bluuebunny/crossref_metadata_2025_split huggingface dataset:
Theories, models and frameworks to understand barriers to the provision of mobility-assistive technologies: a scoping review
Authors: Aldawood Asma , Hind Daniel , Rushton Simon , Field Becky 
Published: May 2024

ObjectivesThere is strong evidence that mobility-assistive technologies improve occupational performance, social participation, educational and employment access and overall quality of life in people with disabilities. However, people with disabilities still face barriers in accessing mobility products and related services. This review aims to summarise and synthesise: (1) theories, models and frameworks that have been used to understand mobility-assistive technology access, (2) determinants of access and (3) gaps in knowledge.DesignA scoping review using the five-step framework by Arksey and O’Malley.Data sourcesWe searched the MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and SCOPUS databases for publications published between 2000 and 2024. We searched for articles published up to 20 March 2024.Eligibility criteriaWe included English-published literature in peer-reviewed journals that reported (a) barriers to the provision of mobility-assistive technologies, (b) including at least one theory, model or framework and (c) between 2000 and 2024.Data extraction and synthesisWe extracted the study characteristics, theories, models, framework usage, research recommendations, key findings on mobility-assistive technology barriers and theoretical propositions. We conduct a theoretical synthesis guided by Turner’s approach.ResultsWe included 18 articles that used 8 theories, models and frameworks, synthesised into 9 propositions. The synthesised theory emphasises that mobility is essential for human flourishing, and that certain health conditions may impose restrictions on mobility. This impact can be alleviated by two direct determinants: (1) the provision of suitable services and (2) their comprehensive provision. Policies and costs influence these services indirectly. Environmental and personal factors also affect the use of these services. Ineffectively addressing these determinants can limit access to mobility-assistive technologies and subsequent disabilities.ConclusionOur synthetic model describes the logic of providing evidence-based mobility-assistive technologies, and we identify the determinants of access that can act as targets for future work to improve the provision of mobility-assistive technologies.
The outcome and related risk factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic: a multicentre retrospective study
Authors: Zhang Quanchao , Lu Caibao , Wu Shaofa , He Jin , Wang Han , Li Jie , Wu Zhifen , Tang Bingshuang , Yang Bingfeng , Liao Shengli , Wang Liao , Chen Hongwei , Li Moqi , He Wenchang , Wang Yiqin , Jiang Lili , Zhao Jing-Hong , Nie Ling 
Published: May 2024

ObjectivesThe study aims to identify the outcome and the related factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic.DesignA multicentre retrospective study of patients with end-stage kidney disease undergone maintenance haemodialysis (HD) in China.Setting6 HD centres in China.ParticipantsA total of 654 HD patients who tested positive for SARS-CoV-2 were ultimately included in the study.Outcome measuresThe primary outcomes of interest were adverse outcomes, including hospitalisation due to COVID-19 and all-cause mortality.ResultsThe average age of the patients was 57 years, with 33.6% of them being over 65 years. Among the patients, 57.5% were male. During the follow-up period, 158 patients (24.2%) experienced adverse outcomes, and 93 patients (14.2%) died. The majority of patients (88/158) developed adverse outcomes within 30 days, and most deaths (77/93) occurred within 1 month. An advanced multivariable Cox regression analysis identified that adverse outcomes were associated with various factors while all-cause mortality was related to advanced age, male gender, high levels of C reactive protein (CRP) and low levels of prealbumin. The Kaplan-Meier curves demonstrated significantly higher all-cause mortality rates in the older, male, high CRP and low prealbumin subgroups.ConclusionsAmong unvaccinated HD patients with confirmed Omicron infections, various factors were found to be linked to adverse outcomes. Notably, age, sex, CRP and prealbumin had a substantial impact on the risk of all-cause mortality.
A Qualitative evaluation in community settings in England exploring the experiences of coaches delivering the NHS Low Calorie Diet programme pilot to ethnically diverse participants
Authors: Dhir Pooja , Maynard Maria , Drew Kevin J , Homer Catherine Verity , Bakhai Chirag , Ells Louisa Jane 
Published: May 2024

BackgroundThe management of type 2 diabetes (T2D) within diverse ethnic populations requires a culturally tailored approach. However, little is known about the experiences of coaches delivering interventions for T2D, such as the National Health Service (NHS) Low Calorie Diet (LCD) programme, to people from diverse ethnic backgrounds.ObjectiveTo explore the experiences of coaches delivering an NHS programme using total diet replacement approaches to individuals from diverse ethnic backgrounds, to inform the effective tailoring and equitable delivery of future interventions.DesignQualitative study.SettingIndividuals delivering the NHS LCD programme.ParticipantsOne-to-one semistructured interviews were conducted with seven health coaches delivering the NHS LCD programme. Inclusion criteria included participants delivering the NHS LCD programme either from a minoritised ethnic background or delivering the programme to those from ethnic minority and white British backgrounds.Main outcome measuresQualitative semistructured interviews conducted through different stages of the programme. Reflexive thematic analysis was used to analyse the transcripts.ResultsKey themes highlighted the following experiences of delivering the LCD programme: (1) training and support needs; (2) needing to understand culture and ethnicity; (3) the impact of language; (4) the use of resources in providing dietary advice and (5) experiences of cultural tailoring. The themes highlight the need to prioritise person-centred care, to integrate culturally tailored approaches and for provision of education and training to those delivering health programmes.ConclusionThese findings describe the experiences of health coaches in tailoring delivery and emphasise the role of cultural competence in ensuring equitable and effective healthcare interventions for diverse populations. This learning can inform future programmes and policies aimed at promoting inclusive healthcare practices.
At the threshold of viability: to resuscitate or not to resuscitate – the perspectives of Israeli neonatologists
Authors: Sperling Daniel , Riskin Arieh , Borenstein-Levin Liron , Hochwald Ori 
Published: May 2024

ObjectiveThis study aims to examine the perspectives of neonatologists in Israel regarding resuscitation of preterm infants born at 22–24 weeks gestation and their consideration of parental preferences. The factors that influence physicians’ decisions on the verge of viability were investigated, and the extent to which their decisions align with the national clinical guidelines were determined.Study designDescriptive and correlative study using a 47-questions online questionnaire.Results90 (71%) of 127 active neonatologists in Israel responded. 74%, 50% and 16% of the respondents believed that resuscitation and full treatment at birth are against the best interests of infants born at 22, 23 and 24 weeks gestation, respectively. Respondents’ decisions regarding resuscitation of extremely preterm infants showed significant variation and were consistently in disagreement with either the national clinical guidelines or the perception of what is in the best interest of these newborns. Gender, experience, country of birth and the level of religiosity were all associated with respondents’ preferences regarding treatment decisions. Personal values and concerns about legal issues were also believed to affect decision-making.ConclusionSignificant variation was observed among Israeli neonatologists regarding delivery room management of extremely premature infants born at 22–24 weeks gestation, usually with a notable emphasis on respecting parents’ wishes. The current national guidelines do not fully encompass the wide range of approaches. The country’s guidelines should reflect the existing range of opinions, possibly through a broad survey of caregivers before setting the guidelines and recommendations.
Early goal enteral nutrition associated with decreased in-hospital death in mechanically ventilated critically ill adults: a retrospective cohort study
Authors: Powierza Camilla S , Doyle Margaret M , Wasden Katherine , Intihar Taylor A , Korwin Amy S , Honiden Shyoko , Knauert Melissa P 
Published: May 2024

IntroductionEarly enteral nutrition (EN) in critically ill adult patients is thought to improve mortality and morbidity; expert guidelines recommend early initiation of EN in critically ill adults. However, the ideal schedule and dose of EN remain understudied.Study objectiveOur objective was to evaluate the relationship between achieving 70% of recommended EN within 2 days of intubation (‘early goal EN’) and clinical outcomes in mechanically ventilated medically critically ill adults. We hypothesised that early goal EN would be associated with reduced in-hospital death.MethodsWe conducted a retrospective cohort study of mechanically ventilated adult patients admitted to our medical intensive care unit during 2013–2019. We assessed the proportion of recommended total EN provided to the patient each day following intubation until extubation, death or 7 days whichever was shortest. Patients who received 70% or more of their recommended total daily EN within 2 days of intubation (ie, ‘baseline period’) were considered to have achieved ‘early goal EN’; these patients were compared with patients who did not (‘low EN’). The primary outcome was in-hospital death; secondary outcomes were successful extubation and discharge alive.Results938 patients met eligibility criteria and survived the baseline period. During the 7-day postintubation period, 64% of all patients reached 70% of recommended daily calories; 33% of patients achieved early goal EN. In unadjusted and adjusted models, early goal EN versus low EN was associated with a lower incidence of in-hospital death (subdistribution HR (SHR) unadjusted=0.63, p=0.0003, SHR adjusted=0.73, p=0.02). Early goal EN was also associated with a higher incidence of successful extubation (SHR unadjusted=1.41, p<0.00001, SHR adjusted=1.27, p=0.002) and discharge alive (SHR unadjusted=1.54, p<0.00001, SHR adjusted=1.24, p=0.02).ConclusionsEarly goal EN was associated with significant improvement in clinical metrics of decreased in-hospital death, increased extubation and increased hospital discharge alive.
Fabry disease: development and progression of left ventricular hypertrophy despite long-term enzyme replacement therapy
Authors: Maurizi Niccolo , Nowak Albina , Gruner Christiane , Namdar Mehdi , Schmied Christian , Porretta Alessandra Pia , Barbey Guillaume , Monzambani Veronique , Monney Pierre , Barbey Frédéric 
Published: May 2024

Background
Enzyme replacement therapy (ERT) may halt or attenuate disease progression in patients with Anderson-Fabry disease (AFD). However, whether left ventricular hypertrophy (LVH) can be prevented by early therapy or may still progress despite ERT over a long-term follow-up is still unclear.

Methods

Consecutive patients with AFD from the Independent Swiss-Fabry Cohort receiving ERT who were at least followed up for 5 years were included. Cardiac progression was defined as an increase of >10 g/m
2
in left ventricular mass index (LVMI) between the first and the last available follow-up transthoracic echocardiography.

Results

60 patients (35 (23–48) years, 39 (65%) men) were followed up for 10.5 (7.2–12.2) years. 22 had LVH at ERT start (LVMI of 150±38 g/m
2
). During follow-up, 22 (36%, 34±15 years) had LVMI progression of 12.1 (7–17.6) g/m
2
per 100 patient-years, of these 7 (11%, 29±13 years) with no LVH at baseline. Three of them progressed to LVH. LVMI progression occurred mostly in men (17 of 39 (43%) vs 5 of 21 (24%), p<0.01) and after the age of 30 years (17 of 22 (77%)). LVH at ERT start was associated with LVMI progression (OR 1.3, 95% CI 1.1 to 2.6; p=0.02). A total of 19 (31%) patients experienced a major AFD-related event. They were predominantly men (17 of 19, 89%), older (45±11 vs 32±9 years) with baseline LVH (12 of 19, 63%), and 10 of 19 (52%) presented with LVMI progression.

Conclusions
Over a median follow-up of >10 years under ERT, 36% of the patients still had LVMI cardiac progression, and 32%, predominantly older men, experienced major AFD-related events. LVH at treatment initiation was a strong predictor of LVMI progression and adverse events on ERT.
Characterising the challenges of managing difficult red blood cell alloantibodies in liver transplant recipients
Authors: Chornenkyy Yevgen , Fink Margaret Catherine , Felicelli Christopher , Stowell Sean R , Ramsey Glenn Eugene , Yang Guang-Yu 
Published: May 2024

AimsFormation of red blood cell alloantibodies (RBCAs) complicates transfusion support in liver transplantation (LT). Difficult RBCAs (DAs, >3 antibodies or antibodies for which <25% donors are antigen negative) further challenge care. This study characterises DA outcomes relative to non-difficult RBCAs (NDAs).MethodsSingle-centre, retrospective analysis of LT patients (2002–2021). RBCAs were defined as clinically significant antibodies. DAs were compared with NDAs.Results89 patients had clinically significant RBCAs (DA=50, NDA=39). More DAs were anti-Jka, anti-M; fewer were anti-E, anti-K (all p<0.05). DA patients often had multiple antibodies (44% vs 12.8% NDA, p=0.0022). Probability of finding antigen-negative blood was lower for DAs (17.4% vs 68.1% NDA, p<0.0001) as was RBCs received (9.4 vs 14.7 units in NDA, p=0.0036). Although survival was similar, patients with DAs had more adverse reactions (8% vs 0%, p=0.128). Some antibodies appeared to occur with specific liver diseases (such as primary sclerosing cholangitis, alcoholic steatohepatitis and recurrent disease); however, due to low sample size, definitive conclusions cannot be made.ConclusionsDA LT recipients contain >1 RBCA, have a lower probability of finding antigen negative blood and may experience more adverse transfusion event (ATE). Despite this, the incidence of ATEs was still quite low.
Implications for driving based on the risk of seizures after ischaemic stroke
Authors: Schubert Kai Michael , Bicciato Giulio , Sinka Lucia , Abraira Laura , Santamarina Estevo , Álvarez-Sabín José , Ferreira-Atuesta Carolina , Katan Mira , Scherrer Natalie , Terziev Robert , Döhler Nico , Erdélyi-Canavese Barbara , Felbecker Ansgar , Siebel Philip , Winklehner Michael , von Oertzen Tim J , Wagner Judith N , Gigli Gian Luigi , Nilo Annacarmen , Janes Francesco , Merlino Giovanni , Valente Mariarosaria , Zafra-Sierra María Paula , Mayor-Romero Luis Carlos , Conrad Julian , Evers S , Lochner Piergiorgio , Roell Frauke , Brigo Francesco , Bentes Carla , Peralta Rita , Pinho e Melo Teresa , Keezer Mark R , Duncan John Sidney , Sander Josemir W , Tettenborn Barbara , Koepp Matthias , Galovic Marian 
Published: May 2024

BackgroundIn addition to other stroke-related deficits, the risk of seizures may impact driving ability after stroke.MethodsWe analysed data from a multicentre international cohort, including 4452 adults with acute ischaemic stroke and no prior seizures. We calculated the Chance of Occurrence of Seizure in the next Year (COSY) according to the SeLECT2.0prognostic model. We considered COSY<20% safe for private and <2% for professional driving, aligning with commonly used cut-offs.ResultsSeizure risks in the next year were mainly influenced by the baseline risk-stratified according to the SeLECT2.0score and, to a lesser extent, by the poststroke seizure-free interval (SFI). Those without acute symptomatic seizures (SeLECT2.00–6 points) had low COSY (0.7%–11%) immediately after stroke, not requiring an SFI. In stroke survivors with acute symptomatic seizures (SeLECT2.03–13 points), COSY after a 3-month SFI ranged from 2% to 92%, showing substantial interindividual variability. Stroke survivors with acute symptomatic status epilepticus (SeLECT2.07–13 points) had the highest risk (14%–92%).ConclusionsPersonalised prognostic models, such as SeLECT2.0, may offer better guidance for poststroke driving decisions than generic SFIs. Our findings provide practical tools, including a smartphone-based or web-based application, to assess seizure risks and determine appropriate SFIs for safe driving.
Curriculum mapping to audit and grow longitudinal graduate medical education leadership training
Authors: Goodwin Andrew , Hughes Kathryn , Hartzell Joshua , Johnson William Rainey 
Published: May 2024

BackgroundResidents need and want practical leadership training, yet leadership curricula are lacking in graduate medical education (GME). We describe our process of curriculum mapping, a method for auditing a curriculum, and its role in iterative leadership curriculum development.AimsTo show how to create a curriculum map for auditing a curriculum using examples from our leadership curriculum and to demonstrate its value through case examples of leadership education integration into existing resident experiences.MethodsWe selected our recent systematic review on current leadership curricula to prioritise leadership content given it was the basis for our initial curriculum. We identified existing resident experiences where training can occur. We use the selected content and training environments, layered with a modified Miller’s pyramid, to construct a curriculum map.ResultsOur curriculum map provides an example of curriculum auditing that reveals opportunities for leadership training that could be integrated into current residency experiences. We provide case examples of application.DiscussionEffective leadership training should address critical topics and capitalise on experiential learning opportunities that exist within residency training programmes. The training must be seamlessly integrated into the demanding obligations of GME trainees, a process that can be achieved using curriculum mapping. Curriculum mapping can provide insight into a residency programme’s leadership curriculum and create a direction for future leadership curriculum development.
Perspectives of a single-anode cylindrical chamber operating in ionization mode and high gas pressure
Authors: Bouet R. , Busto J. , Cecchini V. , Charpentier P. , Chapellier M. , Dastgheibi-Fard A. , Druillole F. , Jollet C. , Hellmuth P. , Gros M. , Lautridou P. , Meregaglia A. , Navick X. F. , Piquemal F. , Roche M. , Thomas B. 
Published: May 2024

AbstractAs part of the R2D2 (Rare Decays with Radial Detector) R &D, the use of a gas detector with a spherical or cylindrical cathode, equipped with a single anode and operating at high pressure, was studied for the search of rare phenomena such as neutrinoless double-beta decay. The presented measurements were obtained with a cylindrical detector, covering gas pressures ranging from 1 to 10 bar in argon and 1 to 6 bar in xenon, using both a point-like source of $$^{210} $$

210

Po (5.3 MeV $$\alpha $$
α
) and a diffuse source of $$^{222}$$

222

Rn (5.5 MeV $$\alpha $$
α
). Analysis and interpretation of the data were developed using the anodic current waveform. Similar detection performances were achieved with both gases, and comparable energy resolutions were measured with both sources. As long as the purity of the gas was sufficient, no significant degradation of the measured energy was observed by increasing the pressure. At the highest operating pressure, an energy resolution better than 1.5% full-width at half-maximum (FWHM) was obtained for both gaseous media, although optimal noise conditions were not reached.
Unveiling tumor invasiveness: enhancing cancer diagnosis with phase-contrast microtomography for 3D virtual histology
Authors: Donato Sandro , Agostino Raffaele G. , Arana Peña Lucia M. , Arfelli Fulvia , Brombal Luca , Longo Renata , Martellani Fulvia , Romano Andrea , Rosano Ida , Saccomano Giulia , Tromba Giuliana , Bonazza Deborah 
Published: May 2024

AbstractMalignant diseases are characterized by a critical trait known as invasiveness, where tumor cells tend to spread from the primary tissue layer into surrounding healthy tissues and distant organs. Presently, histopathology offers essential insights for diagnosing, classifying, predicting outcomes, and guiding patient-specific treatments. However, histology offers two-dimensional data from chosen cutting planes. Although 3D histological volumes can be generated through serial sectioning or whole slide imaging, this method is laborious, may introduce processing artefacts, and lacks isotropic spatial resolution. These limitations pose a considerable challenge to accurate diagnoses, particularly when dealing with micro-infiltrating carcinomas. These lesions, characterized by minute infiltrations, demand a three-dimensional representation for comprehensive visualization, essential for precise identification and assessment. Emerging X-ray-based virtual histology technology offers three-dimensional visualization of soft-tissue specimens, enabling virtual slicing in any direction or at any point. This approach can assist in guiding tissue sectioning for optimal representation of tumor cross sections during histological analysis. Micro-infiltrating carcinomas from the breast, cervix, and thyroid were imaged using X-ray phase-contrast microtomography (PhC-$$\mu$$
μ
CT) at the Elettra synchrotron facility in Trieste, Italy. Comparative assessment of histological and CT slices by pathologists revealed that PhC-$$\mu$$
μ
CT aids in classifying lesions by highlighting distinct tissue components and, notably, identifying tissue invasion. Reviewing a volume image allows pathologists to trace the entire lesion, identifying invasion sites that might be overlooked in individual or serial histological sections. Consequently, this proposed method could complement pathologists’ tools, potentially enhancing diagnoses by minimizing under-staging and reducing false negative results.