bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finding the place for nutrition in healthcare education and practice
Authors: Agwara Ebiambu , Martyn Kathy , Macaninch Elaine , Nyaga Wanja , Buckner Luke , Lepre Breanna , Laur Celia , Ray Sumantra 
Published: May 2024

BackgroundMalnutrition continues to impact healthcare outcomes, quality of life and costs to healthcare systems. The implementation of nutrition care in healthcare practice may improve health outcomes for patients and the community. This paper describes the iterative development and implementation of nutrition medical education resources for doctors and healthcare professionals in England. These resources are part of the Nutrition Education Policy for Healthcare Practice initiative.MethodAction research methodology was employed to develop and implement nutrition education workshops for medical students and doctors. The workshop was developed iteratively by an interdisciplinary project team, and the content was initially based on the General Medical Council outcomes for graduates. It was evaluated using quantitative evaluation tools and informal qualitative feedback captured from attendees using tools provided by the host organisations and developed by the roadshow team.ResultsA total of 6 nutrition education workshops were delivered to 169 participants. This simple educational package demonstrated potential for delivery in different healthcare settings; however, formal feedback was difficult to obtain. Evaluation results indicate that workshops were better received when delivered by doctors known to the participants and included local context and examples. Reported barriers to the workshops included difficulty for participants in finding the time to attend, beliefs that peers gave a low priority to nutrition and uncertainty about professional roles in the delivery of nutrition care.ConclusionA key outcome of this project was the development of resources for nutrition training of doctors, adapted to local needs. However, relatively low attendance and multiple barriers faced in the delivery of these workshops highlight that there is no ideal ‘place’ for nutrition training in current healthcare teaching. Interprofessional education, through relevant clinical scenarios may increase awareness of the importance of nutrition in healthcare, support the alignment of health professional roles and improve subsequent knowledge and skills.
Preliminary adaptation of the systems thinking for everyday work cue card set in a US healthcare system: a pragmatic and participatory co-design approach
Authors: Fell Samantha E , Bowie Paul , Spalding Karen , Medves Jennifer 
Published: May 2024

IntroductionHealthcare is a highly complex adaptive system, requiring a systems approach to understand its behaviour better. We adapt the Systems Thinking for Everyday Work (STEW) cue cards, initially introduced as a systems approach tool in the UK, in a US healthcare system as part of a study investigating the feasibility of a systems thinking approach for front-line workers.MethodsThe original STEW cards were adapted using consensus-building methods with front-line staff and safety leaders.ResultsEach card was examined for relevance, applicability, language and aesthetics (colour, style, visual cues and size). Two sets of cards were created due to the recognition that systems thinking was relatively new in healthcare and that the successful use of the principles on the cards would need initial facilitation to ensure their effective application. Six principles were agreed on and are presented in the cards: Your System outlines the need to agree that problems belong to a system and that the system must be defined. Viewpoints ensure that multiple voices are heard within the discussion. Work Condition highlights the resources, constraints and barriers that exist in the system and contribute to the system’s functions. Interactions ask participants to understand how parts of the system interact to perform the work. Performance guides users to understand how work can be performed daily. Finally, Understanding seeks to promote a just cultural environment of appreciating that people do what makes sense to them. The two final sets of cards were scored using a content validity survey, with a final score of 1.ConclusionsThe cards provide an easy-to-use guide to help users understand the system being studied, learn from problems encountered and understand the everyday work involved in providing excellent care. The cards offer a practical ‘systems approach’ for use within complex healthcare systems.
Psychological safety in an ECMO retrieval team: a qualitative study to inform improvement
Authors: Passariello Maurizio , Tarrant Carolyn 
Published: May 2024

IntroductionIn healthcare teams, psychological safety is associated with improved performance, communication, collaboration and patient safety. Extracorporeal membrane oxygenation (ECMO) retrieval teams are multidisciplinary teams that initiate ECMO therapy for patients with severe acute respiratory failure in referring hospitals and transfer patients to regional specialised centres for ongoing care. The present study aimed to explore an ECMO team’s experience of psychological safety and generate recommendations to strengthen psychological safety.MethodsThe study was conducted in the Royal Brompton Hospital (RBH), part of Guy’s and St Thomas’ NHS Foundation Trust in London. RBH is one of six centres commissioned to provide ECMO therapy in the UK. 10 participants were recruited: 2 consultants, 5 nurses and 3 perfusionists. Semistructured interviews were used to explore the team members’ views on teamwork, their perceived ability to discuss concerns within the team and the interaction between speaking up, teamwork and hierarchy. A Reflexive Thematic Analysis approach was used to explore the interview data.ResultsThe analysis of the interview dataset identified structural and team factors shaping psychological safety in the specific context of the ECMO team. The high-risk environment in which the team operates, the clearly defined process and functions and the structured opportunities that provide legitimate moments to reflect together influence how psychological safety is experienced. Furthermore, speaking up is shaped by the familiarity among team members, the interdependent work, which requires boundary spanning across different roles, and leadership behaviour. A hierarchy of expertise is privileged over traditional institutional ranking.ConclusionThis study surfaced the structural and team factors that influence speaking up in the specific context of an ECMO retrieval team. Such information is used to suggest interventions to improve and strengthen psychological safety.
Role of nebulised magnesium sulfate in treating acute asthma in children: a systematic review and meta-analysis
Authors: Kumar Jogender , Kumar Prawin , Goyal Jagdish Prasad , Rajvanshi Nikhil , Prabhakaran Kalyana , Meena Jitendra , Gupta Atul 
Published: May 2024

ObjectivesTo review the efficacy of nebulised magnesium sulfate (MgSO4) in acute asthma in children.MethodsThe authors searched Medline, Embase, Web of Science and Cochrane Library for randomised controlled trials (RCTs) published until 15 December 2023. RCTs were included if they compared the efficacy and safety of nebulised MgSO4as a second-line agent in children presenting with acute asthma exacerbation. A random-effects meta-analysis was performed, and the Risk of Bias V.2 tool was used to assess the biases among them.Results10 RCTs enrolling 2301 children with acute asthma were included. All trials were placebo controlled and administered nebulised MgSO4/placebo and salbutamol (±ipratropium bromide). There was no significant difference in Composite Asthma Severity Score between the two groups (6 RCTs, 1953 participants; standardised mean difference: −0.09; 95% CI: −0.2 to +0.02, I2=21%). Children in the MgSO4group have significantly better peak expiratory flow rate (% predicted) than the control group (2 RCTs, 145 participants; mean difference: 19.3; 95% CI: 8.9 to 29.8; I2=0%). There was no difference in the need for hospitalisation, intensive care unit admission or duration of hospital stay. Adverse events were minor, infrequent (7.3%) and similar among the two groups.ConclusionsThere is low-certainty evidence that nebulised MgSO4as an add-on second-line therapy for acute asthma in children does not reduce asthma severity or a need for hospitalisation. However, it was associated with slightly better lung functions. The current evidence does not support the routine use of nebulised MgSO4in paediatric acute asthma management.PROSPERO registration numberCRD42022373692.
Exploring the role of blood pressure in the black-white disparity in cardiovascular disease mortality: a causal mediation analysis
Authors: Zhao Fan , Gidwani Risha , Wang May C , Chen Liwei , Nianogo Roch A 
Published: May 2024

BackgroundCardiovascular diseases (CVDs) are the leading cause of death in the USA, and high blood pressure is a major risk factor for CVD. Despite the overall declining rates of CVD mortality in the USA in recent years, marked disparities between racial and ethnic groups persist, with black adults having a higher mortality rate than white adults. We investigated the extent to which blood pressure mediated the black-white disparity in CVD mortality.MethodsData came from the Multi-Ethnic Study of Atherosclerosis, a diverse longitudinal cohort. We included 1325 black and 2256 white community-based adults aged 45–80 years free of clinical CVD at baseline and followed for 14 years. We used causal mediation analysis to estimate the effect of race on CVD mortality that was mediated through blood pressure.ResultsBlack participants had a higher hazard of dying from CVD compared with white participants (adjusted hazard ratio (HR): 1.28 (95% CI 0.88, 1.88)), though estimates were imprecise. Systolic blood pressure mediated 27% (HR: 1.02, 95% CI 1.00, 1.06) and diastolic blood pressure mediated 55% (HR: 1.07, 95% CI 1.01, 1.10) of the racial disparities in CVD mortality between white and black participants. Mediation effects were present in men but not in women.ConclusionsWe found that black-white differences in blood pressure partially explain the observed black-white disparity in CVD mortality, particularly among men. Our findings suggest that public health interventions targeting high blood pressure prevention and management could be important strategies for reducing racial disparities in CVD mortality.
Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study
Authors: Mathieson Stephanie , Collie Alex , Maher Christopher G , Abdel Shaheed Christina , Xia Ting , Gilbert Stephen , Ferreira Giovanni E , Di Donato Michael F 
Published: May 2024

ObjectivesThe increase in gabapentinoid prescribing is paralleling the increase in serious harms. To describe the low back pain workers compensation population whose management included a gabapentinoid between 2010 and 2017, and determine secular trends in, and factors associated with gabapentinoid use.MethodsWe analysed claim-level and service-level data from the Victorian workers’ compensation programme between 1 January 2010 and 31 December 2017 for workers with an accepted claim for a low back pain injury and who had programme-funded gabapentinoid dispensing. Secular trends were calculated as a proportion of gabapentinoid dispensings per year. Poisson, negative binomial and Cox hazards models were used to examine changes over time in incidence and time to first dispensing.ResultsOf the 17 689 low back pain claimants, one in seven (14.7%) were dispensed at least one gabapentinoid during the first 2 years (n=2608). The proportion of workers who were dispensed a gabapentinoid significantly increased over time (7.9% in 2010 to 18.7% in 2017), despite a reduction in the number of claimants dispensed pain-related medicines. Gabapentinoid dispensing was significantly associated with an opioid analgesic or anti-depressant dispensing claim, but not claimant-level characteristics. The time to first gabapentinoid dispensing significantly decreased over time from 311.9 days (SD 200.7) in 2010 to 148.2 days (SD 183.1) in 2017.ConclusionsThe proportion of claimants dispensed a gabapentinoid more than doubled in the period 2010–2017; and the time to first dispensing halved during this period.
Exploring the relationship between embolic acute stroke distribution and supra-aortic vessel patency: key findings from an in vitro model study
Authors: Velasco Gonzalez Aglae , Sauerland Cristina , Görlich Dennis , Ortega-Quintanilla Joaquin , Jeibmann Astrid , Faldum Andreas , Paulus Werner , Heindel Walter , Buerke Boris 
Published: May 2024

BackgroundWe investigated differences in intracranial embolus distribution through communicating arteries in relation to supra-aortic vessel (SAV) patency.MethodsFor this experimental analysis, we created a silicone model of the extracranial and intracranial circulations using a blood-mimicking fluid under physiological pulsatile flow. We examined the sequence of embolus lodgment on injecting 104 frangible clot analogues (406 emboli) through the right internal carotid artery (CA) as SAV patency changed: (a) all SAV patent (baseline), (b) emboli from a CA occlusion, (c) emboli contralateral to a CA occlusion and (d) occlusion of the posterior circulation. The statistical analysis included a descriptive analysis of thrombi location after occlusion (absolute and relative frequencies). Sequences of occlusions were displayed in Sankey flow charts for the four SAV conditions. Associations between SAV conditions and occlusion location were tested by Fisher’s exact test. Two-sided p values were compared with a significance level of 0.05.ResultsThe total number of emboli was 406 (median fragments/clot: 4 (IQR: 3–5)). Embolus lodgment was dependent on SAV patency (p<0.0001). In all scenarios, embolism lodging in the anterior cerebral artery (ACA) occurred after a previous middle cerebral artery (MCA) embolism (MCA first lodge: 96%, 100/104). The rate of ipsilateral ACA embolism was 28.9% (28/97) at baseline, decreasing significantly when emboli originated from an occluded CA (16%, 14/88). There were more bihemispheric embolisations in cases of contralateral CA occlusion (37%, 45/122), with bilateral ACA embolisms preceding contralateral MCA embolism in 56% of cases (14/25 opposite MCA and ACA embolism).ConclusionsAll emboli in the ACA occurred after a previous ipsilateral MCA embolism. Bihemispheric embolisms were rare, except when there was a coexisting occlusion in either CA, particularly in cases of a contralateral CA occlusion.
Cisternal and intraventricular irrigation in subarachnoid and intraventricular haemorrhage
Authors: Lind Allice Nyborg Rosenkrans , Krabbenhøft Mathias Green , Valentin Jan Brink , Haldrup Mette , Dyrskog Stig , Rasmussen Mads , Simonsen Claus Ziegler , Korshoej Anders Rosendal 
Published: May 2024

BackgroundSubarachnoid haemorrhage (SAH) and intraventricular haemorrhage (IVH) are associated with poor patient outcomes. Intraventricular fibrinolysis is effective in clearing IVH and improving patient survival and neurological outcome. By similar rationale, cisternal irrigation has been proposed as a potential method to accelerate haematoma clearance in SAH. We aimed to provide a comprehensive review and meta-analysis evaluating the effect of intraventricular and cisternal irrigation on clinical outcomes in patients with SAH and IVH.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed preparing this systematic review and study selection was performed by multiple investigators. We extracted ORs from the individual studies and aggregated these using a random effects model. The quality of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluations assessment and ROBINS-I or RoB-2.Results24 articles were included. In SAH, we found that cisternal irrigation with fibrinolytic agents was associated with reduced mortality (OR: 0.68, 95% CI 0.46 to 1.00), higher probability of favourable functional outcome (OR: 1.80, 95% CI 1.30 to 2.51), and reduced risks of DCI (OR: 0.28, 95% CI 0.18 to 0.42) and cerebral vasospasm (OR: 0.28, 95% CI 0.18 to 0.42), compared with conventional therapy. Cisternal irrigation with vasodilatory agents was associated with lower mortality (OR: 0.32, 95% CI 0.13 to 0.79) and reduced risk of cerebral vasospasm (OR: 0.37, 95% CI 0.17 to 0.79). The evidence for irrigation therapy of IVH was sparse and insufficient to show any significant effect.ConclusionIn this study, we found that cisternal irrigation could improve the prognosis in patients with SAH compared with conventional therapy. There is no evidence to support cisternal irrigation treatment of IVH.
Review of isomers in the $$A ~\approx ~135$$ region and nuclear shape evolution
Authors: Palit R. , Laskar Md. S. R. , Nag S. , Choudhury D. , Goel N. , Singh S. , Mishra S. N. 
Published: May 2024

AbstractThe measurements of lifetimes and electromagnetic moments of the isomeric states in some of the nuclei around $$A\approx$$

A
≈

135 carried out at BARC-TIFR Pelletron Linac Facility at TIFR, Mumbai, are highlighted. The results from these measurements, along with similar studies reported in the literature, provide a wealth of nuclear structure information in Ba, La, and Ce isotopes in the $$A \approx$$

A
≈

135 region. Comparison of the measured moments with the calculations gives a unique testing ground for the predictive power of the nuclear models. Plans for similar studies in other mass regions are also described at the end.
On multiplicative dependent vectors with coordinates from certain higher order recurrences
Authors: Behera Mitashree , Ray Prasanta Kumar 
Published: May 2024

In this paper, we prove that there are finitely many multiplicative dependent vectors with coordinates from non-degenerate linear recurrence sequences [Formula: see text] of a fixed order [Formula: see text] These sequences satisfy the recurrence relation [Formula: see text] with initials [Formula: see text] [Formula: see text]. Here, the coefficients of the recurrence relation are positive integers satisfying [Formula: see text] or [Formula: see text] In both these conditions, [Formula: see text]
Absolute zeta functions arising from ceiling and floor Puiseux polynomials
Authors: Hirakawa Yoshinosuke , Tomita Takuki 
Published: May 2024

For the [Formula: see text]-lift [Formula: see text] of a monoid scheme X of finite type, Deitmar et al. calculated its absolute zeta function by interpolating [Formula: see text] for all prime powers q using the Fourier expansion. This absolute zeta function coincides with the absolute zeta function of a certain polynomial. In this paper, we characterize the polynomial as a ceiling polynomial of the sequence [Formula: see text], which we introduce independently. Extending this idea, we introduce a certain pair of absolute zeta functions of a separated scheme X of finite type over [Formula: see text] by means of a pair of Puiseux polynomials which estimate “[Formula: see text]” for sufficiently large p. We call them the ceiling and floor Puiseux polynomials of X. In particular, if X is an elliptic curve, then our absolute zeta functions of X do not depend on its isogeny class.
Radiation and Chemo-Sensitizing Effects of DNA-PK Inhibitors Are Proportional in Tumors and Normal Tissues
Authors: Baker Jennifer H.E. , Kyle Alastair H. , Liu Nannan A. , Wang Taixiang , Liu Xinhe , Teymori Sevin , Banáth Judit P. , Minchinton Andrew I. 
Published: May 2024

Abstract
Inhibitors of DNA-dependent protein kinase (PRKDC; DNA-PK) sensitize cancers to radiotherapy and DNA-damaging chemotherapies, with candidates in clinical trials. However, the degree to which DNA-PK inhibitors also sensitize normal tissues remains poorly characterized. In this study, we compare tumor growth control and normal tissue sensitization following DNA-PK inhibitors in combination with radiation and etoposide. FaDu tumor xenografts implanted in mice were treated with 10 to 15 Gy irradiation ± 3 to 100 mg/kg AZD7648. A dose-dependent increase in time to tumor volume doubling following AZD7648 was proportional to an increase in toxicity scores of the overlying skin. Similar effects were seen in the intestinal jejunum, tongue, and FaDu tumor xenografts of mice assessed for proliferation rates at 3.5 days after treatment with etoposide or 5 Gy whole body irradiation ± DNA-PK inhibitors AZD7648 or peposertib (M3814). Additional organs were examined for sensitivity to DNA-PK inhibitor activity in ATM-deficient mice, where DNA-PK activity is indicated by surrogate marker γH2AX. Inhibition was observed in the heart, brain, pancreas, thymus, tongue, and salivary glands of ATM-deficient mice treated with the DNA-PK inhibitors relative to radiation alone. Similar reductions are also seen in ATM-deficient FaDu tumor xenografts where both pDNA-PK and γH2AX staining could be performed. DNA-PK inhibitor-mediated sensitization to radiation and DNA-damaging chemotherapy are not only limited to tumor tissues, but also extends to normal tissues sustaining DNA damage. These data are useful for interpretation of the sensitizing effects of DNA damage repair inhibitors, where a therapeutic index showing greater cell-killing effects on cancer cells is crucial for optimal clinical translation.
β-Aminopropionitrile Induces Distinct Pathologies in the Ascending and Descending Thoracic Aortic Regions of Mice
Authors: Franklin Michael K. , Sawada Hisashi , Ito Sohei , Howatt Deborah A. , Amioka Naofumi , Liang Ching-Ling , Zhang Nancy , Graf David B. , Moorleghen Jessica J. , Katsumata Yuriko , Lu Hong S. , Daugherty Alan 
Published: May 2024

BACKGROUND:
β-aminopropionitrile (BAPN) is a pharmacological inhibitor of LOX (lysyl oxidase) and LOXLs (LOX-like proteins). Administration of BAPN promotes aortopathies, although there is a paucity of data on experimental conditions to generate pathology. The objective of this study was to define experimental parameters and determine whether equivalent or variable aortopathies were generated throughout the aortic tree during BAPN administration in mice.

METHODS:
BAPN was administered in drinking water for a period ranging from 1 to 12 weeks. The impacts of BAPN were first assessed with regard to BAPN dose, and mouse strain, age, and sex. BAPN-induced aortic pathological characterization was conducted using histology and immunostaining. To investigate the mechanistic basis of regional heterogeneity, the ascending and descending thoracic aortas were harvested after 1 week of BAPN administration before the appearance of overt pathology.

RESULTS:
BAPN-induced aortic rupture predominantly occurred or originated in the descending thoracic aorta in young C57BL/6J or N mice. No apparent differences were found between male and female mice. For mice surviving 12 weeks of BAPN administration, profound dilatation was consistently observed in the ascending region, while there were more heterogeneous changes in the descending thoracic region. Pathological features were distinct between the ascending and descending thoracic regions. Aortic pathology in the ascending region was characterized by luminal dilatation and elastic fiber disruption throughout the media. The descending thoracic region frequently had dissections with false lumen formation, collagen deposition, and remodeling of the wall surrounding the false lumen. Cells surrounding the false lumen were predominantly positive for α-SMA (α-smooth muscle actin). One week of BAPN administration compromised contractile properties in both regions equivalently, and RNA sequencing did not show obvious differences between the 2 aortic regions in smooth muscle cell markers, cell proliferation markers, and extracellular components.

CONCLUSIONS:
BAPN-induced pathologies show distinct, heterogeneous features within and between ascending and descending aortic regions in mice.