bluuebunny/crossref_metadata_2025_split huggingface dataset:
Classroom Promotion of Oral Language (CPOL): protocol for a cluster randomised controlled trial of a school-based intervention to improve children’s literacy outcomes at grade 3, oral language and mental health
Authors: Goldfeld Sharon , Snow Pamela , Eadie Patricia , Munro John , Gold Lisa , Le Ha N D , Orsini Francesca , Shingles Beth , Lee Katherine , Connell Judy , Watts Amy 
Published: May 2024

IntroductionOral language and literacy competence are major influences on children’s developmental pathways and life success. Children who do not develop the necessary language and literacy skills in the early years of school then go on to face long-term difficulties. Improving teacher effectiveness may be a critical step in lifting oral language and literacy outcomes. The Classroom Promotion of Oral Language trial aims to determine whether a specifically designed teacher professional learning programme focusing on promoting oral language can lead to improved teacher knowledge and practice, and advance outcomes in oral language and literacy for early years school children, compared with usual practice.Methods and analysisThis is a two-arm cluster multisite randomised controlled trial conducted within Catholic and Government primary schools across Victoria, Australia. The intervention comprises 4 days of face-to-face professional learning for teachers and ongoing implementation support via a specific worker. The primary outcome is reading ability of the students at grade 3, and the secondary outcomes are teacher knowledge and practice, student mental health, reading comprehension and language ability at grade 1; and literacy, writing and numeracy at grade 3. Economic evaluation will compare the incremental costs of the intervention to the measured primary and secondary outcomes.Ethics and disseminationThis trial was approved by the Monash University Human Research Ethics Committee #CF13/2634-2013001403 and later transferred to the University of Melbourne #1545540. The investigators (including Government and Catholic partners) will communicate trial results to stakeholders, collaborators and participating schools and teachers via appropriate presentations and publications.Trial registration numberISRCTN77681972; Pre-results.
Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study
Authors: Fiorini Gianfrancesco , Pellegrini Giacomo , Franchi Matteo , Rigamonti Antonello Emilio , Marazzi Nicoletta , Sartorio Alessandro , Corrao Giovanni , Cella Silvano Gabriele 
Published: May 2024

ObjectivesTo investigate the time course of medication adherence and some of the factors involved in this process in undocumented migrants with chronic diseases.DesignRetrospective cohort study.SettingA big non-governmental organisation in Milano, Italy, giving medical assistance to undocumented migrants.Participants1918 patients, 998 females and 920 males, with at least one chronic condition (diabetes, cardiovascular diseases (CVDs), mental health disorders) seen over a period of 10 years (2011–2020). Their mean age was 49.2±13 years.ResultsAdherence to medications decreased over 1 year in all patients. This was more evident during the first 2 months of treatment. Patients on only one medication were less adherent than those on more than one medication; at 6 months the percentage of patients with high adherence was 33% vs 57% (p<0.0001) for diabetes, 15% vs 46% (p<0.0001) for mental disorders and 35% vs 59% (p<0.0001) for CVDs. Patients with mental disorders had the lowest adherence: 25% at 6 months and 3% at 1 year. Mental disorders, when present as comorbidities, greatly reduced the probability of being highly adherent: risk ratio (RR) 0.72 (95% CI 0.57 to 0.91; p=0.006) at 3 months, RR 0.77, (95% CI 0.59 to 1.01; p=0.06) at 6 months, RR 0.35 (95% CI 0.13 to 0.94; p=0.04) at 1 year. This was especially evident for patients with CVDs, whose percentage of high adherents decreased to 30% (p=0.0008) at 6 months and to 3% (p=0.01) at 1 year. We also noted that highly adherent patients usually were those most frequently seen by a doctor.ConclusionsInterventions to increase medication adherence of undocumented migrants with chronic diseases are necessary, particularly in the first 2 months after beginning treatment. These should be aimed at people-centred care and include more outpatient consultations. Educational interventions should especially be taken into consideration for patients on monotherapy.
Did COVID-19 ICU patient mortality risk increase as Colorado hospitals filled? A retrospective cohort study
Authors: Johnson David R , Ghosh Debashis , Wagner Brandie D , Carlton Elizabeth J 
Published: May 2024

ObjectivesTo assess whether increasing levels of hospital stress—measured by intensive care unit (ICU) bed occupancy (primary), ventilators in use and emergency department (ED) overflow—were associated with decreasing COVID-19 ICU patient survival in Colorado ICUs during the pre-Delta, Delta and Omicron variant eras.DesignA retrospective cohort study using discrete-time survival models, fit with generalised estimating equations.Setting34 hospital systems in Colorado, USA, with the highest patient volume ICUs during the COVID-19 pandemic.Participants9196 non-paediatric SARS-CoV-2 patients in Colorado hospitals admitted once to an ICU between 1 August 2020 and 1 March 2022 and followed for 28 days.Outcome measuresDeath or discharge to hospice.ResultsFor Delta-era COVID-19 ICU patients in Colorado, the odds of death were estimated to be 26% greater for patients exposed every day of their ICU admission to a facility experiencing its all-era 75th percentile ICU fullness or above, versus patients exposed for none of their days (OR: 1.26; 95% CI: 1.04 to 1.54; p=0.0102), adjusting for age, sex, length of ICU stay, vaccination status and hospital quality rating. For both Delta-era and Omicron-era patients, we also detected significantly increased mortality hazard associated with high ventilator utilisation rates and (in a subset of facilities) states of ED overflow. For pre-Delta-era patients, we estimated relatively null or even protective effects for the same fullness exposures, something which provides a meaningful contrast to previous studies that found increased hazards but were limited to pre-Delta study windows.ConclusionsOverall, and especially during the Delta era (when most Colorado facilities were at their fullest), increasing exposure to a fuller hospital was associated with an increasing mortality hazard for COVID-19 ICU patients.
Standard cardiopulmonary resuscitation versus chest compressions only after out-of-hospital cardiac arrest: a protocol for a systematic review and meta-analysis
Authors: An Shulin , Liu Yi , Xi Qian , Zhang Yongqing , Gao Yongli , Zhang Wei 
Published: May 2024

IntroductionThe 2020 American Heart Association guidelines encourage lay rescuers to provide chest compression-only cardiopulmonary resuscitation to simplify the process and encourage cardiopulmonary resuscitation initiation. However, recent clinical trials had contradictory results about chest compression-only cardiopulmonary resuscitation. This study will aim to compare standard and chest compressions-only cardiopulmonary resuscitation after out-of-hospital cardiac arrest.Methods and analysisThis study will retrieve only randomised and quasi-randomised controlled trials from the Cochrane Library, PubMed, Web of Science and Embase databases. Data on study design, participant characteristics, intervention details and outcomes will be extracted by a unified standard form. Primary outcomes to be assessed are hospital admission, discharge, and 30-day survival, and return of spontaneous circulation. The Grading of Recommendations, Assessment, Development and Evaluation framework will evaluate the quality of evidence. Cochrane’s tool for assessing the risk of bias will evaluate risk deviation. If the I2statistic is lower than 40%, the fixed-effects model will be used for meta-analysis. Otherwise, the random-effects model will be used. The search will be performed following the publication of this protocol (estimated to occur on 30 December 2024).DiscussionThis study will evaluate the effect of chest compression-only cardiopulmonary resuscitation after out-of-hospital cardiac arrest and provide evidence for cardiopulmonary resuscitation guidelines.Ethics and disseminationNo patient or public entity will be involved in this study. Therefore, the study does not need to be ethically reviewed. The results of the study will be disseminated through peer-reviewed journal publications and committee conferences.PROSPERO registration numberCRD42021295507.
Medical researchers’ perceptions regarding research evaluation: a web-based survey in Japan
Authors: Minoura Akira , Shimada Yuhei , Kuwahara Keisuke , Kondo Makoto , Fukushima Hiroko , Sugiyama Takehiro 
Published: May 2024

ObjectivesJapanese medical academia continues to depend on quantitative indicators, contrary to the general trend in research evaluation. To understand this situation better and facilitate discussion, this study aimed to examine how Japanese medical researchers perceive quantitative indicators and qualitative factors of research evaluation and their differences by the researchers’ characteristics.DesignWe employed a web-based cross-sectional survey and distributed the self-administered questionnaire to academic society members via the Japanese Association of Medical Sciences.ParticipantsWe received 3139 valid responses representing Japanese medical researchers in any medical research field (basic, clinical and social medicine).OutcomesThe subjective importance of quantitative indicators and qualitative factors in evaluating researchers (eg, the journal impact factor (IF) or the originality of the research topic) was assessed on a four-point scale, with 1 indicating ‘especially important’ and 4 indicating ‘not important’. The attitude towards various opinions in quantitative and qualitative research evaluation (eg, the possibility of research misconduct or susceptibility to unconscious bias) was also evaluated on a four-point scale, ranging from 1, ‘strongly agree’, to 4, ‘completely disagree’.ResultsNotably, 67.4% of the medical researchers, particularly men, younger and basic medicine researchers, responded that the journal IF was important in researcher evaluation. Most researchers (88.8%) agreed that some important studies do not get properly evaluated in research evaluation using quantitative indicators. The respondents perceived quantitative indicators as possibly leading to misconduct, especially in basic medicine (strongly agree—basic, 22.7%; clinical, 11.7%; and social, 16.1%). According to the research fields, researchers consider different qualitative factors, such as the originality of the research topic (especially important—basic, 46.2%; social, 39.1%; and clinical, 32.0%) and the contribution to solving clinical and social problems (especially important—basic, 30.4%; clinical, 41.0%; and social, 52.0%), as important. Older researchers tended to believe that qualitative research evaluation was unaffected by unconscious bias.ConclusionDespite recommendations from the Declaration on Research Assessment and the Leiden Manifesto to de-emphasise quantitative indicators, this study found that Japanese medical researchers have actually tended to prioritise the journal IF and other quantitative indicators based on English-language publications in their research evaluation. Therefore, constantly reviewing the research evaluation methods while respecting the viewpoints of researchers from different research fields, generations and genders is crucial.
What recovery domains are important following a total knee replacement? A qualitative, interview-based study
Authors: Khatri Chetan , Dhaif Fatema , Ellard David , Rodrigues Jeremy Neil , Underwood Martin , Mitchell Paul , Metcalfe Andrew 
Published: May 2024

ObjectivesTo explore people’s views of recovery from total knee replacement (TKR) and which recovery domains they felt were important.DesignSemi-structured interviews exploring the views of individuals about to undergo or who have undergone TKR. A constant-comparative approach with thematic analysis was used to identify themes. The process of sampling, collecting data and analysis were continuous and iterative throughout the study, with interviews ceasing once thematic saturation was achieved.SettingTertiary care centre.ParticipantsA purposive sample was used to account for variables including pre, early or late postoperative status.Results12 participants were interviewed, 4 who were preoperative, 4 early postoperative and 4 late postoperative. Themes of pain, function, fear of complications, awareness of the artificial knee joint and return to work were identified. Subthemes of balancing acute and chronic pain were identified.ConclusionsThe results of this interview-based study identify pain and function, in particular mobility, that were universally important to those undergoing TKR. Surgeons should consider exploring these domains when taking informed consent to enhance shared decision-making. Researchers should consider these recovery domains when designing interventional studies.
Helping patients prepare their dependent children for parental death: mixed-methods evaluation of a codeveloped training programme for palliative and allied healthcare professionals in the UK
Authors: Cockle-Hearne Jane , Groothuizen Johanna Elise , Ream Emma 
Published: May 2024

ObjectivesTo evaluate how the codesigned training programme, ‘No conversation too tough’, can help cancer, palliative and wider healthcare professionals support patients to communicate with their dependent children when a parent is dying. We examined perceptions of learning provided by the training, its contribution to confidence in communicating with families when a parent is dying, and subjective experience of, and reactions to, the training. We also explored potential changes in practice behaviours.DesignPre–post, convergent, parallel, mixed-methods study. Motivations for practice change were measured quantitatively, and qualitatively through semi-structured interviews. Non-parametric analysis was conducted for self-efficacy and outcome expectancy measures; descriptive statistics examined perceptions of usefulness; intentions to use learning in practice and reactions to the training. Semi-structured interviews examined motivations and perceptions of learning in depth. A 6-week, practice log recorded immediate practice effects and reflections.Setting1-day training delivered 3 times, total delegates 36: online December 2021, February 2022, face-to-face March 2022. Questionnaires delivered correspondingly in online or paper formats, semi-structured interviews online.ParticipantsPre–post: palliative care professionals (n=14/12), acute cancer clinical nurse specialists (n=16/11), other healthcare professionals (n=5/5).ResultsPositive changes were observed in self-efficacy (17 of 19 dimensions p<0.003) and outcome expectancies (3 of 14 beliefs p<0.036). Perceptions of usefulness and intentions to use learning in practice mean scores were 82–94 (scales 0=low to 100=high). There was high affirmation for sharing learning and influencing change in the workplace and wider practice. Content, style and delivery were positively endorsed. Further elements to be included in the training were identified.ConclusionsThe training programme has the potential to effect change in practice behaviours. A large-scale study will evaluate the roll-out of the training delivered to individual professionals and whole teams across the UK. It will provide longer-term feedback to understand practice behaviour and mediators of change across professional roles.
Landscape of the gut mycobiome dynamics during pregnancy and its relationship with host metabolism and pregnancy health
Authors: Fu Yuanqing , Gou Wanglong , Wu Ping , Lai Yuwei , Liang Xinxiu , Zhang Ke , Shuai Menglei , Tang Jun , Miao Zelei , Chen Jieteng , Yuan Jiaying , Zhao Bin , Yang Yunhaonan , Liu Xiaojuan , Hu Yayi , Pan An , Pan Xiong-Fei , Zheng Ju-Sheng 
Published: May 2024

Objective
The remodelling of gut mycobiome (ie, fungi) during pregnancy and its potential influence on host metabolism and pregnancy health remains largely unexplored. Here, we aim to examine the characteristics of gut fungi in pregnant women, and reveal the associations between gut mycobiome, host metabolome and pregnancy health.

Design
Based on a prospective birth cohort in central China (2017 to 2020): Tongji-Huaxi-Shuangliu Birth Cohort, we included 4800 participants who had available ITS2 sequencing data, dietary information and clinical records during their pregnancy. Additionally, we established a subcohort of 1059 participants, which included 514 women who gave birth to preterm, low birthweight or macrosomia infants, as well as 545 randomly selected controls. In this subcohort, a total of 750, 748 and 709 participants had ITS2 sequencing data, 16S sequencing data and serum metabolome data available, respectively, across all trimesters.

Results

The composition of gut fungi changes dramatically from early to late pregnancy, exhibiting a greater degree of variability and individuality compared with changes observed in gut bacteria. The multiomics data provide a landscape of the networks among gut mycobiome, biological functionality, serum metabolites and pregnancy health, pinpointing the link between
Mucor
and adverse pregnancy outcomes. The prepregnancy overweight status is a key factor influencing both gut mycobiome compositional alteration and the pattern of metabolic remodelling during pregnancy.

Conclusion
This study provides a landscape of gut mycobiome dynamics during pregnancy and its relationship with host metabolism and pregnancy health, which lays the foundation of the future gut mycobiome investigation for healthy pregnancy.
Charge asymmetric fall under gravity of a plate in general relativity
Authors: Halilsoy M. , Memari V. 
Published: May 2024

AbstractCharged test particle geodesics determine the fall toward a regular plate whose metric is expressed in plane-symmetric form depending only on the z-direction. Falling conditions are obtained in the test electric/magnetic Maxwell fields for both anisotropic and isotropic plates. These results have implications for particle/antiparticle fall differences in the case of a general relativistic plate.
Identification of Clonal Hematopoiesis Driver Mutations through In Silico Saturation Mutagenesis
Authors: Demajo Santiago , Ramis-Zaldivar Joan E. , Muiños Ferran , Grau Miguel L. , Andrianova Maria , López-Bigas Núria , González-Pérez Abel 
Published: May 2024

Abstract
Clonal hematopoiesis (CH) is a phenomenon of clonal expansion of hematopoietic stem cells driven by somatic mutations affecting certain genes. Recently, CH has been linked to the development of hematologic malignancies, cardiovascular diseases, and other conditions. Although the most frequently mutated CH driver genes have been identified, a systematic landscape of the mutations capable of initiating this phenomenon is still lacking. In this study, we trained machine learning models for 12 of the most recurrent CH genes to identify their driver mutations. These models outperform expert-curated rules based on prior knowledge of the function of these genes. Moreover, their application to identify CH driver mutations across almost half a million donors of the UK Biobank reproduces known associations between CH driver mutations and age, and the prevalence of several diseases and conditions. We thus propose that these models support the accurate identification of CH across healthy individuals.
Significance: We developed and validated gene-specific machine learning models to identify CH driver mutations, showing their advantage with respect to expert-curated rules. These models can support the identification and clinical interpretation of CH mutations in newly sequenced individuals.
See related commentary by Arends and Jaiswal, p. 1581
What Formal Languages Can Transformers Express? A Survey
Authors: Strobl Lena , Merrill William , Weiss Gail , Chiang David , Angluin Dana 
Published: May 2024

Abstract
As transformers have gained prominence in natural language processing, some researchers have investigated theoretically what problems they can and cannot solve, by treating problems as formal languages. Exploring such questions can help clarify the power of transformers relative to other models of computation, their fundamental capabilities and limits, and the impact of architectural choices. Work in this subarea has made considerable progress in recent years. Here, we undertake a comprehensive survey of this work, documenting the diverse assumptions that underlie different results and providing a unified framework for harmonizing seemingly contradictory findings.
Bolstering the Boys Club: Security Vetting, Diversity and Diplomatic Gatekeeping
Authors: Stephenson Elise , Rimmer Susan Harris 
Published: May 2024

Summary
Much of the research on gender and diplomacy has focused on those already let into the ‘club’. This article analyses the ‘threshold’ to diplomacy: security clearance processes. Security vetting ultimately determines who progresses, and what level of clearance (and therefore seniority or position) a diplomat can achieve. This article seeks to trace the journey for individuals entering a diplomatic career. It argues that security vetting is simultaneously based on legitimate processes for assessing potential national security threats, and on values interpretation (such as loyalty, maturity and trustworthiness) which may invite bias or lead to illegitimate processes of exclusion. By excavating the gendered history of vetting, we can better understand the limitations of the current de-historicised and ‘impartial’ process. We argue that clearance processes have not sufficiently evolved over the past decades of social progress, which has negative implications for the evolution of diplomacy as a social practice.