bluuebunny/crossref_metadata_2025_split huggingface dataset:
An audit to review the prescribing and monitoring of high-intensity statin therapy in acute coronary syndrome patients
Authors: Malcolm L , Bamford S , Kaur G 
Published: April 2024

Abstract

Introduction
High-intensity statin therapy (HIST) is recommended as secondary prevention following an acute coronary syndrome (ACS). Prior to initiating a statin, a baseline liver function test (LFT) and lipid profile are required, which should be repeated in primary care after 3 months for safety purposes and to measure efficacy. Targets to measure efficacy are defined as part of local, national[1] and European guidance.[2]

Aim
To investigate if a National Health Service (NHS) Health Board are compliant with current guidance on the prescribing and monitoring of HIST in ACS patients.

Methods
A retrospective audit of all new ACS diagnoses in the NHS Ayrshire & Arran in June 2022 was undertaken using inpatient prescribing data. The Clinical Portal system was used to obtain LFT and lipid profile results and these were recorded in Microsoft Excel for analysis.

Results
The patient cohort (n=57) was 58% male, with a mean age of 69 years. LFTs were measured in 96.5% patients on admission and 84.2% at follow-up.

Conclusion
HIST with Atorvastatin 80mg was initiated in most cases (84.2%), with appropriate clinical exceptions. HIST appeared effective with 78.9% of patients achieving a 40% reduction in non-HDL cholesterol and 63% of patients achieving an LDL-C target of &lt;1.8mmol/L. These results highlight the need for clinical review at 3 months to optimise lipid lowering therapy as 37% of patients had not met an LDL-C target of &lt;1.8mmol/L. Interpretation of this data is limited by small sample size due to limited allocation of time for data collection and by the fact that not all patients had both baseline and follow-up lipid profiles taken so it cannot be determined if they met treatment targets (n=38). There is a need for the NHS Health Board to improve lipid profile monitoring of HIST as although LFTs were measured in 96.5% patients on admission and 84.2% at follow-up, only 73.7% had a baseline lipid profile and 47.4% at follow-up. As both are measured using the same blood sample, it is suggested that targeted clinician education regarding lipid profile requesting alongside LFTs could significantly improve adherence to audit standards.

References
1. National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification. 2014 [Last updated 24 May 2023]. (Clinical guideline [CG181]). Available from https://www.nice.org.uk/guidance/cg181
2. European Society of Cardiology. ESC Guidelines on Dyslipidaemias (Management of). Escardio.org. Available from: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Dyslipidaemias-Management-of
Investigating pharmacy students clinical reasoning of antimicrobial stewardship cases using a qualitative, think-aloud methodology
Authors: Fleming A , Barbosa T M , Shah M , O’Driscoll Casanoves P 
Published: April 2024

Abstract

Introduction
Future healthcare workers’ education must include antimicrobial stewardship (AMS) clinical decision-making to achieve optimal clinical outcomes and to treat and prevent infection in a manner that minimises the effects of antimicrobial resistance (AMR) and is safe for patients. Clinical reasoning is an important cognitive process that is essential to evaluate and manage a patient’s medical problem.[1] This study aimed to evaluate the cognitive processes and clinical reasoning skills of pharmacy students when they review AMS cases, as well as identify any existing knowledge gaps in this area that need to be addressed.

Methods
This qualitative study used a case study approach, in which a sample (n=13) of Master of Pharmacy (MPharm) students in an Irish University were recruited to interpret three patient infection cases. Convenience sampling of MPharm students by email invitation was conducted and students took part voluntarily. Semi-structured interviews were conducted, recorded and transcribed verbatim. A think-aloud procedure with verbal protocol analysis was adopted to determine students’ decision-making processes and clinical reasoning.[2] Thematic analysis was used to analyse interview data.

Results
Interviews were conducted with 13 students (5 male, 8 female), all aged 22-27 years old. Overall, students interpreted and reasoned through the cases following a structured approach. Some students adopted different approaches to clinical decision-making and did not always follow all the steps outlined in the clinical reasoning cycle. Within the clinical decision-making process, common themes were identified, as outlined in Table 1. Some knowledge gaps were reported by students, including antibiotic prophylaxis, microorganisms, AMS measures, guideline use, soft tissue infection management, and IV-to-oral switch.

Conclusion
This study provides interesting findings on students’ interpretation and review of infection management and AMS principles which could inform the curriculum development of pharmacy education in AMR and AMS. Educators should consider introducing opportunities to develop clinical reasoning skills to support learning on AMS concepts, particularly in challenging areas such as microbiology, and interpretation and application of guidelines. A limitation of the study is that it was conducted with pharmacy students from one university programme. A strength of the study is the think-aloud methodology which provides in-depth detail on students clinical reasoning thought processes and skills.

References
1. Wright DF, Anakin MG, Duffull SB. Clinical decision-making: an essential skill for 21st century pharmacy practice. Research in Social and Administrative Pharmacy. 2019;15(5):600-6.
2. Pinnock R, Fisher TL, Astley J. Think aloud to learn and assess clinical reasoning. Medical Education. 2016;50(5):585–6.
A Geometric Approach to Polynomial and Rational Approximation
Authors: Bishop Christopher J , Lazebnik Kirill 
Published: April 2024

Abstract
We strengthen the classical approximation theorems of Weierstrass, Runge, and Mergelyan by showing the polynomial and rational approximants can be taken to have a simple geometric structure. In particular, when approximating a function $f$ on a compact set $K$, the critical points of our approximants may be taken to lie in any given domain containing $K$, and all the critical values in any given neighborhood of the polynomially convex hull of $f(K)$.
Cyanobacterial bloom affects structural and functional succession of microbial communities in urban wetland sediments in the Qinghai Plateau
Authors: Wu Yi , Wei Xiaoyan , Mao Xufeng , Song Xiuhua , Wei Xijie , Xie Shunbang , Yu Hongyan , Zhang Lele , Yang Yongxiao 
Published: April 2024

Abstract
Algal blooms significantly affect microbial communities in wetland ecosystems. However, little is known about the succession of sediment microbial communities during algal blooms. This study aimed to investigate the temporal patterns of sediment bacterial community structure and function succession during algal blooms (March to May 2022) with high-throughput sequencing technology. To this end, algal blooms were divided into the bloom stage (BS), decomposition stage (DS) and end stage (ES). The results showed that: (i) The algal blooms were dominated by Microcystis species within Cyanobacteria. Both phytoplankton abundance and biomass reached the peak in the BS, with 45.78 × 105 cells/L and 5.97 mg/L, respectively. (ii) The alpha diversity indices of the sediment bacterial community showed a monotonically increasing trend, with the lowest value in the BS. Cyanobacterial blooms reduced the relative abundance of Actinobacteria and Chloroflexi, and raised that of Firmicutes, Proteobacteria and Bacteroidetes. (iii) Cyanobacterial blooms remarkably decreased the complexity of the co-occurrence network of the sediment bacterial community, which resisted extreme environmental conditions in the BS and DS by increasing positive relationships. (iv) Mantel test showed that phytoplankton biomass, T, dissolved oxygen and organic carbon had significant effects on the sediment bacterial community. The results of this study are important for the ecological management of algal blooms through microorganisms.
When to Text? How the Timing of Text Message Contacts in Mixed-Mode Surveys Impacts Response
Authors: Christian Leah Melani , Sun Hanyu , Slowinski Zoe , Hansen Christopher , Mcroy Martha 
Published: April 2024

Abstract
Using multiple modes of contact has been found to increase survey participation over a single contact mode. Text messaging has emerged as a new mode to contact survey participants in mixed-mode survey designs, especially for surveys that include web and/or phone data collection. However, it is unclear how to best combine text messages with mailings and other outreach contacts to improve response rates and data quality. To explore the effectiveness of using text messaging as a contact mode, we conducted a full factorial experiment that varies the sequencing of text messages with mailing contacts (early versus late reminder) and the time text messages were sent (morning versus afternoon). The experiment was implemented in a follow-up wave of a mixed-mode nationally representative longitudinal survey with two sample groups (Cooperative versus Other Respondents). For Cooperative Respondents, text reminders seemed to be effective at increasing completion rates, with the early text reminder being somewhat more effective than the late text reminder, at least early in the field period. For Other Respondents, text invitations were effective at improving the completion rate, but effects diminished quickly once the invitation letter was sent. Additionally, the early text reminder appears to be more effective than the late text reminder at increasing completion rates for Other Respondents. The sequencing of text messages did not affect data quality across sample groups or substantially impact nonresponse. The time of day the text messages were sent did not affect any of the outcome measures examined.
Olaparib and niraparib as maintenance therapy in patients with newly diagnosed and platinum-sensitive recurrent ovarian cancer: A single-center study in China
Authors: Wang Dengfeng , Shi Xunwei , Pei Jiao , Zhang Can , Peng Liping , Zhang Jie , Zheng Jing , Peng Chunrong , Huang Xiaoqiao , Liu Xiaoshi , Liu Hong , Zhang Guonan 
Published: April 2024

Abstract

Background:
Poly adenosine-diphosphate-ribose polymerase (PARP) inhibitors (PARPi) have been approved to act as first-line maintenance (FL-M) therapy and as platinum-sensitive recurrent maintenance (PSR-M) therapy for ovarian cancer in China for >5 years. Herein, we have analyzed the clinical-application characteristics of olaparib and niraparib in ovarian cancer-maintenance therapy in a real-world setting to strengthen our understanding and promote their rational usage.

Methods:
A retrospective chart review identified patients with newly diagnosed or platinum-sensitive recurrent ovarian cancer, who received olaparib or niraparib as maintenance therapy at Sichuan Cancer Hospital between August 1, 2018, and December 31, 2021. Patient medical records were reviewed. We grouped and analyzed patients based on the type of PARPi they used (the olaparib group and the niraparib group) and the line of PARPi maintenance therapy (the FL-M setting and the PSR-M setting). The primary endpoint was the 24-month progression-free survival (PFS) rate.

Results:
In total, 131 patients (olaparib: n = 67, 51.1%; niraparib: n = 64, 48.9%) were enrolled. Breast cancer susceptibility genes (BRCA) mutations (BRCAm) were significantly less common in the niraparib group than in the olaparib group [9.4% (6/64) vs. 62.7% (42/67), P <0.001], especially in the FL-M setting [10.4% (5/48) vs. 91.4% (32/35), P <0.001]. The 24-month PFS rates in the FL-M and PSR-M settings were 60.4% and 45.7%, respectively. In patients with BRCAm, the 24-month PFS rates in the FL-M and PSR-M settings were 62.2% and 72.7%, respectively.

Conclusions:
Olaparib and niraparib were effective in patients with ovarian cancer without any new safety signals except for skin pigmentation. In patients with BRCAm, the 24-month PFS of the PARPi used in the PSR-M setting was even higher than that used in the FL-M setting.
FACE-Q for Measuring Patient-reported Outcomes after Facial Skin Cancer Surgery: Cross-cultural Validation
Authors: Ottenhof Maarten J. , Dobbs Thomas D. , Veldhuizen Inge , Harrison Conrad J. , Marges Michelle , Lee Erica H. , Hoogbergen Maarten M. , van der Hulst René R.W.J. , Pusic Andrea L. , Sidey-Gibbons Chris J. 
Published: April 2024

Background:
Facial skin cancer and its surgical treatment can affect health-related quality of life. The FACE-Q Skin Cancer Module is a patient-reported outcome measure that measures different aspects of health-related quality of life and has recently been translated into Dutch. This study aimed to evaluate the performance of the translated version in a Dutch cohort using modern psychometric measurement theory (Rasch).

Methods:
Dutch participants with facial skin cancer were prospectively recruited and asked to complete the translated FACE-Q Skin Cancer Module. The following assumptions of the Rasch model were tested: unidimensionality, local independence, and monotonicity. Response thresholds, fit statistics, internal consistency, floor and ceiling effects, and targeting were assessed for all scales and items within the scales. Responsiveness was tested for the “cancer worry” scale.

Results:
In total, 259 patients completed the preoperative questionnaire and were included in the analysis. All five scales assessed showed a good or sufficient fit to the Rasch model. Unidimensionality and monotonicity were present for all scales. Some items showed a local dependency. Most of the scales demonstrate ordered item thresholds and appropriate fit statistics.

Conclusions:
The FACE-Q Skin Cancer Module is a well-designed patient-reported outcome measure that shows psychometric validity for the translated version in a Dutch cohort, using classical and modern test theory.
Assessing Student-Reported Perceptions of Prerequisite Usefulness in Preparation for Didactic Physician Assistant Education
Authors: Souza Lauren T. , Geiser Casey P. , Ryan Shiann N. , Pitchford Kandi D. , Azel Mark A. , Miller Paul 
Published: April 2024

Introduction
To gain admittance to a physician assistant (PA) school, applicants must complete program-specific prerequisite courses and experiences. The lack of standardization contributes to complexity, expense, and limits diversity. This research assessed current didactic PA students’ perceptions of prerequisite courses, course delivery methods, and direct patient care (DPC) experiences to determine which were perceived as the most useful in preparation for didactic PA education.

Methods
An online cross-sectional survey was sent to eligible PA students across the United States. The survey collected opinions on the usefulness of commonly required prerequisite courses, course delivery methods, and DPC experiences. Collected data underwent statistical analysis and qualitative analysis for open-response questions.

Results
A total of 527 students completed the survey. Greater than 50% reported prerequisite courses in science and psychology as well as speech, ethics, cardiopulmonary resuscitation (CPR), medical ethics, medical terminology, and nutrition “prepared them well” or “extremely well.” The most frequently recommended educational delivery method was “in person.” The DPC experiences reported to best prepare students were Medical Assistant, Certified Nursing Assistant, and Scribe. The reported recommended number of DPC hours was 1000 to 1499. Chi-square tests for courses that prepared students “well” and “extremely well” revealed that in-person delivery had a statistically significant association with anatomy, physiology, ethics, CPR, medical ethics, and Spanish.

Discussion
These significant findings should be considered by PA programs when evaluating their requirements for admission. Furthermore, PA education associations should consider universal requirements to reduce applicant barriers, complexity, and expense, which may lead to improved diversity.
Perceptions of U.S. and U.K. Incident Reporting Systems: A Scoping Review
Authors: Gampetro Pamela J. , Nickum Anne , Schultz Celeste M. 
Published: April 2024

Objective
The aim of the study is to evaluate the extent, range, and nature of the literature that concerns healthcare providers’ perceptions following the use of incident reporting systems (IRSs) in the United States (U.S.) and the United Kingdom (U.K.). Literature was compared describing providers’ perceptions of reporting patient safety incidents using IRSs from healthcare systems built on public, private, for-profit, or nonprofit insurers in the U.S., with providers’ perceptions using an IRS within a universal government supported healthcare system in the U.K.

Methods
This scoping review searched literature from 4 electronic databases, producing 4863 articles between January 2010 to March 2023.

Results
Eleven U.S. and 8 U.K. articles met the inclusion criteria. Providers described system and individual barriers when using IRSs. The U.S. providers described more concerns regarding individual barriers (fear of punitive response or retaliation, feel incapable or shamed, unsure of what constitutes a patient safety incident, and concerned about litigation) than providers in the U.K. Both countries had similar responses regarding system barriers, except for U.K. providers who were more concerned than the U.S. about damage to professional culture. Providers in both countries believed incident reporting was ineffective and time consuming with hospital leaders seldom acknowledging or integrating improvement measures based on reported incidents.

Conclusions
Sustainable improvements in patient care must be driven by hospital leadership who create just cultures where reporting of safety concerns is encouraged and respected within nonpunitive milieus.
Reinventing the Body Mass Index: A Machine Learning Approach
Authors: Peregrin-Alvarez JM 
Published: April 2024

AbstractThis study explores the predictive capabilities of the Body Mass Index (BMI) formula across a diverse dataset, examining the potential enhancements achievable through integrating additional parameters using machine learning (ML) models. Various modern ML models were utilized (K-Nearest Neighbors, Neural Networks, Decision Trees, Support Vector Classification, Logistic Regression, and Ridge Classifiers. Ensemble models: voting Classifier, Random Forest, and Gradient Boosting), demonstrating improved accuracy and precision over the traditional BMI calculations. Incorporating age and gender into BMI calculations together with the best performing ML model such as Gradient Boosting offers promise for more accurate and personalized health assessments, with significant implications for clinical practice and public health interventions.
Ethics practices associated with reusing health data: An assessment of patient registries
Authors: van den Akker Olmo R. , Stark Susanne , Strech Daniel 
Published: April 2024

AbstractBackgroundAs routinely collected patient data have become increasingly accessible over the years, more and more attention has been directed at the ethics of using such data for research purposes. Patient data is often available to researchers through patient registries that typically collect data of patients with a specific disease. While ethical guidelines for using patient data are presented frequently in research papers and institutional documents, it is currently unknown how patient registries implement the recommendations from these guidelines in practice and how they communicate their practices. In this project, we assessed to what extent a sample of 51 patient registries provides information about a range of ethics practices.MethodsWe searched for patient registries in the resource database of the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). Our assessment checklist was based on three sources: REQueST, a tool for the assessment of registry quality, AHRQ’s guide for good registry practices, and a systematic review of the principles and norms related to health data sharing by Kalkman and colleagues. The checklist includes 26 questions about five ethics components: governance, conflicts of interest, informed consent, privacy, and use-and-access.ResultsWe found substantial heterogeneity in the way patient registries provide information about ethics practices: some registries rarely provide information; others discuss all relevant practices and more. Patient registries often mentioned their governance structure and any potential conflicts of interests but typically did not describe the responsibilities and rights allocated to their funders. Information about informed consent was often provided to patients but the available documents often lacked relevant information like the benefits and risks of participation. Privacy and use-and-access policies were typically discussed but not very concrete.ConclusionsWe can conclude that registries typically provide information about key ethics practices such as governance, conflicts of interest, informed consent, privacy, and use-and-access procedures, but that this information is often not as detailed as recommended in existing guidelines. The checklist we designed for our assessment could be helpful for the ethical assessments of patient registries and other types of registries in the future, as well as for self-assessment of registries that aim to improve their ethics practices.
Differences in Cellular mechanics and ECM dynamics shape differential development of wing and haltere inDrosophila
Authors: Dilsha C , Shiju Salima , Shah Neel Ajay , Inamdar Mandar M. , Shashidhara L S 
Published: April 2024

ABSTRACTDiverse organ shapes and sizes arise from the complex interplay between cellular properties, mechanical forces, and gene regulation.Drosophilawing-a flat structure and the globular haltere are two homologous flight appendages emerging from a similar group of progenitor cells. The activity of a single Hox transcription factor, Ultrabithorax (Ubx), governs the development of these two distinct organs-wing and haltere with different cell and organ morphologies. Our work reported here on differential development of wing and haltere suggest that the localisation and abundance of actomyosin complexes, apical cell contractility, properties of extracellular matrix, and cell size and shape, which is a result of various cell intrinsic and extrinsic forces, plausibly influence the flat vs. globular geometry of these two organs. We followed the three-dimensional architecture of developing wing and halteres during early pupal morphogenesis, indicating the role of the above-mentioned factors in force generation and in driving differential morphogenesis, leading to different organ shapes. Loss of Ubx function led to wing cell-like cellular features in haltere discs, and corresponding changes at the level of adult organs. We also observed that RNAi-mediated downregulation ofAtrophinorPten, in the background of downregulatedExpanded(or elevated Yki), gave rise to varying degrees of haltere to wing homeotic transformations at the cellular as well as adult organ levels. Finally, we provide simulated scenarios based on computational modelling that propose key ingredients required for producing wing- or haltere-like morphologies inDrosophila.