bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicentre, double-blind, randomised controlled clinical trial comparing intermittent cefoxitin administration versus loading bolus followed by continuous infusion for the prevention of surgical site infection in colorectal surgery: the PROPHYLOXITIN study protocol
Authors: Saint-Genis Quentin , Birckener Julien , Gourdou Vincent , Nicolle Claire , Garnier Marc , Schwindenhammer Victor , Hannezo Cécile , Aveline Christophe , Cinotti Raphaël , Puisney Benjamin , Garot Matthias , Chevalier Stéphanie , Aubert Jean-Sébastien , Wodey Maxime , Lasocki Sigismond , Lecoeur Sylvain , Lagarrigue Charles Jean , Li Anne , Faucher Marion , Foucher Yohann , Frasca Denis , Boisson Matthieu 
Published: January 2025

IntroductionSurgical site infections (SSIs) are the second leading cause of healthcare-associated infections in Europe with the highest rates being reported in colorectal surgery (ranging from 9% to 30%). Surgical antibiotic prophylaxis (SAP) is one of the most efficient measures for SSI prevention and should be started before surgical incision. Cefoxitin is an antibiotic widely used as SAP for colorectal surgery, but its continuous administration is currently the subject of debate due to its potential pharmacokinetic advantages. Therefore, the aim of the PROPHYLOXITIN study is to demonstrate that a loading dose followed by continuous infusion of cefoxitin during colorectal surgery (intervention group) decreases the rate of SSI compared to an intermittent bolus administration (control group).Methods and analysisThe PROPHYLOXITIN study is a superiority, prospective, double-blind, randomised and multicentre study of 2000 patients undergoing colorectal surgery. The primary objective is to demonstrate the superiority of a loading dose of cefoxitin followed by continuous infusion over intermittent bolus administration in reducing the proportion of SSIs within 30 days after colorectal surgery. Subjects will be randomised 1:1 using a secure web-based random-number generator to one of two study groups. Randomised allocation of treatment will be done by minimisation and stratified according to the centre, the localisation of surgery (colon or rectum) and the type of surgical procedure (laparoscopy or laparotomy).Ethics and disseminationThis research has been approved by an independent ethics committee and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.Trial registration numberEudraCT 2022-003262-20 and Clinical trialNCT05755789.
Clinical effectiveness and implementation outcomes of pMDI-to-DPI switch in children between 5 and 12 years of age: a scoping review protocol
Authors: Zain Amanda , Ng Alston Z Y , Yeo Inez , Watts Nick , Sevdalis Nick 
Published: January 2025

IntroductionInhalers are critical in asthma treatment, and inappropriate inhaler use leads to poor asthma outcomes. In adults and adolescents, dry powder inhalers (DPIs) are safe and effective alternatives to mainstay pressurised metered dose inhalers and could bridge the asthma care gap while also reducing the environmental burden of asthma care. Despite being licensed for use in ages 5 years old and older, the evidence for clinical effectiveness is less clear for patients between ages 5 and 12 years. This protocol describes a scoping review. The primary aim of the review is to identify and synthesise evidence on the clinical effectiveness of DPI use in children aged 5–12 years old with asthma and other wheezing conditions. The secondary aim of the review is to outline the implementation strategies and outcomes supporting the prescribing or switching to DPIs in children.Methods and analysisWe will conduct a systematic and comprehensive literature search across four electronic databases (Medline, Embase, Cochrane Library and CINAHL) and grey literature. Screening and data extraction will be done independently by two review authors with discrepancies resolved through consensus. Data will be extracted and charted by two independent reviewers, then presented diagrammatically or tabulated with an accompanying narrative summary.Ethics and disseminationEthical approval was not required for this study as it is a scoping review. The results of this scoping review will be submitted to a peer-reviewed scientific journal for publication.
Improving the diagnostic accuracy of referrals for papilloedema (DIPP) study: protocol for a mixed-methods study
Authors: Huntley Alyson , Skrobot Olivia , Ridd Matthew J , Sherratt Mary-Ann , Lucraft Marcia , Stokes Christina , Bowen Michael , Stuart Beth , Merriel Samuel William David , Atan Denize 
Published: January 2025

Introduction
Papilloedema can be the first sign of life-threatening disease, for example, brain tumours. Due to the potential seriousness of this clinical sign, the detection of papilloedema would normally prompt urgent hospital referral for further investigation. The problem is that many benign structural variations of optic nerve anatomy can be mistaken for papilloedema, so-called pseudopapilloedema. The consequence is that many people are referred to hospital because they are incorrectly identified to have papilloedema when they don’t. As a result, hospital referrals of people with suspected papilloedema in England have increased sharply, leading to increased demand for overstretched hospital services and potentially longer waiting times for hospital appointments for those who do have papilloedema.
The work programme is aimed at the development of guidelines and educational materials that will help support health professionals to correctly identify people with papilloedema. This article describes the protocol for gathering evidence of current referral practices and pathways for people suspected to have papilloedema in England and the development of guidelines based on this evidence and extensive engagement with community- and hospital-based healthcare professionals, patients, and the public.

Methods and analysis
Both qualitative and quantitative data will be collected from Freedom of Information requests to Integrated Care Boards across England about how they organise their community and hospital services for people with suspected papilloedema, with and without headache. Surveys and qualitative interviews of relevant community and hospital healthcare professionals based in England will collect data on how and when people with papilloedema and pseudopapilloedema with or without headache are currently identified and referred to hospital, if needed. This information will be used to inform a Delphi process with the aim of reaching consensus among health professional experts, commissioners and patients on what the most evidence-based and safe diagnostic and referral practices should be for people with suspected papilloedema. The tailored guidelines will be written for healthcare professionals and patients. We will create a range of educational materials and a website designed for health professionals and patients to support the national roll-out and implementation of DIPP study guidelines.

Ethics and dissemination
Ethical approval was granted by the University of Bristol Faculty of Health Sciences Ethics committee (FREC reference: 12457) and Health Research Authority (IRAS no.: 320395). Results of the study will be published on our DIPP study website and disseminated to our stakeholder groups through peer-reviewed journal publications and conference presentations.
Barriers and facilitators to global access to life-saving skills training: an international cross-sectional survey
Authors: Stassen Willem , Chern Yeh Lai , Blewer Audrey L , Kong So Yeon Joyce , Lippert Freddy , Ong Marcus Eng Hock , Zhang Lin , Fu Wah Ho Andrew 
Published: January 2025

IntroductionEmergency care begins in the community, who are often the first on the scene. Where emergency care systems are nascent or absent, bystanders represent the only prehospital emergency care that victims might receive. It is important to equip bystanders through life-saving skills training (LST). The aim of this study was to describe access to LST for laypersons globally and to determine barriers or facilitators for access to LST globally.MethodsA global cross-sectional, online survey was undertaken with stakeholders involved in LST programmes and policies through purposive, snowball sampling. The invitation for participation was distributed to local, regional and international emergency care and resuscitation organisations and their membership. Data were collected using a custom-designed survey, based on the literature and following pilot testing. Data were analysed descriptively and visualised according to countries and regions. Logistic regression was used to identify variables predictive of LST.ResultsA total of 302 responses from 67 countries were analysed. Majority of responses were from high- or upper-middle income countries (61.2%) compared with low- or lower-middle income countries (38.8%). All respondents from Europe reported reliable access to LST. Of respondents who reported no LST is delivered, the highest proportion of these represented the Eastern Mediterranean (18.2%), Africa (17.1%) and South America (16.9%). The most common barrier to accessing LST were cultural views surrounding LST (69.2%), while the most common facilitator was interpersonal relationships to encourage the uptake of LST (71.9%). Country level of income (adjusted OR (AOR) 4.31 (95% CI 1.62 to 11.45), p<01), urban location (AOR 10.57 (95% CI 3.32 to 33.66), p<0.001) and level of EMS development (OR 5.73 (95% CI 1.47 to 22.30), p=0.01) were predictive of access to LST.ConclusionThis study highlights considerable inequity in LST access globally. Future work should seek to mitigate barriers and leverage facilitators through participatory and community-oriented approaches to LST.
Epidemiological analysis of reported acute glyphosate poisoning in Malaysia: identifying risk factors and high-risk groups (2006–2023)
Authors: Razali Mohd Fadhli , Amir Shah Ruddin Nurul Iffah , Abdul Rani Noor Afiza , Mohamed Fahim , Ahmad Nurul Izzah , Leong Yin-Hui 
Published: January 2025

ObjectiveGlyphosate is widely used in Malaysian agriculture but poses a significant under-reported public health concern due to poisoning. This paper aims to study the epidemiology of glyphosate poisoning in Malaysia, assessing severity, identifying risk factors, and high-risk groups.SettingAll glyphosate-related data of the Malaysia National Poison Centre from 2006 to 2023.ParticipantsTelephone inquiries of incidents involving glyphosate made by healthcare professionals across Malaysia. Information received was recorded according to WHO guidelines.OutcomesThe outcome is to provide an overview of national glyphosate poisoning epidemiology, including identifying risk factors and high-risk groups to strategise appropriate measures.ResultsA total of 4548 glyphosate poisoning cases were reported, with males comprising 67.3% of cases. The most affected age groups were 21–30 years (25.5%) and 31–40 years (23.5%). Ingestion was the primary exposure route (93.0%). Intentional poisonings, mainly suicides, accounted for 68.4% (n=3078) of cases. Among the 1420 unintentional cases, 78.2% resulted from ingestion exposures. The incidence rate declined from 1.17 per 100 000 in 2011 to 0.61 in 2023. Significant associations were found between intentional ingestion and sociodemographic factors. From 2013 to 2023, 73.7% of cases were minor, 11.5% moderate, 0.8% severe and 0.1% fatal.ConclusionsIn Malaysia, the reported intentional glyphosate poisoning most commonly affects young adults, resulting in generally minor to moderate symptoms. The study highlights the need for stricter regulations on glyphosate use and improved mental health support, to mitigate poisoning risks. Continued surveillance and public education are essential to address this public health issue.
AI support meets AR visualization for Alice and Bob: personalized learning based on individual ChatGPT feedback in an AR quantum cryptography experiment for physics lab courses
Authors: Coban Atakan , Dzsotjan David , Küchemann Stefan , Durst Jürgen , Kuhn Jochen , Hoyer Christoph 
Published: January 2025

Abstract
Quantum cryptography is a central topic in the quantum technology field that is particularly important for secure communication. The training of qualified experts in this field is necessary for continuous development. However, the abstract and complex nature of quantum physics makes the topic difficult to understand. Augmented reality (AR) allows otherwise invisible abstract concepts to be visualized and enables interactive learning, offering significant potential for improving quantum physics education in university lab courses. In addition, personalized feedback on challenging concepts can facilitate learning, and large language models (LLMs) like ChatGPT can effectively deliver such feedback. This study combines these two aspects and explores the impact of an AR-based quantum cryptography experiment with integrated ChatGPT-based feedback on university students’ learning outcomes and cognitive processes. The study involved 21 groups (11 Group A; 10 Group B) of students in a physics laboratory course at a German university and used four open-ended questions to measure learning outcomes and gaze data as a learning process assessment. Statistical analysis was used to compare scores between feedback and non-feedback questions, and the effect of ChatGPT feedback on eye-tracking data was examined. The results show that ChatGPT feedback significantly improved learning outcomes and affected gaze data. While the feedback on conceptual questions tended to direct attention to the visualizations of the underlying model, the feedback on questions about experimental procedures increased visual attention to the real experimental materials. Overall, the results show that AI-based feedback draws visual attention towards task-relevant factors and increases learning performance in general.
On‐Pump FIBTEM‐A5 Accurately Predicts the A5 Values After Protamine Administration
Authors: Vander Zwaag Stanislaw , Tomko Matus , Madej Tomas , Fassl Jens 
Published: January 2025

Introduction: In the present study, we aimed to investigate whether the measurements of the fibrinogen‐dependent clot firmness in FIBTEM—one of the rotational thromboelastometry (ROTEM) assays—during cardiopulmonary bypass (CPB) accurately predict the values after protamine administration.Materials and Methods: In this single‐center retrospective observational study, we analyzed a database of patients undergoing on‐pump surgeries between May 2022 and February 2024. We included patients in whom an intraoperative ROTEM examination during CPB and a follow‐up examination directly after protamine infusion were performed. We excluded patients who received either fibrinogen concentrate or fresh frozen plasma between the two examinations. FIBTEM A5 values in both examinations were compared. The Wilcoxon signed rank test was used to compare non‐normally distributed data. Linear regression analysis was used to investigate the relationship between the on‐pump and postprotamine FIBTEM A5 values.Results: Seventy patients were included in the statistical analysis. There was a slight but statistically significant difference between FIBTEM A5 during CPB (median 16.0 mm, IQR 10.0–22.0) and after protamine administration (median 15.5 mm, IQR 8.7–22.3, p = 0.021). However, in linear regression analysis, FIBTEM A5 values during the last 30 min of the extracorporeal circulation were a significant predictor of FIBTEM A5 after protamine administration (R = 0.902, R2 = 0.813, adjusted R2 = 0.810, F(df regression, df residual) = 295.980, p < 0.001). The equation: y = 0.911x + 1 describes the line of best fit.Conclusions: Within the normal range limits, there is a very strong correlation between on‐pump FIBTEM A5 values and FIBTEM A5 values after protamine administration.
Factors Influencing Solid Waste Management Practices and Challenges in Awi Administrative Zone, Northwestern Ethiopia
Authors: Atnkut Belsti , Nigussie Atalaye , Kumera Bulti , Tsega Alemu , Tiruneh Fekadu , Minale Wondwosson Kibrie , Anemut Fentanesh , Tazebew Ewunetu , Terefe Baye , Fassil Amare , Gebeyehu Getaneh , Astatkie Tess 
Published: January 2025

Background: Effective management of solid waste, generated as a result of human activities, is crucial. However, improper solid waste management seriously threatens the environment and public health in developing countries including Ethiopia.Objective: This study is aimed at assessing the status of solid waste management practices and identifying key factors in Awi Administrative Zone, Ethiopia.Methods: A community‐based cross‐sectional study design was used to collect the data and then analyze using descriptive statistics and logistic regression modeling. The survey was conducted in select kebeles (wards) (administrative subdivisions) of Injibara, Dangila, and Chagni towns, using two‐stage sampling techniques. Primary and secondary data sources were utilized. The per capita waste generation rate was calculated based on the total solid waste generated in kilograms per total family size of households per year.Results: The per capita per day solid waste generation rates for Injibara, Dangila, and Chagni were 0.443, 0.456, and 0.487 kg/capita/day, respectively. The composition of household solid waste mainly consisted of biodegradable and nonbiodegradable materials. It was concluded that a significant proportion of household solid waste comprised biodegradable organic matter, which could be efficiently recycled or decomposed through microbial activity. Of the households, 40.6% had access to door‐to‐door solid waste collection service, and 35.9% and 26.2% of the households disposed their solid waste on riverside bridge/drainage lines and roadside/open land, respectively. The regression analysis showed that the head of the household’s age, family size, monthly income, solid waste selling practice, solid waste reduction practice, awareness of solid waste disposal rules, frequency of household cleanup campaign participation, and awareness of the impacts of improper solid waste management on the environment and human health were significantly associated with improper solid waste management practices.Conclusion: The study revealed poor performance in solid waste management in the study area, attributed to factors such as inadequate collection system design and schedule, open burning of refuse, substandard condition of the final dumpsite, and lack of community awareness leading to illegal dumping.Recommendations: Based on the findings of the study, we recommend that the town municipality strengthen its door‐to‐door solid waste collection service and distribution of communal bin containers, conduct environmental assessments for better dumpsite selection, and implement a community‐based waste management system to ensure sustainable solutions and continuous education on proper solid waste management practices.
Assessing Variances in Dentist’s Interpretations of Antibiotic Prophylaxis Guidelines: A Survey of Dental School Faculty
Authors: Bereckis Jennifer , Rowan Susan , Hanna Danny , Narvekar Aniruddh , Koerber Anne 
Published: January 2025

Purpose: A recent review by the American Heart Association (AHA) noted a decrease in the prescription of antibiotic prophylaxis (AP) for infective endocarditis (IE) following the release of their guidelines in 2007. However, studies indicate dentists may still face challenges in identifying which procedures require AP and which procedures are considered to involve gingival manipulation (GM) requiring the need for AP.Methods: A sample of dental school faculty was surveyed to assess their likelihood of prescribing AP for various dental procedures when treating individuals at high risk for IE and their perception of the likelihood of those procedures involving GM.Results: A total of 134 individuals responded to the survey. Consensus on AP was not achieved for eight of 24 procedures, and consensus on GM was not achieved for four out of 24 procedures.Conclusions: Data gathered revealed a difference of opinions among dental faculty concerning the appropriate dental procedures warranting the prescription of AP for patients at risk of IE. Similarly, there was a lack of consensus among dental faculty regarding dental procedures specifically involving GM. The discordance observed between these two categories implies a potential lack of clarity in the 2007 AHA guidelines. The criteria related to GM for determining the necessity of AP in high‐risk individuals may introduce confusion for dental faculty, possibly extending to dentists practicing in nonacademic settings. Such ambiguity can potentially contribute to inappropriate decision‐making regarding the prescription of AP.
Preoperative Ketamine Gargle for Prevention of Postoperative Sore Throat After Tracheal Intubation in Adults: A Meta‐Analysis
Authors: Fu Saihao , Miao Mengrong , Bian Jing , Fu Yunxiang , Zhang Jiaqiang , Sun Mingyang 
Published: January 2025

Objective: This meta‐analysis aims to evaluate the impact of preoperative ketamine gargle on postoperative throat pain in patients undergoing general anesthesia with endotracheal intubation (ETI).Methods: A comprehensive search was conducted in databases including PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ClinicalTrials.gov, and others. Data analysis was performed using RevMan 5.4 and Stata Statistical Software 18 (StataCorp., Texas., United States of America). Odds ratio with 95% confidence interval (CI) and mean difference were calculated for outcomes: incidence of postoperative 0, 2, 4, 8, and 24 h sore throat and anesthesia time. The overall certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, with trial sequential analysis (TSA) performed to establish implications for further research.Main outcome: A total of ten RCTs involving 593 patients were included in the analysis. The results demonstrated a significant reduction in the incidence of postoperative sore throat at 0, 2, 4, 8, and 24 h after the operation (0 h: OR: 0.14; 95% CI: 0.04–0.47; p = 0.002; I2 = 67%; 2 h: OR: 0.30; 95% CI: 0.17–0.52; p < 0.0001; I2 = 31%; 4 h: OR: 0.32; 95% CI: 0.20–0.52; p < 0.00001; I2 = 0%; 8 h: OR: 0.40; 95% CI: 0.23–0.70; p = 0.001; I2 = 29%; 24 h: OR: 0.36; 95% CI: 0.25–0.51; p < 0.00001; I2 = 0%) in patients who received ketamine gargle compared to those who received a placebo. In addition, our meta‐analysis indicated that ketamine gargle did not result in a reduction in anesthesia time (min) (MD: −1.16; 95% CI: −6.44–4.11; p = 0.67).Conclusion: Our meta‐analysis demonstrated the efficacy of prophylactic ketamine gargle in reducing the incidence of POST across all studied time intervals in patients requiring tracheal intubation of general anesthesia compared to placebo.
LINE-1 Retrotransposons as Cell-free DNA Biomarkers for Multicancer Early Detection
Authors: Szymanski Jeffrey J. , Chauhan Pradeep S. , Chaudhuri Aadel A. 
Published: January 2025

Summary
LINE-1 retrotransposons, comprising 17% of the genome, drive cancer instability through hypomethylation. The Detection of long Interspersed nuclear element Altered Methylation ON plasma DNA (DIAMOND) assay, targeting LINE-1 hypomethylation with bisulfite sequencing of cell-free DNA, achieved AUCs of 88% to 100% across six cancer types, surpassing mutation-based diagnostics and suggesting utility in early cancer detection and management.
See related article by Michel et al., p. XX .