bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolutionary biological basis of Ashkenazi Lysosomal Storage Diseases: it’s all because of diet
Authors: Dalton Dave 
Published: December 2023

Abstract
An age-old unanswered question that still puzzle evolutionary biologists, is: why do certain autosomal-recessive, lysosomal storages diseases (LSD s), such as, Tay-Sachs, Gaucher, etc. selectively afflict the Ashkenazim more than other Jewish groups and the general population? The most well-accepted theory of ‘population bottleneck and drift’ cannot answer, among other questions, why the Ashkenazim are susceptible to only animal-specific, sphingolipid-mediated LSD s but not to non-animal ones, since genetic drift should influence both animal and non-animal specific LSD s equally. Here, those unanswered questions are answered: Once hunter-gatherers in the Fertile Crescent became agriculturists some eleven-to-twelve millennia back, a dramatic change occurred to their diets. Their earlier low-carbohydrate diets were supplanted by grain-based, high-carbohydrate foods. From those early times, downstream through many millennia, higher consumption of grain-based carbohydrates also meant lower consumption of animal-derived sphingolipids, compared to their forager past. This resulted in selectional pressure in purging those specific enzymes in their cellular lysosomes that were necessary for breaking down complex animal-derived-sphingolipids into simpler lipids. During the past millennium, as the Ashkenazim moved from the Mideast to European locations, their consumption of animal-derived sphingolipid-rich-foods increased, because of the paucity and expense of plant-based, sphingolipid-rich-foods. However, because of missing animal-sphingolipid-specific lysosomal enzymes, those un-catabolized animal-derived-sphingolipids began accumulating/being-stored in their lysosomes, leading to LSD s, which is precisely the storage of those macromolecules in the lysosomes of cells. In contrast, other ethnic Jewish groups did not make such dramatic dietary changes over the past millennium, and hence they generally do not suffer from those LSD s either.
A machine-learning approach based on multiparametric MRI to identify the risk of non-sentinel lymph node metastasis in patients with early-stage breast cancer
Authors: Yu Haitong , Li Qin , Xie Fucai , Wu Shasha , Chen Yongsheng , Huang Chuansheng , Xu Yonglin , Niu Qingliang 
Published: December 2023

Background It has been reported that patients with early breast cancer with 1–2 positive sentinel lymph nodes have a lower risk of non-sentinel lymph node (NSLN) metastasis and cannot benefit from axillary lymph node dissection. Purpose To develop the potential of machine learning based on multiparametric magnetic resonance imaging (MRI) and clinical factors for predicting the risk of NSLN metastasis in breast cancer. Material and Methods This retrospective study included 144 patients with 1–2 positive sentinel lymph node breast cancer. Multiparametric MRI morphologic findings and the detailed demographical characteristics of the primary tumor and axillary lymph node were extracted. The logistic regression, support vector classification, extreme gradient boosting, and random forest algorithm models were established to predict the risk of NSLN metastasis. The prediction efficiency of a machine-learning–based model was evaluated. Finally, the relative importance of each input variable was analyzed for the best model. Results Of the 144 patients, 80 (55.6%) developed NSLN metastasis. A total of 24 imaging features and 14 clinicopathological features were analyzed. The extreme gradient boosting algorithm had the strongest prediction efficiency with an area under curve of 0.881 and 0.781 in the training set and test set, respectively. Five main factors for the metastasis of NSLN were found, including histological grade, cortical thickness, fatty hilum, short axis of lymph node, and age. Conclusion The machine-learning model incorporating multiparametric MRI features and clinical factors can predict NSLN metastasis with high accuracy for breast cancer and provide predictive information for clinical protocol.
Nurses’ perspectives on ethical aspects of telemedicine. A scoping review
Authors: Medina Martin Guillerma , de Mingo Fernández Eva , Jiménez Herrera Maria 
Published: December 2023

Background Changes in health needs led to an increase in virtual care practices such as telemedicine. Nursing plays an essential role in this practice as it is the key to accessing the healthcare system. It is important that this branch of nursing is developed considering all the ethical aspects of nursing care, and not just the legal concepts of the practice. However, this question has not been widely explored in the literature and it is of crucial relevance in the new concept of care. Objective The purpose of this scoping review is to identify the ethical aspects of the development of telemedicine from a nursing practice perspective. Methods A scoping review of the literature based on Arksey and O’Malley’s framework. The search was conducted in Scopus, PubMed/MEDLINE and CINAHL databases, from 2012 to 2022. A total of 1322 articles were retrieved, of which 12 met the inclusion criteria. Ethical considerations The research was conducted in accordance with the best scientific practices. Findings The most relevant aspects were the safety of the patient, the benefits for the user and the digital competence of the professionals. Informed consent and patient’s willingness to use new technologies were relevant to the practice, as was person-centered care and how telemedicine can influence the quality of the therapeutic relationship. Another relevant issue was the concern about professional competence for optimal outcomes. Conclusion It is necessary to further explore and develop the ethical aspects of the new practices, disassociating them from the legal aspects only. Professionals demand more training providing them with more competence and confidence.
Thriving at work, career calling, and moral distress among nurses
Authors: Li Fuda , Zhou Yating , Kuang Pingting 
Published: December 2023

Background Emergency nurses who thrive at work experience positive emotions that help reduce burnout and thus enhance career calling. However, few studies have focused on the relationships among thriving at work, career calling, and moral distress among emergency nurses. Objectives To investigate the relationships among thriving at work, career calling, and moral distress and to explore the mediating role of career calling in the relationship between thriving at work and moral distress among emergency nurses. Design A quantitative, cross-sectional study. Methods A cross-sectional study was conducted by reference to 390 emergency nurses in China using an online survey that include the Thriving at Work Scale, the Career Calling Scale, and the Moral Distress Scale-Revised. The data were analyzed using SmartPLS software. Ethical consideration The study was approved by the Ethics Committee of Hunan Normal University (No. 2023-388). Findings Among emergency nurses, thriving at work is positively associated with career calling, while career calling is negatively associated with moral distress. Career calling negatively and completely mediates the relationship between thriving at work and moral distress (β = −0.087, p < 0.01). Discussion Theoretically, the findings enhance our understanding of the relationships among thriving at work, career calling, and moral distress among emergency nurses. Conclusion By emphasizing the benefits of thriving at work, nursing managers can improve nurses’ level of thriving at work by providing a favorable environment, a flexible scheduling system, and appropriate authorization as well as by ensuring organizational fairness and providing training opportunities in a hierarchical manner.
Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19
Authors: Moshtaghi Fard Zahra , Aghadoost Samira , Moradi Negin , Sarmadi Sarvin , Mohammadi Farnoosh , Bahrami Naghmeh 
Published: December 2023

Objective Cleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic. Design Cross-sectional Study Setting CLP team at Tehran University of Medical Sciences (TUMS). Patients/Participants Thirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP. Interventions ST group received at least 10 ST sessions, and group without ST didn’t receive ST during COVID-19. Main Outcome Measure(s) A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS. Results Total and subscales’ scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren’t statistically significant ( P > .05). Furthermore, according to cleft type, there weren’t any statistically significant differences in total, physical, and social subscales of QoLAdoCleft ( P > .05); however, psychological subscale in CLP had a higher significant score than CPO ( P < .05). Conclusions QOL was weak in all patients with CLP, and receiving/not receiving ST couldn’t make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.
Longitudinal evaluation of environmental contamination with hazardous drugs by surface wipe sampling
Authors: Sessink Paul JM , Tans Birgit , Spriet Isabel , Devolder David 
Published: December 2023

Introduction Exposure of healthcare workers to hazardous drugs can lead to adverse health effects supporting the importance of a continuous monitoring program, for example, by taking surface wipe samples. The objective was to describe the results of repeated monitoring of contamination with hazardous drugs on multiple surfaces in a hospital pharmacy and at two wards using standardized preparation techniques and cleaning procedures. Methods Twelve surfaces in the hospital pharmacy and at two wards were sampled and analyzed for contamination with the hazardous drugs cyclophosphamide, doxorubicin, 5-fluorouracil, gemcitabine, methotrexate, and paclitaxel. The drugs were prepared with a closed-system drug transfer device (CSTD). Sampling of the drugs was performed in four trials during eight months. Liquid chromatography tandem mass spectrometry was used for the analysis of the drugs. Results During the four trials, contamination with five of the six hazardous drugs was found on half of the surfaces in the pharmacy and in a ward. Seventeen out of 288 possible outcomes were positive (6%), with the biological safety cabinet grate ( n = 6) and scanner ( n = 5) most frequently contaminated. The highest level of contamination was observed on the pass-thru window (cyclophosphamide: 2.90 ng/cm2) and the touch screen of the Diana device (5-fluorouracil: 2.38 ng/cm2). Both levels were below the action level of 10 ng/cm2. Conclusions The long-term use of a CSTD in combination with appropriate cleaning has proven effective in achieving low levels of surface contamination with hazardous drugs.
A Novel Therapeutic Method in Gastro-esophageal Reflux Disease
Authors: Leahy Patrick F. 
Published: December 2023

Background Gastro-esophageal reflux disease (GERD/GORD) is a chronic condition in which gastric acid flows backwards up into the esophagus, causing heart burn and a higher disposition to esophageal cancer. The reflux is caused by impairment of the lower esophageal sphincter (LES). Over the past century gastro-esophageal reflux has become the principal gastrointestinal condition of our time. The proton pump inhibitor class of drugs is effective in ameliorating the symptoms of reflux. The cost of investigation of patients in Europe is €100 billion per annum. The cost in days lost from work is €100 billion per annum in Europe. The global cost is 3 times this amount. Methodology The proposed device for treating gastro-esophageal reflux is a biodegradable valve that is placed non surgically in the esophago-gastric junction to prevent reflux from the stomach to the esophagus. Experiment Results 50 simulator studies were performed with the patented device to elucidate the most consistent method of insertion and fixation in a human like simulator. The simulator was designed to replicate the normal human gastro-esophageal anatomy and characteristics. Four animal insertions were performed under ethical regulation at Amsterdam Medical Centre, Netherlands. Three cadaveric experiments were performed at Hackensack University Hospital, New Jersey, USA, to verify the positive outcomes of the simulator studies. Conclusion Successful outcomes of simulator studies and cadaveric experiments allowed the design freeze of a NoReflux device for treating gastro-esophageal reflux disease.
Sleep alterations following elective shoulder surgery: A systematic review
Authors: Karimi Amir H , Langberg Joshua , Stone Michael Allen 
Published: December 2023

Background Poor sleep quality due to nocturnal pain is increasingly reported as a major symptom in several shoulder pathologies. Sleep disturbance has been reported in up to 89% after rotator cuff tears and is frequently reported as the primary reason for referring patients to surgery. As a result, it is important to understand the impact of shoulder surgery on a patient's sleep quality. Methods A systematic literature review in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was performed to identify primary research articles reporting the relationship between sleep and shoulder surgery. The initial query yielded 276 articles. After applying inclusion and exclusion criteria, 12 articles were included discussing the relationship between sleep and shoulder surgery. Results A total of 1097 patients were included in the 12 studies evaluating the impact of shoulder surgery on sleep quality, with the Pittsburgh Sleep Quality Index (PSQI) as the most used survey. Average preoperative PSQI across studies was 9.9 (poor sleep), and postoperative PSQI scores of 5.4 at 6 months (improved sleep). Conclusion Patients with shoulder pathologies have a poor sleep quality that improves after shoulder surgery. However, this improvement might not return sleep quality within the normal range, suggesting other factors might impact postoperative sleep quality. Level of evidence III
Survivorship of the Stryker Ascend Flex uncemented metaphyseal bearing stem at a minimum 2- and 5-year follow-up
Authors: Huynh Richard C , Shields David W , Rashid Mustafa S , Monga Puneet 
Published: December 2023

Introduction The Ascend Flex short stem implant has been reported to have good early clinical outcomes and low revision rates. This retrospective study aimed to evaluate the early to mid-term radiographic and clinical outcomes of patients who underwent primary shoulder arthroplasty with this implant. Methods All consecutive patients who underwent primary shoulder arthroplasty with short uncemented Ascend Flex stems with a minimum of 24-month follow-up were included. The primary outcomes were revision and reoperation rate. The secondary outcomes included stress shielding and Oxford Shoulder Score (OSS). Results Totally, 151 shoulders were eligible for inclusion. Out of which 73 were anatomic total shoulder arthroplasty, 77 were reverse geometry, and 1 was a hemiarthroplasty. Mean follow-up duration was 52 ± 17.2 months. The revision and reoperation rates were 0.6% and 2.6%, respectively. 1.3% anatomic total shoulder arthroplasty (aTSA) cases and 6.5% RSA cases demonstrated stress shielding. OSS improved from 16.1 ± 8.5 to 34.1 ± 12.3 in aTSA cases ( Z = −3.98, p < 0.001) and from 15.6 ± 8.4 to 30.0 ± 13.5 in RSA cases ( Z = −3.41, p < 0.001). Conclusion These findings demonstrate reassuring outcomes for this implant at a mean of 52 months. Further reports are required to document the long-term outcomes for this component.
Acceptability of a proposed practice pharmacist-led review for opioid-treated patients with persistent pain: A qualitative study to inform intervention development
Authors: Cornwall Nicola , Woodcock Charlotte , Ashworth Julie , Harrisson Sarah A , Dikomitis Lisa , White Simon , Helliwell Toby , Hodgson Eleanor , Knaggs Roger , Pincus Tamar , Santer Miriam , Mallen Christian D , Jinks Clare ,   on behalf of the PROMPPT team
Published: December 2023

Introduction Regular review of patients prescribed opioids for persistent non-cancer pain (PCNP) is recommended but not routinely undertaken. The PROMPPT (Proactive clinical Review of patients taking Opioid Medicines long-term for persistent Pain led by clinical Pharmacists in primary care Teams) research programme aims to develop and test a pharmacist-led pain review (PROMPPT) to reduce inappropriate opioid use for persistent pain in primary care. This study explored the acceptability of the proposed PROMPPT review to inform early intervention development. Methods Interviews ( n = 15) and an online discussion forum ( n = 31) with patients prescribed opioids for PCNP and interviews with pharmacists ( n = 13), explored acceptability of a proposed PROMPPT review. A prototype PROMPPT review was then tested and refined through 3 iterative cycles of in-practice testing (IPT) ( n = 3 practices, n = 3 practice pharmacists, n = 13 patients). Drawing on the Theoretical Framework of Acceptability (TFA), a framework was generated (including a priori TFA constructs) allowing for deductive and inductive thematic analysis to identify aspects of prospective and experienced acceptability. Results Patients felt uncertain about practice pharmacists delivering the proposed PROMPPT review leading to development of content for the invitation letter for IPT (introducing the pharmacist and outlining the aim of the review). After IPT, patients felt that pharmacists were suited to the role as they were knowledgeable and qualified. Pharmacists felt that the proposed reviews would be challenging. Although challenges were experienced during delivery of PROMPPT reviews, pharmacists found that they became easier to deliver with time, practise and experience. Recommendations for optimisations after IPT included development of the training to include examples of challenging consultations. Conclusions Uptake of new healthcare interventions is influenced by perceptions of acceptability. Exploring prospective and experienced acceptability at multiple time points during early intervention development, led to mini-optimisations of the prototype PROMPPT review ahead of a non-randomised feasibility study.
Dairy and gluten in disease activity in multiple sclerosis
Authors: Temperley Isabel A , Seldon Alexandra N , Reckord Madeline AW , Yarad Claudia A , Islam Farihah T , Duncanson Kerith , Lea Rodney A , Lechner-Scott Jeannette , Maltby Vicki E 
Published: December 2023

Background Many diets promoted specifically for multiple sclerosis have been suggested to improve disease activity. Dairy and gluten are two components for which the recommendations vary between these diets. Existing research into the association between these dietary components and disease activity has been conflicting. Objective To explore the relationship between dairy and gluten intake and disease activity in multiple sclerosis over a 2-year period, using no evidence of disease activity (NEDA) 3 status. Methods 186 participants’ dairy and gluten intake was retrospectively estimated over 2 years using a dairy and gluten dietary screener. Estimated dairy and gluten intake was compared to disease activity, indicated by no evidence of disease activity 3 status, and quality of life, assessed by the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. Results No significant association was found between mean estimated dairy or gluten intake and NEDA 3 status ( p = 0.15 and 0.60, respectively). Furthermore, there was no significant relationship between dairy or gluten intake and MusiQoL) scores ( p = 0.11 and 0.51, respectively). Conclusion Whilst we cannot rule out modest benefits due to our small sample size, we found that neither dairy nor gluten intake was associated with disease activity or quality of life in this study.
Role of Gardening in Mental Health, Food Security, and Economic Well-Being in Resettled Refugees: A Mixed Methods Study
Authors: Gangamma Rashmi , Walia Bhavneet , Minkoff-Zern Laura-Anne , Tor Shaelise 
Published: December 2023

Executive Summary Home and community gardening is emerging as a beneficial intervention for resettled refugee populations. Using an interdisciplinary lens, we examined whether gardening influences mental health, food security, and economic well-being. A mixed methods study ( n = 29) was conducted with quantitative surveys to assess indicators of mental health, food security, and economic well-being. Qualitative, semi-structured interviews explored gardener participants’ experience of gardening benefits ( n = 10). Participants had on average been in the United States for seven and a half years, with most having lived in refugee camps prior to arrival. Findings showed gardeners reporting fewer symptoms of anxiety, depression, and trauma, and lesser food insecurity than non-gardeners, and similar indicators of economic well-being. Non-parametric regression analysis showed that being a gardener significantly predicted less psychological distress. Qualitative data substantiated these findings with gardeners reporting improved mental health, closer family, social relationships and connections with culture, and more access to fresh and organic food. The multiple, simultaneous benefits of gardening reported here provide strong support for building community-based health promotion programs to assist refugee integration, including long after arrival. The study further highlights the importance of examining these interrelated factors of mental health, food security, and economic well-being simultaneously and reevaluating the established goals of refugee resettlement, particularly in the United States. We offer the following recommendations: • Policymakers and refugee resettlement practitioners should integrate culturally appropriate community-based health promotion efforts in refugee programs long after the initial resettlement period. • Researchers on refugee integration outcomes should include interdisciplinary perspectives that offer comprehensive understanding of processes related to health outcomes. • Policymakers on refugee resettlement and integration should consider the linkages between mental health, food security, and economic well-being.