bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved knowledge on substandard and falsified (SF) medical products through a dedicated course for pharmacy students at three universities in sub-Saharan Africa
Authors: Kusynová Zuzana , Bais Youssra , van den Ham Hendrika A , Mantel-Teeuwisse Aukje K , Etame-Loe Gisele , Kaale Eliangiringa , Sarr Serigne Omar , Guiet-Mati Fatima , Bourdillon-Esteve Pernette 
Published: February 2023

BackgroundToo few pharmacists receive formal training on substandard and falsified (SF) medical products. Strengthening knowledge across pharmacists is considered a moral and ethical duty of academia, that is, to build the health systems’ capacities to combat this global health threat these poor-quality products represent. This study therefore aimed to evaluate whether a dedicated educational course for undergraduate pharmacy students can improve their knowledge on these products.MethodsA survey was conducted at three sub-Saharan universities. Knowledge was assessed through scores on a 20-point questionnaire with questions related to the course content. Scores were compared before and after the course, and a linear mixed-effects model analysis was used to analyse score differences. Students were furthermore asked for feedback and self-assessment. In addition, teachers were interviewed on the context of the course introduction. These data were analysed descriptively.ResultsAmong 335 out of 355 students who completed the survey (n=41/53 in Cameroon, n=244/252 in Senegal and n=50/50 in Tanzania), knowledge of SF medical products was enhanced, with increase in all countries, overall, by 3.5 (95% CI 3.1 to 3.9) score points. Students improved in all offered modules in each country. Students confirmed their improvement through self-assessment.The course was well received among students and teachers. Barriers included time constraints and access to practical means (equipment availability, room allocation, internet accessibility and affordability). These barriers can be overcome by key enablers such as the support from university leadership and early involvement of the university in the course design.ConclusionsThe course improved students’ knowledge on SF medical products. These findings encourage further full implementation of this course in existing curricula beyond the pilot and can inform possible future scale-up. This has a potential for reinforcing the capacity of health systems to protect communities from SF medicines, by empowering all pharmacist across the health systems to intervene.
Sleep hygiene strategies for individuals with chronic pain: a scoping review
Authors: Gupta Charlotte C , Sprajcer Madeline , Johnston-Devin Colleen , Ferguson Sally A 
Published: February 2023

ObjectivesUp to a quarter of the world’s population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain.DesignThis scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain.ResultsThirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy.ConclusionThis scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.
Is anybody ‘Learning’ from deaths? Sequential content and reflexive thematic analysis of national statutory reporting within the NHS in England 2017–2020
Authors: Brummell Zoe , Braun Dorit , Hussein Zainab , Moonesinghe S Ramani , Vindrola-Padros Cecilia 
Published: February 2023

IntroductionThe imperative to learn when a patient dies due to problems in care is absolute. In 2017, the Learning from Deaths (LfDs) framework, a countrywide patient safety programme, was launched in the National Health Service (NHS) in England. NHS Secondary Care Trusts (NSCTs) are legally required to publish quantitative and qualitative information relating to deaths due to problems in care within their organisation, including any learning derived from these deaths.MethodAll LfDs report from 2017 to 2020 were reviewed and evaluated, quantitatively and qualitatively using sequential content and reflexive thematic analysis, through a critical realist lens to understand what we can learn from LfDs reporting and the mechanisms enabling or preventing engagement with the LfDs programme.ResultsThe majority of NSCTs have identified learning, actions and, to a lesser degree, assessed the impact of these actions. The most frequent learning relates to missed/delayed/uncoordinated care and communication/cultural issues. System issues and lack of resources feature infrequently. There is significant variation among NSCTs as to what ‘learning’ in this context actually means and a lack of oversight combining patient safety initiatives.DiscussionEngagement of NSCTs with the LfDs programme varies significantly. Learning as a result of the LfDs programme is occurring. The ability, significance or value of this learning in preventing future patient deaths remains unclear. Consensus about what constitutes effective learning with regard to patient safety needs to be defined and agreed on.
Genetically determined serum serine level has a novel causal effect on multiple sclerosis risk and predicts disability progression
Authors: Lin Xin , Yang Yuanhao , Fuh-Ngwa Valery , Yin Xianyong , Simpson-Yap Steve , van der Mei Ingrid , Broadley Simon A , Ponsonby Anne-Louise ,   Ausimmune/ AusLong Investigators Group, Burdon Kathryn P , Taylor Bruce V , Zhou Yuan 
Published: February 2023

BackgroundThere are currently no specific biomarkers for multiple sclerosis (MS). Identifying robust biomarkers for MS is crucial to improve disease diagnosis and management.MethodsThis study first used six Mendelian randomisation methods to assess causal relationship of 174 metabolites with MS, incorporating data from European-ancestry metabolomics (n=8569–86 507) and MS (n=14 802 MS cases, 26 703 controls) genomewide association studies. Genetic scores for identified causal metabolite(s) were then computed to predict MS disability progression in an independent longitudinal cohort (AusLong study) of 203 MS cases with up to 15-year follow-up.ResultsWe found a novel genetic causal effect of serine on MS onset (OR=1.67, 95% CI 1.51 to 1.84, p=1.73×10−20), such that individuals whose serine level is 1 SD above the population mean will have 1.67 times the risk of developing MS. This is robust across all sensitivity methods (OR ranges from 1.49 to 1.67). In an independent longitudinal MS cohort, we then constructed time-dynamic and time-fixed genetic scores based on serine genetic instrument single-nucleotide polymorphisms, where higher scores for raised serum serine level were associated with increased risk of disability worsening, especially in the time-dynamic model (RR=1.25, 95% CI 1.10 to 1.42, p=7.52×10−4).ConclusionsThese findings support investigating serine as an important candidate biomarker for MS onset and disability progression.
Carrollian and non-relativistic Jackiw–Teitelboim supergravity
Authors: Ravera Lucrezia , Zorba Utku 
Published: February 2023

AbstractWe present non- and ultra-relativistic Jackiw–Teitelboim (JT) supergravity as metric BF theories based on the extended Newton–Hooke and extended AdS Carroll superalgebras in two spacetime dimensions, respectively. The extended Newton–Hooke structure, and, in particular, the invariant metric necessary for the BF construction of non-relativistic JT supergravity, is obtained by performing an expansion of the $$\mathcal {N}=2$$

N
=
2

AdS$$_2$$

2

superalgebra. Subsequently, we introduce the extended AdS$$_2$$

2

Carroll superalgebra, and the associated invariant metric, as a suitable redefinition of the extended Newton–Hooke superalgebra. The mapping involved can be seen as the supersymmetric extension of the duality existing at the purely bosonic level between the extended Newton–Hooke algebra with (positive) negative cosmological constant and the extended (A)dS Carroll algebra in two dimensions. Finally, we provide the Carrollian JT supergravity action in the BF formalism. Moreover, we show that both the non-relativistic and the ultra-relativistic theories presented can also be obtained by direct expansion of $$\mathcal {N}=2$$

N
=
2

JT supergravity.
Gravitational waves from bubble collisions and fluid motion in strongly supercooled phase transitions
Authors: Lewicki Marek , Vaskonen Ville 
Published: February 2023

AbstractWe estimate the gravitational wave spectra generated in strongly supercooled phase transitions by bubble collisions and fluid motion. We derive analytically in the thin-wall approximation the efficiency factor that determines the share of the energy released in the transition between the scalar field and the fluid. We perform numerical simulations including the efficiency factor as a function of bubble radius separately for all points on the bubble surfaces to take into account their different collision times. We find that the efficiency factor does not significantly change the gravitational wave spectra and show that the result can be approximated by multiplying the spectrum obtained without the efficiency factor by its value at the radius $$R_{\textrm{eff}} \simeq 5/\beta $$

R
eff

≃
5
/
β

, where $$\beta $$
β
is the approximate inverse duration of the transition. We also provide updated fits for the gravitational wave spectra produced in strongly supercooled transitions from both bubble collisions and fluid motion depending on the behaviour of the sources after the collision.
First post-Newtonian N-body problem in Einstein–Cartan theory with the Weyssenhoff fluid: Lagrangian and first integrals
Authors: Battista Emmanuele , De Falco Vittorio , Usseglio Davide 
Published: February 2023

AbstractThe rotational dynamics of anN-body system at the first post-Newtonian order in Einstein–Cartan theory is derived. This result is achieved by performing the point-particle limit of the equations of motion of the Weyssenhoff fluid, which models the quantum spin effects residing inside the bodies. For the special case of binary systems, we determine the Lagrangian function and the resulting first integrals underlying the translational dynamics and the spin precession.
Calculations of vacuum mean values of spinor field current and energy–momentum tensor in a constant electric background
Authors: Breev Alexander I. , Gavrilov Sergey P. , Gitman Dmitry M. 
Published: February 2023

AbstractIn the framework of strong-field QED with x-steps, we study vacuum mean values of the current density and energy–momentum tensor of the quantized spinor field placed in the so-called L-constant electric background. The latter background can be, for example, understood as the electric field confined between capacitor plates, which are separated by a sufficiently large distance L. First, we reveal peculiarities of nonperturbative calculating of mean values in strong-field QED with x-steps in general and, in the L-constant electric field, in particular. We propose a new renormalization and volume regularization procedures that are adequate for these calculations. We find necessary representations for singular spinor functions in the background under consideration. With their help, we calculate the above mentioned vacuum means. In the obtained expressions, we show how to separate global contributions due to the particle creation and local ones due to the vacuum polarization. We demonstrate how these contributions can be related to the renormalized effective Heisenberg–Euler Lagrangian.
Novel Mechanically-Alloyed Cu–La–P Ternary Alloy Electrocatalysts for the Alkaline Hydrogen Evolution Reaction
Authors: Sloan Arthur D. , Mir Rameez A. , Thorpe Steven J. 
Published: February 2023

Transition metal phosphides, such as Cu3P, are of research interest as hydrogen evolution electrocatalysts due to a combination of good intrinsic activity and good stability. Rare earth-transition metal alloying is known to improve electrocatalytic performance, especially by the formation of intermetallic phases. Current transition metal phosphide electrocatalyst manufacturing methods are not capable of forming these intermetallic phases. Mechanical alloying is a promising technique to synthesize these intermetallic phases. Alloy powders of Cu3P, Cu19La5P12, and a novel multi-phase Cu74La4P22 composition were prepared using mechanical alloying and evaluated as electrocatalysts for the alkaline hydrogen evolution reaction on a geometric and intrinsic area basis. On an intrinsic basis, the novel Cu–La–P composition demonstrated excellent Tafel performance of 69.4 mV dec−1. Tafel slope, exchange current density, and overpotential data demonstrated the importance of spillover effects in multiphase Cu3P/Cu19La5P12 surface structures. These results suggest that Cu–La–P alloys are promising potential catalysts for electrochemical hydrogen production, and mechanical alloying of rare earth elements is an effective technique for improving the electrochemical performance of transition metal phosphides.
Comparative Associations of Nonalcoholic Fatty Liver Disease and Metabolic Dysfunction–Associated Fatty Liver Disease With Coronary Artery Calcification: A Cross-Sectional and Longitudinal Cohort Study
Authors: Sung Ki-Chul , Yoo Tae Kyung , Lee Mi Yeon , Byrne Christopher D. , Zheng Ming-Hua , Targher Giovanni 
Published: February 2023

Background:
In cross-sectional and retrospective cohort studies, we examined comparative associations between nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction–associated fatty liver disease (MAFLD) and risk of having or developing coronary artery calcification (CAC).

Methods:
Participants who had health examinations between 2010 and 2019 were analyzed. Liver ultrasonography and coronary artery computed tomography were used to diagnose fatty liver and CAC. Participants were divided into a MAFLD and no-MAFLD group and then NAFLD and no-NAFLD groups. Participants were further divided into no fatty liver disease (reference), NAFLD-only, MAFLD-only, and both NAFLD and MAFLD groups. Logistic regression modeling was performed. Cox proportional hazard model was used to examine the risk of incident CAC in participants without CAC at baseline and who had at least two CAC measurements.

Results:
In cross-sectional analyses, 162 180 participants were included. Compared with either the no-NAFLD or no-MAFLD groups, the NAFLD and MAFLD groups were associated with a higher risk of prevalent CAC (NAFLD: adjusted odds ratio [OR], 1.34 [95% CI, 1.29–1.39]; MAFLD: adjusted OR, 1.44 [95% CI, 1.39–1.48]). Among the 4 groups, the MAFLD-only group had the strongest association with risk of prevalent CAC (adjusted OR, 1.60 [95% CI, 1.52–1.69]). Conversely, the NAFLD-only group was associated with a lower risk of prevalent CAC (adjusted OR, 0.76 [95% CI, 0.66–0.87]). In longitudinal analyses, 34 233 participants were included. Compared with either the no-NAFLD or no-MAFLD groups, the NAFLD and MAFLD groups were associated with a higher risk of incident CAC (NAFLD: adjusted hazard ratio, 1.68 [95% CI, 1.43–1.99]; MAFLD: adjusted hazard ratio, 1.82 [95% CI, 1.56–2.13]). Among these 4 groups, the MAFLD-only group had the strongest associations with risk of incident CAC (adjusted hazard ratio, 2.03,[95% CI, 1.62–2.55]). The NAFLD-only group was not independently associated with risk of incident CAC (adjusted hazard ratio, 0.88 [95% CI, 0.44–1.78])

Conclusions:
Both NAFLD and MAFLD are significantly associated with an increased prevalence and incidence of CAC. These associations tended to be stronger for MAFLD.
Association of Brain Arterial Elongation With Risk of Stroke and Death in Stroke-Free Individuals: Results From NOMAS
Authors: Del Brutto Victor J. , Khasiyev Farid , Salehi Omran Setareh , Purohit Meghan , Liu Minghua , Wright Clinton B. , Rundek Tatjana , Elkind Mitchell S.V. , Sacco Ralph L. , Gutierrez Jose 
Published: February 2023

Background:
Brain arterial dilation and elongation characterize dolichoectasia, an arteriopathy associated with risk of stroke and death. We aim to determine whether brain arterial elongation increases the risk of stroke and death independent of brain arterial diameters.

Methods:
We analyzed 1210 stroke-free participants (mean age 71±9 years, 41% men, 65% Hispanic) with available time-of-flight magnetic resonance angiogram from the Northern Manhattan Study, a population-based cohort study across a multiethnic urban community. We obtained baseline middle cerebral artery M1-segment (MCA-M1) and basilar artery (BA) mean lengths and diameters using a semi-automated software. Cox proportional hazards models adjusted for brain arterial diameters and potential confounders yielded adjusted hazards ratios with 95% CIs for the primary outcomes of incident stroke and all-cause mortality, as well as secondary outcomes including noncardioembolic stroke, vascular death, and any vascular event.

Results:
Neither MCA-M1 nor BA lengths correlated with incident stroke or all-cause mortality. Both MCA-M1 and BA larger diameters correlated with all-cause mortality (MCA-M1 aHR, 1.52 [95% CI, 1.03–2.23], BA aHR, 1.28 [95% CI, 1.02–1.61]), as well as larger MCA-M1 diameters with vascular death (aHR, 1.84 [95% CI, 1.02–3.31]). Larger MCA-M1 and BA diameters did not correlate with incident stroke. However, larger BA diameters were associated with posterior circulation noncardioembolic stroke (aHR, 2.93 [95% CI, 1.07–8.04]). There were no statistical interactions between brain arterial lengths and diameters in relation to study outcomes.

Conclusions:
In a multiethnic cohort of stroke-free adults, brain arterial elongation did not correlate with risk of stroke or death, nor influenced the significant association between brain arterial dilation and vascular risk.
Tenecteplase Treatment and Thrombus Characteristics Associated With Early Reperfusion: An EXTEND-IA TNK Trials Analysis
Authors: Yogendrakumar Vignan , Churilov Leonid , Guha Prodipta , Beharry James , Mitchell Peter J. , Kleinig Timothy J. , Yassi Nawaf , Thijs Vincent , Wu Teddy Y. , Brown Helen , Dewey Helen M. , Wijeratne Tissa , Yan Bernard , Sharma Gagan , Desmond Patricia M. , Parsons Mark W. , Donnan Geoffrey A. , Davis Stephen M. , Campbell Bruce C.V. , Dowling Richard , Bush Steven , Scroop Rebecca , Brooks Mark , Asadi Hamed , Ang Timothy , Miteff Ferdinand , Levi Christopher , Zhao Henry , Ng Felix , Alemseged Fana , Rice Henry , de Villiers Laetitia , Redmond Kendal , Leggett David 
Published: February 2023

Background:
Intracranial occlusion site, contrast permeability, and clot burden are thrombus characteristics that influence alteplase-associated reperfusion. In this study, we assessed the reperfusion efficacy of tenecteplase and alteplase in subgroups based on these characteristics in a pooled analysis of the EXTEND-IA TNK trial (Tenecteplase Versus Alteplase Before Endovascular Therapy for Ischemic Stroke).

Methods:
Patients with large vessel occlusion were randomized to treatment with tenecteplase (0.25 or 0.4 mg/kg) or alteplase before thrombectomy in hospitals across Australia and New Zealand (2015–2019). The primary outcome, early reperfusion, was defined as the absence of retrievable thrombus or >50% reperfusion on first-pass angiogram. We compared the effect of tenecteplase versus alteplase overall, and in subgroups, based on the following measured with computed tomography angiography: intracranial occlusion site, contrast permeability (measured via residual flow grades), and clot burden (measured via clot burden scores). We adjusted for covariates using mixed effects logistic regression models.

Results:

Tenecteplase was associated with higher odds of early reperfusion (75/369 [20%] versus alteplase: 9/96 [9%], adjusted odds ratio [aOR], 2.18 [95% CI, 1.03–4.63]). The difference between thrombolytics was notable in occlusions with low clot burden (tenecteplase: 66/261 [25%] versus alteplase: 5/67 [7%], aOR, 3.93 [95% CI, 1.50–10.33]) when compared to high clot burden lesions (tenecteplase: 9/108 [8%] versus alteplase: 4/29 [14%], aOR, 0.58 [95% CI, 0.16–2.06];
P
interaction
=0.01). We did not observe an association between contrast permeability and tenecteplase treatment effect (permeability present: aOR, 2.83 [95% CI, 1.00–8.05] versus absent: aOR, 1.98 [95% CI, 0.65–6.03];
P
interaction
=0.62). Tenecteplase treatment effect was superior with distal M1 or M2 occlusions (53/176 [30%] versus alteplase: 4/42 [10%], aOR, 3.73 [95% CI, 1.25–11.11]), but both thrombolytics had limited efficacy with internal carotid artery occlusions (tenecteplase 1/73 [1%] versus alteplase 1/19 [5%], aOR, 0.22 [95% CI, 0.01–3.83];
P
interaction
=0.16).

Conclusions:
Tenecteplase demonstrates superior early reperfusion versus alteplase in lesions with low clot burden. Reperfusion efficacy remains limited in internal carotid artery occlusions and lesions with high clot burden. Further innovation in thrombolytic therapies are required.
Certified Robustness to Text Adversarial Attacks by Randomized [MASK]
Authors: Zeng Jiehang , Xu Jianhan , Zheng Xiaoqing , Huang Xuanjing 
Published: February 2023

Abstract
Very recently, few certified defense methods have been developed to provably guarantee the robustness of a text classifier to adversarial synonym substitutions. However, all the existing certified defense methods assume that the defenders have been informed of how the adversaries generate synonyms, which is not a realistic scenario. In this study, we propose a certifiably robust defense method by randomly masking a certain proportion of the words in an input text, in which the above unrealistic assumption is no longer necessary. The proposed method can defend against not only word substitution-based attacks, but also character-level perturbations. We can certify the classifications of over 50% of texts to be robust to any perturbation of five words on AGNEWS, and two words on SST2 dataset. The experimental results show that our randomized smoothing method significantly outperforms recently proposed defense methods across multiple datasets under different attack algorithms.