bluuebunny/crossref_metadata_2025_split huggingface dataset:
Good Lawmaking, Democracy, and Accountability
Authors: Economou Emmanouil M L , Kyriazis Nicholas C 
Published: July 2024

ABSTRACT
In the present paper, we analyze good lawmaking under the general aspect of democracy and accountability. We present briefly the procedure of lawmaking and accountability under the direct democracy of ancient Athens during the Classical times (508–323 BC), giving one characteristic example, followed with a comparison with modern lawmaking under representative democracy. We argue that accountability in present-day democracies has three drawbacks, that are related to (i) the principal-agent problem, (ii) the fact that accountability is only periodic since elections are held every four years (iii) the information asymmetry between government and citizens, which makes difficult for citizens to understand the issues (regarding lawmaking) in depth or hold a government accountable for its actions and decisions on various matters. We explain how the ancient Athenian democrats dealt effectively with these institutional inconsistencies. We finally conclude by offering some proposals for improving the quality of democracy nowadays, inspired by the functioning of the Athenian-related institutions.
Semi-biological photosystem: harnessing carbon dots and Geobacter sulfurreducens for solar-driven hydrogenation
Authors: Yau Mandy Ching Man , Kalathil Shafeer 
Published: July 2024

Abstract
Semi-biological photosynthesis utilizes the unique ability of microbial catalysts together with synthetic photosensitizers (semiconductors) to produce high-value chemicals from sustainable feedstocks. In this work, we devise a semi-biological hybrid system consisting of sustainable photosensitizers, carbon dots in the size range of 5–35 nm (CDs) interfaced with bacteria, Geobacter sulfurreducens, to reduce fumarate to succinate as a model hydrogenation reaction. After 7 days of solar irradiation, using quantitative proton nuclear magnetic resonance spectroscopy (qNMR), the CD−G. sulfurreducens photosystem produced ∼18 mM of succinate without the need for a redox mediator. Moreover, in reusing the CDs, ∼70% of the succinate (compared to the previous cycle) was recovered. The proposed photobiohybrid system paves a new avenue for sustainable solar-to-chemical conversion in high-value chemical production.
Leadership and Followership Dynamics in Interprofessional Health Care Teams: Attending Physician Perspectives
Authors: Barry Erin S. , Teunissen Pim , Varpio Lara , Vietor Robert , Kiger Michelle 
Published: July 2024

Abstract

Purpose
Effective interprofessional health care team (IHT) members collaborate to reduce medical errors, use resources effectively, and improve patient outcomes, making interprofessional collaboration imperative. Because physicians are often designated as the positional leaders of IHTs, understanding their perspectives on collaboration within IHTs could help to mitigate the disconnects between what is suggested in theory and what is happening in practice. This study aimed to explore leader-follower dynamics within medical teams that are commonly working in clinical care contexts.

Method
Using a constructivist approach, the authors conducted 12 individual, semistructured interviews from November 2022 to September 2023 with attending physicians who have led IHTs in perioperative (i.e., preoperative clinic, operating room, postoperative and recovery unit) or emergency department settings. The transcripts were analyzed from December 2022 to December 2023 using inductive thematic analysis.

Results
Three themes explained the physician perceptions of IHT leadership-followership dynamics: (1) physicians are comfortable sharing leadership intraprofessionally, (2) the clinical culture and environment constrain interprofessional followership and shared leadership, and (3) hierarchical models hold true even while active followers are appreciated, when appropriate.

Conclusions
The data in this study suggest that, in perioperative and emergency department settings, shared leadership largely may not occur interprofessionally but occurs intraprofessionally. Participants suggested that the clinical culture and environment (i.e., legal concerns, hierarchical assumption, patient care ownership responsibilities) constrained interprofessional followership and shared leadership. On the basis of the study’s findings and how they align with previous research, future research into interprofessional collaboration and followership roles should focus on what factors enable and constrain active followership and shared leadership. Such collaboration can only be achieved when active followership and shared leadership are allowed and promoted. These findings and others suggest that not all contexts are enabling such types of interprofessional collaboration due to legal concerns, hierarchical traditions, and patient ownership considerations.
Malignant Catatonia in the Setting of Acute Methamphetamine and Cocaine Intoxication
Authors: Mullen Nicholas J. , Meyer Karre VaKara M. , Balasanova Alëna A. 
Published: July 2024

Background
Malignant catatonia is a potentially lethal neuropsychiatric syndrome characterized by psychomotor abnormalities and autonomic instability. Patients with this syndrome require immediate treatment. Various psychiatric conditions and nonpsychiatric medical problems can trigger malignant catatonia. Use of psychostimulant drugs, including methamphetamine and cocaine, has not been previously reported to precipitate malignant catatonia.

Case Summary
This case concerns a 35-year-old man hospitalized for psychosis due to methamphetamine and cocaine intoxication. He developed malignant catatonia the day after admission. He was treated with lorazepam for malignant catatonia, and his blood pressure was controlled with clonidine. Over 7 days, his condition resolved, and his mental status and vital signs returned to baseline. He was discharged to the community in stable condition and has returned to his baseline functional status. He remains free of catatonia and has maintained abstinence from methamphetamine and cocaine.

Conclusions
Acute intoxication with psychostimulant drugs is a possible trigger for malignant catatonia, and administration of high potency first-generation antipsychotics in this setting may increase the risk. Patients hospitalized for stimulant intoxication should be monitored for signs and symptoms of catatonia, and D2 receptor antagonist medications should be used with caution in this population. Our case supports the potential role of altered dopamine and norepinephrine signaling in the pathogenesis of malignant catatonia. The patient provided written and verbal consent to publish the information in this case report.
High Positive End-expiratory Pressure (PEEP) with Recruitment Maneuvers versus Low PEEP during General Anesthesia for Surgery: A Bayesian Individual Patient Data Meta-analysis of Three Randomized Clinical Trials
Authors: Mazzinari Guido , Zampieri Fernando G. , Ball Lorenzo , Campos Niklas S. , Bluth Thomas , Hemmes Sabrine N. T. , Ferrando Carlos , Librero Julian , Soro Marina , Pelosi Paolo , Gama de Abreu Marcelo , Schultz Marcus J. , Serpa Neto Ary ,   for REPEAT on behalf of the PROVHILO, iPROVE, and PROBESE investigators and the PROVE Network investigators
Published: July 2024

Background:
The influence of high positive end-expiratory pressure (PEEP) with recruitment maneuvers on the occurrence of postoperative pulmonary complications after surgery is still not definitively established. Bayesian analysis can help to gain further insights from the available data and provide a probabilistic framework that is easier to interpret. The objective was to estimate the posterior probability that the use of high PEEP with recruitment maneuvers is associated with reduced postoperative pulmonary complications in patients with intermediate-to-high risk under neutral, pessimistic, and optimistic expectations regarding the treatment effect.

Methods:
Multilevel Bayesian logistic regression analysis was performed on individual patient data from three randomized clinical trials carried out on surgical patients at intermediate to high risk for postoperative pulmonary complications. The main outcome was the occurrence of postoperative pulmonary complications in the early postoperative period. This study examined the effect of high PEEP with recruitment maneuvers versus low PEEP ventilation. Priors were chosen to reflect neutral, pessimistic, and optimistic expectations of the treatment effect.

Results:
Using a neutral, pessimistic, or optimistic prior, the posterior mean odds ratio for high PEEP with recruitment maneuvers compared to low PEEP was 0.85 (95% credible interval, 0.71 to 1.02), 0.87 (0.72 to 1.04), and 0.86 (0.71 to 1.02), respectively. Regardless of prior beliefs, the posterior probability of experiencing a beneficial effect exceeded 90%. Subgroup analysis indicated a more pronounced effect in patients who underwent laparoscopy (odds ratio, 0.67 [0.50 to 0.87]) and those at high risk for postoperative pulmonary complications (odds ratio, 0.80 [0.53 to 1.13]). Sensitivity analysis, considering severe postoperative pulmonary complications only or applying a different heterogeneity prior, yielded consistent results.

Conclusions:
High PEEP with recruitment maneuvers demonstrated a moderate reduction in the probability of postoperative pulmonary complication occurrence, with a high posterior probability of benefit observed consistently across various prior beliefs, particularly among patients who underwent laparoscopy.
The Association of Preoperative Bone Mineral Density and Outcomes After Anterior Cervical Discectomy and Fusion
Authors: Gong Davin C. , Baumann Anthony N. , Muralidharan Aditya , Piche Joshua D. , Anderson Paul A. , Aleem Ilyas 
Published: July 2024

Study Design:
This is a systematic review.

Objective:
To evaluate anterior cervical discectomy and fusion (ACDF) outcomes and complications as a function of preoperative bone mineral density (BMD).

Summary of Background Data:
Preoperative BMD optimization is commonly initiated before lumbar spinal fusion, but the effects of BMD on ACDF are less known. Consequently, it remains unclear whether preoperative BMD optimization is recommended before ACDF.

Methods:
This systematic review included relevant clinical articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Web of Science, SCOPUS, and MEDLINE from database inception until October 1, 2023. Eligible studies included those evaluating low BMD and outcomes after ACDF. All articles were graded using the Methodological Index for Non-Randomized Studies (MINORS) scale and Critical Appraisal Skills Programme (CASP) assessment tools.

Results:
The initial retrieval yielded 4271 articles for which 4 articles with 671 patients were included in the final analysis. The mean patient age was 56.4 ± 3.9 years, and 331 patients (49.3%) were female. A total of 265 (39.5%) patients had low BMD (T score<-1.0) before ACDF. Preoperative low BMD was associated with cage subsidence in single-level ACDF (odds ratio (OR) 2.57; P=0.063; 95% Confidence Interval (CI): 0.95–6.95), but this result did not reach statistical significance. Osteoporosis (T score<-2.5) was associated with the development of adjacent segment disease following ACDF (OR 4.41; P<0.01; 95% CI: 1.98–9.83). Low pre-operative BMD was associated with reoperation within 2 years (P<.05) and strongly associated with pseudarthrosis (OR: 11.01; P=0.002; 95% CI 2.4–49.9).

Conclusions:
Patients with low BMD who undergo ACDF have higher rates of subsidence, adjacent segment disease, and pseudarthrosis than those with normal BMD. Given the individual and system-wide burdens associated with these complications, some patients may benefit from preoperative BMD screening and optimization before undergoing ACDF.
A randomized, pilot trial comparing vaginal hyaluronic acid to vaginal estrogen for the treatment of genitourinary syndrome of menopause
Authors: Agrawal Surbhi , LaPier Zoe , Nagpal Shavy , Oot Antoinette , Friedman Steven , Hade Erinn M. , Nachtigall Lila , Brucker Benjamin M. , Escobar Christina 
Published: July 2024

Abstract

Objective
The aim of this study was to compare the efficacy of a non-hormone alternative, vaginal hyaluronic acid (HLA), to a standard-of-care therapy, vaginal estrogen, for the treatment of genitourinary syndrome of menopause (GSM).

Methods
This was a randomized, parallel arm pilot trial. Women with GSM were randomized to an HLA vaginal suppository or vaginal estrogen cream for 12 wk to compare the primary outcome, the vulvovaginal symptom questionnaire (VSQ) score. Secondary outcomes included the following: the female sexual function index (FSFI), the vaginal symptom index (VSI), visual analog scale (VAS) for dyspareunia, vaginal itching, and vaginal dryness, patient global impression of improvement (PGI-I) at follow-up, vaginal maturation index, and vaginal pH. Differences between treatment groups were estimated using the two-sided, two-sample t-test and 95% confidence intervals.

Results
Forty-nine women were randomized and 45 participants (vaginal estrogen = 23, vaginal HLA = 22) provided data at week 12. Baseline characteristics were similar in both groups. On the VSQ, there was no observed difference in overall scores between the HLA and vaginal estrogen groups at 12 wk (P = 0.81). Improvement was seen within both treatment groups on the VSQ after 12 wk. The VAS score, total VSI score, total FSFI score, and vaginal pH improved over time; however, improvement did not differ between study arms. Over 90% participants noted improvement on the PGI-I in both groups (P = 0.61). No treatment-related serious adverse events occurred.

Conclusions
There were no clinically meaningful differences between vaginal HLA and vaginal estrogen for the treatment of GSM after 12 wk. Vaginal HLA may be a promising non-hormone therapy for GSM.
Rules of medication for leucorrhea in ancient books of traditional Chinese medicine based on latent structure model and association rules
Authors: Zhang Yuxin , Wang Wenlai , Yang Xinming , Chu Ce , Chen Xiangyun , Ding Wei , He Zhanzhan , Yuan Yulu , Wei Tong , Xu Yongqi , Yang Zhen , Zhao Hongxia 
Published: July 2024

Objective:
To analyze syndrome differentiation and medication rules for leucorrhea in ancient books of traditional Chinese medicine (TCM) based on the “Chinese Medical Code” using the latent structure model.

Methods:
The formulations for leucorrhea were searched in the Chinese Medical Code (software), based on which an Excel sheet was created to conduct frequency analysis and construct a matrix of high-frequency medications. The high-frequency medications for leucorrhea were then analyzed using the Latent 5.0 software and a latent structure model. With SPSS Modeler and Latent 5.0 as the main analysis methods, Chinese medications with a frequency >1.00% were investigated using the latent structure model and association rules, and the medication rules in treating leucorrhea with TCM were dissected based on the data of frequency.

Results:
For 373 kinds of Chinese medicines retrieved from 236 TCM prescriptions, the total medication frequency was 2522. Chinese Angelica (Angelicae Sinensis Radix), White Peony Root (Paeoniae Radix Alba), Indian Buead Tuckahoe (Poria), Common Oyster Shell (Ostreae Concha), and Largehead Atractylodes Rhizome (Atractylodis Macrocephalae Rhizoma) were high-frequency medicines for leucorrhea. Tonic, heat-clearing, and qi-regulating medicines had a high frequency of usage. According to a formula-based analysis of the evidence, the main syndromes of leucorrhea included liver qi affecting the spleen pattern, damp heat accumulation pattern, liver qi stagnation pattern, liver-stomach disharmony pattern, yin deficiency of the liver and kidney pattern, and spleen deficiency with dampness pattern, which are generally in line with the etiology and pathogenesis of leucorrhea, namely pathogenic dampness as the detrimental factor together with spleen-kidney dysfunction. However, in ancient books, emphasis was laid out on the regulation of the liver. This study determined 31 association rules for treating leucorrhea, where the primary compatible medicines contained Chinese Angelica (Angelicae Sinensis Radix)-Nutgrass Galingale Rhizome (Cyperus rotundus), Chinese Angelica (Angelicae Sinensis Radix)-Szechwan Lovage Rhizome (Ligusticum chuanxiong Hort.), White Peony Root (Paeoniae Radix Alba)-Szechwan Lovage Rhizome (Ligusticum chuanxiong Hort.), White Peony Root (Paeoniae Radix Alba)-Adhesive Rehmannia Root Tuber (Rehmanniae Radix) and Tangerine Peel (Citri Reticulatae Pericarpium)-Ternate Pinellia (Rhizoma Pinelliae).

Conclusion:
The medication rules targeting leucorrhea in the Chinese Medical Code were mainly represented by the regulation of qi and blood, as well as the 3 internal organs—the kidney, spleen, and liver.
Exploring barriers to employee voice among certified nursing assistants: A qualitative study
Authors: Kee Karin , Nies Henk , van Wieringen Marieke , Beersma Bianca 
Published: July 2024

Background
Research shows that voice—the communication of ideas, concerns, and perspectives by employees to those in positions to instigate changes—is related to job satisfaction, retention, and organizational improvement. Nevertheless, health care professionals often do not exercise voice. Although researchers have explored the barriers registered nurses working in hospitals experience in expressing their voices, there has been a notable lack of attention in research and practice to the voice of certified nursing assistants working in long-term care settings.

Purposes
Ensuring that certified nursing assistants can exercise voice is essential for the welfare and well-being of this occupational group and critical for the success of their organizations. Therefore, we explore the barriers certified nursing assistants encounter that hinder them from exercising voice.

Methodology
We conducted seven focus groups in which 24 Dutch certified nursing assistants participated.

Results
The results show that respondents were not always willing to exercise voice, which stemmed primarily from negative prior experiences with exercising voice. Respondents were further not always able to exercise voice, as the conditions under which they had to do so were unfavorable. Finally, respondents sometimes lacked the necessary skills to convey their ideas, concerns, and perspectives effectively.

Practice Implications
Our findings indicate that health care managers must address multiple factors if they wish to enhance the voice of certified nursing assistants.
A Qualitative Analysis of a Mindfulness-Based Stress Management Program to Reduce Stress and Burnout for Health Care Staff
Authors: Sos Tammy , Melton Bridget 
Published: July 2024

Occupational stress in the work setting can lead to burnout. Health care workers are at a higher risk of experiencing stress and burnout. Mindfulness has gained momentum as a coping mechanism for stress and feelings of burnout, although it is unknown which mindfulness practices are the most effective for reducing feelings of occupational stress. The purpose of the qualitative portion of this mixed-methods study was to explore health care staff’s perceptions of the characteristics of mindfulness interventions that were effective in reducing their stress and feelings of burnout. Health care staff consisting of nurses, State Tested Nursing Aides, housekeeping staff, culinary staff, activities staff, social workers, and chaplain staff (N = 48) in a senior care and rehabilitation setting in a Midwestern city were invited to attend a semi-structured focus group, post-intervention. Thematic analysis was used to identify 3 main themes: ease of use promotes effective implementation, positive impact of mindfulness on self and others, and home- and work-related factors affect implementation. Overall, participants perceived benefit from various mindfulness practices for reducing their feelings of stress and burnout in the workplace. Guidance, ease of use of the mindfulness practice, and addressing barriers such as time and location can help with implementation.
Effects of Auricular Acupressure on Nurses’ Perceived Stress, Sleep Quality, and Presenteeism
Authors: Sim Hyunseo , Park Younghee 
Published: July 2024

The physical and psychological health management of nurses is very important not only for individual nurses but also for organizations and patients. However, nurses are exposed to high stress, sleep problems, and high presenteeism. Therefore, this study aimed to examine the effects of auricular acupressure (AA) on nurses’ stress, sleep problems, and presenteeism. This randomized controlled trial encompassed 60 nurses divided into an experimental group (n = 30) and a control group (n = 30). Auricular acupressure using AA stickers with small magnets attached was performed in the experimental group, and a placebo AA using simple AA stickers (without the small magnets) was performed in the control group. The treatment lasted 7 weeks. To confirm the results, stress, sleep quality, and presenteeism were measured at pre- and posttest. There was a statistically significant difference in scores for sleep quality (t = −1.98, P = .047), health problems (z = −2.38, P = .017), and work impairment (t = −4.46, P < .001) between the experimental and control groups at posttest. Auricular acupressure increased sleep quality scores and decreased presenteeism. Auricular acupressure using AA stickers with small magnets attached was effective in improving sleep quality and reducing presenteeism in nurses.
MicroRNAs as Bile-based biomarkers in pancreaticobiliary cancers (MIRABILE): a cohort study
Authors: Liu Daniel S.K. , Puik Jisce R. , Venø Morten T. , Mato Prado Mireia , Rees Eleanor , Patel Bhavik Y. , Merali Nabeel , Galloway Daniel , Chan Grace , Phillips Natalie , Wadsworth Christopher , Vlavianos Panagiotis , Potts Jonathan , Sivakumar Shivan , Davidson Brian R. , Besselink Marc G. , Swijnenburg Rutger-Jan , Jiao Long R. , Kazemier Geert , Giovannetti Elisa , Krell Jonathan , Frampton Adam E. 
Published: July 2024

Background:
Biliary obstruction can be due to both malignant and benign pancreaticobiliary disease. Currently, there are no biomarkers that can accurately help make this distinction. MicroRNAs (miRNAs) are stable molecules in tissue and biofluids that are commonly deregulated in cancer. The MIRABILE study aimed to identify miRNAs in bile that can differentiate malignant from benign pancreaticobiliary disease.

Materials and methods:
There were 111 patients recruited prospectively at endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) for obstructive jaundice, and bile was aspirated for cell-free RNA (cfRNA) extraction and analysis. In a discovery cohort of 78 patients (27 with pancreatic ductal adenocarcinoma (PDAC), 14 cholangiocarcinoma (CCA), 37 benign disease), cfRNA was subjected to small-RNA sequencing. LASSO regression was used to define bile miRNA signatures, and NormFinder to identify endogenous controls. In a second cohort of 87 patients (34 PDAC, 14 CCA, 39 benign disease), RT-qPCR was used for validation.

Results:
LASSO regression identified 14 differentially-expressed bile miRNAs of which 6 were selected for validation. When comparing malignant and benign pancreaticobiliary disease, bile miR-340 and miR-182 were validated and significantly differentially expressed (P<0.05 and P<0.001, respectively). This generated an AUC of 0.79 (95% CI: 0.70–0.88, sensitivity 65%; specificity 82%) in predicting malignant disease.

Conclusion:
Bile collected during biliary drainage contains miRNAs able to differentiate benign from malignant pancreaticobiliary diseases in patients with obstructive jaundice. These bile miRNAs have the potential to increase diagnostic accuracy.