bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Caffeine-Taurine Co-Ingestion on Endurance Cycling Performance in High Temperature and Humidity Environments
Authors: Yu Peiqi , Fan Yongzhao , Wu Hao 
Published: February 2024

Background: Taurine (TAU) and caffeine (CAF), as common ergogenic aids, are known to affect exercise performance; however, the effects of their combined supplementation, particularly in high temperature and humidity environments, have not been studied. Hypothesis: The combination of TAU and CAF will have a greater effect on endurance cycle performance and improve changes in physiological indicators during exercise compared with TAU or CAF supplementation alone and placebo. Study Design: Single-blind crossover randomized controlled study. Level of Evidence: Level 1. Methods: Twelve university students majoring in physical education volunteered to receive 4 different supplement ingestions: (1) placebo (maltodextrin), (2) TAU, (3) CAF, (4) TAU + CAF. After a 7-day washout period, participants completed a time to exhaustion (TTE) test in the heat (35°C, 65% relative humidity). Results: All experimental groups improved TTE compared with the placebo group. Peak and mean power of countermovement jump were significantly higher in the CAF group compared with the placebo group before the exhaustion exercise ( P = 0.02, d = 1.2 and P = 0.04, d = 1.1, respectively). Blood lactate was significantly lower after the exhaustion test in the TAU group compared with the CAF ( P < 0.01, d = 0.8) and TAU + CAF ( P < 0.01, d = 0.7) groups. Core temperature in the TAU group was significantly reduced in the placebo group later in the exhaustion test ( P < 0.01, d = 1.9). Conclusion: In high temperature and humidity environments, acute TAU, CAF, and combined supplementation all improved TTE and did not affect recovery from lower limb neuromuscular fatigue compared with placebo, with TAU having the best effect. Combined supplementation failed to exhibit superimposed performance. Clinical Relevance: The results provide suggestions for the effects of TAU, CAF, and their combined intake on exercise performance in high temperature and humidity environments.
Qualitative assessment of expectations on the content, form and way of delivery of a prehabilitation programme in patients with lung resection surgery – A Swiss tertiary centre experience
Authors: Eser Prisca , Klaus Colette , Vetsch Thomas , Ernst Raphaela , Engel Dominique 
Published: February 2024

Objective: To assess the interest in a prehabilitation programme of patients awaiting lung resection and to identify expectations from such a programme. Introduction: At present, in Switzerland, there are no multimodal clinical prehabilitation programmes for lung resection patients awaiting surgery. Methods: Semi-structured face-to-face interviews were conducted with patients who have had or were awaiting lung resection at a Swiss tertiary centre. Thematic analysis was performed to identify common prespecified themes. Results: Twenty-two patients (45.5% female, age 70.6 ± 16.6 years) were interviewed. Seventy-seven percent were interested in a prehabilitation programme. Sixty-two percent, 67% and 90% were interested in endurance, strength and respiratory training, respectively. Six patients (27%) were active smokers, of whom two (one-third) were interested in a smoking cessation programme. Seventy-six percent were interested in nutrition counselling and 90% in receiving education on risk factor management. Forty percent preferred centre-based training/counselling sessions, 20% preferred home-based training/counselling and 30% found both forms acceptable. Patients were willing to perform prehabilitation activities on 2.6 days/week for a total of 162 min/week. Participating in peer groups was desired by only 25%. Conclusions: Patients with lung resection were highly interested in participating in prehabilitation, albeit only for a mean time cost of 2.7 h per week. Offering a prehabilitation programme with a combination of in-hospital group sessions and home-based training seems feasible.
Teledermatology in practice: Report of Mayo Clinic experience
Authors: Aghazadeh Mohandesi Nessa , Puiu Tudor , Mittal Setu , Hall Matthew R , Sokumbi Olayemi , Mangold Aaron R , Colgan Michael B , Tollefson Megha M , Sartori-Valinotti Julio C 
Published: February 2024

Background Delivery of dermatologic care through telemedicine was accelerated by the COVID-19 pandemic. We sought to analyze the teledermatology experience across Mayo Clinic's health care system to identify strengths and limitations of teledermatology. Methods Electronic health records of dermatology televisits were reviewed from multiple U.S. Mayo Clinic sites from January 2020 through January 2021. Results A total of 13,181 dermatology televisits were conducted in 6468 unique patients. Patients were primarily female (60.2%), and mean age of all patients was 34.1 years. Synchronous / live video conferencing visits were the most common (40.0%) telecare modality. Synchronous / live audio conferencing and asynchronous / store-and-forward visits comprised 33.0% and 27.0% of appointments. In total, 3944 televisits (29.9%) were successfully concluded via a single appointment. An in-person appointment was needed for 1693 patients (26.2%) after their initial televisit. For patients with a single televisit, synchronous / live video conferencing was the most common virtual modality (58.0% vs 32.2% of patients with multiple visits, p < 0.001). Patients needing in-person follow-up visits were slightly older than those who did not (mean [SD], 38.8 [22.3] vs 35.0 [23.6] years; p < 0.001) but without any sex-based difference. Around one-third of patients needed an in-person follow-up visit after their initial asynchronous / store-and-forward visit which was higher when compared with synchronous / live audio and video conferencing. Conclusion Single dermatology televisits effectively managed nearly one-third of patients who did not require in-person follow-up. An initial synchronous / live video conferencing was more likely to yield a single clinical encounter, whereas asynchronous / store-and-forward visits required more in-person follow-up. Future studies are required that focus on dermatology-specific cost, diagnoses, access, quality of care, and outcomes.
Mortality and Heart Transplantation After Hybrid Palliation of Hypoplastic Left Heart Syndrome: A Systematic Review and Meta-Analysis
Authors: Jacquemyn Xander , Singh Tajinder P. , Gossett Jeffrey G. , Averin Konstantin , Kutty Shelby , Zühlke Liesl J. , Abdullahi Leila H. , Kulkarni Aparna 
Published: February 2024

Background Newborns with hypoplastic left heart syndrome (HLHS) who are considered at increased risk for death following Norwood/Sano surgery often undergo hybrid palliation (HP) as initial surgery. We aimed to compile the HP experience in HLHS and its variants and assess the rates of, and risk factors for, death and heart transplantation. Methods CINAHL, CINAHL PLUS, PubMed/MEDLINE, and SCOPUS were systematically searched for HP outcome studies of death or heart transplantation in HLHS between 1998 and 2022. Pooled incidence was estimated, and potential risk factors were identified using random-effects meta-analysis and reconstructed time-to-event data from Kaplan-Meier curves. Results Thirty-three publications were included in our review. Overall, of 1,162 patients 417 died and 57 underwent heart transplantation, resulting in a combined outcome of 40.7%, (474/1,162). There was a trend toward decreasing mortality risk across the stages of palliation. Pooled mortality between HP and comprehensive stage 2 palliation was 25%, after stage 2 up to Fontan palliation was 16%, and 6% post-Fontan. The incidence of death or heart transplantation was higher in high-risk patients—43% died and 10% received heart transplantation. Conclusion Our systematic review and meta-analysis found high rates of death or heart transplantation in HP of HLHS patients between HP and Fontan surgeries. All patients should be closely followed during the initial interstage period, which is associated with the highest hazard. Prospective studies on appropriate patient selection, indications, and / or alternatives, as well as refining HP strategies for managing newborns with HLHS are needed to improve outcomes.
Neonatal Intensive Care Unit Nurses’ Knowledge and Use of Sucrose for Neonatal Pain Management in Saudi Arabia
Authors: Faqihi Sumayah , Ismail Ahmad , Hasan Abd Al-Hadi 
Published: February 2024

Introduction Sucrose is an evidence-based intervention used for short-term pain management and distress from minor procedures. Limited research exists on nurses’ knowledge and use of sucrose in Neonatal Intensive Care Units in Saudi Arabia. Objective To assess nurses’ knowledge and use of sucrose in Neonatal Intensive Care Units in Saudi Arabia. Methods A cross-sectional online survey was used to collect data from a convenience sample of 68 neonatal intensive care nurses in Saudi Arabia. A modified tool assessed the knowledge and use of sucrose. Logistic regression analysis was used to find the predictors for sucrose use. Results Most respondents never used sucrose for neonatal pain management and did not receive any training on sucrose. The mean knowledge of nurses regarding sucrose and its use was very low (38%): 16% had a high level of knowledge regarding sucrose, 13% moderate, 19% low, and 52% very low. Nurses who received training on sucrose use and nurses who read or heard about sucrose predicted the use of sucrose. Conclusion Nurses’ knowledge and use of sucrose were inadequate. Interventional programs are needed to enhance the nurses’ knowledge regarding sucrose and its use and to enhance the utilization of sucrose as a pain management intervention in the Neonatal Intensive Care Units in Saudi Arabia.
Narratives, Sensemaking, and Didactic Relationships in Longitudinal Integrated Clerkship Education
Authors: Olajire Abigail , Benton Mark 
Published: February 2024

OBJECTIVE To understand what longitudinal integrated clerkship (LIC) participants found meaningful and valuable about their experiences while grounded in a communicated narrative sensemaking (CNSM) framework. METHODS Semi-structured interviews were conducted with a cohort of 3 LIC students and 7 of their 12 preceptors. Interviews were designed to elicit narratives ie time-ordered accounts of events, experiences, or reflections. Narratives were identified and coded to understand aspects of experiences. RESULTS Participants made sense of their experiences by narrating stories of LIC length allowing relationships to grow over time in a way that gave students a holistic perspective on patient care, built deep relationships between students and preceptors, and grew student confidence. CONCLUSION Participants value longitudinal integration in LICs because it allows for unique perspectives on patient care and builds deep meaningful mentor relationships with preceptors. Relationships in LICs must be managed carefully because much LIC learning is facilitated by relationships. The clerkship is a crucial aspect of medical education of which sense will be made by physicians during their whole lives.
Assessing Direction of India’s Exports: A Dynamic Framework
Authors: Chakrabartty Satyendra Nath , Sinha Deepankar 
Published: February 2024

Decision on trade policies with emphasis on bilateral trade relationships needs knowledge about the direction of exports of the exporting country along with associated changes like degree of specialisation, etc. The direction of export for a product or sector can be taken as a set consisting of destination countries (DCs) and corresponding export potentiality. The set reflects the direction, composition and value of trade potentials and helps to decide export-boosting measures of several sectors, focusing on a country. The paper suggests the use of ratio and geometrically aggregated revealed comparative advantage (RCA) values for individual and combined sector growth (positive or negative), respectively. This approach overcomes the static properties of RCA and shift-share analysis typically used to reveal the patterns of trade direction. The pattern is investigated by geometric aggregation of ratios of RCA at the current period over the base period for each sector. The index follows log-normal distribution and shows fluctuations of RCA for a product/sector across time. Such curves of fluctuations for different countries may facilitate meaningful inter-country comparisons. Second, this paper suggests the use of bilateral RCA to determine the direction of India’s exports for a particular sector, enabling the determination of its potential markets. JEL Classification: F1, F4
Flexible packaging past, present and future: Reflections on a century of technology advancement
Authors: Morris Barry A 
Published: February 2024

Since its inception nearly 100 years ago, flexible packaging has seen tremendous growth due to its ability to meet packaging needs at the lowest cost and with the least amount of material usage. The modern era of flexible packaging began in the early twentieth century with the introduction of cellophane, a transparent “wonder” film which enabled the development of large distribution channels of pre-packaged goods and changed consumer lifestyles and buying habits. New processes and materials have continually advanced flexible packaging technology. In concert, the scientific understanding of materials and polymer processing has progressed. This paper traces the history of flexible packaging, describing major developments in technology and the science behind them. Flexible packaging has constantly evolved to meet new demands and challenges. This bodes well for the future as the industry address its end-of-life shortcomings and moves towards a more circular economy. Learnings from the past, guided by improved scientific insight and engineering principles, can be leveraged to adapt flexible packaging to changing market, societal and regulatory demands.
Measuring pesticides in the atmosphere: current status, emerging trends and future perspectives
Authors: Brüggemann Martin , Mayer Simon , Brown David , Terry Adrian , Rüdiger Julian , Hoffmann Thorsten 
Published: February 2024

AbstractThere is a long history in environmental sciences to investigate and understand the fate of chemicals in the environment. For pesticides, this has led to systematic assessments of compounds by both academic and regulatory bodies, particularly for soil and water. As we show here, in recent years, there is an increasing interest in the potential presence of pesticide residues in air and related exposure risks. Based on a literature review for the years 2002–2022, we find a growing number of air monitoring studies with an average of 6.7 studies/year since 2020, with passive sampling methods contributing significantly to this rise. Most studies are concentrated in Europe and North America, with France leading in the number of monitoring studies. However, due to a lack of harmonization, and thus, the use of diverse methods and approaches, it remains challenging to derive potential exposure risks, to assess data quality of studies, and to compare datasets. In this perspective, we focus on current and emerging trends of different air monitoring approaches and highlight how they influence the interpretation of data. To improve the comparability and utility of data, and to ensure that air monitorings meet certain quality requirements, we propose a path forward, including: (1) Standardization and harmonization of methods: Adopting well-characterized and widely applied methods from air quality research as a basis for standardizing pesticide monitoring, with a clear distinction between relevant exposure and total air concentrations. (2) Tiered approach for monitoring programs: A dynamic concept where initial passive sampling identifies potential exposure risks, followed by active sampling for quantitative data, and, if necessary, extensive monitoring programs. This approach balances the need for detailed data with resource constraints. (3) Data interpretation and transparency: Public availability of data and clear reporting of methods, analysis, and uncertainties are crucial for the credibility and utility of monitoring studies. Overall, we see that harmonization of standards is critical for assessing exposure risks from pesticides in air and for informing regulatory decisions and mitigation strategies. Collaboration with the air quality and atmospheric research community is strongly recommended to leverage existing expertise in sampling, analysis, and data interpretation.
Do mouthwashes affect the optical properties of resin cement?
Authors: Çakır Kılınç Nazire Nurdan , Yıldız Pınar 
Published: February 2024

Abstract
Objectives
The objective of this study was to evaluate the effect of mouthwashes on the optical properties of resin cement.

Materials and methods
One hundred and 60 resin cement discs (6x2mm) were produced from 4 different brands of resin cement (Panavia V5, Estecem II, RelyX Veneer, NX3) with the help of a Teflon mould. The discs were divided into 4 subgroups, 1 of which served as the control group, to be immersed in mouthwashes after measuring the initial L, a, and b values on white and black backgrounds. Colour measurements were repeated after the 1st and 7th days. The collected data were used to calculate the ∆E00 value to measure colour stability, the translucency parameter (TP00), and the contrast ratio parameter (CR) to compare translucency change. Data were statistically analysed using mixed-design analysis of ANOVA and the Bonferroni-Dunn test. Repeated measures ANOVA was used for dependent results (α = 0.05).

Results
On the ∆E00, TP00, and CR parameters; the joint effect of resin groups, mouthwash groups, and measurement times were found to be statistically significant. The ∆E00 (colour difference) parameter; the joint effect of resin groups, mouthwash groups, and measurement times was found to be statistically significant. The TP00; the joint effect of resin groups, mouthwash groups, and measurement times were found to be statistically significant. The CR parameter; the joint effect of resin groups, mouthwash groups, and measurement times was found to be statistically significant. In the Estecem II (Tokuyama) group, the means of Listerine Cool Mint (Johnson & Johnson) was above acceptable limits in both time periods. In the Panavia V5 (Kuraray Noritake) group, the color change was above acceptable limits in all time periods and in all mouthwash groups. Among the resin materials used, Estecem II (Tokuyama) shows the most color change. Listerine Cool Mint (Johnson & Johnson) caused more color change than other mouthwashes at all times.

Conclusions
Within the limitations of this study; the colour stability and translucency value of resin cement depend on both the resin cement content and the mouthwash. Long-term use of mouthwash may adversely affect the optical properties of the resin cement.

Clinical relevance
Clinicians should take into account the fact that mouthwash use and the composition of the resin cement employed will have an impact on the colour of laminate veneers.
Delivering medical leadership training through the Healthcare Leadership Academy: a four year analysis
Authors: Zarif Azmaeen , Bandyopadhyay Soham , Miller George , Malawana Johann 
Published: February 2024

Abstract
Background
Formal leadership training is typically targeted at senior health professionals. The Healthcare Leadership Academy (HLA) was formed in 2016 to provide a leadership programme for students and early-career health professionals. This study analyses the effectiveness of the HLA scholarship programme as an intervention for improving interest in and preparing scholars for future leadership roles.

Methods
Survey data was used to assess the effectiveness of the HLA Scholarship program in cultivating leadership development. Questions required either multiple-choice, free text, ranking or Likert scale (‘strongly agree’, ‘agree’, ‘neither agree nor disagree’, ‘disagree’, ‘strongly disagree) responses. Participants spanned six regions (London, Newcastle, Bristol, Belfast, Edinburgh, and Amsterdam) in four countries (England, Scotland, Northern Ireland, and the Netherlands). Descriptive statistical analyses were conducted, and insights were drawn from the open-ended survey questions using a leadership framework.

Results
Seventy participants who underwent the course between 2016 and 2020 completed the questionnaire. Nearly all (99%) found that the training provided on the programme had equipped them to be more effective leaders, with 86% of respondents stating that they were more likely to take on leadership roles. Nearly all (97.1%) found the course to be either of good or very good quality. Nineteen insights were identified from free text responses that fitted under one of the four themes of the leadership framework: “optimising”, “resolving uncertainty”, “enhancing adaptability”, and “promulgating a vision”.

Conclusions
Healthcare leadership is a non-negotiable component of healthcare delivery in the 21st Century. As healthcare professionals, it is our duty to be effective leaders confident and competent in navigating the increasingly complex systems within which we operate for the benefit of ourselves, colleagues, and patients. By accounting for known shortcomings and developing ameliorative measures, the HLA Scholarship programme addresses unmet needs in a structured manner to support effective long-term healthcare leadership development.
Attitudes toward learning communication skills among Iranian medical students
Authors: Kandevani Naser Yousefzadeh , Labaf Ali , Mirzazadeh Azim , Pormehr Pegah Salimi 
Published: February 2024

AbstractBackgroundAttitudes determine behavior, and alterations in attitude may result in behavioral changes. Medical students would benefit from learning communication skills. This study aimed to determine the attitude of medical students toward the importance of learning communication skills and the training courses and their role in contributing.MethodsIn this cross-sectional study, 442 medical students from three different levels of medical training were enrolled. Students in the first 4 years of the medical program were classified as basic sciences and physiopathology students, those in the fifth and sixth years were classified as clerkship students, and those in the last three terms of medical training were classified as interns. The attitude among these three groups was assessed by the Communication Skills Attitude Scale (CSAS) questionnaire, and the contributing factors were determined.ResultsThe mean total points for attitude in positive and negative aspects were 50.7 and 30.9, respectively showing a positive attitude toward communication skills among medical students. The median scores of the scales Important in Medical Content, Excuse, Learning, and Overconfidence varied significantly from highest to lowest, respectively. Gender, educational level, ethnic origin, language, family burden, paternal literacy, history of presence in communication skills courses, self-report from communication skills, and need to further learning in this era showed significant association with attitude (P < 0.05).ConclusionsIt may be concluded that generally, medical students have a positive attitude toward communication skills, and this perspective is a multi-factorial entity that programming according to the various related factors would help to attainment of additional communication capabilities among medical students.