bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging
Authors: May Tom , Towler Lauren , Smith Louise E , Horwood Jeremy , Denford Sarah , Rubin G James , Hickman Matthew , Amlôt Richard , Oliver Isabel , Yardley Lucy 
Published: November 2023

Abstract
Background
The 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to control transmission, multiple public health measures were implemented, including vaccination, contact tracing and isolation. This study examines knowledge, attitudes, and perceptions of mpox among a sample of GBMSM during the 2022-23 outbreak in the UK, including facilitators for and barriers to the uptake of public health measures.

Methods
Interviews were conducted with 44 GBMSM between May and December 2022. Data were analysed using reflexive thematic analysis. Positive and negative comments pertaining to public health measures were collated in a modified version of a ‘table of changes’ to inform optimisations to public health messages and guidance.

Results
Most interviewees were well informed about mpox transmission mechanisms and were either willing to or currently adhering to public health measures, despite low perceptions of mpox severity. Measures that aligned with existing sexual health practices and norms were considered most acceptable. Connections to GBMSM networks and social media channels were found to increase exposure to sexual health information and norms influencing protective behaviours. Those excluded or marginalized from these networks found some measures challenging to perform or adhere to. Although social media was a key mode of information sharing, there were preferences for timely information from official sources to dispel exaggerated or misleading information.

Conclusions
There are differential needs, preferences, and experiences of GBMSM that limit the acceptability of some mitigation and prevention measures. Future public health interventions and campaigns should be co-designed in consultation with key groups and communities to ensure greater acceptability and credibility in different contexts and communities.
Implementation of the polluter pay’s principle in tobacco control in the UK: a stakeholder analysis
Authors: Smith Marissa J. , Patterson Chris , Buckton Christina , Hilton Shona 
Published: November 2023

Abstract
Background
The polluter’s pay principle (PPP) aims to internalise external costs and assign liability to the polluter for the harmful cost of their products to society. Tobacco companies continue to manufacture and sell harmful cigarettes, earning billions in profits each year from these products. Meanwhile, governments and their people are left to ‘clean up’ and deal with the detrimental health consequences. This paper explores with expert stakeholders how the PPP could be implemented within the context of tobacco control in the United Kingdom (UK).

Methods
Twenty-four semi-structured interviews and two follow-up discussion groups were conducted with UK and international experts on tobacco control, public health, economics, or law from the academic, public, private and third sector. Participants considered the facilitators and barriers to implementing the PPP to tobacco control in the UK. Thematic analysis was employed, aided by NVivo 12, and data were compared to examine the views expressed by the different types of experts.

Results
Stakeholders favoured the implementation of the PPP in the context of tobacco control and indicated that it could be acceptable and feasible to implement and that it would likely have support from policymakers and the public alike. Stakeholders unanimously agreed that any legislation and administration should be free from tobacco industry influence; however, differences arose concerning who should oversee the implementation.

Conclusion
The PPP from environmental law was predominantly seen as an approach that could be usefully applied to the tobacco industry. However, there is no one size fits all template, therefore its implementation would need to be adapted to fit the UK context.
Automatic craniomaxillofacial landmarks detection in CT images of individuals with dentomaxillofacial deformities by a two-stage deep learning model
Authors: Tao Leran , Li Meng , Zhang Xu , Cheng Mengjia , Yang Yang , Fu Yijiao , Zhang Rongbin , Qian Dahong , Yu Hongbo 
Published: November 2023

Abstract
Background
Accurate cephalometric analysis plays a vital role in the diagnosis and subsequent surgical planning in orthognathic and orthodontics treatment. However, manual digitization of anatomical landmarks in computed tomography (CT) is subject to limitations such as low accuracy, poor repeatability and excessive time consumption. Furthermore, the detection of landmarks has more difficulties on individuals with dentomaxillofacial deformities than normal individuals. Therefore, this study aims to develop a deep learning model to automatically detect landmarks in CT images of patients with dentomaxillofacial deformities.

Methods
Craniomaxillofacial (CMF) CT data of 80 patients with dentomaxillofacial deformities were collected for model development. 77 anatomical landmarks digitized by experienced CMF surgeons in each CT image were set as the ground truth. 3D UX-Net, the cutting-edge medical image segmentation network, was adopted as the backbone of model architecture. Moreover, a new region division pattern for CMF structures was designed as a training strategy to optimize the utilization of computational resources and image resolution. To evaluate the performance of this model, several experiments were conducted to make comparison between the model and manual digitization approach.

Results
The training set and the validation set included 58 and 22 samples respectively. The developed model can accurately detect 77 landmarks on bone, soft tissue and teeth with a mean error of 1.81 ± 0.89 mm. Removal of region division before training significantly increased the error of prediction (2.34 ± 1.01 mm). In terms of manual digitization, the inter-observer and intra-observer variations were 1.27 ± 0.70 mm and 1.01 ± 0.74 mm respectively. In all divided regions except Teeth Region (TR), our model demonstrated equivalent performance to experienced CMF surgeons in landmarks detection (p  >  0.05).

Conclusions
The developed model demonstrated excellent performance in detecting craniomaxillofacial landmarks when considering manual digitization work of expertise as benchmark. It is also verified that the region division pattern designed in this study remarkably improved the detection accuracy.
Symptom and problem clusters in German specialist palliative home care - a factor analysis of non-oncological and oncological patients’ symptom burden
Authors: Gesell Daniela , Hodiamont Farina , Wikert Julia , Lehmann-Emele Eva , Bausewein Claudia , Nauck Friedemann , Jansky Maximiliane ,   , for the COMPANION study group
Published: November 2023

Abstract
Background
Specialist palliative home care (SPHC) aims to maintain and improve patients’ quality of life in the community setting. Symptom burden may differ between oncological and non-oncological patients. However, little is known about diagnosis-related differences of SPHC patients. This study aims to describe the prevalence of physical symptom burden and psychosocial problems of adult patients in SPHC, and to evaluate diagnosis-related symptom clusters.

Methods
Secondary analysis of data from a prospective, cross-sectional, multi-centre study on complexity of patients, registered at the German Register for Clinical Studies (DRKS trial registration number: DRKS00020517, 12/10/2020). Descriptive statistics on physical symptom burden and psychosocial problems at the beginning of care episodes. Exploratory and confirmatory factor analyses to identify symptom and problem clusters.

Results
Seven hundred seventy-eight episodes from nine SPHC teams were included, average age was 75 years, mean duration of episode 18.6 days (SD 19.4). 212/778 (27.2%) had a non-oncological diagnosis. Main burden in non-oncological episodes was due to poor mobility (194/211; 91.9%) with significant diagnosis-related differences (χ² = 8.145, df = 1, p = .004; oncological: 472/562; 84.0%), and due to weakness (522/565; 92.4%) in oncological episodes. Two symptom clusters (psychosocial and physical) for non-oncological and three clusters (psychosocial, physical and communicational/practical) for oncological groups were identified. More patients in the non-oncological group compared to the oncological group showed at least one symptom cluster (83/212; 39.2% vs. 172/566; 30.4%).

Conclusion
Patients with non-oncological diseases had shorter episode durations and were more affected by symptom clusters, whereas patients with oncological diseases showed an additional communicational/practical cluster. Our findings indicate the high relevance of care planning as an important part of SPHC to facilitate anticipatory symptom control in both groups.
Psychometric assessment of the US person-centered prenatal and maternity care scales in a low-income predominantly Latinx population in California
Authors: Afulani Patience A. , Coleman-Phox Kimberly , Leon-Martinez Daisy , Fung Kathy Z. , Martinez Erica , Garza Mary A. , McCulloch Charles E. , Kuppermann Miriam 
Published: November 2023

Abstract
Objectives
To assess psychometric properties of two scales developed to measure the quality of person-centered care during pregnancy and childbirth in the United States—the Person-Centered Prenatal Care (PCPC-US) and Person-Centered Maternity Care (PCMC-US) scales—in a low-income predominantly Latinx population in California.

Methods
Data were collected from July 2020 to June 2023 from surveys of low-income pregnant and birthing people in Fresno, California, participating in the “Engaging Mothers and Babies; Reimagining Antenatal Care for Everyone” (EMBRACE) trial. Research staff administered the 26-item PCPC-US scale at 30–34 weeks’ gestation (n = 315) and the 35-item PCMC-US scale at 10–14 weeks after birth (n = 286), using the language preferred by the participant (English or Spanish). We assessed construct, criterion, and known group validity and internal consistency of the scales.

Results
78% of respondents identified as Latinx. Factor analysis identified one dominant factor for each scale that accounted for over 60% of the cumulative variance, with most items loading at > 0.3. The items also loaded adequately on sub-scales for “dignity and respect,” “communication and autonomy,” and “responsive and supportive care.” Cronbach’s alpha for the full scales were > 0.9 and between 0.70 and 0.87 for the sub-scales. Summative scores range from 0 to 100, with higher scores indicating higher person-centered care. Correlations with scores on scales measuring prenatal care quality and birth experience provided evidence for criterion validity, while associations with known predictors provided evidence for known-group validity.

Conclusions
The PCPC-US and PCMC-US scales, which were developed using a community-engaged process and found to have good psychometric properties in a largely high-income sample of Black women, were shown to also have good psychometric properties in a sample of low-income primarily Latinx women. Both scales provide valid and reliable tools to measure person-centered care experiences among minoritized communities to support efforts to reduce existing birth inequities.
Positioning, power and agency in postgraduate primary care supervision: a study of trainee narratives
Authors: Jackson Dawn , Brady Josephine , Dawkins Donna 
Published: November 2023

Abstract
Background
Postgraduate supervision takes place within complex training environments, where experiences are shaped by the socio-cultural context and wider profession, and where tensions permeate. Bordin’s working alliance-based model of supervision suggests that quality relationships encompass agreement on the goals and tasks of supervision, in the context of an emotional bond. However, as trainees and their supervisors navigate the demands of providing safe clinical care, alongside educational support, disagreement on expectations for supervision may emerge. By applying a critical lens, this research draws on positioning theory to explore General Practice trainees’ experiences of supervision.

Methods
In 2017–2019 a series of narrative interviews were undertaken with 13 General Practice trainees in the United Kingdom (UK). Participants were purposively sampled based on end-of-year performance, gender, training location and training status. Interviews were analysed using Brown and Gilligan’s Listening Guide, which was adapted to incorporate an exploration of positioning, power and agency.

Results
Trainees appeared to hold variable positions, such as ‘insiders’, ‘outsiders’, ‘peers’ and ‘problem trainees’. Supervisors, through talk and the degree of access afforded, contributed to this positioning. Some trainees viewed their supervisors as brokers and guides as they navigated their training, whilst others were suspicious of the supervisor role. For trainees who raised concerns about their supervisor through formal channels, results were not often satisfactory. Others chose to navigate difficulty in supervision through informal means. This typically involved mastery of artefacts of training, such as the electronic appointment book or training portfolio.

Conclusions
This paper builds on Bordin’s model of supervision to encourage greater clarity in supervisory discussions, exploring assumptions, and recognising the influences of environment, power, positioning, and agency. We have developed a Model of the Supervisory Alliance in Postgraduate GP Training (MSA-GP) to serve as a springboard for discussion for trainees and their supervisors.
Engineering the synthetic β-alanine pathway in Komagataella phaffii for conversion of methanol into 3-hydroxypropionic acid
Authors: Àvila-Cabré Sílvia , Pérez-Trujillo Míriam , Albiol Joan , Ferrer Pau 
Published: November 2023

Abstract
Background
Methanol is increasingly gaining attraction as renewable carbon source to produce specialty and commodity chemicals, as it can be generated from renewable sources such as carbon dioxide (CO2). In this context, native methylotrophs such as the yeast Komagataella phaffii (syn Pichia pastoris) are potentially attractive cell factories to produce a wide range of products from this highly reduced substrate. However, studies addressing the potential of this yeast to produce bulk chemicals from methanol are still scarce. 3-Hydroxypropionic acid (3-HP) is a platform chemical which can be converted into acrylic acid and other commodity chemicals and biopolymers. 3-HP can be naturally produced by several bacteria through different metabolic pathways.

Results
In this study, production of 3-HP via the synthetic β-alanine pathway has been established in K. phaffii for the first time by expressing three heterologous genes, namely panD from Tribolium castaneum, yhxA from Bacillus cereus, and ydfG from Escherichia coli K-12. The expression of these key enzymes allowed a production of 1.0 g l−1 of 3-HP in small-scale cultivations using methanol as substrate. The addition of a second copy of the panD gene and selection of a weak promoter to drive expression of the ydfG gene in the PpCβ21 strain resulted in an additional increase in the final 3-HP titer (1.2 g l−1). The 3-HP-producing strains were further tested in fed-batch cultures. The best strain (PpCβ21) achieved a final 3-HP concentration of 21.4 g l−1 after 39 h of methanol feeding, a product yield of 0.15 g g−1, and a volumetric productivity of 0.48 g l−1 h−1. Further engineering of this strain aiming at increasing NADPH availability led to a 16% increase in the methanol consumption rate and 10% higher specific productivity compared to the reference strain PpCβ21.

Conclusions
Our results show the potential of K. phaffii as platform cell factory to produce organic acids such as 3-HP from renewable one-carbon feedstocks, achieving the highest volumetric productivities reported so far for a 3-HP production process through the β-alanine pathway.
Influence of metabolic tumor burden on reference tissues’ standardized uptake values in 18F-FDG PET/CT sequential imaging
Authors: Badawy Ahmed , Maamoun Marwa Mohamed , Kandeel Ahmed Abdelsamie , Anwar Hoda 
Published: November 2023

Abstract
Background
Extremely hypermetabolic neoplastic tissues have been hypothesized to act as a “sink” reducing the amount of radiopharmaceutical available for uptake in other tissues, i.e., superscan phenomenon, the purpose of the study is to correlate the percent of change of metabolic tumor burden (MTB) with the standardized uptake values (SUVs) in reference tissues (liver, blood pool, brain and muscles) in sequential F-18-FDG PET/CT studies after therapy for different response groups (progression, regression and resolution) in all patients and in lymphoma patients.

Results
In all patients: there was significant negative correlation between % of change in MTB with % of change of SUV in liver, blood pool, brain and muscles (p < 0.05). In progression group: there was significant negative correlation between % of change in MTB with % of change of SUV in liver and in muscles only. In regression group: there was no significant correlation in all organs. In lymphoma patients: there was significant negative correlation between % of change in MTB with % of change of SUV in liver, blood pool and brain but not in muscles.

Conclusions
MTB can potentially affect F-18-FDG biodistribution in reference organs, which has a negative impact on semiquantitative analysis during interpretation of sequential studies. In lymphoma patients, normalizing tumor FDG uptake can be done to muscles as a potential stable reference tissue given that all other factors that could alter biodistribution were considered.
Pre-Operative Management and Its Influence on Maladaptive Behavioural Disorders in Children
Authors: Petríková Z. Adamcová , Kenderessy P. Kenderessy , Petrík O. Petrík , Adamec T. Adamec 
Published: November 2023

Anaesthetics and their influence on children’s brains have become one of the most discussed problems in paediatric anaesthesiology. The experimental studies on animal models have shown that the anaesthetics used in general anaesthesia should have an influence on neurodegenerative processes, neuroapoptosis and the unregulated death of the neuronal cells in the developing brain. Due to this reality, scientists are trying to discover how to minimize the adverse effects of anaesthesia and revise other alternatives of prevention anaesthesia-induced maladaptive behavioural disorders, especially in children.
The paper will present the procedures of preoperative management at a children’s faculty hospital in Banská Bystrica, Slovakia, our working place, and reveal how to minimize the adverse effects of anesthesia presenting in maladaptive behavioural disorders.
EARLY-STAGE SELF-ASSEMBLING PEPTIDE HYDROGEL-BASED INTERVENTION FOR ARTICULAR PATELLA CARTILAGE REPAIR
Authors: Warren James , Cowie Raelene , Jennings Louise , Wilcox Ruth , Fermor Hazel 
Published: November 2023

AbstractObjectivesThe aim of this study was to develop an in vitro GAG-depleted patella model and assess the biomechanical effects following treatment with a SAP:CS self-assembling hydrogel.MethodsPorcine patellae (4–6 month old) were harvested and subject to 0.1% (w/v) sodium dodecyl sulfate (SDS) washes to remove GAGs from the cartilage. Patellae were GAG depleted and then treated by injection with SAP (∼ 6 mM) and CS (10 mg) in Ringer's solution through a 30G needle. Native, GAG depleted and SAP:CS treated patellae were tested through static indentation testing, using 15g load, 5mm indenter over 1hr period. The degree of deformation of each group was assessed and compared (Mann-Whitney, p<0.05). Native, GAG depleted, sham (saline only) and SAP:CS treated paired patellae and femurs were additionally characterized tribologically through sequential wear testing when undergoing a walking gait profile (n=6 per group). The cartilage surfaces were assessed and compared (Mann-Whitney, p<0.05) using the ICRS scoring system, surface damage was illustrated through the application of Indian ink.ResultsStatic indentation tests indicated significant increase in indentation deformation of GAG depleted group compared to native group (n=6, p<0.01) and significant reduction in deformation of SAP:CS treated group compared to GAG depleted group (n=6, p<0.05). Sequential wear tests indicated a significant increase in the cartilage damage on the both surfaces of the patellofemoral joint in the GAG depleted group, compared to the native group (n=6, p<0.001), Following SAP:CS treatment, significant protection from damage was observed on femoral surface (n=6, p<0.005), with some non-significant reduction in damage on the patella surface. Sham injections showed no significant increase in damage compared to the native and treated samples.ConclusionsThe ∼50% reduction of GAGs represented a moderate osteoarthritic patella cartilage model. This same loss transferred to the dynamic wear tests with significant changes in the damage on the femoral counter face associated with the GAG loss. SAP:CS treatment showed promise in restoring cartilage stiffness to treat Chondromalacia patella in static indentation tests. Sequential wear tests showed that the SAP:CS treatment protects the cartilage layer of both surfaces in the patellofemoral joint from damage in an extreme degeneration model. The sham injections showed that injecting cartilage with a 30G and saline does not cause any significant damage to the cartilage layer.Declaration of Interest(a) fully declare any financial or other potential conflict of interest
ASSESSMENT OF HEMIARTHROPLASTY IN AN ANATOMICAL HIP SIMULATOR
Authors: Diaz Roberto Leonardo , Williams Sophie , Jimenez-Cruz David , Board Timothy 
Published: November 2023

AbstractBACKGROUNDHemi-arthroplasty (HA) as a treatment for fractured neck of femur has slightly increased since 2019 and remarkably after the COVID pandemic. The main drawback of the treatment is ongoing cartilage deterioration that may require revision to THR.OBJECTIVEThis study assessed cartilage surface damage in hip HA by reproducing anatomical motion and loading conditions in a hip simulator.METHODSExperimental design. HA tests were conducted using porcine acetabula and CoCr femoral heads. Five groups (n=4) were included: a control group comprising natural tissue and four HA groups where the acetabula were paired with metal heads to allow radial clearance (RC) classed as small (RC<0.6mm), large (2mm<RC<4mm), extra-large (4mm<RC), and oversized (RC<−0.6mm). Tests were carried out in an anatomical hip simulator that reproduced a simplified twin peak gait cycle, adapted for porcine hip joints, from the ISO 14242 standard for wear of THR prostheses (peak load of 900N). The test length was 6 hours, with photogrammetry taken at 1-hour intervals. Ringers solution was used as a lubricant.RESULTSNo changes were observed in the control group. However, cartilage surface changes were observed in all hemi-arthroplasty groups. Discolouration on the cartilage surface was noticeable at the posterior-superior part of the acetabulum after 1-hour (extra-large and oversized groups). Damage severity and location were characteristic of each clearance group. Of all the groups, the oversized group showed more significant damage. No labrum separation was seen after the simulation.CONCLUSIONSThese results are relevant to understand the effect of femoral head clearance on cartilage damage risk after HA.Declaration of Interest(a) fully declare any financial or other potential conflict of interest