bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engagement of vulnerable communities in HIV prevention research in India: a qualitative investigation
Authors: Chakrapani Venkatesan , Loganathan Vijayalakshmi , Saha Paromita , Bose Devi Leena , Khan Nabeela , Aurora Tiara , Narayan Jyoti , Mukherjee Joyeeta , Hadi Saif ul , Dewan Chitrangna 
Published: January 2024

Abstract
Background
Meaningful community engagement (CE) in HIV prevention research is crucial for successful and ethically robust study implementation. We conducted a qualitative study to understand the current CE practices in HIV prevention research and to identify expressed and implicit reasons behind translational gaps highlighted by communities and researchers.

Methods
For this exploratory qualitative study, we recruited a purposive sample of participants from Indian government-recognised key populations such as men who have sex with men, transgender women, people who inject drugs and female sex workers; general population adults and adolescents/youth; and researchers. We conducted 13 virtual focus groups (n = 86) between July and October 2021. Data were explored from a critical realist perspective and framing analysis (i.e., examining how the participants framed the narratives).

Results
Participants reported that study communities, especially those from key populations, were primarily involved in data collection, but not necessarily with optimal training. Involvement of communities before the start of the study (e.g., obtaining feedback on the study’s purpose/design) or once the study is completed (e.g., sharing of findings) were highlighted as priorities for meaningful engagement. Participants suggested meaningful CE in all stages of the study: (1) before the study—to get inputs in finalising the study design, drafting comprehensible informed consent forms and culturally-appropriate data collection tools, and deciding on appropriate monetary compensation; (2) during the study—adequate training of community field research staff; and (3) after the study—sharing the draft findings to get community inputs, and involving communities in advocacy activities towards converting evidence into action, policy or programs. Timely and transparent communications with communities were explicitly stated as critical for gaining and maintaining trust. Mutual respect, reciprocity (e.g., appropriate monetary compensation) and robust community feedback mechanisms were considered critical for meaningful CE.

Conclusions
The findings highlighted the translational gaps and priority areas for capacity building to strengthen CE in HIV prevention research. It is not only important to engage communities at various stages of research but to understand that trust, dignity, respect, and reciprocity are fundamentally preferred ways of meaningful community engagement.
Association between intraoperative blood salvage and coagulation disorder after cardiopulmonary bypass
Authors: Morinaga Masahiro , Yoshitani Kenji , Ogata Soshiro , Fukushima Satsuki , Matsuda Hitoshi 
Published: January 2024

Abstract
Background
This study investigated whether intraoperative blood salvage was associated with coagulation disorder diagnosed by conventional coagulation tests and thromboelastography (TEG) after cardiopulmonary bypass (CPB).

Study design and methods
This was a prospective, observational study. Ninety-two patients who underwent cardiovascular surgery with CPB were enrolled. We evaluated coagulation function in patients with or without cell salvage blood transfusion at the following time points: before CPB, just after protamine administration, and 1 h after protamine administration. We evaluated platelet count, fibrinogen concentration, and TEG parameters. Patients were considered to have coagulation disorder if one or more of the following criteria were present: (1) residual heparin, (2) low platelet count, (3) low fibrinogen level, (4) low clotting factor level, and (5) hyperfibrinolysis.

Results
Fifty-three of 92 patients (57.6%) received intraoperative cell salvage. Coagulation disorder was observed in 56 of 92 patients (60.9%) after CPB. There was no significant difference between patients with or without intraoperative blood salvage in terms of the incidence of coagulation disorder (p = 0.542) or the total volume of blood from the drain after CPB (p = 0.437). Intraoperative blood salvage was not associated with coagulation disorder diagnosed by either TEG or conventional coagulation tests (odds ratio 1.329, 95% confidence interval: 0.549–3.213, p = 0.547). There were no significant interactions between patients with or without intraoperative blood salvage regarding coagulation parameters derived from TEG.

Conclusions
The incidence of coagulation disorder and the total blood volume from the drain after CPB did not differ significantly between patients with or without intraoperative blood salvage.
Grating-based x-ray dark-field CT for lung cancer diagnosis in mice
Authors: Guo Peiyuan , Zhang Li , Lu Jincheng , Zhang Huitao , Zhu Xiaohua , Wu Chengpeng , Zhan Xiangwen , Yin Hongxia , Wang Zhenchang , Xu Yan , Wang Zhentian 
Published: January 2024

Abstract
Background
The low absorption of x-rays in lung tissue and the poor resolution of conventional computed tomography (CT) limits its use to detect lung disease. However, x-ray dark-field imaging can sense the scattered x-rays deflected by the structures being imaged. This technique can facilitate the detection of small alveolar lesions that would be difficult to detect with conventional CT. Therefore, it may provide an alternative imaging modality to diagnose lung disease at an early stage.

Methods
Eight mice were inoculated with lung cancers simultaneously. Each time two mice were scanned using a grating-based dark-field CT on days 4, 8, 12, and 16 after the introduction of the cancer cells. The detectability index was calculated between nodules and healthy parenchyma for both attenuation and dark-field modalities. High-resolution micro-CT and pathological examinations were used to crosscheck and validate our results. Paired t-test was used for comparing the ability of dark-field and attenuation modalities in pulmonary nodule detection.

Results
The nodules were shown as a signal decrease in the dark-field modality and a signal increase in the attenuation modality. The number of nodules increased from day 8 to day 16, indicating disease progression. The detectability indices of dark-field modality were higher than those of attenuation modality (p = 0.025).

Conclusions
Compared with the standard attenuation CT, the dark-field CT improved the detection of lung nodules.

Relevance statement
Dark-field CT has a higher detectability index than conventional attenuation CT in lung nodule detection. This technique could improve the early diagnosis of lung cancer.

Key points
• Lung cancer progression was observed using x-ray dark-field CT.
• Dark-field modality complements with attenuation modality in lung nodule detection.
• Dark-field modality showed a detectability index higher than that attenuation in nodule detection.

Graphical Abstract
RETRACTED ARTICLE: Shapley-based interpretation of deep learning models for wildfire spread rate prediction
Authors: Qayyum Faiza , Samee Nagwan Abdel , Alabdulhafith Maali , Aziz Ahmed , Hijjawi Mohammad 
Published: January 2024

Abstract
Background
Predicting wildfire progression is vital for countering its detrimental effects. While numerous studies over the years have delved into forecasting various elements of wildfires, many of these complex models are perceived as “black boxes”, making it challenging to produce transparent and easily interpretable outputs. Evaluating such models necessitates a thorough understanding of multiple pivotal factors that influence their performance.

Results
This study introduces a deep learning methodology based on transformer to determine wildfire susceptibility. To elucidate the connection between predictor variables and the model across diverse parameters, we employ SHapley Additive exPlanations (SHAP) for a detailed analysis. The model’s predictive robustness is further bolstered through various cross-validation techniques.

Conclusion
Upon examining various wildfire spread rate prediction models, transformer stands out, outperforming its peers in terms of accuracy and reliability. Although the models demonstrated a high level of accuracy when applied to the development dataset, their performance deteriorated when evaluated against the separate evaluation dataset. Interestingly, certain models that showed the lowest errors during the development stage exhibited the highest errors in the subsequent evaluation phase. In addition, SHAP outcomes underscore the invaluable role of explainable AI in enriching our comprehension of wildfire spread rate prediction.
A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion
Authors: Elshewy Nesma , Ramadan Adel Ali , Sameh Wael Mohamed , Eid Mohamed Emad-ElDeen , El Achy Samar , Ezz Eldin Omnia 
Published: January 2024

Abstract
Background
Muscle invasion in bladder cancer is a paramount factor in prognosis and setting the management plan. MRI is gaining preference in this field, being noninvasive with no radiation hazards and having good resolution, especially with the development of the standardized system of (VI RADS). Moreover, multiple other imaging features can aid in predicting muscle invasion. We studied some of the most commonly reported features to develop the most reliable combination to anticipate the presence of muscle invasion.

Results
Our prospective study on 80 patients showed 39 (48.75%) muscle invasive (MIBC) and 41 (51.25%) non-muscle invasive (NMIBC) bladder cancer cases. The inter-observer agreement on the VI RADS score and the ADC measurements were very good and they had high-accuracy predicting muscle invasion with areas under the curve (AUCs) on ROC curve analysis reaching 0.905 and 0.857, respectively. The imaging variables that showed statistically significant differences between NMIBC and MIBC cases were: the multiplicity of the lesions, vesicoureteric junction (VUJ) involvement with distal ureteric backpressure, tumor–wall contact length (TCL), tumor volume, tumor shape (sessile or papillary), presence of a stalk, the final VI RADS score and the ADC value. On the multiple regression analysis model, the multiplicity of the lesions, the minimum ADC value by ROI method and the final VI RADS score showed independent correlation with muscle invasion, negatively with the first two and positively with the latter. The combination of the six statistically significant variables on the univariate regression analysis (final VI RADS score, minimum ADC by ROI, multiplicity, index tumor shape, TCL and distal ureteric backpressure changes) showed the best AUC (0.944).

Conclusions
VI RADS has good diagnostic accuracy regarding muscle invasion; however, this can even be enhanced by including other quantitative and qualitative commonly reported MRI features as a proposed modification to the VI RADS.
Association Between Trimethylamine N-oxide and Adverse Kidney Outcomes and Overall Mortality in Type 2 Diabetes Mellitus
Authors: Yu Ping-Shaou , Wu Ping-Hsun , Hung Wei-Wen , Lin Ming-Yen , Zhen Yen-Yi , Hung Wei-Chun , Chang Jer-Ming , Tsai Jong-Rung , Chiu Yi-Wen , Hwang Shang-Jyh , Tsai Yi-Chun 
Published: January 2024

Abstract

Context
Type 2 diabetes (T2D) is the major contributor to chronic kidney disease and end-stage kidney disease (ESKD). The influence of trimethylamine N-oxide (TMAO) on kidney outcomes in T2D remains unclear.

Objective
To examine the association between fasting serum TMAO levels and adverse kidney outcomes in patients with T2D.

Methods
Between October 2016 and June 2020, patients with T2D were recruited and monitored every 3 months until December 2021. Serum TMAO levels were assessed using liquid chromatography-mass spectrometry. The primary kidney outcomes were doubling of serum creatinine levels or progression to ESKD necessitating dialysis; the secondary kidney outcome was a rapid 30% decline in estimated glomerular filtration rate within 2 years. All-cause mortality was also evaluated.

Results
Among the 440 enrolled patients with T2D, those in the highest serum TMAO tertile (≥0.88 μM) were older, had a longer diabetes duration, elevated blood urea nitrogen, and lower estimated glomerular filtration rate. Over a median follow-up period of 4 years, 26 patients (5.9%) had a doubling of serum creatinine level or progression to ESKD. After propensity score weighting, the patients in the highest serum TMAO tertile had a 6.45-fold increase in the risk of doubling of serum creatinine levels or progression to ESKD and 5.86-fold elevated risk of rapid decline in kidney function compared with those in the lowest tertile. Additionally, the stepwise increase in serum TMAO was associated with all-cause mortality.

Conclusion
Patients with T2D with elevated circulating TMAO levels are at higher risk of doubling serum creatinine, progressing to ESKD, and mortality. TMAO is a potential biomarker for kidney function progression and mortality in patients with T2D.
Comparisons of Metabolic Measures to Predict T1D vs Detect a Preventive Treatment Effect in High-Risk Individuals
Authors: Sims Emily K , Cuthbertson David , Jacobsen Laura , Ismail Heba M , Nathan Brandon M , Herold Kevan C , Redondo Maria J , Sosenko Jay 
Published: January 2024

Abstract

Context
Metabolic measures are frequently used to predict type 1 diabetes (T1D) and to understand effects of disease-modifying therapies.

Objective
Compare metabolic endpoints for their ability to detect preventive treatment effects and predict T1D.

Methods
Six-month changes in metabolic endpoints were assessed for (1) detecting treatment effects by comparing placebo and treatment arms from the randomized controlled teplizumab prevention trial, a multicenter clinical trial investigating 14-day intravenous teplizumab infusion and (2) predicting T1D in the TrialNet Pathway to Prevention natural history study. For each metabolic measure, t-Values from t tests for detecting a treatment effect were compared with chi-square values from proportional hazards regression for predicting T1D. Participants in the teplizumab prevention trial and participants in the Pathway to Prevention study selected with the same inclusion criteria used for the teplizumab trial were studied.

Results
Six-month changes in glucose-based endpoints predicted diabetes better than C-peptide–based endpoints, yet the latter were better at detecting a teplizumab effect. Combined measures of glucose and C-peptide were more balanced than measures of glucose alone or C-peptide alone for predicting diabetes and detecting a teplizumab effect.

Conclusion
The capacity of a metabolic endpoint to detect a treatment effect does not necessarily correspond to its accuracy for predicting T1D. However, combined glucose and C-peptide endpoints appear to be effective for both predicting diabetes and detecting a response to immunotherapy. These findings suggest that combined glucose and C-peptide endpoints should be incorporated into the design of future T1D prevention trials.
Percutaneous infraclavicular subclavian vein catheters in paediatric cancer patients in comparison with critically ill children: a one-year experience from a Tunisian hospital
Authors: Jarraya Anouar , Kammoun Manel , Sarhan Ahmad , Abdelhedi Ahmad , Kolsi Kamel 
Published: January 2024

Background: Paediatric cancer and critically ill patients frequently require central venous catheters for prolonged intravenous therapy. The aim of this study is to compare the difficulty of catheter insertion and the morbidity related to this procedure in these two populations and to investigate risk factors for complications Methods: This prospective observational study was conducted at the Hedi Chaker University Hospital in Sfax, Tunisia, from July 2021 to July 2022. We included all patients aged three months to 14 years who required an infraclavicular subclavian vein catheterization. Patients were divided into two groups: Group 1 included children with malignancies; and Group 2 included critically ill paediatric patients. Then, we compared the demographic data, the difficulty of the catheterization procedure, and catheter-related complications. We also investigated risk factors for complications using a logistic regression model. The significance level was P<0.05 Results: We included 65 infants and children requiring central venous access, 28 of whom suffered from malignancies. The demographic parameters were comparable. However, the time for the procedure and the number of attempts were higher in the malignancy group with P<0.001. Central venous catheter complications were present 46.4% of the time in Group 1 compared to 21.6% in Group 2 (P=0.032). Malignancies were associated with an increased risk of complications (aOR = 2.95; 95%CI: 0.63-13.8) Conclusions: This study showed increased difficulty and higher morbidity related to infraclavicular subclavian vein catheterization among infants and children suffering from cancer
Care bundles and peripheral arterial catheters
Authors: Reynolds Heather , Gowardman John , Woods Christine 
Published: January 2024

HIGHLIGHTS What we know about the topic: Recommendations for the use of vascular access care bundles to reduce infection are followed for different devices. The risk of arterial catheter-related infection is comparable with short-term, non-cuffed central venous catheters. There are practice concerns for clinicians inserting and caring for peripheral arterial catheters. What this paper adds: The selected studies had a theme of decreased infection after using bundled strategies for all devices. Few studies addressed use of bundles for care of peripheral arterial catheters. High-quality research should be performed about using care bundles for insertion and care of arterial catheters. Introduction: A scoping review of the literature was performed. Aims/objectives: To find information on the use of care bundles for care of arterial, central, and peripherally inserted venous catheters. Methods: Data was extracted by 2 independent researchers using standardized methodology Results: Results of 84 studies included 2 (2.4%) randomized controlled trials, 38 (45.2%) observational studies, 29 (34.5%) quality projects, and 15 (17.9%) reviews. Populations had more adults than pediatric patients. All studies had the most prominent theme of decreased infection in all devices after using bundle strategies. Discussion and conclusions: The mapping of available evidence strongly supports the use of care bundles to reduce infection in the care of all intravascular devices. However, deficiencies regarding practice concerns about insertion and care of arterial catheters highlight areas for future research with the aim to eliminate the gap in the evidence of studies of care bundles for peripheral arterial catheters.
How do advanced nurse practitioners enhance healthcare outcomes in frail older patients living in care homes?
Authors: Read Haley , Nindrajog Bhuvnesh , Mortimore Gerri 
Published: January 2024

Background: As the UK healthcare service strains to meet the demand from its ageing population for 24-hour care, there is an increased need to develop an effective way to provide quality care to frail residents living in care homes. The role of the advanced nurse practitioner (ANP) has evolved over the last 20 years, developing in part to meet the shortfall of GPs and geriatric specialist doctors. Despite research having been previously conducted in the US and Canada into how the ANP role can function within care homes, there has been limited exploration into how the role can enhance UK healthcare outcomes in relation to the 2019 NHS Long-Term Plan, which aimed to provide care closer to home for ageing patients. Aims: This paper was designed to critically review published primary research papers and evaluate the impact of the ANP role on healthcare outcomes for frail elderly care home residents. Its objective was to help guide future healthcare delivery policy within the UK. Methods: A saturated systematic search of primary research literature was conducted. An inclusion/exclusion criterion was also utilised. Key papers identified were subject to critical synthesis, using ratified critical appraisal tools from the Joanna Briggs Institute and mixed-method appraisal tool by Hong et al (2018) . A thematic/narrative approach was employed to evaluate the findings of the mixed-method heterogenic-style research. Results: A total of 14 primary research papers met the criteria, which included mixed methods of study from across four English language-speaking countries. Five outcome themes were recurrent throughout the synthesis of the results, including, in order of prevalence: improved/equivalent quality of care; successful collaborative role; reduced hospitalisations; timely access to primary/secondary care; colleague/patient/family satisfaction. Discussion: Following the review of the highlighted themes, there was a consensus that ANPs positively influence the care quality of elderly patients living within care homes. Although no superiority over a physician approach was found, there was indication of supplementary benefits when including ANPs in the care home setting. These include instilling positive role models into the healthcare environment, increasing the general knowledge and education capacity of care staff, and streamlining communication—especially within advanced care planning and coordination of care. These qualities clearly encompass the current NHS priorities of the 2019 Long-Term Plan and the Enhanced Health in Care Homes Framework, which are set to be fully achieved by 2024.
Protocol for Surgery or Cast of the EpicoNdyle in Children’s Elbows (SCIENCE)
Authors: Achten Juul , Appelbe Duncan , Spoors Louise , Peckham Nicholas , Kandiyali Rebecca , Mason James , Ferguson David , Wright James , Wilson Nicola , Preston Jennifer , Moscrop Amy , Costa Matthew , Perry Daniel C. 
Published: January 2024

AimsThe management of fractures of the medial epicondyle is one of the greatest controversies in paediatric fracture care, with uncertainty concerning the need for surgery. The British Society of Children’s Orthopaedic Surgery prioritized this as their most important research question in paediatric trauma. This is the protocol for a randomized controlled, multicentre, prospective superiority trial of operative fixation versus nonoperative treatment for displaced medial epicondyle fractures: the Surgery or Cast of the EpicoNdyle in Children’s Elbows (SCIENCE) trial.MethodsChildren aged seven to 15 years old inclusive, who have sustained a displaced fracture of the medial epicondyle, are eligible to take part. Baseline function using the Patient-Reported Outcomes Measurement Information System (PROMIS) upper limb score, pain measured using the Wong Baker FACES pain scale, and quality of life (QoL) assessed with the EuroQol five-dimension questionnaire for younger patients (EQ-5D-Y) will be collected. Each patient will be randomly allocated (1:1, stratified using a minimization algorithm by centre and initial elbow dislocation status (i.e. dislocated or not-dislocated at presentation to the emergency department)) to either a regimen of the operative fixation or non-surgical treatment.OutcomesAt six weeks, and three, six, and 12 months, data on function, pain, sports/music participation, QoL, immobilization, and analgesia will be collected. These will also be repeated annually until the child reaches the age of 16 years. Four weeks after injury, the main outcomes plus data on complications, resource use, and school absence will be collected. The primary outcome is the PROMIS upper limb score at 12 months post-randomization. All data will be obtained through electronic questionnaires completed by the participants and/or parents/guardians. The NHS number of participants will be stored to enable future data linkage to sources of routinely collected data (i.e. Hospital Episode Statistics).Cite this article: Bone Jt Open 2024;5(1):69–77.