bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Exploratory Evaluation of Barriers to Study Leave Application Amongst Psychiatric Trainees in the West Midlands
Authors: Cunningham Rebecca , Burlingham Amy , Kelani Bukola 
Published: July 2023

AimsBetween 2018–2021 there was a downward trend in study leave applications and the total spending on trainee study leave activities. There was concern that trainees may not be maximising educational opportunities. The authors were aware of anecdotal evidence indicating barriers to applying for study leave and therefore sought to objectively explore this. We aimed to evaluate qualitative and quantitative responses amongst psychiatric trainees within the West Midlands deanery regarding study leave applications. We also endeavoured to identify positive aspects and barriers, to improve knowledge and confidence in the process and identify areas for improvement in making the system more accessible.MethodsThe authors met with Health Education West Midlands to clarify current processes and gather objective data regarding study leave applications between 2018 and 2021. A survey was distributed to all Psychiatric trainees in the West Midlands in December 2021. The survey was open for three weeks and contained closed and open questions. Data were analysed and a thematic analysis was completed independently by the authors to allow for triangulation.ResultsThere were 62 responses (response rate of 27%) from trainees ranging from CT1-ST7+. 55% were unclear about the study leave application process, and of these, 79% said this had prevented them from applying. Only 37% of trainees found the process ‘very’ or ‘moderately easy’, with 23% finding it ‘very difficult’. When exploring barriers, worryingly 69% of trainees did not know where to find the list of approved courses. Other themes included too many signatures being required, long delays in forms being returned and money being reimbursed.ConclusionThe majority of respondents were unclear about the study leave process or found it difficult. This acts as a barrier to application in the majority of cases and may have a knock-on effect on the overall quality of training. By identifying these barriers, we are now able to address these more directly.The results were presented at a deanery wide level leading to a better understanding of the reduction in spending of study leave funding. Phase two of the project will see the introduction of an electronic application system, aiming for an easier and shorter process, in addition to creating consistency across trusts. There may have been some confounding factors, such as COVID-19 that may have contributed to the decline in study budget being utilised.
Edge-Centric Analysis of Time-Varying Functional Connectivity in Schizophrenia Using the COBRE Dataset
Authors: Gee Abigail , Morgan Sarah 
Published: July 2023

AimsDifferences in static and dynamic resting-state functional connectivity have been identified in patients with schizophrenia, individuals at high risk of psychosis and those with psychotic-like experiences. Analysis of dynamic connectivity is important to understand the temporal fluctuations in functional connectivity. Studies of dynamic functional connectivity have been conducted using methods such as the sliding-window technique and co-activation patterns (CAPs). In this study edge-centric analysis has been used to examine differences in time-varying connectivity in patients with schizophrenia compared to healthy controls. This method overcomes some of the limitations of other methods as it has higher temporal resolution and unwraps the data without applying additional modelling or requiring user-defined specification of parameters.MethodsWe analysed resting-state fMRI data from 67 patients with schizophrenia and 81 healthy controls using the Center for Biomedical Research Excellence (COBRE) dataset. The edge-time series for these subjects was calculated by omitting the averaging step when calculating the correlation between time series at each node. This effectively unwrapped the functional connectivity correlations and produced a measure of cofluctuation at each timeframe. The edge time series can be aggregated into a single measure of dynamic whole brain co-fluctuation by calculating the root sum square (RSS). We analysed the frequency and amplitude of the high amplitude peaks of cofluctuation and the patterns of activity seen during peaks and troughs.ResultsThe results showed that mean peak amplitude was lower in patients with schizophrenia compared to controls (t-stat= -3.13, p = 0.0021). Patients with schizophrenia also had significantly less frequent peaks (t-stat= -2.80, p = 0.0058).The pattern of activation at peaks in controls was more homogenous between control subjects compared to patients with schizophrenia. We identified networks that were significantly less activated in patients than in controls during peaks, troughs and transitionary time points.ConclusionThis study suggests that in patients with schizophrenia the whole brain cofluctuations during resting-state are less frequent and lower in amplitude. This is in keeping with previous studies which have identified that patients with schizophrenia spend significantly less time than healthy controls in states of large-scale connectivity. Further studies looking at larger transdiagnostic samples and antipsychotic naïve patients will be important to build on these results.
Hypercalcaemia and Primary Hyperparathyroidism – an Underappreciated Contributor to Psychiatric Presentations
Authors: Ghoneim Fatma , Shanley Ivan , Ford Jennifer 
Published: July 2023

AimsHypercalcaemia can lead to many neuropsychiatric symptoms from fatigue, lethargy, anxiety, irritability, and insomnia to impaired concentration and memory, depression, delirium, and psychosis. Primary hyperparathyroidism (PHPT), which is the most common cause of hypercalcaemia, is a relatively common disorder affecting 1 in 500 women and 1 in 2000 men aged over 40 years. A patient, with a diagnosis of Alzheimer's disease, subtype mixed, had hypercalcaemia on admission which wasn't corrected until 4 months of the admission had passed. Calcium correction precipitated a marked improvement in the patient's mental state. In order to learn from this incident, an audit was carried out to look at possible gaps in performing blood tests, and how abnormal calcium levels can affect patients’ mental states.MethodsRetrospective data collection was performed to obtain blood results for all patients -aged 40 years or above- admitted to inpatient wards in South Essex within a six month period (from April 2022 to September 2022). A total number of 333 patients (173 males and 160 females) were identified.ResultsBone Profile was checked in 248 patients (127 males and 121 females). Twelve patients were found to have hypercalcaemia on admission - mean age 65.7 years, female: male ratio of 3:1. No patients were found to have hypocalcaemia.Hypercalcaemia was addressed in only 2 of 12 patients. Parathyroid hormone (PTH) was tested either before or during admission to mental health services in 6 patients, PTH was found to be elevated (greater than 9.3 pmol/L) in 4 patients (2 males and 2 females), below the midpoint of the reference range in one patient, and below the lower limit of the reference range in one patient.ConclusionPatients with hypercalcemia had different diagnoses - anxiety, depression, adjustment disorder, mania, psychosis, and dementia. It was the first admission for three patients with a mean age of 76 years. Six patients were known to services but it appeared that the recent admissions were associated with hypercalcaemia. Active management of hypercalcaemia in 2 patients resulted in improvement in their mental state.We found that risk of PHPT in mental health inpatients aged over 40 years old was increased by 1.45% (95% CI: -0.0620% to 5.6256%, P = 0.0390) in females, and was increased by 1.52% (95% CI: 0.3573% to 5.5031%, P < 0.0001) in males. Hereby, testing for bone profile should be routinely recommended for mental health patients.
Order amidst disorder for two-dimensional nanoribbons with various boundary conditions
Authors: Novotny Mark A. , Inkoom G. , Novotný Tomáš 
Published: July 2023

Abstract
We show quantum systems with disordered Hamiltonians may exhibit order in commonly measured quantities. This counter-intuitive situation is demonstrated using a conventional tight binding model for two-dimensional nanoribbons with various boundary conditions. The analysis uses the traditional non-equilibrium Green's function (NEGF) methodology for electron transport. We study quantum dragon nanodevices that exhibit order amidst disorder. Each disordered Hamiltonian nanodevice shows order in both the bond currents and the local density of states (LDOS) of the propagating electrons.
Microvascular Complications Are Associated With Coronary Collateralization in Type 2 Diabetes and Chronic Occlusion
Authors: Gurgoglione Filippo Luca , Pitocco Dario , Montone Rocco A , Rinaldi Riccardo , Bonadonna Riccardo C , Magnani Giulia , Calvieri Camilla , Solinas Emilia , Rizzi Alessandro , Tartaglione Linda , Flex Andrea , Viti Luca , Trani Carlo , Ardissino Diego , Crea Filippo , Niccoli Giampaolo 
Published: July 2023

Abstract

Context
Coronary collateral (CC) vessel development appears to be protective with regard to adverse cardiovascular events and survival in patients with coronary chronic total occlusion (CTO). The influence of type 2 diabetes mellitus (T2DM) on CC growth has been controversial. In particular, the role of diabetic microvascular complications (DMC) in determining coronary collateralization has not been elucidated.

Objective
To investigate whether patients with DMC presented differences in CC vessel presence and grading as compared with patients without DMC.

Methods
We conducted a single-center observational study, including consecutive T2DM patients, without previous cardiovascular history, undergoing a clinically indicated coronary angiography for chronic coronary syndrome (CCS) and angiographic evidence of at least one CTO. Patients were subdivided into 2 study groups according to the presence/absence of at least one DMC (neuropathy, nephropathy, or retinopathy). The presence and grading of angiographically visible CC development from the patent vessels to the occluded artery were assessed using the Rentrop classification.

Results
We enrolled 157 patients (mean age 68.6 ± 9.8 years; 120 [76.4%] men). Patients with DMC (75 [47.8%]) had a higher prevalence of CC (69 [92.0%] vs 62 [75.6%], P = .006) and high-grade CC (55 [73.3%] vs 39 [47.6%], P = .001) compared with those without, and we found a positive association between the number of DMC in each patient and the prevalence of high-grade CC.

Conclusion
Among T2DM patients with coronary CTO, the presence of DMC was associated with a high CC development.
Effect of Obesity on Clinical Characteristics of Primary Aldosteronism Patients at Diagnosis and Postsurgical Response
Authors: Ruiz-Sánchez Jorge Gabriel , Paja-Fano Miguel , González Boillos Marga , Pla Peris Begoña , Pascual-Corrales Eider , García Cano Ana María , Parra Ramírez Paola , Martín Rojas-Marcos Patricia , Vicente Delgado Almudena , Gómez Hoyos Emilia , Ferreira Rui , García Sanz Iñigo , Recasens Sala Monica , Barahona San Millan Rebeca , Picón César María José , Díaz Guardiola Patricia , García González Juan Jesús , Perdomo Carolina M , Manjón Miguélez Laura , García Centeno Rogelio , Percovich Juan Carlos , Rebollo Román Ángel , Gracia Gimeno Paola , Robles Lázaro Cristina , Morales-Ruiz Manuel , Hanzu Felicia A , Araujo-Castro Marta 
Published: July 2023

Abstract

Context
Patients with obesity have an overactivated renin-angiotensin-aldosterone system (RAAS) that is associated with essential hypertension. However, the influence of obesity in primary aldosteronism (PA) is unknown.

Objective
We analyzed the effect of obesity on the characteristics of PA, and the association between obesity and RAAS components.

Methods
A retrospective study was conducted of the Spanish PA Registry (SPAIN-ALDO Registry), which included patients with PA seen at 20 tertiary centers between 2018 and 2022. Differences between patients with and without obesity were analyzed.

Results
A total of 415 patients were included; 189 (45.5%) with obesity. Median age was 55 years (range, 47.3-65.2 years) and 240 (58.4%) were male. Compared to those without obesity, patients with obesity had higher rates of diabetes mellitus, chronic kidney disease, obstructive apnea syndrome, left ventricular hypertrophy, prior cardiovascular events, higher means of systolic blood pressure, and required more antihypertensive drugs. Patients with PA and obesity also had higher values of serum glucose, glycated hemoglobin A1c, creatinine, uric acid, and triglycerides, and lower levels of high-density lipoprotein cholesterol. Levels of blood aldosterone (PAC) and renin were similar between patients with and without obesity. Body mass index was not correlated with PAC nor renin. The rates of adrenal lesions on imaging studies, as well as the rates of unilateral disease assessed by adrenal vein sampling or I-6β-iodomethyl-19-norcholesterol scintigraphy, were similar between groups.

Conclusion
Obesity in PA patients involves a worse cardiometabolic profile, and need for more antihypertensive drugs but similar PAC and renin levels, and rates of adrenal lesions and lateral disease than patients without obesity. However, obesity implicates a lower rate of hypertension cure after adrenalectomy.
Evaluation of effect of incorporating 0.5% Chloramine-T as disinfectant in type III gypsum product on its setting time and abrasion resistance
Authors: Gujjelwar Smruti , Dhamande Mithilesh , Kambala Seema Sathe , Pathak Ankita , Mangal Kashish 
Published: July 2023

Background: Laboratory bacterial cross-contamination is very high in dentistry, to avoid this disinfection is a necessity. Gypsum products are a medium of cross infection between the dentist and the laboratory personnel. The purpose of this study was to determine, if Chloramine-T is added as a disinfectant in the gypsum type III material, then are there any changes in the setting time and abrasion resistance of the gypsum. Methods: For setting time vicat needle apparatus (Brand- AIMIL Ltd.) was used for two groups one with Chloramine-T (Group-1) and one without Chloramine-T (Group-2) as disinfectant. For abrasion resistance a two body wear test was used, testing was done in two groups one with Chloramine-T (group-3) and one without Chloramine-T (Group-4) as disinfectant. For both the tests, each group had 35 samples. Pre weight and post weight of the samples were recorded for both control and experimental groups to measure abrasion resistance. For setting time the initial setting time was recorded for both the groups. Results: It was discovered that the mean value calculated for setting time was 0.08 seconds more than the control group which is significant statistical value but this difference does not make a significant change while clinically manipulating gypsum as the initial setting time is 4-6 minutes. Also the difference in the mean value was not found as statistically significant for abrasion resistance of type III gypsum product before adding Chloramine-T between the control and experimental group. Conclusions: The physical features of dental stone are unaltered with the addition of Chloramine-T as a disinfected for type III gypsum product and hence it can be utilised for all of its dental applications. Gypsum product added with Chloramine-T as a disinfectant will prevent cross-contamination from occurring and help in maintaining the sanitisation.
Metformin as adjunctive therapy in combination with multidrug treatment for multibacillary leprosy: A protocol for a randomized double-blind, controlled Phase 2 trial in Indonesia (MetLep Trial)
Authors: Krismawati Hana , Muchtar Sri V. , Rahardjani Mutia , Oktaviani Margareta , . Syamsiah , Imbiri Nelly , Hasvitasari Dian , Fajrianti Dwi , Tarino Nico , Wulandari Fitri , Kestelyn Evelyne , van Crevel Reinout , Walker Steve , Geskus Ronald , Geluk Annemieke , Hamers Raph L. , Soebono Hardyanto , Grijsen Marlous L. 
Published: July 2023

Background: The clinical management of leprosy is complicated by leprosy reactions (LR) causing irreversible nerve damage and disabilities. LR often require long-term use of corticosteroids causing serious side effects. Adjunct host-directed therapy (HDT) is a potentially attractive strategy in leprosy to prevent LR and associated immunopathology, modulate immunological memory that protects against recurrence, and thereby reduce nerve damage, disability and corticosteroid-associated morbidities. Metformin, a well-tolerated, safe and cheap anti-hyperglycaemic drug, is repurposed as HDT in auto-immune and infectious diseases, like tuberculosis (TB). Metformin use in people with diabetes is associated with reduced risks of TB-infection, progression to active TB, treatment failure and TB-mortality. Given the similarities both mycobacteria share, we hypothesize that among persons with multibacillary (MB) leprosy, adjunctive metformin may prevent/mitigate LR. Methods: We will perform a double-blind controlled proof-of-concept trial in which people with newly diagnosed multibacillary leprosy will be randomized (1:1) to metformin hydrochloride 1000mg extended release once daily versus placebo for 24 weeks in addition to standard-of-care WHO MB multidrug therapy (MDT) during 48 weeks. We aim to enrol 166 participants aged between 18 and 65 years, across five clinical sites in two leprosy endemic areas in Indonesia. Primary endpoints are the proportion of participants experiencing a LR and the frequency of (serious) adverse events. Secondary endpoints are the severity and time to first LR, the number of LR, the cumulative corticosteroid usage, and quality of life. The total study follow-up is 48 weeks. Discussion: LR signify the most important cause of irreversible nerve damage leading to anatomical deformities and disabilities, imposing a social and financial burden on those affected. Our study aims to evaluate the efficacy, tolerability and safety of adjunct metformin added to MDT in persons with multibacillary leprosy, and explore its effects on clinical and immunological endpoints. ClinicalTrials.gov registration: NCT05243654 (17/02/2022)
Risk factors for in-hospital patient falls: a retrospective analysis
Authors: Ali Albsoul Rania , FitzGerald Gerard , Hughes James A , Alshyyab Muhammad Ahmed 
Published: July 2023

Background/Aims Falls are a key patient safety concern because of the associated physical injuries, emotional impact and financial burden on patients and the healthcare system. This study aimed to describe the characteristics of falls and assess the potential risk factors among hospitalised patients in a medium-sized acute care hospital in Queensland, Australia. Methods This was a retrospective descriptive study using routinely collected information. The study was conducted in a medium-sized public hospital in Queensland, Australia. Characteristics of patients, their fall risk classification and circumstances of patient falls were extracted from the incident report provided by the hospital. Data were analysed using descriptive statistics. Results A total of 677 patient fall incidents were documented on the hospital's electronic incident system from 2015–17. The majority of falls (98%) occurred in inpatient units and caused no or minimal harm to patients. Older age groups (75–84 years and 85–94 years) made up the greatest proportion of patients who fell. Falls were largely related to toileting activities. The most common locations for inpatient falls were the bed, bedside trolley or treatment chair. Conclusions Intervention studies are needed to develop and evaluate procedures to prevent falls, particularly for activities with a high risk of falls, such as toileting, and for older patients.
Upregulated ribosome pathway plays a key role in HDAC4, improving the survival rate and biofunction of chondrocytes
Authors: Guo Li , Guo Hua , Zhang Yuanyu , Chen Zhi , Sun Jian , Wu Gaige , Wang Yunfei , Zhang Yang , Wei Xiaochun , Li Pengcui 
Published: July 2023

AimsTo explore the novel molecular mechanisms of histone deacetylase 4 (HDAC4) in chondrocytes via RNA sequencing (RNA-seq) analysis.MethodsEmpty adenovirus (EP) and a HDAC4 overexpression adenovirus were transfected into cultured human chondrocytes. The cell survival rate was examined by real-time cell analysis (RTCA) and EdU and flow cytometry assays. Cell biofunction was detected by Western blotting. The expression profiles of messenger RNAs (mRNAs) in the EP and HDAC4 transfection groups were assessed using whole-transcriptome sequencing (RNA-seq). Volcano plot, Gene Ontology, and pathway analyses were performed to identify differentially expressed genes (DEGs). For verification of the results, the A289E/S246/467/632 A sites of HDAC4 were mutated to enhance the function of HDAC4 by increasing HDAC4 expression in the nucleus. RNA-seq was performed to identify the molecular mechanism of HDAC4 in chondrocytes. Finally, the top ten DEGs associated with ribosomes were verified by quantitative polymerase chain reaction (QPCR) in chondrocytes, and the top gene was verified both in vitro and in vivo.ResultsHDAC4 markedly improved the survival rate and biofunction of chondrocytes. RNA-seq analysis of the EP and HDAC4 groups showed that HDAC4 induced 2,668 significant gene expression changes in chondrocytes (1,483 genes upregulated and 1,185 genes downregulated, p < 0.05), and ribosomes exhibited especially large increases. The results were confirmed by RNA-seq of the EP versus mutated HDAC4 groups and the validations in vitro and in vivo.ConclusionThe enhanced ribosome pathway plays a key role in the mechanism by which HDAC4 improves the survival rate and biofunction of chondrocytes.Cite this article: Bone Joint Res 2023;12(7):433–446.
APLICAÇÃO DO FILTRO DE KALMAN NA DETERMINAÇÃO DO PRAZO DE VALIDADE DE ALIMENTOS PERECÍVEIS
Authors: Araújo Péricles César 
Published: July 2023

A simplicidade metodológica do Filtro de Kalman viabiliza sua aplicação para determinar o prazo de validade no setor da indústria de alimentos perecíveis, incorporando a opinião dos degustadores ao modelo através da a priori da média e da variância. Isso é possível, considerando dois aspectos: a) que o Filtro de Kalman é uma caso particular do Método Linear Bayesiano, e b) que o Método Linear Bayesiano é um processo recursivo, que segue o esquema bayesiano e usa somente os primeiros e segundos momentos das distribuições envolvidas.
RESENHA - LENÇÓIS, UMA PONTE ENTRE A GEOLOGIA E O HOMEM.
Authors: Barreto de Santana José Carlos 
Published: July 2023

Sabemos todos que atualmente os nossos cientistas não são muito afeitos – com a possível exceção dos matemáticos – a escrever livros sobre suas disciplinas. Preferem a publicação de artigos originais, de memórias, em revistas de circulação internacional. Com isso aumentam o volume de seus curricula vitae, o que facilita a obtenção de ajuda das agências financeiras da pesquisa científica, para congressos e simpósios, para bolsas destinadas a estudantes de mestrado e doutorado. Têm evidentemente razão em intensificar seus trabalhos de pesquisa - o verdadeiro homem de ciência trabalha nos seus problemas de investigação e neles pensa sem cessar. Ninguém lhes pode, portanto, impor horários burocráticos arbitrários. O mal é que as próprias agências de financiamento de ciência e tecnologia não dão a devida importância às obras de exposição das idéias adquiridas, à sua divulgação por aqueles que são os mais indicados para fazê- lo, que descobrem e se dispõem a expor por novos métodos o que já é conhecido e que, assim, transmitem aos jovens a essência das coisas, só possível quando o escritor tem a chama da investigação científica (LOPES, 1995).