bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengths of ecosystem services concept for radiation protection
Authors: Beauquier Sophie , Gilbin Rodolphe , Billarand Yann , Bonzom Jean-Marc , Radakovitch Olivier , Goni Felipe Ramirez , Simon-Cornu Marie 
Published: May 2023

Abstract
The successful ecosystem services concept, defined as the benefits people obtain from ecosystems is still not really reflected in the current approaches for protecting public and environment against radiation promoted by the International Commission on Radiological Protection or other similar approaches. Yet some recent thoughts from international organizations lead us to believe that an eco-based approach could be more promoted in the coming years in environmental radiation protection field. The French Institute for Radiation Protection and Nuclear Safety has identified different fields of application of this concept into radiation protection, in line with its integrated approach of radiological risks management. As the ecosystem services approach makes it possible to highlight biophysical and socio-economic approaches of the impacts of ionizing radiation on ecosystems, it represents a subject of primary importance for future works conducted by IRSN. However, the operationality of the ecosystem services concept is the subject of many debates. In many situations, scientists have not yet fully understood how radioactive contamination could affect ecosystem services, and how to articulate with certainty cause and effect relationships between state of an ecosystem and provision of services. In addition, the concept is also accompanied by contradictory perceptions of the status of humans in ecosystems. To solve these knowledge gaps and uncertainties, it is necessary to acquire robust data on the impacts of radiation on ecosystems both under experimental and realistic conditions, and to integrate all potential consequences (direct and indirect, ecotoxicological but also economic and cultural).
Introduction: Marking Race in Twentieth Century British History
Authors: Matera Marc , Natarajan Radhika , Perry Kennetta Hammond , Schofield Camilla , Waters Rob 
Published: May 2023

Abstract
How might historians narrate Britain’s past if we centre imperial racial formation and its contestations? The thirtieth anniversary of Paul Gilroy’s There Ain’t No Black in the Union Jack: The Cultural Politics of Race and Nation provided an opportunity for a new generation of scholars to consider the frameworks of race in British history. In 1987, Gilroy challenged Marxist approaches that treated race as secondary to or even a mechanistic expression of class inequality. He showed that the failure to account for race and empire positioned racialized subjects as perpetual outsiders. Taking up Gilroy’s analysis as a point of departure, this thematic issue brings together analyses of the state, institutions, and individuals to propose new periodizations, geographies, and methodologies for understanding twentieth-century British history. In this introduction, Marc Matera, Radhika Natarajan, Kennetta Hammond Perry, Camilla Schofield, and Rob Waters describe the five-year conversation that led to this thematic issue, introduce their respective essays, and explain why race must be understood not as a descriptive category but as an analytical framework for understanding Britain’s past.
Use of the dTAG system in vivo to degrade CDK2 and CDK5 in adult mice and explore potential safety liabilities
Authors: Yenerall Paul , Sung Tae , Palyada Kiran , Qian Jessie , Arat Seda , Kumpf Steven W , Wang Shih-Wen , Biddle Kathleen , Esparza Carlos , Chang Stephanie , Scott Wesley , Collette Walter , Winrow Taylor-Symon , Affolter Tim , Shirai Norimitsu , Thibault Stephane , Wang Julia , Liu Ling , Bauchmann Mary , Frey Jessica , Steyn Stefanus , Sacaan Aida , Vitsky Allison , Ahn Youngwook , Paul Tom , Lum Lawrence , Oyer Jon , Yang Amy , Hu Wenyue 
Published: May 2023

Abstract
The degradation tag (dTAG) system for target protein degradation can remove proteins from biological systems without the drawbacks of some genetic methods, such as slow kinetics, lack of reversibility, low specificity, and the inability to titrate dosage. These drawbacks can make it difficult to compare toxicity resulting from genetic and pharmacological interventions, especially in vivo. Because the dTAG system has not been studied extensively in vivo, we explored the use of this system to study the physiological sequalae resulting from CDK2 or CDK5 degradation in adult mice. Mice with homozygous knock-in of the dTAG sequence onto CDK2 and CDK5 were born at Mendelian ratios despite decreased CDK2 or CDK5 protein levels in comparison with wild-type mice. In bone marrow cells and duodenum organoids derived from these mice, treatment with the dTAG degrader dTAG-13 resulted in rapid and robust protein degradation but caused no appreciable change in viability or the transcriptome. Repeated delivery of dTAG-13 in vivo for toxicity studies proved challenging; we explored multiple formulations in an effort to maximize degradation while minimizing formulation-related toxicity. Degradation of CDK2 or CDK5 in all organs except the brain, where dTAG-13 likely did not cross the blood brain barrier, only caused microscopic changes in the testis of CDK2dTAG mice. These findings were corroborated with conditional CDK2 knockout in adult mice. Our results suggest that the dTAG system can provide robust protein degradation in vivo and that loss of CDK2 or CDK5 in adult mice causes no previously unknown phenotypes.
Brachyury positively regulates extracellular matrix synthesis via directly promoting aggrecan transcription in nucleus pulposus
Authors: Wu Yinghui , Xia Yanzhang , Yue Caichun , Xin Tianwen , Wang Qiang , Zhang Hong , Shen Cong , Shen Minghong , Gu Yao , Shen Jun 
Published: May 2023

AbstractNucleus pulposus (NP) degeneration is characterized by the decreased cellularity of nucleus pulposus cells (NPCs) and diminished content of hydrophilic extracellular matrix (ECM). Overexpression of brachyury has been reported to reverse the degenerated NPCs into healthy phenotypes. However, the direct correlation between brachyury and ECM has not been fully elucidated. This study revealed that brachyury expression decreased in human degenerated NP tissues and Lipopolysaccharide (LPS)‐induced degenerated rat NPCs model. In vitro and in vivo experiments further showed that brachyury deficiency suppressed the synthesis of aggrecan and collagen II in NP. Mechanistically, ChIP‐qPCR assays demonstrated that brachyury bound to the promoter region of aggrecan in NPCs. Furthermore, luciferase reporter assays revealed that brachyury transcriptionally activated aggrecan expression through binding with a novel specific motif. In rat in vivo model, brachyury overexpression partially reversed the degenerative phenotype. In conclusion, brachyury positively regulated ECM synthesis via directly promoting aggrecan transcription in NPCs. Accordingly, it may be helpful to be developed into a promising therapeutic target for NP degeneration.
Supporting the Health and Well-Being of Caregivers of Persons with Pain
Authors: Tonkikh Orly , Chi Nai-Ching , Herr Keela A. , Fishman Scott M. , Young Heather M. 
Published: May 2023

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.
This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
The Arrhythmogenicity of Sotalol and its Role in Heart Failure: A Literature Review
Authors: Augustin Najwan , Alvarez Chikezie , Kluger Jeffrey 
Published: May 2023

Abstract:
According to the American Heart Association, approximately 6 million adults have been afflicted with heart failure in the United States in 2020 and are more likely to have sudden cardiac death accounting for approximately 50% of the cause of mortality. Sotalol is a nonselective β-adrenergic receptor antagonist with class III antiarrhythmic properties that has been mostly used for atrial fibrillation treatment and suppressing recurrent ventricular tachyarrhythmias. The use of sotalol in patients with left ventricular dysfunction is not recommended by the American College of Cardiology or American Heart Association because studies are inconclusive with conflicting results regarding safety. This article aims to review the mechanism of action of sotalol, the β-blocking effects on heart failure, and provide an overview of clinical trials on sotalol use and its effects in patients with heart failure. Small- and large-scale clinical trials have been controversial and inconclusive about the use of sotalol in heart failure. Sotalol has been shown to reduce defibrillation energy requirements and reduce shocks from implantable cardioverter-defibrillators. Torsades de Pointes is the most life-threatening arrhythmia that has been documented with sotalol use and occurs more commonly in women and heart failure patients. Thus far, mortality benefits have not been demonstrated with sotalol use and larger multicenter studies are required going forward.
Applying the 2022 Cardiovascular and Pulmonary Entry-Level Physical Therapist Competencies to Physical Therapist Education and Practice
Authors: Smith Nancy , Campbell Angela , Johanson Morgan , Bartlo Pamela , Bauer Naomi , Everett Sagan 
Published: May 2023

Background and Purpose.
Competency-based education (CBE) is an emerging topic within physical therapy (PT). It has emerged to assure all stakeholders that physical therapist education program graduates are proficient in the requisite knowledge, skills, and behaviors (KSBs) essential for entry-level practice. Competencies have existed within cardiovascular and pulmonary (CVP) PT since 1980, updated in 2008, and most recently updated in 2022. This article discusses how individuals should apply the 2022 CVP competencies to clinical practice and education.

Position and Rationale.
The 2022 CVP competencies were developed using a modified mixed-method Delphi approach. These competencies set a level of proficiency for KSBs used within entry-level CVP PT practice following the patient–client management model. The position put forward in this article describes how and why multiple stakeholder groups should apply these entry-level competencies specifically for graduates of physical therapist education programs who are entering practice (entry level). The competencies provide a more detailed description of expected proficiency for entry-level CVP PT practice than currently available documents. These competencies may form the basis for developing entrustable professional activities (EPAs).

Discussion and Conclusion.
The establishment of entry-level competencies is essential for use by multiple stakeholders to inform physical therapist curriculum, provide clinical instructors with a reference for expected levels of proficiency during final student clinical experiences, guide content on the Federation of State Boards of PT national licensure examination, and prepare employers to provide needed continued professional development, based on the clinical environment. These competencies lend themselves to the future development of EPAs in the PT profession for CVP PT.
Using an individualized pain management plan for African American adults with sickle cell disease
Authors: Macey-Stewart Karen V. , Louie Kem 
Published: May 2023

ABSTRACT

Background.
The increased lifespan of individuals having sickle cell disease (SCD) causes an overall increase in hospitalizations and more instances in which pain may not be well controlled.

Local problem.
The mainstay treatment for severe pain is opioids and the underlying cause. Laws affecting opioid prescribing, implicit bias, racial inequity, poor research funding, and lack of knowledge contribute to poor patient outcomes.

Method.
Data were collected retrospectively using electronic medical record data from before and after the intervention.

Intervention.
The individualized pain management plan (IPMP) was initiated in collaboration with the patient, pain nurse practitioner (NP), and hematologist.

Result.
The mean length of stay for the traditional pain management plan (TPMP) was 7.89 days compared with 5.66 days for the IPMP, with a mean difference of 2.23 days, t = 2.278, p = .024 (p < .05). There was a decrease in the admission of the individuals with the IPMP, with 25% readmitted within 30 days of discharge, versus 59.0% who were readmitted using the TPMP. Chi-square showed statistical significance (χ2 = 61.667, p = .000) in using nonpharmacological interventions with the IPMP group.

Conclusion.
The IPMP with a patient-centered approach did improve patient outcomes for African American adults living with SCD.
Use of Virtual Reality Simulations to Embody a Patient
Authors: Flood Lisa Sue 
Published: May 2023

Background:
Using immersive virtual reality (VR), students are able to physically and emotionally embody patients while interacting in simulated environments with family and health care providers.

Purpose:
This pilot study explored how embodying patients with Alzheimer disease and terminal cancer at end of life using highly immersive VR impacted nursing students' confidence, feelings, and perceptions.

Methods:
A quasi-experimental design was used with a convenience sample of bachelor of science in nursing students who completed pre/posttest scaled and open-ended questions.

Results:
Participants (N = 32) reported significant confidence increases; feelings about dying and hospice were also significantly changed. The majority described how the simulations would impact their future nursing care.

Conclusion:
Using VR, students experienced disease, dying, and health care from the patient's perspective reporting differences in confidence, feelings, and perceptions. Immersive VR simulations warrant further study and have the potential to transform nursing education and impact health care.
How much do young Australians know about syphilis compared with chlamydia and gonorrhoea? Findings from an online survey
Authors: Bittleston Helen , Goller Jane L. , Temple-Smith Meredith , Coombe Jacqueline , Hocking Jane S. 
Published: May 2023

Abstract

Background
There is increased heterosexual transmission of syphilis in Australia, an infection with severe outcomes. Australian policy emphasises increasing sexually transmissible infection (STI) knowledge/awareness. However, little is known about young Australians’ perceptions and knowledge of syphilis.

Methods
Our online sexual health survey was open 2nd May–21st June 2022 to 16-29-year-olds in Australia. We asked participants if they were aware of syphilis, their personal risk perception, and perceived severity of infection and compared to results for chlamydia/gonorrhoea. Multivariable and multinomial logistic regression was used to assess characteristics associated with outcomes. We measured STI knowledge using ten true/false statements (five syphilis, five chlamydia/gonorrhoea).

Results
Among 2018 participants (69.1% women, 48.9% heterosexual), 91.3% had heard of syphilis (versus 97.2% for chlamydia and 93.3% for gonorrhoea). Older (25-29 years aOR = 2.4, 95%CI 1.4-4.4) and gay/lesbian (aOR = 2.8, 95%CI 1.4-5.3) respondents were more likely to have heard of syphilis, as were those who were non-Aboriginal, sexually active, and with a school-based sex education. Syphilis knowledge was lower than chlamydia/gonorrhoea knowledge (p < 0.001). 59.7% perceived syphilis to have serious health impacts (versus 36.4% for chlamydia and 42.3% for gonorrhoea). Older respondents were more likely (25-29 years aOR 2.1, 95%CI 1.6-2.8), and gay/lesbian respondents less likely (aOR 0.7, 95%CI 0.6-1.0) to perceive syphilis to have serious health impacts. One-fifth of sexually active participants were unsure of their risk of syphilis.

Conclusions
Most young Australians are aware of syphilis, but few have comprehensive knowledge about the infection relative to chlamydia/gonorrhoea. Considering increasing heterosexual transmission, syphilis health promotion campaigns should expand their focus.
Simplified lung ultrasound method to predict the respiratory support needs of neonates whose mothers had pregnancy complications: a diagnostic accuracy study
Authors: Lin Xin-Ao , Wang Xue-Feng , Fan Xiao-Bo , Xi Guan-Nan , Wang Ji-Mei 
Published: May 2023

Objective:
Some pregnancy complications are associated with respiratory problems in infants. Early identification and implementation of respiratory support are needed for these infants. This study aimed to (1) use lung ultrasound (LU) for predicting the respiratory support requirements of infants and (2) simplify the examination method to facilitate its clinical application.

Methods:
Neonates underwent LU examinations within 1 hour of birth. The infants were divided into a pregnancy complication (PC) group and a control group according to their mothers’ clinical data. The primary outcome measure was the need for respiratory support. Predictive models were established based on the differences in LU patterns between the two groups. The predictive value of the models was compared with that of the LU score (LUS) system, which has been widely used in other studies. Simplified models were established by analyzing the predictive effects of LU patterns in different parts of the lungs. Predictive reliability was tested using the receiver operating characteristic curve analysis.

Results:
PC and control groups had 29 and 117 neonates, respectively; a total of 22 neonates required respiratory support. The PC and control groups showed differences in respiratory support requirements, A-lines, and coalesced B-lines. The percentages of A-lines and coalesced B-lines were associated with respiratory support requirements. The optimal cutoff values for the percentages of the A-lines and coalesced B-lines were 55.7% and 24.5%, respectively. Similar effects were obtained by calculating the percentage of coalesced B-lines in four areas (R3, R4, L3, and L4). These methods were judged as more visual and convenient than LUS assessment.

Conclusion:
The percentages of A-line and coalesced B-lines on LU images can be used to predict the respiratory support needs of neonates whose mothers had pregnancy complications. Only four areas (R3, R4, L3, and L4) had similar predictive values.
Non-English Primary Language
Authors: Bakillah Emna , Sharpe James , Tong Jason K. , Goldshore Matthew , Morris Jon B. , Kelz Rachel R. 
Published: May 2023

Objective:
To examine access to cholecystectomy and post-operative outcomes among non-English primary speaking patients.

Summary Background Data:
The population of U.S. residents with limited English proficiency is growing. Language affects health literacy and is a well-recognized barrier to healthcare in the U.SA. Historically marginalized communities are at greater risk of requiring emergent gallbladder operations. However, little is known about how primary language affects surgical access and outcomes of common surgical procedures such as cholecystectomy.

Methods:
We conducted a retrospective cohort study of adult patients following receipt of cholecystectomy in Michigan, Maryland, and New Jersey utilizing the Healthcare Cost and Utilization Project State Inpatient Database and State Ambulatory Surgery and Services Database (2016-2018). Patients were classified by primary spoken language: English or non-English. The primary outcome was admission type. Secondary outcomes included operative setting, operative approach, in-hospital mortality, post-operative complications, and length of stay. Multivariable logistic and Poisson regression were used to examine outcomes.

Results:
Among 122,013 cholecystectomy patients, 91.6% were primarily English speaking and 8.4% were non-English primary language speaking. Primary non-English speaking patients had a higher likelihood of emergent/urgent admissions (OR 1.22, 95% CI 1.04-1.44, P=0.015) and a lower likelihood of having an outpatient operation (OR 0.80, 95% CI 0.70-0.91, P=0.0008). There was no difference in use of minimally invasive approach or post-operative outcomes based on primary language spoken.

Conclusions:
Non-English primary language speakers were more likely to access cholecystectomy via the emergency department and less likely to receive outpatient cholecystectomy. Barriers to elective surgical presentation for this growing patient population needs to be further studied.
Neoadjuvant Chemotherapy versus Upfront Surgery for Resectable Pancreatic Adenocarcinoma
Authors: Sugawara Toshitaka , Rodriguez Franco Salvador , Sherman Samantha , Torphy Robert J. , Colborn Kathryn , Franklin Oskar , Ishida Jun , Grandi Samuele , Al-Musawi Mohammed H. , Gleisner Ana , Schulick Richard D. , Del Chiaro Marco 
Published: May 2023

Objective:
To assess the association of survival with neoadjuvant chemotherapy (NAC) in resectable pancreatic adenocarcinoma (PDAC).

Summary Background Data:
The early control of potential micrometastases and patient selection using NAC has been advocated for patients with PDAC. However, the role of NAC for resectable PDAC remains unclear.

Methods:
Patients with clinical T1 and T2 PDAC were identified in the National Cancer Database from 2010 to 2017. Kaplan-Meier estimates and Cox regression models were used to compare survival. To address immortal time bias, landmark analysis was performed. Interactions between preoperative factors and NAC were investigated in subgroup analyses. A propensity score analysis was performed to compare survival between multiagent NAC and upfront surgery.

Results:
In total, 4,041 patients were treated with upfront surgery and 1,175 patients treated with NAC (79.4% multiagent NAC, 20.6% single-agent NAC). Using a landmark time of 6 months after diagnosis, patients treated with multiagent NAC had longer median overall survival, compared to upfront surgery and single-agent NAC. (35.8 vs. 27.1 vs. 27.4 mo). Multiagent NAC was associated with lower mortality rates compared to upfront surgery (adjusted HR, 0.77; 95% CI, 0.70–0.85), whereas single-agent NAC was not. The association of survival with multiagent NAC were consistent in analyses using the matched data sets. Interaction analysis revealed that multiagent NAC was associated with lower mortality rates across age, facility type, CA 19-9 levels, and clinical T/N stages, except in patients with body/tail tumors.

Conclusion:
The findings suggest that multiagent NAC followed by resection is associated with improved survival compared to upfront surgery.