bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing Leak and Increasing Comfort of an N95 Filtering Facepiece Respirator for Aged-Care Workers Using a Customized, Soft, and Compliant Mask Frame
Authors: Chapman Darius , Strong Campbell , Dharmaprani Dhani , Kaur Prabhpreet , Tiver Kathryn , Ganesan Anand N. 
Published: May 2024

Abstract
This prospective cohort study examines the quantitative fit-factor and tolerability impact of a novel custom frame designed to fit beneath N95 filtering facepiece respirators (FFRs) in a healthcare setting. Conducted at a medium-sized metropolitan residential aged care facility (RACF) in South Australia, sixty participants underwent quantitative fit testing while wearing institutional-provided N95 FFRs. Utilizing three-dimensional (3D) face scanning with a proprietary iPhone app, personalized frames were created using flexible silicone foam with a rigid plastic interior “backbone” to ensure compliance and comfort. Following the fitting of custom frames, participants underwent repeat quantitative fit testing using the same style and size of N95 FFRs. Results indicate a remarkable improvement, with 81.5% of participants achieving a pass on quantitative fit testing when using their custom frame in conjunction with the N95 FFRs, compared to a baseline pass rate of only 21.7% (odds ratio (OR) 20.9, 95% confidence interval (CI): 8.26, 58.50, p &lt; 0.001 via logistic regression). Additionally, participants reported a 2.4 times higher level of tolerability when wearing the custom frame with their N95 FFRs compared to using FFRs alone (p &lt; 0.001). In conclusion, the study demonstrates that wearing a customized frame device under an N95 FFR significantly enhances the likelihood of achieving a pass on quantitative fitting and offers a substantially more tolerable experience for wearers. These findings highlight the potential of personalized frame devices to improve respiratory protection efficacy and wearer comfort in healthcare settings.
Challenges to the proof of violence, and social stigma for ethnic migrant women in the current Victims of Family Violence (VFV) visa policy in Aotearoa New Zealand
Authors: Ayallo Irene , Kelly Tyler 
Published: May 2024

Introduction: Ethnic victim-survivors[1] from Middle Eastern, African, and Latin American (MELAA) communities are unlikely to apply for the VFV visas (Ayallo, 2019), which does not reflect the number of family violence experiences in these communities. Instead, this paper argues that it is a testament to specific cultural factors determining their engagement with this policy. While some of these have previously been reported, their cultural aspects are not adequately understood.
Approach: Data were drawn from a study exploring the cultural contexts within which ethnic migrant women engage with the VFV visa policy. The study used narrative inquiry and semi-structured interviews to explore 20 participants’ experiences with the VFV visa policy process. Participants included ten victim-survivors and ten supporting non-medical practitioners.
Findings: Analyses showed that victim-survivors face significant barriers in accessing this visa. Proving that violence occurred, hardship and inability to return to their country of origin due to social stigma are complex and challenging for ethnic migrant women. The cultural reasons discussed in this paper include that psychological abuse is dominant, violence occurs transnationally, and hardship and social stigma are understood collectively and socially.
Implications: Given the potential of this visa policy initiative to provide safety for victim-survivor, recommendations for change are proposed. A humanitarian and compassionate approach that arises from the experiences of the 20 participants and a critical examination of countries with comparable policy frameworks is proposed. Further research is recommended with relevant stakeholders to explore the practicality of implementing such a humanitarian application process in the Aotearoa context.

[1] The term is used here to refer to individuals who have experienced family violence and successfully or unsuccessfully engaged with the VFV visa policy. In this paper, the term is used interchangeably with woman/women as appropriate (reflecting that in this study, all victim-survivors were women).
Comparing the effectiveness and cost-effectiveness of sulfonylureas and newer diabetes drugs as second-line therapy for patients with type 2 diabetes
Authors: Franchi Matteo , Pellegrini Giacomo , Avogaro Angelo , Buzzetti Giuliano , Candido Riccardo , Cavaliere Arturo , Consoli Agostino , Marzona Irene , Mennini Francesco Saverio , Palcic Stefano , Corrao Giovanni 
Published: May 2024

IntroductionWe aimed to compare the effectiveness and cost-effectiveness profiles of glucagon-like peptide-1 receptor agonist (GLP-1-RA), sodium-glucose cotransporter 2 inhibitor (SGLT2i), and dipeptidyl peptidase-4 inhibitor (DPP-4i) compared with sulfonylureas and glinides (SU).Research design and methodsPopulation-based retrospective cohort study based on linked regional healthcare utilization databases. The cohort included all residents in Lombardy aged ≥40 years, treated with metformin in 2014, who started a second-line treatment between 2015 and 2018 with SU, GLP-1-RA, SGLT2i, or DPP-4i. For each cohort member who started SU, one patient who began other second-line treatments was randomly selected and matched for sex, age, Multisource Comorbidity Score, and previous duration of metformin treatment. Cohort members were followed up until December 31, 2022. The association between second-line treatment and clinical outcomes was assessed using Cox proportional hazards models. The incremental cost-effectiveness ratios (ICERs) were calculated and compared between newer diabetes drugs and SU.ResultsOverall, 22 867 patients with diabetes were included in the cohort, among which 10 577, 8125, 2893 and 1272 started a second-line treatment with SU, DPP-4i, SGLT2i and GLP-1-RA, respectively. Among these, 1208 patients for each group were included in the matched cohort. As compared with SU, those treated with DPP-4i, SGLT2i and GLP-1-RA were associated to a risk reduction for hospitalization for major adverse cardiovascular events (MACE) of 22% (95% CI 3% to 37%), 29% (95% CI 12% to 44%) and 41% (95% CI 26% to 53%), respectively. The ICER values indicated an average gain of €96.2 and €75.7 each month free from MACE for patients on DPP-4i and SGLT2i, respectively.ConclusionsNewer diabetes drugs are more effective and cost-effective second-line options for the treatment of type 2 diabetes than SUs.
Associations between prior healthcare use, time to diagnosis, and clinical outcomes in inflammatory bowel disease: a nationally representative population-based cohort study
Authors: Jayasooriya Nishani , Saxena Sonia , Blackwell Jonathan , Bottle Alex , Creese Hanna , Petersen Irene , Pollok Richard C G 
Published: May 2024

BackgroundTimely diagnosis and treatment of inflammatory bowel disease (IBD) may improve clinical outcomes.ObjectiveExamine associations between time to diagnosis, patterns of prior healthcare use, and clinical outcomes in IBD.DesignUsing the Clinical Practice Research Datalink we identified incident cases of Crohn’s disease (CD) and ulcerative colitis (UC), diagnosed between January 2003 and May 2016, with a first primary care gastrointestinal consultation during the 3-year period prior to IBD diagnosis. We used multivariable Cox regression to examine the association of primary care consultation frequency (n=1, 2, >2), annual consultation intensity, hospitalisations for gastrointestinal symptoms, and time to diagnosis with a range of key clinical outcomes following diagnosis.ResultsWe identified 2645 incident IBD cases (CD: 782; UC: 1863). For CD, >2 consultations were associated with intestinal surgery (adjusted HR (aHR)=2.22, 95% CI 1.45 to 3.39) and subsequent CD-related hospitalisation (aHR=1.80, 95% CI 1.29 to 2.50). For UC, >2 consultations were associated with corticosteroid dependency (aHR=1.76, 95% CI 1.28 to 2.41), immunomodulator use (aHR=1.68, 95% CI 1.24 to 2.26), UC-related hospitalisation (aHR=1.43, 95% CI 1.05 to 1.95) and colectomy (aHR=2.01, 95% CI 1.22 to 3.27). For CD, hospitalisation prior to diagnosis was associated with CD-related hospitalisation (aHR=1.30, 95% CI 1.01 to 1.68) and intestinal surgery (aHR=1.71, 95% CI 1.13 to 2.58); for UC, it was associated with immunomodulator use (aHR=1.42, 95% CI 1.11 to 1.81), UC-related hospitalisation (aHR=1.36, 95% CI 1.06 to 1.95) and colectomy (aHR=1.54, 95% CI 1.01 to 2.34). For CD, consultation intensity in the year before diagnosis was associated with CD-related hospitalisation (aHR=1.19, 95% CI 1.12 to 1.28) and intestinal surgery (aHR=1.13, 95% CI 1.03 to 1.23); for UC, it was associated with corticosteroid use (aHR=1.08, 95% CI 1.04 to 1.13), corticosteroid dependency (aHR=1.05, 95% CI 1.00 to 1.11), and UC-related hospitalisation (aHR=1.12, 95% CI 1.03 to 1.21). For CD, time to diagnosis was associated with risk of CD-related hospitalisation (aHR=1.03, 95% CI 1.01 to 1.68); for UC, it was associated with reduced risk of UC-related hospitalisation (aHR=0.83, 95% CI 0.70 to 0.98) and colectomy (aHR=0.59, 95% CI 0.43 to 0.80).ConclusionElectronic records contain valuable information about patterns of healthcare use that can be used to expedite timely diagnosis and identify aggressive forms of IBD.
Mapping patient education encounters in elective surgery: a cohort study and cross-sectional survey
Authors: Booker James , Penn Jack , Koh Chan Hee , Newall Nicola , Rowland David , Sinha Siddharth , Hanrahan John G , Williams Simon C , Sayal Parag , Marcus Hani J 
Published: May 2024

ObjectiveDevelop a process map of when patients learn about their proposed surgery and what resources patients use to educate themselves.DesignA mixed methods design, combining semistructured stakeholder interviews, quantitative validation using electronic healthcare records (EHR) in a retrospective cohort and a cross-sectional patient survey.SettingA single surgical centre in the UK.ParticipantsFourteen members of the spinal multidisciplinary team were interviewed to develop the process map.This process map was validated using the EHR of 50 patients undergoing elective spine surgery between January and June 2022. Postprocedure, feedback was gathered from 25 patient surveys to identify which resources they used to learn about their spinal procedure. Patients below the age of 18 or who received emergency surgery were excluded.InterventionsElective spine surgery and patient questionnaires given postoperatively either on the ward or in follow-up clinic.Primary and secondary outcome measuresThe primary outcome was the percentage of the study cohort that was present at encounters on the process map. Key timepoints were defined if >80% of patients were present. The secondary outcome was the percentage of the study cohort that used educational resources listed in the patient questionnaire.ResultsThere were 342 encounters which occurred across the cohort, with 16 discrete event categories identified. The initial surgical clinic (88%), anaesthetic preoperative assessment (96%) and admission for surgery (100%) were identified as key timepoints. Surveys identified that patients most used verbal information from their surgeon (100%) followed by written information from their surgeon (52%) and the internet (40%) to learn about their surgery.ConclusionsProcess mapping is an effective method of illustrating the patient pathway. The initial surgical clinic, anaesthetic preoperative assessment and surgical admission are key timepoints where patients receive information. This has future implications for guiding patient education interventions to focus at key timepoints.
Healthcare-associated infections in long-term care facilities: a systematic review and meta-analysis of point prevalence studies
Authors: Bennett Noleen , Tanamas Stephanie K , James Rodney , Ierano Courtney , Malloy Michael J , Watson Eliza , Sluggett Janet K , Dunt David , Thursky Karin , Worth Leon J 
Published: May 2024

ObjectivesResidents of long-term care facilities (LTCFs) are especially vulnerable to acquiring healthcare-associated infections (HAIs). Our systematic review and meta-analysis estimated the burden of HAIs, identified the most frequent HAIs and explored the impact of facility-level and surveillance methodological differences on HAI burden in LTCFs, as determined by point prevalence studies (PPS).DesignSystematic review and meta-analysis.Data sourcesBibliographic databases MEDLINE (Ovid), Embase (Ovid) and CINAHL (EBSCOhost) were searched for potentially eligible English-language original research publications. References of short-listed full-text publications, the European Centre for Disease Control and Prevention website and an unpublished 2016–2022 Australian Aged Care PPS report were also checked.Eligibility criteriaPPS monitoring HAIs, published and undertaken between January 1991 and June 2023 in LTCFs.Data extraction and synthesisTwo reviewers independently screened for eligible PPS and if included, assessed risk of bias for each PPS using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. Meta-analysis was performed using a generalised linear mixed model.Results31 publications (including 123 PPS from 33 countries encompassing 709 860 residents) were included. Nine PPS (7.3%) were allocated a JBI quality score greater than 80% while 30 PPS (24.4%) were allocated a score between 70% and 80%. The overall pooled HAI point prevalence was 3.5% (95% CI 3.1% to 4.0%); 3.9% (95% CI 3.2% to 4.7%) when higher bias-risk PPS (<70% quality score) were excluded. Of 120 PPS, the most frequently reported HAIs were urinary tract (UTIs; 38.9%), respiratory tract (RTIs; 33.6%) and skin or soft tissue (SSTIs; 23.7%) infections. HAI point prevalence varied by geographical region (p<0.001), study decade (p<0.001) and HAI surveillance definitions used (p<0.001). There was no difference across facility types (p=0.57) or season (p=0.46).ConclusionsHAIs remain a global public health problem and threat to the safety of LTCF residents; effective infection prevention and control strategies to reduce HAIs in LTCFs are still required. Guidance specifically about the prevention and management of UTIs, RTIs and SSTIs should be prioritised.PROSPERO registration numberCRD42023406844.
Quality of life among residents of informal urban settlements during the COVID-19 pandemic in Salvador, Brazil
Authors: Mogaji Hammed , Nery Nivison , Argibay Hernan D , Cruz Jaqueline S , Carneiro Ianei O , Lustosa Ricardo , Ko Albert I , Costa Federico , Begon Mike , Khalil Hussein 
Published: May 2024

BackgroundDisadvantaged populations, especially those living in rural and informal settlements, constitute the most affected during the COVID-19 pandemic. However, there is limited information on the health-related quality of life (HRQOL) and indirect consequences of non-pharmaceutical interventions implemented during the pandemic.MethodsWe leveraged on an ongoing prospective open-cohort survey and performed a cross-sectional analysis of data collected between November 2021 and July 2022 among 793 residents above age 5 in a large slum community in the city of Salvador, Brazil. We describe the HRQOL of residents, explored participants’ perception about the pandemic, and the relationship between sociodemographic, economic and employment data on physical and mental health scores using both χ2statistics and separate mixed-effects regression models.ResultsMost participants were female (58.9%), aged 18–45 years (45%), with nearly half (49.7%) employed before pandemic, of whom 38.8% lost jobs during the pandemic. Food insecurity was 69.6%, and only 27.1% received government aid. Those retaining employment during the pandemic had better physical (β: 4.02, 95% CI 1.34 to 6.69, p<0.001) and mental (β: 3.08, 95% CI 0.60 to 5.56, p<0.001) health. Females had lower physical health scores than males (β: −2.44, 95% CI −3.94 to −0.94, p=0.002). Older participants had lower physical health scores (β: −9.11, 95% CI −12.14 to −6.07, p<0.001), but higher schooling improved physical health (p<0.001). Females and older adults faced more COVID-impacted challenges (p<0.001) related to health, education, family, social relationships, work, finances and employment.ConclusionWe found lower HRQOL among adults, females, the unemployed and those with lower school attainment. In addition, women and individuals in older age groups reported experiencing COVID-impacted mental challenges more frequently than others. These findings highlight the need to prioritise creation of economic opportunities and expansion of existing assistance programmes for marginalised populations residing in these slums.
Identification of individual-level clinical factors associated with increased risk of death during heatwaves: a time-stratified case-crossover study using national primary care records in England
Authors: Thompson Ross , Kovats Sari , Hajat Shakoor , Macintyre Helen , O’Connell Emer 
Published: May 2024

BackgroundDespite an increase in heat-related deaths occurring in England in recent years, one of the key recommended actions of identifying individuals at risk and deploying targeted interventions is not routinely undertaken. A major contributing factor to this is a lack of understanding of the individual-level risk factors that would support an evidence-based approach to targeted prevention.ObjectiveTo identify individual-level clinical risk factors for heat-related mortality in England by using primary care records and to estimate potential effect modification of a range of pre-existing conditions, clinical measurements and prescribed medications.MethodsA time-stratified case-crossover analysis was undertaken of 37 individual-level clinical risk factors. Patient’s data were obtained from the Clinical Practice Research Datalink. Conditional logistic regression was used to characterise associations between temperature and the risk of death on hot days.ResultsHeat mortality risk was modified by a large range of pre-existing conditions, with cardiorespiratory, mental health and cognitive function conditions, diabetes and Parkinson’s, all increasing risk. The most striking increase was observed for depression with an OR of 1.25 (95% CI 1.09 to 1.44), the highest observed for pre-existing conditions. Individuals prescribed medications to treat heart failure and high blood pressure also have increased odds of death during heatwaves. There appears to be evidence of an increasing trend in ORs for diastolic blood pressure (DBP) categories, with ORs increasing from low DBP up to prehypertensive DBP group.ConclusionsThis is the first study to explore a comprehensive set of individual-level clinical risk factors and heat using primary care records in England. Results presented have important implications for patient medication management during heat events, incorporating heat-risk considerations into other health policies such as suicide prevention plans and highlighted potential differences between clinical vulnerability and patients at risk.
Increased risk of adverse gestational outcomes in pregnant women with primary Sjögren’s syndrome
Authors: Tan Zhen , Shao Meilin , Zhou Yingbo , Wang Li , Ma Yan , Xiang Nan , Yuan Xiang , Wang Bin , Xie Xiangliang , Zhou Mingtao , Wang Yumin , Li Sidong , Li Xiaomei 
Published: May 2024

ObjectivesThis study aimed to identify risk factors contributing to diverse pregnancy outcomes in primary Sjögren’s syndrome (pSS) cases.MethodsA retrospective analysis was conducted on pregnant individuals with pSS, who received outpatient or inpatient care across multiple hospitals in Anhui Province, China, from January 2015 to December 2022.ResultsThis study included 164 pregnant women with pSS and 328 control subjects, with no statistically significant difference in average age between the two groups. Analysis of pregnancy outcomes revealed that, compared with the control group, pregnant women in the pSS group were more likely to experience miscarriages, both spontaneous (12.80% vs 1.52%, p<0.001) and therapeutic (6.10% vs 0.91%, p<0.05). The proportion of placental abnormalities detected during prenatal ultrasound in women from the pSS group was higher (14.63% vs 6.40%, p<0.05). In the analysis of pregnancy outcomes for live-born neonates, a higher incidence of congenital heart abnormalities was observed in the pSS group (27.34% vs 12.03%, p<0.05). While there were no significant differences between the pSS pregnancies in terms of both normal and adverse pregnancy outcomes, a comparison of fetal survival and fetal loss in pSS pregnancies revealed a greater use of prophylactic anticoagulant therapy in the fetal survival group. Notably, the application of low molecular weight heparin (LMWH) emerged as an independent protective factor for fetal survival.ConclusionsCompared with non-autoimmune controls, pregnancy in women with pSS presents more challenges. Importantly, we observed that the use of LMWH as anticoagulant therapy is an independent protective measure for fetal survival.
Percolating lives: statistical mechanics in Naples
Authors: Esposito Salvatore , Amabile Alessandro 
Published: May 2024

AbstractWe reconstruct the intriguing case of the formation of the Naples group of Statistical Mechanics, which took more than two decades, from the first steps at the end of 1960 aimed at acquiring skills and knowledge abroad, until the formal establishment of the group at the beginning of the 1990 s. A number of important results were obtained seamlessly during this period by Antonio Coniglio and his large number of collaborators, but although favorable opportunities for the formation of the group emerged, starting from the beginning of the 1980 s, several factors (including a certain disinterest in supporting research in Italy) effectively delayed the formation of a group by about a decade. We here provide a fairly comprehensive picture of the relevance of the group of Neapolitan statistical physicists even before its formation, also reviewing the main contributions achieved by these people both during the process of formation of the group and in the first decade of its life.
Momentum non-conservation in a scalar quantum field theory with a planar $$\theta$$ interface
Authors: Velázquez Daniel G. , Martínez von Dossow R. , Urrutia Luis F. 
Published: May 2024

AbstractMotivated by the recent interest aroused by non-dynamical axionic electrodynamics in the context of topological insulators and Weyl semimetals, we discuss a simple model of the magnetoelectric effect in terms of a $$\theta$$
θ
-scalar field that interacts through a delta-like potential located at a planar interface. Thus, in the bulk regions the field is constructed by standard free waves with the absence of evanescent components. These waves have to be combined into linear superposition to account for the boundary conditions at the interface in order to yield the corresponding normal modes. Our aim is twofold: first we quantize the $$\theta$$
θ
-scalar field using the normal modes in the canonical approach and then we look for applications emphasizing the effect of momentum non-conservation due to the presence of the interface. To this end, we calculate the decay of a standard scalar particle into two $$\theta$$
θ
-scalar particles showing the opening of new decay channels. As a second application, we deal with the two-body scattering of standard charged scalar particles mediated by a $$\theta$$
θ
-scalar particle, focusing on the momentum non-conserving contribution of the scattering amplitude $${{\mathcal {M}}}^{NC}$$

M

NC

. We define a generalization of the usual cross section in order to quantify the emergence of these events. We also study the allowed kinematical region for momentum non-conservation as well as the position of the poles of the amplitude $${{\mathcal {M}}}^{NC}$$

M

NC

. Finally, the ratio of the magnitudes between $${{\mathcal {M}}}^{NC}$$

M

NC

and the momentum conserving amplitude is discussed in the appropriate region of momentum space.