bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling the Impact of Community First Responders
Authors: van den Berg Pieter L. , Henderson Shane G. , Jagtenberg Caroline J. , Li Hemeng 
Published: April 2024

In community first responder (CFR) systems, traditional emergency service response is augmented by a network of trained volunteers who are dispatched via an app. A central application of such systems is out-of-hospital cardiac arrest (OHCA), where a very fast response is crucial. For a target performance level, how many volunteers are needed, and from which locations should they be recruited? We model the presence of volunteers throughout a region as a Poisson point process, which permits the computation of the response-time distribution of the first-arriving volunteer. Combining this with known survival-rate functions, we deduce survival probabilities in the cardiac arrest setting. We then use convex optimization to compute a location distribution of volunteers across the region that optimizes either the fraction of incidents with a fast response (a common measure in the industry) or patient survival in the case of OHCA. The optimal location distribution provides a bound on the best possible performance with a given number of volunteers. This can be used to determine whether introducing a CFR system in a new region is worthwhile or can serve as a guide for additional recruitment in existing systems. Effective target areas for recruitment are not always obvious because volunteers recruited from one area may be found in various areas across the city depending on the time of day; we explicitly capture this issue. We demonstrate these methods through an extended case study of Auckland, New Zealand. This paper was accepted by Carri Chan, healthcare management. Funding: This research was financed in part by the Netherlands Organization for Scientific Research (NWO) in the form of a Rubicon grant (019.172EN.016) to C. J. Jagtenberg and a Veni grant (VI.Veni.191E.005) to P. L. van den Berg. S. G. Henderson and H. Li were supported in part by National Science Foundation [Grant CMMI-2035086]. Vrije Universiteit Amsterdam and Erasmus University received funding from TKI Dinalog [Grant 2023-1-307TKI]. Some of this work has been executed under the TKI Dinalog [Grant 2023-1-307TKI]. Part of this work was completed during a research visit made possible by a [Distinguished Visitor Award] from the University of Auckland. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.04024 .
Experiences of learning disability nurses within community nursing teams, working in collaboration with primary care
Authors: Turton Amy , Davis Joe 
Published: April 2024

Background: The approach and understanding of healthcare systems and societies regarding people who have a diagnosis of learning disability (LD) varies across countries; however, it is widely reported that those with LDs report feeling disempowerment and devalued by those working in healthcare. When an individual is devalued, they are more likely to have poorer health outcomes. International human rights laws, such as the Convention on the Rights of Persons with Disabilities, set out an international responsibility to address LD-related inequalities and mistreatment. In England, LD nurses predominantly work within community teams to improve patients living with LDs' holistic access to healthcare and reduce the health inequalities they experience. Exploration of the literature failed to identify any relevant research on the specific role and experiences of the LD nurse within a community team. Aim: This study aimed to explore the lived experiences of a LD nurse working with LD patients within a community setting. The research was conducted by an advanced clinical practitioner (ACP). Method: Semi-structured interviews were used to gather data from four participants. These interviews were recorded and analysed for themes and repeat experiences. Data were analysed using Braun and Clark's (2006) six step model. Findings: LD nurses reported that their patients benefited when they worked collaboratively with primary care. Discussion: The LD nurse was shown to improve access to healthcare for people living with a formal diagnosis of LD or intellectual disability. However, the LD community nurse role is not well known or understood. The LD nurse, when working collaboratively with primary care, often becomes a ‘token’ role that is not utilised. Investment in the role is required to ensure it reaches its full potential. The ACP is best placed to lead on these recommendations and contribute to building the research base in this area of expertise. The role is essential in reducing health inequalities and improving holistic healthcare outcomes for adults with a LD living within the community in the UK. Recommendations: It is recommended that a LD nurse, primary care pathway and an outcome measure tool for workforce planning are implemented within the LD nurse community setting. Future research within and outside the UK is needed to explore the experiences of LD nurses in other geographical locations.
Outcomes of a consultant physiotherapy upper limb clinic: reducing the patient journey through early access to specialist care
Authors: Tunnicliffe Helen , Wood Richard , Armstrong Alison , Ullah Aamer 
Published: April 2024

Background: Many patients referred into secondary care for a ‘surgical opinion’ do not have a surgical target. Aims: An intermediate care consultant physiotherapy upper limb clinic was set up to reduce the patient journey and deliver the right advice/treatment at the first point of assessment. Method: A clinic was set up to: enable an expert clinical assessment; deliver education to the patient regarding diagnosis, treatment options and likely outcomes; arrange appropriate imaging; and deliver care on the day (advice, specialist physiotherapy, injection or splinting). This creates a proactive approach to waiting list management and ensures early management for patients. Results: Complete data from the first 173 patients seen are presented. A total of 99.5% had treatment delivered on the day. Waiting times were reduced by a mean of 3.5 months for appointment, and 27 weeks for physiotherapy input. All received on-the-day expert physiotherapy advice, exercise programmes and progression advice. Oxford Shoulder Score improved by 17.5 (mean). QuickDASH scores improved by 34.72 (mean). Patient satisfaction was extremely positive. Conclusion: The clinic has been successful at shortening the patient journey, reducing the burden on secondary care and delivering best care in a timely manner.
Opportunities and aspirations of diagnostic radiographers within advanced practice
Authors: House Sophie , Snaith Beverly 
Published: April 2024

Background: Radiography has a strong history of role development. One well-established area is the interpretation (reporting) of diagnostic images. Although perceived by many to operate at the advanced level, increasing clarity within the profession means it is important to ascertain whether individuals understand their level and the potential for development. While prior studies have considered role implementation and impact, there has been limited exploration of individual expectation and aspiration for role development. Aims: To ascertain the perspectives of radiographers in established and developing image reporting roles across one imaging network in England, to enable reflection upon role utilisation and aspirations of future development. Methods: Radiographers across a single integrated care system in the north of England and working and/or training within projection radiography (X-ray) reporting roles were invited to participate in online focus groups. Anonymous demographic information, including postgraduate qualifications and scope of practice, was also collected. Results: This study highlighted varied utilisation of radiographers in image reporting, despite scopes of practice being similar. For the majority, roles were not meeting personal expectations, and lack of clarity was negatively impacting job satisfaction. Challenging clinical environments and staffing deficits were common barriers highlighted. Conclusion: Inconsistent implementation has the potential to negatively impact service delivery and capacity. Such variation affects staff satisfaction and morale. Employers should ensure expectations are realistic and that support mechanisms enable consistent development.
An Integrated Framework of Online Learning Effectiveness in Institutions of Higher Learning
Authors: Abdullah Nor Liza , Ramdan Mohamad Rohieszan , Ngah Nor Syamaliah , Yin Khoo Yin , Shokory Suzyanty Mohd , Fuad Dayang Rafidah Syariff M. , Yonus Azita 
Published: April 2024

<p style="text-align:justify">In the early stages of adopting online learning, both learners and teachers displayed resistance, but the COVID-19 pandemic has forced a widespread shift to digital learning. To facilitate this transition, there is a growing focus on highlighting the effectiveness of online learning, which directly impacts learning outcomes. This study investigates online learning effectiveness through an integrated framework that considers online assessment practices and online course design as independent variables, with online learning support as a moderating variable. Understanding the effectiveness of online learning is crucial as hybrid learning becomes the &quot;new norm&quot; in education, combining online and offline methods for teaching the digital generation. Using a quantitative research design involving 232 students at Universiti Kebangsaan Malaysia, the study found that online assessment practices and course design significantly influence students perceived learning outcomes in an online learning environment. Additionally, online learning support positively moderates this relationship. These findings offer a comprehensive perspective on how online assessment practices, course design, and support systems contribute to the quality of higher education in Malaysia amidst evolving educational practices.</p></p>

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Effects of Outdoor Education on Elementary School Students’ Perception of Scientific Literacy and Learning Motivation
Authors: Fan Ming-Ren , Tran Ngoc-Huy , Nguyen Lam-Huu-Phuoc , Huang Chin-Fei 
Published: April 2024

<p style="text-align:justify">This study aims to explore the impact of outdoor education on senior elementary school students&#39; perceptions of scientific literacy and learning motivation. 42 senior elementary school students (25 males, 17 females; average age = 11.6) were enrolled and divided into experimental (N = 21) and control (N = 21) groups. Participants were taught the same content about science for four weeks. The control group adopted traditional indoor teaching, whereas the experimental group adopted outdoor education. Before and after the course, each student completed the 23 items of scientific literacy and the 6 items of learning motivation scale. The results show that the experimental group had significantly higher perceptions of scientific literacy and learning motivation. The outdoor education teaching method has positive effects on the higher levels of awareness and creative development of students. These findings imply that outdoor education has a positive effect on improving students&#39; perceptions of scientific literacy and learning motivation.</p></p>

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THz-TDS with gigahertz Yb-based dual-comb lasers: noise analysis and mitigation strategies
Authors: Willenberg Benjamin , Phillips Christopher R. , Pupeikis Justinas , Camenzind Sandro L. , Liebermeister Lars , Kohlhass Robert B. , Globisch Björn , Keller Ursula 
Published: April 2024

We investigate terahertz time-domain spectroscopy using a low-noise dual-frequency-comb laser based on a single spatially multiplexed laser cavity. The laser cavity includes a reflective biprism, which enables generation of a pair of modelocked output pulse trains with slightly different repetition rates and highly correlated noise characteristics. These two pulse trains are used to generate the THz waves and detect them by equivalent time sampling. The laser is based on Yb:CALGO, operates at a nominal repetition rate of 1.18 GHz, and produces 110 mW per comb with 77 fs pulses around 1057 nm. We perform THz measurements with Fe-doped photoconductive antennas, operating these devices with gigahertz 1 µm lasers for the first time, to our knowledge, and obtain THz signal currents approximately as strong as those from reference measurements at 1.55 µm and 80 MHz. We investigate the influence of the laser’s timing noise properties on THz measurements, showing that the laser’s timing jitter is quantitatively explained by power-dependent shifts in center wavelength. We demonstrate reduction in noise by simple stabilization of the pump power and show up to 20 dB suppression in noise by the combination of shared pumping and shared cavity architecture. The laser’s ultra-low-noise properties enable averaging of the THz waveform for repetition rate differences from 1 kHz to 22 kHz, resulting in a dynamic range of 55 dB when operating at 1 kHz and averaging for 2 s. We show that the obtained dynamic range is competitive and can be well explained by accounting for the measured optical delay range, integration time, as well as the measurement bandwidth dependence of the noise from transimpedance amplification. These results will help enable a new approach to high-resolution THz-TDS enabled by low-noise gigahertz dual-comb lasers.
Mendelian randomization study of whole blood viscosity and cardiovascular diseases
Authors: Bhak Youngjune , Tenesa Albert 
Published: April 2024

Aims
Association between whole blood viscosity (WBV) and an increased risk of cardiovascular disease (CVD) has been reported. However, the causal relationship between WBV and CVD remains not thoroughly investigated. The aim of this study was to investigate the causal relation between WBV and CVD.

Methods
Two-sample Mendelian randomization (MR) was employed, with inverse variance weighting (IVW) as the primary method, to investigate the casual relationship between WBV and CVD. The calculated WBV and medical records of 378,210 individuals participating in the UK Biobank study were divided into halves and analyzed.

Results
The means of calculated WBVs were 16.9 (standard deviation: 0.8) and 55.1 (standard deviation: 17.2) for high shear rate (HSR) and low shear rate (LSR), respectively. 37,859 (10.0%) major cardiovascular events (MACE) consisted of 23,894 (6.3%) cases of myocardial infarction (MI), 9,245 (2.4%) cases of ischemic stroke, 10,377 (2.7%) cases of revascularization, and 5,703 (1.5%) cases of coronary heart disease-related death. In the MR analysis, no evidence was found indicating a causal effect of WBV on MACE (IVW p-value for HSR = 0.81, IVW p-value for LSR = 0.47), MI (0.92, 0.83), ischemic stroke (0.52, 0.74), revascularization (0.71, 0.54), and coronary heart disease-related death (0.83, 0.70). The lack of sufficient evidence for causality persisted in other MR methods, including weighted median and MR-egger.

Conclusions
The Mendelian randomization analysis conducted in this study does not support a causal relationship between calculated WBV and CVD.
Mental health status in healthcare workers during COVID-19 pandemic: An online questionnaire study in the southwest Iran
Authors: Sarvandian Sara , Hosseinpour Shima , Hoseinynejad Khojasteh , Davasaz Irani Reza , Pakseresht Sirus , Rahimi Zahra 
Published: April 2024

ObjectivesThis study aimed to evaluate Mental Health Status, such as stress, anxiety, or depression symptoms, during the Covid-19 pandemic in healthcare workers at Ahvaz Jundishapur University of Medical Sciences.MethodsThis study is an online cross-sectional study conducted on healthcare professionals at Ahvaz Jundishapur University of Medical Science from November 25, 2020, to March 30 2021. PHQ9 and Kessler collected outcome variables of depression, anxiety, and psychological distress questionnaires.ResultsIn total, 2552 healthcare workers in 24 hospitals and 212 Comprehensive health centers were enrolled in this study. The mean age of participants was 37.94 ± 8.07 years, and 25.3% were male. There was a significant difference between the mean Kessler and PHQ9 Scale scores on males and females (P< 0.001). Also, the results showed a significant difference between depression, anxiety, and stress and working in the intensive care unit. According to the result of the Kessler scale, 27% of participants had moderate to severe. Most respondents (65.5%) in all professions had moderate to severe mental distress scores according to the Kessler scale. The logistic regression model results illustrated the relationship between depression and anxiety with gender, workplace, support from families, and collogue job satisfaction, and feeling the stress of media coverage of COVID-19 were statistically significant (P< 0.05).ConclusionsThe present study revealed that medical and health workers suffer from mental health problems. In this study, up to one-fifth of medical staff had stress, anxiety, or depression symptoms, and more than half had psychological distress. Low educational level, lack of family support, lack of colleague’s support, and being a female were the significant risk factors for stress, anxiety, and psychological distress in medical staff.
Risk and protective factors for self-harm and suicide behaviours among serving and ex-serving personnel of the UK Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force: A systematic review
Authors: Williamson Charlotte , Croak Bethany , Simms Amos , Fear Nicola T. , Sharp Marie-Louise , Stevelink Sharon A. M. 
Published: April 2024

Background
Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force.

Methods
A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach.

Results
Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support.

Conclusion
Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.
Exploring the impact of arginine-supplemented immunonutrition on length of stay in the intensive care unit: A retrospective cross-sectional analysis
Authors: Martin Niels D. , Schott Laura L. , Miranowski Mary K. , Desai Amarsinh M. , Lowen Cynthia C. , Cao Zhun , Araujo Torres Krysmaru 
Published: April 2024

Background
Arginine-supplemented enteral immunonutrition has been designed to optimize outcomes in critical care patients. Existing formulas may be isocaloric and isoproteic, yet differ in L-arginine content, energy distribution, and in source and amount of many other specialized ingredients. The individual contributions of each may be difficult to pinpoint; however, all cumulate in the body’s response to illness and injury. The study objective was to compare health outcomes between different immunonutrition formulas.

Methods
Real-world data from October 2015 –February 2019 in the PINC AI™ Healthcare Database (formerly the Premier Healthcare Database) was reviewed for patients with an intensive care unit (ICU) stay and ≥3 days exclusive use of either higher L-arginine formula (HAF), or lower L-arginine formula (LAF). Multivariable generalized linear model regression was used to check associations between formulas and ICU length of stay.

Results
3,284 patients (74.5% surgical) were included from 21 hospitals, with 2,525 receiving HAF and 759 LAF. Inpatient mortality (19.4%) and surgical site infections (6.2%) were similar across groups. Median hospital stay of 17 days (IQR: 16) did not differ by immunonutrition formula. Median ICU stay was shorter for patients receiving HAF compared to LAF (10 vs 12 days; P<0.001). After adjusting for demographics, visit, severity of illness, and other clinical characteristics, associated regression-adjusted ICU length of stay for patients in the HAF group was 11% shorter [0.89 (95% CI: 0.84, 0.94; P<0.001)] compared to patients in the LAF group. Estimated adjusted mean ICU length of stay was 9.4 days (95% CI: 8.9, 10.0 days) for the HAF group compared to 10.6 days (95% CI: 9.9, 11.3 days) for the LAF group (P<0.001).

Conclusions
Despite formulas being isocaloric and isoproteic, HAF use was associated with significantly reduced ICU length of stay, compared to LAF. Higher arginine immunonutrition formula may play a role in improving health outcomes in primarily surgical critically ill patients.
Pharmacological prevention of bone loss and fractures following solid organ transplantations: Protocol for a systematic review and network meta-analysis
Authors: Deng Jiawen , Moskalyk Myron , Hou Wenteng , Zuo Qi Kang , Luo Jinyu 
Published: April 2024

Introduction
Solid organ transplant (SOT) recipients can experience bone loss caused by underlying conditions and the use of immunosuppressants. As a result, SOT recipients are at risk for decreased bone mineral density (BMD) and increased fracture incidences. We propose a network meta-analysis (NMA) that incorporates all available randomized control trial (RCT) data to provide the most comprehensive ranking of anti-osteoporotic interventions according to their ability to decrease fracture incidences and increase BMD in SOT recipients.

Methods
We will search MEDLINE, EMBASE, Web of Science, CINAHL, CENTRAL and CNKI for relevant RCTs that enrolled adult SOT recipients, assessed anti-osteoporotic therapies, and reported relevant outcomes. Title and full-text screening as well as data extraction will be performed in-duplicate. We will report changes in BMD as weighted or standardized mean differences, and fracture incidences as risk ratios. SUCRA scores will be used to provide rankings of interventions, and quality of evidence will be examined using RoB2 and CINeMA.

Discussions
To our knowledge, this systematic review and NMA will be the most comprehensive quantitative analysis regarding the management of bone loss and fractures in SOT recipients. Our analysis should be able to provide physicians and patients with an up-to-date recommendation for pharmacotherapies in reducing incidences of bone loss and fractures associated with SOT. The findings of the NMA will be disseminated in a peer-reviewed journal.