bluuebunny/crossref_metadata_2025_split huggingface dataset:
An observer tool to enhance learning of incoming anesthesia residents’ skills during simulation training of central venous catheter insertion: a randomized controlled trial
Authors: Benhamou Dan , Tant Sarah , Gille Benoit , Bornemann Yannis , Ruscio Laura , Kamel Karl , Dunyach Chloé , Jeannin Bénédicte , Bouilliant-linet Maxime , Blanié Antonia 
Published: December 2023

Abstract
Background
Central venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for much of the session. To improve learning during observation periods, the use of an observer tool (OT) has been advocated but its educational effectiveness is not well defined.

Methods
Incoming anesthesia residents were randomized to use an OT (i.e. procedural skill-based checklist) (OT+) or not (OT-) when observing other residents during a simulation bootcamp. The primary outcome was a composite score (total 60 points) evaluating CVC procedural skills rated immediately after the training. This score covers theoretical knowledge explored by multiple choice questions (MCQs) (/20), perceived improvement in knowledge and skills (/20), perceived impact on future professional life (/10) and satisfaction (/10). Measurements were repeated 1 month later. Residents in each group recorded the number of CVCs placed and their clinical outcomes (attempts, complications) during the first month of their clinical rotation using a logbook.

Results
Immediately after training, the composite score was similar between the two groups: 45.3 ± 4.2 (OT+, n = 49) and 44.4 ± 4.8 (OT-, n = 42) (p = 0.323). Analysis of sub-items also showed no difference. Results at 1 month were not different between groups.
Analysis of the logbook showed no difference between groups. No serious complications were reported.

Conclusions
The use of a procedural task-based OT by incoming anesthesia residents and used during CVC insertion simulation training was not associated with better learning outcomes, neither immediately after the session nor when re-evaluated 1 month later. The training at least once on simulator of all residents could limit the impact of OT. Further studies are necessary to define the place of OT in simulation training.
Essential health services delivery and quality improvement actions under drought and food insecurity emergency in north-east Uganda
Authors: Njuguna Charles , Tola Habteyes Hailu , Maina Benson Ngugi , Magambo Kwikiriza Nicholas , Phoebe Nabunya , Tibananuka Evelyne , Turyashemererwa Florence M. , Rubangakene Moses , Richard Kisubika , Opong George , Richard Ssekitoleko , Opesen Chris , Mateeba Tim , Muyingo Edmond , George Upenytho , Namukose Samalie , Woldemariam Yonas Tegegn 
Published: December 2023

Abstract
Background
Essential health services can be disrupted due to several naturally occurring public health emergencies such as drought, flood, earthquake and outbreak of infectious diseases. However, little evidence exists on the status of essential health services delivery under the effect of drought and food insecurity. North-east Uganda is severely affected by prolonged drought that significantly affected the livelihood of the residents. Therefore, we aimed to determine the current status of essential health services and quality improvement (QI) actions in health facilities in north-east Uganda.

Methods
We used a descriptive cross-sectional study design to assess the availability of essential health service and quality improvement activities in drought and food insecurity affected districts of north-east Uganda. We included a total of 150 health facilities from 15 districts with proportionated multistage sampling method. We interviewed health facilities’ managers and services focal persons using structured questionnaire and observation checklist. We used a descriptive statistic to analyze the data with SPSS version 22.

Results
A few health facilities (8.7%) had mental health specialist. There was also lack of capacity building training on essential health services. Considerable proportion of health facilities had no non-communicable diseases (38.3%), mental health (47.0%), and basic emergency obstetric care (40.3%) services. Stock out of essential medicines were observed in 20% of health facilities. There was lack of supportive supervision, and poor documentation of QI activities.

Conclusion
Essential health service and QI were suboptimal in drought and food insecure emergency affected districts. Human resource deployment (especially mental health specialist), provision of capacity building training, improving non-communicable diseases, mental health and basic emergency obstetric care services are required to improve availability of essential health services. Supporting supply chain management to minimize stock out of medicines, and promoting QI activities are also vital to assure quality of health service in drought and food insecurity affected districts in north-Eastern Uganda.
Correlation of Streptococcus agalactiae concentration on immune system and effective dose of inactivated vaccine for Chitralada 3 strain Nile tilapia (Oreochromis niloticus) in Thailand
Authors: Khunrang Thanakorn , Pooljun Chettupon , Wuthisuthimethavee Suwit 
Published: December 2023

AbstractThe main pathogen in the Nile tilapia (Oreochromis niloticus) culture, Streptococcus agalactiae, causes economic harm. Infected fish’s immune systems worked to eliminate of the infection. This study demonstrated the effect of different bacterial concentrations on tilapia immunity and optimal vaccine concentration to induce immunity in Nile tilapia. The experiment was performed at 102, 104, 106, 108, and 1010 CFU/fish of S. agalactiae compared with the control (PBS) through intraperitoneal injection for 72 h. Fish that survived employed to gather blood, and immune responses were assessed through measures of the survival rate include blood smears, antibody titers, and immunoglobulin gene expression. The vaccine experiment investigated formalin-inactivated S. agalactiae vaccination and administered S. agalactiae injections for 14 days. The statistic revealed a significant difference (p < 0.05) in the 108 and 1010 CFU/fish injections with high survival rates (62.22% and 53.33%, respectively). Immunoglobulin gene expression was highly represented in the 1010 CFU/fish injection; antibody titers were significantly improved from the control group, and antibody levels were high in the 1010 CFU/fish injection. The analysis of blood cell types using the blood smear method revealed a progressive increase in leucocytes, particularly lymphocytes, neutrophils, and monocytes, in the treatment group compared to the control group. Moreover, the erythrocyte/leucocyte ratio decreased significantly in response to the high bacterial injection, indicating an increase in leucocytes. Conversely, the erythrocyte level stayed ed within at the 7.03–9.70 × 102 cell/ml and shown no significant difference (p > 0.05). The lymphocytes were almost two-fold in 1010 CFU/fish compared to 108 CFU/fish. As depicted in the lowest concentration of 106 CFU/fish, the vaccine performance had a high relative percent survival (RPS) at 86.67%. This research suggested that the tilapia infected with high S. agalactiae concentrations did not affect the mortality of the tilapia, and vaccine concentration was effective in 106 CFU/fish.
Recognizing puzzling PD1 + infiltrates in marginal zone lymphoma by integrating clonal and mutational findings: pitfalls in both nodal and transformed splenic cases
Authors: Deng Jili , Cao Youjun , Diao Xinting , Wu Meng , Li Xianghong , Shi Yunfei 
Published: December 2023

Abstract
Background
A marked increase in PD1-positive TFH cells in nodal MZL cases (NMZL) was reported previously and could prompt suspicion for a diagnosis of peripheral T-cell lymphoma (PTCL), especially angioimmunoblastic T-cell lymphoma (AITL).

Case presentation
To demonstrate that the pitfall might exist not only in NMZL but also in transformed splenic MZL (tSMZL), two NMZL cases (70 y/o female with enlarged left cervical lymph node and 75 y/o male with generalized lymphadenopathy) and one case of tSMZL (47 y/o male with nodal and extranodal involvement) with obvious PD1-positive T-cell hyperplasia were described here. Although all their initial diagnoses were prompted to be AITL, they were comprehensively characterized by clinical features, morphologic, immunophenotypic, clonality, and targeted exosome sequencing (TES) findings. Case 1 and Case 2 were NMZL with increased PD1 + T cells in the “peripheral pattern” or “mixed peripheral and central pattern”, and Case 3 was SMZL with abundant PD1-positive T cells in the “nodular pattern” that transformed to tSMZL (DLBCL) with PD1-positive T cells distributed in the “diffuse pattern.” In addition to the monoclonal IG rearrangement and polyclonal TCR rearrangement results, TES demonstrated enriched and recurrent mutations in MZLs and failed to find aberrations described in AITL- or TFH-derived lymphomas.

Conclusions
It is important to realize that this pitfall can also occur in more diagnostically difficult tSMZL cases; the integration of histopathology with clonality and mutation studies is also highlighted.
Family UNited: piloting of a new universal UNODC family skills programme to improve child mental health, resilience and parenting skills in Indonesia and Bangladesh
Authors: Haar Karin , El-Khani Aala , Narotama Narendra , Hussain Amir , Fitri Eva , Badrujaman Aip , Wahyuni Eka , Naheeaan Shah Mohammad , Yassine Ali , Maalouf Wadih 
Published: December 2023

Abstract
Background
Family is one of the most influential social institutions and caregivers act as the main protective factors for children’s mental health and resilience skills. Family skills programmes support caregivers to be better parents and strengthen positive age-specific and age-appropriate family functioning and interactions. We developed a universal, brief and light programme for implementation in low-resource settings, the Family UNited (FU) programme, and conducted a pilot study to show feasibility of implementation, replicability and effectiveness in improving family functioning, child behaviour and resilience.

Methods
We recruited caregivers with children aged 8–14 years through schools in East Java, Indonesia and Dhaka, Bangladesh to the FU programme. Demographic data, emotional and behavioural difficulties of children, child resilience and parental skills and family adjustment measures were collected from children and caregivers before, 2 and 6 weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire), PAFAS (Parenting and Family Adjustment Scales) and CYRM-R (Child and Youth Resilience Measure).

Results
We enrolled 29 families in Bangladesh and allocated 37 families to the intervention and 33 to the control group in Indonesia. Overall, there was no effect over time in the control group on any of the PAFAS subscales, whereas significant reductions in scores were found on six of the seven subscales in either country in the intervention group, most prominently in caregivers with higher scores at baseline. We found highly significant reductions in total SDQ scores in the intervention group in both countries, whereas there was no effect over time in the control group in Indonesia. Boys in the intervention group in Indonesia and in Bangladesh seemed to have benefitted significantly on the SDQ as well as the total resilience scale. Overall, on the CYRM-R, particularly children below the 33rd percentile at pre-test benefitted substantially from the programme.

Conclusions
The implementation of a brief family skills programme was seemingly effective and feasible in resource-limited settings and positively improved child mental health, resilience and parenting practices and family adjustment skills. These results suggest the value of such a programme and call for further validation through other methods of impact assessment and outcome evaluation.
Trial registration: Clinical Trial Registration: ISRCTN99645405, retrospectively registered, 22 September, 2022.
Interventions to promote cost-effectiveness in adult intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study
Authors: Kansal Amit , Latour Jos M. , See Kay Choong , Rai Sumeet , Cecconi Maurizio , Britto Carl , Conway Morris Andrew , Dominic Savio Raymond , Nadkarni Vinay M. , Rao B. K. , Mishra Rajesh 
Published: December 2023

Abstract
Background
There is limited evidence to guide interventions that promote cost-effectiveness in adult intensive care units (ICU). The aim of this consensus statement is to identify globally applicable interventions for best ICU practice and provide guidance for judicious use of resources.

Methods
A three-round modified online Delphi process, using a web-based platform, sought consensus from 61 multidisciplinary ICU experts (physicians, nurses, allied health, administrators) from 21 countries. Round 1 was qualitative to ascertain opinions on cost-effectiveness criteria based on four key domains of high-value healthcare (foundational elements; infrastructure fundamentals; care delivery priorities; reliability and feedback). Round 2 was qualitative and quantitative, while round 3 was quantitative to reiterate and establish criteria. Both rounds 2 and 3 utilized a five-point Likert scale for voting. Consensus was considered when > 70% of the experts voted for a proposed intervention. Thereafter, the steering committee endorsed interventions that were identified as ‘critical’ by more than 50% of steering committee members. These interventions and experts’ comments were summarized as final considerations for best practice.

Results
At the conclusion of round 3, consensus was obtained on 50 best practice considerations for cost-effectiveness in adult ICU. Finally, the steering committee endorsed 9 ‘critical’ best practice considerations. This included adoption of a multidisciplinary ICU model of care, focus on staff training and competency assessment, ongoing quality audits, thus ensuring high quality of critical care services whether within or outside the four walls of ICUs, implementation of a dynamic staff roster, multidisciplinary approach to implementing end-of-life care, early mobilization and promoting international consensus efforts on the Green ICU concept.

Conclusions
This Delphi study with international experts resulted in 9 consensus statements and best practice considerations promoting cost-effectiveness in adult ICUs. Stakeholders (government bodies, professional societies) must lead the efforts to identify locally applicable specifics while working within these best practice considerations with the available resources.
Expanding the list of sequence-agnostic enzymes for chromatin conformation capture assays with S1 nuclease
Authors: Maria Gridina , Andrey Popov , Artem Shadskiy , Nikita Torgunakov , Andrey Kechin , Evgeny Khrapov , Oxana Ryzhkova , Maxim Filipenko , Veniamin Fishman 
Published: December 2023

AbstractThis study presents a novel approach for mapping global chromatin interactions using S1 nuclease, a sequence-agnostic enzyme. We develop and outline a protocol that leverages S1 nuclease's ability to effectively introduce breaks into both open and closed chromatin regions, allowing for comprehensive profiling of chromatin properties. Our S1 Hi–C method enables the preparation of high-quality Hi–C libraries, marking a significant advancement over previously established DNase I Hi–C protocols. Moreover, S1 nuclease's capability to fragment chromatin to mono-nucleosomes suggests the potential for mapping the three-dimensional organization of the genome at high resolution. This methodology holds promise for an improved understanding of chromatin state-dependent activities and may facilitate the development of new genomic methods.
The use of foundational ontologies in biomedical research
Authors: Bernabé César H. , Queralt-Rosinach Núria , Silva Souza Vítor E. , Bonino da Silva Santos Luiz Olavo , Mons Barend , Jacobsen Annika , Roos Marco 
Published: December 2023

AbstractBackgroundThe FAIR principles recommend the use of controlled vocabularies, such as ontologies, to define data and metadata concepts. Ontologies are currently modelled following different approaches, sometimes describing conflicting definitions of the same concepts, which can affect interoperability. To cope with that, prior literature suggests organising ontologies in levels, where domain specific (low-level) ontologies are grounded in domain independent high-level ontologies (i.e., foundational ontologies). In this level-based organisation, foundational ontologies work as translators of intended meaning, thus improving interoperability. Despite their considerable acceptance in biomedical research, there are very few studies testing foundational ontologies. This paper describes a systematic literature mapping that was conducted to understand how foundational ontologies are used in biomedical research and to find empirical evidence supporting their claimed (dis)advantages.ResultsFrom a set of 79 selected papers, we identified that foundational ontologies are used for several purposes: ontology construction, repair, mapping, and ontology-based data analysis. Foundational ontologies are claimed to improve interoperability, enhance reasoning, speed up ontology development and facilitate maintainability. The complexity of using foundational ontologies is the most commonly cited downside. Despite being used for several purposes, there were hardly any experiments (1 paper) testing the claims for or against the use of foundational ontologies. In the subset of 49 papers that describe the development of an ontology, it was observed a low adherence to ontology construction (16 papers) and ontology evaluation formal methods (4 papers).ConclusionOur findings have two main implications. First, the lack of empirical evidence about the use of foundational ontologies indicates a need for evaluating the use of such artefacts in biomedical research. Second, the low adherence to formal methods illustrates how the field could benefit from a more systematic approach when dealing with the development and evaluation of ontologies. The understanding of how foundational ontologies are used in the biomedical field can drive future research towards the improvement of ontologies and, consequently, data FAIRness. The adoption of formal methods can impact the quality and sustainability of ontologies, and reusing these methods from other fields is encouraged.
Inhaled drug delivery: a randomized study in intubated patients with healthy lungs
Authors: Dugernier Jonathan , Le Pennec Déborah , Maerckx Guillaume , Allimonnier Laurine , Hesse Michel , Castanares-Zapatero Diego , Depoortere Virginie , Vecellio Laurent , Reychler Gregory , Michotte Jean-Bernard , Goffette Pierre , Docquier Marie-Agnes , Raftopoulos Christian , Jamar François , Laterre Pierre-François , Ehrmann Stephan , Wittebole Xavier 
Published: December 2023

Abstract
Background
The administration technique for inhaled drug delivery during invasive ventilation remains debated. This study aimed to compare in vivo and in vitro the deposition of a radiolabeled aerosol generated through four configurations during invasive ventilation, including setups optimizing drug delivery.

Methods
Thirty-one intubated postoperative neurosurgery patients with healthy lungs were randomly assigned to four configurations of aerosol delivery using a vibrating-mesh nebulizer and specific ventilator settings: (1) a specific circuit for aerosol therapy (SCAT) with the nebulizer placed at 30 cm of the wye, (2) a heated-humidified circuit switched off 30 min before the nebulization or (3) left on with the nebulizer at the inlet of the heated-humidifier, (4) a conventional circuit with the nebulizer placed between the heat and moisture exchanger filter and the endotracheal tube. Aerosol deposition was analyzed using planar scintigraphy.

Results
A two to three times greater lung delivery was measured in the SCAT group, reaching 19.7% (14.0–24.5) of the nominal dose in comparison to the three other groups (p < 0.01). Around 50 to 60% of lung doses reached the outer region of both lungs in all groups. Drug doses in inner and outer lung regions were significantly increased in the SCAT group (p < 0.01), except for the outer right lung region in the fourth group due to preferential drug trickling from the endotracheal tube and the trachea to the right bronchi. Similar lung delivery was observed whether the heated humidifier was switched off or left on. Inhaled doses measured in vitro correlated with lung doses (R = 0.768, p < 0.001).

Conclusion
Optimizing the administration technique enables a significant increase in inhaled drug delivery to the lungs, including peripheral airways. Before adapting mechanical ventilation, studies are required to continue this optimization and to assess its impact on drug delivery and patient outcome in comparison to more usual settings.
Thermal Cracking in High Volume of Fly Ash and GGBFS Concrete
Authors: Zhang Yingda , Kim Taehwan , Castel Arnaud , Xu Tengfei 
Published: December 2023

AbstractSupplementary cementitious materials (SCMs) such as fly ash and ground granulated blast furnace slag (GGBFS) are found to control the maximum temperature and the accompanying thermal gradients effectively. However, SCMs also lead to low early age strength development. Thus, it is crucial to understand the cracking behaviour of SCMs-based concrete affected by the mix design parameters. In this paper, the thermal cracking resistance was evaluated using a rigid cracking frame (RCF) with a computer-controlled temperature profile. The temperature profile was determined using the software ConcreteWorks by assuming the centre point of the mass concrete. The free shrinkage frame (FSF) and match-curing oven follow the same temperature profile as RCF to measure the free total deformation and time-dependent mechanical properties of concrete, respectively. An analytical model was proposed to calculate the autogenous shrinkage and the thermal stress separately. A time-dependent cracking risk coefficient allowing to estimate the risk of early age cracking of concrete was also proposed.
Morphological and functional trait divergence in endemic fish populations along the small-scale karstic stream
Authors: Acar Elif , Kaymak Nehir 
Published: December 2023

Abstract
Background
Organisms with broad distribution ranges, such as fish, often exhibit local ecological specializations based on their utilization of food and habitat. Populations of species that live in different habitat types (lotic vs. lentic) show morphological variations. However, the phenotypic differences of endemic fish populations in a small karst river basin under anthropogenic pressure are still not fully understood. In this study, the functional traits and morphological variations of the populations of endemic Pseudophoxinus antalyae Bogutskaya, 1992, in the Düden Stream basin, which is subjected to various anthropogenic disturbances and habitat types in southwestern Anatolia of Türkiye, were examined using linear measurements and geometric morphometric analysis.

Results
Differences have been identified in functional traits, particularly those related to food acquisition between populations. Results of both univariate and multivariate analyses revealed significant differences in body shape and size among populations living at sites along the stream with different habitat and environmental characteristics.

Conclusions
The reason for these differences determined in the morphology and traits of the populations may depend on habitat types, ecological, or environmental, and obstruction of gene flow. More detailed studies are needed to explain the mechanisms (genetic and ecological) that cause these differences.