bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘People that suffer or have been through it know the answers’: stakeholders’ perspectives on improving healthcare systems for end-of-life care in chronic obstructive pulmonary disease
Authors: Landers Amanda , Pitama Suzanne G. , Palmer Suetonia C. , Beckert Lutz 
Published: December 2023

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is a progressive and disabling lung condition with a high mortality. Our research has shown that health care for end-of-life COPD is poorly integrated. The aim of this study was to involve people with end-of-life COPD, their support people and health professionals in the design of healthcare services to help improve the delivery of care for advanced COPD, including informing system-level quality improvement.

Design
We conducted a focus group study involving stakeholders of healthcare services: people with end-of life COPD, support people, bereaved support people, and community- and hospital-based health care professionals.

Methods
We conducted qualitative analysis using deductive structural coding, and then inductive descriptive and pattern coding. Analyses were triangulated by investigators. The research positioned people with end-of-life COPD, their support people and health professionals as experts in healthcare services. Critical theory and Actor-Network theory informed the analysis.

Results
Seven focus groups involving 74 participants reported their experiences of end-of-life care for COPD. Five themes related to healthcare systems responses to improving care quality were identified: governance, system integration, resource design and development, standardisation of processes, and communication.

Conclusion
Stakeholders provided multiple healthcare system-level responses to end-of-life care in COPD that could inform healthcare service design and clinical quality improvement.
Costs of major depression covered / not covered in British Columbia, Canada
Authors: Cressman Sonya , Ghanbarian Shahzad , Edwards Louisa , Peterson Sandra , Bunka Mary , Hoens Alison M. , Riches Linda , Austin Jehannine , Vijh Rohit , McGrail Kimberlyn , Bryan Stirling 
Published: December 2023

Abstract
Background
Major depressive disorder (MDD) is one of the world’s leading causes of disability. Our purpose was to characterize the total costs of MDD and evaluate the degree to which the British Columbia provincial health system meets its objective to protect people from the financial impact of illness.

Methods
We performed a population-based cohort study of adults newly diagnosed with MDD between 2015 and 2020 and followed their health system costs over two years. The expenditure proportion of MDD-related, patient paid costs relative to non-subsistence income was estimated, incidences of financial hardship were identified and the slope index of inequality (SII) between the highest and lowest income groups compared across regions.

Results
There were 250,855 individuals diagnosed with MDD in British Columbia over the observation period. Costs to the health system totalled >$1.5 billion (2020 CDN), averaging $138/week for the first 12 weeks following a new diagnosis and $65/week to week 52 and $55/week for weeks 53–104 unless MDD was refractory to treatment ($125/week between week 12–52 and $101/week over weeks 53–104). The proportion of MDD-attributable costs not covered by the health system was 2-15x greater than costs covered by the health system, exceeding $700/week for patients with severe MDD or MDD that was refractory to treatment. Population members in lower-income groups and urban homeowners had disadvantages in the distribution of financial protection received by the health system (SII reached − 8.47 and 15.25, respectively); however, financial hardship and inequities were mitigated province-wide if MDD went into remission (SII − 0.07 to 0.6).

Conclusions
MDD-attributable costs to health systems and patients are highest in the first 12 weeks after a new diagnosis. During this time, lower income groups and homeowners in urban areas run the risk of financial hardship.
Streamlining robotic-assisted abdominoperineal resection
Authors: Yamada Kazunosuke , Imaizumi Jun , Kato Ryuji , Takada Takahiro , Ojima Hitoshi 
Published: December 2023

Abstract
Background
Robot-assisted surgery has proven to be a safe and feasible approach for the management of rectal cancer, including abdominoperineal resection (APR). However, it often incurs longer operative times and higher costs. This study aimed to overcome these limitations by adopting a synchronous approach utilizing an optimized team composition.

Methods
Data on patients who underwent robot-assisted APR at our facility between June 2022 and June 2023 were analyzed. The key points of the optimized approach included the following: At the start of the surgery, the surgeon performed an anococcygeal ligament resection from the perineal side while the bedside assistants set up the ports. Then, through console manipulation, the presacral fascia, elevated by previously placed gauze, was easily and safely incised, providing access to the perineal region.

Results
A total of nine patients were included in this study. The median operation time was 231 min, and the intraoperative blood loss was 170 ml. The operation time was reduced to 167.5 min, and the blood loss was 80.5 ml in cases without a trainee. Surgical site infections, classified as Clavien–Dindo grade II complications, were observed in two cases, but no obvious urinary or erectile dysfunction was observed.

Conclusion
The study results indicate that the challenges associated with APR can be efficiently addressed without requiring additional personnel by streamlining team composition and the synchronous approach. This optimization strategy minimizes the need for a larger surgical team, while maximizing the utilization of surgical time and resources.
Clinical significance of dynamical network indices of surface electromyography for reticular neuromuscular control assessment
Authors: Li Jinping , Kang Xianglian , Li Ke , Xu Ying , Wang Zhengfei , Zhang Xinzhi , Guo Qingjia , Ji Runing , Hou Ying 
Published: December 2023

Abstract
Background
There is currently no objective and accurate clinical assessment of reticular neuromuscular control in healthy subjects or patients with upper motor neuron injury. As a result, clinical dysfunctions of neuromuscular control could just be semi-quantified, efficacies and mechanisms of various therapies for neuromuscular control improving are difficult to verify.

Methods
Fourteen healthy participants were required to maintain standing balance in the kinetostatics model of Gusu Constraint Standing Training (GCST). A backward and upward constraint force was applied to their trunk at 0°, 20° and 25°, respectively. The multiplex recurrence network (MRN) was applied to analyze the surface electromyography signals of 16 muscles of bilateral lower limbs during the tests. Different levels of MRN network indices were utilized to assess reticular neuromuscular control.

Results
Compared with the 0° test, the MRN indices related to muscle coordination of bilateral lower limbs, of unilateral lower limb and of inter limbs showed significant increase when participants stood in 20° and 25° tests (P < 0.05). The indices related to muscle contribution of gluteal, anterior thigh and calf muscles significantly increased when participants stood in 20° and 25° tests (P < 0.05).

Conclusions
This study applied the dynamical network indices of MRN to analyze the changes of neuromuscular control of lower limbs of healthy participants in the kinetostatics model of GCST. Results showed that the overall coordination of lower limb muscles would be significantly enhanced during performing GCST, partly by the enhancement of neuromuscular control of single lower limb, and partly by the enhancement of joint control across lower limbs. In particular, the muscles in buttocks, anterior thighs and calves played a more important role in the overall coordination, and their involvement was significantly increased. The MRN could provide details of control at the bilateral lower limbs, unilateral lower limb, inter limbs, and single muscle levels, and has the potential to be a new tool for assessing the reticular neuromuscular control.
Trial registration ChiCTR2100055090
REtinal Detachment Outcomes Study (REDOS): study protocol for a factorial, randomized controlled trial
Authors: Hébert Mélanie , Bourgault Serge , Caissie Mathieu , Tourville Éric , Dirani Ali 
Published: December 2023

Abstract
Background
Few large randomized controlled trials provide strong evidence to guide surgical repair of primary rhegmatogenous retinal detachment (RRD) repair. The purpose of this factorial, single-blind, randomized controlled trial is to analyze and compare the surgical outcomes, functional visual outcomes, complications, and quality of life associated with RRD repair using (A) pars plana vitrectomy only (PPV) or PPV with scleral buckle (PPV-SB) and (B) sulfur hexafluoride gas (SF6) or perfluoropropane gas (C3F8) tamponade.

Methods
Eligible patients with moderately complex RRD will be randomized 1:1 to PPV or PPV-SB and 1:1 to SF6 or C3F8 gas tamponade. Approximately 560 patients will be recruited to be able to detect a difference of around 10% in SSAS rate between the groups. Patients will be followed using multimodal imaging and quality of life questionnaires after the surgical repair until 1 year postoperative. The primary outcome will be a single-surgery anatomic success (SSAS), defined as the absence of reoperation for recurrent RRD in the operating room. Secondary outcomes will be pinhole visual acuity (PHVA) at 8–10 weeks and 6 months, final best-corrected visual acuity (BCVA), final retina status (i.e., attached or detached), time to onset of RRD recurrence, severity and number of complications, and questionnaire results.

Discussion
This will be the first 2 × 2 factorial RCT examining repair techniques in primary RRD. It will also be the first RCT to compare gas tamponade between the two most common agents. Notably, it will be adequately powered to detect a clinically significant effect size. The use of multimodal imaging will also be a novel aspect of this study, allowing us to compare head-to-head the impact of adding an SB to the retina’s recovery after RRD repair and of differing gas tamponades. Until now, the treatment of RRD has been largely guided by pragmatic retrospective cohort studies. There is a lack of strong evidence guiding therapeutic decisions and this trial will address (1) whether supplemental SB is justified and (2) whether longer duration gas tamponade with C3F8 is necessary.

Trial registration
ClinicalTrials.gov NCT05863312. Registered on 18 May 2023.
Effects of opioid-free anaesthesia on postoperative nausea and vomiting in patients undergoing video-assisted thoracoscopic surgery (OFA-PONV trial): study protocol for a randomised controlled trial
Authors: Yan Xiang , Liang Chen , Jiang Jia , Ji Ying , Wu Anshi , Wei Changwei 
Published: December 2023

Abstract
Background
Postoperative nausea and vomiting (PONV) is a common complication after general anaesthesia and is associated with morbidity and prolonged length of stay. Growing evidence suggest that opioid-free general anaesthesia (OFA) may reduce PONV in various surgical settings. We aim to evaluate the efficacy of OFA on the incidence of PONV compared with opioid-based anaesthesia among adults undergoing thoracoscopic surgery.

Methods
This is a prospective, single-centre, randomised controlled trial comparing OFA and opioid-based anaesthesia for thoracoscopic surgery. A total of 168 adults will be randomised with a 1:1 ratio to receive either opioid-free anaesthesia or opioid-based anaesthesia. The primary outcome will be the incidence of PONV within 24 h after operation. The secondary outcomes will include the severity of PONV, quality of recovery, pain at rest, 6-min walking test, and health-related quality of life after operation.

Discussion
The benefit-risk of OFA for patients after operation is contradictory in previous studies, so further study is required. This trial will focus on the effect of OFA on the incidence of PONV in patients undergoing thoracoscopic surgery. This trial adopts uniformed PONV and perioperative pain management, standardised randomised and blind, clear-cut inclusion and exclusion criteria, and standardised scales to assess the severity of PONV after surgery, the quality of postoperative recovery, and the health status at 6 months. The findings of this study will help to provide references to promote early recovery of patients after lung surgery.

Trial registration
ClinicalTrials.gov NCT05411159. Registered on 9 June 2022.
The role of Dodola Community Conservation Area for large mammal conservation, Ethiopia
Authors: Mekonnen Geremew , Girma Zerihun 
Published: December 2023

AbstractThe role of community conservation areas for large mammals is rarely evaluated. We investigated the species richness and frequency of sightings of large mammals in the Dodola Community Conservation Area. The study area was stratified into three habitat types, and 49 lines transect was laid (27 Dry evergreen Afromontane forests, 20 Sub-afro-alpine habitats, and 2 plantation forests) based on the topography, land use, and vegetation cover of the study area. A total of 24 species of large mammals were identified and recorded in the study area. Though the community conservation area is home to diverse species of mammals, including some endemic and endangered ones such as mountain nyala and Bale Monkey, human encroachment, agriculture, and overgrazing are prominent in the area, putting huge pressure on flora and fauna. Therefore, we recommend the participatory approach be strengthened to ensure sustainable coexistence between people and wildlife.
Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature
Authors: Abutalib Mohammed Ali , Shams Anwar , Tamur Shadi , Khalifa Eman A. , Alnefaie Ghaliah Obaid , Hawsawi Yousef M. 
Published: December 2023

Abstract
Introduction
Papillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary thyroid carcinoma can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet distant spread is very uncommon.

Case presentation
Herein, we discuss a Saudi male patient in his early 50s with a history of papillary thyroid carcinoma who presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination together with immune-histochemical staining and molecular studies of pleural effusion aspiration concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space.

Conclusions
Papillary thyroid carcinoma seldom causes metastatic niches in the pleural space; this is a rare clinical presentation, nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded. A definitive diagnosis of metastatic papillary thyroid carcinoma can be made using clinical presentation, cytologic examination, immunohistochemical investigation, and molecular testing. The most common mutation found in papillary thyroid carcinoma cases is the V600E mutation found in the BRAF gene, yet these patients have a relatively low probability of cancer recurrence. Patients with papillary thyroid carcinoma who have the BRAF mutation frequently experience metastases and relapses of the disease after the cancer has progressed aggressively. To help with therapy planning and the introduction of BRAF inhibitors, genetic testing for BRAF mutation may therefore prove to be a useful tool, especially in cases of aggressive subtypes of TC.
Vidofludimus inhibits porcine reproductive and respiratory syndrome virus infection by targeting dihydroorotate dehydrogenase
Authors: Yang Yuanqi , Gao Yanni , Zhang Lujie , Liu Xing , Sun Yangyang , Bai Juan , Jiang Ping 
Published: December 2023

AbstractPorcine reproductive and respiratory syndrome virus (PRRSV) infection has caused huge economic losses in global swine industry over the last 37 years. PRRSV commercial vaccines are not effective against all epidemic PRRSV strains. In this study we performed a high-throughput screening (HTS) of an FDA-approved drug library, which contained 2339 compounds, and found vidofludimus (Vi) could significantly inhibits PRRSV replication in Marc-145 cells and primary porcine alveolar macrophages (PAMs). Compounds target prediction, molecular docking analysis, and target protein interference assay showed that Vi interacts with dihydroorotate dehydrogenase (DHODH), a rate-limiting enzyme in the de novo pyrimidine synthesis pathway. Furthermore, PRRSV infection was restored in the presence of excess uridine and cytidine which promote pyrimidine salvage, or excess orotate which is the product of DHODH in the de novo pyrimidine biosynthesis pathway, thus confirming that the antiviral effect of Vi against PRRSV relies on the inhibition of DHODH. In addition, Vi also has antiviral activity against Seneca virus A (SVA), encephalomyocarditis virus (EMCV), porcine epidemic diarrhea virus (PEDV), and pseudorabies virus (PRV) in vitro. These findings should be helpful for developing a novel prophylactic and therapeutic strategy against PRRSV and other swine viral infections.
Social acceptance of geothermal technology on a global view: a systematic review
Authors: Renoth Robin , Buchner Elmar , Schmieder Martin , Keim Maximilian , Plechaty Manfred , Drews Michael 
Published: December 2023

Abstract
Background
The role of geothermal technology in the context of global efforts toward carbon-free and clean energy production is becoming increasingly important. Social acceptance is a decisive factor in the successful implementation of geothermal projects.

Main text
This systematic review summarizes the major aspects and evaluates the crucial outcomes of recent research on community acceptance as a dimension of social acceptance of geothermal technology since 2011, on a global scale. From the literature, we identified and grouped researched acceptance factors into five main acceptance categories, namely ‘project organization and process’, ‘environment’, ‘municipality’, ‘technology’, and ‘governance’. Each category comprises a number of specific acceptance factors addressed by different survey methods (e.g., interviews, questionnaires, content analyses) in the relevant publications. The acceptance factor categories ‘technology’ and ‘governance’ are remarkably underrepresented, whereas the acceptance factors combined in the categories ‘project organization’ and ‘municipality’ are frequently mentioned in the literature. Acceptance factors combined within the category ‘environment’, ‘trust in key actors’, and ‘information about the project’ are expectedly the most dominant ones in the papers studied. Interestingly, acceptance categories and number of mentions of acceptance factors are comparable in all survey methods applied in the various studies. Besides the acceptance factors combined in the categories ‘environment’ and ‘project organization and process’, ‘knowledge about geothermal technology’ (an acceptance factor from the category ‘municipality’) represents the predominant acceptance factor of geothermal technology.

Conclusions
Deeper knowledge, in particular about the technical aspects of geothermal energy generation, might enable a more comprehensive and holistic view on geothermal technology. Furthermore, the integration of all relevant groups of stakeholders in the process of implementation of geothermal projects strongly influences their social acceptance. Following the results of our systematic literature review, we propose these aspects should be addressed in more detail in future research on the community acceptance of geothermal technology and energy production.
To hear or not to hear: selective tidal stream transport can interfere with the detectability of migrating silver eels in a Tidal River
Authors: Merk Benedikt , Höhne Leander , Freese Marko , Marohn Lasse , Hanel Reinhold , Pohlmann Jan-Dag 
Published: December 2023

AbstractAcoustic telemetry provides valuable insights into behavioural patterns of aquatic animals such as downstream migrating European eels (Anguilla anguilla), so called silver eels. The behaviour of silver eels during the migration is known to be influenced by environmental factors, yet so is the performance of acoustic telemetry networks. This study quantifies the impact of these environmental factors on both, migration behaviour and receiver performance to determine possible limiting conditions for detecting tagged eels in tidal areas. A dominance analysis of the selected models describing migration speed, activity and receiver performance was conducted following 234 silver eels that were tagged with acoustic transmitters and observed by a receiver network in the Ems River during two subsequent migration seasons. The results suggest a passive locomotion of silver eels during their downstream migration by taking advantage of selective tidal stream transport (STST). It is further shown that water temperature, salinity, turbidity, precipitation, and especially current velocity were major parameters influencing migration activity and speed. At the same time, analyses of the detection probability of tagged eels under varying environmental conditions indicated a decreased receiver performance during increased current velocities, meaning that high migration activity and -speed coincides with reduced detection probability. Consequently, there is a risk that particularly during phases of increased activity, migration activity may be underestimated due to reduced acoustic telemetry performance. To avoid bias in telemetry studies, it is, therefore, crucial to conduct range tests and adjust the receiver placement in areas and conditions of high current velocities.
Cultural adaptation of an integrated eating disorders prevention and healthy weight management program
Authors: Simpson Courtney C. , Boutté Rachel L. , Burnette C. Blair , Weinstock Madison , Goel Neha , Mazzeo Suzanne E. 
Published: December 2023

Abstract
Background
Both eating disorder (ED) prevention and weight management interventions often focus on the thin ideal. Yet, many Black and Latina women do not view thinness as their body ideal. This study used focus groups to investigate the influence of race, ethnicity, and culture on appearance ideals and inform the cultural adaptation and integration of two established programs addressing EDs and weight management: the Body Project, and Healthy Weight Interventions.

Methods
White (n = 10), Black (n = 14), and Latina (n = 6) women participated in racially and ethnically homogenous focus groups.

Results
Thematic analysis identified several themes, including: (1) diverse beauty standards across groups, (2) lack of acknowledgement of racialized beauty standards in prevention and cultural appropriation, (3) culturally-specific impacts of standards, (4) harm of appearance-related comments, (5) limitations of available resources, (6) stigma/minimization of mental health, (7) barriers to inclusive programming, and (8) facilitators of inclusive programming.

Conclusions
Results suggested that current programs’ emphasis on thinness limit their relevance for women of color, and perpetuate the misconception that EDs primarily affect White women. Findings highlight the need for culturally responsive prevention.