bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cryptosporidium
impacts epithelial turnover and is resistant to induced death of the host cell
Authors: Wallbank Bethan A. , Pardy Ryan D. , Brodsky Igor E. , Hunter Christopher A. , Striepen Boris 
Published: July 2024

ABSTRACT

Infection with the apicomplexan parasite
Cryptosporidium
is a leading cause of diarrheal disease. Cryptosporidiosis is of particular importance in infants and shows a strong association with malnutrition, both as a risk factor and as a consequence.
Cryptosporidium
invades and replicates within the small intestine epithelial cells. This is a highly dynamic tissue that is developmentally stratified along the villus axis. New cells emerge from a stem cell niche in the crypt and differentiate into mature epithelial cells while moving toward the villus tip, where they are ultimately shed. Here, we studied the impact of
Cryptosporidium
infection on this dynamic architecture. Tracing DNA synthesis in pulse-chase experiments
in vivo,
we quantified the genesis and migration of epithelial cells along the villus. We found proliferation and epithelial migration to be elevated in response to
Cryptosporidium
infection. Infection also resulted in significant cell loss documented by imaging and molecular assays. Consistent with these observations, single-cell RNA sequencing of infected intestines showed a gain of young and a loss of mature cells. Interestingly, enhanced epithelial cell loss was not a function of enhanced apoptosis of infected cells. To the contrary,
Cryptosporidium
-infected cells were less likely to be apoptotic than bystanders, and experiments in tissue culture demonstrated that infection provided enhanced resistance to chemically induced apoptosis to the host but not bystander cells. Overall, this study suggests that
Cryptosporidium
may modulate cell apoptosis and documents pronounced changes in tissue homeostasis due to parasite infection, which may contribute to its long-term impact on the developmental and nutritional state of children.

IMPORTANCE

The intestine must balance its roles in digestion and nutrient absorption with the maintenance of an effective barrier to colonization and breach by numerous potential pathogens. An important component of this balance is its constant turnover, which is modulated by a gain of cells due to proliferation and loss due to death or extrusion. Here, we report that
Cryptosporidium
infection changes the dynamics of this process increasing both gain and loss of enterocytes speeding up the villus elevator. This leads to a much more immature epithelium and a reduction of the number of those cells typically found toward the villus apex best equipped to take up key nutrients including carbohydrates and lipids. These changes in the cellular architecture and physiology of the small intestine may be linked to the profound association between cryptosporidiosis and malnutrition.
Most major bleeds in preterm infants occur in the absence of severe thrombocytopenia: an observational cohort study
Authors: van der Staaij Hilde , Hooiveld Nadine M A , Caram-Deelder Camila , Fustolo-Gunnink Suzanne F , Fijnvandraat Karin , Steggerda Sylke J , de Vries Linda S , van der Bom Johanna G , Lopriore Enrico 
Published: July 2024

Objective
To describe the incidence of major bleeds according to different platelet counts in very preterm infants, and to explore whether this association is influenced by other risk factors for bleeding.

Design
Observational cohort study.

Setting
A Dutch tertiary care neonatal intensive care unit.

Patients
All consecutive infants with a gestational age at birth <32 weeks admitted between January 2004 and July 2022.

Exposure

Infants were stratified into nine groups based on their nadir platelet count (×10
9
/L) during admission (<10, 10–24, 25–49, 50–99, 100–149, 150–199, 200–249, 250–299 and ≥300), measured before the diagnosis of a major bleed and before any platelet transfusion was administered.

Main outcome measure
Incidence of major bleeds during admission. Logistic regression analysis was used to quantify the relationship between nadir platelet count and incidence of major bleeds.

Results

Among 2772 included infants, 224 (8%) developed a major bleed. Of the infants with a major bleed, 92% (206/224) had a nadir platelet count ≥50×10
9
/L. The incidence of major bleeds was 8% among infants with and without severe thrombocytopenia (platelet count <50×10
9
/L), 18/231 (95% CI 5 to 12) and 206/2541 (95% CI 7 to 9), respectively. Similarly, after adjustment for measured confounders, there was no notable association between nadir platelet counts below versus above 50×10
9
/L and the occurrence of major bleeds (OR 1.09, 95% CI 0.61 to 1.94).

Conclusion
In very preterm infants, the vast majority of major bleeds occur in infants without severe thrombocytopenia.
Retrospective analysis on the outcomes of contact lens-associated keratitis in a tertiary centre: an evidence-based management protocol to optimise resource allocation
Authors: Cai Yijun , Clancy Noah , Watson Martin , Hay Gordon , Angunawela Romesh 
Published: July 2024

Abstract

Background/aims
Contact lens-associated keratitis (CLAK) is a common sight-threatening complication of contact lens use. Current management protocols in the UK are based on historical practice and necessitate a review for every patient within 48 hours regardless of severity, increasing the treatment burden on a resource-limited healthcare service. Our study aims to identify the different risk factors associated with CLAK, categorise CLAK using a novel grading system and recommend modifications to current management protocols based on the outcomes in the individual subgroups.

Methods
The retrospective cohort study identified 161 eyes from 153 patients with CLAK from the electronic patient records of a tertiary eye centre between 1 July 2021 and 28 February 2022. Patients were categorised based on epithelial defect size (grade 1: <1.0 mm, grade 2: 1.0–2.0 mm, grade 3: >2.0 mm) and their risk factors, clinical features, treatments and outcomes were analysed.

Results
The most significant risk factors for CLAK include extended-wear contact lens, poor hygiene and prolonged duration of wear. Grades 1 and 2 CLAKs have excellent outcomes following an empirical treatment regime with topical moxifloxacin with 96% discharged within 48 hours and 94.1% discharged in 2 weeks, respectively. Grade 3 CLAKs require prolonged average duration of treatment.

Conclusion
We recommend typical grade 1 and 2 CLAKs can be discharged with empirical fluoroquinolone treatment. Grade 3 and all CLAKs with atypical features require monitoring for resolution, further diagnostics or treatment. We provide an evidence-based approach to reduce unnecessary patient visits and optimise resource allocation in an urban setting.
Shared decision-making in the management of pulmonary nodules: a systematic review of quantitative and qualitative studies
Authors: Yuan Jingmin , Xu Fenglin , Sun Yan , Ren Hui , Chen Mingwei , Feng Sifang 
Published: July 2024

ObjectiveThe objective of this systematic review was to explore the evidence regarding shared decision-making (SDM) in the management of pulmonary nodules.DesignSystematic review of quantitative and qualitative studies.Data sourceStudies published in English or Chinese up to April 2022 were extracted from nine databases: PubMed, PsycINFO, EMBASE, Cochrane Library, Web of Science and CINAHL, China National Knowledge Infrastructure, Wanfang Data and SinoMed Data.Eligibility criteriaStudies were eligible if patients or healthcare providers are faced with pulmonary nodule management options or the interventions or experiences were focused on the patient–healthcare provider relationship or health education to make, increase or support shared decisions. All types of studies were included, including quantitative and qualitative studies. Grey literature and literature that had not been peer reviewed were excluded. Poster abstracts and non-empirical publications such as editorials, letters, opinion papers and review articles were excluded.Data extraction and synthesisTwo reviewers independently screened abstracts and full texts, assessed quality using Joanna Briggs Institute’s critical appraisal tools, and extracted data from included studies. Thematic syntheses were used to identify prominent themes emerging from the data.ResultsA total of 12 studies met the inclusion criteria, 11 of which were conducted in USA. These included six qualitative studies and six quantitative studies (including both survey and quasi-experimental designs). Three major themes with specific subthemes emerged: (1) Opportunity (uncertainty in the diagnosis and treatment of pulmonary nodules, willingness to participate in decision-making); (2) Ability (patient’s lack of knowledge, physician’s experience); and (3) Different worldview (misconception, distress among patients, preference for diagnosis and treatment).ConclusionsUncertainty in the management of pulmonary nodules is the opportunity to implement SDM. Patients’ lack of knowledge, distress, and misunderstandings between healthcare providers and patients are both the main obstacles and the causes of the application of SDM.
Exploring medical first responders’ perceptions of mass casualty incident scenario training: a qualitative study on learning conditions and recommendations for improvement
Authors: Schulz Fredrik , Nguyen Quynh , Baetzner Anke , Sjöberg David , Gyllencreutz Lina 
Published: July 2024

ObjectiveDespite participating in scenario training, many medical first responders (MFRs) perceive themselves as inadequately prepared to respond to mass casualty incidents (MCIs). The objective of this study was to conduct a comprehensive examination of traditional MCI scenario training methods, focusing on their inherent strengths and limitations. An investigation into the perceptions of MFRs who had participated in MCI scenario training was carried out to identify potential areas for improvement and provide recommendations for refining MCI training protocols.DesignQualitative inductive approach using semistructured interviews that took place between October 2021 and February 2022. Data were analysed with qualitative content analysis.SettingMCI scenario training involving four organisations (three emergency medical services and one search-and-rescue organisation) tasked with responding to MCIs, collectively representing four European Union countries.Participants27 MFRs (17 emergency medical services personnel and 10 search-and-rescue volunteers) were recruited to participate in the study.ResultsTwo categories and seven associated subcategories (shown in parentheses) were identified as influencing the learning outcomes for MFRs: Training in a context mirroring real-world incidents (conducting incident scene risk assessment, realistic representation in casualties, incorporating scenario variety into the curriculum, interagency collaboration, role alignment when training incident site management) and use of a pedagogical framework (allowing for mistakes, the importance of post-training evaluation).ConclusionsThis study reaffirms the value of traditional MCI scenario training and identifies areas for enhancement, advocating for realistic scenarios, interagency collaboration, improved incident site management skills and thorough post-training evaluation. It suggests a shift in MCI training conceptualisation and delivery. The potential of virtual reality technologies as a valuable addition to training methods is explored, with a note on the need for further research to ascertain the long-term effectiveness of these technologies. However, the selection of a training method should consider programme goals, target population and resources.
Post-traumatic stress disorder symptoms following exposure to acute psychological trauma in children aged 8–16 years in South Africa: protocol for the Sinethemba longitudinal study
Authors: Sharp Tamsin H , Chideya Yeukai , Giuliani Alessandra , Hunt Xanthe , Tomlinson Mark , Seedat Soraya , Creswell Cathy , Fearon Pasco , Hamilton-Giachritsis Catherine , Hiller Rachel , Meiser-Stedman Richard , Du Toit Stefani , Stewart Jackie , Halligan Sarah L 
Published: July 2024

IntroductionChildren exposed to trauma are vulnerable to developing post-traumatic stress disorder (PTSD) and other adverse mental health outcomes. In low-and middle-income countries (LMICs), children are at increased risk of exposure to severe trauma and co-occurring adversities. However, relative to high-income countries, there is limited evidence of the factors that predict good versus poor psychological recovery following trauma exposure in LMIC children, and the role of caregiver support in these high-adversity communities.Methods and analysisWe will conduct a longitudinal, observational study of 250 children aged 8–16 years and their caregivers in South Africa, following child exposure to acute trauma. Dyads will be recruited from community hospitals following a potentially traumatic event, such as a motor vehicle accident or assault. Potential participants will be identified during their hospital visit, and if they agree, will subsequently be contacted by study researchers. Assessments will take place within 4 weeks of the traumatic event, with 3-month and 6-month follow-up assessments. Participants will provide a narrative description of the traumatic event and complete questionnaires designed to give information about social and psychological risk factors. Child PTSD symptoms will be the primary outcome, and wider trauma-related mental health (depression, anxiety, behavioural problems) will be secondary outcomes. Regression-based methods will be used to examine the association of psychosocial factors in the acute phase following trauma, including caregiver support and responding, with child PTSD and wider mental health outcomes.Ethics and disseminationEthical approvals have been granted by Stellenbosch University and the University of Bath, with additional approvals to recruit via hospitals and healthcare clinics being granted by the University of Cape Town, the Department of Health and the City of Cape Town. Study findings will be disseminated via publication in journals, workshops for practitioners and policy-makers, and public engagement events.
Impact of C-level positions on hospital performance: a scoping review protocol
Authors: Henzler Dennis , Zuchowski Matthias Lukas , Alscher Mark Dominik , Nagel Eckhard 
Published: July 2024

IntroductionThe objective of this scoping review is to identify evidence of the impact of hospital managers in top management (c-suite) on hospital performance. Managers generally have various effects on organisational objectives of their organisations. In recent years, the healthcare sector has experienced alterations in hospital governance structures, together with the emergence of new c-suite positions, aligning more closely with those found in private organisations. Their impact on hospital performance (ie, quality of care) is not well known. This scoping review seeks to identify all the available evidence of their impact on the organisational objectives. This scoping review will include primary studies, reviews and commentaries that describe the impact of top management team members on organisational outcomes in a hospital setting.Methods and analysisThe search strategy aims to locate both published and unpublished documents (ie, grey literature) using a three-step search strategy. An exploratory search of Medline and Google Scholar identified keywords and Medical Subject Headings terms. A second search of Medline (PubMed), Web of Science Core Collection, ScienceDirect, Business Source Premier (EBScoHost), JSTOR, BASE, Lens.org and the Google Search Engine will be performed. The scope of the search will cover 1990-present time using English search terms. Manual searching by two reviewers will be added to the search strategy. The identified documents will be independently screened, selected by two researchers and extracted by one researcher. The data are then presented in tables and graphics coupled with a descriptive summary.Ethics and disseminationAs this study neither involves human participants nor unpublished secondary data, an ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal.Trial registration numberThe protocol was registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/EBKUP).
Does clinical experience influence the effects of team simulation training in stroke thrombolysis? A prospective cohort study
Authors: Ajmi Soffien Chadli , Kurz Martin , Lindner Thomas Werner , Dalen Ingvild , Ersdal Hege Langli 
Published: July 2024

ObjectivesAfter introducing a team simulation training programme at our hospital, we saw a reduction in door-to-needle times (DNT) for stroke thrombolysis but persisting variability prompting further investigation. Our objective is to examine this gap through assessing: (1) whether there is an association between DNT and the clinical experience of neurology registrars and (2) whether experience influences the benefits from attending simulation.DesignProspective cohort study.Setting and participantsPatients treated with intravenous thrombolysis between January 2016 and 2020 at a Norwegian stroke centre.Primary and secondary outcome measuresUsing DNT and prior intravenous thrombolysis administrations (case-based definition of clinical experience) as continuous variables, a mixed effects linear regression model was performed to examine the association between clinical experience, DNT and simulation attendance. For dichotomised analyses, neurology registrars with 15 or more prior treatments were defined as experienced.ResultsA total of 532 patients treated by 36 neurology registrars from January 2016 to 2020 were included. There was a linear association between clinical experience and DNT (test for non-linearity p=0.479). Each prior intravenous thrombolysis administration was associated with a significant 1.1% decrease in DNT in the adjusted analysis (ΔDNT −1.1%; 95% CI, −2.2% to −0.0%; p=0.048). The interaction between effects of clinical experience and simulation on DNT was not statistically significant (p=0.150). In the dichotomised analysis, experienced registrars had similar gains from attending simulation sessions (mean DNT from 18.5 min to 13.5 min) compared with less experienced registrars (mean DNT from 22.4 min to 17.4 min).ConclusionsLess experienced registrars had longer DNT in stroke thrombolysis. Attending team simulation training was associated with similar improvements for experienced and inexperienced neurology registrars. We suggest a focus on high-quality onboarding programmes to close the experience-related quality gap. Our findings suggest that both inexperienced and experienced neurology registrars might benefit from team simulation training for stroke thrombolysis.
Benchmarking a universal smoking machine adaptor for tobacco product testing
Authors: El-Hellani Ahmad , Watson Clifford H , Huang Michelle , Wilson Clark W , Fleshman Clint C , Tran Hang , Chafin Dana , McGuigan Megan , Bravo Cardenas Roberto , Petitti Ryan , Pancake Mary , Bennett Chad , Mays Darren , Keller-Hamilton Brittney L , Jones Jeremy , Ye Wei , Schaff Jason , Borthwick Robert P , Williamson Raymond L , Wagener Theodore L , Brinkman Marielle C 
Published: July 2024

SignificanceCharacterisation of tobacco product emissions is an important step in assessing their impact on public health. Accurate and repeatable emissions data require that a leak-tight seal be made between the smoking or vaping machine and the mouth-end of the tobacco product being tested. This requirement is challenging because of the variety of tobacco product mouth-end geometries being puffed on by consumers today. We developed and tested a prototype universal smoking machine adaptor (USMA) that interfaces with existing machines and reliably seals with a variety of tobacco product masses and geometries.MethodsEmissions were machine-generated using the USMA and other available adaptors for a variety of electronic cigarettes (n=7 brands), cigars (n=4), cigarillos (n=2), a heated tobacco product, and a reference cigarette (1R6F), and mainstream total particulate matter (TPM) and nicotine were quantified. Data variability (precision, n≥10 replicates/brand) for all products and error (accuracy) from certified values (1R6F) were compared across adaptors.ResultsTPM and nicotine emissions generated using the USMA were accurate, precise and agreed with certified values for the 1R6F reference cigarette. Replicate data indicate that USMA repeatability across all tobacco products tested generally meets or exceeds that from the comparison adaptors and extant data.ConclusionThe USMA seals well with a variety of combustible tobacco products, e-cigarettes with differing geometries and plastic-tipped cigarillos. Variability for all measures was similar or smaller for the USMA compared with other adaptors.
Mass distributions in 12C + 232Th fission: role of shell effects and excitation energy
Authors: Kumar S. , Patra S. , Mhatre A. , Kumar A. , Ramachandran K. , Tripathi R. 
Published: July 2024

AbstractThis article reports the measurement of cross sections of charge and mass identified fission products and the mass distributions in 232Th(12C,f) reaction at 62.5, 70.7 and 102.9 MeV beam energies to investigate the role of single particle effects. The study was carried out using the recoil catcher technique followed by off-line γ-ray spectrometry. Cross sections of 32, 54 and 64 fission products were measured for 62.5, 70.7 and 102.9 MeV beam energies, respectively. The mass distributions obtained at 62.5 and 70.7 MeV show a flat-top nature indicating significant asymmetric fission contribution (heavy mass peak corresponding to Z range of 54–56), whereas, a nearly Gaussian behaviour was observed at 102.9 MeV indicating dominant contribution from symmetric fission. The experimental mass distributions were in gross agreement with the “GEF, 2021/1.1” calculations which predicted significant asymmetric fission contribution dominated by Z ≈ 55 (‘Standard 2’ mode) at 62.5 and 70.7 MeV. The present study shows the significant role of charge polarization resulting in the deviation of the most probable charge (ZP) values from those obtained using UCD hypothesis. “GEF, 2023/2.1” calculations were unable to explain the observed mass distributions with significant asymmetric fission contribution due to comparatively lower contribution from higher chance fission resulting from the lower saddle point energies. An attempt has been made to estimate the mass distributions arising from the complete fusion fission and α-transfer induced fission. The trend shows an increase in the α-transfer induced fission contribution with increasing beam energy which is in qualitative agreement with the sum-rule model calculations.
Yadism: yet another deep-inelastic scattering module
Authors: Candido Alessandro , Hekhorn Felix , Magni Giacomo , Rabemananjara Tanjona R. , Stegeman Roy 
Published: July 2024

AbstractWe present , a library for the evaluation of both polarized and unpolarized deep-inelastic scattering (DIS) structure functions and cross sections up to N$$^{3}$$3LO in perturbative QCD. The package provides computations of observables in fixed-flavor and zero-mass variable flavor number schemes. The implementation of the general mass variable flavor number schemes is supported through the high virtuality limits for the heavy flavor coefficients. In addition, provides a set of tools for the generation of interpolation grids in the PDF-independent format, allowing to test the PDF dependence on any DIS observable without needing to rerun the computation. This work is part of an ongoing effort to standardize the format of theory predictions in high-energy physics within the framework. The code is open source, written in and documented to facilitate usage, integrations, and further extensions. Finally, the code has been benchmarked against the widely used and libraries.