bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of best practice guidelines for clinical and community service providers to prevent suicide in LGBTQA+ young people: A Delphi expert consensus study
Authors: Strauss Penelope , Marion Larissa , Hill Nicole TM , Gilbey Dylan , Waters Zoe , Moore Julia K , Costanza Marco , Lamblin Michelle , Robinson Jo , Lin Ashleigh , Perry Yael 
Published: January 2024

Objective: The aim of this study was to develop best practice guidelines for preventing suicide and reducing suicidal thoughts and behaviours in LGBTQA+ young people (lesbian, gay, bisexual, trans, queer/questioning, asexual, and those of other diverse sexualities and genders) within clinical and community service settings in Australia. Methods: We conducted a Delphi expert consensus study. A systematic literature search and interviews with key informants informed an initial 270-item questionnaire. Two expert panels completed the questionnaire, delivered over two rounds: (1) Australian professionals with expertise in LGBTQA+ mental health/suicide prevention and (2) Australian LGBTQA+ young people aged 14–25 with lived experience of suicidal thoughts and/or behaviours. Items endorsed as ‘essential’ or ‘important’ by >80% of both expert panels were included in the guidelines. Results: A total of 115 people participated in the Delphi process; n = 52 professionals completed Round 1, and n = 42 completed Round 2; n = 63 LGBTQA+ young people completed Round 1, and n = 50 completed Round 2. A total of 290 items were included in the guidelines and grouped into: (1) general principles for creating an affirming and inclusive environment for LGBTQA+ young people; (2) assessing suicide risk and working with suicidal LGBTQA+ young people; (3) considerations for specific LGBTQA+ populations; and (4) advocating for LGBTQA+ young people. Conclusion: These guidelines are the first of their kind in Australia. They provide practical support to service providers regardless of prior training in LGBTQ+ identities or mental health, with the aim of reducing suicidal thoughts and behaviours, and preventing suicide, in LGBTQA+ young people.
The relation between perceived non-native features in the L1 speech of English migrants to Austria and their phonetic manifestation in L1 productions
Authors: Ditewig Sanne , Reubold Ulrich , Mayr Robert , Mennen Ineke 
Published: January 2024

Aims: The purpose of this research was to investigate to what extent the most commonly identified non-native features in the L1 speech of late consecutive bilinguals are reflected in differences in the bilinguals’ productions of these features compared with those of monolingual speakers of the L1. Design: We investigated the L1 accent of English migrants to Austria and monolingual English speakers in the United Kingdom in two inter-related studies. Data: In Study 1, an accent-perception experiment, native English listeners rated the nativeness of the monolinguals’ and bilinguals’ L1 English productions of read sentences, using a 6-point scale, and subsequently commented on the accentual features associated with perceived non-nativeness. In Study 2, the monolinguals’ and bilinguals’ productions of the most commonly identified non-native features from Study 1 were compared acoustically and auditorily. Findings: The accent-perception experiment revealed significantly higher non-nativeness ratings for the bilinguals than the monolinguals. These were associated with a wide range of segmental and prosodic features ( n = 836 feature tokens), with /iː/ and /ɪ/ the most commonly identified for segments, and articulation rate and intonation for prosody. The phonetic analysis of these features in Study 2, in turn, revealed that the bilinguals produced /ɪ/ closer to /iː/ than the monolinguals and had more final rises in questions, with the articulation rate differences between them just failing to reach significance. Originality: This is the first study to document a direct link between the features perceived as non-native in bilinguals’ L1 speech and their measurable manifestation in non-native L1 speech productions. Significance: This research contributes significantly to our understanding of the relationship between the perception and production of attrition in L1 speech, and shows that where listeners are able to provide consistent, detailed descriptions of the features associated with non-nativeness, they truthfully reflect measurable patterns in the speech signal.
Language exposure within peer and family contexts and bilingual reading profiles of German–Russian and German–Turkish adolescents in Germany
Authors: Dünkel Nora , Knigge Michel , Brandt Hanne 
Published: January 2024

Aims and Objectives: While research has focused on effects of language exposure within the family, evidence for the role of the quality and quantity of language exposure within peer contexts for the acquisition of both majority language (ML) and heritage language (HL) skills is still limited. Against this background, the present contribution investigates the patterns in which language exposure within family and peer contexts relate to different bilingual reading outcomes of migrant adolescents. Design: The data used for this contribution provide a unique opportunity to fill in this research gap as it contains standardized reading assessments in the ML and HL as well as questionnaires on language exposure within peer and family contexts. Data and Analysis: Using multinomial regression models with a sample of n = 803 adolescents with German–Russian and German–Turkish language backgrounds, we investigate the role of adolescents’ bests friends’ language backgrounds and language skills as well as adolescents’ language use with parents for the prediction of different bilingual reading outcomes (i.e., skilled bilingual readers, skilled ML readers, skilled HL readers, and low-skilled bilingual readers). Findings: The results indicate that dual inclusion into best friendships with both monolingual German as well as HL peers might be a favorable friendship pattern as it is positively related to both the skilled bilingual reading and the skilled ML reading outcome. Furthermore, we observe a tendency that skilled bilingual readers benefit from having a high-skilled HL speaking best friend. In addition, HL use with parents is an important predictor for HL skills, but not a hindrance for high ML proficiency. Effects of the peer group predictors are rather small, nevertheless they add value for explaining bilingual language outcomes controlling for relevant predictors.
Performance of a preventive care programme for osteoporosis in primary care settings in Singapore during the COVID-19 pandemic
Authors: Chong Chin Kwang , Chua Wei Ting , Wong Susie Ling Yii , Tham Tat Yean 
Published: January 2024

Background The Agency for Care Effectiveness of Singapore has advised primary care physicians to use osteoporosis screening tools to risk-stratify patients in the primary care setting. Objective This paper aims to report the uptake of a “Predict and Prevent” workflow for osteoporosis using risk scoring and BMD measurement in patients with chronic diseases seen in a network of primary care clinics in Singapore from 2020 to 2021. Methods A “Predict and Prevent” osteoporosis preventive care programme was implemented at a network of 11 primary care clinics. The programme included all adult patients that consulted at the clinic for a chronic condition. OSTA score was computed for each patient. All patients who consented to further fracture risk screening underwent FRAX scoring. Female patients with a high-risk OSTA score and females with diabetes with intermediate-risk OSTA score (per protocol), or those with high-risk FRAX score were recommended to undergo BMD measurement. Results Of the 6,332 adult patients with chronic diseases without baseline osteoporosis seen in the various clinics, 81.1% underwent OSTA scoring; 28.1% were intermediate risk and 7.0% were high risk. Among the per-protocol population ( n = 531), 38 (7.1%) underwent BMD testing. FRAX scoring (without BMD) was done on 939 patients (17.3%); 31.5% had a high hip fracture risk. Only 14 patients had FRAX with BMD; 57.1% had a high hip fracture risk. Conclusion A “Predict and Prevent” workflow could be implemented to screen, detect and potentially treat patients at high risk of osteoporosis. The rate of BMD measurement is low and needs to be improved.
The Effect of Mandatory Fitness Requirements on Cardiovascular Events: A State-by-State Analysis Using a National Database
Authors: Dzikowicz Dillon J. , Saoji Sankalp Babarao , Tam Wai Cheong , Brunner Wendy M. , Carey Mary G. 
Published: January 2024

Background: Cardiovascular events are known to be the leading cause of death among on-duty firefighters. Implementing fitness standards may help reduce the incidence of cardiovascular deaths; however, standards vary between firefighter type and states. We aimed to investigate the rate of cardiovascular events among firefighters across states. Methods: Using publicly available data from the United States Fire Administration, we explored the rates of cardiovascular deaths between firefighter type (e.g., career, volunteer, and wildland) and state. Specifically, we examined rates of cardiovascular deaths between California and Tennessee, which have fitness standards for all firefighters, and New York, which does not have fitness standards for volunteer firefighters. We used descriptive statistics and trend analysis to examine the data. Findings: Most cardiovascular events occur among volunteer firefighters (60.6%, n = 877). Volunteer firefighters had 7.5 (95% CI = [4.8, 11.7], p < .001) greater odds of cardiovascular events compared to wildland firefighters, who had the lowest incidence of cardiovascular events (1.7%, n = 24). New York reported the most cardiovascular events ( n = 161), primarily among volunteer firefighters (73.9%, n = 119). After the passage of legislation mandating fitness standards in California, a downtrend in the number of volunteer firefighter fatalities is observed. However, a null effect was observed in Tennessee after the passage of similar fitness standards as in California. Conclusions/Applications to Practice: Volunteer firefighters are significantly more likely to die of a cardiovascular event than career and wildland firefighters, both of which have stricter fitness standards. However, the effect of legislation mandating stricter fitness standards among volunteers did not produce a clear benefit for preventing fatalities. Nurses need to promote cardiovascular health among volunteer firefighters.
Movement patterns during gait initiation in older adults with various stages of frailty: a biomechanical analysis
Authors: Hommen Jana Maria , Batista João P. , Bollheimer L. Cornelius , Hildebrand Frank , Laurentius Thea , Siebers Hannah Lena 
Published: January 2024

Abstract
Background
Gait initiation is challenging for older individuals with poor physical function, particularly for those with frailty. Frailty is a geriatric syndrome associated with increased risk of illness, falls, and functional decline. This study examines whether spatial and temporal parameters of gait initiation differ between groups of older adults with different levels of frailty, and whether fear of falling, and balance ability are correlated with the height of lifting the food during gait initiation.

Methods
Sixty-one individuals aged > 65 years, classified by Fried frailty phenotype, performed five self-paced gait initiation trials. Data was collected using a three-dimensional passive optical motion capture system, consisting of 10 cameras with the ability to perceive reflective markers, and two force plates. The total duration of gait initiation and the duration of its four sub-phases, the first step length, and the maximum foot clearance during the first step were derived, and compared statistically between groups. Additionally, an association analysis was conducted between foot clearance and fear of falling, and confidence in balance in older individuals.

Results
Frail individuals had significantly longer unloading durations, and total durations of gait initiation compared to non-frail older adults. Additionally, they had shorter first step lengths compared to non-frail older adults. Pre-frail older adults also showed shorter steps compared to the non-frail group. However, there were no significant differences between groups for the maximum foot clearance during the first step. Nevertheless, the maximum foot clearance of older individuals correlated significantly with their fear of falling and confidence in balance.

Conclusion
Older adults with reduced physical function and signs of frailty mainly display longer duration of gait initiation and decreased first step length compared to non-frail older adults. The release phase is decreased as the double support phase is prolonged in frail patients. This information can guide the development of specialized exercise programs to improve mobility in this challenging motion between static and dynamic balance.
Physio-biochemical and metabolomic responses of the woody plant Dalbergia odorifera to salinity and waterlogging
Authors: Cisse El- Hadji Malick , Jiang Bai-Hui , Yin Li-Yan , Miao Ling-Feng , Li Da-Dong , Zhou Jing-Jing , Yang Fan 
Published: January 2024

Background
Trees have developed a broad spectrum of molecular mechanisms to counteract oxidative stress. Secondary metabolites via phenolic compounds emblematized the hidden bridge among plant kingdom, human health, and oxidative stress. Although studies have demonstrated that abiotic stresses can increase the production of medicinal compounds in plants, research comparing the efficiency of these stresses still needs to be explored. Thus, the present research paper provided an exhaustive comparative metabolomic study in Dalbergia odorifera under salinity (ST) and waterlogging (WL).

Results
High ST reduced D. odorifera's fresh biomass compared to WL. While WL only slightly affected leaf and vein size, ST had a significant negative impact. ST also caused more significant damage to water status and leaflet anatomy than WL. As a result, WL-treated seedlings exhibited better photosynthesis and an up-regulation of nonenzymatic pathways involved in scavenging reactive oxygen species. The metabolomic and physiological responses of D. odorifera under WL and salinity ST stress revealed an accumulation of secondary metabolites by the less aggressive stress (WL) to counterbalance the oxidative stress. Under WL, more metabolites were more regulated compared to ST. ST significantly altered the metabolite profile in D. odorifera leaflets, indicating its sensitivity to salinity. WL synthesized more metabolites involved in phenylpropanoid, flavone, flavonol, flavonoid, and isoflavonoid pathways than ST. Moreover, the down-regulation of L-phenylalanine correlated with increased p-coumarate, caffeate, and ferulate associated with better cell homeostasis and leaf anatomical indexes under WL.

Conclusions
From a pharmacological and medicinal perspective, WL improved larger phenolics with therapeutic values compared to ST. Therefore, the data showed evidence of the crucial role of medical tree species’ adaptability on ROS detoxification under environmental stresses that led to a significant accumulation of secondary metabolites with therapeutic value.
Association of T-wave electrocardiogram changes and type 2 diabetes: a cross-sectional sub-analysis of the MASHAD cohort population using the Minnesota coding system
Authors: Soflaei Saffar Sara , Nazar Eisa , Sahranavard Toktam , Fayedeh Farzad , Moodi Ghalibaf AmirAli , Ebrahimi Mahmoud , Alimi Hedieh , Shahri Bahram , Izadi-Moud Azadeh , Ferns Gordon A. , Ghodsi Alireza , Mehrabi Saeed , Tarhimi Milad , Esmaily Habibollah , Moohebati Mohsen , Ghayour-Mobarhan Majid 
Published: January 2024

Abstract
Background
Type 2 Diabetes Mellitus (T2DM) has become a major health concern with an increasing prevalence and is now one of the leading attributable causes of death globally. T2DM and cardiovascular disease are strongly associated and T2DM is an important independent risk factor for ischemic heart disease. T-wave abnormalities (TWA) on electrocardiogram (ECG) can indicate several pathologies including ischemia. In this study, we aimed to investigate the association between T2DM and T-wave changes using the Minnesota coding system.

Methods
A cross-sectional study was conducted on the MASHAD cohort study population. All participants of the cohort population were enrolled in the study. 12-lead ECG and Minnesota coding system (codes 5–1 to 5–4) were utilized for T-wave observation and interpretation. Regression models were used for the final evaluation with a level of significance being considered at p < 0.05.

Results
A total of 9035 participants aged 35–65 years old were included in the study, of whom 1273 were diabetic. The prevalence of code 5–2, 5–3, major and minor TWA were significantly higher in diabetics (p < 0.05). However, following adjustment for age, gender, and hypertension, the presence of TWAs was not significantly associated with T2DM (p > 0.05). Hypertension, age, and body mass index were significantly associated with T2DM (p < 0.05).

Conclusions
Although some T-wave abnormalities were more frequent in diabetics, they were not statistically associated with the presence of T2DM in our study.
Analysis of the survival time of patients with heart failure with reduced ejection fraction: a Bayesian approach via a competing risk parametric model
Authors: Norouzi Solmaz , Hajizadeh Ebrahim , Jafarabadi Mohammad Asghari , Mazloomzadeh Saeideh 
Published: January 2024

Abstract
Purpose
Heart failure (HF) is a widespread ailment and is a primary contributor to hospital admissions. The focus of this study was to identify factors affecting the extended-term survival of patients with HF, anticipate patient outcomes through cause-of-death analysis, and identify risk elements for preventive measures.

Methods
A total of 435 HF patients were enrolled from the medical records of the Rajaie Cardiovascular Medical and Research Center, covering data collected between March and August 2018. After a five-year follow-up (July 2023), patient outcomes were assessed based on the cause of death. The survival analysis was performed with the AFT method with the Bayesian approach in the presence of competing risks.

Results
Based on the results of the best model for HF-related mortality, age [time ratio = 0.98, confidence interval 95%: 0.96–0.99] and ADHF [TR = 0.11, 95% (CI): 0.01–0.44] were associated with a lower survival time. Chest pain in HF-related mortality [TR = 0.41, 95% (CI): 0.10–0.96] and in non-HF-related mortality [TR = 0.38, 95% (CI): 0.12–0.86] was associated with a lower survival time. The next significant variable in HF-related mortality was hyperlipidemia (yes): [TR = 0.34, 95% (CI): 0.13–0.64], and in non-HF-related mortality hyperlipidemia (yes): [TR = 0.60, 95% (CI): 0.37–0.90]. CAD [TR = 0.65, 95% (CI): 0.38–0.98], CKD [TR = 0.52, 95% (CI): 0.28–0.87], and AF [TR = 0.53, 95% (CI): 0.32–0.81] were other variables that were directly related to the reduction in survival time of patients with non-HF-related mortality.

Conclusion
The study identified distinct predictive factors for overall survival among patients with HF-related mortality or non-HF-related mortality. This differentiated approach based on the cause of death contributes to the estimation of patient survival time and provides valuable insights for clinical decision-making.
Successful clinical approach to the metastatic uterine leiomyosarcoma to the epicardium—a case report
Authors: Krzelj Kristina , Lekic Ante , Luksic Vlatka Reskovic , Milicic Davor , Ilic Ivana , Simetic Luka , Dzepina Zrinka Starcevic , Gasparovic Hrvoje , Biocina Bojan , Safradin Ivica 
Published: January 2024

Abstract
Background
Uterine leiomyosarcoma is a rare and aggressive tumour with a poor prognosis. Its metastases to the heart are even rarer, especially to the epicardium. The majority of reported cardiac metastases of uterine leiomyosarcoma were in the cardiac chambers or intramyocardial. Surgical resection of the uterine leiomyosarcoma in the early stages is the only definitive treatment for this disease. However, in the cases of cardiac metastasis, surgery is recommended only in emergencies and patients with expected beneficial outcomes.

Case presentation
Our patient was a 49-year-old female referred to the Department of Cardiac Surgery for scheduled surgery of pericardial neoplasia. The patient underwent a hysterectomy and adnexectomy three years prior owing to the uterine leiomyosarcoma. A regular follow-up magnetic resonance imaging of the abdomen and pelvis discovered neoplasia in the diaphragmic portion of the pericardium. No other signs of primary disease relapse or metastases were found. The patient was asymptomatic. The multidisciplinary team concluded that the patient is a candidate for surgery. Surgery included diastolic cardiac arrest achievement and resection of the tumour. Macroscopically, a parietal layer of the pericardium was completely free from the tumour that invaded only the apical myocardium of the left ventricle. Completed histopathology confirmed the diagnosis of leiomyosarcoma of the uterine origin. Three months after surgery, the patient received adjuvant chemotherapy with doxorubicin and dacarbazine. One year after surgery, there are no signs of new metastases.

Conclusions
Strict surveillance of patients with uterine leiomyosarcoma after successful treatment of the early stage of the disease is of utmost importance to reveal metastatic disease to the heart in a timely manner and to treat it with beneficial outcomes. Surgery with adjuvant chemotherapy might be a good approach in patients with a beneficial prognosis. From a surgical point of view, it is challenging to assess the appropriate width of the resection edges to be radical enough and, at the same time, sufficiently conservative to ensure the satisfactory postoperative function of the remaining myocardium and avoid repetitive tumour growth. Therefore, intraoperative histopathology should always be performed.