bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facilitating active participation in anticoagulant decisions in advanced kidney disease: co-production of a question prompt list
Authors: Parker Kathrine , Needham Abigail , Thachil Jecko , Mitra Sandip , Lewis Penny 
Published: January 2025

Abstract

Background
People with chronic kidney disease are at increased risk of thrombotic and bleeding episodes making anticoagulant treatment decisions challenging. Currently, there are no support tools for people with chronic kidney disease regarding anticoagulant therapy decisions. This work aimed to co-produce materials to support shared-decision making when considering anticoagulant use in advanced chronic kidney disease.

Methods
Focus groups were undertaken to explore the views of people with kidney disease towards anticoagulant prescribing. Data was thematically analysed based on Makoul and Clayman’s model of shared-decision making. Co-production methods were used to develop a question prompt list based on themes from the focus groups in conjunction with people with kidney disease over three meetings.

Results
A question prompt list, to be used by patients when initiated on anticoagulant therapy, was co-produced. These questions were based upon participants’ experiences of the various stages of shared-decision making within the context of anticoagulant use in advanced chronic kidney disease. Of particular importance to participants was the individualised discussion around treatment risks and follow up arrangements.

Conclusion
Shared-decision making is important when initiating medication to ensure the best outcomes for patients, yet it can be difficult to engage in shared-decision making without prompts or guidance. This co-produced question prompt list could be included as part of national guideline to support shared-decision making for anticoagulant initiation in patients with advanced chronic kidney disease.
Self-administered active versus sham acupressure for diarrhea predominant irritable bowel syndrome: a nurse-led randomized clinical trial
Authors: Asal Maha Gamal Ramadan , El-Sayed Ahmed Abdelwahab Ibrahim , Alsenany Samira Ahmed , Ramzy Zahraa Hassan , Dawood Rasha Fathy Ahmed 
Published: January 2025

Abstract

Background
Diarrhea-predominant irritable bowel syndrome (IBS-D) significantly impacts patients’ quality of life, with existing treatments offering limited relief. Self-administered acupressure presents a potential non-invasive, cost-effective treatment option that could alleviate symptoms and enhance health outcomes in these patients.

Aim
This randomized controlled trial aimed to evaluate the effect of active acupressure compared to sham acupressure on primary and secondary outcomes among IBS-D patients.

Method
The study included 63 patients with IBS-D, recruited from Alexandria Main University Hospital, Egypt. Participants were randomized into either an active acupressure group or a sham acupressure group. Both groups underwent two days of training, followed by four weeks of intervention. The active group applied pressure to specific therapeutic acupoints, while the sham group used non-therapeutic points. Outcomes were assessed at baseline, week 2, and week 4.

Results
The active acupressure group showed a significant reduction in symptom severity, improved stool consistency, and frequency, and greater adequate symptom relief by week 4 compared to the sham group. Psychological outcomes, including anxiety and depression, also improved significantly in the active group. Additionally, the active group reported reduced use of rescue medications.

Conclusion
Active acupressure is an effective nursing intervention for alleviating symptoms of IBS-D, particularly when applied consistently over time. It improves both physical and psychological outcomes, offering a valuable non-pharmacological treatment option.

Implications
Nurses can integrate self-administered acupressure into IBS-D care plans, teaching patients this technique to manage symptoms independently, thus enhancing their quality of life (QOL) and reducing reliance on conventional medications. This intervention aligns with holistic nursing care and offers a cost-effective, patient-friendly solution for managing IBS-D.

Trial registration
This study was prospectively registered as a randomized controlled trial in https://clinicaltrials.gov/ Registration Date: January 7, 2023, Registration Number: NCT05702255.
Barriers to and facilitators of healthcare professionals in ADR reporting in a tertiary care hospital in India
Authors: N Ian Osoro , KP Suhaib , R Jamuna Rani , MG Rajanandh 
Published: January 2025

Abstract

Introduction
Several adverse drug reactions (ADRs) go unreported within a healthcare setting despite the risks they cause. We therefore decided to conduct this study in order to recognize the obstacles that hinder the healthcare professionals (HCPs) in a tertiary care hospital in Kattankulathur, Tamil Nadu from reporting ADRs and what strategies ought to be implemented.

Methods
We carried out a cross-sectional study among the HCPs such as doctors, pharmacists and nurses within our institution. A pre-validated questionnaire was used to collect data on the socio-demographics, barriers and facilitators in reporting ADR. A 2 weeks timeline was given to the HCPs to fill the questionnaire forms. Out of the 107 forms distributed, we received 80 of them that were duly filled. Data was analyzed using IBM SPSS version 26.

Results
Out of the 80 HCPs, only 22 of them had reported any ADRs in their career. 52% of our HCPs reported the lack of understanding of ADR reporting mechanism as their main hindrance. Additionally, 25 (31%) of the HCPs stated that reporting ADRs is time consuming. 18 (22%) of them reported a fear of legal liability. 13 (16%) of them stated that the reporting from is complicated and 29 (36%) stated a lack of motivation as the reason for not reporting ADR. Majority of our HCPs 76 (95%) recommended the need for continuous medical education and training as the best strategy to improve ADR reporting.

Conclusion
Barriers such as time constraints, workload pressures and competing priorities often hinder HCPs from dedicating adequate attention to ADR reporting. The inclusion of topics related to ADR reporting in the curriculum (i.e. clinical pharmacology) and increased awareness from the ADR monitoring centre were seen to be significant facilitators to enhance ADR reporting among health care practitioners.
An antibacterial, antioxidant and hemostatic hydrogel accelerates infectious wound healing
Authors: Zhou Ziyi , Zhang Dengjun , Ning Xuchao , Jin Linbo , Lin Yijing , Liang Chen , Wen Xin , Huang Tianhao , Zhou Junli , Zhang Yiming 
Published: January 2025

Abstract
Hydrogel drug-delivery system that can effectively load antibacterial drugs, realize the in-situ drug release in the microenvironment of wound infection to promote wound healing. In this study, a multifunctional hydrogel drug delivery system (HA@TA-Okra) was constructed through the integration of hyaluronic acid methacrylate (HAMA) matrix with tannic acid (TA) and okra extract. The composition and structural characteristics of HA@TA-Okra system and its unique advantages in the treatment of diverse wounds were systematically evaluated. TA, due to its unique chemical structure, is able to anchor within the HAMA network through interactions and cross-linking, conferring exceptional mechanical strength and stability to the hydrogel. Both TA and okra extract possess antioxidant and antibacterial properties, and when they two acts synergistically they can effectively scavenge free radicals, enhance antibacterial action, diminishing the risk of wound infection. In vitro experiments revealed that HA@TA-Okra system has superior properties, such as rapid gel response, remarkable swelling regulation, and potent antioxidant ability. Furthermore, the HA@TA-Okra system significantly outperformed conventional dressings in terms of hemostatic performance in a rat hemorrhage model. We further evaluated the repair role of HA@TA-Okra system in vivo by establishing an animal model of full-thickness skin defects and a model of infected total skin defects. The results confirmed its positive effects in fighting bacterial infection, reducing inflammation and promoting wound healing. In summary, the HA@TA-Okra system exhibits comprehensive properties such as antibacterial, antioxidant and hemostatic properties, which has a potential application in the field of tissue repair medicine.

Graphical Abstract
Overuse of medical imaging and effects of payer-provider integration: quasi-experimental evidence from Finland
Authors: Lavaste Konsta 
Published: January 2025

Abstract

Background
Healthcare expenditures have risen in middle- and high-income countries. One of the potential contributors is the overuse of diagnostics. I explore whether medical imaging is overused when privately owned clinics in Finland treat patients with voluntary private health insurance (VPHI).

Methods
I employ administrative insurance claims data from a major Finnish insurance company, covering 2016–2019, and exploit two market entries of clinics owned by the company in 2017. The underlying assumption is that the insurance company’s own clinics had weaker incentives to overuse imaging than other privately owned clinics because the payer and the provider belonged to the same entity. I identify the overuse using the staggered difference-in-differences (DID) strategy, in which I consider patients from cities with a market entry as the treatment group and compare them to patients in other similar cities.

Results
I find that the market entries decreased the use of radiography and ultrasound imaging in the treatment of VPHI policyholders, suggesting that private clinics overused these imaging technologies. The more expensive computed tomography (CT) and magnetic resonance imaging (MRI) were, however, not overused.

Conclusions
The results show that private clinics in Finland overused some imaging technologies when treating VPHI policyholders. The extent and magnitude of overuse can, however, vary considerably between imaging technologies and medical ailments.
Synergistic antimicrobial activity of essential oils mixture of Moringa oleifera, Cinnamomum verum and Nigella sativa against Staphylococcus aureus using L-optimal mixture design
Authors: Abu-Hussien Samah H. , Nasry Antony R. , Samy Ziad , El-Sayed Salwa M. , Bakry Ashraf , Ebeed Naglaa , Elhariry Hesham , ElNoby Thanaa 
Published: January 2025

Abstract
The urgent need to address the growing problem of antimicrobial resistance in multidrug-resistant bacteria requires the development of pioneering approaches to treatment. The present study aims to evaluate the antimicrobial potential of the essential oils (EOs) of Moringa oleifera (moringa), Cinnamomum verum (cinnamon), and Nigella sativa (black seed) and the synergistic effect of the mixture of these oils against Staphylococcus aureus MCC 1351. Statistical modeling revealed cinnamon oil had the highest individual antimicrobial potency, followed by black seed oil. The combination of the three EOs exhibited significant synergistic effects compared to the individual oils, with a Fractional Inhibitory Concentration (∑FIC) index of 0.27. L-Optimal mixture design of response surface methodology (RSM) identified the optimal mixture as moringa: cinnamon: black seed oils by the ratio of (1:1:1) in run 15 (0.338:0.307:0.355 mL) (v/v). This mixture exhibited significant antibacterial efficacy, outperforming individual oils and conventional antibiotics like tetracycline. Specifically, the combination reduced the MIC values from 3.12, 0.78, and 6.25 to 0.25, 0.06, and 0.78 μg/mL for moringa, cinnamon, and black seed oil, respectively. Synergistic interactions between oils further boosted efficacy, with moringa-cinnamon and cinnamon-black seed pairings exhibiting the strongest synergies. The developed predictive models for IZD and MIC showed excellent fit, with R2 values of 0.9843 and 0.9958, respectively. Pareto chart analysis highlighted the predominant individual and synergistic effects, with the Moringa-Cinnamon interaction exhibiting the highest positive synergy. Notably, the oil mixture of run 15 demonstrated excellent biocompatibility, maintaining 97.6% viability of normal human skin fibroblasts (HSF) after 24 h exposure to 200 μL EOs of the mixture per mL. Gas chromatography mass spectrometry (GC/MS) identified abundant bioactive phytochemicals like cinnamaldehyde, linoleic acid, and palmitic acid methyl esters underlying the observed antimicrobial effects. This rationally designed, synergistic phytochemical combination presents a promising natural therapeutic against antibiotic-resistant S. aureus while exhibiting minimal cytotoxicity. The results underscore how combining essential oils could help address the issue of antibiotic resistance in S. aureus.
Perspectives and experiences regarding pre-exposure prophylaxis (PrEP) in a community sample of Veterans with unhealthy alcohol use: overall and across sexual orientation and gender identity
Authors: Fletcher Olivia V. , Beaver Kristine , Austin Elizabeth J. , van Draanen Jenna , Edelman E. Jennifer , Williams Emily C. 
Published: January 2025

Abstract

Background
Unhealthy alcohol use is an independent, modifiable risk factor for HIV, but limited research addresses alcohol use and HIV prevention synergistically. Groups that experience chronic stigma, discrimination, and/or other marginalization, such as sexual and gender minoritized groups, may have enhanced HIV risk related to unhealthy alcohol use. We described awareness of and experiences with pre-exposure prophylaxis (PrEP) among a community sample of Veterans reporting unhealthy alcohol use (relative to those without), overall and across self-reported sexual orientation and gender identity.

Methods
Using data collected from a national online survey of Veterans recruited via Facebook ads, community organizations, and listservs, we assessed variation in four PrEP outcomes (knowledge, experience, willingness, and conversations with doctors) across patterns of unhealthy alcohol use among all respondents reporting any lifetime drinking (n = 1,041) and then within sexual orientation and gender identity groups using Chi-square or Fisher’s exact tests.

Results
Among 1,041 eligible Veterans, 440 (42%) screened positive for unhealthy alcohol use. Veterans with unhealthy alcohol use were not more likely to have heard of PrEP (58.2% vs. 55.4%, p = 0.37), but trended toward more likely to have taken PrEP (7.5% vs. 5.0%, p = 0.09), to be willing to take PrEP (30.5% vs. 27.6%, p = 0.06), and to have spoken with a doctor about PrEP (11.4% vs. 7.7%, p = 0.04). Those with heavy episodic drinking also trended toward higher prevalence of PrEP awareness (60.0% vs. 54.6%, p = 0.09), and were more likely to have taken PrEP (8.3% vs. 4.7%, p = 0.02), to be willing to use PrEP (34.6% vs. 25.5%, p < 0.01), and to have had conversations with doctors about PrEP (12.7% vs. 7.2%, p < 0.01). Similar patterns were observed for severe unhealthy alcohol use and past-year frequent heavy episodic drinking. Generally, sexual/gender minoritized Veterans with unhealthy alcohol use reported more PrEP-affirming responses than those without but associations with unhealthy alcohol use were similar.

Conclusions
Unhealthy alcohol use was prevalent, particularly among Veterans with minoritized sexual orientation/gender identity, but not clearly linked to increased PrEP-literacy and use despite its known status as an HIV risk factor. Across groups, > 25% of individuals were willing to take PrEP. Interventions targeting both alcohol use and HIV prevention should capitalize on this.
Maritime logistics and economic growth in the context of APEC: a two-stage data envelopment analysis study
Authors: Delfin-Ortega Odette 
Published: January 2025

Abstract
The objective of this research is to analyze the factors influencing port efficiency from 2000 to 2023 using data envelopment analysis methodology and a dynamic ordinary least squares econometric model. In the first phase, the evaluation of port efficiency revealed an average score of 52%; with 10 ports showing high efficiency and two ports with efficiency below 1%. The results indicated the need for strategies to improve port efficiency in the region as enhancing infrastructure, streamlining processes, and improving logistics. In the second phase, Gross domestic product (GDP) per capita, the economically active population, and connectivity were used as independent variables to examine their impact on efficiency. The dynamic ordinary least squares model revealed that GDP per capita is the most influential factor in port efficiency, followed by maritime connectivity. These findings suggest that economic capacity and logistic networks are fundamental for improving port efficiency. On the other hand, the economically active population had a lesser impact, highlighting the importance of having a highly skilled workforce. The research concludes that it is crucial for port authorities to invest in infrastructure and human capital development to achieve more efficient and competitive ports. These efforts should focus on improving connectivity and promoting economic growth, which is essential for the sustainable development of the port sector.
Evaluation of aerosol loading and its relationship with geopotential height in Nigeria’s Guinea Coast
Authors: Ibe Onyinyechi Caroline , Nwofor Okechukwu Kelechi , Okoro Ugochukwu Kingsley 
Published: January 2025

Abstract
Climate variability and atmospheric changes significantly affect weather patterns and human activities. Aerosols impact the Earth's climate by influencing cloud formation, scattering radiation, and cooling the planet. However, aerosols, like black carbon, absorb and reemit radiation, contributing to global warming. This study aims to assess aerosol optical depth (AOD) over Nigeria's Guinea Coast, compare aerosol loading across the region, examine the relationship between aerosol loading and geopotential height, and explore the impact of meteorological variables on aerosol levels. AOD data were sourced from MODIS, while geopotential height and meteorological data was obtained from MERRA-2. The study found significant aerosol loading during the dry season, particularly along the coastal region (Lagos, Warri, and Port Harcourt), and lower AOD during the wet season. Geopotential height values were higher during the wet season, especially at 1000-hPa and 850-hPa. A positive correlation was found between AOD and geopotential height. Wind speeds were higher in the north and along the coast, with specific humidity at 1000-hPa directly correlating with geopotential height and inversely with wind speed. The study also showed that the annual AOD distribution mirrors geopotential height patterns at 1000-hPa, with higher values in southern Nigeria. In conclusion, aerosol loading is higher during the dry season, particularly in coastal regions and at lower atmospheric levels. The study highlights how seasonal changes and geographical factors influence aerosol distribution. It also shows that geopotential height strongly affects aerosol concentration, with higher heights linked to increased AOD. This underscores the importance of surface-level aerosols for human health, agriculture, and visibility, and suggests that geopotential height influences where aerosol loading is highest.
Attosecond microscopy —Advances and outlook
Authors: Vogelsang J. , Mikkelsen A. , Ropers C. , Gaida J. H. , Garg M. , Kern K. , Miao J. , Schultze M. , Ossiander M. 
Published: January 2025

Abstract
Attosecond microscopy aims to record electron movement on its natural length and time scale. It is a gateway to understanding the interaction of matter and light, the coupling between excitations in solids, and the resulting energy flow and decoherence behavior, but it demands simultaneous temporal and spatial resolution. Modern science has conquered these scales independently, with ultrafast light sources providing sub-femtosecond pulses and advanced microscopes achieving sub-nanometer resolving power. In this perspective, we inspect the challenges raised by combining extreme temporal and spatial resolution and then highlight how upcoming experimental techniques overcome them to realize laboratory-scale attosecond microscopes. Referencing proof-of-principle experiments, we delineate the techniques’ strengths and their applicability to observing various ultrafast phenomena, materials, and sample geometries.
Insulitis and Exocrinitis in Autoantibody-positive Nondiabetic Individuals: Role of HLA Genotypes
Authors: Diedisheim Marc , Mallone Roberto , Pugliese Alberto , Dubois-Laforgue Danièle , Larger Etienne 
Published: January 2025

Abstract

Context
Type 1 diabetes (T1D) is characterized by the presence of autoantibodies on a genetic background largely determined by HLA class II haplotypes. Stage 1 T1D is characterized by the presence of multiple autoantibodies and normoglycemia.

Objective
To investigate the prevalence of high-risk HLA-DQB1 haplotypes and the extent of islet autoimmunity in pancreatic tissues from nondiabetic organ donors with autoantibodies.

Design
We analyzed 117 virtual pancreatic slides from 30 antibody-positive nondiabetic donors from the Network for Pancreatic Organ Donors with Diabetes (nPOD).

Patients
Thirty nondiabetic individuals positive for ≥1 autoantibody. HLA haplotypes were classified as at risk (DQ2, namely DQB1*02:01 and/or DQ8, namely DQB1*03:02), protective (DQ6, namely DQB1*06:02) or neutral (other HLA-DQ alleles).

Main Outcome Measure
CD3+ lymphocyte infiltration of both endocrine and exocrine pancreas, according to HLA.

Results
Among these 30 individuals with a median age of 25 years (interquartile range 21-39); median body mass index 24 kg/m2 (21-30), 23 were single autoantibody-positive and 7 were positive for 2 autoantibodies. β-cell mass was normal in all. HLA-DQ allele distribution was similar to that of autoantibody-negative nondiabetic nPOD donors and differed from that of nPOD donors with stage 3 T1D. Insulitis was identified only in 1 case. CD3+ lymphocyte densities did no correlate with HLA status or autoantibody number or titers, neither in islets nor in the exocrine pancreas.

Conclusion
Contrary to stage 3 T1D, autoantibody-positive donors had normal β-cell mass and no significant insulitis, suggesting heterogeneity in the progression of autoimmunity, even in the presence of genetic risk, rather than a uniform slow-progressing process.