bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
Authors: Álvarez-Zaballos Sara , Vázquez-Alen Pilar , Muñoz Patricia , de Alarcón Arístides , Gutiérrez Carretero Encarnación , Álvarez-Uría Ana , Fariñas Mª Carmen , Rodríguez-García Raquel , Goenaga Miguel Ángel , Cuervo Guillermo , Plata-Ciezar Antonio , Hidalgo-Tenorio Carmen , Aldamiz-Echevarría Gonzalo , Martínez-Sellés Manuel 
Published: May 2024

Background: Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national cohort of IE. Methods: Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021. Results: Out of 5667 IE cases, 1125 had acute stroke (19.8%): 818 ischemic strokes (811 cardioembolic strokes (193 with hemorrhagic transformation), 4 transient ischemic attacks, 3 lacunar infarctions), 127 intracranial hemorrhages, and 27 other neurological complications (cerebral abscesses, encephalitis, and meningitis). Compared to patients without stroke, those with stroke had a similar mean age (69 years) but were more frequently female (68.2% vs 63.7%, p = 0.04) and had a higher incidence of intracardiac complications (35% vs 30%, p = 0.01), surgical indication (69.9% vs 65.9%, p = 0.001), in-hospital mortality (40.9% vs 22.0%, p < 0.001), and 1-year mortality (46.2% vs 27.9%, p < 0.001). The following variables were independently associated with stroke: mitral location (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.34–1.8, p < 0.001), vascular phenomenon (OR = 2.9, 95% CI = 2.4–3.6, p = 0.0001), acute renal failure (OR = 1.2, 95% CI = 1.0–1.4, p = 0.021), septic shock (OR = 1.3, 95% CI = 1.1–1.6, p = 0.007), sepsis (OR = 1.3, 95% CI = 1.1–1.6, p = 0.005), surgery indicated but not performed (OR = 1.4, 95% CI = 1.2–1.7, p < 0.001), community-acquired IE (OR = 1.2, 95% CI = 1–1.4, p = 0.017), and peripheral embolization (OR = 1.6, 95% CI = 1.4–1.9, p < 0.001). Stroke was an independent predictor of in-hospital (OR = 2.1, 95% CI = 1.78–2.51, p < 0.001) and 1-year mortality (hazard ratio = 1.9, 95% CI = 1.6–2.5). Conclusion: One-fifth of patients with IE have concomitant stroke. Stroke is associated with mortality.
Influence of the External Workload on Calf Muscle Strain Injuries in Professional Football Players: A Pilot Study
Authors: Soler Aitor , Agulló Fidel , Hernández-Davó Jose , Raya-González Javier , Del Coso Juan , González-Ródenas Joaquín , Moreno-Pérez Víctor 
Published: May 2024

Background: The influence of external workload variables on the development of calf muscle strainsin football players has not been previously explored. Hypothesis: Overloaded players would have an increased risk of calf muscle strain injury. Study Design: Prospective observational study. Level of Evidence: Level 4. Methods: A total of 41 professional football players from 1 team were monitored for 2 consecutive seasons. Total distance covered (TD), and distances covered at high-intensity running, high sprint running, low (LACC) and high (HACC) acceleration, low (LDEC) and high (HDEC) deceleration, and at high metabolic load distance (HMLD) were monitored with GPS units. Accumulated players’ external workload in the week before injury was compared with the weekly mean value of the 6 weeks before injury occurred for each player. Results: Ten players (24.3%) suffered 16 calf muscle strain injuries (3.1 injuries per 1000 hours of match play; 0.5 injuries per 1000 hours of training exposure). Players with a calf muscle injury were older ( p = 0.03), with higher body weight ( p = 0.01) and height ( p = 0.03). Injured players displayed substantially higher total training volume ( p < 0.01), TD ( p < 0.01), LACC ( p < 0.01), LDEC ( p < 0.01), HACC ( p < 0.01), HDEC ( p < 0.01), and HMLD ( p = 0.03) in the week before injury, in comparison with the mean values of these variables in the 6 weeks before injury. Conclusion: A week with a higher-than-habitual external workload might increase the risk of calf muscle strain injury in professional football players. Calf muscle injuries were preceded by a week with unusually high workloads associated with accelerating and decelerating distances and higher training volumes. Clinical Relevance: Monitoring external workload indicators may be helpful in determine players with a higher risk of calf muscle strain injury due to excessive workload during training/competition.
Effect of Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training on Maximal Oxygen Uptake
Authors: Dunn Ryan A. , Fry Lauren A. , Sekiguchi Yasuki , Benjamin Courteney L. , Manning Ciara N. , Huggins Robert A. , Stearns Rebecca L. , Casa Douglas J. 
Published: May 2024

Background: Maximal oxygen uptake (VO2max) is an important determinant of endurance performance. Heat acclimation/acclimatization (HA/HAz) elicits improvements in endurance performance. Upon heat exposure reduction, intermittent heat training (IHT) may alleviate HA/HAz adaptation decay; however, corresponding VO2max responses are unknown. Hypothesis: VO2max is maintained after HAz/HA; IHT mitigates decrements in aerobic power after HAz/HA. Study Design: Interventional study. Level of Evidence: Level 3. Methods: A total of 27 male endurance runners (mean ± SD; age, 36 ± 12 years; body mass, 73.03 ± 8.97 kg; height, 178.81 ± 6.39 cm) completed VO2max testing at 5 timepoints; baseline, post-HAz, post-HA, and weeks 4 and 8 of IHT (IHT4, IHT8). After baseline testing, participants completed HAz, preceded by 5 days of HA involving exercise to induce hyperthermia for 60 minutes in the heat (ambient temperature, 39.13 ± 1.37°C; relative humidity, 51.08 ± 8.42%). Participants were assigned randomly to 1 of 3 IHT groups: once-weekly, twice-weekly, or no IHT. Differences in VO2max, velocity at VO2max (vVO2), and maximal heart rate (HRmax) at all 5 timepoints were analyzed using repeated-measure analyses of variance with Bonferroni corrections post hoc. Results: No significant VO2max or vVO2 differences were observed between baseline, post-HAz, or post-HA ( P = 0.36 and P = 0.09, respectively). No significant group or time effects were identified for VO2max or vVO2 at post-HA, IHT4, and IHT8 ( P = 0.67 and P = 0.21, respectively). Significant HRmax differences were observed between baseline and post-HA tests ( P < 0.01). No significant group or time HRmax differences shown for post-HA, IHT4, and IHT8 ( P = 0.59). Conclusion: VO2max was not reduced among endurance runners after HA/HAz and IHT potentially due to participants’ similar aerobic training status and high aerobic fitness levels. Clinical Relevance: HAz/HA and IHT maintain aerobic power in endurance runners, with HAz/HA procuring reductions in HRmax.
Job satisfaction among midwives in low and middle-income countries: A protocol for systematic review and meta-analysis
Authors: Deressa Jembere Tesfaye , Negeri Haweni Adugna , Gurmessa Teshome Oljira , Tesfaye Biruk Hailu , Habteyes Abrham Tesfaye , Kassa Roza Teshome 
Published: May 2024

Objectives: The main objective of this study is to assess the level of midwives’ job satisfaction in low- and middle-income countries. Methods: A comprehensive literature search will be carried out using the following databases: Google Scholar, PubMed/Medline, Embase, CINHAL, SCOPUS, Web of Science, and Science Direct. This systematic review and meta-analysis will be carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All identified observational studies reporting the level of job satisfaction among midwives in low- and middle-income countries will be considered. The extracted quantitative data will be analyzed using STATA version 17. Heterogeneity among the included studies will be assessed through the I2 test statistics. Finally, a random-effects meta-analysis model will be computed to estimate the pooled level of job satisfaction among midwives. Furthermore, publication bias will be assessed using a funnel plot and Egger’s regression test, and sensitivity analysis will be conducted to evaluate the stability of the overall effects in the presence of outliers. The protocol has been registered in the PROSPERO-International Prospective Register of Systematic Reviews, with the registration number CRD42023400122. Conclusion: This systematic review and meta-analysis will be an important source to identify the level of job satisfaction among midwives working in the health facilities of low- and middle-income countries. Researchers, stakeholders, and healthcare systems also use these and managers to determine why midwives’ levels of job satisfaction are high or low compared to other studies in the future.
Reclaiming artificial intelligence accounts: A plea for a participatory turn in artificial intelligence inquiries
Authors: Gourlet Pauline , Ricci Donato , Crépel Maxime 
Published: May 2024

How to participate in artificial intelligence otherwise? Put simply, when it comes to technological developments, participation is either understood as public debates with non-expert voices to anticipate risks and potential harms, or as a way to better design technical systems by involving diverse stakeholders in the design process. We advocate for a third path that considers participation as crucial to problematise what is at stake and to get a grip on the situated developments of artificial intelligence technologies. This study addresses how the production of accounts shape problems that arise with artificial intelligence technologies. Taking France as a field of study, we first inspected how media narratives account for the entities and issues of artificial intelligence, as reported by the national press over the last decade. From this inspection, we identified four genres and described their performative effects. We then conducted a participatory inquiry with 25 French artificial intelligence practitioners’ to ground artificial intelligence in situated experiences and trajectories. These experiential accounts enabled a plural problematisation of artificial intelligence, playing with the geometries of artificial intelligence and its constituencies, while diversifying and thickening its problems. To conclude, we discuss how participatory inquiries, through experiential and plural accounts offer a refreshing weaving of artificial intelligence problems into the fabric of its deployments. Our participatory approach seeks to re-politicise artificial intelligence from practitioners’ situated experiences, by making the ongoing relationships between past trajectories, current frictions and future developments tangible and contestable, opening avenues to contribute otherwise.
The patient-reported wearing-off phenomenon with monoclonal antibody treatments for multiple sclerosis
Authors: Marian Lindsey M , Harris Kathleen A , Conway Devon S 
Published: May 2024

Background Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due. Objectives To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics. Methods Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9. Results We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, p = 0.005). The wearing-off effect (β = −0.52, p = 0.04) and higher Patient Health Questionnaire-9 (β = −0.09, p < 0.01) scores were associated with significantly reduced treatment satisfaction. Conclusion The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.
Predictive Factors of Cloxacillin Susceptibility in Primary Bacterial Spinal Infection
Authors: Tang Chris Yuk Kwan , Ho Pak Leung 
Published: May 2024

Study Design Prognostic study. Objectives The objective of this study is to identify predictive factors for cloxacillin susceptibility in spinal infections. Methods A retrospective analysis was conducted using data from January 1, 1997, to December 31, 2021. The study included patients presenting with back pain and either a positive bacterial culture from the spine or radiological evidence of spinal infection (spondylodiscitis and/or epidural abscess) along with positive bacterial blood culture. Results Among 171 patients (127 males, 44 females), 53.2% had Staphylococcus isolates, with 40.4% showing cloxacillin resistance. Lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, and residence in an old age home predicted gram-positive bacteria with cloxacillin resistance and gram-negative bacteria as causative organisms ( P<.05). The 30-day and 1-year all-cause mortality rates were 0% and 8.2%, respectively. Higher red cell distribution width (RDW >16.1%) and Charlson comorbidity index (CCI) scores predicted 1-year all-cause mortality ( P<.05). Intensive care unit admission was required for 9.9% of patients. Conclusions This study identified predictive factors for spinal infection by gram-positive bacteria with cloxacillin resistance and gram-negative bacteria. Patients with lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, or residency in an old age home upon admission should avoid standalone cloxacillin therapy and consider antibiotics with gram-negative coverage. Higher RDW (>16.1%) and CCI scores were associated with increased 1-year all-cause mortality. These findings contribute to treatment decision-making and improving patient outcomes in spinal infections.
Predictors and components of inpatient asthma hospital cost: A retrospective cohort study. Analysis from a sample of 14 Belgian hospitals
Authors: Seret Jehan , Bruyneel Arnaud , Larcin Lionel , Gooset Fabienne , Azzi Djohra , Martins Dimitri , Van Den Bulcke Julie , Leclercq Pol , Pirson Magali 
Published: May 2024

Background: Addressing the challenges of asthma has involved various approaches, including the examination of costs associated with hospitalization. However, there is a limited number of studies that have investigated the actual expenses incurred by hospital settings in caring for asthma patients. This study aims to describe the costs, predictors, and breakdown of expenditures in different categories. Design and methods: A retrospective cohort study was conducted, involving 314 hospital stays of patients over 12 years old who were admitted for asthma and classified under APR-DRG 141 (asthma). Univariate and multiple linear regression analyses were performed. Results: The median cost, regardless of DRG severity, amounted to 2.314€ (1.550€−3.847€). Significant variations were observed when the sample was stratified based on the severity of DRG, revealing a cost gradient that increases with severity. The length of stay followed a similar trend. Six predictors were identified: age, admission to intensive care, asthma severity, severity level of the DRG, winter admission, and length of stay. The cost breakdown showed that 44% constituted direct costs, 25% were indirect costs, 26% were attributed to medical procedures performed outside the patient unit, and 5% were related to medication administration. Conclusions: This study initiates a discussion on the role of reducing hospital costs in strategies aiming at controlling asthma-related costs. We argue that cost reduction cannot be achieved solely at the hospital level but must be approached from a public health perspective. This includes promoting high-quality outpatient care and addressing factors leading to poor adherence to the care plan.
The Effectiveness of High-Fidelity Simulation on Clinical Competence Among Nursing Students
Authors: Nair Manju Avinash , Muthu Priyalatha , Abuijlan Israa A. M. 
Published: May 2024

Introduction Clinical competence is a pre-requisite for every student nurse to showcase their proficiency in providing quality nursing care. Effective clinical experience during the study period plays a pivotal role in developing clinical competence among nursing students. Hence, the purpose of the study was to find the effectiveness of high fidelity simulation (HFS) on clinical competence among nursing students. Objectives The objectives of the study were to determine the impact of HFS on level of clinical competence among nursing students, to find the association between selected demographic characteristics of nursing students with their level of clinical competence and also, to find the association between academic performances of nursing students with their level of competence. Method The current study employed a quasi-experimental study design. Sixty-five nursing students from second year Bachelor of Science in Nursing (BSN) program were selected using consecutive sampling technique. The data was collected using demographic data form, objective structured clinical examination (OSCE) grade performa, and academic score sheet. SPSS version 24 was used to analyze data. Results The study revealed a significant impact of HFS on clinical competence of nursing students. Majority (52.3%) of the nursing students obtained high level clinical competence following the HFS. The findings showed a significant association between gender and medium of instruction with the level of clinical competence of nursing students. Further, there was a significant correlation between academic performance and level of clinical competence of the nursing students. Conclusion HFS served as a useful pedagogical approach in fulfilling the clinical learning outcomes. It further facilitated readiness of nursing students in second year BSN in terms of developing competence and confidence for clinical placement at the hospital for the third year of their study. However, further research is required to determine if HFS can be used in developing clinical reasoning skills in nursing students.
The additive value of complementing diagnostic idiopathic intracranial hypertension criteria by MRI – an external validation study
Authors: Macher Stefan , Marik Wolfgang , Krajnc Nik , Mitsch Christoph , Michl Martin , Mueller Nina , Novak Klaus , Zaic Sina , Woeber Christian , Pemp Berthold , Bsteh Gabriel 
Published: May 2024

Abstract
Background
Recently, diagnostic criteria including a standardized MRI criterion were presented to identify patients suffering from idiopathic intracranial hypertension (IIH) proposing that IIH might be defined by two out of three objective findings (papilledema, ≥ 25 cm cerebrospinal fluid opening pressure (CSF-OP) and ≥ 3/4 neuroimaging signs).

Methods
To provide independent external validation, we retrospectively applied the proposed diagnostic criteria to our cohort of patients with clinical suspicion of IIH from the Vienna IIH database. Neuroimaging was reevaluated for IIH signs according to standardized definitions by a blinded expert neuroradiologist. We determined isolated diagnostic accuracy of the neuroimaging criterion (≥ 3/4 signs) as well as overall accuracy of the new proposed criteria.

Results
We included patients with IIH (n = 102) and patients without IIH (no-IIH, n = 23). Baseline characteristics were balanced between IIH and no-IIH groups, but papilledema and CSF-OP were significantly higher in IIH. For the presence of ≥ 3/4 MRI signs, sensitivity was 39.2% and specificity was 91.3% with positive predictive value (PPV) of 95.2% and negative predictive value (NPV) 25.3%. Reclassifying our cohort according to the 2/3 IIH definition correctly identified 100% of patients without IIH, with definite IIH and suggested to have IIH without papilledema by Friedman criteria, respectively.

Conclusion
The standardized neuroimaging criteria are easily applicable in clinical routine and provide moderate sensitivity and excellent specificity to identify patients with IIH. Defining IIH by 2/3 criteria significantly simplifies diagnosis without compromising accuracy.
Integrated transcriptome and metabolome analysis reveals the regulation of phlorizin synthesis in Lithocarpus polystachyus under nitrogen fertilization
Authors: Zeng Suping , Yu Longhua , He Ping , Feng Hui , Wang Jia , Zhang Huacong , Song Yunxia , Liu Ren , Li Yueqiao 
Published: May 2024

AbstractBackgroundNitrogen (N) is essential for plant growth and development. InLithocarpus polystachyusRehd., a species known for its medicinal and food value, phlorizin is the major bioactive compound with pharmacological activity. Research has revealed a positive correlation between plant nitrogen (N) content and phlorizin synthesis in this species. However, no study has analyzed the effect of N fertilization on phlorizin content and elucidated the molecular mechanisms underlying phlorizin synthesis inL. polystachyus.ResultsA comparison of theL. polystachyusplants grown without (0 mg/plant) and with N fertilization (25, 75, 125, 175, 225, and 275 mg/plant) revealed that 75 mg N/plant fertilization resulted in the greatest seedling height, ground diameter, crown width, and total phlorizin content. Subsequent analysis of the leaves using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) detected 150 metabolites, including 42 flavonoids, that were differentially accumulated between the plants grown without and with 75 mg/plant N fertilization. Transcriptomic analysis of theL. polystachyusplants via RNA sequencing revealed 162 genes involved in flavonoid biosynthesis, among which 53 significantly differed between the N-treated and untreated plants. Fertilization (75 mg N/plant) specifically upregulated the expression of the genes phenylalanine ammonia-lyase (PAL), 4-coumarate-CoA ligase (4CL), and phlorizin synthase (PGT1) but downregulated the expression of trans-cinnamate 4-monooxygenase (C4H), shikimate O-hydroxycinnamoyltransferase (HCT), and chalcone isomerase (CHI), which are related to phlorizin synthesis. Finally, an integrated analysis of the transcriptome and metabolome revealed that the increase in phlorizin after N fertilization was consistent with the upregulation of phlorizin biosynthetic genes. Quantitative real-time PCR (qRT‒PCR) was used to validate the RNA sequencing data. Thus, our results indicated that N fertilization increased phlorizin metabolism inL. polystachyusby regulating the expression levels of thePAL,PGT1, 5-O-(4-coumaroyl)-D-quinate 3’-monooxygenase (C3’H),C4H, andHCTgenes.ConclusionsOur results demonstrated that the addition of 75 mg/plant N toL. polystachyussignificantly promoted the accumulation of flavonoids, including phlorizin, and the expression of flavonoid synthesis-related genes. Under these conditions, the genesPAL,4CL, andPGT1were positively correlated with phlorizin accumulation, whileC4H,CHI, andHCTwere negatively correlated with phlorizin accumulation. Therefore, we speculate thatPAL,4CL, andPGT1participate in the phlorizin pathway under an optimal N environment, regulating phlorizin biosynthesis. These findings provide a basis for improving plant bioactive constituents and serve as a reference for further pharmacological studies.