bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEASURING THE PREVALENCE, SEVERITY, AND SOURCES OF DISABILITY: A NEW APPROACH
Authors: Evans D W , Brownhill K 
Published: August 2024

BackgroundDisability is an important multifaceted construct. Identifying sources of disability could help optimise patient care. The aim of this study was to test an approach that not only estimates severity of disability, but also identifies the source(s) of this disability.MethodsAn online survey was used to collect data from a convenience sample, recruited via email and social media invitations. Two generic measures of disability, the 8-item Universal Disability Index (UDI8) and Groningen Activity Restriction Scale (GARS) were used to estimate the prevalence and severity of disability in this sample. Non-zero UDI8 item responses generated conditional sub-questions, in which participants could attribute their activity limitations to one or more sources (pain, fatigue, worry, mood, and other). This allowed for a decomposition of UDI8 scores into source components.Results403 participants enrolled; 334 completed all UDI8 and GARS items. Of these, 85.3% (285/334) reported at least one restricted activity via the UDI8, while 43.4% (145/334) reported some reduced independence via the GARS. Disability severity increased with age until approximately 40 years, after which it decreased gradually. Pain component scores were high in all individuals with higher and lower disability severity, whereas fatigue component scores were highest in individuals reporting higher disability severity. Worry, mood, and other component scores were not high at any level of disability severity.ConclusionsThis approach should be used to identify the prevalence, severity and sources of disability in the general population and in specific patient groups.Conflicts of interestNo conflicts of interestSources of fundingNo funding obtained
PAIN RELIEF AFTER INSTRUMENTED SPINAL SURGERY
Authors: Wilson M.J. , Cole A. , Hewson D. , Hind D. , Hawksworth O. , Hyslop M. , Keetharuth A. , Macfarlane A. , Martin B. , McLeod G. , Rombach I. , Swaby L. , Tripathi S. , Wilby M. 
Published: August 2024

BackgroundOver 55,000 spinal operations are performed annually in the NHS. Effective postoperative analgesia facilitates early mobilisation and assists rehabilitation and hospital discharge, but is difficult to achieve with conventional, opioid-based, oral analgesia. The clinical and cost-effectiveness of two alternative techniques, namely intrathecal opioid and the more novel erector-spinae plane blockade, is unknown. The Pain Relief After Instrumented Spinal Surgery (PRAISE) trial aims to evaluate these techniques.MethodsPRAISE is a multicentre, prospective, parallel group, patient-blinded, randomised trial, seeking to recruit 456 adult participants undergoing elective, posterior lumbar-instrumented spinal surgery from up to 25 NHS hospitals. Participants will be randomised 1:1:1 to receive (1) Usual Care with local wound infiltration, (2) Intrathecal Opioid plus Usual Care with local wound infiltration or (3) Erector Spinae Plane blockade plus Usual Care with no local wound infiltration. The primary outcome is pain on movement on a 100mm visual analogue scale at 24 hours post-surgery. Secondary outcomes include pain at rest, leg pain, quality of recovery (QoR-15), postoperative opioid consumption, time to mobilisation, length of hospital stay, health utility (EQ-5D-5L), adverse events and resource use. Parallel economic evaluation will estimate incremental cost-effectiveness ratios.ResultsDifferences in the primary outcome at 24 hours will be estimated by mixed-effects linear regression modelling, with fixed effects for randomisation factors and other important prognostic variables, and random effects for centre, using the as-randomised population. Treatment effects with 95% confidence intervals will be presented.ConclusionThe study is due to open in May 2024 and complete in 2026.Conflicts of InterestNo conflicts of interest declaredSources of FundingNIHR Health Technology Award – grant number NIHR153170Trial presentations so farAPOMP 2023 and 2024; RCOA conference, York, November 2023; Faculty of Pain Management training day, London, February 2024.
“YOU'RE NOT BLEEDING SO PHONE 111!”: HOW NHS 111 EXPERIENCES INFORM THE DECISION TO ATTEND THE EMERGENCY DEPARTMENT WITH LOW BACK PAIN
Authors: Mouton L. , Roberts L.C. , Ryan C. 
Published: August 2024

Purpose and backgroundLow back pain (LBP), a leading cause of chronic disability, is associated with high and disproportionate socioeconomic costs. Clinical assessment and triage via the NHS 111 service aims to reduce pressure on the urgent and emergency care system. Studies show that many attend the emergency department (ED) against advice, when they could be better managed elsewhere. The aim of this research was to explore how patients with LBP perceive and interact with NHS 111, and how this may have influenced their decision to attend ED.Methods and ResultsThis was a secondary analysis of a cross-sectional, qualitative dataset of 47 patients (26M:21F, aged 23–79 years) purposively sampled with LBP, who attended 1 of 4 EDs in the UK in 2021, (during the pandemic). The participants took part in online, semi-structured interviews, mean duration 45-minutes (range 23–156 minutes), within six weeks of their ED visit. The interviews were audio-recorded, transcribed verbatim and thematically analysed.Three key themes were identified: purpose, process and performance. The themes showed mixed understanding and low awareness of the purpose of NHS 111, despite its strong triage role. Long waits for call backs however, sometimes resulted in patients attending ED, along with previous negative perspectives and experiences.ConclusionThis research suggests enhanced visibility and knowledge of NHS 111 would increase its use by people with LBP. Further exploration comparing outcomes of callers to NHS 111 with those who seek care elsewhere, could help evaluate how NHS 111 can best help people with LBP and prevent unnecessary ED attendance.No conflicts of interest Sources of fundingFunding for primary data: Health Education England & National Institute of Health and Care Research (ICA-CDRF-2018-04-ST2-040)
DOES MANUAL HANDLING TRAINING INFLUENCE SPINE KINEMATICS?
Authors: Annetts S. , Hemming R. 
Published: August 2024

BackgroundMusculoskeletal disorders, including low back pain, affects 68% of UK physiotherapists across their career with patient handling considered a key risk factor. Manual handling training is mandatory for all allied health professionals, however there is limited research investigating whether professionals adopt recommended manual handling principles following training.Purpose of StudyTo investigate spinal angles when facilitating sit-to-stand, and a turning manoeuvre in bed, comparing first-year physiotherapy students (who have not received manual handling training) with final-year physiotherapy students (who have received manual handling training).MethodsCross-sectional pilot study (n= 20; 10 first-year, 10 final-year). All participants were exposed to a short training video outlining how to safely perform each manoeuvre. Retroreflective markers were attached to: L4, ASIS, PSIS, T12, C7, tragus and canthus. Spinal (neck, thoracic, lumbar and pelvic) angles were established via digital photographs using a bespoke MATLAB programme (MathWorks). A Mann-Whitney U test was conducted to determine between group differences.ResultsNo statistically significant results were observed between first-year and final-year students for both manoeuvres (p<0.05), except for neck angle during the turning manoeuvre (final-year students demonstrating more upright postures, p=0.037).Interestingly, for the turning manoeuvre in bed it was noted that none of the participants adjusted the bed height.ConclusionThe results suggest that clinical experience and routine manual handling training may not have a significant effect on spinal posture, especially in relation to pelvic, lumbar and thoracic angles. Further work is needed to understand how training relates to adoption of manual handling principles in practice.Conflicts of interestNoneSources of fundingNone
Estimating the replicability of highly cited clinical research (2004–2018)
Authors: da Costa Gabriel Gonçalves , Neves Kleber , Amaral Olavo 
Published: August 2024

Introduction
Previous studies about the replicability of clinical research based on the published literature have suggested that highly cited articles are often contradicted or found to have inflated effects. Nevertheless, there are no recent updates of such efforts, and this situation may have changed over time.

Methods
We searched the Web of Science database for articles studying medical interventions with more than 2000 citations, published between 2004 and 2018 in high-impact medical journals. We then searched for replications of these studies in PubMed using the PICO (Population, Intervention, Comparator and Outcome) framework. Replication success was evaluated by the presence of a statistically significant effect in the same direction and by overlap of the replication’s effect size confidence interval (CIs) with that of the original study. Evidence of effect size inflation and potential predictors of replicability were also analyzed.

Results
A total of 89 eligible studies, of which 24 had valid replications (17 meta-analyses and 7 primary studies) were found. Of these, 21 (88%) had effect sizes with overlapping CIs. Of 15 highly cited studies with a statistically significant difference in the primary outcome, 13 (87%) had a significant effect in the replication as well. When both criteria were considered together, the replicability rate in our sample was of 20 out of 24 (83%). There was no evidence of systematic inflation in these highly cited studies, with a mean effect size ratio of 1.03 [95% CI (0.88, 1.21)] between initial and subsequent effects. Due to the small number of contradicted results, our analysis had low statistical power to detect predictors of replicability.

Conclusion
Although most studies did not have eligible replications, the replicability rate of highly cited clinical studies in our sample was higher than in previous estimates, with little evidence of systematic effect size inflation. This estimate is based on a very select sample of studies and may not be generalizable to clinical research in general.
Perspectives of providing magnesium sulfate to patients with preeclampsia and eclampsia: A qualitative study amongst nurse-midwives in Dar es Salaam, Tanzania
Authors: Chikwala Victor Z. , Massae Agnes F. , Mushy Stella E. , Tarimo Edith A. M. 
Published: August 2024

Background
Preeclampsia and eclampsia are among the leading direct causes of maternal death and morbidity worldwide. Up to 34% of maternal deaths in Tanzania are due to preeclampsia/ eclampsia. Magnesium sulfate is recommended for preventing and treating convulsions in women with Preeclampsia or eclampsia. However, evidence suggests limited knowledge of its dosage and proper toxicity assessment after administration among health care providers.

Aim of the study
This study explored nurse-midwives’ perspectives on providing MgSO4 to patients with preeclampsia or eclampsia in Tanzania.

Materials and methods
A descriptive exploratory qualitative study using in-depth interviews was conducted to understand nurse-midwives’ perspectives on providing magnesium sulfate to patients with PE/E. Nineteen nurse-midwives were interviewed from three hospitals in the Dar es Salaam region. We used a semi-structured interview guide in Kiswahili language to collect data. All interviews were digitally recorded and transcribed verbatim. We analyzed data using inductive content analysis.

Results
This study revealed that nurse-midwives provide magnesium sulfate to save the lives of women and their unborn children. Nurse-midwives reasoned that confidence in their skill enhances provision of magnesium sulfate. However, they were concerned about its effect on the progress of labour. Ineffective use of magnesium sulfate emerged from inadequate training, an unsupportive work environment, and underutilization of the existing guidelines.

Conclusion
Nurse-midwives have clear drive to provide magnesium sulfate to women with preeclampsia or eclampsia. However, inadequate training, underutilization of guidelines and unsupportive work environment lead to ineffective use of magnesium sulfate. Targeted practical training should be emphasized for nurse-midwives mastery of clinical competencies.
Supply chain efficiency a structural analysis in Türkiye's retail sector
Authors: Abdelhadi Anas , Akkartal Erkut 
Published: August 2024

Goal: To investigate the impact of the Internet of Things (IoT) on the effectiveness and environmental friendliness of supply chains in Turkey's retail industry.
Methodology: Applies structural equation modeling to examine data from 315 retail experts, specifically investigating the impact of IoT on supply chain integration and agility within a defined timeframe. This methodology involves doing a thorough examination of the adoption of technology and its impact on operational performance.
Results: Finds notable enhancements in supply chain performance by implementing IoT, as demonstrated by improved integration, flexibility, and immediate access to real-time data. These technological improvements enhance the sustainability, efficiency, and flexibility of supply chain systems.
Limitations of the investigation: Recognizes limitations pertaining to the study's extent, techniques for gathering data, and the possible fluctuations in IoT adoption rates among various retail industries.
Practical implications: Proposes practical approaches for retail managers to utilize IoT technology in order to enhance supply chain efficiency and sustainability, highlighting the significance of integrating technology and implementing responsive mechanisms.
Originality: This study provides unique and valuable insights into how the Internet of Things (IoT) can contribute to the improvement of sustainable supply chain practices in the Turkish retail industry. It serves as a valuable resource for both professionals and researchers who are interested in the intersection of technology, sustainability, and supply chain management.
Retraction: DNA Analysis of Ancient Skeletal Remains
Authors: Eliášová I. , Mazura I. , Smejtek L. 
Published: August 2024

Following publication of the report: Eliášová I., Mazura I., Smejtek L.: DNA analysis of ancient skeletal remains, Folia Biologica (Praha), 2010; 56(2): 47-50, Folia Biologica was notified by Dr. Daniel Vaněk with the request to retract the publication for the reasons of plagiarism (inappropriate use of data and of the intellectual content of a former coauthor, who was eliminated from the published report) and strong accusation that the data are incorrect and do not support the conclusions of the report. Folia Biologica notified the institutions of all authors with the request to carry out an investigation concerning the work leading to the publication. The investigation was conducted at the Faculty of Science, Charles University in Prague, the main institution linked to the reported work.The investigation concluded that there were no signs of plagiarism or inappropriate use of data, but certainly the input of Dr. Vaněk was inappropriately acknowledged and there were some indications of data over­interpretation. Folia Biologica offered the Authors to publish a Correction and Addendum, which appeared in Folia Biologica 2013; 59(1): 51.Folia Biologica was contacted again by Dr. Vaněk with the request to retract the original publication and reject the acknowledgement.Folia Biologica therefore invited all authors and Dr. Vaněk to settle the dispute. Only the first author of the original publication and Dr. Vaněk accepted the invitation.This debate pointed out possible inaccuracies of data in the original publication, especially concerning the Father – Son relationship and the frequency of investigated alleles in the studied material. The investigation also showed that Dr. Vaněk was inappropriately removed from the list of authors in the final stages of manuscript preparation.Folia Biologica requested reexamination of the potentially erroneous or insufficient data with the aim to publish their appropriate correction. One party of the dispute, Dr. Vaněk, agreed to this solution, but the other party stated that the cooperation after almost two years of continuing allegations and investigations was not possible.Since there is no indication that the situation may be clarified in a foreseeable time frame, and Folia Biologica cannot support the full content of the publication, the original publication as well as the Correction and Addendum are retracted by the journal.
Bottom-up PBPK modeling of phenytoin brain disposition in postpartum newborns after intrauterine dosing
Authors: Alsmadi Mo’tasem M. 
Published: August 2024

Abstract

Objectives
The antiepileptic phenytoin has a narrow therapeutic window, nonlinear pharmacokinetics, and can cross the placenta causing apathy and jitteriness in postpartum newborns. Further, the sudden decay of phenytoin concentration can cause withdrawal seizures. This work aimed to assess the brain toxic exposure to phenytoin in newborns after transplacental transfer using neonatal saliva-brain correlations.

Methods
The phenytoin dose that the newborn receives transplacentally at birth was estimated using verified physiologically based pharmacokinetic (PBPK) model simulations in third-trimester pregnancy (pregnancy T3). Such doses were used as an input to the newborn PBPK model to estimate the neonatal levels of phenytoin and their correlations in brain extracellular fluid (bECF), plasma, and saliva.

Results
The PBPK model-estimated neonatal plasma and bECF concentrations of phenytoin were below the necessary thresholds for anticonvulsant and toxic effects. The neonatal salivary thresholds for phenytoin anticonvulsant and toxic effects were estimated to be 1.3 and 2.5 mg/L, respectively using the plasma-saliva-bECF correlations established herein.

Conclusions
The salivary TDM of phenytoin can be a more convenient option for avoiding phenytoin brain toxicity in newborns of epileptic mothers. Still, the appropriateness of using the same adult values of phenytoin anticonvulsant and toxic effects for infants needs investigation.
Network and cybersecurity applications of defense in adversarial attacks: A state-of-the-art using machine learning and deep learning methods
Authors: Khaleel Yahya Layth , Habeeb Mustafa Abdulfattah , Albahri A. S. , Al-Quraishi Tahsien , Albahri O. S. , Alamoodi A. H. 
Published: August 2024

Abstract
This study aims to perform a thorough systematic review investigating and synthesizing existing research on defense strategies and methodologies in adversarial attacks using machine learning (ML) and deep learning methods. A methodology was conducted to guarantee a thorough literature analysis of the studies using sources such as ScienceDirect, Scopus, IEEE Xplore, and Web of Science. A question was shaped to retrieve articles published from 2019 to April 2024, which ultimately produced a total of 704 papers. A rigorous screening, deduplication, and matching of the inclusion and exclusion criteria were followed, and hence 42 studies were included in the quantitative synthesis. The considered papers were categorized into a coherent and systematic classification including three categories: security enhancement techniques, adversarial attack strategies and defense mechanisms, and innovative security mechanisms and solutions. In this article, we have presented a systematic and comprehensive analysis of earlier studies and opened the door to potential future studies by discussing in depth four challenges and motivations of adversarial attacks, while three recommendations have been discussed. A systematic science mapping analysis was also performed to reorganize and summarize the results of studies to address the issues of trustworthiness. Moreover, this research covers a large variety of network and cybersecurity applications of defense in adversarial attack subjects, including intrusion detection systems, anomaly detection, ML-based defenses, and cryptographic techniques. The relevant conclusions well demonstrate what have achieved in defense mechanisms against adversarial attacks. In addition, the analysis revealed a few emerging tendencies and deficiencies in the area to be remedied through better and more dependable mitigation methods against advanced persistent threats. The findings of this review have crucial implications for the community of researchers, practitioners, and policy makers in network and cybersecurity using artificial intelligence applications.
Adapting and extending multimodal (inter)action analysis to investigate synchronous multimodal online language teaching
Authors: Wigham Ciara R. , Satar Müge 
Published: August 2024

Abstract
Multimodal (inter)action analysis offers a powerful and robust methodology for the study of action and interaction between social actors, their environment, and the objects and tools within. Yet its implementation in the analysis of synchronous multimodal online data sets, e.g. (inter)actions via videoconferencing, is limited. Drawing on our research in understanding teacher-learner (inter)actions in instruction-giving fragments in synchronous multimodal online language lessons, we describe and illustrate the ways in which we adapted and extended some of the methodological and analytical tools. These include (1) the use of a grounded theory approach in delineating and identifying higher-level actions, (2) the embodiment and disembodiment of frozen actions, (3) electronic print mode, (4) semiotic lag, (5) semiotic (mis)alignment, (6) modal density (mis)alignment, and (7) how modal density can be achieved by brisk modal shifts in addition to through modal intensity and complexity. We conclude by a call for further educational research in online teaching platforms using the framework to have richer understandings of the (inter)actions between social actors with particular roles and identities (teachers-learners), their environment, and the objects and tools within, which bring their “own material properties, feel and techniques of use, affordances and limitations” (Chun, Dorothy, Richard Kern & Bryan Smith. 2016. Technology in language use, language teaching, and language learning. The Modern Language Journal 100. 64–80: 65).