bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing implementation: elucidating the role of behavior change techniques and corresponding strategies on determinants and implementation performance: a cross-sectional study
Authors: Dubbeldeman Eveline M. , Crone Mathilde R. , Kiefte-de Jong Jessica Christina , van der Kleij Rianne M.J.J. 
Published: June 2024

Abstract
Introduction
Behavior change techniques (BCTs) are considered as active components of implementation strategies, influencing determinants and, ultimately, implementation performance. In our previous Delphi study, experts formulated ‘implementation hypotheses’, detailing how specific combinations of BCTs and strategies (referred to as BCT-strategy combinations) might influence determinants and guideline implementation within youth care. For example, educational meetings providing instructions on guideline use were hypothesized to enhance practitioners' knowledge and, consequently, guideline implementation. However, these hypotheses have not been verified in practice yet.

Method
We conducted a cross-sectional study involving practitioners and management professionals from youth (health)care organizations. Using questionnaires, we obtained data on the presence of BCT-strategy combinations and their perceived influence on determinants and implementation performance. Chi-squared tests and regression analyses were employed to determine the influence of specific BCT-strategy combinations on determinants and implementation performance.

Results
Our analyses included data from 104 practitioners and 34 management professionals. Most of the management professionals indicated that the BCT-strategy combinations positively influenced or had the potential to influence their implementation performance. At the practitioner level, half of the combinations were perceived to have a positive influence on determinants and implementation performance. Furthermore, practitioners who reported the absence of BCT-strategy combinations were more skeptical about their potential influence on determinants and implementation performance.

Conclusion
Several BCT-strategy combinations were perceived to improve or potentially improve implementation performance of both practitioners and management professionals. In the development and evaluation of implementation efforts, we advocate for clearly describing the implementation effort’s objective and using frameworks that detail the BCTs inducing behavior change, the strategy employed, and the processes driving the observed changes. Understanding these interconnected processes is important in designing targeted, evidence-based behavior change interventions. This understanding optimizes resource allocation and contributes to the overall success of implementation efforts in youth care.
Application of lightweight steel-UHPC composite beam in bridge emergency repair
Authors: Hong Lujia , Li Zhiyong , Peng Yao 
Published: June 2024

AbstractThis paper mainly introduces the emergency repair process for small- and medium-span bridges. The causes of deterioration were analysed by investigating old bridges. After comparison and selection of schemes, the scheme of beam replacement was confirmed using a lightweight steel ultra-high performance concrete (UHPC) composite beam as the superstructure. The main components of the calculations and the design are introduced in detail. Finally, through the load test of the bridge, it was shown that the lightweight steel-UHPC composite beam had good performance and met the requirements of Highway Level I bearing capacity. The lightweight steel-UHPC composite beam described in this paper has the characteristics of high strength, light weight, fast construction, excellent working performance, and remarkable social and economic benefits. It can be popularised and applied in the emergency repair of small- and medium-span bridges and new bridges.
Effects of dissolved organic matter on the toxicity of micro- and nanoplastic particles to Daphnia - a meta-analysis
Authors: Salomon Sophia , Grubmüller Eric , Kropf Philipp , Nickl Elisa , Rühl Anna , Weigel Selina , Becker Felix , Antonio Vital Ana Leticia , Laforsch Christian , Schott Matthias , Mair Magdalena M. 
Published: June 2024

AbstractEffects of micro- and nanoplastic particles (MNP) on organisms have been increasingly reported in recent years, with a large number of studies conducted on water fleas of the genus Daphnia. Most of the available studies used pristine particles that have not been exposed to the environment or to organic substances. In natural environments, however, organic substances like dissolved organic matter (DOM) attach to the MNP, forming an ecocorona on the particles’ surface. How the formation of an ecocorona influences MNP toxicity is still uncertain. While some studies suggest that DOM can mitigate the negative effects of MNP on organisms, other studies did not find such associations. In addition, it is unclear whether the DOM attached to the particles’ surface attenuates the effects of MNP directly or whether co-exposure with DOM solved in the medium attenuates MNP toxicity indirectly, for instance by increasing Daphnia‘s resilience to stressors in general. To draw more solid conclusions about the direction and size of the mediating effect of DOM on MNP-associated immobilization in Daphnia spp., we synthesized evidence from the published literature and compiled 305 data points from 13 independent studies. The results of our meta-analysis show that the toxic effects of MNP are likely reduced in the presence of certain types of DOM in the exposure media. We found similar mediating effects when MNP were incubated in media containing DOM before the exposure experiments, although to a lesser extent. Future studies designed to disentangle the effects of DOM attached to the MNP from the general effects of DOM in the exposure medium will contribute to a deeper mechanistic understanding of MNP toxicity in nature and enhance the reliability of MNP risk assessment.
Graphical Abstract
Quantitative Pupillometry Predicts Return to Play and Tracks the Clinical Evolution of Mild Traumatic Brain Injury in US Military Academy Cadets: A Military Traumatic Brain Injury Initiative Study
Authors: Dengler Bradley A. , Meister Melissa , Aderman Michael , Malvasi Steven R. , Ross Jeremy D. , Fu Adele , Haight Thaddeus , Bartanusz Viktor , Kambe Charles , Boulter Jason H. , Cameron Kenneth L. 
Published: June 2024

BACKGROUND AND OBJECTIVES:
The objective of this study was to determine the utility of the pupillary light reflex use as a biomarker of mild traumatic brain injury (mTBI).

METHODS:
This prospective cohort study was conducted at The US Military Academy at West Point. Cadets underwent a standard battery of tests including Balance Error Scoring System, Sports Concussion Assessment Tool Fifth Edition Symptom Survey, Standard Assessment of Concussion, and measure of pupillary responses. Cadets who sustained an mTBI during training events or sports were evaluated with the same battery of tests and pupillometry within 48 hours of the injury (T1), at the initiation of a graded return to activity protocol (T2), and at unrestricted return to activity (T3).

RESULTS:
Pupillary light reflex metrics were obtained in 1300 cadets at baseline. During the study period, 68 cadets sustained mTBIs. At T1 (<48 hours), cadets manifested significant postconcussion symptoms (Sports Concussion Assessment Tool Fifth Edition P < .001), and they had decreased cognitive performance (Standardized Assessment of Concussion P < .001) and higher balance error scores (Balance Error Scoring System P < .001) in comparison with their baseline assessment (T0). The clinical parameters showed normalization at time points T2 and T3. The pupillary responses demonstrated a pattern of significant change that returned to normal for several measures, including the difference between the constricted and initial pupillary diameter (T1 P < .001, T2 P < .05), dilation velocity (T1 P < .01, T2 P < .001), and percent of pupillary constriction (T1 P < .05). In addition, a combination of dilation velocity and maximum constriction velocity demonstrates moderate prediction ability regarding who can return to duty before or after 21 days (area under the curve = 0.71, 95% CI [0.56-0.86]).

CONCLUSION:
This study's findings indicate that quantitative pupillometry has the potential to assist with injury identification and prediction of symptom severity and duration.
Effects of ganciclovir combined with recombinant human interferon-α on clinical efficacy and immune function in children with infectious mononucleosis
Authors: Sun Ling , Bi Jing , Zhen Weina , Wang Meiying , Song Haobin 
Published: June 2024

Objective: To evaluate the effects of ganciclovir combined with recombinant human interferon on clinical efficacy and immune function of children with infectious mononucleosis(IM).
Methods: This was a retrospective study. Children (n=120) with IM hospitalized in Beijing Children’s Hospital Affiliated to Capital Medical University Baoding Hospital from January 2020 to January 2022 were selected and randomly divided into study group and control group((n=60). Patients in the control group were treated with ganciclovir by intravenous infusion, and patients in the study group were given ganciclovir+recombinant human interferon-α1b. The time for eliminating clinical symptoms, the levels of inflammatory cytokines, immune function condition and T-lymphocyte subsets between the two groups were compared and analyzed.
Results: After treatment, the time for body temperature returned to normal, time for recovery from cervical lymphadenopathy, time for recovery from hepatosplenomegaly and time for disappearance of angina and oral mucosal congestion in the study group were significantly shorter than those in the control group(p= 0.00); after treatment, the levels of TNF-a and IL-6 in the study group were significantly lower than those in the control group; the indexes of CD3+ and CD8+ in the study group were significantly lower than those in the control group; after treatment, the levels of CD4+ and CD4+/CD8+ in the study group were significantly higher than those in the control group.
Conclusion: Ranciclovir combined with recombinant human interferon-α1b, rapid improvements of clinical symptoms, significantly decreased inflammatory cytokines, improved T-lymphocyte function and no significant increase in adverse drug reactions were found in children with IM.
doi: https://doi.org/10.12669/pjms.40.7.8705
How to cite this: Sun L, Bi J, Zhen W, Wang M, Song H. Effects of ganciclovir combined with recombinant human interferon-α on clinical efficacy and immune function in children with infectious mononucleosis. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.8705
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
“It Takes More Than a Pill to Kill”: Bounded Accountability in Disciplining Professional Misconduct Despite Heightened Transparency
Authors: Kaynak Ece , Rahman Hatim A. 
Published: June 2024

Existing theory suggests that professionals are ineffective at regulating the work of their peers, especially when it comes to disciplining misconduct, because of professional norms of collegiality. In response, transparency measures have been put in place over the years to increase accountability toward key external audiences, such as the public, and to ensure that professionals hold guilty peers accountable for misconduct. Few studies, however, have sufficiently investigated how professionals discipline peer misconduct in the face of transparency measures. We gained access to a state medical board’s internal deliberations about how to discipline physicians guilty of overprescribing opioids, endangering public health. We found that even in the most egregious cases, the board predominantly refrained from implementing stringent disciplinary action despite extensive transparency measures. Our data allow us to theorize what we call bounded accountability, which refers to individuals charged with holding guilty actors accountable for their misconduct instituting only limited discipline. We found four mechanisms that constrained the exercise of accountability: information asymmetries between regulatory bodies, bureaucratic inefficiencies of the disciplinary apparatus, shared professional beliefs among decision makers, and interpersonal emotions between decision makers and the guilty professionals whom they are put in charge of disciplining. We found that these mechanisms operated at the field, occupational, organizational, and interpersonal levels, respectively. Utilizing a highly consequential study context, our findings suggest that when professional misconduct is disciplined by members of the same occupation, bounded accountability is the most likely outcome, even with extensive transparency measures in place. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2023.17932 .
How nurses can apply spiritual care to improve the daily lives of people with learning disabilities and their families
Authors: Argles Ishmay Jessica Slechta , Arrey Sally 
Published: June 2024

Background: Most UK nursing research into spirituality overlooks its daily application in certain specialties, notably learning disability nursing. Aims: To explore spirituality over the lifespans of people with learning disabilities and how spiritual care affects their quality of life. To provide practical examples for nurses on how to apply spiritual care in their daily practice. Methods: A literature review conducted between January 2002 and July 2022) following recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Thomas and Harden's (2008) approach to thematic synthesis was used to structure 10 full-text articles into three key themes. Findings: The three key themes were: the role of the nurse, the impacts on the individual, and family/carer perspectives. Conclusion: The nursing role in using spiritual care encompasses care planning an individual's spiritual activities, facilitating meaningful time alone, nurturing values such as self-acceptance, building therapeutic relationships, and advocating for progression in existing social structures and legislation.
Skin integrity preservation using a nurse-constructed silicone adhesive Foley catheter
Authors: Van Houten Cathleen T , Mann Carrie L , Misiti Natalya , Qualls Brandon W 
Published: June 2024

Aims: Skin breakdown is common in the intensive care unit (ICU). This pilot evaluation aimed to determine whether a nurse-constructed urinary catheter securement device using a silicone adhesive could reduce the complications of blistering and other skin breakdowns in a high-risk ICU population with Foley catheters. Design: A prospective, non-randomised performance improvement study using a convenience sample was carried out. Subjects and setting: The study sample consisted of 29 patients with urethral Foley catheters and any degree of thigh oedema in a surgical ICU at an academic quarternary medical center. Methods: Patients were fitted with a standard acrylic-adhesive catheter securement device on one thigh and a nurse-constructed device on the contralateral thigh. At the beginning of each 12-hour shift, the nurse moved the Foley catheter from one securement device to the other; the nurse recorded the assessment findings at the end of the shift. Results: The average age of the 29 patients was 61±16 (range 20–87) years. Visible skin compromise occurred in 21% of the time with the standard acrylic securement device; an equal percentage of men and women developed skin breakdown. Oedema status was a significant factor related to skin breakdown. There was no visible damage to the skin associated with the nurse-constructed silicone-adhesive device. Conclusions: A silicone adhesive urinary catheter securement device causes less skin damage than one with acrylic adhesive. One-step application, pain-free and atraumatic removal, and reliable securement are essential considerations in product development.
Healthcare utilization 9 months pre- and post- COVID-19 hospitalization among patients discharged alive
Authors: Zaidan Mohammed , Puebla Neira Daniel , Polychronopoulou Efstathia , Yong-Fang Kuo , Sharma Gulshan 
Published: June 2024

Background
Emerging evidence suggests that there is an increase in healthcare utilization (HCU) in patients due to Coronavirus Disease 2019 (COVID-19). We investigated the change in HCU pre and post hospitalization among patients discharged home from COVID-19 hospitalization for up to 9 months of follow up.

Study design and methods
This retrospective study from a United States cohort used Optum® de-identified Clinformatics Data Mart; it included adults discharged home post hospitalization with primary diagnosis of COVID-19 between April 2020 and March 2021. We evaluated HCU of patients 9 months pre and post -discharge from index hospitalization. We defined HCU as emergency department (ED), inpatient, outpatient (office), rehabilitation/skilled nursing facility (SNF), telemedicine visits, and length of stay, expressed as number of visits per 10,000 person-days.

Results
We identified 63,161 patients discharged home after COVID-19 hospitalization. The cohort of patients was mostly white (58.8%) and women (53.7%), with mean age 72.4 (SD± 12) years. These patients were significantly more likely to have increased HCU in the 9 months post hospitalization compared to the 9 months prior. Patients had a 47%, 67%, 65%, and 51% increased risk of ED (rate ratio 1.47; 95% CI 1.45–1.49; p < .0001), rehabilitation (rate ratio 1.67; 95% CI 1.61–1.73; p < .0001), office (rate ratio1.65; 95% CI 1.64–1.65; p < .0001), and telemedicine visits (rate ratio 1.5; 95% CI 1.48–1.54; p < .0001), respectively. We also found significantly different rates of HCU for women compared to men (women have higher risk of ED, rehabilitation, and telemedicine visits but a lower risk of inpatient visits, length of stay, and office visits than men) and for patients who received care in the intensive care unit (ICU) vs those who did not (ICU patients had increased risk of ED, inpatient, office, and telemedicine visits and longer length of stay but a lower risk of rehabilitation visits). Outpatient (office) visits were the highest healthcare service utilized post discharge (64.5% increase). Finally, the risk of having an outpatient visit to any of the specialties studied significantly increased post discharge. Interestingly, the risk of requiring a visit to pulmonary medicine was the highest amongst the specialties studied (rate ratio 3.35, 95% CI 3.26–3.45, p < .0001).

Conclusion
HCU was higher after index hospitalization compared to 9 months prior among patients discharged home post-COVID-19 hospitalization. The increases in HCU may be driven by those patients who received care in the ICU.
Vitamin D and thyroid function: A mendelian randomization study
Authors: Pleić Nikolina , Babić Leko Mirjana , Gunjača Ivana , Zemunik Tatijana 
Published: June 2024

Background
Numerous organs, including the thyroid gland, depend on vitamin D to function normally. Insufficient levels of serum 25-hydroxyvitamin D [25(OH)D] are seen as a potential factor contributing to the emergence of several thyroid disorders, however, the causal relationship remains unclear. Here we use a Mendelian randomization (MR) approach to investigate the causal effect of serum 25(OH)D concentration on the indicators of thyroid function.

Methods
We conducted a two-sample MR analysis utilizing summary data from the most extensive genome-wide association studies (GWAS) of serum 25(OH)D concentration (n = 443,734 and 417,580), thyroid-stimulating hormone (TSH, n = 271,040), free thyroxine (fT4, n = 119,120), free triiodothyronine (fT3, n = 59,061), total triiodothyronine (TT3, n = 15,829), as well as thyroid peroxidase antibody levels and positivity (TPOAb, n = 12,353 and n = 18,297), low TSH (n = 153,241), high TSH (n = 141,549), autoimmune hypothyroidism (n = 287,247) and autoimmune hyperthyroidism (n = 257,552). The primary analysis was conducted using the multiplicative random-effects inverse variance weighted (IVW) method. The weighted mode, weighted median, MR-Egger, MR-PRESSO, and Causal Analysis Using Summary Effect estimates (CAUSE) were used in the sensitivity analysis.

Results
The IVW, as well as MR Egger and CAUSE analysis, showed a suggestive causal effect of 25(OH)D concentration on high TSH. Each 1 SD increase in serum 25(OH)D concentration was associated with a 12% decrease in the risk of high TSH (p = 0.02). Additionally, in the MR Egger and CAUSE analysis, we found a suggestive causal effect of 25(OH)D concentration on autoimmune hypothyroidism. Specifically, each 1 SD increase in serum 25(OH)D concentration was associated with a 16.34% decrease in the risk of autoimmune hypothyroidism (p = 0.02).

Conclusions
Our results support a suggestive causal effect which was negative in direction across all methods used, meaning that higher genetically predicted vitamin D concentration possibly lowers the odds of having high TSH or autoimmune hypothyroidism. Other thyroid parameters were not causally influenced by vitamin D serum concentration.
The impact of the COVID-19 pandemic for children in custody: An analysis of inspection reports
Authors: Lennox Charlotte , Duncan-Zaleski Martha , Nasim Sahara , Shirley Olivia , Ross Kenny , Chitsabesan Prathiba , Robinson Louise , Shaw Jenny , Leonard Sarah 
Published: June 2024

Background
Children in custodial settings are a vulnerable group. Prior to the COVID-19 pandemic there were concerns about the safety of children in these settings. COVID-19 has had an impact on everyone but given the vulnerability of children in custody, there were concerns about the impact of COVID-19 restrictions. All custody settings for children are independently inspected and this research aimed to analyse data from inspection reports. Twenty-six inspection reports undertaken between March 2020 and October 2021 were analysed to understand the impact of COVID-19 on delivery of usual care/regime.

Results
Data showed that across all site’s children spent considerable amounts of time isolated and in some cases, this was deemed to amount to solitary confinement. There was evidence of some positive experiences, in the smaller sites, around COVID-19 slowing the pace of life allowing staff and children could foster relationships. However, in the larger sites, isolation was extreme and COVID-19 policies such as ‘bubbles’ appear to have created unintended consequences as sites have moved into recovery, leading to increased violence and stress. COVID-19 directly impacted staffing levels. This and the COVID-19 policies to reduce mixing also had an impact on how children’s behaviour, welfare and safeguarding was managed. In some larger sites, being COVID-19 secure was prioritised over the needs of the children.

Conclusions
This research highlights the importance of multi-site longitudinal research to understand how children, staff and institution’s function. The experiences of children in custody during COVID-19 differed by site type. The research suggests that the larger sites are struggling to keep children safe and there should be a shift towards smaller, more therapeutic environments. More research is needed to understand the longer-term unintended consequences of COVID-19 policy in custody, for these vulnerable children.