the Cochrane Library 2011–May 2023 for systematic reviews and original research studies, both randomised and observational. Settings were limited to high-income countries. Screening and eligibility were done in duplicate, while data extraction was done by one reviewer and checked by a second reviewer. The synthesis of results is narrative. Certainty of evidence was based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework.ResultsThree systematic reviews and three original research studies provided moderate certainty evidence that patient decolonisation reduced MDRO infections, although restricted to certain populations and organisms. One systematic review provided low certainty evidence that universal gloving was beneficial, again limited to certain populations. One systematic review and two original research studies provided low certainty evidence of benefit for environmental decontamination. One systematic review and one new original study provided low certainty evidence of benefit for cohorting in outbreak settings, and very low certainty evidence of benefit in endemic settings. Six original research studies provide mixed evidence for benefit of contact precautions. There is very low certainty evidence of a signal of increased non-infectious adverse events under patients in contact isolation.ConclusionIn general, the reviewed patient safety practices reduced MDRO infections, but certainty of evidence was low.PROSPERO registration numberCRD42023444973.
Cyclotron Radiation Emission Spectroscopy
Authors: Oblath Noah S. , VanDevender Brent A. 
Published: September 2024

Major advances in experimental nuclear and particle physics are often motivated by the need to answer challenging questions. In 2009, Monreal and Formaggio were motivated by the problem of measuring the absolute mass of the neutrino to propose the technique that would come to be called cyclotron radiation emission spectroscopy (CRES). They needed to measure the energies of the electrons from tritium beta decay with extremely high precision, which could be achieved by measuring the frequency of the cyclotron radiation from many individual magnetically trapped electrons. The technique was put into practice first by the Project 8 Collaboration and then by the He6-CRES Collaboration for the study of nonstandard weak interactions. In this review, we present the CRES experiments that have been performed to date, describe the phenomenology of CRES that has so far been explored, and cover potential applications of CRES that have been proposed.
Whole Exome Sequencing in Children With Type 1 Diabetes Before Age 6 Years Reveals Insights Into Disease Heterogeneity
Authors: Ribeiro Andreia Fiúza , Fitas Ana Laura , Pires Marcela Oliveira , Matoso Paula , Ligeiro Dário , Sobral Daniel , Penha-Gonçalves Carlos , Demengeot Jocelyne , Caramalho Íris , Limbert Catarina 
Published: September 2024

Aims: This study is aimed at comparing whole exome sequencing (WES) data with the clinical presentation in children with type 1 diabetes onset ≤ 5 years of age (EOT1D).Methods: WES was performed in 99 unrelated children with EOT1D with subsequent analysis to identify potentially deleterious rare variants in MODY genes. High‐resolution HLA class II haplotyping, SNP genotyping, and T1D‐genetic risk score (T1D‐GRS) were also evaluated.Results: Eight of the ninety‐nine EOT1D participants carried a potentially deleterious rare variant in a MODY gene. Rare variants affected five genes: GCK (n = 1), HNF1B (n = 2), HNF4A (n = 1), PDX1 (n = 2), and RFX6 (n = 2). At diagnosis, these children had a mean age of 3.0 years, a mean HbA1c of 10.5%, a detectable C‐peptide in 5/8, and a positive islet autoantibody in 6/7. Children with MODY variants tend to exhibit a lower number of pancreatic autoantibodies and a lower fasting C‐peptide compared to EOT1D without MODY rare variants. They also carried at least one high‐risk DR3‐DQ2 or DR4‐DQ8 haplotype and exhibited a T1D‐GRS similar to the other individuals in the EOT1D cohort, but higher than healthy controls.Conclusions: WES found potentially deleterious rare variants in MODY genes in 8.1% of EOT1D, occurring in the context of a T1D genetic background. Such genetic variants may contribute to disease precipitation by a β‐cell dysfunction mechanism. This supports the concept of different endotypes of T1D, and WES at T1D onset may be a prerequisite for the implementation of precision therapies in children with autoimmune diabetes.
Polygenic Scoring for Detection of Ascending Thoracic Aortic Dilation
Authors: DePaolo John , Biagetti Gina , Judy Renae , Wang Grace J. , Kelly John J. , Iyengar Amit , Goel Nicholas J. , Desai Nimesh D. , Szeto Wilson Y. , Bavaria Joseph E. , Levin Michael G. , Damrauer Scott M. 
Published: September 2024

BACKGROUND:
Ascending thoracic aortic dilation is a complex heritable trait that involves modifiable and nonmodifiable risk factors. Polygenic scores (PGS) are increasingly used to assess risk for complex diseases. The degree to which a PGS can improve aortic diameter prediction in diverse populations is unknown. Presently, we tested whether adding a PGS to clinical prediction algorithms improves performance in a diverse biobank.

METHODS:
The analytic cohort comprised 6235 Penn Medicine Biobank participants with available echocardiography and clinical data linked to genome-wide genotype data. Linear regression models were used to integrate PGS weights derived from a genome-wide association study of thoracic aortic diameter performed in the UK Biobank and were compared with the performance of the previously published aorta optimized regression for thoracic aneurysm (AORTA) score.

RESULTS:
Cohort participants had a median age of 61 years (IQR, 53–70) and a mean ascending aortic diameter of 3.36 cm (SD, 0.49). Fifty-five percent were male, and 33% were genetically similar to an African reference population. Compared with the AORTA score, which explained 30.6% (95% CI, 29.9%–31.4%) of the variance in aortic diameter, AORTA score+UK Biobank–derived PGS explained 33.1%, (95% CI, 32.3%–33.8%), the reweighted AORTA score explained 32.5% (95% CI, 31.8%–33.2%), and the reweighted AORTA score+UK Biobank–derived PGS explained 34.9% (95% CI, 34.2%–35.6%). When stratified by population, models including the UK Biobank–derived PGS consistently improved upon the clinical AORTA score among individuals genetically similar to a European reference population but conferred minimal improvement among individuals genetically similar to an African reference population. Comparable performance disparities were observed in models developed to discriminate cases/noncases of thoracic aortic dilation (≥4.0 cm).

CONCLUSIONS:
We demonstrated that inclusion of a UK Biobank–derived PGS to the AORTA score confers a clinically meaningful improvement in model performance only among individuals genetically similar to European reference populations and may exacerbate existing health care disparities.
Views of Polish High School Students on the Criteria for Assessing Farm Animal Welfare
Authors: Stępnik Konrad , Adamczyk Krzysztof , Łapczyński Mariusz , Opala Aleksandra 
Published: September 2024

Abstract
We surveyed young people’s opinions on the criteria for assessing farm animal welfare, which provided information on how they understand the human-animal relationship. Among the Polish high school students surveyed, the prevailing opinion was that the most important criterion for assessing farmed animals’ welfare is their sentience. Most respondents considered the method of housing to be the least important criterion. Among high school students, the dominant belief was that animals are capable of suffering. Respondents differed mainly in their beliefs about the intensity of emotions and suffering experienced by nonhuman vertebrates. These differences affected the dietary choices of young people and their willingness to take actions that indirectly contribute to ensuring a higher level of animal welfare. The results of the research indicate the need to consider the perspective of young people as a specific social category in debates on welfare.
Age and growth rate estimated by skeletochronology in loggerhead sea turtles from French Mediterranean waters
Authors: Medetian Dimitri , Miaud Claude 
Published: September 2024

Abstract
Skeletochronology was used to determine the ages of 30 loggerhead sea turtles (Caretta caretta) found in French Mediterranean waters. Histological sections were performed with 30 humeri collected on stranded C. caretta on the coast of Provence and the Gulf of Lion. Lines of arrested growth (LAGs) were used to evaluate age, considering only one period of arrested growth per year. Two successive LAGs delimit an interval that is proportional to the individual’s body growth. In a first step, we created a skeletogram for each individual that identified its LAGs. Secondly, we measured the areas delineating successive intervals to determine individual growth patterns over the years. Two methods were used to deduce sea turtle age from histological sections: the correction factor (CF) method and the growth rate (GR) method, the latter using Von Bertalanffy growth function. Age estimations varied from 4.3 to 24.7 years (mean ± SD = 10.1 ± 4.8) with the CF method and from 6.2 to 25.6 years (mean ± SD = 12.2 ± 5.2) with the GR method, with no significant difference between the methods. The study sample was thus mostly composed of juveniles, which is also the most frequent life stage observed in the study area. The annual curved carapace length growth rate calculated with every LAG interval varied from 1.0 to 6.9 cm/year (mean ± SD = 3.5 ± 1.4, ). High variability in interindividual growth rates were observed, which is of interest in understanding the complex lifecycle of these long-lived marine reptiles.
Time Metaphors in the Menologium
Authors: Castaño Emilia , Verdaguer Clavera Isabel 
Published: September 2024

Abstract
This article explores the predominant metaphorical construals of time in the Menologium. Drawing on Conceptual Metaphor Theory and previous research on the role of space and motion in the conceptualization of time in Modern English and Old English, the Menologium is analyzed from a linguistic point of view to get an insight into how conventional time metaphors were used to describe the course of the Anglo-Saxon liturgical year. This analysis shows a persistent metaphorical link between time, motion and the circular and sagittal – front-back – spatial axes reflected in the use of lexical items such as the preposition ymb or motion verbs to describe the passing of time. The result is a complex time model which is simultaneously cyclical and linear, where days, months and years are conceptualized as circular but also bounded time units sequentially proceeding towards a stationary observer, the reader. In this view the various parts of a year and liturgical feasts are seen as periodically recurring in a time framework that also sees each point in time as unique. This analysis of the Menologium complements previous studies of the poem with a conceptual metaphor approach in which cognitive linguistics is brought to bear on literary analysis.
Compulsory Community Treatment Orders and health outcomes for Māori in New Zealand
Authors: Beaglehole Ben , Frampton Chris , Newton-Howes Giles , Kirikiri Arahia , Lacey Cameron 
Published: September 2024

Background: We have previously analysed outcomes for all community treatment orders commenced during a 10-year period in New Zealand. Given Te Tiriti O Waitangi obligations to scrutinise health and consider equity for Māori, we completed this analysis to consider community treatment-order outcomes according to ethnicity. Methods: Ministry of Health databases provided demographic, service use and medication dispensing data for community treatment-order recipients between 2009 and 2018. As non-Māori on community treatment orders are older, less deprived and less likely to be diagnosed with a Psychotic Disorder, data were categorised according to age (<35/⩾35 years), level of deprivation (New Zealand Dep levels ⩽3, 4–6 and ⩾7) and diagnosis (Psychotic Disorder/non-Psychotic Disorder). The incidences of key outcome measures (admissions, community care, medication dispensing) were calculated for periods on/off community treatment orders for Māori and non-Māori to consider the differential impact of community treatment orders according to ethnicity. Results: Māori have high rates of community treatment order utilisation and are younger, more likely to be diagnosed with a Psychotic Disorder and spend longer receiving compulsory treatment than non-Māori. Non-Māori are more likely to receive more additional depot antipsychotic medication on–community treatment orders compared with periods off-community treatment order than Māori but other clear patterns of response distinguishing between Māori and non-Māori were not present. Conclusion: The differences between Māori and non-Māori for community treatment-order utilisation suggest the presence of structural inequity in underlying mental illness distribution and treatment provision. Māori cultural expertise at all levels of healthcare including healthcare planning and delivery is required to make advances and reduce disparity.
Aspirin may be more suitable for patients with major depression: Evidence from two-sample Mendelian randomization analysis
Authors: Zhu Haohao , Qu Yucai , Zhou Qin , Du Zhiqiang , Zhou Zhenhe , Jiang Ying 
Published: September 2024

Objective: Utilizing two-sample Mendelian randomization (TSMR) analysis, this study aims to explore the potential bidirectional causal relationship between common nonsteroidal anti-inflammatory drugs (paracetamol, ibuprofen, aspirin) and major depression (MD) from a genetic standpoint. Methods: We employed summarized data from a Genome-Wide Association Study (GWAS) of European populations. The inverse variance weighted (IVW) method was used for TSMR analysis; outcomes were evaluated based on p-value, OR (Odds Ratio), and 95% confidence interval (95% CI). Results: From a genetic perspective, the study found that the use of paracetamol and ibuprofen increased the risk of MD (IVW (MRE): OR = 2.314, 95% CI: 1.609–3.327; p = 6.07E-06) and (IVW (MRE): OR = 2.308, 95% CI: 1.780–3.653; p = 0.002), respectively. No significant causal relationship was found between aspirin and MD ( p > 0.05). Reverse TSMR analysis found that MD increased the genetic predisposition to use paracetamol, ibuprofen, and aspirin (IVW (MRE): OR = 1.042, 95% CI: 1.030–1.054, p = 3.07E-12), (IVW (FE): OR = 1.015, 95% CI: 1.007–1.023, p = 1.13E-04), (IVW (MRE): OR = 1.019, 95% CI: 1.009–1.030, p = 4.22E-04), respectively. Other analytical methods and sensitivity analyses further supported the robustness and reliability of these findings. Conclusion: This study provides preliminary genetic evidence through bidirectional TSMR analysis that MD increases the genetic predisposition to use paracetamol, ibuprofen, and aspirin, aiding clinicians in devising preventive strategies against the misuse of non-steroidal anti-inflammatory drugs. Moreover, we found that the use of paracetamol and ibuprofen increases the risk of MD, whereas aspirin did not. This suggests a crucial clinical implication: clinicians treating MD patients could opt for the relatively safer aspirin over paracetamol and ibuprofen.
Tall and Fall Versus Drop and Drive Strategy in College Baseball Pitchers for Velocity and Elbow Valgus Torque
Authors: Giordano Kevin , Nebel Adam R. , Fava Anthony , Oliver Gretchen D. 
Published: September 2024

Background: Depending on anthropometrics and coaching style, pitchers are taught to pitch with a stride strategy that are traditionally classified as “tall and fall” or “drop and drive” for the purpose of maximizing pitch velocity. Purpose/Hypothesis: The purpose of this study was to determine the effects of stride strategy (tall and fall vs drop and drive) in college baseball pitching on pitch velocity and elbow valgus torque. It was hypothesized that pitch velocity and elbow valgus torque would increase as pitchers aligned more with the tall and fall technique. Study Design: Controlled laboratory study. Methods: Markerless motion capture data were recorded on 64 collegiate pitchers (height, 1.89 ± 0.06 m; weight, 93.06 ± 9.44 kg) during game play at the host institution during the 2023 season. Peak magnitudes of body center of mass (COM) vertical displacement were determined using a straight-line trajectory between peak knee height and lead foot contact and used as a continuous variable. Pitchers were required to throw ≥4 fastballs during their outing to be included in the analysis. Multilevel modeling was used to determine associations between peak magnitudes of positive and negative vertical displacement of COM on pitch velocity and elbow valgus torque. Every fastball throughout the season with biomechanics data for each pitcher was included in the multilevel model. Results: Fastball velocity was mean ± SD 90.68 ± 2.90 mph (40.54 ± 1.29 m/s). Mean maximal negative vertical COM displacement was −0.91 ± 0.47 inches (−0.023 ± 0.012 m), which occurred 18.1% ± 5.75% of the way between peak knee height and stride foot contact. Mean maximal positive vertical COM displacement was 1.73 ± 1.14 inches (0.044 ± 0.029 m), which occurred 65.7% ± 7.8% of the time from peak knee height to stride foot contact. Positive COM displacement (β = 0.54; P < .001) and timing of peak positive COM displacement (β = 1.82; P = .023) reduced interpitcher variance by 9.9% and improved the ability of our model to predict fastball velocity. Negative COM displacement improved the ability of our model to predict ball velocity (β = −0.45; P = .021). Vertical COM displacement did not influence elbow valgus torque. Conclusion: Increasing vertical COM displacement in either the positive or the negative direction resulted in increased fastball velocity but did not result in greater elbow valgus torque. This indicates that the stride method may be used for performance enhancement but is unlikely to influence ulnar collateral ligament injury risk in college baseball pitchers. Clinical Relevance: Clinicians should not use stride mechanics as an injury risk indicator or diagnostic factor in injury etiology for college baseball pitchers.
Cerebral Sinus Venous Thrombosis in Pediatric Acute Lymphoblastic Leukemia: Incidence, Clinical Characteristics, and Long-term Neurologic Outcomes
Authors: Johnson-Bishop Lindsay , Karakas Cemal , Kralik Stephen F , Cohen Clay T , Zobeck Mark , Park Nick , Rabin Karen , Pehlivan Davut , Bhar Saleh 
Published: September 2024

Objective To describe the incidence, clinical characteristics, and long-term outcomes of cerebral sinus venous thrombosis in children with acute lymphoblastic leukemia. Methods This was a retrospective cohort study comprising pediatric patients with newly diagnosed or first-relapse acute lymphoblastic leukemia who developed cerebral sinus venous thrombosis at Texas Children's Hospital from 2002 to 2019. Results Nineteen cases (1.7%) with cerebral sinus venous thrombosis were identified in all pediatric patients with acute lymphoblastic leukemia (n = 1129). Increased risk of cerebral sinus venous thrombosis was observed with age >10 years ( P = .006). Twelve cases (63%) occurred during the induction, 4 (21%) during maintenance, and 3 (16%) during the consolidation phases of leukemia therapy. Seizures (10/19) and headaches (9/19) were the most common presenting symptoms. After treatment with anticoagulation therapy, we observed full resolution of thrombosis in 10 (53%) and partial resolution in 8 patients (42%). Long-term neurologic outcomes at follow-up in the 14 patients who survived included normal neurologic examinations (n = 10), epilepsy (n = 3), and focal neurologic deficits (n = 2). The death occurred in 5 individuals. Conclusion Cerebral sinus venous thrombosis is a notable complication of pediatric acute lymphoblastic leukemia therapy. Older age (>10 years) was a risk factor for developing cerebral sinus venous thrombosis. Despite variable patient presentations and treatment durations, favorable clinical outcomes were observed in most patients after the treatment with anticoagulation for a minimum of 3 months.