bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality and health-related quality of life in older adults with long-term use of opioids, z-hypnotics or benzodiazepines: a prospective observational study at 5 years follow-up
Authors: Bjelkarøy Maria Torheim , Simonsen Tone Breines , Siddiqui, Tahreem Ghazal , Cheng Socheat , Grambaite Ramune , Benth Jūratė Šaltytė , Lundqvist Christofer 
Published: February 2024

ObjectivesDisease and medication use in older age is a consequence of age-related declining health. Multimorbidity followed by polypharmacy is common. Central nervous system depressing (CNSD) drugs such as opioids, benzodiazepines and z-hypnotics are not recommended for long-term use in older adults but are in use by many. We aimed to assess mortality and change in health-related quality of life (HRQoL) in older adults with long-term use of CNSDs.MethodA prospective observational study was conducted at Akershus University Hospital, Norway, 2017–2019, with follow-up in 2021–2022, including 246 participants aged 65–90. At 5-year follow-up, 78 (32%) participants had passed away. Mortality data were collected from patient electronic health records. Of the surviving 168 (68%), we collected further follow-up data from 38 (16%) participants. Follow-up included demographic and clinical data. The EuroQuol Group EQ-5D-5L questionnaire was used to measure HRQoL. Analysis include Cox regression model for survival data and linear mixed model for change in HRQoL over time.ResultsAt follow-up, 78 (31.7%) were deceased. Mean survival time was 3.3 years. Total time for survival data was 4.7 years. Mortality was higher among participants with long-term use of CNSD (HR 1.9 95% CI (1.2 to 3.2), p=0.01). The multivariable analysis found being older (HR 1.1 95% CI (1.0 to 1.1), p=0.020) and male sex (HR 2.1 95% CI (1.2 to 3.5), p=0.008) to be associated with increased risk of mortality. According to the linear mixed model (n=38), there was no significant difference between surviving users and non-users in change in HRQoL EQ-5D-5L index from baseline to follow-up.ConclusionMortality was higher for long-term users of CNSDs at 5-year follow-up. Being older and male sex were associated with mortality. Among survivors, there was no significant difference between the groups in change of HRQoL over time.Trial registration numberNCT03162081; 22 May 2017.
Post-traumatic growth among emergency nurses after COVID-19 in Shanghai, China: a qualitative study
Authors: Jiang Jinxia , Liu Yue , Han Peng , Zhang Pengjia , Shao Haiyan , Dai Zhenjuan , Zhuang Yugang 
Published: February 2024

ObjectivesThis study aims to investigate the post-traumatic growth of emergency nurses (ENs) in Shanghai, China, in 2022 following the COVID-19 pandemic.DesignA phenomenological qualitative research approach was employed, with 17 ENs being interviewed between July and August 2022. Data collection was conducted through semistructured, in-depth interviews, and data analysis was carried out using the Colaizzi’s seven-step analysis method.SettingA third-level hospital in Shanghai.ParticipantsA total of 17 ENs were interviewed through face-to-face, semistructured, in-depth interviews.ResultsThree main themes and eight subthemes were extracted from the data: (a) stress, (b) restructuring and (c) growth.ConclusionSignificant stress was imposed on ENs by the Shanghai COVID-19 pandemic, but cognitive restructuring was successfully undergone by them, leading to the experience of growth. It is recommended that post-traumatic growth levels be enhanced through professional psychological counselling and tailored support measures for different stages.
Exploring the palliative care ecosystem in Thailand: a protocol for a scoping review and bibliometric analysis
Authors: Phenwan Tharin , Anantapong Kanthee , Sripaew Supakorn , Vinayavekhin Sukrit 
Published: February 2024

IntroductionPalliative care is an approach that aims to holistically improve the quality of life, care and death of people living with life-limiting conditions as well as their families. In Thailand, palliative care became one of its national strategies as of 2014. However, the access to as well as the quality of palliative care being delivered still varies across the nation, due to multiple factors spanning multiple levels. Consequently, there is a need to comprehensively understand the current palliative care ecosystem in Thailand. This review aims to explore, map and conceptualise the literature available on the palliative care ecosystem in Thailand, and how the service being delivered influences the quality of life, death and care of people living with life-limiting conditions alongside their families.Methods and analysisThis review will consist of two stages. First, a scoping review guided by the Joanna Briggs Institute methodology for scoping reviews will be initially conducted. A systematic literature search using Medical Subject Heading and text words related to palliative care will be performed in PubMed, CINAHL and Thai Citation Index from 2013 to 2023. Grey literature will be searched via alternative sources: Google keyword searching and stakeholders consultation. References of included sources will be handsearched to identify further resources.The population, concept and context framework is used to frame the inclusion and exclusion criteria. This will be further refined after the initial search, reflecting the iterative nature of a scoping review. Articles will be independently screened by three reviewers. A Microsoft Excel spreadsheet will be used as the data extraction tool. Data will be extracted and presented using a narrative synthesis approach.Second, included articles from the scoping review will be further analysed and visualised using a bibliometric analysis technique. This stage involves a computational method, including statistical analysis and content analysis of the articles’ bibliographic details.Ethics and disseminationThis paper describes a protocol for a scoping review and bibliographical analysis. As such, ethical approval was not required. Information relating to the review will be stored with Open Science Framework Registries. The findings of this proposed scoping review will be distributed through a peer-reviewed publication, academic seminars, conferences and patients and public involvement groups.
Qualitative focus group discussions exploring PrEP method and service delivery preferences among female sex workers and their managers in four Zambian provinces
Authors: Evens Emily , Munthali Tendai , Mangunje Featherstone , Kotaka Mercy L , Burke Holly M , Musonda Bupe , Musonda Musonda , Todd Catherine S 
Published: February 2024

ObjectivesTo describe the experiences of oral HIV pre-exposure prophylaxis (PrEP) use, preferences comparing oral PrEP to future long-acting PrEP products (the dapivirine vaginal ring (PrEP ring) and injectable cabotegravir (CAB PrEP)), and service provision preferences among female sex workers (FSWs) and their managers.MethodsQualitative formative focus group discussions were conducted in two urban (Copperbelt, Lusaka) and two rural (Central, Luapula) provinces in Zambia. Consenting participants included 43 FSWs and 36 sex work managers. Eligible participants self-identified as FSWs or sex work managers, were 18 years or older and spoke English, Nyanja or Bemba.ResultsFSWs had a median age of 28 years and 60% reported ever using oral PrEP. Among potential future HIV prevention options, most FSWs preferred longer acting PrEP methods, mainly CAB PrEP over the PrEP ring. This preference was consistent across provinces. Many FSWs had personal oral PrEP experience and appreciated the high effectiveness but conveyed that the realities of daily use, including pill visibility, and attributed side effects did not meet their needs. FSWs and managers also identified frequent stigma and misinformation-related barriers to PrEP access and use at community and facility levels. Most FSWs and managers agreed that informing non-paying or long-term partners of PrEP use was acceptable. Participants offered recommendations for greater sensitisation and peer-led services or service extension through trusted figures in the community.ConclusionsZambian FSWs and their managers preferred longer acting PrEP methods, particularly CAB PrEP, as part of comprehensive HIV prevention method choice, with little difference between provinces. PrEP programming led by FSW peers, managers or other trusted figures was recommended to address misinformation, sensitise partners and potentially deliver services to circumvent perceived stigma at health facilities.
Developing the Ready Military Medical Force: military-specific training in Graduate Medical Education
Authors: Baird Emily W , Lammers Daniel T , Betzold Richard D , Brown Shaun R , Tadlock Matthew D , Eckert Matthew J , Cox Daniel B , Kerby Jeffrey D , Gurney Jennifer M , Elster Eric A , Holcomb John B , Jansen Jan O 
Published: February 2024

IntroductionGraduate Medical Education plays a critical role in training the next generation of military physicians, ensuring they are ready to uphold the dual professional requirements inherent to being both a military officer and a military physician. This involves executing the operational duties as a commissioned leader while also providing exceptional medical care in austere environments and in harm’s way. The purpose of this study is to review prior efforts at developing and implementing military unique curricula (MUC) in residency training programs.MethodsWe performed a literature search in PubMed (MEDLINE), Embase, Web of Science, and the Defense Technical Information Center through August 8, 2023, including terms “graduate medical education” and “military.” We included articles if they specifically addressed military curricula in residency with terms including “residency and operational” or “readiness training”, “military program”, or “military curriculum”.ResultsWe identified 1455 articles based on title and abstract initially and fully reviewed 111. We determined that 64 articles met our inclusion criteria by describing the history or context of MUC, surveys supporting MUC, or military programs or curricula incorporated into residency training or military-specific residency programs.ConclusionWe found that although there have been multiple attempts at establishing MUC across training programs, it is difficult to create a uniform curriculum that can be implemented to train residents to a single standard across services and specialties.
Apossínclise: do uso à exaustão diacrônica
Authors: Oliveira Thiago Soares de 
Published: February 2024

Este trabalho objetiva conceituar o que se denomina de “exaustão diacrônica” a partir do abandono (ou diminuição de uso) das construções interpoladas e dos “níveis de permeabilidade da mudança”, a fim de ponderar que a modificação do registro escrito de uma construção sintática, quando ocorre, é um resultado da estabilidade e da uniformidade de fenômenos que já haviam sido abandonados na oralidade e que, se atinge o nível sintático, está-se diante de uma mudança profunda e sistemática. Para tanto, adota-se a pesquisa bibliográfica, já que fontes especializadas podem auxiliar na construção do arcabouço teórico necessário ao cumprimento do objetivo traçado. Por fim, conclui-se que o progressivo processo de apagamento de uso da apossínclise, após intermitências e/ou rarefações, deve-se a um processo de exaustão diacrônica que atravessa os níveis de permeabilidade da língua em relação à mudança, tudo em busca de maior clareza e exatidão no emprego das sentenças.
Motivações para tocar na banda marcial escolar: uma análise das narrativas de seus ex-integrantes
Authors: Silva Rodrigo Lisboa da 
Published: February 2024

Este artigo apresenta resultados de uma pesquisa qualitativa de mestrado que buscou investigar as percepções e experiências de dez ex-integrantes de bandas marciais escolares de CIDADE – que não seguiram estudos superiores ou profissionalizantes nem carreira na área – a respeito de seus percursos de formação musical (XX, 20XX). Com o uso de entrevistas narrativas (FLICK, 2004; GIBBS, 2009; PENNA, 2021), esses sujeitos revelaram, dentre outros aspectos, suas significações subjetivas, relações e motivações com a música e a banda escolar. A análise das narrativas revelou que a decisão em tocar na banda marcial escolar pode estar relacionada a incentivos da família e de amigos, à oportunidade de assistir aos ensaios ou a uma apresentação na escola, à possibilidade de aprender um instrumento musical, apresentar-se e ser prestigiado pela comunidade. Evidenciou ainda que a prática na banda escolar pode favorecer um encontro com o sentido de vida, ou seja, um projeto para dedicar-se mesmo que momentaneamente (AQUINO, 2013; FRANKL, 2022; MIGUEZ, 2014). Conclui-se que as bandas marciais escolares são ferramentas importantes para a iniciação musical e que fatores extrínsecos – incentivo de familiares e amigos, por exemplo – podem ser importantes para o ingresso de novos estudantes.
Evaluation of a school intervention to improve adherence to the Mediterranean Diet
Authors: Michael Katerina , Talias Michael A 
Published: February 2024

Objective: To evaluate the effects of a nutrition education programme conducted during health education lessons on students’ adherence to the Mediterranean Diet (MD) and their body mass index (BMI). Design: Quasi-experimental pre-test/post-test research design: two study conditions (intervention and control groups). Setting: Two urban schools, the 11th and 21st primary schools in Limassol, Cyprus. Method: Two hundred and thirty-five fifth- and sixth-grade students participated in the programme. One hundred and fifteen were in the intervention group school (the 11th primary school), and 120 were in the control group school (the 21st primary school). Students in the intervention school participated in nine 80-minute lessons during the health education class. The curriculum focused on the MD and included cooking activities, food tasting and parental involvement. The primary outcomes were subsequent adherence to the MD, nutritional knowledge, self-efficacy physical activity and BMI. Results: Following the implementation of the intervention, the intervention group showed a significant increase in nutritional knowledge, self-efficacy and adherence to the MD ( p < .001). The intervention group also had significantly higher nutritional knowledge and MD Quality Index scores than the control group ( p < .001). However, no effect was observed on children’s BMI ( p > .05). Conclusion: The intervention successfully improved children’s dietary habits in the intervention group by increasing adherence to the MD, but it did not affect their BMI. The results show some promise for addressing poor nutrition through education.
Multiple exposures to low-dose ionizing radiation induced the initiation and progression of pro-atherosclerotic phenotypes in mice and vascular endothelial cell damage
Authors: Liu Meng-Meng , Ding Chun-Yan , Li Zhi-Hui , Yi Ru-Han , Ma Li-Ping , Ou Xiang-Ming , Liu Hai-Xiang , Gao Ling , Liu Qing-Jie 
Published: February 2024

Objective This study aimed to investigate the effects of low-dose radiation on the abdominal aorta of mice and vascular endothelial cells. Methods Wild-type and tumor-bearing mice were exposed to 15 sessions of low-dose irradiation, resulting in cumulative radiation doses of 187.5, 375, and 750 mGy. The effect on the cardiovascular system was assessed. Immunohistochemistry analyzed protein expressions of PAPP-A, CD62, P65, and COX-2 in the abdominal aorta. Microarray technology, Gene Ontology analysis, and pathway enrichment analysis evaluated gene expression changes in endothelial cells exposed to 375 mGy X-ray. Cell viability was assessed using the Cell Counting Kit 8 assay. Immunofluorescence staining measured γ-H2AX levels, and real-time polymerase chain reaction quantified mRNA levels of interleukin-6 (IL-6), ICAM-1, and Cx43. Results Hematoxylin and eosin staining revealed thickening of the inner membranes and irregular arrangement of smooth muscle cells in the media membrane at 375 and 750 mGy. Inflammation was observed in the inner membranes at 750 mGy, with a clear inflammatory response in the hearts of tumor-bearing mice. Immunohistochemistry indicated increased levels of PAPP-A, P65, and COX-2 post-irradiation. Microarray analysis showed 425 up-regulated and 235 down-regulated genes, associated with processes like endothelial cell-cell adhesion, IL-6, and NF-κB signaling. Cell Counting Kit 8 assay results indicated inhibited viability at 750 mGy in EA.hy926 cells. Immunofluorescence staining demonstrated a dose-dependent increase in γ-H2AX foci. Reverse transcription quantitative PCR results showed increased expression of IL6, ICAM-1, and Cx43 in EA.hy926 cells post 750 mGy X-ray exposure. Conclusion Repeated low-dose ionizing radiation exposures triggered the development of pro-atherosclerotic phenotypes in mice and damage to vascular endothelial cells.
Thermal, mechanical, electrical properties of poystyrene/poly (styrene-b-isobutylene-b-styrene/carbon nanotube nanocomposites
Authors: Şen Sinan , Cengiz Melek Irmak , Tekay Emre 
Published: February 2024

In this study, high impact polystyrene (HIPS) materials was prepared by using a styrenic elastomer (10, 20, 30 wt%) and carbon nanotube (CNT) (3, 5, 7, 10 phr) by melt blending technique as alternative to commercial HIPS including polybutadiene rubber. The poly (styrene- b-isobutylene- b-styrene) (SIBS) was used as thermoplastic elastomer with polystyrene (PS) to improve its poor impact resistance and CNT was added to PS/SIBS blend matrix to maintain its strength and stiffness. The modulus, tensile strength and toughness values of the blends decreased while those of impact resistance increased in comparison to neat PS. The impact strength of PS20SIBS blend containing 20 wt% SIBS was found to be approximately 530% higher than pure PS. The nanocomposites of the PS20SIBS exhibited a decrease in the size of SIBS particles with increasing CNT compared to PS20SIBS. This was ascribed to the increased viscosity of PS matrix via CNT filler, preventing the coalescence of the elastomer domains. Compared to the PS20SIS, its nanocomposites showed higher strength, modulus and toughness, but lower impact strength. The toughness of the nanocomposite containing 5 phr CNT (PS20SIBS-5CNT), increased by 117% while its creep deformation decreased by approximately 40%, in comparison with PS20SIBS blend. Although PS20SIBS-5CNT exhibited lower impact strength than the PS20SIBS blend due to the dispersion of smaller SIBS particles in the PS matrix, it still increased the impact strength of pure PS by 188%. The PS20SIBS-5CNT nanocomposite, which improved impact strength and creep resistance with optimal toughness and tensile modulus can be used as a novel HIPS material that tunes the hardness-toughness/impact balance effectively. Moreover, the same nanocomposite was found to reach the conductivity threshold by exhibiting 106 times lower electrical resistance in comparison with that containing 3 phr CNT, leading to a conductive filer network with 5 phr loading of the nanotubes into the system.
The effect of psychedelics on the level of brain-derived neurotrophic factor: A systematic review and meta-analysis
Authors: Shafiee Arman , Arabzadeh Bahri Razman , Rafiei Mohammad Ali , Esmaeilpur Abianeh Fatemeh , Razmara Parsa , Jafarabady Kyana , Amini Mohammad Javad 
Published: February 2024

Background: Recent interest in the potential therapeutic effects of psychedelics has led to investigations into their influence on molecular signaling pathways within the brain. Aims: Integrated review and analysis of different studies in this field. Methods: A systematic search was conducted across international databases including Embase, Scopus, Web of Science, and PubMed from inception to 9 July 2023. Eligibility criteria encompassed published and peer-reviewed studies evaluating changes in brain-derived neurotrophic factor (BDNF) levels after psychedelic consumption. Outcomes: A total of nine studies were included in our study. The meta-analysis demonstrated significantly higher BDNF levels in psychedelic consumers compared to healthy controls, with a pooled standardized mean difference of 0.26 (95% CI: 0.10–0.42, I2 = 38.51%, p < 0.001). Leave-one-out analysis indicated robustness in results upon removal of individual psychedelics. No significant publication bias was observed. The results highlight the potential influence of psychedelics on neuroplasticity by altering BDNF levels. Conclusions: More precisely, the documented rise in BDNF levels indicates a neurobiological mechanism by which psychedelics could enhance synaptic plasticity and foster the growth of neurons. Given the limited data available on this topic, the conclusions remain uncertain. Consequently, we highly recommend additional research with more extensive sample sizes to yield more reliable evidence in this field.
Differences in Clinical Outcomes Between Patients With Retear After Supraspinatus Tendon Repair and Those With Intact Repair at 5-Year Follow-up
Authors: Yau W.P. 
Published: February 2024

Background: It is well known that rotator cuff repair is associated with an overall retear rate of 21% to 26%. However, a cuff retear may not necessarily be associated with poor clinical outcomes. Hypothesis: There would be no difference in clinical outcomes between patients with a cuff retear and those with an intact repair at a midterm follow-up of 5 years. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective study was conducted involving patients who received arthroscopic complete repair of the supraspinatus tendon between January 2009 and December 2017. Patients who did not have a postoperative magnetic resonance imaging (MRI) scan or who had a follow-up of <5 years were excluded. Clinical outcomes, including the visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and active forward flexion (FF) of the involved shoulder were assessed at the 2-year and 5-year follow-up points. Results: The study group included 105 patients with a mean follow-up of 85 months. MRI scans were performed at a mean of 20 months. Fourteen full-thickness cuff retears and 91 intact repairs were identified using postoperative MRI scans. Significant improvement in VAS score, ASES score, and FF were found between the preoperative assessment and the 2 designated follow-up points (2 years and 5 years) in both the cuff retear and the intact repair groups ( P < .001). The VAS and ASES scores at the 2-year follow-up for the intact repair group were 1.8 ± 2.0 and 80.7 ± 18.1, respectively. The corresponding values for the retear group were 2.3 ± 2.2 and 71.9 ± 19.5, respectively. No significant difference was found between the 2 groups in the VAS and ASES scores at the 2-year follow-up. However, patients with an intact repair had a better VAS score (1.4 ± 1.8; P = .049) and ASES score (81.7 ± 17; P = .019) than those with a cuff retear at the 5-year assessment (3.0 ± 2.8 and 67.1 ± 22.9, respectively). In the intact repair group, 91% of patients achieved the minimal clinically important difference for the 5-year VAS score, compared with 54% in the cuff retear group ( P < .001). The corresponding values for the 5-year ASES score were 80% and 54%, respectively ( P = .044). FF measurements at the 5-year follow-up in patients with intact repair and those with a cuff retear were 161°± 23° and 144°± 37°, respectively ( P = .059). Continuous improvement in VAS score and FF between the 2-year and 5-year follow-up was observed in the intact repair group ( P = .005 and P = .04, respectively). Conclusion: The patients with an intact repair had better VAS and ASES scores compared with those who had a cuff retear at a midterm follow-up of 5 years. Between the 2-year and the 5-year follow-up, some further improvement was observed in the VAS score and FF in the intact repair group.