bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicentre, national, investigator-initiated, randomised, parallel-group, register-based superiority trial to compare extended ECG monitoring versus standard ECG monitoring in elderly patients with ischaemic stroke or transient ischaemic attack and the effect on stroke, death and intracerebral bleeding: the AF SPICE protocol
Authors: Engdahl Johan , Straat Kajsa , Isaksson Eva , Rooth Elisabeth , Svennberg Emma , Norrving Bo , Euler Mia von , Hellqvist Kjersti , Gu Weigang , Ström Jakob O , Själander Sara , Eriksson Marie , Åsberg Signild , Wester Per 
Published: November 2023

IntroductionAtrial fibrillation (AF) is a major risk factor for ischaemic stroke and transient ischaemic attack (TIA), and AF detection can be challenged by asymptomatic and paroxysmal presentation. Long-term ECG monitoring after ischaemic stroke or TIA is recommended by all major societies in cardiology and cerebrovascular medicine as a secondary prophylactic measure. However, data on stroke reduction are lacking, and the recommendations show significant diversity.Methods and analysisAF SPICE is a multicentre, national, investigator-initiated, randomised, parallel-group, register-based trial comparing extended ECG monitoring versus standard ECG monitoring in patients admitted with ischaemic stroke or TIA, with a composite endpoint of stroke, all-cause-mortality and intracerebral bleeding. Patients aged ≥70 years without previous AF will be randomised 1:1 to control (standard ECG monitoring) or intervention (extended ECG monitoring). In the control arm, patients will undergo 48±24 hours (ie, a range of 24–72 hours) of continuous ECG monitoring according to national recommendations. In the intervention arm, patients will undergo 14+14 days of continuous ECG monitoring 3 months apart using an ECG patch device, which will provide an easy-accessed, well-tolerated 14-day continuous ECG recording. All ECG patch recordings will be read in a core facility. In cases of AF detection, oral anticoagulation will be recommended if not contraindicated. A pilot phase has been concluded in 2022, which will transcend into the main trial during 2023–2026, including approximately 30 stroke units. The sample size was calculated to be 3262 patients. The primary outcome will be collected from register data during a 36-month follow-up.Ethics and disseminationEthical approval has been provided by the Swedish Ethical Review Authority, reference 2021–02770. The trial will be conducted according to the ethical principles of the Declaration of Helsinki and national regulatory standards. Positive results from the study have the potential for rapid dissemination in clinical practice.Trial registration numberNCT05134454.
Prevalence and correlates of burn-out among Nigerian medical doctors during the COVID-19 pandemic: a cross-sectional study
Authors: Pius Ruth Eshikotse , Ajuluchukwu Janet Ngozi , Roberts Alero Ann 
Published: November 2023

IntroductionPhysician burn-out was an issue before the pandemic. Medical personnel have faced several clinical and non-clinical challenges because of the novel coronavirus (SARS-CoV-2) pandemic, which predisposes them to burn-out. There is a paucity of studies that shed light on the level of burn-out and its association with work-related factors for Nigerian medical doctors. This study aims to examine the level of burn-out among Nigerian medical doctors during the COVID-19 pandemic and explore possible associations between burn-out and sociodemographic, work-related and COVID-19-related factors.MethodologyA cross-sectional study was conducted among 251 medical doctors in a tertiary hospital in Nigeria. A questionnaire was used to obtain sociodemographic history, work-associated factors, COVID-19-related parameters and burn-out history. Personal, work-related and patient-related burn-out were evaluated with the use of the Copenhagen Burnout Inventory.ResultsThe number of doctors enrolled in this study was 251 with a median age of 34; 51.4% were males. The percentage of doctors who had personal, work-related and patient-related burn-out were 62.2%, 52.2 % and 27.5%, respectively. The univariate analysis revealed a correlation between burn-out scores and cadre, age, sex, years of experience, marital status, weekly work hours and number of calls. After multiple regression, female gender (p=0.012), those with less than 6 years of work experience (p=0.004) and those working for at least 71 hours in a week (p=0.0001) remained correlated with higher burn-out scores. Additionally, physicians who had a person with COVID-19 in their immediate environment had an independent correlation with higher work-related burn-out scores (p=0.043).ConclusionThe prevalence of burn-out is high among Nigerian doctors and is linked to some sociodemographic, work-related and COVID-19-related factors. Due to the adverse effects of burn-out on physician well-being and patient care, strategies need to be put in place to identify and mitigate burn-out among Nigerian physicians.
Prevention of psychosocial distress consequences in somatic hospital inpatients via a stepped and collaborative care model: protocol of SomPsyNet, a stepped wedge cluster randomised trial
Authors: Meinlschmidt Gunther , Frick Alexander , Baenteli Iris , Karpf Christina , Studer Anja , Bachmann Marco , Dörner Andreas , Tschudin Sibil , Trost Sarah , Wyss Kaspar , Fink Günther , Schwenkglenks Matthias , Caviezel Seraina , Rocco Tabea , Schaefert Rainer 
Published: November 2023

IntroductionApproximately 30% of somatic hospital inpatients experience psychosocial distress, contributing to increased (re-)hospitalisation rates, treatment resistance, morbidity, and direct and indirect costs. However, such distress often remains unrecognised and unaddressed. We established ‘SomPsyNet’, a ‘stepped and collaborative care model’ (SCCM) for somatic hospital inpatients, aiming at alleviating this issue through early identification of distress and provision of appropriate care, providing problem-focused pathways and strengthening collaborative care. We report the protocol of the ‘SomPsyNet’ study, aiming to evaluate implementation and impact of the SCCM on distressed patients’ health-related quality of life. Secondary objectives include assessing efficacy of the screening procedures, influence of SCCM on other health outcomes and associated costs.Methods and analysisOur stepped wedge cluster randomised trial conducted at three tertiary hospitals comprises three conditions: treatment as usual (TAU) without screening for distress (phase 0), TAU with screening but without consequences (phase I, main comparator) and TAU with screening and psychosomatic-psychiatric consultations for those distressed (phase II). The time-of-transition between phases I and II was randomised. Sample size target is N=2200–2500 participants, with 6 month follow-up for distressed (anticipated n=640–700) and a subsample of non-distressed (anticipated n=200) patients. Primary outcome is mental health-related quality of life (SF-36 ‘Mental Health Component Summary score’); secondary outcomes include psychosocial distress, anxiety, depressive and somatic symptoms, symptom burden and distress, resilience, social support and qualitative of life, assessed by internationally accepted instruments, with good psychometric properties. Further, health claims data will be used to assess SCCM’s impact on direct and indirect costs.Ethics and disseminationSomPsyNet adheres to the Helsinki Declaration and is approved by the ‘Ethikkommission Nordwest- und Zentralschweiz’ (2019–01724). Findings will be published in peer-reviewed journals and communicated to participants, healthcare professionals and the public.Trial registration numberSwiss National Clinical Trials Portal; ClinicalTrials.gov (NCT04269005, updated 19.09.2023).
Determinants of implementing deprescribing for older adults in English care homes: a qualitative interview study
Authors: Warmoth Krystal , Rees Jessica , Day Jo , Cockcroft Emma , Aylward Alex , Pollock Lucy , Coxon George , Craig Trudy , Walton Bridget , Stein Ken 
Published: November 2023

ObjectivesTo explore the factors that may help or hinder deprescribing practice for older people within care homes.DesignQualitative semistructured interviews using framework analysis informed by the Consolidated Framework for Implementation Research (CFIR).SettingParticipants were recruited from two care home provider organisations (a smaller independently owned organisation and a large organisation) in England.ParticipantsA sample of 23 care home staff, 8 residents, 4 family members and 1 general practitioner were associated with 15 care homes.ResultsParticipants discussed their experiences and perceptions of implementing deprescribing within care homes. Major themes of (1) deprescribing as a complex process and (2) internal and external contextual factors influencing deprescribing practice (such as beliefs, abilities and relationships) were interrelated and spanned several CFIR constructs and domains. The quality of local relationships with and support from healthcare professionals were considered more crucial factors than the type of care home management structure.ConclusionsSeveral influencing social and contextual factors need to be considered for implementing deprescribing for older adults in care homes. Additional training, tools, support and opportunities need to be made available to care home staff, so they can feel confident and able to question or raise concerns about medicines with prescribers. Further work is warranted to design and adopt a deprescribing approach which addresses these determinants to ensure successful implementation.
Reducing unwarranted variation: can a ‘clinical dashboard’ be helpful for hospital executive boards and top-level leaders?
Authors: Tjomsland Ole , Thoresen Christian , Ingebrigtsen Tor , Søreide Eldar , Frich Jan C 
Published: November 2023

Background/aimIn the past decades, there has been an increasing focus on defining, identifying and reducing unwarranted variation in clinical practice. There have been several attempts to monitor and reduce unwarranted variation, but the experience so far is that these initiatives have failed to reach their goals. In this article, we present the initial process of developing a safety, quality and utilisation rate dashboard (‘clinical dashboard’) based on a selection of data routinely reported to executive boards and top-level leaders in Norwegian specialist healthcare.MethodsWe used a modified version of Wennberg’s categorisation of healthcare delivery to develop the dashboard, focusing on variation in (1) effective care and patient safety and (2) preference-sensitive and supply-sensitive care.ResultsEffective care and patient safety are monitored with outcome measures such as 30-day mortality after hospital admission and 5-year cancer survival, whereas utilisation rates for procedures selected on cost and volume are used to follow variations in preference-sensitive and supply-sensitive care.ConclusionWe argue that selecting quality indicators of patient safety, quality and utilisation rates and presenting them in a dashboard may help executive hospital boards and top-level leaders to focus on unwarranted variation.
Random walks in correlated diffusivity landscapes
Authors: Pacheco-Pozo Adrian , Sokolov Igor M. 
Published: November 2023

Abstract
In recent years, several experiments have highlighted a new type of diffusion anomaly, which was called Brownian yet non-Gaussian diffusion. In systems displaying this behavior, the mean squared displacement of the diffusing particles grows linearly in time, like in a normal diffusion, but the distribution of displacements is non-Gaussian. In situations when the convergence to Gaussian still takes place at longer times, the probability density of the displacements may show a persisting peak around the distribution’s mode, and the pathway of convergence to the Gaussian is unusual. One of the theoretical models showing such a behavior corresponds to a disordered system with local diffusion coefficients slowly varying in space. While the standard pathway to Gaussian, as proposed by the Central Limit Theorem, would assume that the peak, under the corresponding rescaling, smoothens and lowers in course of the time, in the model discussed, the peak, under rescaling, narrows and stays sharp. In the present work, we discuss the nature of this peak. On a coarse-grained level, the motion of the particles in the diffusivity landscape is described by continuous time random walks with correlations between waiting times and positions. The peak is due to strong spatiotemporal correlations along the trajectories of diffusing particles. Destroying these correlations while keeping the temporal structure of the process intact leads to the decay of the peak. We also note that the correlated CTRW model reproducing serial correlations between the waiting times along the trajectory fails to quantitatively reproduce the shape of the peak even for the decorrelated motion, while being quite accurate in the wings of the PDF. This shows the importance of high-order temporal correlations for the peak’s formation.

Graphical abstract
Graded trace generating functions of Aut(ΓKn) acting on A(ΓKn)
Authors: de Vasconcelos José Eder Salvador , de Lima Márcio Dias , Fernandes Karoline Victor 
Published: November 2023

In this paper, we describe the algebras [Formula: see text] associated with the Hasse graph of the poset of the faces of the complete graph at n vertices [Formula: see text]. Present the relations that define this algebra, calculate the Hilbert series of quadratic grade algebra [Formula: see text] and the graded trace generating functions of [Formula: see text] acting on [Formula: see text] and show that [Formula: see text] is a Koszul algebra. The methodology adopted in this paper consists of building the algebra [Formula: see text] using [I. Gelfand, V. Retakh, S. Serconek and R. L. Wilson, On a class of algebras associated to directed graphs, Selecta Math. 11(2) (2005) 281], giving a presentation based on what was established by [V. Retakh, S. Serconek and R. L. Wilson, On a class of koszul algebras associated to directed graphs, J. Algebra 304(2) (2006) 1114–1129] in terms of the vertices of the graph [Formula: see text]. After that, we use [V. Retakh, S. Serconek and R. L. Wilson, Hilbert series of algebras associated to directed graphs, J. Algebra 312(1) (2007) 142–151] to determine the Hilbert series of [Formula: see text] and use [9] again to show that this algebra is a Koszul algebra. We use [J. Caldeira, A. De Souza Lima and J. Eder Salvador De Vasconcelos, Representations of automorphism groups of algebras associated to star polygons, J. Algebra Appl. 18(10) (2019) 1950197; C. Duffy, Representations of Aut(A([Formula: see text])) acting on homogeneous components of [Formula: see text] and [Formula: see text], Adv. Appl. Math. 42(1) (2009) 94–122] to determine the generating functions of the graduated trace of [Formula: see text] acting on [Formula: see text].
Phase diagrams of bismuth ferrite barium titanate thin films with misfit strains and their improved electrical properties
Authors: Dong Hanting , Ke Liang , Hui Xiangjun , Mao Jiangfeng , Du Haiqing , Gao Qifeng 
Published: November 2023

Phase diagrams of BiFeO3-BaTiO3 (BF–BT) thin films were constructed via thermodynamic model calculation, as well as their electrical properties. The calculated morphotropic phase boundary (MPB) of BF–BT thin films without strain is located near the composition of 0.663BF–0.337BT, which agrees well with the experimental results of reported BF–BT ceramics (between 0.66BF–0.34BT and 0.71BF–0.29BT). The permittivity, tunability and [Formula: see text]of BF–BT thin films on Si substrates are higher than those on SrTiO3(ST) plates, which are also in accordance with the measured data in the literature. Further calculation indicates that 0.7BF–0.3BT and 0.6BF–0.4BT thin films can achieve enormous piezoelectric coefficient [Formula: see text] ([Formula: see text]1200 and [Formula: see text]1000 pm/V, respectively) by selecting the substrates with the TEC respectively of 0.3 and 3.1 × 10[Formula: see text]/[Formula: see text]C, because of the phase transition from aa phase to rhombohedral phase. Such results help to clarify the phase diagrams of BF–BT thin films, implying that huge [Formula: see text]can be achieved by choosing the composition near MPB on the substrates with small TEC.
3D active fault kinematic behaviour reveals rapidly alternating near-surface stress states in the Eastern Alps
Authors: Baroň Ivo , Melichar Rostislav , Sokol L´uboš , Rowberry Matt , Plan Lukas , Stemberk Josef 
Published: November 2023

Abstract
Stress variations in the Earth's crust need to be understood in both the spatial and temporal domains to address a number of pressing societal issues. In this paper, precise three-dimensional records of fault kinematic behaviour obtained by mechanical extensometers are used to investigate changes in stress states along major faults in the Eastern Alps. The monitored faults are fractures with evident Upper Quaternary displacement and are directly attributed to their master tectonic structures. The results demonstrate that activity at the submillimetric scale is highly episodic; periods of repose are punctuated by conspicuous reactivation events affecting one or more of the displacement components. An original approach named the SMB2018 method is used to define the stress state associated with each fault reactivation event. The outputs evidence significant short-term changes in the local stress regime. The directions of the principal normal stresses calculated from these reactivation events present generally similar patterns for both compressional and extensional stress states. Consequently, submillimetric fault activity cannot be controlled by a rotating stress field; such shifts can only be caused by a change in the magnitude of the individual principal normal stresses so that the maximum compression changes to the minimum and vice versa.
The Relationship between Moral Sensitivity and Professional Behaviour and Its Comparison in First- and Last-Year Undergraduate Nursing Students
Authors: Bagheri Maryam , Shahriari Mohsen , Hassanvand Pegah , Mohammadi Pelarti Akram , Ghanavatpour Afarin 
Published: November 2023

Background. Nursing students should be equipped with ethical sensitivity and professional behaviour because they will face challenging ethical issues in their future work environment. This study aimed to determine the relationship between moral sensitivity and professional behaviour and compare it in first- and last-year undergraduate nursing students. Methods. This study was a cross-sectional, correlational study that was conducted at Isfahan University of Medical Sciences in 2019. The sample size of this study was 238 nursing students. The tools used in this study were the Persian versions of the moral sensitivity questionnaire and the professional behaviour questionnaire. The data were analyzed using SPSS 18 software. Results. Linear regression showed that the total score of moral sensitivity of nursing students had a significant relationship with their professional behaviour

p

<

0.05

. The result of the univariate analysis showed that the mean total score of moral sensitivity and professional behaviour was significantly higher in the last year than in first-year students

p

<

0.05

. Conclusion. Considering the relationship between moral sensitivity and the professional behaviour of nursing students, the promotion of moral sensitivity can become the basis for the development of the professional behaviour of nursing students. Therefore, it is suggested to focus on teaching the principles of nursing ethics to develop the moral sensitivity of undergraduate nursing students.
Diagnostic value of a logistic model of occupational lead poisoning using hematological parameters
Authors: Sun Guokang , Xiang Pinpin , Chen Yiping , Li Zheng , Wu Bo , Rao Yanping , Zhu Zheng 
Published: November 2023

Objective We investigated the predictive value of a logistic model utilizing hematological parameters in diagnosing occupational lead poisoning. Methods This retrospective study (September 2020–December 2022) included patients with occupational lead poisoning. Differences in hematological parameters were compared between individuals with occupational blood lead poisoning and healthy individuals. We used logistic regression analysis to develop a diagnostic prediction model for occupational blood lead poisoning. Receiver operating characteristic (ROC) curves and corresponding area under the ROC curve values were used to assess the diagnostic value of hematological parameters and logistic models. Results Compared with controls, several indicators were significantly higher in the group with blood lead poisoning, but others were significantly lower. Logistic regression analysis showed that the red blood cell distribution width coefficient of variation (RDW-CV), neutrophil/lymphocyte ratio (NLR), and percentage of small red blood cells (Micro%) were independent factors in diagnosing occupational blood lead poisoning. The logistic regression model constructed based on these three parameters had sensitivity 78.7% and specificity 83.8% for diagnosing occupational lead poisoning. Conclusion We identified RDW-CV, NLR, and Micro% as independent predictors in the diagnosis of occupational lead poisoning. A logistic regression model that includes these may contribute to better detection of occupational lead poisoning.
Ptah of the Place of Beauty
Authors: Ghabriel Ikram 
Published: November 2023

This paper offers new insights into the worship of Ptah of the Place of Beauty in Thebes by analysing a range of evidence, including tomb scenes, graffiti, stelae, ostraca, and other resources. It aims to provide a better understanding of the development of the cult of this local Theban form of Ptah, as well as his iconography, cult centre(s), and his worshippers. In addition, the article investigates the connection between Ptah of the Place of Beauty and the Valley of the Queens and explores whether the rock-cut chapels between Deir el-Medina and the Valley of the Queens could be considered as the cult centre of Ptah of the Place of Beauty, as proposed by Bruyère.[Formula: see text]
Associations Between Body Mass Index and Cognitive Change in the ACTIVE Study: Variations by Race and Social Determinants of Health
Authors: Aiken-Morgan Adrienne T. , McDonough Ian M. , Parisi Jeanine M. , Clay Olivio J. , Thomas Kelsey R. , Rotblatt Lindsay J. , Thorpe Roland J. , Marsiske Michael 
Published: November 2023

Objectives: The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Methods: Secondary data analysis of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which included participants who self-identified as African American or Black ( n = 728) and White ( n = 2028). Latent growth curve modeling was used to assess study aims. Results: Increases in BMI were associated with less cognitive decline over 10 years across each cognition domain. Race moderation effects were noted for speed and memory. Relationships between BMI and cognitive trajectories were mediated by economic stability for speed and reasoning. Discussion: Overall, these findings are consistent with the “obesity paradox.” Further research is needed to elucidate patterns of results by race.