bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climate warming shifts riverine macroinvertebrate communities to be more sensitive to chemical pollutants
Authors: Sinclair Tom , Craig Peter , Maltby Lorraine L. 
Published: April 2024

AbstractFreshwaters are highly threatened ecosystems that are vulnerable to chemical pollution and climate change. Freshwater taxa vary in their sensitivity to chemicals and changes in species composition can potentially affect the sensitivity of assemblages to chemical exposure. Here we explore the potential consequences of future climate change on the composition and sensitivity of freshwater macroinvertebrate assemblages to chemical stressors using the UK as a case study. Macroinvertebrate assemblages under end of century (2080–2100) and baseline (1980–2000) climate conditions were predicted for 608 UK sites for four climate scenarios corresponding to mean temperature changes of 1.28 to 3.78°C. Freshwater macroinvertebrate toxicity data were collated for 19 chemicals and the hierarchical species sensitivity distribution model was used to predict the sensitivity of untested taxa using relatedness within a Bayesian approach. All four future climate scenarios shifted assemblage compositions, increasing the prevalence of Mollusca, Crustacea and Oligochaeta species, and the insect taxa of Odonata, Chironomidae, and Baetidae species. Contrastingly, decreases were projected for Plecoptera, Ephemeroptera (except for Baetidae) and Coleoptera species. Shifts in taxonomic composition were associated with changes in the percentage of species at risk from chemical exposure. For the 3.78°C climate scenario, 76% of all assemblages became more sensitive to chemicals and for 18 of the 19 chemicals, the percentage of species at risk increased. Climate warming‐induced increases in sensitivity were greatest for assemblages exposed to metals and were dependent on baseline assemblage composition, which varied spatially. Climate warming is predicted to result in changes in the use, environmental exposure and toxicity of chemicals. Here we show that, even in the absence of these climate‐chemical interactions, shifts in species composition due to climate warming will increase chemical risk and that the impact of chemical pollution on freshwater macroinvertebrate biodiversity may double or quadruple by the end of the 21st century.
City diplomacy of ordinary cities: Harnessing migrant inclusion policies for international engagement in Amadora, Portugal
Authors: Desille Amandine , Lacroix Thomas 
Published: April 2024

AbstractThis paper adds to the literature on urban diplomacy by focusing on the role of smaller cities with an active international engagement in migration matters. What are the motives driving the involvement of these “ordinary” cities in international groupings? What role do these cities play in the circulation of policies related to migration integration? How does it translate into local policies? To do so, we rely on a quantitative analysis of 64 networks around the world and on the case study of Amadora (Portugal). It is argued that “ordinary” cities may gain visibility when participating in transnational networks of cities. However, the research also shows that the city involvement is driven by the search for financial capacities, thereby nurturing a form of dependency from international subsidies. In addition, Amadora's involvement in city networks is not necessarily connected with actual activism in favor of migrant integration. The research shows the tensions between political discourses at national and local levels, and the loopholes of the “transnationalization” of migration governance.
Behaviour, barriers and facilitators of shared decision making in breast cancer surgical treatment: A qualitative systematic review using a ‘Best Fit’ framework approach
Authors: Zheng Hongying , Yang Linning , Hu Jiale , Yang Yan 
Published: April 2024

AbstractBackgroundDue to the diversity and high sensitivity of the treatment, there were difficulties and uncertainties in the breast cancer surgical decision‐making process. We aimed to describe the patient's decision‐making behaviour and shared decision‐making (SDM)‐related barriers and facilitators in breast cancer surgical treatment.MethodsWe searched eight databases for qualitative studies and mixed‐method studies about breast cancer patients' surgical decision‐making process from inception to March 2021. The quality of the studies was critically appraised by two researchers independently. We used a ‘best fit framework approach’ to analyze and synthesize the evidence.ResultsTwenty‐eight qualitative studies and three mixed‐method studies were included in this study. Four themes and 10 subthemes were extracted: (a) struggling with various considerations, (b) actual decision‐making behaviours, (c) SDM not routinely implemented and (d) multiple facilitators and barriers to SDM.ConclusionsPatients had various considerations of breast surgery and SDM was not routinely implemented. There was a discrepancy between information exchange behaviours, value clarification, decision support utilization and SDM due to cognitive and behavioural biases. When individuals made surgical decisions, their behaviours were affected by individual‐level and system‐level factors. Therefore, healthcare providers and other stakeholders should constantly improve communication skills and collaboration, and emphasize the importance of decision support, so as to embed SDM into routine practice.Patient and Public ContributionThis systematic review was conducted as part of a wider research entitled: Breast cancer patients' actual participation roles in surgical decision making: a mixed method research. The results of this project helped us to better analyze and generalize patients' views.
Novel motivational interviewing‐based intervention improves engagement in physical activity and readiness to change among adolescents with chronic pain
Authors: Forgács‐Kristóf Katalin , Ádám Szilvia , Vargay Adrienn , Major János 
Published: April 2024

AbstractIntroductionEngaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI‐based physical activity promotion programme, the M3 training.MethodsIn our exploratory study with 35 adolescent–parent dyads, we evaluated the feasibility by enrolment, drop‐out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open‐ended questions. We also assessed changes in pain self‐efficacy and readiness to change after the M3 training intervention.ResultsThe M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self‐efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents.ConclusionM3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe.Patient or Public ContributionThe preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere).
#DryByChristmas: A patient and public involvement study on women's engagement with humorous pelvic floor muscle training digital nudges on social media
Authors: Harper Rosie C. , Sheppard Sally , Miller Elaine , Stewart Carly , Clark Carol J. 
Published: April 2024

AbstractIntroductionPatient and public involvement (PPI) is essential for women's health research. Little is known about how women engage with humorous social media and behavioural health messaging targeting pelvic floor muscle training (PFMT). This PPI aimed to understand how women engage with a humorous social media campaign encouraging PFMT. The study findings will influence the co‐design of a digital intervention to support women's adherence to PFMT.MethodsThe Guidance for Reporting Involvement of Patients and the Public Version 2 short form was used to report the study's findings. The study examined public engagement with a humorous social media campaign encouraging PFMT in women. A healthcare professional and comedian ran the campaign following the national guidelines for engagement in PFMT. Instagram analytics gave insight into the demographics of the public who engaged, how they engaged and the most popular content. The behaviour change techniques (BCTs) used in the digital nudges that generated the highest levels of engagement were analysed using the Capability Opportunity Motivation Behaviour Change Wheel.ResultsThe majority (96%) of the population showing the highest levels of engagement were women aged 35–44 years and were based in the United Kingdom (77%). The Instagram account saw an increase in engagement by 12% over the 3‐month campaign, with 22,032 users seeing digital nudges and 2645 engaging with the digital nudges. The preferred way of engaging was using Likes (9723). The common themes in the digital nudges that generated the highest levels of engagement were BCTs associated with the ‘social influences’ theoretical domain framework that targeted the core behaviour opportunity.ConclusionThe study findings suggest humour may improve women's engagement with online PFMT programmes; however, more rigorous research is required to better understand diverse women's experiences of humorous online PFMT nudges. Future studies may use PFMT mobile apps instead of social media to capture true user engagement and adherence to PFMT more accurately. The insights gained from the study will be taken forward to co‐design a digital behavioural intervention as part of a larger study.Public ContributionMembers of the public were involved in the co‐design of a digital health intervention that will be trialled as part of a larger research study. The public was involved using the social media platform Instagram. Public engagement with a humorous social media campaign to encourage women to engage with pelvic floor exercises was captured using Instagram analytics, for example, the timing of engagement.
Deceptive learning in histopathology
Authors: Shahamatdar Sahar , Saeed‐Vafa Daryoush , Linsley Drew , Khalil Farah , Lovinger Katherine , Li Lester , McLeod Howard T. , Ramachandran Sohini , Serre Thomas 
Published: April 2024

AimsDeep learning holds immense potential for histopathology, automating tasks that are simple for expert pathologists and revealing novel biology for tasks that were previously considered difficult or impossible to solve by eye alone. However, the extent to which the visual strategies learned by deep learning models in histopathological analysis are trustworthy or not has yet to be systematically analysed. Here, we systematically evaluate deep neural networks (DNNs) trained for histopathological analysis in order to understand if their learned strategies are trustworthy or deceptive.Methods and resultsWe trained a variety of DNNs on a novel data set of 221 whole‐slide images (WSIs) from lung adenocarcinoma patients, and evaluated their effectiveness at (1) molecular profiling of KRAS versus EGFR mutations, (2) determining the primary tissue of a tumour and (3) tumour detection. While DNNs achieved above‐chance performance on molecular profiling, they did so by exploiting correlations between histological subtypes and mutations, and failed to generalise to a challenging test set obtained through laser capture microdissection (LCM). In contrast, DNNs learned robust and trustworthy strategies for determining the primary tissue of a tumour as well as detecting and localising tumours in tissue.ConclusionsOur work demonstrates that DNNs hold immense promise for aiding pathologists in analysing tissue. However, they are also capable of achieving seemingly strong performance by learning deceptive strategies that leverage spurious correlations, and are ultimately unsuitable for research or clinical work. The framework we propose for model evaluation and interpretation is an important step towards developing reliable automated systems for histopathological analysis.
Integrated preparation of B4C–TiB2 multilayer graded ceramics with high hardness and high toughness
Authors: Tan Wenkang , Zou Ji , Wang Weimin , Ji Wei , Fu Zhengyi 
Published: April 2024

AbstractThe enhancement in the comprehensive performance of hardness, toughness, and strength is significant for ceramic materials. In this study, the B4C–TiB2 multilayer graded ceramics were designed and integrally manufactured by spark plasma sintering method using B4C and TiB2 as raw materials. The B4C–TiB2 multilayer graded ceramics feature a transition from the top layer with high hardness to the bottom layer with high toughness, passing through an intermediate layer. The gradient change of this material is observed in both the hardness and fracture toughness, reaching values of 36.2–28.4 GPa and 2.2–6.2 MPa m.5. The compressive strength reaches up to 2960 MPa, whereas the bending strength gets to 677 MPa in the appropriate loading direction. The structure forms a gradient pattern with high hardness on the front side, high toughness on the back side, and overall low density and high strength. This study may facilitate the development of impact‐resistant performance of lightweight materials.
Multiscale nonlinear analysis of 3D orthogonal woven C/SiC composites based on the CT reconstruction
Authors: Du Xiyan , He Chunwang , Ma Lianhua 
Published: April 2024

AbstractDue to the effects of manufacturing process, there are lots of distributed voids in the interior area of three‐dimensional (3D) woven C/SiC composites, leading to the difficulties in predictions of damage evolution and ultimate strength. In this work, the mesoscale geometry of 3D woven C/SiC composites is reconstructed based on the high‐resolution CT scanning, considering the yarn path, yarn profile, and void content. The CT‐based reconstructed model agrees well with the experimental observations. Then, the constitutive laws of mesoscale constituents and macroscale structure are established and implemented numerically by the user‐defined material subroutine UMAT. Finally, the established constitutive laws are applied for the reconstructed model, and the mesoscale and macroscale nonlinear progressive damage behavior of 3D woven C/SiC composite structures are predicted using the hierarchical multiscale method, which are also validated by the experiments. The established CT‐based multiscale computational scheme would be a potential tool for performance evaluation and design of composites.
Home‐based management on hospital re‐admission rates in COPD patients: A systematic review
Authors: Corcoran Rita , Moore Zena , Avsar Pinar , Murray Bridget 
Published: April 2024

AbstractAimTo determine the impact of home‐based management on hospital re‐admission rates in patients with chronic obstructive pulmonary disease (COPD).DesignSystematic review methodology was utilized, combining meta‐analysis, where appropriate, or a narrative analysis of the data from included studies.Data SourcesElectronic databases CINAHL, MEDLINE, PubMed, Embase and SAGE journals for primary papers, 2015 to 2021, were searched between December 2020 and March 2021, followed by hand‐searching key journals, and reference lists of retrieved papers.MethodsThe review followed the guidance of PRISMA. Data were extracted using a predesigned data extraction tool. Quality appraisal was undertaken using RevMan ‘risk of bias’ tool. Meta‐analysis was undertaken using RevMan software.ResultsThis review integrates evidence from eight studies, five Random Control Trials, two observational studies and one retrospective study. The studies span three continents, Asia, Europe and North America, and include 3604 participants with COPD. Home‐based management in patients with COPD resulted in a statistically significant reduction in rates of hospital readmission. For the outcomes, length of stay and mortality, while slightly in favour of home‐based management, the results were not statistically significant.ConclusionGiven the burden of COPD on healthcare systems, and crucially on individuals, this review identified a reduction in hospital re‐admission rate, a clinically important outcome.ImpactThis study focused on the impact on hospital re‐admission rates among the COPD patient cohort when home‐based management was involved. A statistically significant reduction in rates of re‐admission to the hospital was identified. This is positive for the patient, in terms of hospital avoidance, and reduces the burden on hospital systems. Further research is needed to determine the impact on cost‐effectiveness and to quantify the most ideal type of care package that would be recommended for home‐based management.
The impact of digital technology use on nurses' professional identity and relations of power: a literature review
Authors: Knop Michael , Mueller Marius , Kaiser Stephanie , Rester Christian 
Published: April 2024

AbstractAimThis study seeks to review how the use of digital technologies in clinical nursing affects nurses' professional identity and the relations of power within clinical environments.DesignLiterature review.Data SourcesPubMed and CINAHL databases were searched in April 2023.MethodsWe screened 874 studies in English and German, of which 15 were included in our final synthesis reflecting the scientific discourse from 1992 until 2023.ResultsOur review revealed relevant effects of digital technologies on nurses' professional identity and power relations. Few studies cover outcomes relating to identity, such as moral agency or nurses' autonomy. Most studies describe negative impacts of technology on professional identity, for example, creating a barrier between nurses and patients leading to decreased empathetic interaction. Regarding power relations, technologically skilled nurses can yield power over colleagues and patients, while depending on technology. The investigation of these effects is underrepresented.ConclusionOur review presents insights into the relation between technology and nurses' professional identity and prevalent power relations. For future studies, dedicated and critical investigations of digital technologies' impact on the formation of professional identity in nursing are required.Implications for the ProfessionNurses' professional identity may be altered by digital technologies used in clinical care. Nurses, who are aware of the potential effects of digitized work environments, can reflect on the relationship of technology and the nursing profession.ImpactThe use of digital technology might lead to a decrease in nurses' moral agency and competence to shape patient‐centred care. Digital technologies seem to become an essential measure for nurses to wield power over patients and colleagues, whilst being a control mechanism. Our work encourages nurses to actively shape digital care.Reporting MethodWe adhere to the JBI Manual for Evidence Synthesis where applicable. EQUATOR reporting guidelines were not applicable for this type of review.Patient or Public ContributionNo patient or public contribution.
A computable biomedical knowledge system: Toward rapidly building candidate‐directed acyclic graphs
Authors: Bai Yongmei , Shi Xuanyu , Du Jian 
Published: April 2024

AbstractAimIt is essential for health researchers to have a systematic understanding of third‐party variables that influence both the exposure and outcome under investigation, as shown by a directed acyclic graph (DAG). The traditional construction of DAGs through literature review and expert knowledge often needs to be more systematic and consistent, leading to potential biases. We try to introduce an automatic approach to building network linking variables of interest.MethodsLarge‐scale text mining from medical literature was utilized to construct a conceptual network based on the Semantic MEDLINE Database (SemMedDB). SemMedDB is a PubMed‐scale repository of the “concept‐relation‐concept” triple format. Relations between concepts are categorized as Excitatory, Inhibitory, or General.ResultsTo facilitate the use of large‐scale triple sets in SemMedDB, we have developed a computable biomedical knowledge (CBK) system (https://cbk.bjmu.edu.cn/), a website that enables direct retrieval of related publications and their corresponding triples without the necessity of writing SQL statements. Three case studies were elaborated to demonstrate the applications of the CBK system.ConclusionsThe CBK system is openly available and user‐friendly for rapidly capturing a set of influencing factors for a phenotype and building candidate DAGs between exposure‐outcome variables. It could be a valuable tool to reduce the exploration time in considering relationships between variables, and constructing a DAG. A reliable and standardized DAG could significantly improve the design and interpretation of observational health research.
Risk factors for intraoperative and delayed perforation related with gastric endoscopic submucosal dissection
Authors: Mimura Takuya , Yamamoto Yoshinobu , Suzuki Haruhisa , Takizawa Kohei , Hirasawa Toshiaki , Takeuchi Yoji , Ishido Kenji , Hoteya Shu , Yano Tomonori , Tanaka Shinji , Kudara Norihiko , Nakagawa Masahiro , Mashimo Yumi , Ishigooka Masahiro , Fukase Kazutoshi , Shimazu Taichi , Ono Hiroyuki , Tanabe Satoshi , Kondo Hitoshi , Iishi Hiroyasu , Ninomiya Motoki , Oda Ichiro ,   the J‐WEB/EGC group
Published: April 2024

AbstractBackground and AimPerforation is one of the most important complications of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Several studies have examined risk factors for intraoperative and delayed perforations, but most were retrospective analyses with small numbers of patients.MethodsThis study represents a secondary analysis of a Japanese multicenter prospective cohort study. We investigated the factors associated with each type of perforation using 9015 patients with 9975 EGCs undergoing ESD between July 2010 and June 2012.ResultsIntraoperative perforation occurred in 198 patients (2.2%) with 203 lesions (2.0%), necessitating emergency surgery for four lesions (0.04% [2.0%, 4/203]). Delayed perforation occurred in another 37 patients (0.4%) with 42 lesions (0.4%), requiring emergency surgery for 12 lesions (0.12% [28.6%, 12/42]). Factors showing significant independent correlations with intraoperative perforation were upper or middle third of the stomach; remnant stomach or gastric tube; procedure time ≥100 min; tumor size >35 mm; body mass index (BMI) < 18.5 kg/m2; and ≥72 years. Factors showing significant independent correlations with delayed perforation were procedure time ≥60 min; BMI < 18.5 kg/m2; ≥75 years; ulceration; and tumor size >20 mm. Intraoperative perforation occurred most frequently at the greater curvature in the upper third of the stomach (7.9%), whereas delayed perforation occurred most frequently at the greater curvature in the middle third (1.2%).ConclusionThis multicenter prospective cohort study clarified the risk and risk factors of intraoperative and delayed perforation related to ESD for EGCs, providing information to help endoscopists reduce perforation.