bluuebunny/crossref_metadata_2025_split huggingface dataset:
27 Palliative care day services operate through therapeutic relationships
Authors: Kernohan George , Brazil Kevin , Coast Jo , Finucane Anne , Graham-Wisener Lisa , Hasson Felicity , Jones Louise , Jordan Joanne , McCorry Noleen , McIlfatrick Sonja 
Published: May 2024

IntroductionMarie Curie Palliative Care Day Services have been developed to support people with life-limiting illness who live in their own home. Patients attend on a regular basis, typically receiving a mix of clinical and social care. Despite their popularity and general satisfaction (Kernohan et al, 2006), there is ambiguity concerning the content.AimTo provide in-depth knowledge of day services by mapping services at three Marie Curie Hospice sites.MethodsWe: reviewed the records of a 25% random stratified sample of new patients attending in 2015, providing evidence on the content of care; undertook focus groups with staff, focusing on their knowledge and experience of providing Day Services.ResultsThe three services are characterised by:• wide-ranging care that spans physical, psychological, emotional and social domains;• care for both patients and their informal carers;• the development of patient-patient and patient-professional therapeutic relationships• extremely proactive care, based on regular assessment and follow-up;• being able to respond to a majority of identified needs ‘in-house’;• where such response in unavailable, ensuring onward referral and follow-up;• extensive liaison with other health and social care providers.ConclusionFindings contribute to the limited evidence base on the organisation and content of day services. They highlight how these services are firmly rooted in, but extend beyond, their immediate context to promote holistic, patient-centred care. This care is premised on meaningful therapeutic relationships, which form between patients themselves and between patients and day services staff.Reference. Kernohan WG, Hasson F, Hutchinson P, Cochrane B. Patient satisfaction with hospice day care. Support Care Cancer2006;14(5):462–8.
30 Development of quality indicators for UK palliative day services (QUALPALUK)
Authors: McCorry Noleen K , Dempster Martin , O’Connor Sean , Armour Kathy , Coast Joanna , Donnelly Michael , Finucane Anne , Fyvie Joan , Jones Louise , Kernohan George , Leemans Kathleen , Perkins Paul 
Published: May 2024

IntroductionQuality indicators are explicitly defined and measurable items that evaluate and describe healthcare (Campbell, 2002). They can provide care users, staff, providers, and purchasers with feedback in relation to the quality of care, sometimes against benchmarks or previous quality assessments. In addition, by providing a valid and reliable means of measuring quality of care, quality indicators (although not sufficient by themselves) can act as a starting point for quality improvement. There are currently no quality indicators designed to assess the quality of palliative day services (PDS).AimTo develop a set of quality indicators to appraise the care provided by PDS in the UK.MethodsThe RAND/UCLA appropriateness method was utilised. This multi-stage method combines best available evidence alongside expert consensus. The resultant draft set of indicators was tested for feasibility in 5 UK hospices. A parallel strategy of stakeholder engagement was implemented throughout the research lifecycle.ResultsThe initial list of 185 candidate indicators identified by a systematic review was reduced to a final list of 30 core indicators, which were found to be appropriate and feasible.ConclusionsThis quality indicator set is the first to be produced for PDS, and is available for use by services. It represents a valuable, acceptable and feasible means to assess quality of care in PDS, and a means of identifying goals for quality improvement. Successful implementation of quality indicators in routine practice requires attention to a range of key enablers and barriers.Reference. Campbell, S M. (2002) ‘Research Methods Used In Developing And Applying Quality Indicators In Primary Care’.Quality and Safety in Health Care,11(4), pp. 358–364
43 A systematic review and critical discourse analysis (CDA) of the reporting of do not attempt cardiopulmonary resuscitation (DNACPR) decisions in UK national broadsheet and tabloid newspapers
Authors: Gray Alice E , Sleeman Katherine E , Bristowe Katherine 
Published: May 2024

IntroductionThe Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is a routine aspect of medical care, but there can be misunderstandings among patients and the public relating to these decisions. The aim of this study was to identify how DNACPR decisions are portrayed in print media, and understand how this contributes to public opinion.MethodsA systematic review using three databases (Newsbank’s Access World News, ‘Factiva’ database and ‘Daily Mail Historical Archive’) was conducted, for articles published between January 2000 and September 2016. A Critical Discourse Analysis was carried out at three levels: textual (micro); discursive practice (meso); sociocultural practice (macro).Results116 articles were identified, comprising a corpus of 68082 words. Textual analysis demonstrated two opposing portrayals: the vulnerable patient requiring life saving through CPR, and the medical body failing in their duty to keep the patient alive. Analysis of discursive practice found the power of truth-telling lay with patients and families who associated DNACPR with poor-quality care and concealment suspicions. Sociocultural analysis found DNACPR decisions were incorporated into wider end of life care criticisms.ConclusionsThis study demonstrates an overwhelmingly negative and inaccurate portrayal of DNACPR within print media, contributing to the public’s mistrust of professionals and their decision-making power. A DNACPR decision awareness campaign to communicate realities about DNACPR decisions more effectively with the public is urgently needed. Access to accurate information will improve understanding between the public and clinicians.
60 Can the ‘surprise question‘ be used to correctly identify people nearing the end of life?: a review
Authors: Vickerstaff Victoria , White Nicola , Kupeli Nuriye , Stone Patrick 
Published: May 2024

IntroductionIt has been shown that clinicians are inaccurate at prognostication (White et al., 2016) and recognising dying patients (Neuberger et al., 2013). Patients who would benefit from palliative care may be missed because validated prognostic tools (Pirovano et al., 1999; Morita et al., 1999) are not routinely used, either due to the perceived complexity or inconvenience. The surprise question (SQ) (“Would you be surprised if this patient died within the next χ months?”) offers an alternative to standard prognostic estimates.AimTo evaluate the performance of the SQ in patients nearing the end of life.MethodsWe searched numerous databases, including: Medline, Embase, CINAHL, AMED. Studies were included if they reported the SQ and were written in English.ResultsOut of the 357 studies identified, 22 were included in the review. In these studies, 25 718 estimates were reported. The results showed a wide variation in the reported accuracy of the SQ, with sensitivity ranging from 11.6% to 96.6% and specificity ranging from 13.9% to 78.6%. The AUROC score across the studies ranged from 0.512 to 0.822. Doctors appeared to be more accurate than nurses at recognising people in the last year of life (c-statistic=0.735 vs. 0.688).ConclusionsThe performance of the SQ varied greatly across the studies. Further work is required to understand the processes by which clinicians arrive at their prognostic estimates, to refine the accuracy of the SQ and to compare its performance against other more sophisticated prognostic tools, particularly in populations where a higher proportions of deaths occur.References. Morita, T., Tsunoda, J., Inoue, S. and Chihara, S., 1999. The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer, 7(3), pp.128–133.. Neuberger, J., Guthrie, C. and Aaronovitch, D., 2013. More care, less pathway: a review of the Liverpool Care Pathway.Department of Health.. Pirovano, M., Maltoni, M., Nanni, O., Marinari, M., Indelli, M., Zaninetta, G., Petrella, V., Barni, S., Zecca, E., Scarpi, E. and Labianca, R., 1999. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. Journal of pain and symptom management, 17(4), pp.231–239.. White, N., Reid, F., Harris, A., Harries, P. and Stone, P., 2016. A systematic review of predictions of survival in palliative care: How accurate are clinicians and who are the experts?. PLoS One, 11(8), p.e0161407.
Spherically symmetric anisotropic charged neutron stars in f(Q, T) gravity
Authors: Das Krishna Pada , Debnath Ujjal 
Published: May 2024

AbstractIn this work, we have investigated a new solution for charged anisotropic compact stellar system in the framework of an extended theory of symmetric teleparallel gravity known as f(Q, T) gravity with the non-metricity term Q and the trace T for energy–momentum tensor. We have constructed a complete set of the gravitational field equations for a non-linear function $$f(Q,T)=\alpha Q + \beta (1+Q^{2}) + \lambda T$$

f

(
Q
,
T
)

=
α
Q
+
β

(
1
+

Q
2

)

+
λ
T

with $$\alpha , \beta $$

α
,
β

and $$\lambda $$
λ
are dimensionless constant parameters in case of static spherically symmetric space-time. To evaluate the expression of relevant unknown constants interior space-time has been matched with exterior Reissner–Nordstr$$\ddot{\textrm{o}}$$

o
¨

m metric. We have performed a graphical discussion in detail to test the behavior of physical parameters in the interior region of a stellar system like energy density, radial and tangential pressure, anisotropies of matter portion, electric field intensity etc. Also, to check the physical validity of our solutions, we have performed various tests viz., energy conditions, stability, mass–radius relation, surface redshift etc. The hydrostatic equilibrium position of our stellar system has been analysed through the TOV equation. Finally, we have determined that our stellar structure solutions satisfy all required physical conditions for viability and acceptability in the context of some pulsar like neutron stars. So our model can be used to characterise the neutron stars in f(Q, T) modified gravity.
Preclinical Study of Pulsed Field Ablation of Difficult Ventricular Targets: Intracavitary Mobile Structures, Interventricular Septum, and Left Ventricular Free Wall
Authors: Nies Moritz , Watanabe Keita , Kawamura Iwanari , Santos-Gallego Carlos G. , Reddy Vivek Y. , Koruth Jacob S. 
Published: May 2024

BACKGROUND:
Endocardial catheter-based pulsed field ablation (PFA) of the ventricular myocardium is promising. However, little is known about PFA’s ability to target intracavitary structures, epicardium, and ways to achieve transmural lesions across thick ventricular tissue.

METHODS:
A lattice-tip catheter was used to deliver biphasic monopolar PFA to swine ventricles under general anesthesia, with electroanatomical mapping, fluoroscopy and intracardiac echocardiography guidance. We conducted experiments to assess the feasibility and safety of repetitive monopolar PFA applications to ablate (1) intracavitary papillary muscles and moderator bands, (2) epicardial targets, and (3) bipolar PFA for midmyocardial targets in the interventricular septum and left ventricular free wall.

RESULTS:
(1) Papillary muscles (n=13) were successfully ablated and then evaluated at 2, 7, and 21 days. Nine lesions with stable contact measured 18.3±2.4 mm long, 15.3±1.5 mm wide, and 5.8±1.0 mm deep at 2 days. Chronic lesions demonstrated preserved chordae without mitral regurgitation. Two targeted moderator bands were transmurally ablated without structural disruption. (2) Transatrial saline/carbon dioxide assisted epicardial access was obtained successfully and epicardial monopolar lesions had a mean length, width, and depth of 30.4±4.2, 23.5±4.1, and 9.1±1.9 mm, respectively. (3) Bipolar PFA lesions were delivered across the septum (n=11) and the left ventricular free wall (n=7). Twelve completed bipolar lesions had a mean length, width, and depth of 29.6±5.5, 21.0±7.3, and 14.3±4.7 mm, respectively. Chronically, these lesions demonstrated uniform fibrotic changes without tissue disruption. Bipolar lesions were significantly deeper than the monopolar epicardial lesions.

CONCLUSIONS:
This in vivo evaluation demonstrates that PFA can successfully ablate intracavitary structures and create deep epicardial lesions and transmural left ventricular lesions.
Randomized, Multicenter Study to Assess the Effects of Different Doses of Sildenafil on Mortality in Adults With Pulmonary Arterial Hypertension
Authors: Hoeper Marius M. , Ewert Ralf , Jansa Pavel , Sirenko Yuriy , Skride Andris , Balagtas Cecile , Hackley Sarah , Vogt Susanne , Abreu Paula , Haughie Scott , Hassan Tarek , Oudiz Ronald J. 
Published: May 2024

BACKGROUND:
Sildenafil, approved for pulmonary arterial hypertension (PAH), has a recommended adult dose of 20 mg TID, with a previously approved 5-mg TID dose by the US Food and Drug Administration. Safety concerns arose because of common off-label use of higher doses, particularly after pediatric data linked higher doses to increased mortality. To assess this, the Food and Drug Administration mandated a study evaluating the effects of various sildenafil doses on mortality in adults with PAH.

METHODS:
This randomized, double-blind study compared sildenafil at doses of 5, 20, or 80 mg TID in adults with PAH. The primary objective was noninferiority of 80 mg of sildenafil versus 5 mg for all-cause mortality. Secondary end points included time to clinical worsening and change in 6-minute walk distance at 6 months. Interim analyses were planned at 50% and 75% of the anticipated mortality events. Safety and tolerability were assessed in the intention-to-treat population.

RESULTS:

The study was halted after the first interim analysis, demonstrating noninferiority for 80 mg of sildenafil versus 5 mg. Of 385 patients enrolled across all dose groups, 78 died. The primary analysis showed a hazard ratio of 0.51 (99.7% CI, 0.22–1.21;
P
<0.001 for noninferiority) for overall survival comparing 80 mg of sildenafil with 5 mg. Time to clinical worsening favored 80 mg of sildenafil compared with 5 mg (hazard ratio, 0.44 [99.7% CI, 0.22–0.89];
P
<0.001). Sildenafil at 80 mg improved 6-minute walk distance from baseline at 6 months compared with 5 mg (least square mean change, 18.9 m [95% CI, 2.99–34.86];
P
=0.0201). No significant differences were found between 80 mg of sildenafil and 20 mg in mortality, clinical worsening, and 6-minute walk distance. Adverse event–related drug discontinuations were numerically higher with 80 mg of sildenafil.

CONCLUSIONS:
Sildenafil at 80 mg was noninferior to sildenafil at 5 mg when examining all-cause mortality in adults with PAH. Secondary efficacy end points favored 80 mg of sildenafil over 5 mg. On the basis of these findings, the Food and Drug Administration recently revoked the approval of 5 mg of sildenafil for adults with PAH, reinforced 20 mg TID as the recommended dose, and now allows dose titration up to 80 mg TID, if needed.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02060487.
Career and Performance of the Artillery Officers in the Batteries of the Siege of Cartagena (1873–1874)
Authors: Cameno Mayo Diego 
Published: May 2024

Abstract
The pacification of cantonal Cartagena occurred at a very difficult time for Spain. The republican government had to face several conflicts at the same time, as well as internal disorder and indiscipline in the Army. In these pages, an investigation is proposed, from the field of prosopography, on the artillery officers who were in charge of the cannon batteries and who ended up surrendered in Cartagena. The objective is to know their previous and future trajectories, in addition to the training they received to successfully fulfill their mission.
Effectiveness and tolerability of eptinezumab in treating patients with migraine resistant to conventional preventive medications and CGRP (receptor) antibodies: a multicentre retrospective real-world analysis from Germany
Authors: Scheffler Armin , Wenzel Pauline , Bendig Merle , Gendolla Astrid , Basten Jale , Kleinschnitz Christoph , Nsaka Michael , Lindner Diana , Naegel Steffen , Burow Philipp , Fleischmann Robert , Holle Dagny 
Published: May 2024

Abstract
Background
Eptinezumab is a monoclonal antibody that targets calcitonin gene-related peptide (CGRP mAb) and is used for migraine prophylaxis. Efficacy data are mainly from clinical trials, real-world data are hardly available yet. Reimbursement policy in Germany leads to eptinezumab mainly being used in patients having failed pre-treatment with other CGRP mAb. To date, it is unclear whether eptinezumab is efficacious and well tolerated in this population and how the treatment response differs from patients who are naive to CGRP mAbs.

Methods
We analysed clinical routine data of 79 patients (episodic migraine (EM): n = 19; chronic migraine (CM): n = 60) from four different centres in Germany. All patients were treated with eptinezumab (100mg). Differences in monthly headache (MHD), migraine (MMD) and acute medication days (AMD) after three months were analysed. The correlation of response with the number of CGRP mAb failures was evaluated. Significance level has been corrected (alpha = 0.017).

Results
After three months MHD, MMD and AMD were significantly reduced. In EM, the median reduction for MHD was 4.0 days (IQR: -6.5 to -1.0; p = 0.001), for MMD 3.0 days (IQR: -5.5 to -1.5; p < 0.001) and for AMD 2.0 days (IQR: -5.0 to -0.5; p = 0.006). In CM, median reduction of MHD was 4 days (IQR: -8.0 to 0.0; p < 0.001), 3.0 days (IQR: -6.0 to-1.0; p < 0.001) for MMD and 1.0 day (IQR: -5.0 to 0.0; p < 0.001) for AMD. All patients were resistant to conventional preventive therapies and most to CGRP mAbs. Fourteen patients had never received a CGRP mAb and 65 patients had received at least one mAb without sufficient effectiveness and/or intolerability (one: n = 20, two: n = 28, three: n = 17). There was a significant association between the number of prior therapies and the 30% MHD responder rate (none: 78.6%, one: 45.0%, two: 32.1%, three: 23.5%, p = 0.010). Regarding tolerability, 10.4% (8/77) reported mild side effects.

Conclusions
The effectiveness of eptinezumab is significantly reduced in patients who have not previously responded to other CGRP mAbs. However, limitations such as the retrospective nature of the analysis, the small sample size and the short treatment period with only the lower dose of eptinezumab must be considered when interpreting the results.
Blockade of the ADAM8-Fra-1 complex attenuates neuroinflammation by suppressing the Map3k4/MAPKs axis after spinal cord injury
Authors: Qian Zhanyang , Li Rulin , Zhao Tianyu , Xie Kunxin , Li PengFei , Li Guangshen , Shen Na , Gong Jiamin , Hong Xin , Yang Lei , Li Haijun 
Published: May 2024

Abstract
Background
Mechanical spinal cord injury (SCI) is a deteriorative neurological disorder, causing secondary neuroinflammation and neuropathy. ADAM8 is thought to be an extracellular metalloproteinase, which regulates proteolysis and cell adherence, but whether its intracellular region is involved in regulating neuroinflammation in microglia after SCI is unclear.

Methods
Using animal tissue RNA-Seq and clinical blood sample examinations, we found that a specific up-regulation of ADAM8 in microglia was associated with inflammation after SCI. In vitro, microglia stimulated by HMGB1, the tail region of ADAM8, promoted microglial inflammation, migration and proliferation by directly interacting with ERKs and Fra-1 to promote activation, then further activated Map3k4/JNKs/p38. Using SCI mice, we used BK-1361, a specific inhibitor of ADAM8, to treat these mice.

Results
The results showed that administration of BK-1361 attenuated the level of neuroinflammation and reduced microglial activation and recruitment by inhibiting the ADAM8/Fra-1 axis. Furthermore, treatment with BK-1361 alleviated glial scar formation, and also preserved myelin and axonal structures. The locomotor recovery of SCI mice treated with BK-1361 was therefore better than those without treatment.

Conclusions
Taken together, the results showed that ADAM8 was a critical molecule, which positively regulated neuroinflammatory development and secondary pathogenesis by promoting microglial activation and migration. Mechanically, ADAM8 formed a complex with ERK and Fra-1 to further activate the Map3k4/JNK/p38 axis in microglia. Inhibition of ADAM8 by treatment with BK-1361 decreased the levels of neuroinflammation, glial formation, and neurohistological loss, leading to favorable improvement in locomotor functional recovery in SCI mice.

Graphical Abstract
Women’s country of birth and failure to catch up an overdue cervical cancer cytological screening participation during pregnancy in France, an observational study based on survey sources
Authors: Lyonnais Elisabeth , Vigoureux Solène , Blondel Béatrice , Wylomanski Sophie , Azria Elie 
Published: May 2024

Abstract
Background
Cervical cancer is the fourth most common cancer among women worldwide, both for incidence and mortality. Prevention relies on screening with a Pap test to detect precancerous lesions, which can then be treated. Access to this screening is currently both improvable and inequitable. Pregnancy may be an ideal moment for women to catch up on their overdue cervical cancer screening. In the general population, women's risk of not being screened is associated with their place of birth and other social factors; this may be true as well among pregnant women. Our objective was to study the association between women's place of birth and their failure to catch up with this screening during pregnancy.

Methods
The 2016 French National Perinatal Survey included 13,147 women who gave birth after 21 weeks of gestation. The association between their place of birth and failure to catch up on this screening (defined by the absence of a Pap test during pregnancy for women overdue for it) was adjusted for age, parity, education level, health insurance, and when they began prenatal care with logistic regression models.

Results
Among the women for whom screening was then recommended, 49% were not up to date at the start of pregnancy, and of these, 53% were not caught up before delivery. After adjustment for other risk factors, maternal place of birth was not associated with a higher risk of failure to catch up with this screening during pregnancy. However, factors identified as associated with this risk included a low education level and late start of prenatal care.

Conclusion
About half of women overdue for cervical cancer screening did not catch up with it during their pregnancy. Professionals should pay special attention to women with lower education levels and late initiation of prenatal care, who constitute a group at high risk of not catching up on this screening during pregnancy.