bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supplementary orthopaedic screening for children and adolescents to prevent permanent skeletal deformities – protocol for the “OrthoKids” study
Authors: Scheckel B. , Naumann M. , Simic D. , Stock S. , Loose O. , Breig M. , Albrecht K. , Braun K. , Kucher R. , Deininger S. , Schmid L. , John M. , Grohnert A. , Giertz C. , Wirth T. 
Published: November 2023

AbstractBackgroundSkeletal deformities (SD) in children and adolescents can lead to arthritic conditions, impairment of quality of life, and high treatment costs in the long term. However, comprehensive data on the prevalence of SDs in children and adolescents are limited and it remains therefore unclear whether there is a healthcare gap. “OrthoKids” is a project that addresses this evidence gap by implementing an orthopaedic screening for children and adolescents that supplements existing detection examinations within statutory standard care in Germany.ObjectiveTo detect SDs so that they can be treated as needed at an early stage.MethodsThe implementation of the supplementary orthopaedic screening will be evaluated through an exploratory cohort study that is set up in the German state Baden-Wuerttemberg. 20,000 children and adolescents aged 10 to 14 years will be recruited as a prospective cohort. A retrospective control cohort will be formed based on claims data provided by two cooperating statutory health insurances (SHIs). Participating children and adolescents receive a one-time orthopaedic screening. If at least one SD is diagnosed, treatment will be provided as part of the statutory standard care. Within the scope of the project, a follow-up examination will be performed after one year. An IT-platform will complement the study. The primary outcome measure is the point prevalence of scoliosis, genu varum/valgum, hip dysplasia, and flat feet. Secondary outcome measures are (i) the point prevalence of further less common SDs, (ii) health-related quality of life (HRQoL), (iii) sports ability based on activity (physical/athletic), physical constraints, and (sports) injuries, as well as (iv) monetary consequences of the orthopaedic screenings’ implementation. Implementation determinants will be evaluated, too.DiscussionIf the supplementary orthopaedic screening proves to be viable, it could be considered as a supplementary examination for children and adolescents within the frame of SHI in Germany. This could relieve the burden of disease among children and adolescents with SDs. In addition, it could disburden SHIs in the medium to long term.Trial registrationThe OrthoKids study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) on 26th July 2022 under the number 00029057.
Nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure: a context-based study
Authors: Akbarian-Rokni Mostafa , Mardani-Hamooleh Marjan , Abbasi Mohammad , Seyedfatemi Naima , Pezaro Sally 
Published: November 2023

Abstract
Background
High quality end-of-life care is essential. Yet for those experiencing heart failure, the provision of high-quality end- of -life care can be challenging. The aim of this study was to explore Iranian nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure.

Methods
Conventional content analysis was used to analyze qualitative data collected from nurses (n = 33) using semi-structured and individual interviews. Participants were aged between 29 and 51 years. The majority of participants were women (n = 20). Most had a bachelor’s degree (n = 24), and work experience of between 7 and 18 years.

Results
Nurses challenges in providing end-of-life care to those with heart failure included (1) adverse consequences relating to compassion fatigue and continued futility in care and (2) lack of palliative care services with regards to a lack of specialists, lack of support from health systems, and poor teamwork.

Conclusions
This is the first qualitative study to explore Iranian nurses’ challenges in providing end-of-life care to those with heart failure. Investment is required in education and research in this area. Particular attention must be paid to prevention of compassion fatigue. Law changes would enable the delivery of higher-quality palliative care in this context overall.
Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan
Authors: Haq Zia Ul , Sher Zarghona Fazal , Khattak Farhad Ali , Zala  , Hakim Muhammad , Ullah Naeem , Rahim Abid , Hussain Umar , Afaq Saima 
Published: November 2023

Abstract
Background
The COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives.

Methods
A cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.

Results
A total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn’t receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn’t receive training, labeled as “high risk” compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10–0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25–0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23–12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don’t have skills to wear them.

Conclusion
Our findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.
Standardizing post-cardiac arrest care across rural–urban settings – qualitative findings on proposed post-cardiac arrest learning community intervention
Authors: May Teresa L , Siladi Skye , Daley Alison L , Riker Richard , Zanichkowsky Rita , Burla Michael , Swan Erica , Talbot Jean A 
Published: November 2023

Abstract
Background
Standardization of post-cardiac arrest care between emergency department arrival and intensive care unit admission can be challenging, particularly for rural centers, which can experience significant delays in interfacility transfer. One approach to addressing this issue is to form a post-cardiac arrest learning community (P-CALC) consisting of emergency department (ED) and intensive care unit (ICU) physicians and nurses who use data, shared resources, and collaboration to improve post-cardiac arrest care. MaineHealth, the largest regional health system in Maine, launched its P-CALC in 2022.

Objective
To explore P-CALC participants’ perspectives on current post-cardiac arrest care, attitudes toward implementing a P-CALC intervention, perceived barriers and facilitators to intervention implementation, and implementation strategies.

Methods
We conducted semi-structured, individual, qualitative interviews with 16 staff from seven system EDs spanning the rural–urban spectrum. Directed content analysis was used to discern key themes in transcribed interviews.

Results
Participants highlighted site- and system-level factors influencing current post-cardiac arrest care. They expressed both positive attitudes and concerns about the P-CALC intervention. Multiple facilitators and barriers were identified in regard to the intervention implementation. Five proposed implementation strategies emerged as important factors to move the intervention forward.

Conclusions
Implementation of a P-CALC intervention to effect system-wide improvements in post-cardiac arrest care is complex. Understanding providers’ perspectives on current care practices, feasibility of quality improvement, and potential intervention impacts is essential for program development.
Leveraging transcriptomics to develop bronchopulmonary dysplasia endotypes: a concept paper
Authors: Moreira Alvaro G. , Arora Tanima , Arya Shreyas , Winter Caitlyn , Valadie Charles T. , Kwinta Przemko 
Published: November 2023

Abstract
Impact
Bronchopulmonary dysplasia has multiple definitions that are currently based on phenotypic characteristics. Using an unsupervised machine learning approach, we created BPD subclasses (e.g., endotypes) by clustering whole microarray data. T helper 17 cell differentiation was the most significant pathway differentiating the BPD endotypes.

Introduction
Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity. Discovery of BPD endotypes in an unbiased format, derived from the peripheral blood transcriptome, may uncover patterns underpinning this complex lung disease.

Methods
An unsupervised agglomerative hierarchical clustering approach applied to genome-wide expression of profiling from 62 children at day of life five was used to identify BPD endotypes. To identify which genes were differentially expressed across the BPD endotypes, we formulated a linear model based on least-squares minimization with empirical Bayes statistics.

Results
Four BPD endotypes (A, B,C,D) were identified using 7,319 differentially expressed genes. Across BPD endotypes, 5,850 genes had a p value < 0.05 after multiple comparison testing. Endotype A consisted of neonates with a higher gestational age and birthweight. Endotypes B-D included neonates between 25 and 26 weeks and a birthweight range of 640 to 940 g. Endotype D appeared to have a protective role against BPD compared to Endotypes B and C (36% vs. 62% vs. 60%, respectively). The most significant pathway focused on T helper 17 cell differentiation.

Conclusion
Bioinformatic analyses can help identify BPD endotypes that associate with clinical definitions of BPD.
Efficacy and nephrotoxicity of polymyxin B in elderly patients with carbapenem resistant bacterial infection
Authors: Xia G. L. , Xu X. , You X. B. , Wang X. , Feng D. D. , Lei S. , Jiang R. L. 
Published: November 2023

Abstract
Background
To study the efficacy and nephrotoxicity of polymyxin B in the treatment of elderly patients with carbapenem-resistant organism (CRO) infection.

Methods
The clinical and microbiological data of patients with CRO-infected sepsis treated with polymyxin B were retrospectively analyzed. The effective rate, bacterial clearance, incidence and recovery rate of acute renal injury (AKI) and prognosis-related indicators in AKI at different stages were compared.

Results
The effective rate of 215 elderly patients with CRO infection treated with polymyxin was 50.7%. The total bacterial clearance rate was 44.2%, the total incidence of AKI was 37.2%, the recovery rate of AKI was 35%, and the incidence range of polymyxin B-related AKI was 10.2–37.2%. Logistic multivariate regression analysis showed that the predictors of AKI in elderly patients were high APACHE II score, long duration of polymyxin, chronic renal insufficiency and ineffective outcome; the ROC curve showed that the cutoff value for predicting AKI was a serum creatinine concentration of 73 mmol/L before polymyxin B use, and the AUC was 0.931.

Conclusions
Rational use of polymyxin B is safe and effective in elderly patients with CRO infection, and its effective outcome can improve the recovery rate of AKI.
Mannose-doped metal-organic frameworks induce tumor cell pyroptosis via the PERK pathway
Authors: Jin Nianqiang , Wang Binhang , Liu Xinyao , Yin Chengcheng , Li Xing , Wang Zilin , Chen Xi , Liu Yunling , Bu Wenhuan , Sun Hongchen 
Published: November 2023

Abstract
Background
The implementation of pyroptosis exhibits significant potential as a tactic to enhance tumor immune microenvironments. Previous applications of pyroptosis inducers have encountered various limitations, such as the development of drug resistance, manifestation of toxic side effects, and a deficiency in targeting capabilities. As a result, there is a growing demand for tumor therapeutic molecules that can overcome these obstacles. Therefore, the objective of this study is to develop a multifunctional nanospheres that addresses these challenges by enabling high-precision targeting of tumor cells and inducing effective pyroptosis.

Results
We prepared a mannose-modified MOF called mannose-doped Fe3O4@NH2-MIL-100 (M-FNM). M-FNM could enter CAL27 cells through MR-mediated endocytosis, which caused in a significant increase in the level of intracellular ROS. This increase subsequently triggered ER stress and activated the PERK-eIF2α-ATF4-CHOP signaling pathway. CHOP then mediated the downstream cascade of Caspase-1, inducing pyroptosis. In in vivo experiments, M-FNM demonstrated excellent targeting ability and exhibited anti-tumor effects. Additionally, M-FNM reshaped the immune microenvironment by promoting the infiltration of anti-tumor immune cells, primarily T lymphocytes.

Conclusions
M-FNM significantly decreased tumor growth. This novel approach to induce pyroptosis in tumor cells using M-FNM may offer new avenues for the development of effective immunotherapies against cancer.
Clinical characteristics and prognostic factors for primary pediatric and adolescent Non-Hodgkin Lymphomas of the gastrointestinal tract: a population-based study
Authors: Wu Peng , Zhu Dongsheng , Lou Yi , Wang Xinxin 
Published: November 2023

Abstract
Purpose
To investigate the clinical features and survival outcomes of primary gastrointestinal non-Hodgkin lymphomas (PGINHL) in pediatric and adolescent population, we conducted a population-based cohort study.

Methods
All pediatric and adolescent patients with PGINHL diagnosed between 2000 and 2019 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Kaplane-Meier estimations were used to generate survival curves based on various criteria. To compare survival curves, the log-rank test was applied. A multivariate Cox proportional hazards model was developed to investigate the effect of each component on overall survival.

Results
A total of 334 pediatric and adolescent with PGINHL patients were identified. The median age at diagnosis was 12 years (range 1.0–19 years). Tumors were most commonly found in the small bowel (47.3%), followed by the large bowel (42.8%) and the stomach (9.9%). Overall, the most common histological subtype was Burkitt lymphoma (56.9%), followed by diffuse large B-cell lymphoma (DLBCL) (27.8%). Overall survival rates for all patients were 92.2% at 5- year and 91.6% at 10- year, respectively. The Cox proportional hazard regression revealed that only chemotherapy was an important independent predictor in this model. Patients with chemotherapy have a higher survival rate than those without.

Conclusions
Our study revealed that only chemotherapy was found to be the most important predictor of the OS in pediatric and adolescent PGINHL, providing critical information for therapeutic care.
Ethnobotanical study of traditional forage plants in the Gansu–Ningxia–Inner Mongolia junction zone: conservation and sustainable utilization for animal husbandry
Authors: Xie Jian , Liu Xiaoqi , Luo Mingxia , Liu Fusong , Liu Sha , Zhao Yongxia , Zhang Xingsheng , Zhao Wenji , Wu Faming 
Published: November 2023

Abstract
Introduction
This study aims to safeguard the ethnobotanical knowledge pertaining to traditional forage plants within the ethnically diverse Gansu–Ningxia–Inner Mongolia junction zone. It seeks to establish a foundation for the sustainable utilization of these traditional resources for animal husbandry.

Methods
A combination of literature research, village interviews, participatory observation, and ethnobotanical quantitative evaluation methods was employed to investigate and study the traditional knowledge of wild forage plants used by local residents in the study area.

Results
Local residents provided information on 73 forage plants, which were identified as 116 distinct wild forage plant species. These plants belong to 22 families and play an active role in the lives of the local inhabitants. Notably, the families Poaceae, Fabaceae, and Asteraceae are prominent, comprising the most abundant and widely utilized wild forage plants. Bing Cao (collectively referring to plants of the Agropyron, Leymus, and Psammochloa), Suo Cao (collectively referring to plants of the genus Stipa), and Ku Cai (encompassing Lactuca tatarica (L.) C.A.Mey. and Ixeris polycephala Cass.) emerge as the most representative and vital wild forage plants for animal husbandry. Additionally, plants within the Astragalus (referred to collectively as NiaoZi by local residents) in the Fabaceae family, as well as plants from the Amaranthaceae family, exhibit notable significance.

Conclusion
Animal husbandry assumes a pivotal role in the local agricultural economy, and the 116 wild forage plants investigated hold substantial importance in its development. Among these, 59 and 103 plant resources display high developmental potential, making them prospective candidates for high-quality cultivated forage grasses. Additionally, extensive grazing practices have resulted in significant ecological degradation within this already fragile ecosystem. The cultivation of forage grasses and the practice of pen-based animal husbandry may emerge as crucial strategies for sustainable development in this area.
Dissecting the autism-associated 16p11.2 locus identifies multiple drivers in neuroanatomical phenotypes and unveils a male-specific role for the major vault protein
Authors: Kretz Perrine F. , Wagner Christel , Mikhaleva Anna , Montillot Charlotte , Hugel Sylvain , Morella Ilaria , Kannan Meghna , Fischer Marie-Christine , Milhau Maxence , Yalcin Ipek , Brambilla Riccardo , Selloum Mohammed , Herault Yann , Reymond Alexandre , Collins Stephan C. , Yalcin Binnaz 
Published: November 2023

Abstract
Background
Using mouse genetic studies and systematic assessments of brain neuroanatomical phenotypes, we set out to identify which of the 30 genes causes brain defects at the autism-associated 16p11.2 locus.

Results
We show that multiple genes mapping to this region interact to regulate brain anatomy, with female mice exhibiting far fewer brain neuroanatomical phenotypes. In male mice, among the 13 genes associated with neuroanatomical defects (Mvp, Ppp4c, Zg16, Taok2, Slx1b, Maz, Fam57b, Bola2, Tbx6, Qprt, Spn, Hirip3, and Doc2a), Mvp is the top driver implicated in phenotypes pertaining to brain, cortex, hippocampus, ventricles, and corpus callosum sizes. The major vault protein (MVP), the main component of the vault organelle, is a conserved protein found in eukaryotic cells, yet its function is not understood. Here, we find MVP expression highly specific to the limbic system and show that Mvp regulates neuronal morphology, postnatally and specifically in males. We also recapitulate a previously reported genetic interaction and show that Mvp+/−;Mapk3+/− mice exhibit behavioral deficits, notably decreased anxiety-like traits detected in the elevated plus maze and open field paradigms.

Conclusions
Our study highlights multiple gene drivers in neuroanatomical phenotypes, interacting with each other through complex relationships. It also provides the first evidence for the involvement of the major vault protein in the regulation of brain size and neuroanatomy, specifically in male mice.
Statistical analysis plan for the LAKANA trial: a cluster-randomized, placebo-controlled, double-blinded, parallel group, three-arm clinical trial testing the effects of mass drug administration of azithromycin on mortality and other outcomes among 1–11-month-old infants in Mali
Authors: Luoma Juho , Adubra Laura , Alber Dagmar , Ashorn Per , Ashorn Ulla , Cloutman-Green Elaine , Diallo Fatoumata , Ducker Camilla , Elovainio Riku , Fan Yue-Mei , Gates Lily , Gruffudd Gwydion , Haapaniemi Tiia , Haidara Fadima , Hallamaa Lotta , Ihamuotila Rikhard , Klein Nigel , Martell Owen , Sow Samba , Vehmasto Taru , Cheung Yin Bun 
Published: November 2023

AbstractBackgroundThe Large-scale Assessment of the Key health-promoting Activities of two New mass drug administration regimens with Azithromycin (LAKANA) trial in Mali aims to evaluate the efficacy and safety of azithromycin (AZI) mass drug administration (MDA) to 1–11-month-old infants as well as the impact of the intervention on antimicrobial resistance (AMR) and mechanisms of action of azithromycin. To improve the transparency and quality of this clinical trial, we prepared this statistical analysis plan (SAP).Methods/designLAKANA is a cluster randomized trial that aims to address the mortality and health impacts of biannual and quarterly AZI MDA. AZI is given to 1–11-month-old infants in a high-mortality setting where a seasonal malaria chemoprevention (SMC) program is in place. The participating villages are randomly assigned to placebo (control), two-dose AZI (biannual azithromycin-MDA), and four-dose AZI (quarterly azithromycin-MDA) in a 3:4:2 ratio. The primary outcome of the study is mortality among the intention-to-treat population of 1–11-month-old infants. We will evaluate relative risk reduction between the study arms using a mixed-effects Poisson model with random intercepts for villages, using log link function with person-years as an offset variable. We will model outcomes related to secondary objectives of the study using generalized linear models with considerations on clustering.ConclusionThe SAP written prior to data collection completion will help avoid reporting bias and data-driven analysis for the primary and secondary aims of the trial. If there are deviations from the analysis methods described here, they will be described and justified in the publications of the trial results.Trial registrationClinicalTrials.gov IDNCT04424511. Registered on 11 June 2020.