bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a microcosting protocol to determine the economic cost of diagnostic genomic testing for rare diseases in Australia
Authors: Mordaunt Dylan A , Stark Zornitza , Santos Gonzalez Francisco , Dalziel Kim , Goranitis Ilias 
Published: November 2023

IntroductionGenomic testing is a relatively new, disruptive and complex health technology with multiple clinical applications in rare diseases, cancer and infection control. Genomic testing is increasingly being implemented into clinical practice, following regulatory approval, funding and adoption in models of care, particularly in the area of rare disease diagnosis. A significant barrier to the adoption and implementation of genomic testing is funding. What remains unclear is what the cost of genomic testing is, what the underlying drivers of cost are and whether policy differences contribute to cost variance in different jurisdictions, such as the requirement to have staff with a medical license involved in testing. This costing study will be useful in future economic evaluations and health technology assessments to inform optimal levels of reimbursement and to support comprehensive and comparable assessment of healthcare resource utilisation in the delivery of genomic testing globally.MethodsA framework is presented that focuses on uncovering the process of genomic testing for any given laboratory, evaluating its utilisation and unit costs, and modelling the cost drivers and overall expenses associated with delivering genomic testing. The goal is to aid in refining and implementing policies regarding both the regulation and funding of genomic testing. A process-focused (activity-based) methodology is outlined, which encompasses resources, assesses individual cost components through a combination of bottom-up and top-down microcosting techniques and allows disaggregation of resource type and process step.Ethics and disseminationThe outputs of the study will be reported at relevant regional genetics and health economics conferences, as well as submitted to a peer-reviewed journal focusing on genomics. Human research ethics committee approval is not required for this microcosting study. This study does not involve research on human subjects, and all data used in the analysis are either publicly available.
Healthcare professionals’ priorities for training to identify and manage distress experienced by young people with a stoma due to inflammatory bowel disease: a consensus study using online nominal group technique
Authors: Saunders Benjamin , Polidano Kay , Chew-Graham Carolyn A , Fisher Tamsin , Corp Nadia , McDermott-Hughes Megan , Farmer Adam D , Bray Lucy 
Published: November 2023

ObjectivesYoung people with a stoma due to inflammatory bowel disease (IBD) commonly experience distress; however, this is not always well managed in clinical settings. More effective support may/is likely to reduce the possibility of individuals experiencing sustained distress, which may engender depression or anxiety. This study aimed to gain consensus among a multidisciplinary group of healthcare professionals (HCPs) on priorities for training in the identification and management of distress in this population. One of the authors is a young person with a stoma.DesignParticipants were recruited through Twitter (X) and the researchers’ clinical/research contacts. Two consensus group meetings were conducted using Nominal Group Technique, involving participants generating, discussing and rating on a Likert scale, topics for inclusion in an HCP training package.SettingOnline video conferencing. Participants were located across England, with one based in the USA.ParticipantsNineteen HCPs participated: three general practitioners, three stoma nurses, two IBD nurses, nine clinical psychologists and two gastroenterologists.ResultsTwenty-five topics were generated by participants; 19 reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7-point Likert scale. These included: recognising and validating different levels of, and variation in, distress; tackling stigma and normalising having a stoma; everyday practicalities of stoma management, including food and sleep; opening and holding conversations about stoma-related distress; considering the impact of different cultural beliefs on adaptation after stoma surgery; training in simple techniques for gauging the patient’s distress during clinical encounters; having conversations about body image; and myth-busting common fears, such as odour.ConclusionsThis study is the first to identify HCP training priorities for managing stoma-related distress in young people. Consensus was reached for 19 topics, reflecting the varied needs of young people with a stoma. Findings will inform development of a training package for HCPs treating young people with IBD and a stoma.
Protocol for the development and validation of a patient-reported experience measure (PREM) for people with hearing loss: the PREM-HeLP
Authors: Pryce Helen , Smith Sian Karen , Burns-O'Connell Georgina , Knibb Rebecca , Greenwood Rosemary , Shaw Rachel , Hussain Saira , Banks Jonathan , Hall Amanda , Straus Jean , Noble Sian 
Published: November 2023

IntroductionHearing loss is a common chronic health condition and adversely affects communication and social function resulting in loneliness, social isolation and depression. We know little about the patient experience of living with hearing loss and their views on the quality of the audiology service. In this study, we will develop and validate the first patient-reported experience measure (PREM) to understand patients’ experiences of living with hearing loss and their healthcare interactions with audiology services.Methods and analysisWe will develop the PREM in three phases: (1) development of PREM prototype (items/statements) derived from previous qualitative work and narrative review, (2) cognitive interview testing of the PREM prototype using a ‘think aloud’ technique to examine the acceptability and comprehensibility of the tool and refine accordingly and (3) psychometric testing of the modified PREM with 300 participants to assess the reliability and validity of the tool using Rasch analyses with sequential item reduction. Eligible participants will be young people and adults aged 16 years and over who have hearing loss. Participants will be recruited from three clinical sites located in England (Bath, Bristol) and Scotland (Tayside) and non-clinical settings (eg, lip-reading classes, residential care settings, national charity links, social media).Ethics and disseminationThe study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022; ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales (HCRW) Approval (approval date: 14 June 2022; IRAS project ID: 308816). Findings will be shared with our patient and public involvement groups, academics, audiology communities and services and local commissioners via publications and presentations. The PREM will be made available to clinicians and researchers without charge.
Sequential Monte Carlo with cross-validated neural networks for complexity of hyperbolic black hole solutions in 4D
Authors: Hatefi Armin , Hatefi Ehsan 
Published: November 2023

AbstractThis paper investigates the self-similar solutions of the Einstein-axion-dilaton configuration from type IIB string theory and the global SL(2,R) symmetry. We consider the Continuous Self Similarity (CSS), where the scale transformation is controlled by an SL(2, R) boost or hyperbolic translation. The solutions stay invariant under the combination of space-time dilation with internal SL(2,R) transformations. We develop a new formalism based on Sequential Monte Carlo (SMC) and artificial neural networks (NNs) to estimate the self-similar solutions to the equations of motion in the hyperbolic class in four dimensions. Due to the complex and highly nonlinear patterns, researchers typically have to use various constraints and numerical approximation methods to estimate the equations of motion; thus, they have to overlook the measurement errors in parameter estimation. Through a Bayesian framework, we incorporate measurement errors into our models to find the solutions to the hyperbolic equations of motion. It is well known that the hyperbolic class suffers from multiple solutions where the critical collapse functions have overlap domains for these solutions. To deal with this complexity, for the first time in literature on the axion-dilaton system, we propose the SMC approach to obtain the multi-modal posterior distributions. Through a probabilistic perspective, we confirm the deterministic $$\alpha $$
α
and $$\beta $$
β
solutions available in the literature and determine all possible solutions that may occur due to measurement errors. We finally proposed the penalized Leave-One-Out Cross-validation (LOOCV) to combine the Bayesian NN-based estimates optimally. The approach enables us to determine the optimum weights while dealing with the co-linearity issue in the NN-based estimates and better predict the critical functions corresponding to multiple solutions of the equations of motion.
Three of North America's geoheritage sites and the lost 1863 exploration of Giovanni Capellini
Authors: Contessi Michela , Fiorillo Anthony R. , Fanti Federico 
Published: November 2023

Abstract
Geoparks and the valorization of sites with a strong geoheritage component is a new frontier for sustainable tourism. A UNESCO special recognition was established in 2015, and much work has been undertaken in establishing sites in Europe and Asia, yet only five localities have been recognized by UNESCO in North America. This paper discusses three sites relevant to geoheritage – Pulpit Rock in Massachusetts, Montmorency Falls in Quebec and Niagara Falls in New York and Ontario – which were visited in 1863 by the newly appointed professor of geology at Bologna University, Giovanni Capellini. During his four-month journey across northeastern North America, he made sketches, took notes and collected more than 2000 specimens that together provide a depth of perspective on the importance of the geoheritage of the sites he visited. We chose these sites, among the many visited by Capellini, because Niagara Falls is now seeking UNESCO recognition, and the other two, though no longer fully accessible, remain important tourist sites and areas of geological interest.
In Situ Green Synthesis of Co3O4@ZnO Core-Shell Nanoparticles Using Datura stramonium Leaf Extract: Antibacterial and Antioxidant Studies
Authors: Tadesse Gezahegn , Ananda Murthy H. C. , Ravikumar C. R. , Naveen Kumar T. , Teshome Lema , Desalegn Tegene 
Published: November 2023

Investigating and synthesizing potent antibacterial NPs using biological methods is highly preferred, and it involves nontoxic, cost-effective, and environmentally friendly chemicals and methods. Antibiotic drug resistance and oxidative stress have become a serious public health issue worldwide. Hence, the key objective of this study was to biologically synthesize and characterize the potent antibacterial Co3O4@ZnO core-shell nanoparticles for the antibacterial application. The radical scavenging ability of green synthesized Co3O4@ZnO core-shell nanoparticles was also determined. In this study, Co3O4@ZnO core-shell nanoparticles (CZCS NPs) have been synthesized using three different core to shell materials ratios of Co3O4 to ZnO (0.5 : 0.25 CZCS (1), 0.5 : 0.5 CZCS (2), and 0.5 : 0.75 M CZCS (3)) by employing Datura stramonium leaf extract. The polycrystalline nature of Co3O4@ZnO core-shell nanoparticles was investigated using the XRD and SAED characterization techniques. The investigated nanostructure of Co3O4@ZnO core-shell nanoparticles appeared with Co3O4 as the core and ZnO as an outer shell. Additionally, a variety of physicochemical properties of the nanoparticles were determined using various characterization techniques. The average crystallite sizes of CZCS (1), CZCS (2), and CZCS (3) were found to be

24
±
1.4

,

22
±
1.5

, and

25
±
1.5

nm, respectively. The band gap energy values for CZCS (1), CZCS (2), and CZCS (3) determined from the UV-DRS data were found to be 2.75, 2.76, and 2.73 eV, respectively. The high inhibition activities against S. aureus, S. pyogenes, E. coli, and P. aeruginosa bacterial strains were obtained for the small size CZCS (2) nanoparticles at the concentration of 100 mg/mL with 22 ± 0.34, 19 ±

0
.
32

, 18 ±

0.45

, and 17 ±

0

.32 mm values, respectively. The high inhibition performance of CZCS (2) nanoparticles against Gram-positive and Gram-negative bacteria which is even above the control drug ampicillin is because of its small size and synergistic effect. The percentage scavenging activity of Co3O4@ZnO core-shell nanoparticles was also studied and CZCS (2) nanoparticles showed a good scavenging capacity (86.87%) at 500 μg/mL with IC50 of 209.26 μg/mL.
Status and Influencing Factors of Nurses’ Perception of Toxic Leadership Behavior: A Cross-Sectional Study
Authors: Guo Xueqin , Li Xin , Wang Yuhan , Wang Yumei , Jin Huan , Xiao Fang , Xiang Yuting , Xu Chenzi , Wang Yangjing , He Jia , Xiong Lijuan 
Published: November 2023

Aim. The aim of this study is to analyse the toxic leadership behavior of nurse managers perceived by nurses and its related factors. Background. Toxic leadership is becoming more common as a risk factor in nursing. However, there is a scarcity of research on the elements that influence toxic leadership practices from the perspective of nurses’ perceptions. Methods. A cross-sectional study was conducted with 455 nurses from August to October 2022. A demographic information questionnaire and a negative behavior scale for nurse managers were used. Descriptive statistics, Kruskal–Wallis H test or Mann–Whitney U test, and multiple linear regression were used to explore the relevant factors of nurses’ perceived toxic leadership behaviors of nurse managers. Results. The population was dominated by 423 (92.97%) females, 318 (69.89%) married, and 420 (92.31%) with a bachelor’s degree. The toxic leadership behavior scale score for nurse managers was 109 (87, 123) and the score for each entry was (2.94 ± 0.92). Gender, educational level, department, number of night shifts, and nature of employment were the influencing factors of the negative leadership behavior of nurse leaders as perceived by nurses (

P

< 0.05), explaining a total of 43.1% of the total variance. Conclusion. In general, nurses’ perceived toxic leadership behaviors of nurse managers were at a moderate level. More toxic leadership behaviors were observed by nurses who were female, less educated, on busy units, with unstable nature of appointments, and with frequent night shift rotation. Implications for Nursing Management. Focus on the psychological condition of nurses who are female, less educated, work in busy units, have an unstable nature of employment, and rotate night shifts frequently. The negative impacts of toxic leadership behaviors might be lessened as a result.
Clinical Benefit of Intravascular Imaging Compared With Conventional Angiography in Left Main Coronary Artery Intervention
Authors: Kwon Woochan , Lee Joo Myung , Yun Kyeong Ho , Choi Ki Hong , Lee Seung-Jae , Lee Jong-Young , Lee Sang Yeub , Kim Sang Min , Cho Jae Young , Kim Chan Joon , Ahn Hyo-Suk , Nam Chang-Wook , Yoon Hyuck-Jun , Park Yong Hwan , Lee Wang Soo , Jeong Jin-Ok , Song Pil Sang , Doh Joon-Hyung , Jo Sang-Ho , Yoon Chang-Hwan , Kang Min Gyu , Koh Jin-Sin , Lee Kwan Yong , Lim Young-Hyo , Cho Yun-Hyeong , Cho Jin-Man , Jang Woo Jin , Chun Kook-Jin , Hong David , Park Taek Kyu , Yang Jeong Hoon , Choi Seung-Hyuk , Gwon Hyeon-Cheol , Hahn Joo-Yong , Song Young Bin ,   for The RENOVATE COMPLEX-PCI Investigators
Published: November 2023

BACKGROUND:
The RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention) demonstrated that intravascular imaging–guided percutaneous coronary intervention (PCI) improved clinical outcome compared with angiography-guided PCI for patients with complex coronary artery lesions. This study aims to assess whether the prognostic benefit of intravascular imaging–guided procedural optimization persists in patients undergoing PCI for left main coronary artery disease.

METHODS:
Of 1639 patients enrolled in the RENOVATE-COMPLEX-PCI, 192 patients with left main coronary artery disease were selected for the current prespecified substudy. Selected patients were randomly assigned to either the intravascular imaging–guided PCI group (n=138) or the angiography-guided PCI group (n=54). The primary end point was target vessel failure defined as a composite of cardiac death, target vessel–related myocardial infarction, or clinically driven target vessel revascularization.

RESULTS:

At a median follow-up of 2.1 years (interquartile range 1.1 to 3.0 years), intravascular imaging–guided PCI was associated with lower incidence of primary end point compared with angiography-guided PCI (6.8% versus 25.1%; hazard ratio, 0.31 [95% CI, 0.13–0.76];
P
=0.010). This significant reduction in primary end point was mainly driven by a lower risk of cardiac death or spontaneous target vessel–related myocardial infarction (1.6% versus 12.7%; hazard ratio, 0.16 [95% CI, 0.03–0.82];
P
=0.028). Intravascular imaging–guided PCI was independently associated with a lower risk of primary end point, even after adjusting for various clinical factors (hazard ratio, 0.29 [95% CI, 0.12–0.72];
P
=0.007).

CONCLUSIONS:
Intravascular imaging–guided PCI showed clinical benefit over angiography-guided PCI for left main coronary artery disease in reducing the risk of cardiac death, target vessel–related myocardial infarction, or target vessel revascularization.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03381872.
Dental Caries, Race and Incident Ischemic Stroke, Coronary Heart Disease, and Death
Authors: Sen Souvik , Logue Lawson , Logue Makenzie , Otersen Elizabeth A.L. , Mason Emma , Moss Kevin , Curtis James , Hicklin David , Nichols Cynthia , Rosamond Wayne D. , Gottesman Rebecca F. , Beck James 
Published: November 2023

BACKGROUND:
Dental caries is a highly prevalent disease worldwide. In the United States, untreated dental caries is present in >1 in 5 adults. The objective of this study was to determine the relationship between dental caries and incident ischemic stroke, coronary heart disease (CHD) events, and death.

METHODS:
The dental cohort (n=6351) of the ARIC study (Atherosclerosis Risk in Communities) was followed for incident ischemic stroke, CHD event, and all-cause mortality. Of all the participants at visit 4 (n=11 656), those who were unable to go through dental examination, or with prevalent ischemic stroke and CHD events, were excluded. The full-mouth dental examination was conducted at visit 4 (1996–1998), assessing dental caries. The dose response of decayed, missing, and filled surfaces due to caries was assessed and related to the outcome. Outcomes were assessed through the end of 2019. Additionally, the effect of regular dental care utilization on dental caries was evaluated.

RESULTS:

Participants with ≥1 dental caries had an increased risk of stroke (adjusted hazard ratio [HR], 1.40 [95% CI, 1.10–1.79]) and death (adjusted HR, 1.13 [95% CI, 1.01–1.26]) but not for CHD events (adjusted HR, 1.13 [95% CI, 0.93–1.37]). The association of dental caries and ischemic incident stroke was significantly higher in the African American population compared with the White subgroup (interaction term
P
=0.0001). Increasing decayed, missing, and filled surfaces were significantly associated with stroke (adjusted HR, 1.006 [95% CI, 1.001–1.011]) and death (adjusted HR, 1.003 [95% CI, 1.001–1.005]) but not CHD (adjusted HR, 1.002 [95% CI, 1.000–1.005]). Regular dental care utilization lowered (adjusted odds ratio, 0.19 [95% CI, 0.16–0.22];
P
<0.001) the chance of caries.

CONCLUSIONS:
Among the cohort, dental caries was independently associated with the risk of ischemic stroke and death, with the effect higher in African American participants. Regular dental care utilization was associated with a lower chance of caries, emphasizing its relevance in the prevention of these events.
Fine Particulate Matter Exposure, Genetic Susceptibility, and the Risk of Incident Stroke: A Prospective Cohort Study
Authors: Huang Keyong , Jia Jiajing , Liang Fengchao , Li Jianxin , Niu Xiaoge , Yang Xueli , Chen Shufeng , Cao Jie , Shen Chong , Liu Xiaoqing , Yu Ling , Lu Fanghong , Wu Xianping , Zhao Liancheng , Li Ying , Hu Dongsheng , Huang Jianfeng , Liu Yang , Gu Dongfeng , Liu Fangchao , Lu Xiangfeng 
Published: November 2023

BACKGROUND:
Both genetic factors and environmental air pollution contribute to the risk of stroke. However, it is unknown whether the association between air pollution and stroke risk is influenced by the genetic susceptibilities of stroke and its risk factors.

METHODS:

This prospective cohort study included 40 827 Chinese adults without stroke history. Satellite-based monthly fine particulate matter (PM
2.5
) estimation at 1-km resolution was used for exposure assessment. Based on 534 identified genetic variants from genome-wide association studies in East Asians, we constructed 6 polygenic risk scores for stroke and its risk factors, including atrial fibrillation, blood pressure, type 2 diabetes, body mass index, and triglyceride. The Cox proportional hazards model was applied to evaluate the hazard ratios and 95% CIs for the associations of PM
2.5
and polygenic risk score with incident stroke and the potential effect modifications.

RESULTS:

Over a median follow-up of 12.06 years, 3147 incident stroke cases were documented. Compared with the lowest quartile of PM
2.5
exposure, the hazard ratio (95% CI) for stroke in the highest quartile group was 2.72 (2.42–3.06). Among individuals at high genetic risk, the relative risk of stroke was 57% (1.57; 1.40–1.76) higher than those at low genetic risk. Although no statistically significant interaction was found, participants with both the highest PM
2.5
and high genetic risk showed the highest risk of stroke, with ≈4× that of the lowest PM
2.5
and low genetic risk group (hazard ratio, 3.55 [95% CI, 2.84–4.44]). Similar upward gradients were observed in the risk of stroke when assessing the joint effects of PM
2.5
and genetic risks of blood pressure, type 2 diabetes, body mass index, atrial fibrillation, and triglyceride.

CONCLUSIONS:

Long-term exposure to PM
2.5
was associated with a higher risk of incident stroke across different genetic susceptibilities. Our findings highlighted the great importance of comprehensive assessment of air pollution and genetic risk in the prevention of stroke.