bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engaging Clinical Learners Asynchronously With Social Annotation for Case‐Based Discussions
Authors: Adamson Dylan T. , Kavalukas Sandra , Shaw M. Ann , Weingartner Laura A. 
Published: February 2025

ABSTRACTBackgroundClinical educators are often challenged to sustain learner engagement beyond the clinical learning environment. A social annotation platform is an instructional tool typically used in bachelor's‐level and other nonmedical instructional settings to facilitate asynchronous discussions for reading assignments. This work aimed to promote asynchronous engagement among clinical learners by adapting a social annotation platform for case‐based learning.ApproachWe piloted a social annotation platform in a 4‐week surgical residency preparatory course with fourth‐year medical students. We designed four longitudinal clinical cases representing common scenarios that surgical interns may encounter. Students discussed each case section asynchronously on the platform by annotating case content and replying to peer discussion comments.EvaluationWe measured engagement through activity on the platform and collected student perceptions through a postcourse evaluation survey. Nine students completed the residency preparatory course over 4 weeks in 2023. Engagement was high, with 95% of reading assignments completed. On average, students submitted nine discussion comments per assignment (three required) and spent 62 active minutes discussing each case section. Students engaged more overall with nonclinical topics. All students completed the postcourse survey and indicated that the platform was easy to navigate. Students appreciated being able to see peers' line of thinking through the case and reported feeling engaged with other students.ImplicationA social annotation platform may offer an effective tool for engaging clinical students asynchronously. This platform can be used in clinical education to provide instructional flexibility for faculty while helping students feel engaged with their peers and clinical curriculum.
The effects of resting time, centrifugation time, and technician training on plasma sample quantity and quality: Implications for the Dog Aging Project
Authors: Holland Sydney N. , Tinkle Amanda K. , Prescott Jena N. , Blattman Brianna L. ,   Dog Aging Project Consortium, Creevy Kate E. , Fajt Virginia R. 
Published: February 2025

AbstractBackgroundThe Dog Aging Project (DAP) is a large‐scale longitudinal study of aging in dogs. For some dogs in the DAP, blood samples for plasma isolation are collected by non‐DAP personnel. However, plasma samples are sometimes inadequate, which can lead to, for example, insufficient volume for assays.ObjectiveWe aimed to examine three factors that may affect plasma yield: resting time after sample collection, centrifugation time, and level of operator or technician training.MethodsWe designed three experiments using a convenience sample of five dogs. Each experiment varied one of the three factors and held the other two constant. Experiment 1 examined five different resting times: 10 min and 1, 4, 24, and 72 h. Experiment 2 compared centrifugation times of 7 and 14 min. Experiment 3 compared trained and untrained personnel. The sample resting was always under refrigeration. Experimental outcomes were total plasma volume, number of successful aliquots, hemolysis, and lipemia.ResultsA resting time of 72 h yielded statistically significantly lower plasma volume than resting times ≤4 h. Resting times of 24 and 72 h also had statistically significantly higher hemolysis scores compared with other resting time points. In addition, trained operators or technicians yielded an average of 0.5 more aliquots. Outcomes were similar by centrifugation time in Experiment 2.ConclusionTo mitigate sample loss, we recommend shorter post‐collection resting times and ensuring technician proficiency. Additionally, increasing the requested whole blood volume may improve sample yield.
Underlying Mechanisms Controlling Wear of Ti6Al4V-SS316L Tribo-Pair at Varying Sliding Speed and Contact Area in Vacuum
Authors: Philip Jibin T. , Singh Kamini , Kailas Satish Vasu 
Published: February 2025

Abstract
In tribo-systems, tribological behavior is influenced by a combination of several mechanisms. Among them, plastic deformation mechanisms (PDMs) and tribo-chemical reactions (TCRs) are particularly significant. The article explores the role of these fundamental mechanisms during the dry sliding of a Ti6Al4V-pin against an SS316L disk. PDM was controlled by changing the sliding speed (0.01–1.5 ms−1). To explore the interdependence of TCR submechanisms, namely, the formation of a mechanically mixed layer (MML) and tribo-oxidation, the pin diameter was varied (2.1, 4.6, and 6.6 mm) while maintaining a constant vacuum environment and contact pressure. At low sliding speeds (0.01–0.3 ms−1), the high wear-rate and coefficient of friction (CoF) are due to the dominance of PDM, enabled by adiabatic shear banding (ASB). Within the sliding speed range of 0.3–0.7 ms−1, a durable and wear-resistant MML forms on the pin surface incorporating Fe transferred from the disk. As the MML attains its highest stable thickness (≈51 µm at 0.7 ms−1), the lowest values of wear-rate (18.15 × 10−4 mm3/Nm) and CoF (0.324) are observable. Above 0.7 ms−1, thermally induced phase transformation-assisted material softening leads to a substantial increase in wear-rate and CoF. The case is otherwise for the smallest pin (2.1 mm) sliding at 1.5 ms−1. As sliding speed increases, wear transitions from adhesion to mild abrasion and then to severe adhesion.
Experiencing the “Unpredictable Inevitables”: Creating Opportunities on a Taught Master’s Program for Structured One-to-One Physical Activity Behavior-Change Support for Adolescent Girls (The HERizon Project)
Authors: Wood Hannah Clare , Carey Laura , Cowley Emma S. , Cacciatore Isabella , Ballinger Jennifer , Glover Ellie , Gore Payal , Simpson Amelia , Wells Nicole , Mansfield Chiara , Whitcomb-Khan Gabriella , Watson Paula M. 
Published: February 2025

This case study presents the experiences of MSc Sport Psychology students delivering a psychologically informed behavior-change intervention within the context of a PhD research project to develop their applied practice skills. We aimed to provide an example of how higher education providers can create such an opportunity for master’s students to conduct individualized support sessions in a safe and structured environment, while preserving the autonomy needed for professional growth. The placement was situated within the HERizon project (conducted between 2021 and 2022), an online physical activity behavior-change intervention for adolescent girls. MSc students worked as “Activity Mentors” and provided weekly one-to-one support for participants via video calls. In this case study, we reflect on what we learned as both students and supervisors responsible for the delivery of HERizon, both immediately after completing the project and 3 years after the experience, and offer recommendations for future practice.
Exploring the Path Between Life-Course Trajectories of Physical Activity Levels and Cardiometabolic Disease Incidence: Insights From the ATTICA Cohort Study (2002–2022)
Authors: Dimitriadis Nikos , Arnaoutis Giannis , Tambalis Konstantinos D. , Chrysohoou Christina , Barkas Fotios , Liberopoulos Evangelos , Sfikakis Petros P. , Pitsavos Christos , Tsioufis Costas , Panagiotakos Demosthenes 
Published: February 2025

Objective: To evaluate the paths between lifelong physical activity levels and the development of cardiometabolic disease. Methods: The ATTICA is a population-based cohort study with a 20-year follow-up conducted in the Attica region, Greece and included, 3042 adult males and females (45 [11] y). Participants physical activity levels’ tracking together with data regarding cardiovascular disease, obesity, hypertension, hypercholesterolemia, and diabetes incidence, were available in 1988 participants (45 [12] y old, 987 males and 1001 females), at 20-year follow-up. Physical activity levels were evaluated using the validated International Physical Activity Questionnaire, in all examinations (2001–2002, 2006, 2012, and 2022). Four physical activity trajectories were defined, that is, consistently active/inactive and changed from active/inactive. Path analysis was applied using structure equation models. Results: 54% of participants were classified as always inactive, 5% classified as became inactive from physically active, 38% as became active and, only 3% sustained physical activity levels. Participants who reported being consistently physically active throughout the 20-year period were 6% (OR, 0.94, 95% CI, 0.89–0.99) less likely to develop cardiovascular disease as compared with those who remained consistently physically inactive, had 21% lower risk of developing hypercholesterolemia (OR, 0.79, 95% CI, 0.59–1.04), 33% lower risk of obesity (OR, 0.67, 95% CI, 0.44–1.02), and 30% lower risk of diabetes (OR, 0.70, 95% CI, 0.48–1.03). Conclusions: Lifelong physical activity was strongly associated with reduced fatal or nonfatal cardiovascular disease events, as well as reduced risk of developing other cardiometabolic disorders, hypercholesterolemia, obesity, and diabetes.
Blood folate level needed for fully effective fortification in the prevention of neural tube defects
Authors: Wald Nicholas J , Vale Stephen H , Bestwick Jonathan P , Morris Joan K 
Published: February 2025

ObjectiveNeural tube defects (NTDs) are a preventable folate deficiency disorder; increasing folic acid intake through food fortification increases serum and red blood cell folate and reduces the risk of an NTD pregnancy. There is controversy over the blood folate level needed to achieve the full preventive effect because of discrepant study conclusions.MethodsResults from two published studies were used to determine the relationship between serum folate and NTD risk which was compared with the observed result in a randomised trial of folic acid that increased serum folate from 5 ng/mL to 44 ng/mL among women who took a 4 mg daily periconceptional folic acid supplement.ResultsBoth studies showed a proportional (logarithmic) relationship between serum folate and NTD risk without evidence of a folate threshold above which there is no further NTD risk reduction. The suggestion of a threshold is due to the incorrect interpretation of the folate-NTD risk association when plotted on arithmetic scales, which conceals the proportional relationship between the two. Also, both studies accurately estimated the observed result from the randomised trial that achieved a median serum folate level of 44 ng/mL and an 83% preventive effect. This is much higher than has been achieved with current levels of folic acid fortification with serum folate between 10 and 16 ng/mL, resulting in an approximate 20% preventive effect.ConclusionTo achieve fully effective fortification, median population serum folate levels need to be about 44 ng/mL, which would globally prevent about 250 000 NTD cases every year.
Monitoring the neurological complications of chimeric antigen receptor (CAR) T-cell therapy in patients with sensory and physical impairments and non-native-speaking backgrounds using modified immune effector cell-associated encephalopathy (ICE) scores: a case series
Authors: Kazzi Christina , Simpson Ty , Abbott Cassandra , Wronski Miriam , Seery Nabil , Tan Tracie Huey-Lin , Wesselingh Robb , Ko Katherine , Wong Shu Min , Inam Shafqat , Tam Constantine , Fleming Shaun , O’Brien Terence J , Alpitsis Rubina , Spencer Andrew , Malpas Charles , Monif Mastura 
Published: February 2025

BackgroundImmune effector cell-associated neurotoxicity syndrome (ICANS) is a common complication of chimeric antigen receptor (CAR) T-cell therapy. Current practice guidelines recommend the immune effector cell-associated encephalopathy (ICE) score for the assessment and monitoring of ICANS.ObjectiveTo demonstrate modifications to ICE score to patients with vision and hearing impairments or who are who are from non-native-speaking backgrounds.MethodsWe discuss five cases and the modifications made to adapt the ICE score to meet patients’ needs.ResultsModifications to ICE score was feasible and it assisted with CAR T cell therapy outcome monitoring.DiscussionThese cases highlight the need for flexible and patient-tailored strategies and the importance of collaboration between multidisciplinary teams and patients’ families/caregivers when monitoring patients for ICANS after CAR T-cell therapy.
Integration of healthcare services for HIV and non-communicable diseases in sub-Saharan Africa: protocol for a scoping review of randomised controlled trials
Authors: Murphy Lauren , Bulstra Caroline A , Figi John T , Fladger Anne , Atun Rifat 
Published: February 2025

IntroductionStand-alone HIV clinics in sub-Saharan Africa (SSA) have effectively expanded antiretroviral therapy since the 2000s, transforming HIV from a deadly infection into a chronic condition. However, over the past decade, there has been a significant rise in the prevalence of non-communicable diseases (NCDs) globally and in SSA. People living with HIV are at higher risk for some NCDs, including hypertension, diabetes and different cancers. The region’s current healthcare infrastructure is not equipped to address this growing burden. Integrating health services for HIV and NCDs (ie, combining services for HIV with services for hypertension, diabetes, depression and mental health, substance use disorder or cancer) could be one strategy for responding to these challenges. In this scoping review, we aim to identify randomised controlled trials on HIV-NCD integration, assess implemented integration models and measured outcomes and highlight evidence gaps.Methods and analysisThis scoping review will follow the Arksey and O’Malley (2005) methodological framework. Reporting will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. We will conduct a systematic search of the databases OVID Medline, Embase, Web of Science, Global, Africa Index Medicus, including terms related to HIV, NCDs and healthcare integration. Included trials must have been conducted within SSA and have been published in English or French after 1 January 2010. We will not select based on sample size or number of clusters. Both the title and abstract screening and full-text screening will be done in Covidence by at least two reviewers working independently. Data extraction will focus on key variables, including study design, geographical location, integration intervention, measured outcomes and reported findings.Ethics and disseminationThis scoping review aims to generate new insights from publicly available research. Therefore, ethical approval is not required. Study findings will be shared through discussion with policymakers, implementation science researchers and healthcare providers. The results of this study are intended to be published in a peer-reviewed journal.Trial registrationThis protocol has been registered with Center for Open Science OSF Registry (DOI: 10.17605/OSF.IO/RGQSN). The search was conducted on 25 March 2024 and updated on 21 October 2024. The review is expected to be completed by March 2025.
Association of pre-diabetes with the risks of adverse health outcomes and complex multimorbidity: evidence from population-based studies in the NIS and UK Biobank
Authors: Wu Yafei , Fan Xiude , Shi Yingzhou , Yuan Zinuo , Zhang Yue , Han Junming , Yuan Zhongshang , Li Mingzhuo , Cheng Yiping , Feng Xiaoshan , Wang Zhixiang , Xuan Ruirui , Dong Yingchun , Tian Yang , Dong Hang , Guo Qingling , Song Yongfeng , Zhao Jiajun 
Published: February 2025

IntroductionThis study aimed to examine the risk of common diseases among people with pre-diabetes and explored the relationship between pre-diabetes and multimorbidity (in this case, two or more comorbid diseases).MethodsAn observational multicohort study using data from the UK Biobank database and the National Inpatient Sample (NIS) database (2016–2018) was conducted. We analysed 461 535 participants and 17 548 442 patients aged 18 years or older from both databases, of whom 14.0% and 0.7% were diagnosed with pre-diabetes, respectively. A total of 76 common diseases of various body systems were selected as adverse health outcomes for analysis.ResultsAmong 64 523 individuals with pre-diabetes in the UK Biobank, the mean age was 60 years, 35 304 (54.7%) were female. There were 24 non-overlapping diseases associated with pre-diabetes with significant multiple test results in both databases, and most of them are circulatory system diseases. Compared with normoglycaemia, the confounder-adjusted HR in the UK Biobank for pre-diabetes was 1.46 (95% CI 1.43 to 1.49) for accompanying complex multimorbidity (ie, four or more pre-diabetes-related diseases), the corresponding confounder-adjusted OR in the NIS study was 10.03 (95% CI 9.66 to 10.40).ConclusionPre-diabetes was associated with a significantly higher risk of multimorbidity. Pre-diabetes, thus, might represent an important target for multimorbidity prevention, and stronger emphasis on its management seems necessary to reduce the risk of the development of multiple comorbidities, especially before the onset of overt diabetes.
Effects of Hyperoxia on Pulmonary Inflammation and organ injury in a human in vivo model (HIPI): study protocol of a randomised, double-blind, placebo-controlled trial
Authors: Linden Dermot , Dorrian Delia , Tandel Shikha , McKelvey Michael , Bailey Melanie , Conlon John , Moore David , Carr Sharon , Taggart Clifford C , Bradley Judy M , Kidney Joseph , OKane Cecilia M , McAuley Daniel Francis 
Published: February 2025

IntroductionLiberal administration of supplemental oxygen (O2) is ubiquitous across numerous healthcare settings. However, appropriate O2titration targets remain controversial and despite numerous large-scale randomised trials, there is an ongoing lack of consensus regarding optimal oxygenation strategies and the absence of high-quality mechanistic data pertaining to the potential proinflammatory effects of hyperoxia.Methods and analysisWe hypothesise that (1) short-term exposure to hyperoxia will induce mild pulmonary inflammation and cellular injury and that (2) hyperoxia will accentuate pulmonary inflammation and cellular injury in the setting of inhaled lipopolysaccharide challenge. To test our hypotheses, we will conduct a randomised, double-blind, placebo-controlled study of hyperoxia administered via a high-flow nasal O2delivery system (fractional inspired oxygen 1.0, 60 L/min flow rate) compared with synthetic medical air. Blocked randomisation will be undertaken by an independent clinical trials statistician. Healthy non-smoking adult volunteers (<45 years of age), taking no regular medications will be recruited. Bronchoalveolar lavage (BAL) will be performed at 6 hours. The study outcome measures will include BAL markers of inflammation and injury (including but not limited to interleukin (IL)-8, IL-6, tumour necrosis factor alpha), BAL differential cell counts, BAL markers of oxidative stress (superoxide dismutase and glutathione), alveolar epithelial cell injury (SP-D, vWF, RAGE) and markers of systemic inflammation (neutrophils and plasma C-reactive protein).Ethics and disseminationDissemination of the research findings will be achieved in the following ways: (1) Our findings will be presented at national and international meetings with open-access abstracts online and (2) in accordance with the open-access policies proposed by the leading research funding bodies we aim to publish the findings in high quality peer-reviewed open-access journals.Trial registration numberNCT05414370.
Age-stratified effects of intravenous ferric derisomaltose in heart failure with iron deficiency: insights from the IRONMAN trial
Authors: Sze Shirley , Squire Iain , Kalra Paul R , Cleland John G , Petrie Mark C , Kalra Philip A , Ahmed Fozia , Banerjee Prithwish , Boos Christopher J , Chapman Callum , Cowburn Peter James , Dixon Lana , Duckett Simon , Lane Rebecca , Foley Paul , Lang Ninian N , Lyons Kristopher , Ray Robin , Schiff Rebekah , Thomson Elizabeth A , Robertson Michele , Ford Ian 
Published: February 2025

BackgroundIntravenous iron therapy with ferric derisomaltose (FDI) has been shown to improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency. However, its effects across different age groups remain unclear. This analysis of the Effectiveness of Intravenous Iron Treatment versus Standard Care in Patients with Heart Failure and Iron Deficiency (IRONMAN) trial explored the efficacy and safety of FDI across age groups.MethodsThe IRONMAN trial was a prospective, open-label, blinded end point randomised controlled trial enrolling patients with HFrEF and iron deficiency. This prespecified analysis stratified the population into four quarters by age group: <67 years, 67–73 years, 74–79 years, >79 years. The primary outcome was a composite of recurrent heart failure hospitalisations and cardiovascular death. Secondary outcomes included changes in haemoglobin and quality of life. Clinical outcomes comparing FDI versus usual care in each age subgroup were analysed by the method of Linet alfor recurrent events and Cox proportional hazards model for time to first event. Interactions between age and treatment effects were explored.ResultsAmong 1137 randomised patients (median age 73 years), the primary outcome rate ratio (FDI vs usual care) was 0.87 (95% CI 0.61 to 1.23) in patients <67 years, 0.93 (95% CI 0.66 to 1.32) in those aged 67–73 years, 0.88 (95% CI 0.59 to 1.33) in those aged 74–79 years and 0.66 (95% CI 0.45 to 0.96) in those aged >79 years (p-interaction=0.38). Improvements in haemoglobin and quality of life scores at 4 months did not differ statistically across age groups (p-interaction=0.92 and 0.64, respectively). Older patients were more symptomatic at baseline, with higher N-terminal-pro B-type natriuretic peptide levels and poorer renal function, but safety outcomes did not differ across age groups.ConclusionsWe found no evidence that the effects of FDI on heart failure hospitalisations, cardiovascular death, haemoglobin and quality of life differed by age. These findings support its use in patients with HFrEF and iron deficiency, including older adults.Trial registration numberNCT02642562.