bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom
Authors: Irving Dulcie , Page Bethan , Carthey Jane , Higham Helen , Undre Shabnam , Vincent Charles 
Published: February 2024

Abstract
Background
Healthcare systems are operating under substantial pressures, and often simply cannot provide the standard of care they aspire to within the available resources. Organisations, managers, and individual clinicians make constant adaptations in response to these pressures, which are typically improvised, highly variable and not coordinated across clinical teams. The purpose of this study was to identify and describe the types of everyday pressures experienced by surgical teams and the adaptive strategies they use to respond to these pressures.

Methods
We conducted interviews with 20 senior multidisciplinary healthcare professionals from surgical teams in four major hospitals in the United Kingdom. The interviews explored the types of everyday pressures staff were experiencing, the strategies they use to adapt, and how these strategies might be taught to others.

Results
The primary pressures described by senior clinicians in surgery were increased numbers and complexity of patients alongside shortages in staff, theatre space and post-surgical beds. These pressures led to more difficult working conditions (e.g. high workloads) and problems with system functioning such as patient flow and cancellation of lists. Strategies for responding to these pressures were categorised into increasing or flexing resources, controlling and prioritising patient demand and strategies for managing the workload (scheduling for efficiency, communication and coordination, leadership, and teamwork strategies).

Conclusions
Teams are deploying a range of strategies and making adaptations to the way care is delivered. These findings could be used as the basis for training programmes for surgical teams to develop coordinated strategies for adapting under pressure and to assess the impact of different combinations of strategies on patient safety and surgical outcomes.
The development of the adult nervous system in the annelid Owenia fusiformis
Authors: Carrillo-Baltodano Allan M. , Donnellan Rory D. , Williams Elizabeth A. , Jékely Gáspár , Martín-Durán José M. 
Published: February 2024

Abstract
Background
The evolutionary origins of animal nervous systems remain contentious because we still have a limited understanding of neural development in most major animal clades. Annelids — a species-rich group with centralised nervous systems — have played central roles in hypotheses about the origins of animal nervous systems. However, most studies have focused on adults of deeply nested species in the annelid tree. Recently, Owenia fusiformis has emerged as an informative species to reconstruct ancestral traits in Annelida, given its phylogenetic position within the sister clade to all remaining annelids.

Methods
Combining immunohistochemistry of the conserved neuropeptides FVamide-lir, RYamide-lir, RGWamide-lir and MIP-lir with gene expression, we comprehensively characterise neural development from larva to adulthood in Owenia fusiformis.

Results
The early larval nervous system comprises a neuropeptide-rich apical organ connected through peripheral nerves to a prototroch ring and the chaetal sac. There are seven sensory neurons in the prototroch. A bilobed brain forms below the apical organ and connects to the ventral nerve cord of the developing juvenile. During metamorphosis, the brain compresses, becoming ring-shaped, and the trunk nervous system develops several longitudinal cords and segmented lateral nerves.

Conclusions
Our findings reveal the formation and reorganisation of the nervous system during the life cycle of O. fusiformis, an early-branching annelid. Despite its apparent neuroanatomical simplicity, this species has a diverse peptidergic nervous system, exhibiting morphological similarities with other annelids, particularly at the larval stages. Our work supports the importance of neuropeptides in animal nervous systems and highlights how neuropeptides are differentially used throughout development.
Percutaneous pulmonary valve implantation in a patient with congenitally corrected transposition of the great arteries: a case report
Authors: Kapalka Michal , Galeczka Michal , Krawiec Michal , Fiszer Roland 
Published: February 2024

Abstract
Background
Percutaneous pulmonary valve implantation has become an attractive method of dysfunctional right ventricle outflow tract treatment.

Case presentation
We describe a unique case of a 20-year-old Caucasian male patient with a complex cyanotic heart defect, namely pulmonary atresia, with congenitally corrected transposition of the great arteries and ventricular septal defect after Rastelli-like surgery at the age of 5 years with homograft use. At the age of 20 years, the patient needed percutaneous pulmonary valve implantation owing to homograft dysfunction. Despite unusual course of the coronary arteries, balloon testing in the landing zone of the right ventricle outflow tract excluded potential coronary artery compression. Then, after presentation, a Melody valve was implanted successfully in the pulmonary valve position. The 8-year follow-up was uneventful.

Conclusion
This is likely the first description of a percutaneous pulmonary valve implantation in such anatomy. Such a procedure is feasible; however, it requires exceptional caution owing to the anomalous coronary arteries course, which can be the reason for their compression.
Virome diversity shaped by genetic evolution and ecological landscape of Haemaphysalis longicornis
Authors: Ye Run-Ze , Li Yu-Yu , Xu Da-Li , Wang Bai-Hui , Wang Xiao-Yang , Zhang Ming-Zhu , Wang Ning , Gao Wan-Ying , Li Cheng , Han Xiao-Yu , Du Li-Feng , Xia Luo-Yuan , Song Ke , Xu Qing , Liu Jing , Cheng Nuo , Li Ze-Hui , Du Yi-Di , Yu Hui-Jun , Shi Xiao-Yu , Jiang Jia-Fu , Sun Yi ,   Tick Genome and Microbiome Consortium (TIGMIC), Cui Xiao-Ming , Ding Shu-Jun , Zhao Lin , Cao Wu-Chun 
Published: February 2024

Abstract
Background
Haemaphysalis longicornis is drawing attentions for its geographic invasion, extending population, and emerging disease threat. However, there are still substantial gaps in our knowledge of viral composition in relation to genetic diversity of H. longicornis and ecological factors, which are important for us to understand interactions between virus and vector, as well as between vector and ecological elements.

Results
We conducted the meta-transcriptomic sequencing of 136 pools of H. longicornis and identified 508 RNA viruses of 48 viral species, 22 of which have never been reported. Phylogenetic analysis of mitochondrion sequences divided the ticks into two genetic clades, each of which was geographically clustered and significantly associated with ecological factors, including altitude, precipitation, and normalized difference vegetation index. The two clades showed significant difference in virome diversity and shared about one fifth number of viral species that might have evolved to “generalists.” Notably, Bandavirus dabieense, the pathogen of severe fever with thrombocytopenia syndrome was only detected in ticks of clade 1, and half number of clade 2-specific viruses were aquatic-animal-associated.

Conclusions
These findings highlight that the virome diversity is shaped by internal genetic evolution and external ecological landscape of H. longicornis and provide the new foundation for promoting the studies on virus-vector-ecology interaction and eventually for evaluating the risk of H. longicornis for transmitting the viruses to humans and animals.
The various facets of orthorexic eating behavior: five case reports of individuals with supposed orthorexia nervosa
Authors: Barthels Friederike , Fischer Maren , Keskini Raphaela , Schöl Amelie Marie , Pietrowsky Reinhard 
Published: February 2024

Abstract
Background
Orthorexia nervosa, defined as a fixation on eating healthy according to subjective criteria, is recently being discussed as another variant of disordered eating behavior. Further characteristics are rigid adherence to nutritional rules, anxieties and avoidance behavior in the context of eating as well as a focus on health, not on body shape or weight loss, which is supposed to differentiate orthorexic from other disordered eating behavior. Although diagnostic criteria have been suggested, they have rarely been used in case reports published to date. Hence, the aim of this study was to present five individuals with supposed orthorexia nervosa, using preliminary diagnostic criteria to assess their eating behavior.

Case presentation
The five cases (three females, two males) reveal the great variety of disordered eating behavior. Fear of unhealthy overweight (case A), supposed orthorexic eating behavior as a coping strategy for anorexia nervosa (case B), the exclusive consumption of animal products with a total exclusion of fruits and vegetables (case C), the fixation on exercise and athletic goals (case D) as well as a focus on a vegan diet and unprocessed foods (case E) are facets of orthorexia nervosa with varying degrees of impairment.

Conclusions
It is concluded that orthorexia nervosa manifests itself in very different ways and that more research is needed in order to determine whether it could be a useful additional category of disordered eating behavior.
A test of pre-exposure spacing and multiple context pre-exposure on the mechanisms of latent inhibition of dental fear: A study protocol
Authors: Geers Andrew L. , Seligman Laura D. , Pituch Keenan A. , Colagiuri Ben , Marusak Hilary A. , Rabinak Christine A. , Al-Ado Sena L. , Turner Natalie , Nedley Michael 
Published: February 2024

Abstract
Background
Latent inhibition occurs when exposure to a stimulus prior its direct associative conditioning impairs learning. Results from naturalistic studies suggest that latent inhibition disrupts the learning of dental fear from aversive associative conditioning and thereby reduces the development of dental phobia. Although theory suggests latent inhibition occurs because pre-exposure changes the expected relevance and attention directed to the pre-exposed stimulus, evidence supporting these mechanisms in humans is limited. The aim of this study is to determine if two variables, pre-exposure session spacing and multiple context pre-exposure, potentiate the hypothesized mechanisms of expected relevance and attention and, in turn, increase latent inhibition of dental fear.

Methods
In a virtual reality simulation, child and adult community members (ages 6 to 35) will take part in pre-exposure and conditioning trials, followed by short- and long-term tests of learning. A 100ms puff of 60 psi air to a maxillary anterior tooth will serve as the unconditioned stimulus. Pre-exposure session spacing (no spacing vs. sessions spaced) and multiple context pre-exposure (single context vs. multiple contexts) will be between-subject factors. Stimulus type (pre-exposed to-be conditioned stimulus, a non-pre-exposed conditioned stimulus, and an unpaired control stimulus) and trial will serve as within-subject factors. Baseline pain sensitivity will also be measured as a potential moderator.

Discussion
It is hypothesized that spaced pre-exposure and pre-exposure in multiple contexts will increase the engagement of the mechanisms of expected relevance and attention and increase the latent inhibition of dental fear. It is expected that the findings will add to theory on fear learning and provide information to aid the design of future interventions that leverage latent inhibition to reduce dental phobia.
Genome-wide identification and expression patterns in response to signals from cadmium of StCADs gene family in potato (Solanum tuberosum L.)
Authors: Yang XinYu , Lv HePing , Zhang Wu , Liang HongJie , Gao YanPing , Kang YiChen , Wu YanBin , Wang FangFang , Xi Chunyan 
Published: February 2024

Abstract
Background
With the rapid development of the economy and society, soil pollution is becoming more and more serious. Heavy metal cadmium (Cd) pollution is one of the typical problems, which poses a potentially serious threat to crop production and human health. Cinnamyl alcohol dehydrogenase (CAD) is a key enzyme in lignin synthesis and plays an important role in plant resistance to external stress. In this study, combined with bioinformatics analysis and expression pattern analysis, the members of the potato CAD family were identified, and their physical and chemical properties, evolutionary characteristics and chromosome location were clarified, as well as their regulatory effects on Cd tolerance.

Results
A total of 50 StCAD genes belonging to 6 subfamilies were obtained, and all of them were located in the cytoplasm. Members of the same family had similar gene structures and functional domains. The promoter region of each StCAD family member contains at least 5 or more abiotic stress response elements, indicating that the family had potential functions in regulating stress. According to the expression pattern analysis, most genes in this family were upregulated after Cd stress, further enhanced CAD activity and significantly promoted lignin accumulation in potato roots.

Conclusion
In summary, the StCAD family plays an important role in potato response to Cd stress. This study lays a foundation for further studies on the functions of the StCAD family and provides candidate genes for Cd resistance molecular breeding in potato.

Graphical Abstract
Group-based positive psychotherapy for people living with acquired brain injury: a protocol for a feasibility study
Authors: Fisher Zoe , Field Susannah , Fitzsimmons Deb , Hutchings Hayley , Carter Kym , Tod Daniel , Gracey Fergus , Knight Alec , Kemp Andrew H. 
Published: February 2024

Abstract
Background
Acquired brain injury (ABI) and other chronic conditions are placing unprecedented pressure on healthcare systems. In the UK, 1.3 million people live with the effects of brain injury, costing the UK economy approximately £15 billion per year. As a result, there is an urgent need to adapt existing healthcare delivery to meet increasing current and future demands. A focus on wellbeing may provide an innovative opportunity to reduce the pressure on healthcare services while also supporting patients to live more meaningful lives. The overarching aims of the study are as follows: (1) evaluate the feasibility of conducting a positive psychotherapy intervention for individuals with ABI and (2) ascertain under what conditions such an intervention would merit a fully powered randomised controlled trial (RCT) compared to a standard control group (TAU).

Methods and analysis
A randomised, two-arm feasibility trial involving allocation of patients to either a treatment group (positive psychotherapy) or control group (treatment as usual) group, according to a 1:1 ratio. A total of 60 participants at three sites will be recruited including 20 participants at each site. Assessments will be conducted at baseline, on completion of the 8-week intervention and 3 months following completion. These will include a range of questionnaire-based measures, psychophysiology and qualitative outcomes focusing on feasibility outcomes and participant experience. This study has been approved by the Wales Research Ethics Committee (IRAS project ID: 271,251, REC reference: 19/WA/0336).

Discussion
This study will be the first to examine the feasibility of an innovative, holistic positive psychotherapy intervention for people living with ABI, focused on individual, collective and planetary wellbeing, and will enable us to determine whether to proceed to a full randomised controlled trial.

Trial registration
ISRCTN12690685, registered 11th November 2020.
Costus speciosus leaf and seed extracts for wound healing: a comparative evaluation using mice excision wound models
Authors: Zishan Shafiul Azam , Uddin Md. Maien , Mohammad Mahatir , Asadul Karim Azad S. M. , Naima Jannatul , Ibban Sadab Sipar , Saiful Islam Arman Md. 
Published: February 2024

AbstractBackgroundThe present study investigated the potential wound healing activity comparisons between ethanol leaf & seed extracts ofCostus speciosustopical formulation using mice Excision wound models, compared to Neomycin sulphate ointment as a standard drug. To assess the efficacy ofCostus speciosusointment as a potential alternative to commercially available ointments, a study was conducted using a cohort of 16 healthy male mice, aged between 3 and 4 months. The ointment formulation was prepared utilizing ethanol extracts from both the leaves and seeds, presented in a dosage form for application. This investigation seeks to provide insights into the comparative effectiveness ofCostus speciosusointments in relation to conventional market preparations, with a focus on its potential applicability as an alternative therapeutic option. The parameter measured was wound contraction and epithelization period.ResultThe mice groups treated with seed & leave extracts ointment showed better wound size changes than the negative and standard groups. However, the leaf extract ointment promotes the formation of granulation in tissue, allowing the reepithelization phase to occur more rapidly than seed extract. From the 1st day to the results of the 9th day of the extract indicate that there is a significant increase (P < 0.05) in the percentage of wound contraction in the group. After 21 days the wound was healed fully. These results suggest that ointment of ethanol leaf extract ofCostus speciosuscould be an answer to facilitate wound healing compared to seed extract, to approve the traditional claims of the plant in wound healing activity.ConclusionThe study concludes that ethanol leaf and seed extracts ofCostus speciosusexhibit potential wound healing activity in mice excision wound models. The topical formulation of these extracts significantly enhances wound closure, reduces wound size, and increases tensile strength compared to the control group. The efficacy of the extracts is comparable to the standard drug, Neomycin sulphate ointment. Therefore, the use ofCostus speciosusextracts in topical formulations can be considered a promising alternative for the treatment of wounds. However, further studies are needed to determine the safety and efficacy of these extracts in humans.
Real-world experience of full-thickness traumatic macular hole among young patients
Authors: Venugopal Ragukumar , Das Anthony Vipin , Takkar Brijesh , Stewart Michael W. , Narayanan Raja 
Published: February 2024

Abstract
Objective
To describe the demographics, clinical, and imaging characteristics, and visual outcomes in young patients with full-thickness traumatic macular hole (TMH).

Methods
This retrospective hospital-based study included patients with full-thickness TMH who presented between August 2010 and June 2021. Demographic data, clinical findings, and imaging characteristics were extracted from an electronic medical record system. Regression analyses were performed to determine significant associations among variables and to identify predictors of visual outcomes.

Results
144 (0.005%) patients among 2,834,616 were diagnosed with Full thickness TMH. The majority of them were male (89.58%; odds ratio [OR] = 6.71) and the holes were unilateral. The mean age at presentation was 23.37 ± 8.19 years. Ball were the most common cause of injuries (22.22%), followed by stick (14.58%) and firecracker (12.50%). The mean LogMAR visual acuity (VA) at presentation was 1.18 ± 0.72, with 25.69% of eyes having VA < 20/400. The mean minimum hole diameter was 619.34 ± 336.16 μm. Sub-retinal fluid was present in 44.44%, followed by intraretinal fluid in 34.03% of eyes. Macular holes closed after vitrectomy in 66.67% of eyes, with mean final VA of 1.07 ± 0.85. Baseline VA was a strong predictor of final VA (R2 = 0.677; p = 0.000168).

Conclusion
Traumatic macular hole is a unilateral condition with significant visual impairment that is mainly seen in males during the third decade of life. Surgery is successful in most cases but improvements in VA are modest.
Left common peroneal nerve palsy caused by cross-legged sitting during epidural labor analgesia: a case report
Authors: Ogawa Shunya , Kanda Hirotsugu , Kurosaki Hiromichi , Kawamata Tomoyuki 
Published: February 2024

Abstract
Background
Nerve injury in epidural labor analgesia can occur with various potential causes. We report a rare case of left common peroneal nerve palsy after delivery caused by a prolonged period of sitting cross-legged during epidural labor.

Case report
Epidural labor analgesia in a 28-year-old primipara started at 39 weeks of gestation. She sat cross-legged to prompt delivery for approximately 4 h with a break of a few minutes every hour. She had numbness in her left lower limb and difficulty in dorsiflexion of the ankle joint that did not improve until 3 h after delivery. We made a diagnosis of left common peroneal nerve palsy. Most of the symptoms had improved at 2 months postpartum.

Conclusion
Epidural labor analgesia prevented recognition of prolonged peroneal head compression caused by sitting cross-legged. When this position is used to facilitate delivery, it should be released frequently owing to the possibility of a neurologic deficit.
Prioritizing Patient Reported Outcome Measures (PROMs) to use in the clinical care of youth living with mental health concerns: a nominal group technique study
Authors: Bajgain Kalpana Thapa , Mendoza Justino , Naqvi Farwa , Aghajafari Fariba , Tang Karen , Zwicker Jennifer , Santana Maria-Jose 
Published: February 2024

Abstract
Background
In the past few decades, particularly in the mental health setting, there has been growing interest in using Patient Reported Outcome Measures (PROMs) to assess the efficacy of the treatments in healthcare systems. Despite recent initiatives for global harmonization, there remains a lack of consensus on which PROMs are best practice and appropriate. Engagement of the service users, such as patients and family members/caregivers, is vital at this stage to ensure the selected PROMs are feasible, relevant, and acceptable to them. This study aimed to prioritize PROMs by youth and family/caregiver based on feasibility, relevance, and overall importance to be used in the clinical care of youth living with anxiety and/or depression.

Methods
Ten validated and widely used PROMs were presented to the patients and family/caregivers. Nominal group techniques were employed to prioritize the PROMs based on feasibility, relevance, and overall importance.

Results
For patients and families/caregivers, the PROMs, Revised Child Anxiety and Depression Scale (RCAD 25), and The Young Person’s Core (YP-CORE) were the highest priorities. Both felt that RCAD 25 was comprehensive, short, easy, and quick to complete, whereas regarding YP-CORE, patients and family/caregivers thought it was also short and relevant. Due to some specific concerns, the Strength and Difficulties Questionnaire and Child Health Questionnaire were the lowest prioritized by patients and family/caregivers.

Conclusion
It is of utmost importance that patient’s and family/caregivers’ voices or opinions are considered while selecting and implementing PROMs in mental health settings. Our study provides practical recommendations around measures best suited to achieve this.