bluuebunny/crossref_metadata_2025_split huggingface dataset:
The outcomes of postgraduate palliative care education and training: assessment and comparison of nurses and physicians
Authors: Marciniak Kevin , Scherg Alexandra , Paal Piret , Mason Stephen , Elsner Frank 
Published: July 2023

Abstract
Background
Within Germany, there is a heterogeneous range of training and continuing education in palliative care for different professional groups. The German Society for Palliative Medicine (DGP), together with the German Hospice and Palliative Care Association (DHPV), have defined quality requirements for postgraduate training in palliative care. These requirements include the evaluation of course structures and the assessment of outcomes.

Aim
To assess the ‘learning gains’ in palliative care nurses and physicians undertaking continuing education programmes, and evaluate the structures and processes. To identify if/how the continuing education programmes could be improved.

Material and methods
The development of Nurses’ and Physicians’ learning was determined using a retrospective self-assessment procedure. The evaluation was based on learning objectives developed in the DGP Education Working Group, using a six-point Likert scale for each item, and space for ‘free-text’ comments. Assessments were conducted after training.

Results
Five hundred twenty nine self-assessments were recorded (456 nurses / 73 physicians). An increase in learning is demonstrated in all areas (knowledge, skills, social and self-competence) for each profession. The greatest gain was in symptom control. However, there were significant differences in the extent of learning gains between nurses and physicians.

Conclusion
Analysis suggests current training results in improvements, but personal competences progress less than knowledge and skills. One way to improve this would be to introduce more interprofessional continuing education elements. Evaluation, as a basis for improving training concepts, is essential for continual development.
Interdisciplinary collaboration in serious illness conversations in patients with multiple myeloma and caregivers – a qualitative study
Authors: Myrhøj Cæcilie Borregaard , Viftrup Dorte Toudal , Jarden Mary , Clemmensen Stine Novrup 
Published: July 2023

Abstract
Background
There is growing evidence that conversations between healthcare professionals and patients with serious illness can improve the quality of end-of-life cancer care. Yet, there is lack of insight into how different healthcare professions collaborate to deliver serious illness communication, as well as patients’ and caregivers’ perceptions of this collaboration between the nurse and physician. This study explores the interdisciplinary collaboration between nurses and physicians in serious illness conversations with patients diagnosed with multiple myeloma and their caregivers.

Methods
Eleven dyadic interviews were conducted with 22 patients and caregivers, and two focus group interviews involving four nurses and the other with four physicians. Data analysis and reporting were conducted using reflexive thematic analysis within phenomenological epistemology.

Results
The interdisciplinary collaboration was characterized by three main themes: (1) Importance of relationships, (2) Complementary perspectives, and (3) The common goal.

Conclusion
This study highlights the importance of interdisciplinarity in serious illness conversations as it enhances the use of existential and descriptive language when addressing medical, holistic, and existential issues. The use of broader language also reflects that interdisciplinary interaction strengthens the expertise of each professional involved in patient care. Through interdisciplinary collaboration, the preferences, hopes, and values of the patient and caregiver can be integrated into the treatment plan, which is key in providing the delivery of optimal care. To promote cohesive and coordinated collaboration, organizational changes are recommended such as supporting continuity in patient–healthcare professional relationships, providing interdisciplinary training, and allocating time for pre-conversation preparation and post-conversation debriefing.
Numerical simulation study on the evolution characteristics of the stress induced by mining in deep adjacent working faces
Authors: Ma Shoulong , Zhang Mingwei , Ma Lu , Tian Zhuangcai , Li Xue , Su Zhenhao 
Published: July 2023

Abstract
Background
The mining-induced stress in the surrounding rock after coal seam mining is the primary cause of damage and failure of the surrounding rock in the mining area. However, the magnitude and direction of the stress field induced by mining in the overburden strata during the excavation process of deep and adjacent coal seams are not yet clear, and it is difficult to determine how adjacent working faces interact with each other.

Results
In this study, a large-scale numerical model was built using FLAC3D (Fast Lagrange Analysis Continua) to simulate the sequential mining process of three adjacent working faces (No.1, No.2, and No.3) in Liuzhuang Coal Mine located in southern China. The results showed that the maximum height of plastic zone development after mining in the No.1 working face was 41 m, and the maximum height of plastic zone development was 33.8 m away from the 13 coal seam. It did not affect the top and bottom of the No.3 working face. The development height of the plastic zone on the roof of the No.2 working face after mining was 52m, and the top and bottom plates of the No.3 working face remained intact. The plastic zone of the floor of the No.3 working face after mining was not communicated with the plastic zone of the roof of the No.1 and No.2 working faces. There was a complete rock layer between the two coal seams, and there was not the mutual influence of the mining activities. During the mining process of working faces No.1 and No.2, the range of dynamic pressure influence was extended up to 100m ahead of the working face. During the mining process of the No.3 working face, the range of dynamic pressure influence was 120 m ahead of the working face. The No.1 working face goaf and the mining of No.2 working face had not disturbance to the No.3 working face.

Conclusions
After the mining of No.1 and No.2 working faces, the stress in the goaf significantly decreased, and the lateral support stress concentration area of No.1 and No.2 working faces had a relatively small impact on the 13 coal seam. Therefore, the No.1 goaf and mining of No.2 working faces had not disturbance to No.3 working face.
Evaluating the Suitability of the Low Energy Availability in Females Questionnaire (LEAF-Q) for Female Football Players
Authors: Dasa Marcus S. , Friborg Oddgeir , Kristoffersen Morten , Pettersen Gunn , Sagen Jørn V. , Sundgot-Borgen Jorunn , Rosenvinge Jan H. 
Published: July 2023

Abstract
Background
The Low Energy Availability in Females Questionnaire (LEAF-Q) is a screening tool developed to detect endurance athletes and dancers at risk for development of persistent low energy availability (LEA) and the female athlete triad (Triad). This study investigated the applicability of the LEAF-Q in a cohort of sixty professional female football players.

Methods
The participants were classified as at risk (≥ 8) or not at risk (< 8) for persistent LEA and the Triad according to their LEAF-Q score, before being compared. Receiver operating curves were then conducted to examine the ability of the overall LEAF-Q and subcategories to correctly determine the presence of clinically defined markers of the Triad. Additionally, Youden’s index was calculated to determine the best fitting cut-off values.

Results
Thirty-two percent of participants were classified as at risk by the LEAF-Q. We found no statistically significant differences between the two groups for any markers associated with persistent LEA. Except for acceptable accuracy in determining menstrual status, all other LEAF-Q components exhibited poor accuracy and predictive values. Youden’s index scores imply that increasing the overall and injury cut-off values to ≥ 10 and ≥ 5 respectively, would yield increased performance.

Conclusions
Our findings do not support the use of the LEAF-Q for the purpose of detecting LEA and Triad conditions among female football players.
Balanced crystalloids (RInger’s lactate) versus normal Saline in adults with diabetic Ketoacidosis in the Emergency Department (BRISK-ED): a protocol for a pilot randomized controlled trial
Authors: Yan Justin W. , Slim Ahmed , Van Aarsen Kristine , Choi Yun-Hee , Byrne Christopher , Poonai Naveen , Collins Haley , Clemens Kristin K. 
Published: July 2023

Abstract
Background
Current guidelines for diabetic ketoacidosis (DKA) recommend treatment with normal saline (NS). However, NS, with its high chloride concentrations, may worsen acidosis and contribute to a hyperchloremic metabolic acidosis. Alternatives to NS are balanced crystalloids (e.g. Ringer’s Lactate [RL]) which have chloride concentrations similar to human plasma; therefore, treatment with balanced crystalloids may lead to faster DKA resolution. A recent systematic review and meta-analysis by Catahay et al. (2022) demonstrated the need for more blinded, high-quality trials comparing NS versus RL in the treatment of DKA.

Methods
We describe a protocol for BRISK-ED (Balanced crystalloids [RInger’s lactate] versus normal Saline in adults with diabetic Ketoacidosis in the Emergency Department). Our study is a single-centre, triple-blind, pilot randomized controlled trial (RCT) of adults (≥ 18 years) with DKA presenting to an academic tertiary care ED in London, Canada.
Patients with clinical suspicion for DKA will be screened and those found to not meet DKA criteria or have euglycemic DKA will be excluded. We will aim to recruit 52 patients with DKA and will randomize them 1:1 to receive intravenous RL or NS.
The primary feasibility outcome will be recruitment rate, and the primary efficacy outcome will be time elapsed from ED presentation to DKA resolution. Secondary outcomes include time to insulin infusion discontinuation, intensive care unit admission, in-hospital death, and major adverse kidney events within 30 days, defined as a composite of: i) death, ii) new renal replacement therapy, or iii) final serum creatinine ≥ 200% baseline at the earliest of hospital discharge or 30 days after ED presentation. Patients, clinicians, and outcome assessors will be blinded to allocation group. We will follow an intention-to-treat analysis. Gehan-Wilcoxon, Mann–Whitney U, or chi-square tests will be used to compare groups as appropriate.

Discussion
The results of this pilot study will inform the design and feasibility of a full-scale, multicentre RCT to assess fluid choice in adult ED patients with DKA. If proven to demonstrate faster resolution of DKA, administration of balanced crystalloids may replace NS in diabetes treatment guidelines and improve patient and health systems outcomes.

Trial registration
ClinicalTrials.gov, Registration # NCT04926740; Registered June 15, 2021.
OUTdoor Swimming as a nature-based Intervention for DEpression (OUTSIDE): study protocol for a feasibility randomised control trial comparing an outdoor swimming intervention to usual care for adults experiencing mild to moderate symptoms of depression
Authors: Massey Heather , Denton Hannah , Burlingham Amy , Violato Mara , Bibby-Jones Anna-Marie , Cunningham Rebecca , Ciccognani Sandy , Robertson Sam , Strauss Clara 
Published: July 2023

Abstract
Background
Depression is common and the prevalence increasing worldwide; at least 1 in 10 people will experience depression in their lifetime. It is associated with economic costs at the individual, healthcare and societal level. Recommended treatments include medication and psychological therapies. However, given the long waiting times, and sometimes poor concordance and engagement with these treatments, a greater range of approaches are needed. Evidence for the potential of outdoor swimming as an intervention to support recovery from depression is emerging, but randomised controlled trials (RCTs) evaluating clinical and cost-effectiveness are lacking. This study seeks to investigate the feasibility of conducting a definitive superiority RCT, comparing an 8-session outdoor swimming course offered in addition to usual care compared to usual care only, in adults who are experiencing mild to moderate symptoms of depression. Feasibility questions will examine recruitment and retention rates, acceptability of randomisation and measures, and identify the primary outcome measure that will inform the sample size calculation for a definitive full-scale RCT. This study will also explore potential facilitators and barriers of participation through evaluation questionnaires, focus-group discussions and interviews.

Methods/design
To address these aims and objectives, a feasibility superiority RCT with 1:1 allocation will be undertaken. We will recruit 88 participants with mild to moderate symptoms of depression through social prescribing organisations and social media in three sites in England. Participants will be randomised to either (1) intervention (8-session outdoor swimming course) plus usual care or (2) usual care only. Both groups will be followed up for a further 8 weeks.

Discussion
If findings from this feasibility RCT are favourable, a fully powered RCT will be conducted to investigate the clinical- and cost-effectiveness of the intervention. Findings from the definitive trial will provide evidence about outdoor swimming for depression for policymakers and has the potential to lead to greater choice of interventions for adults experiencing symptoms of depression.

Trial registration
Current controlled trial registration number is ISRCTN 90851983 registered on 19 May 2022.
Endoscopy-assisted purely total outer wall excision for pediatric Sylvian arachnoid cysts
Authors: Wu Mingxing , Di Fei , Ma Mingle , Li Jiye , Li Yanbin , Zhang Bingke 
Published: July 2023

Abstract

Background
To present a novel endoscopy-assisted surgical strategy of Sylvian arachnoid cysts (ACs).

Case presentation
Endoscopy-assisted surgery was performed on 9 children (May 2019–December 2021). All patients were evaluated with CT and/or MRI and had regular follow-up examinations. The procedure consisted of performing a small temporal craniotomy (2 cm) behind the hairline. After dural opening, the surgery was performed with the assistance of a rigid 30-degree transcranial endoscope, self-irrigating bipolar forceps, and other standard endoscopic instruments. Steps included total excision of the AC outer wall and dissection of arachnoid adhesion around the cystic edge to communicate the residual cyst cavity with subdural space. Compared with the microscopical procedure, a 30-degree transcranial endoscope provides a wider view, especially for the lateral part exposure of the outer wall.
The average age of the patients was 27.7 months (range 13–44 months). The Sylvian AC was in the right hemisphere in three patients and six in the left, respectively. 1 patient suffered transient postoperative epilepsy. There was no mortality or additional postoperative neurological deficit in this series. All of the patients achieved significant clinical improvement after surgery. Radiological examination after the operation showed a significant reduction in all cases (100%, 9/9) and disappearance in one case (11.1%, 1/9). Postoperative subdural fluid collection occurred in six cases and completely resolved spontaneously in 9 months.

Conclusion
The study demonstrated the minimally invasive, safety, and effectivity of the endoscopy-assisted purely total outer wall excision.
Components of peritonitis preventive self-care education programs associated with self-care knowledge and behavior among patients undergoing peritoneal dialysis in Japan: a cross-sectional study
Authors: Kugai Haruna , Igarashi Ayumi , Anezaki Saori , Fukui Chie , Saito Nami , Hamasaki Yoshifumi , Yamamoto-Mitani Noriko 
Published: July 2023

Abstract
Background
Preventing peritoneal dialysis (PD)-associated peritonitis remains a major concern in continuing safe treatment and improving patient quality of life. This study aimed to determine the self-care education and quality care initiatives performed for patients undergoing PD and explored their association with patient self-care knowledge and behavior regarding peritonitis prevention.

Methods
A nationwide cross-sectional survey was conducted with PD patients and their nurses in Japanese hospitals as respondents. Nurses provided the regular practice of self-care education and quality care initiatives for PD patients within the hospital while patients answered questions on their self-care knowledge and behaviors. Multivariate logistic regression analyses were performed to explore the factors of patients’ self-care knowledge and behaviors.

Results
We analyzed data on 170 patients (mean age: 65.1 years old) matched with those of 58 nurses from 58 hospitals. Although most educational contents were taught, teaching methods varied; evaluating patients’ learning levels and re-educating during follow-up periods were less frequently performed. As for quality care initiatives, 60% of hospital nurses monitored peritonitis rates, 33% shared peritonitis-associated information with relevant departments, and 47% had performed home visits before PD patients' discharge in the past. The factors of patients’ self-care knowledge include nurses’ re-educating during follow-ups (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.01–1.22, p = 0.025), sharing information with relevant departments (OR = 1.66, 95% CI = 1.01–2.74, p = 0.047), and patients’ younger age (OR = 0.98, 95% CI = 0.96–1.00, p = 0.019). Hospitals performing home visits and patients’ perceived social support were associated with both self-care knowledge (OR = 1.16, 95% CI = 1.01–1.34, p = 0.038 and OR = 1.33, 95% CI = 1.10–1.61, p = 0.003, respectively) and behavior (OR = 1.29, 95% CI = 1.02–1.64, p = 0.031 and OR = 1.61, 95% CI = 1.14–2.28, p = 0.007, respectively).

Conclusions
Re-education during follow-up visits, sharing information, and home visits before discharge may benefit patients in promoting peritonitis preventive self-care.
Optical coherence tomography findings in children of patients with Alzheimer-type dementia
Authors: Eliaçık Sinan , Aykaç Serdar , Yılmaz Hayati 
Published: July 2023

Abstract
Background
Ocular imaging receives much attention as a source of potential biomarkers for dementia. This study aims to study structural changes in the retina and optic nerve in children of healthy and demented parents and to confirm the applicability of optic nerve tomography as a potential noninvasive marker for the early diagnosis of dementia.

Methods
Healthy individuals with a parent diagnosed with Alzheimer’s disease (AD) and healthy controls with healthy parents were included in the study. Included individuals had undergone Montreal Cognitive Assessment Scale and Mini-Mental Test by a single neurologist physician to confirm not having dementia. All the subjects then underwent a complete ophthalmological examination, including refractive error and keratometry readings, best-corrected visual acuity measurement with a Snellen chart (converted to LogMAR), intraocular pressure (IOP) measurement, slit-lamp biomicroscopy, dilated fundus examination, axial length measurement and optical coherence tomography (OCT) for the parapapillary retinal nerve fiber layer (pRNFL), basal membrane opening—minimum rim width (BMO-MRW), and macular thickness analysis. Only the right eyes of the subjects were evaluated. OCT findings of these two groups were compared.

Results
The temporosuperior sector the pRNFL thicknesses at all 3 circles (3.5, 4.1, and 4.5) were significantly thinner in the children of the dementia group than in healthy controls (p = 0.023, 0.039, and 0.016, respectively). For the remaining sectors, the thicknesses of the pRNFL were also thinner, however, the differences were not significant (p > 0.05 for all). BMO-MRW at all sectors, were not also different significantly between the groups (p > 0.05 for all). Parents’ dementia grade were found to be an important factor that the BMO-MRW at the temporal sector, got thinner with increasing grade (B = − 20.631, 95% CI − 42.121 to − 0.019, and p = 0.049).

Conclusion
We believe that OCT can be used as a noninvasive biomarker in the preclinical period, when supported by more extensive studies in people whose parents have AD.
The study of long noncoding RNA TUG 1 and ZEB2-AS1 expression in newly diagnosed Egyptian adult acute myeloid leukemia patients
Authors: Abdelrahman Amira Mohamed Noureldin , Diab Safia Mohammed , Shabaan Howyda Moh. Kamal , Ahmed Mai Nasser Abdelmomen , Nabil Reem 
Published: July 2023

Abstract
Background
The hematopoietic malignancy acute myeloid leukemia is a fatal disease with poor clinical prognoses. Long non-coding RNA taurine-upregulated gene1 (lncRNA TUG1) and zinc finger E-box binding homeobox 2 antisense RNA1 (lncRNA ZEB2-AS1) are reported to participate in the development and progression of different types of malignancies. The goal of the current study was to evaluate the prognostic value of the lncRNAs TUG1 and ZEB2-AS1 as well as their various expression patterns in newly diagnosed Egyptian adult acute myeloid leukemia patients.

Methods
We assessed the expression levels of both lncRNA TUG1 and lncRNA ZEB2-AS1 using the quantitative real-time reverse transcription polymerase chain reaction technique (qRT-PCR) in 80 newly diagnosed AML patients and 20 healthy subjects.

Results
lncRNA TUG1 expression was significantly higher in the AML cases compared to the controls (P < 0.001), whereas lncRNA ZEB2-AS1 expression was considerably lower in the AML cases in comparison with the controls (P < 0.001). The expression levels of the lncRNAs ZEB2-AS1 and TUG1 exhibited a significantly positive association in the AML group (P < 0.001). There was no difference in overall survival (OS) and disease-free survival (DFS) between the groups with low and high lncRNA TUG1 expression (P = 0.139 and 0.918, respectively). Furthermore, the AML cases with higher lncRNA ZEB2-AS1 expression levels had shorter DFS than patients with lower lncRNA ZEB2-AS1 expression levels (P = 0.014), while OS did not significantly differ between the studied cases with lower and higher lncRNA ZEB2-AS1 expression (P = 0.589).

Conclusion
Overexpression of lncRNA TUG1 could serve as a diagnostic biomarker for Egyptian adult AML cases, while lncRNA ZEB2-AS1 high expression could be regarded as an indicator of poor outcome in Egyptian adult AML studied cases.