bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nationwide trends in intensive care unit utilization in the elective endovascular treatment of unruptured intracranial aneurysms
Authors: Padmanaban Varun , Benjamin William J. , Cohrs Austin , Jareczek Francis J. , Hazard Sprague W. , Zacko Joseph Christopher , Church Ephraim W. , Simon Scott D. , Cockroft Kevin M. , Leslie Douglas L. , Wilkinson David Andrew 
Published: March 2024

Objective Multiple studies suggest routine post-operative intensive care unit (ICU) stays after endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs) is unnecessary, though rates of ICU utilization nationwide are unknown. We aim to evaluate rates and characteristics of ICU utilization in patients undergoing elective endovascular repair of UIAs. Methods This is a retrospective cohort study utilizing a nationwide private-payer database in the United States to evaluate the ICU utilization in patients undergoing elective endovascular repair of UIAs between 2005 and 2019. Demographics and pre-operative comorbidities as well as post-procedural complications and discharge status were compared. An analysis of charges and costs was also performed. Results Among 6218 patients who underwent elective EVT of a UIA, 4890 (78.6%) were admitted to the ICU post-operatively. There were no differences in age, sex, or Charlson comorbidity scores in patients admitted to the ICU post-operatively compared to those admitted elsewhere. ICU utilization was more common in urban locations compared to rural. 12.7% of patients had ICU-specific needs sufficient to be billed by a critical care provider. Total provider costs were significantly higher in patients utilizing the ICU post-operatively, even among uncomplicated patients with routine discharges. Conclusion Most patients undergoing elective endovascular UIA repair in the United States are admitted to the ICU postoperatively. Only 12.7% have ICU needs, and these patients are predictable from pre-operative characteristics or peri-operative complications. Reducing ICU use in this subgroup of patients may be an important target to improve healthcare value in this patient population.
Factors responsible for student nurses’ use of non-sterile gloves: An exploratory qualitative study
Authors: Bate Jennifer 
Published: March 2024

Background Disposable non-sterile gloves are part of the personal protective equipment (PPE) to be considered to protect oneself from the risk of infection. They have subsequently become the topic of concern related to increased use, inappropriate use, and potentially increasing the risk of cross-infection and environmental impact of plastic waste. Aim/objective This study aimed to explore the views of pre-registration student nurses about non-sterile glove use in clinical practice and to identify the factors that impact student nurses’ decision on whether to wear non- sterile gloves. Methods Using a social constructivist approach, the study was organised in a higher education institution. Semi-structured interviews were conducted with second year student nurses, utilising a theoretical domains framework (TDF). Findings/Results The key findings showed that students had limited awareness of the national infection prevention and control best practice procedures. The primary influential factors for non-sterile gloves use behaviour were personal protection, the type of care interventions required and the observations of peers and role models. Discussion The study found limited awareness on the importance of infection prevention and control precautions, including the correct procedure for donning, and doffing of personal protection equipment, along with a lack of confidence to challenge non-compliance.
A Three-Arm Randomized Controlled Study Comparing Patient-Reported Outcomes in People With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion or Multiple Daily Injections
Authors: Barnard-Kelly Katharine , Thienel Florian , Mader Julia K. , Oliver Nick , Franek Edward , Vesper Iris , Dagenbach Nicole , Vogt Gerhard , Etter Tobias , Künsting Thomas 
Published: March 2024

Background: The aim of this study was to compare patient-reported outcomes (PROs) in people with type 1 diabetes using either continuous subcutaneous insulin infusion (CSII) with two different insulin patch pumps or multiple daily injections (MDIs). Materials and methods: In this randomized three-arm study, people with type 1 diabetes on MDI therapy were included and used either MDI, the Accu-Chek Solo micropump system (Solo) or Omnipod for 26 weeks. From weeks 26 to 39, all participants used CSII with Solo. Patient-reported outcomes were assessed using the diabetes technology questionnaire (DTQ); in addition, HbA1c values were measured. Results: Overall, 181 participants were randomized (61 MDI arm, 62 Solo arm, 58 Omnipod arm) and 142 completed the study. After 26 weeks in the study, the DTQ “change” score in the Solo group (105.9 [100.6-111.2]; baseline-adjusted mean [95% confidence interval]) was significantly higher than in the MDI group (94.8 [89.6-100.0]) ( P = .001). The comparison between the Solo group (105.1 [99.1-111.1]) and the Omnipod group (108.7 [103.1-114.4]) showed no significant differences ( P = .382). HbA1c increased by 0.2% ± 0.7% in the MDI group and decreased in both pump groups (Solo group −0.2% ± 0.8% and Omnipod group −0.1% ± 0.8%). Differences in HbA1c between the Solo group and the MDI group were significant ( P = .009), but not between the Solo group and the Omnipod group ( P = .896). Conclusions: This study showed that switching from MDI to CSII improves both psychosocial well-being and physiological outcomes. Furthermore, there were no substantial differences between the established and the recently released patch pump. Trial registration at www.clinicaltrials.gov is NCT03478969.
Efficacy of telerehabilitation with digital and robotic tools for the continuity of care of people with chronic neurological disorders: The TELENEURO@REHAB protocol for a randomized controlled trial
Authors: Rossetto Federica , Mestanza Mattos Fabiola Giovanna , Gervasoni Elisa , Germanotta Marco , Pavan Arianna , Cattaneo Davide , Aprile Irene , Baglio Francesca 
Published: March 2024

Context Chronic Neurological Disorders (CNDs) are among the leading causes of disability worldwide, and their contribution to the overall need for rehabilitation is increasing. Therefore, the identification of new digital solutions to ensure early and continuous care is mandatory. Objective This protocol proposes to test the usability, acceptability, safety, and efficacy of Telerehabilitation (TR) protocols with digital and robotic tools in reducing the perceived level of disability in CNDs including Parkinson's Disease (PD), Multiple Sclerosis (MS), and post-stroke patients. Design, Setting, and Subjects This single-blinded, multi-site, randomized, two-treatment arms controlled clinical trial will involve PD (N = 30), MS (N = 30), and post-stroke (N = 30). Each participant will be randomized (1:1) to the experimental group (20 sessions of motor telerehabilitation with digital and robotic tools) or the active control group (20 home-based motor rehabilitation sessions according to the usual care treatment). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and at follow-up (T2, 2 months after treatment). Main Outcome Measures a multifaceted evaluation including quality of life, motor, and clinical/functional measures will be conducted at each time-point of assessment. The primary outcome measures will be the change in the perceived level of disability as measured by the World Health Organization Disability Assessment Schedule 2.0. Conclusion The implementation of TR protocols will enable a more targeted and effective response to the growing need for rehabilitation linked to CNDs, ensuring accessibility to rehabilitation services from the initial stages of the disease.
Experiences of remote consultation in UK primary care for patients with mental health conditions: A systematic review
Authors: Antonio Serena , Joseph David , Parsons Joanne , Atherton Helen 
Published: March 2024

Objectives There has been a rapid shift from face-to-face to remote consultation across healthcare settings. 90% of patients with mental health conditions are cared for entirely in primary care. Remote consultation can present challenges and benefits for patients with mental health conditions. The aim of this systematic review was to collate and examine the evidence relating to remote consultation in UK primary care on the experiences of patients with mental health conditions. Methods Six major databases were searched for empirical studies published in the English language between 1 January 2010 and 21 October 2022. Studies were included where remote consultation occurred between a patient and primary care clinician. Outcomes of interest include mode of remote consultation, patient experiences and characteristics. Final included studies were assessed for quality, and results analysed with narrative synthesis. Results Six studies met the inclusion criteria, covering a range of mental health conditions and remote consultation modalities (telephone, video, online, email, text-based). Patients were overall satisfied with remote consultation, with particular benefit for certain mental health conditions or anxious patients. However, several studies found that face-to-face was the preferred method, with highlighted negatives to remote consultation, such as inflexibility of online formats. Acceptability of remote consultation is context specific and influenced by the purpose of the consultation and individual patient. Remote consultation may reduce anxiety in some patients, but is potentially less acceptable than face-to-face for relational appointments. Conclusions Acceptability of remote consultation is context dependent. There is a lack of evidence surrounding patient characteristics and access to remote consultation.
The role of mentoring and coaching of healthcare professionals for digital technology adoption and implementation: A scoping review
Authors: Scandiffio Jillian , Zhang Melody , Karsan Inaara , Charow Rebecca , Anderson Melanie , Salhia Mohammad , Wiljer David 
Published: March 2024

Objective Mentoring and coaching practices have supported the career and skill development of healthcare professionals (HCPs); however, their role in digital technology adoption and implementation for HCPs is unknown. The objective of this scoping review was to summarize information on healthcare education programs that have integrated mentoring or coaching as a key component. Methods The search strategy and keyword searches were developed by the project team and a research librarian. A two-stage screening process consisting of a title/abstract scan and a full-text review was conducted by two independent reviewers to determine study eligibility. Articles were included if they: (1) discussed the mentoring and/or coaching of HCPs on digital technology, including artificial intelligence, (2) described a population of HCPs at any stage of their career, and (3) were published in English. Results A total of 9473 unique citations were screened, identifying 19 eligible articles. 11 articles described mentoring and/or coaching programs for digital technology adoption, while eigth described mentoring and/or coaching for digital technology implementation. Program participants represented a diverse range of industries (i.e., clinical, academic, education, business, and information technology). Digital technologies taught within programs included electronic health records (EHRs), ultrasound imaging, digital health informatics, and computer skills. Conclusions This review provided a summary of the role of mentoring and/or coaching practices within digital technology education for HCPs. Future training initiatives for HCPs should consider appropriate resources, program design, mentor-learner relationship, security concerns and setting clear expectations for program participants. Future research could explore mentor/coach characteristics that would facilitate successful skill transfer.
What's out there? A scoping review of autism-related policies and research interests at U.K. higher education institutions
Authors: Cray Jess , Hull Laura , Sedgewick Felicity 
Published: March 2024

Background There is a growing number of autistic students in U.K. higher education institutions (HEIs), who may require autism-specific support to optimise their academic achievement, long-term prospects, and well-being. This study undertook the first known review of publicly available autism-related policies at U.K. HEIs. Methods Public websites of 132 HEIs were searched for eleven key terms, and the results of these searches were assessed using a policy appraisal approach. Qualitative framework analysis then explored the content of the policies identified. Results Three hundred thirty-six policies were identified from 92 HEIs, with 40 HEIs having no policies meeting search terms. The most common policy results were ‘autism support’ and ‘disability adjustments’. The qualitative analysis showed a wide range of policies which covered most areas of higher education life but with significant inconsistency in content and quality. Conclusions While many U.K. HEIs appear to be aware of autistic students and the need to support them, most institutions have minimal publicly available policies regarding support for autistic students. The policies to support students which do exist are patchy at best, and non-existent in some cases, requiring more work at individual institutions and across the HEI sector.
A multiplex RPA-CRISPR/Cas12a-based POCT technique and its application in human papillomavirus (HPV) typing assay
Authors: Liu Yan , Chao Zhujun , Ding Wei , Fang Tanfeng , Gu Xinxian , Xue Man , Wang Wei , Han Rong , Sun Wanping 
Published: March 2024

AbstractPersistent infection with high-risk human papillomavirus (HR-HPV) is the primary and initiating factor for cervical cancer. With over 200 identified HPV types, including 14 high-risk types that integrate into the host cervical epithelial cell DNA, early determination of HPV infection type is crucial for effective risk stratification and management. Presently, on-site immediate testing during the HPV screening stage, known as Point of Care Testing (POCT), remains immature, severely limiting the scope and scenarios of HPV screening. This study, guided by the genomic sequence patterns of HPV, established a multiplex recombinase polymerase amplification (RPA) technology based on the concept of “universal primers.” This approach achieved the multiple amplification of RPA, coupled with the CRISPR/Cas12a system serving as a medium for signal amplification and conversion. The study successfully constructed a POCT combined detection system, denoted as H-MRC12a (HPV—Multiple RPA—CRISPR/Cas12a), and applied it to high-risk HPV typing detection. The system accomplished the typing detection of six high-risk HPV types (16, 18, 31, 33, 35, and 45) can be completed within 40 min, and the entire process, from sample loading to result interpretation, can be accomplished within 45 min, with a detection depth reaching 1 copy/μL for each high-risk type. Validation of the H-MRC12a detection system’s reproducibility and specificity was further conducted through QPCR on 34 clinical samples. Additionally, this study explored and optimized the multiplex RPA amplification system and CRISPR system at the molecular mechanism level. Furthermore, the primer design strategy developed in this study offers the potential to enhance the throughput of H-MRC12a detection while ensuring sensitivity, providing a novel research avenue for high-throughput detection in Point-of-Care molecular pathogen studies.
Causal relationship between immune cells and telomere length: mendelian randomization analysis
Authors: Li Yujian , Lai Shenglin , Kan Xuan 
Published: March 2024

Abstract
Background
The causal relationship between immune cells and telomere length remains controversial.

Methods
Data on the immune cells were obtained from a previous study with 3,757 participants. Data on telomere length were obtained from the OpenGWAS database. Genome-Wide Association Study (GWAS) data were obtained and screened for eligible instrumental variables (IVs) using the TwoSampleMR package and the Phenoscanner database. To investigate the genetic causality between immune cells and telomere length, Mendelian randomization (MR) analysis and Bayesian weighted Mendelian randomization (BWMR) analysis were used.

Results
MR analysis showed that there is indeed a genetic causal relationship between immune cells and telomere length. A total of 16 immune cells were successfully validated. A positive correlation was found between telomere length and immune cells such as CD28 + CD45RA + CD8br %CD8br (OR = 1.002, 95%CI: 1.000-1.003). A negative correlation was found between telomere length and immune cells such as Transitional AC (OR = 0.991, 95%CI: 0.984–0.997) (P < 0.05). Reverse MR analysis similarly confirmed that telomere length can affect four types of immune cells, including CD25 on IgD + CD24- (OR = 1.291, 95%CI: 1.060–1.571), at the genetic level.

Conclusion
There is indeed a mutual genetic causality between immune cells and telomere length, which will provide theoretical basis and support for more subsequent clinical studies.
Characterization of the major autolysin (AtlC) of Staphylococcus carnosus
Authors: Merz Maximilian , Schiffer Carolin J. , Klingl Andreas , Ehrmann Matthias A. 
Published: March 2024

Abstract
Background
Autolysis by cellular peptidoglycan hydrolases (PGH) is a well-known phenomenon in bacteria. During food fermentation, autolysis of starter cultures can exert an accelerating effect, as described in many studies on cheese ripening. In contrast, very little is known about autolysis of starter cultures used in other fermentations. Staphylococcus (S.) carnosus is often used in raw sausage fermentations, contributing to nitrate reduction and flavor formation. In this study, we analyzed the influence of PGHs of the strains S. carnosus TMW 2.146 and S. carnosus TMW 2.2525 on their autolytic behavior. The staphylococcal major autolysin (Atl), a bifunctional enzyme with an N-acetylmuramoyl-L-alanine amidase and a glucosaminidase as an active site, is assumed to be the enzyme by which autolysis is mainly mediated.

Results
AtlC mutant strains showed impaired growth and almost no autolysis compared to their respective wild-type strains. Light microscopy and scanning electron microscopy showed that the mutants could no longer appropriately separate from each other during cell division, resulting in the formation of cell clusters. The surface of the mutants appeared rough with an irregular morphology compared to the smooth cell surfaces of the wild-types. Moreover, zymograms showed that eight lytic bands of S. carnosus, with a molecular mass between 140 and 35 kDa, are processed intermediates of AtlC. It was noticed that additional bands were found that had not been described in detail before and that the banding pattern changes over time. Some bands disappear entirely, while others become stronger or are newly formed. This suggests that AtlC is degraded into smaller fragments over time. A second knockout was generated for the gene encoding a N-acetylmuramoyl-L-alanine amidase domain-containing protein. Still, no phenotypic differences could be detected in this mutant compared to the wild-type, implying that the autolytic activity of S. carnosus is mediated by AtlC.

Conclusions
In this study, two knockout mutants of S. carnosus were generated. The atlC mutant showed a significantly altered phenotype compared to the wild-type, revealing AtlC as a key factor in staphylococcal autolysis. Furthermore, we show that Atl is degraded into smaller fragments, which are still cell wall lytic active.
Minimal alveolar concentration of sevoflurane in combination with remimazolam in adults during laryngeal mask insertion: an up-down sequential allocation study
Authors: Huang Yan , Liao HongYu , Li LinJi , Xu Juan , Jiang PingPing , Guo YanXia , Liu KunPeng 
Published: March 2024

Abstract
Background
Remimazolam is a novel ultrashort-acting intravenous benzodiazepine sedative-hypnotic. The combination of remimazolam and sevoflurane does not increase respiratory sensitivity, produce bronchospasm, or cause other adverse conditions. We aimed to observe the effects of different remimazolam doses on the minimum alveolar concentration (MAC) of sevoflurane at end-expiration during laryngeal mask insertion and evaluate the effect of sex on the efficacy of the combination of remimazolam on the suppression of laryngeal mask insertion in adult patients.

Methods
We included 240 patients undergoing laparoscopic surgery under general anesthesia with elective placement of a laryngeal mask (120 males and 120 females). The patients were randomly divided into four groups according to sex: a control group (randomization for female patients, RF0; randomization for male patients, RM0) and three remimazolam groups (RF1, RM1 / RM2, RF2 / RM3, RF3), with 30 patients in each group. Induction was established by vital capacity rapid inhalation induction (VCRII), using 8% sevoflurane and 100% oxygen (6 L/min) in all patients. The (RF1, RM1), (RM2, RF2), and (RM3, RF3) groups were continuously injected with remimazolam at doses of 1, 1.5, and 2.0 mg/kg/h, respectively, while the (RM0, RF0) group was injected with an equal volume of normal saline. The end-expiratory concentration of sevoflurane was adjusted to a preset value after the patient’s eyelash reflex disappeared. After the end-expiratory concentration of sevoflurane was kept stable for at least 15 min, the laryngeal mask was placed, and the patient’s physical response to the mask placement was observed immediately and within 30 s of placement. The MAC of sevoflurane was measured using the up-and-down sequential method of Dixon.

Results
The calculated MAC of end-expiratory sevoflurane during laryngeal mask insertion in adult females was (2.94 ± 0.18)%, (2.69 ± 0.16)%, (2.32 ± 0.16)% and (1.83 ± 0.15)% in groups RF0, RF1, RF2 and RF3; (2.98 ± 0.18)%, (2.80 ± 0.19)%, (2.54 ± 0.15)% and (2.15 ± 0.15)% in male groups RM0, RM1, RM2 and RM3, respectively. The MAC values were significantly lower in the (RF1-RF3, RM1-RM3) group when compared to the (RF0, RM0) group. There was no significant difference between (RF0, RF1) and (RM0, RM1), but the MAC value of the RF2-RF3 group was significantly lower than that of the RM2-RM3 group.

Conclusions
Remimazolam can effectively reduce end-expiratory sevoflurane MAC values during laryngeal mask placement in adults. When remimazolam was measured above 1.5 mg/kg/h, the effect of inhibiting laryngeal mask implantation in female patients was stronger than that in male patients. Remimazolam at a dose of 1–2 mg/kg/h combined with sevoflurane induction can be safely and effectively used in these patients.