bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the gut microbiome in glaucoma risk from the causal perspective
Authors: Wu Yaxuan , Shi Ronghua , Chen He , Zhang Zicheng , Bao Siqi , Qu Jia , Zhou Meng 
Published: January 2024

ObjectiveEvidence from observational studies has reported possible associations between the gut microbiome (GM) and glaucoma. However, the causal effect of GM on glaucoma risk remains to be determined.Methods and analysisWe conducted two-sample bidirectional Mendelian randomisation (MR) analyses to explore the causal association between GM and glaucoma. Genome-wide association study summary statistics of 196 GM taxa (n=18 340) and glaucoma (18 902 cases and 358 375 controls) were obtained from MiBioGen and FinnGen Consortium. Inverse variance weighted, MR-Egger, weighted median, weighted mode, Mendelian Randomisation Pleiotropy Residual Sum and Outlier, MR-Egger intercept and Cochran’s Q statistical analyses were used to supplement MR results and sensitivity analysis. An independent cohort from the Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol (MRC-IEU) Consortium (1715 cases and 359 479 controls) was used to validate causal effects.ResultsResults of the MR analysis suggested that the familyOxalobacteraceae(OR 0.900, 95% CI 0.843 to 0.961, p=0.002) and the genusEggerthella(OR 0.881, 95% CI 0.811 to 0.957, p=0.003) had a negative effect on glaucoma, whereas the genusBilophila(OR 1.202, 95% CI 1.074 to 1.346, p=0.001),LachnospiraceaeUCG010(OR 1.256, 95% CI 1.109 to 1.423, p=0.0003) andRuminiclostridium 9(OR 1.258, 95% CI 1.083 to 1.461, p=0.003) had a positive effect on glaucoma. Among these, the positive causal effect ofLachnospiraceaeUCG010(OR 1.002, 95% CI 1.000 to 1.004, p=0.033) on glaucoma was replicated in an independent cohort.ConclusionThis MR analysis from large population studies demonstrated the causal effect of GM on glaucoma risk and supported the role of GM in influencing glaucoma susceptibility.
Virtual reality technology for surgical learning: qualitative outcomes of the first virtual reality training course for emergency and essential surgery delivered by a UK–Uganda partnership
Authors: Please Helen , Narang Karamveer , Bolton William , Nsubuga Mike , Luweesi Henry , Richards Ndiwalana Billy , Dalton John , Tendo Catherine , Khan Mansoor , Jjingo Daudi , Bhutta Mahmood F , Petrakaki Dimitra , Dhanda Jagtar 
Published: January 2024

IntroductionThe extensive resources needed to train surgeons and maintain skill levels in low-income and middle-income countries (LMICs) are limited and confined to urban settings. Surgical education of remote/rural doctors is, therefore, paramount. Virtual reality (VR) has the potential to disseminate surgical knowledge and skill development at low costs. This study presents the outcomes of the first VR-enhanced surgical training course, ‘Global Virtual Reality in Medicine and Surgery’, developed through UK-Ugandan collaborations.MethodsA mixed-method approach (survey and semistructured interviews) evaluated the clinical impact and barriers of VR-enhanced training. Course content focused on essential skills relevant to Uganda (general surgery, obstetrics, trauma); delivered through: (1) hands-on cadaveric training in Brighton (scholarships for LMIC doctors) filmed in 360°; (2) virtual training in Kampala (live-stream via low-cost headsets combined with smartphones) and (3) remote virtual training (live-stream via smartphone/laptop/headset).ResultsHigh numbers of scholarship applicants (n=130); registrants (Kampala n=80; remote n=1680); and attendees (Kampala n=79; remote n=556, 25 countries), demonstrates widespread appetite for VR-enhanced surgical education. Qualitative analysis identified three key themes: clinical education and skill development limitations in East Africa; the potential of VR to address some of these via 360° visualisation enabling a ‘knowing as seeing’ mechanism; unresolved challenges regarding accessibility and acceptability.ConclusionOutcomes from our first global VR-enhanced essential surgical training course demonstrating dissemination of surgical skills resources in an LMIC context where such opportunities are scarce. The benefits identified included environmental improvements, cross-cultural knowledge sharing, scalability and connectivity. Our process of programme design demonstrates that collaboration across high-income and LMICs is vital to provide locally relevant training. Our data add to growing evidence of extended reality technologies transforming surgery, although several barriers remain. We have successfully demonstrated that VR can be used to upscale postgraduate surgical education, affirming its potential in healthcare capacity building throughout Africa, Europe and beyond.
Coming back for more: factors linked to higher participation among Veterans with chronic pain in an innovative VA-YMCA wellness clinic
Authors: Preddie Alaina K , Donnelly Claire E , Miech Edward J , Myers Laura J , Williams Linda S , Damush Teresa M 
Published: January 2024

In 2019, the Indianapolis VA developed a Wellness Clinic in partnership with the Young Men’s Christian Associations (YMCA) to comprehensively address Veterans’ chronic pain. Our specific aims were twofold: (1) to evaluate the implementation of the Veterans Health Indiana (VHI) Wellness Clinic on patient utilisation and (2) to evaluate patient functioning.We conducted a mixed-methods evaluation, which included the extraction of VA administrative data to identify a patient cohort; the conduct of chart review to extract clinic utilisation, clinical outcomes collected during pain-related healthcare services and comorbidities; and semistructured interviews with Veteran patients who used the VHI Wellness Clinic in different patterns to identify challenges and facilitators to clinic utilisation. We applied configurational analysis to a Veteran sample who had their first visit to the VHI Wellness Clinic in March/April 2019 to pinpoint difference-making factors linked to Veterans’ successful participation.The cohort included 312 Veterans (83% male), mean age of 55.4 years. The configurational model included six factors: participation in physical therapy, pain psychology or pain education sessions (22%); presence of any ‘no-shows’ (57% had 0); history of depression (39%) and clinic referral source (51% self-referred from primary care). The model consisted of four different pathways to successful participation, explaining 60% of cases in the higher-participation group with 86% consistency. Patient outcomes after clinic utilisation demonstrated a significant reduction in self-reported pain and pain catastrophising across time. Moreover, patients reported distance to clinic as both a facilitator and challenge.This mixed-methods analysis identified specific biopsychosocial factors and clinical services directly linked to higher Veteran participation in a new VA-YMCA Wellness Clinic. The VHI Wellness Clinic embedded within a YMCA facility is a feasible and efficacious healthcare delivery model for primary care patients experiencing chronic pain. Additional marketing to clinical providers for referrals and to patients to extend its reach is needed.
Mental Health Admissions to Paediatric Wards Study (MAPS): a protocol for the analysis of Hospital Episode Statistics (HES) data
Authors: Hudson Lee Duncan , Ward Joseph , Vázquez-Vázquez Adriana , Settle Kate , Cornaglia Francesca , Gibson Faith , Phillips Kirsty , Mathews Gabrielle , Roberts Helen , Roland Damian , Nicholls Dasha E , Elphinstone Holly , Viner Russell 
Published: January 2024

IntroductionChildren and young people (CYP) presenting with a mental health (MH) crisis are frequently admitted to general acute paediatric wards as a place of safety. Prior to the pandemic, a survey in England showed that CYP occupied 6% of general paediatric inpatient beds due to an MH crisis, and there have been longstanding concerns about the quality of care to support these patients in this setting. Mental Health Admissions to Paediatric Wards Study aims to generate a theory of change (ToC) model to improve the quality of care for CYP admitted to acute paediatric services after presenting in a MH crisis.Methods and analysisWe will undertake a national (England), sequential, mixed methods study to inform a ToC framework alongside a stakeholder group consisting of patients, families/carers and healthcare professionals (HCPs). Our study consists of four work packages (WP) undertaken over 30 months. WP1 is limited to using national routine administrative data to identify and characterise trends in MH admissions in acute paediatric wards in England between 2015– 2022.Ethics and disseminationWP1 received ethical approval (Ref 23/NW/0192). We will publish the overall synthesis of data and the final ToC to improve care of CYP with MH crisis admitted to general acute paediatric settings. As coproducers of the ToC, we will work with our stakeholder group to ensure wide dissemination of findings. Potential impacts will be on service development, new models of care, training and workforce planning.
Tenecteplase thrombolysis for stroke up to 24 hours after onset with perfusion imaging selection: the umbrella phase IIa CHABLIS-T randomised clinical trial
Authors: Cheng Xin , Hong Lan , Churilov Leonid , Lin Longting , Ling Yifeng , Zhang Jin , Yang Jianhong , Geng Yu , Wu Danhong , Liu Xueyuan , Zhou Xiaoyu , Zhao Yuwu , Zhai Qijin , Zhao Liandong , Chen Yangmei , Guo Ying , Yu Xiaofei , Gong Fan , Sui Yi , Li Gang , Yang Lumeng , Gu Hong-Qiu , Wang Yilong , Parsons Mark , Dong Qiang 
Published: January 2024

Background
The performance of intravenous tenecteplase in patients who had an acute ischaemic stroke with large/medium vessel occlusion or severe stenosis in an extended time window remains unknown. We investigated the promise of efficacy and safety of different doses of tenecteplase manufactured in China, in patients who had an acute ischaemic stroke with large/medium vessel occlusion beyond 4.5-hour time window.

Methods
The CHinese Acute tissue-Based imaging selection for Lysis In Stroke-Tenecteplase was an investigator-initiated, umbrella phase IIa, open-label, blinded-endpoint, Simon’s two-stage randomised clinical trial in 13 centres across mainland China. Participants who had salvageable brain tissue on automated perfusion imaging and presented within 4.5–24 hours from time of last seen well were randomised to receive 0.25 mg/kg tenecteplase or 0.32 mg/kg tenecteplase, both with a bolus infusion over 5–10 s. The primary outcome was proportion of patients with promise of efficacy and safety defined as reaching major reperfusion without symptomatic intracranial haemorrhage at 24–48 hours after thrombolysis. Assessors were blinded to treatment allocation. All participants who received tenecteplase were included in the analysis.

Results
A total of 86 patients who had an acute ischaemic stroke identified with anterior large/medium vessel occlusion or severe stenosis were included in this study from November 2019 to December 2021. All of the 86 patients enrolled either received 0.25 mg/kg (n=43) or 0.32 mg/kg (n=43) tenecteplase, and were available for primary outcome analysis. Fourteen out of 43 patients in the 0.25 mg/kg tenecteplase group and 10 out of 43 patients in the 0.32 mg/kg tenecteplase group reached the primary outcome, providing promise of efficacy and safety for both doses based on Simon’s two-stage design.

Discussion
Among patients with anterior large/medium vessel occlusion and significant penumbral mismatch presented within 4.5–24 hours from time of last seen well, tenecteplase 0.25 mg/kg and 0.32 mg/kg both provided sufficient promise of efficacy and safety.

Trial registration number

ClinicalTrials.gov Registry (
NCT04086147
,
https://clinicaltrials.gov/ct2/show/NCT04086147
).
Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of cerebral aneurysm: a nationwide cohort study
Authors: Baik Minyoul , Jeon Jimin , Kim Jinkwon , Yoo Joonsang 
Published: January 2024

Introduction
Stent-assisted coil embolisation (SACE) for the treatment of unruptured cerebral aneurysms has been increasingly used. Long-term advantages of antiplatelet therapy (APT) post-SACE treatment are still not well understood. We investigated the long-term effects of APT on clinical prognosis after SACE.

Patients and methods
We conducted a retrospective study using nationwide health insurance claims data from South Korea, including patients with cerebral aneurysm treated with SACE from January 2009 to December 2020. The study outcomes consisted of the occurrence of cerebral infarction and major haemorrhage. To evaluate the impact of APT, we employed a multivariable time-dependent Cox proportional hazards regression model for each of the three distinct periods: 1–12 months, 12–24 months and >24 months after SACE.

Results
This study included 17 692 unruptured cerebral aneurysm patients treated with SACE. During the mean follow-up of 4.2 years, there were 379 (2.1%) patients with cerebral infarction and 190 (1.1%) patients with major haemorrhage. The percentage of patients receiving APT was 79.5% at 1 year, which gradually decreased to 58.3% at 2 years after SACE. APT was beneficial in preventing cerebral infarction within 12 months after SACE (adjusted HR (aHR) 0.56; 95% CI, 0.35 to 0.89; p=0.014). After 12 months, this association was not evident. APT increased the risk of haemorrhage after 24 months (aHR 1.76; 95% CI 1.11 to 2.87; p=0.016).

Discussion and conclusion
Our findings suggest that in patients with unruptured cerebral aneurysm treated with SACE, the reasonable duration of APT for preventing cerebral infarction might be 1 year after SACE.
Reteplase versus alteplase for acute ischaemic stroke within 4.5 hours (RAISE): rationale and design of a multicentre, prospective, randomised, open-label, blinded-endpoint, controlled phase 3 non-inferiority trial
Authors: Li Shuya , Gu Hong-Qiu , Dai Hongguo , Lu Guozhi , Wang Yongjun 
Published: January 2024

Background and purpose
Reteplase is the third generation of alternative thrombolytic agent. We hypothesis that reteplase will be non-inferior to alteplase in achieving excellent functional outcome at 90 days among eligible patients with acute ischaemic stroke.

Methods and design
Reteplase versus alteplase for acute ischaemic stroke within 4.5 hours (RAISE) trial is a multicentre, prospective, randomised, open-label, blinded endpoint (PROBE), controlled phase 3 non-inferiority trial. A total of 1412 eligible patients will be randomly assigned to receive either reteplase at a dose of 18 mg+ 18 mg or alteplase 0.9 mg/kg at a ratio of 1:1. An independent data monitoring committee will review the trail’s progress and safety data.

Study outcomes
The primary efficacy outcome of this study is proportion of individuals attaining an excellent functional outcome, defined as modified Rankin Scale (mRS) 0–1 at 90 days. The secondary efficacy outcomes encompass favourable functional outcome defined as mRS 0–2, major neurological improvement on the National Institutes of Health Stroke Scale, ordinal distribution of mRS and Barthel Index score of at least 95 points at 90 days. The primary safety outcomes are symptomatic intracranial haemorrhage at 36 hours within 90 days.

Discussion
The RAISE trial will provide crucial insights into the selection of thrombolytic agents for stroke thrombolysis.

Trial registration number

NCT05295173
.
An introduction to the Bowland Shale Formation, UK: processes and resources
Authors: Emmings J. F. , Parnell J. , Stephenson M. H. , Lodhia B. H. 
Published: January 2024

Abstract

This volume showcases recent geological, geophysical and geochemical research on the Carboniferous Bowland Shale Formation. The Bowland Shale is a relatively thick and extensive Palaeozoic black shale unit with a long history of debate and controversy in the UK. The Bowland Shale is proven in many of the key Carboniferous basins in the Midlands, northern England and North Wales, and represents a significant, near-continuous temporal record spanning 16 Myr including the important mid-Carboniferous boundary (Mississippian–Pennsylvanian). Since the first geological surveys in the late nineteenth century, the Bowland Shale has been of interest for a variety of reasons, including the search for Irish-type Pb–Zn base metal mineral deposits, and as a source rock in conventional hydrocarbon systems. In the mid-2000s, attention turned to the Bowland Shale as a target for unconventional hydrocarbon extraction, shale gas, following success in the USA. This placed the Bowland Shale at the centre of a series of interconnected controversies and debates from the local to national scale. The geological credibility of the purported shale gas resource in the UK was – and continues to be – highly contentious. This volume contributes to a more updated view of the Bowland Shale, covering topics such as sedimentary, geochemical and physical properties and processes, basin-forming events, hydrocarbon prospectivity, mineralization and heat and fluid flow in the subsurface. The volume also includes a field guide to some of the key localities in the UK. With the benefit of hindsight offered by the latest generation of research, the early regional shale gas assessments failed to attach sufficient weight to the compositional heterogeneity, structural complexity, compartmentalization and highly variable exhumation, erosion and palaeo-heat flow history of the Bowland Shale. The following topics are identified as promising avenues for future research beyond shale gas: (1) the role of the Bowland Shale in the context of mineral systems; (2) the role of the Bowland Shale as a cap rock in the Lower Carboniferous limestone geothermal play and potentially as an analogue of CO
2
or radioactive waste storage in the UK; and (3) pathways and mechanisms for weathering, alteration and trace element release from the Bowland Shale into the surface and/or subsurface environment.
Report on an open dataset to constrain the Balmuccia peridotite body (Ivrea-Verbano Zone, Italy) through a participative gravity-modelling challenge
Authors: Hetényi György , Baron Ludovic , Scarponi Matteo , Subedi Shiba , Michailos Konstantinos , Dal Fergus , Gerle Anna , Petri Benoît , Zwahlen Jodok , Langone Antonio , Greenwood Andrew , Ziberna Luca , Pistone Mattia , Zanetti Alberto , Müntener Othmar 
Published: January 2024

AbstractThe Balmuccia peridotite exposes relatively fresh mantle rocks at the Earth’s surface, and as such it is of interest for geologists and geophysicists. The outcrop is a kilometre-scale feature, yet its extent at depth is insufficiently imaged. Our aim is to provide new constraints on the shape of the density anomaly this body represents, through 3D gravity modelling. In an effort to avoid personal or methodology bias, we hereby launch an invitation and call for participative modelling. We openly provide all the necessary input data: pre-processed gravity data, geological map, in situ rock densities, and digital elevation model. The expected inversion results will be compared and jointly analysed with all participants. This approach should allow us to conclude on the shape of the Balmuccia peridotite body and the associated uncertainty. This crowd effort will contribute to the site surveys preparing a scientific borehole in the area in frame of project DIVE.
Bioflocculation of pollutants in wastewater using flocculant derived from Providencia huaxiensis OR794369.1
Authors: Selepe Tlou Nelson , Maliehe Tsolanku Sidney 
Published: January 2024

Abstract
Background
Water pollution has become a major environmental and health concern due to increasing population and industrialisation. Microbial flocculants are promising agents for treatment of contaminated water owing to their effectiveness, eco-friendliness, and high biosafety levels. In this study, culture conditions of Providencia huaxiensis OR794369.1 were optimised and its bioflocculant was extracted, characterised and used to treat wastewater.

Results
The maximum flocculating activity of 92% and yield of 3.5 g/L were obtained when cultivation conditions were: 3% inoculum size, starch, casein, initial pH of 6, cultivation temperature of 30 oC and 72 h of fermentation. The bioflocculant is an amorphous glycoprotein biomolecule with 37.5% carbohydrates, 27.9% protein, and 34.6% uronic acids. It is composed of hydroxyl, amino, alkanes, carboxylic acid and amines groups as its main functional structures. It was found to be safe to use as it demonstrated non-cytotoxic effects on bovine dermis and African green monkey kidney cells, illustrating median inhibitory concentration (IC50) values of 180 and > 500 µg/mL on both cell lines, respectively. It demonstrated the removal efficiencies of 90% on chemical oxygen demand (COD), 97% on biological oxygen demand (BOD) and 72% on Sulphur on coal mine wastewater. It also revealed the reduction efficacies of 98% (COD) and 92% (BOD) and 70% on Sulphur on domestic wastewater.

Conclusion
The bioflocculant was effective in reducing pollutants and thus, illustrated potential to be used in wastewater treatment process as an alternative.
The formation mechanism of primary health care team effectiveness : a qualitative comparative analysis research
Authors: Li Chanjiao , Cui Lu , Zhou Siyu , He Anning , Ni Ziling 
Published: January 2024

Abstract
Background
Team-based care is an essential part of primary health care (PHC), and its team service delivery process is a systematic one involving multiple and complex influences. Research on the formation mechanism can help improve the effectiveness of primary health care teams (PHCTs).

Methods
First, based on the Donabedian model, we explored the theoretical framework of a PHC team’s effectiveness formation mechanism. Semi-structured interviews were conducted with 23primary health care team members in Hangzhou, Zhejiang Province, China. A total of seven factors were then included as conditional variables using the crisp set qualitative comparative analysis (csQCA) to explore the complex influences between them and the outcome variable through univariate necessity analysis and path configuration analysis.

Results
Univariate necessity analysis showed that only “Clear Goals” in the structural dimension were necessary for team effectiveness perception. Six pathways to good primary health care team perception of effectiveness were identified. Two of these paths were more typical.

Conclusion
“Clear Goals” was the core variable that should be emphasized when exploring the mechanism of PHCT formation. The results suggest that human resources in the management team should be rationally allocated, goal-oriented, and given good attention. Future studies should explore complex combinations of PHCT factors to improve the effectiveness of PHCTs.
Mucormycosis mimicking portal hypertensive haemorrhage as a complication of alcoholic liver cirrhosis: a case report
Authors: Ji Ran 
Published: January 2024

AbstractMucor is a rare cause of gastrointestinal ulcers. This case describes a case of mucormycosis that occurred in a patient with liver cirrhosis who was hospitalized to accept a splenectomy for traumatic splenic rupture. During the perioperative period, the patient developed upper gastrointestinal bleeding(UGIB), which was diagnosed as mucormycosis-related gastric ulcer according to gastroscopy. Patients with liver cirrhosis often get UGIB for Portal hypertension, but they also can develop UGIB for multiple other reasons, including infectious ulcers for immunosuppression. The case emphasizes the importance of excluding fungal-induced ulcer haemorrhage before diagnosing Portal hypertensive-induced variceal haemorrhage in patients with liver cirrhosis.