bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Prevalence of Collagenopathies in Preterm- and Term-Born Children With Periventricular Venous Hemorrhagic Infarction
Authors: Ilves Norman , Pajusalu Sander , Kahre Tiina , Laugesaar Rael , Šamarina Ustina , Loorits Dagmar , Kool Pille , Ilves Pilvi 
Published: July 2023

Introduction The aim of this study was to evaluate genetic risk factors in term-born children with antenatal periventricular hemorrhagic infarction (PVHI), presumed antenatal periventricular venous infarction and periventricular hemorrhagic infarction in preterm neonates. Methods Genetic analysis and magnetic resonance imaging were performed in 85 children: term-born children (≥36 gestational weeks) with antenatal periventricular hemorrhagic infarction (n = 6) or presumed antenatal (n = 40) periventricular venous infarction and preterm children (<36 gestational weeks) with periventricular hemorrhagic infarction (n = 39). Genetic testing was performed using exome or large gene panel (n = 6700 genes) sequencing. Results Pathogenic variants associated with stroke were found in 11 of 85 (12.9%) children with periventricular hemorrhagic infarction/periventricular venous infarction. Among the pathogenic variants, COL4A1/A2 and COL5A1 variants were found in 7 of 11 (63%) children. Additionally, 2 children had pathogenic variants associated with coagulopathy, whereas 2 other children had other variants associated with stroke. Children with collagenopathies had significantly more often bilateral multifocal stroke with severe white matter loss and diffuse hyperintensities in the white matter, moderate to severe hydrocephalus, moderate to severe decrease in size of the ipsilesional basal ganglia and thalamus compared to children with periventricular hemorrhagic infarction/periventricular venous infarction without genetic changes in the studied genes ( P ≤ .01). Severe motor deficit and epilepsy developed more often in children with collagenopathies compared to children without genetic variants ( P = .0013, odds ratio [OR] = 233, 95% confidence interval [CI]: 2.8-531; and P = .025, OR = 7.3, 95% CI: 1.3-41, respectively). Conclusions Children with periventricular hemorrhagic infarction/periventricular venous infarction have high prevalence of pathogenic variants in collagene genes ( COL4A1/A2 and COL5A1). Genetic testing should be considered for all children with periventricular hemorrhagic infarction/periventricular venous infarction; COL4A1/A2 and COL5A1/A2 genes should be investigated first.
Numerical analysis of catalyst particle deposition characteristics in a flue gas turbine with an improved particle motion and deposition model
Authors: Cai Liuxi , Yao Jiawei , Hou Yanfang , wang Shunsen , Li Yun , Feng Zhenping 
Published: July 2023

To more accurately understand and predict the deposition behavior of catalyst particles in the flue gas turbine cascade, test and numerical combined study is performed in this paper. Based on the systematic analysis of the deposition process and physical mechanism of the catalyst particles, the traditional DRW model, critical velocity particle deposition model and removal model were corrected with the user defined function custom function and validated with the actual deposition morphology. On this basis, the effects of the particle Stokes number and flue gas parameters on the particle deposition characteristics of the flue gas turbine cascade were detailed investigated. The results show that the revised DRW model, critical velocity and removal model can more accurately predict the deposition location and deposition rate of particles in the turbine cascade. With the increase in the Stokes number of particles, the average particle impact rate on the blade surface gradually increased, while the average deposition rate showed a trend of first increasing and then decreasing. The average deposition rate of particles in the rotor blade surface is roughly twice as high as that in the stator surface. With the increase of the flue gas expansion ratio, the deposition rate of particles less than 3 μm gradually increases, while the deposition rate of particles greater than 3 μm tends to decrease. In addition, the change in the flue gas expansion ratio has no obvious effect on the particle deposition distribution in different size ranges.
Ethical Challenges to the Self-care of Nurses during the Covid-19 Pandemic
Authors: Manookian Arpi , Nayeri Nahid Dehghan , Dashti Seemin , Shahmari Mehraban 
Published: July 2023

Background The emerging working conditions triggered by the COVID-19 pandemic have imposed numerous ethical challenges on the nurses, which, in turn, can negatively impact the nurses’ physical and mental health, and thus their work performance through intensifying negative emotions and psychological pressures. Aim The purpose of this study was to highlight the nurses’ perceptions of the ethical challenges that they faced regarding their self-care during the COVID-19 pandemic. Research design A qualitative, descriptive study with a content analysis approach. Participants and research context The data were collected through semi-structured interviews with 19 nurses working in the COVID-19 wards of two university-affiliated hospitals. These nurses were selected using a purposive sampling method and the data were analyzed using a content analysis approach. Ethical considerations The study was approved by the TUMS Research Council Ethics Committee under the code: IR.TUMS.VCR.REC.1399.594. In addition, it is based on the participants’ informed consent and confidentiality. Findings Two themes and five sub-themes were identified, including ethical conflicts (the conflict between self-care and comprehensive patient care, prioritization of life, and inadequate care) and inequalities (intra- and inter-professional inequalities). Conclusion The findings demonstrated that the nurses’ care is a prerequisite for the patients’ care. Considering that the ethical challenges faced by nurses are related to unacceptable working conditions, organizational support, and lack of access to facilities such as personal protective equipment, it seems essential to support nurses and provide adequate working conditions to provide patients with quality care.
Interventions for youth suicide and suicide-related behaviour: An update to a systematic review
Authors: Bailey Eleanor , Robinson Jo , Witt Katrina 
Published: July 2023

Objective To update our 2018 review with the latest evidence from randomised controlled trials (RCTs) on the effectiveness of interventions to prevent youth suicide and suicide-related behaviour. Method In keeping with our 2018 review, Embase, PsycInfo, and Medline were searched using relevant key words. Included trials were RCTs evaluating the impact of an intervention or approach designed to prevent or reduce youth suicide and suicide-related behaviour. Key data were extracted, and results synthesised narratively. Results Thirty RCTs were included across clinical ( n = 13), educational ( n = 8), and community settings ( n = 9). No trials were conducted in workplace or primary care settings, or with indigenous populations, and few trials involved partnerships with young people. There were some concerns or a high risk of bias for most trials. Conclusion While a relatively large number of RCTs have been published in recent years, knowledge gaps remain. Further high-quality RCTs are needed, including those focussing on vulnerable population groups. Meaningful consumer involvement and a stronger emphasis on implementation are also recommended.
Thrombolysis for central retinal artery occlusion: An individual participant-level meta-analysis
Authors: Shahjouei Shima , Bavarsad Shahripour Reza , Dumitrascu Oana M 
Published: July 2023

Background: Whether thrombolysis improves outcomes in non-arteritic central retinal artery occlusion (naCRAO) is uncertain. We aimed to evaluate the rate of visual recovery after intra-venous thrombolysis (IVT) or intra-arterial thrombolysis (IAT) administration of tissue plasminogen activator (tPA) or urokinase among patients with naCRAO and explore the parameters affecting the final visual acuity (VA). Aim: We systematically searched six databases. Logarithm of the minimum angle of resolution (logMAR) and VA of ⩾20/100 were used to quantify visual recovery. To explore the role of other factors on visual recovery, we defined two models for studies with aggregated data (designs 1 and 2) and 16 models for individual participant data (IPD, models 1–16). Summary of Review: We included data from 771 patients out of 72 publications in nine languages. Visual improvement for ⩾0.3 logMAR was reported in 74.3% of patients who received IVT-tPA within 4.5 h (CI: 60.9–86.0%; unadjusted rate: 73.2%) and 60.0% of those who received IAT-tPA within 24 h (CI: 49.1–70.5%; unadjusted rate: 59.6%). VA of ⩾20/100 was observed among 39.0% of patients after IVT-tPA within 4.5 h and 21.9% of those with IAT-tPA within 24 h. IPD models highlighted the association between improved visual outcomes and VA at presentation, at least 2 weeks follow-up before reporting the final VA, antiplatelet therapy, and shorter symptom onset to thrombolysis window. Conclusion: Early thrombolytic therapy with tPA is associated with enhanced visual recovery in naCRAO. Future studies should refine the optimum time window for thrombolysis in naCRAO.
Mortality risk prediction of the electrocardiogram as an informative indicator of cardiovascular diseases
Authors: Tsai Dung-Jang , Lou Yu-Sheng , Lin Chin-Sheng , Fang Wen-Hui , Lee Chia-Cheng , Ho Ching-Liang , Wang Chih-Hung , Lin Chin 
Published: July 2023

Background The electrocardiogram (ECG) may be the most popular test in the management of cardiovascular disease (CVD). Although wide applications of artificial intelligence (AI)-enabled ECG have been developed, an integrating indicator for CVD risk stratification was not investigated. Since mortality may be the most important global outcome, this study aimed to develop a survival deep learning model (DLM) to establish a critical ECG value and explore the associations with various CVD events. Methods We trained a DLM with 451,950 12-lead resting ECGs obtained from 210,552 patients, for whom 23,592 events occurred. The internal validation set included 27,808 patients with one ECG for each patient. The external validations were performed in a community hospital with 33,047 patients and two transnational data sets with 233,647 and 1631 ECGs. We distinguished the cause of mortality and additionally investigated CVD-related outcomes, including new-onset acute myocardial infarction (AMI), stroke (STK), and heart failure (HF). Results The DLM achieved C-indices of 0.858/0.836 in internal/external validation sets by using ECG over a 10-year period. The high-mortality-risk group identified by the proposed DLM presented a hazard ratio (HR) of 14.16 (95% confidence interval (CI): 11.33–17.70) compared to the low-risk group in the internal validation and presented a higher risk of cardiovascular (CV) mortality (HR: 18.50, 95% CI: 9.82–34.84), non-CV mortality (HR: 13.68, 95% CI: 10.76–17.38), AMI (HR: 4.01, 95% CI: 2.24–7.17), STK (HR: 2.15, 95% CI: 1.70–2.72), and HF (HR: 6.66, 95% CI: 4.54–9.77), which was consistent in an independent community hospital. The transnational validation also revealed HRs of 4.91 (95% CI: 2.63–9.16) and 2.29 (95% CI: 2.15–2.44) for all-cause mortality in the SaMi-Trop and Clinical Outcomes in Digital Electrocardiography 15% (CODE15) cohorts. Conclusions The mortality risk by AI-enabled ECG may be applied in passive electronic-health-record-based CVD risk screening, which may identify more asymptomatic and unaware high-risk patients.
“Caring for Breast Cancer Patients Is a Work That Brings Sorrow”: A Qualitative Interview Study with Nurses in Tanzania
Authors: Kidayi Paulo L. , Manhica Hélio , Nakazzi Sandra , Mtuya Christina C. , Aune Ragnhild E. , Serventi Furaha , Mahande Michael Johnson , Björling Gunilla 
Published: July 2023

Introduction Breast cancer is increasing in sub-Saharan Africa (SSA), and most women are diagnosed at a late stage. This leads to increased suffering for the patients and challenging care situations for nurses. Limited resources in healthcare, lack of oncology training, and low health literacy in society result in even more demanding situations for nurses. Objective The objective was to explore nurses’ experiences of caring women for with breast cancer in Tanzania. Methods The study employed a descriptive qualitative design. Fifteen nurses, working in oncology units in three major hospitals in Tanzania were interviewed using a semistructured interview guide. The participants had a minimum of 6 months experience of caring for breast cancer patients. Purposive sampling was used. Data were analyzed by qualitative content analysis. Results Two main themes emerged: Challenges in caring for breast cancer patients and Nurses’ psychological distress. The late diagnosis was very challenging for the nurses. Low health literacy regarding breast cancer disease and treatment, patients’ financial difficulties, minimal oncology nursing education, and technology in healthcare systems were also major challenges. The nurses experienced psychological distress, lost hope, and faced ethical dilemmas while providing cancer care. Conclusion The findings of this study conclude that nurses face emotional distress and ethical dilemmas while caring for patients with breast cancer. Late diagnosis, lack of infrastructure and resources, and low health literacy among patients, family, and healthcare providers have a great impact on the stress that the nurses experience.
Factors Affecting Mechanical Ventilator Weaning Success and 28-Day Survival Among Patients With Acute Respiratory Distress Syndrome Secondary to COVID-19
Authors: Aldabayan Yousef Saad , Tolba Asmaa Atiaa , Alrajeh Ahmed Mansour , Ahmed Ahmed Talaat , Mahgoub Asmaa Aly , Glalah Ayman A. Abou , Abdelhafez Amal Ismael 
Published: July 2023

Introduction The process of weaning patients off mechanical ventilation (MV) is difficult and complex. Critical care nurses must maintain continuity of care for patients undergoing MV weaning, assess patients’ overall condition, and meet patients’ needs. Objectives The study aimed to explore clinical factors of MV weaning success and 28-day survival among patients with acute respiratory distress syndrome secondary to COVID-19. Methods This prospective observational study was conducted on 90 newly admitted patients in the general intensive care unit Assiut Univeristy Main Hospital in Egypt from October 2021 to March 2022. The researchers applied a standard weaning protocol for all of the patients in this study and then assessed the outcome variables: success or failure of weaning trials from a mechanical ventilator, and 28-day survival. Results In total, 50 (55.6%) patients were successfully weaned from MV, and 45 (50%) patients survived at 28 days. In a multivariate regression analysis, dynamic compliance (OR, 1.115; 95% CI, 1.010–1.230, p = .031*), lymphocyte count (OR, 3.025; 95% CI, 1.322–6.923, p = .009*), urine output (OR, 1.002; 95% CI, 1.001–1.004, p = .002*), and alanine aminotransferase (ALT; OR, 0.993; 95% CI, 0.988–0.999, p = .017*) were significantly associated with weaning success. In addition, age (OR, 1.058; 95% CI, 1.015–1.102; p = .007*), lymphocyte count (OR, 3.304; 95% CI, 1.348–8.100; p = .009*), urine output (OR, 1.003; 95% CI, 1.001–1.004; p = .001*), and ALT (OR, 0.994; 95% CI, 0.989–0.99, p = .015*) were significantly associated with survival at 28 days. Conclusion Dynamic lung compliance, lymphocyte count, urine output, and ALT were found to be predictive parameters that may affect the success of weaning off MV. Additionally, it was found that age, lymphocyte count, urine output, and ALT are predictors of survival at 28 days. We recommend further studies with larger, more systematic samples and complete follow-up, focusing on pulmonary function and quality of life in postweaning patients with acute respiratory distress syndrome.
Inpatient hospice admissions. Who is admitted and why: a mixed-method prospective study
Authors: Haraldsdottir Erna , Lloyd Anna , Bijak Martyn , Milton Libby , Finucane Anne M. 
Published: July 2023

Background: Over the next two decades, the numbers of people who will need palliative care in the United Kingdom and Ireland is projected to increase. Hospices play a vital role supporting people who require specialist palliative care input through community-based and inpatient palliative care services. Evidence is needed to understand the role of these different services to inform future service development. Objectives: To describe the reasons for admission, and outcomes at the end of the stay, for patients admitted to two hospice inpatient units (IPUs). Design: This was a mixed-methods study using a convergent, parallel mixed-methods design. Methods: We reviewed the case notes of all patients admitted to two hospice inpatient units from July to November 2019; conducted semi-structured interviews with patients and families; as well as brief structured interviews with inpatient unit staff. Results: Two hundred fifty-nine patients were admitted to a hospice IPU, accounting for 276 admissions in total. Overall, 53% were female; median age was 71 years (range: 26–95 years). Most patients (95%) were White British or Scottish, and 95% had a cancer diagnosis. Most patients were admitted from the community, under one-third were admitted from hospital. Most (85%) had previous palliative care involvement. Nearly, half had district nurse support (48%). Worry and anxiety was frequently reported as a reason for admission, alongside physical concerns. Median length of stay was 12 days, and 68% died during their stay. Hospice was recorded as the preferred place of care for 56% of those who died there. Conclusions: Sustained efforts to promote the hospice as place of care for people with conditions other than cancer are needed alongside greater clarity regarding of the role of the hospice IPU, and who would benefit most from IPU support.
Estimation of migraine prevalence considering active and inactive states across different age groups
Authors: Piccininni Marco , Brinks Ralph , Rohmann Jessica L. , Kurth Tobias 
Published: July 2023

AbstractBackgroundMigraine is a very common headache disorder on the population level, characterized by symptomatic attacks (activity). For many people with migraine, the migraine symptoms intermittently or permanently cease during their lifetime (inactive migraine). The current diagnostic classification of migraine considers two states: active migraine (having migraine symptoms within the last year) and not having active migraine (including both individuals with inactive migraine and those who never had migraine). Defining a state of inactive migraine that has gone into remission may better capture the trajectories of migraine across the lifespan and contribute to a better understanding of its biological processes. We aimed to quantify the prevalence of never, active, and inactive migraine separately, using modern prevalence and incidence estimation methodology to better describe the complexity of migraine trajectories at the population level.MethodsUsing a multistate modeling approach, data from the Global Burden of Disease (GBD) study, and results from a population-based study, we estimated the transition rates by which individuals moved between migraine disease states and estimated prevalences of never, active and inactive migraine. We used data from the GBD project and a hypothetical cohort of 100,000 people with a starting age of 30 and 30 years of follow-up, both in Germany and globally, stratified by sex.ResultsIn Germany, the estimated rate of transition from active to inactive migraine (remission rate) increased after the age of 22.5 in women and 27.5 in men. The pattern for men in Germany was similar to the one observed on the global level. The prevalence of inactive migraine among women reaches 25.7% in Germany and 16.5% globally at age 60. For men, the inactive migraine prevalence estimates at the same age were 10.4% in Germany and 7.1% globally.ConclusionsConsidering an inactive migraine state explicitly reflects a different epidemiological picture of migraine across the lifecourse. We have demonstrated that many women of older ages may be in an inactive migraine state. Many pressing research questions can only be answered if population-based cohort studies collect information not only on active migraine but also on inactive migraine states.
Routine developmental screening in Australian general practice: a pilot study
Authors: Alexander Karyn , Mazza Danielle 
Published: July 2023

Abstract
Background
Parents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations.

Methods
The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners.

Results
Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners’ motivation to use PEDS tools and perceptions of environmental constraints.

Conclusions
A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices.