bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stress and Resilience in the Nursing Profession: Staff and Supervisor Perceptions, Assumptions and Responsibility for Health: A Generic Qualitative Study
Authors: HELAß Madeleine , GREINACHER Anja , GENRICH Melanie , MÜLLER Andreas , ANGERER Peter , GÜNDEL Harald , JUNNE Florian , NIKENDEI Christoph , MAATOUK Imad 
Published: August 2024

Abstract

Background
Supervisor–subordinate relationship is high relevant in dealing with work-related stress and providing a compassionate, high-quality, and safe nursing care while meeting the needs of the hospital. Our aim was to identify and compare nurses’ work-related stress and the factors of resilience from the perspective of registered nurses and supervisors in clinical inpatient settings.
Design:
Generic qualitative study using half-standardized interviews.
Methods
Fifty nurses and supervisors from different departments from a German hospital of maximum medical care participated in this study between August and November 2018. Nineteen face-to-face interviews and five focus groups were conducted. Transcripts were subjected to structured qualitative content analysis.
Results
Systematised in Lazarus’s transactional model, nurses, and supervisors mentioned similar risk and resilience factors of stress. Disagreement in suggested responsibility for nurses’ stress or health and an evaluation of implemented measures meeting the nurses’ needs are discussed.
Conclusion
Nursing staff and supervisors should enforce exchange to reduce disagreements in perceptions and to improve mutual understanding. Furthermore, measures to meet nurses’ needs to minimize stress and to improve collaboration and job satisfaction should be developed in close coordination with the target group. The focus should be placed on restructuring training and education programs with supplementation of self-responsibility promotion.
Trail registration:
The study was registered with the German Register for Clinical Studies (DRKS00013482).
DE_HyART trial: Study protocol for phase 2 randomised controlled study assessing the role of dose escalation using [18F] FMISO PET CT in head and neck cancers
Authors: Tandon Sarthak , Gupta Manoj , Ahlawat Parveen , Nayak Apoorva , Bellige Akash , Rai Shreya , Arora Vikas , Yadav Vishal , Singh Abhishek , Chufal Kundan Singh , Sethi Jaskaran Singh , Pahuja Anjali , Simson David , Ahmad Irfan , Patodi Vibhor , Ansari Azhar , Gupta Priya , Vyas Harsh , Saha Rajat , Agarwal Mudit , Choudhary Partha S , Dewan Ajay Kumar , Gairola Munish 
Published: August 2024

Abstract

Background:
Head and neck squamous cell carcinoma (HNSCC) is often treated with radiotherapy, frequently combined with chemotherapy, to improve overall survival (OS). Despite advancements, locoregional control (LRC) remains a significant challenge, with 15–50% of patients experiencing locoregional recurrence, negatively impacting OS and quality of life. Hypoxia within tumor cells is a critical factor contributing to treatment failure, necessitating higher radiation doses to achieve similar therapeutic effects as in normoxic cells. This study aims to investigate the role of dose escalation using [18F] FMISO PET CT to target hypoxic sub-volumes in HNC to improve LRC.
Methods:
The DE-HyART trial is an open-label, parallel, randomized, single-center, phase II study. Patients with HNC will undergo [18F] FMISO PET CT to identify hypoxic regions. Patients will be stratified into three arms based on their hypoxia status. Arm 1 will include normoxic patients receiving standard care and serving as external controls. Arm 2 will receive standard radiotherapy of 70 Gy in 2 Gy fractions, while Arm 3 will receive an additional boost to the hypoxic sub-volumes, delivering a total of 80 Gy (Phase 2). All patients in Arms 2 and 3 will also receive concurrent chemotherapy with cisplatin. Patients will be monitored weekly for treatment tolerance, with acute adverse events recorded according to NCI CTCAE v5.0. The primary endpoint is LRC, defined as the time from randomization to the first histopathologically confirmed relapse of locoregional disease. Secondary endpoints include OS, acute and late toxicity, and patient-reported outcomes assessed using the EORTC QLQ-C30 and QLQ-H&N35 questionnaires.
Discussion:
This study addresses a critical gap in the management of HNC by targeting hypoxic regions within tumors, potentially improving LRC and, consequently, OS. The use of [18F] FMISO PET CT for identifying hypoxic sub-volumes allows for tailored radiation dose escalation, which could overcome the radioresistance associated with hypoxia. By comparing outcomes among normoxic patients (Arm 1), standard radiotherapy (Arm 2), and dose-escalated treatment (Arm 3), this trial aims to establish a more effective therapeutic strategy for HNC patients.
Trial Registration:
This trial is registered with the Clinical Trials Registry of India (CTRI/2024/04/065373), registered on 08th April 2024 on ctri.nic.in and clinicaltrials.gov (NCT06087614) registered on 18th September 2023 on clinicaltrials.gov.
Four Weeks of 'Living Low-Training High' Enhances Anaerobic Capacity in Elite Sanda Athletes
Authors: Li Liang , Mei Tao 
Published: August 2024

Abstract

Introduction:
Altitude training or normobaric hypoxic training is considered an effective method to enhance athletes' performance. The aim of this study is to investigate the effects of 4 weeks of “living low-training high” (LLTH) on the anaerobic exercise capacity of elite martial arts Sanda athletes.
Methods
A randomized controlled trial design was employed, dividing Sanda athletes into training (LLTH) and control (Con) groups. The LLTH group (n = 17) underwent hypoxic training sessions simulating altitudes of 2200 m (FiO2 ≈ 15.9%) and 2900 m (FiO2 ≈ 14.6%), while the Con group (n = 17) trained in a normoxic environment. Wingate anaerobic power and blood lactate were measured pre- and post-intervention.
Results
The LLTH group demonstrated marked improvements in anaerobic power parameters compared to their baseline values. Specifically, significant increases were noted in total work (from 297.9 ± 13.2 to 314.0 ± 14.5 J/kg, p = 0.01), peak anaerobic power (from 947.9 ± 38.2 to 1008.2 ± 38.4 W, p < 0.001), relative peak power (from 12.5 ± 0.7 to 12.7 ± 0.6 W/kg, p < 0.001), average power (from 573.3 ± 20.24 to 603.1 ± 18.3 W, p < 0.001), and a decrease in time to peak power (from 6.3 ± 0.6 to 6.2 ± 0.6 s, p < 0.001), along with a reduced power drop rate (from 21.5 ± 2.4 to 19.3 ± 2.2 W/s, p < 0.001). Furthermore, blood lactate levels measured in the quiet state post-intervention were significantly lower in the LLTH group compared to the Control group (1.13 ± 0.18 vs. 2.87 ± 0.82 mmol/L, p < 0.001). Similarly, within the LLTH group, blood lactate levels decreased significantly from pre- to post-intervention (2.90 ± 1.05 to 1.13 ± 0.18 mmol/L, p < 0.001). No significant differences were observed in other physiological parameters or measurement sites between the two groups.
Conclusion
Four weeks of LLTH intervention enhanced the anaerobic exercise capacity of elite martial arts Sanda athletes, aiding their performance in high-intensity, short-duration activities.
Improve the projection of East China summer precipitation with emergent constraints
Authors: Jiang Zhihong , Zhu huanhuan , Li Laurent , Wei Li , Sheng Jiang 
Published: August 2024

Abstract

Under global warming, summer precipitation over East China was projected to increase by current state-of-the-art climate models, but large inter-model spread exists. Here we try to reduce the projection uncertainty by imposing constraints. Our procedure consists of firstly decomposing the projected future precipitation into inter-model principal components. The two leading modes (region-wide uniform monopole and north-south dipole, accounting for 55% of variability), by emergent constraints, are then linked to the simulation of historical precipitation in the northwest Pacific and the tropical Pacific (constraining areas). This allows us to reduce the range of projected precipitation in East China by 24%, with a relatively uniform increase for the first mode and a larger increase in the north subregion for the second. It is also shown that the emergent relations of both modes are physically consistent, with an enhancement of future zonal land-sea thermal contrast and a La Niña-like pattern.
Clinical-pathologic classification of anti-HMGCR-positive immune-mediated necrotizing myopathy
Authors: Cao Yuyan , Li Wei , He Xiongjun , Liao Meiqi , Hu Kexin , Wu Shenghao , Zhang Xin , Liao Qianyi , Shen Ziqi , Liang Zaoxin , Zheng Chaoren , Jiang Haishan , Huang Qin , Zheng Hui 
Published: August 2024

Abstract

Anti-HMGCR-positive immune-mediated necrotizing myopathy (IMNM) was initially considered as an exclusively skeletal muscular disease characterized by predominant proximal muscle weakness, observed in elderly patients with an acute duration. However, an increasing number of patients presented extra-muscular involvements coinciding with other autoimmune antibodies. Moreover, some juvenile patients showed chronic weakness of shoulder and hip girdle musculature, resembling limb-girdle muscular dystrophy (LGMD). The present study aims to develop the essential and easily available clinical-pathological classification for anti-HMGCR-positive IMNM patients. Eighteen anti-HMGCR-positive IMNM patients were from Nanfang Hospital and fifty were from published studies. We separated patients into two subgroups, including the overlap (with coexistence of other antibodies) and non-overlap groups (with only anti-HMGCR-positive patients). Medical information, including the clinical and pathological features, together with their treatments and prognosis were compared. We found that compared to the non-overlap anti-HMGCR-positive IMNM group, overlap patients had more extra-muscular symptoms, corresponding to the coexistence of other myositis-specific antibodies (MSAs) and resulting different treatments and prognoses. The early onset age and chronic process, together with the special pathology of resembling LGMD indicated that this is likely a different subtype in non-overlap anti-HMGCR-positive IMNM patients. The results revealed that the anti-HMGCR-positive IMNM patients can be separated into overlap and non-overlap anti-HMGCR-positive IMNM patients. The non-overlap group can be further divided into LGMD-like and non-LGMD-like anti-HMGCR-positive IMNM. However, the confirmed classification of anti-HMGCR-positive IMNM patients requires further proteomics and transcriptomics studies and could potentially be useful for individualized treatment decision making.
Cumulative incidence of chronic pain after visiting a Dutch Emergency Department with acute pain
Authors: MOL S. , BROWN A. V. , KUIJPER T. M. , BOUWHUIS M. G. , GROOT B. , OUT A. J. , Ibelings M. G. , Koopman J. S. H.A. 
Published: August 2024

Abstract

Background: Chronic pain is a substantial problem in modern healthcare resulting in health care overutilization. The cumulative incidence of developing chronic pain after visiting the emergency department with acute pain has been determined for specific patient groups only. If the cumulative incidence of chronic pain in emergency department patients with acute pain is high, more proactive measures are justified to limit development of chronic pain.
The primary objective was to study the cumulative incidence of chronic pain in patients visiting Dutch emergency departments with acute pain. In addition, we compared the Health-Related Quality of Life (HRQOL) and pain related interference with work.
Methods: In this prospective multicenter cohort study data was collected from adult patients visiting the emergency department with acute pain. Chronic pain was defined by means of a numeric rating scale (NRS) of ≥1 measured 90 days after the initial visit. HRQOL was measured with European Quality of Life (EQ-5D-5L) and Short Form (SF-36) questionnaires.
Results: 1906 patients were included of which 825 had complete data. Of these, 559 patients (67.8%; 95%CI: 64.5% - 70.9%) scored an NRS ≥1 after 90 days. Incidence with completed analyses (with imputed data) was similar. Patients with chronic pain reported a significantly lower HRQOL; EQ-5D-5L index (median 0.82 vs. 1.00) and significantly more pain related hindrance (median 1.00 vs. 0.00).
Conclusions: 67.8% of the responders scored NRS ≥1 90 days after ED-visit with acute pain. Regardless of the used definition, chronic pain is associated with a lower HRQOL and more pain related hindrance.
Exploring the Vaginal Microbiome During Pregnancy: Microbial Diversity, E. coli pathogenicity, and Links to Urinary Tract Colonization
Authors: Boutouchent Nassim , Vu Thi Ngoc Anh , Landraud Luce , Kennedy Sean P. 
Published: August 2024

Abstract

This study explores the role of the vaginal microbiota (VM) in the pathophysiology of asymptomatic bacteriuria (ASB), which requires systematic screening and antibiotic treatment during pregnancy. We hypothesize that disruptions in the VM composition may promote the ascending colonization of bacteria from the gut to the urinary tract, reinforcing the existence of a gut-urogenital axis. A healthy VM is typically characterized by low diversity and is dominated by lactic acid-producing species, notably those from the Lactobacillus genus. Diversity analyses of whole genomes metagenomic sequencing data from 1,553 pregnant women revealed a metagenomic signature characterized by an increase in phylogenetic diversity within the VM during ASB. This shift includes both a decrease in lactobacilli and an increase in the abundance of taxa associated with the gut microbiota, particularly Enterobacterales, with a substantial rise in Escherichia coli abundance. Worldwide, E. coli remains the most common etiological agent of bacteriuria during pregnancy and also a major causative agent of newborn infections. Given its importance and the limited data on its characterization within the VM during pregnancy, we performed genomic assembly and analysis of this species from pregnant women of this cohort. Molecular typing and antimicrobial resistance characterization of 72 assembled E. coli genomes revealed a genomic signature of Extra-Intestinal pathogenic E. coli (“ExPEC”) strains, which are involved in various extraintestinal infections such as urinary tract infections, newborn infections and bacteremia. Moreover, the presence of this species in the vaginal environment was associated with a substantial variation of the microbial diversity, primarily marked by a decrease in abundance of Lactobacillus species. Overall, our study shows how disruption in key bacterial group within the VM can disrupt its stability, potentially leading to the colonization by opportunistic pathogens.
Acute cholecystitis management at a tertiary care center: are we following current guidelines?
Authors: Spota Andrea , Hassanpour Amir , Shlomovitz Eran , Gomez David , Al-Sukhni Eisar 
Published: August 2024

Abstract

Purpose
After the Tokyo 2018 guidelines (TG2018) were published, evidence from the 2018 CHOCOLATE RCT supported early cholecystectomy for acute cholecystitis (AC), even in high-risk patients. This study aims to investigate AC management at our tertiary care center in the years following these publications.
Methods
A retrospective cohort study was performed of patients admitted from 2018–2023. AC severity was graded using TG2018 definitions. Comorbidities were summarized using Charlson Comorbidity Index (CCI) and frailty using the 5-item modified Frailty Index (5mFI). Compliance with TG2018 recommendations for management strategy was investigated. Outcomes were compared between patients who underwent surgery versus NOM. Subset analysis based on patients’ age, frailty, and comorbidities was performed.
Results
Among 642 AC patients, 57% underwent cholecystectomy and 43% NOM (22% percutaneous cholecystostomy, 21% antibiotics only). NOM patients had greater length of stay (LOS), complications, deaths, readmissions, and discharge to nursing/rehab versus surgery patients. In 70% of patients managed non-operatively, TG2018 were not followed. Patients managed non-operatively despite TG2018 were more likely to undergo delayed cholecystectomy compared to those in whom guidelines were followed (17% vs 4%). In subset analysis, healthy octogenarians were significantly less likely to be managed according to TG2018 (9.4%); patients undergoing surgery had a trend towards shorter LOS (3.1 vs 4.8 days) than those managed non-operatively but no difference in other outcomes.
Conclusion
Most patients undergoing NOM could potentially undergo cholecystectomy if guidelines are considered. A more objective approach to risk assessment may optimize patient selection and outcomes.
Raman spectra DFT simulation of M.Tuberculosis cell wall components
Authors: Kundalevich Anna , Kapitunova Anastasia , Zyubin Andrey , Samusev Ilia 
Published: August 2024

Abstract

The article reflects the results of theoretical simulation using the DFT method for the components of the cell wall of Mycobacterium tuberculosis. Theoretical Raman spectra of mycolic acids (alpha, keto, methoxy) and arabinogalactan were obtained. The theoretical data were compared with experimental SERS results. The characteristic bands corresponding to markers of antibiotic resistance have been refined. The promise of the DFT-based approach for analyzing the complex structure of the mycobacterial wall has been demonstrated.
Distinctive Characterization of the Detoxification of Hexavalent Cr(VI) by Pterocarpus Marsupium Bark Carbon (PBC, APBC, and BPBC)
Authors: SURYA S. , NANDHAKUMAR V. , VEERAVELAN K. , RAKINI A. , HERYANTO HERYANTO 
Published: August 2024

Abstract

The purpose of this research is to investigate the removal of Hexavalent-Chromium Cr(VI) ion using activated carbons prepared from the barks of Pterocarpus Marsupium Roxb. by phosphoric acid, specifically Pterocarpus Marsupium Bark Carbon, Acid modified Pterocarpus Marsupium Bark Carbon, and Base modified Pterocarpus Marsupium Bark Carbon. Batch adsorption studies are performed by varying factors such as solution pH, adsorbent dosage, contact time, starting concentration, and temperature. Freundlich, Langmuir, Temkin, and Dubinin-Radushkevich isotherm equations were used to process equilibrium data. Isotherm constant values were found and their relevance was explained. The adsorption of Cr(VI) ions onto PBC, APBC, and BPBC was compared. The data collected from the influence of contact time for varying beginning concentrations were processed using the kinetic equations of Lagergren, ΔHo, and Webber Morris. The expected adsorption capacity and rate constants were determined. The adsorption capacities predicted were compared to experimental adsorption capacities. The statistical method Mean Summation of Error Squares (MSSE) was used to find the best-fitting model. The thermodynamic quantities ΔH°, ΔS°, and ΔG° were calculated using equilibrium data collected at various temperatures. The conclusions drawn from these values were addressed. The ability of adsorbents loaded with Cr (VI) ions to regenerate in acidic, alkaline, and neutral mediums was examined. To understand the adsorbate-adsorbent interactions, the FTIR spectra and EDAX of adsorbents were examined before and after sorption of Cr (VI) ions.
Clinical and Biologic Profiles of Patients with Acute Respiratory Distress Syndrome by Prevalence of Chronic Obstructive Pulmonary Disease or Emphysema; A Cohort Study
Authors: Nath Sridesh , Qurashi Hafiz , Kitsios Georgios D. , Bain William , Suber Tomeka , Prendergast Niall , Hensley Matthew , Schaefer Caitlin , Zhang Yingze , Bon Jessica , McVerry Bryan J. , Evankovich John , Shah Faraaz Ali 
Published: August 2024

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) is a critical care disorder characterized by diffuse lung injury. The impact of pre-existing chronic obstructive pulmonary disease (COPD) or emphysema on ARDS pathogenesis is not well characterized.
Methods: Secondary analysis of ARDS patients enrolled in the Acute Lung Injury Registry and Biospecimen Repository at the University of Pittsburgh between June 2012 and September 2021. Patients were categorized into two mutually exclusive groups by the prevalence of COPD or emphysema at the time of ARDS diagnosis. The COPD/emphysema group comprised ARDS patients with radiological evidence of emphysema, chart diagnosis of COPD, or both. Demographics, lung mechanics, and clinical outcomes were obtained from the electronic medical record. Host-response biomarkers known to have validated associations with ARDS were previously measured in plasma and lower respiratory tract samples using a customized Luminex assay. Continuous and categorical variables were compared between groups with and without COPD/emphysema.
Results: 217 patients with ARDS were included in the study, 57 (27%) had COPD/emphysema. Patients with COPD/emphysema were older (median 62 [interquartile range 55-69] versus 53 [41-64] years, p<0.01), more likely to be male (62% vs 44%, p=0.02) and had a higher prevalence of congestive heart failure (25% vs 4%, p<0.01) compared to patients without COPD/emphysema. Baseline demographics, laboratory parameters, and mechanical ventilatory characteristics were otherwise similar between the two groups. No difference in 90-day mortality was observed between groups; however, patients with COPD/emphysema had shorter duration of intensive care unit (ICU) stay (median 10 [7-18] versus 16 [9-28] days, p=0.04) and shorter duration of mechanical ventilation (median 7 [4-16] vs 12 [6-20] days, p=0.01). Host response biomarkers in serum and lower respiratory tract samples did not significantly differ between groups.
Conclusion: ARDS patients with COPD or emphysema had similar respiratory mechanics, host response biomarker profiles, and mortality compared to those without COPD or emphysema but with a shorter median duration of mechanical ventilation and ICU length of stay. Future studies should address differences in clinical and biological responses by disease severity, and should investigate the impact of severity of COPD and emphysema on mechanical ventilation and targeted therapeutic strategies in ARDS.