bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtually the same? Examining the impact of the COVID-19 related shift to virtual lung cancer multidisciplinary team meetings in the UK National Health Service: a mixed methods study
Authors: Groothuizen Johanna Elise , Aroyewun Eunice , Zasada Magdalena , Harris Jenny , Hewish Madeleine , Taylor Cath 
Published: June 2023

ObjectivesTo evaluate the impact of the shift to virtual lung cancer multidisciplinary team meetings (MDTMs) in response to the COVID-19 pandemic, specifically in relation to the magnitude of information technology (IT) issues and distractions and MDT members’/managers’ perceptions and experiences of this shift.DesignA mixed methods study comprising real-time observations of IT issues/distractions within virtual MDTM case discussions held between April and July 2021 and qualitative data from interviews/surveys.SettingEight hospital organisations in Southern England.ParticipantsTeam members (respiratory physicians, surgeons, oncologists, radiologists, pathologists, palliative care professionals, nurses and MDT coordinators) and managers (n=190) across 8 local MDTs.ResultsMDTM observations (n=1664) highlighted significant variation between teams regarding IT functionality. IT issues and other distractions relating to the virtual MDTM format were observed 465 times affecting 20.6% of case discussions, most of which were audio issues (18.1%). Case discussions that had audio issues were, on average, 26 s longer (t(1652)=−2.77, p<0.01). A total of 73 MDT members and managers participated in the survey and 41 participated in interviews, with all 8 teams being represented. Increased flexibility, reduced travel time and easier real-time access to patient information were seen as the main advantages of virtual MDTMs. Views regarding the impact on relational aspects and communication differed. In line with observational findings, concerns were raised in relation to IT, including having inappropriate equipment, insufficient bandwidth (impairing image sharing and video communication) and an overarching theme that virtual meeting platforms provided were not fit for purpose.ConclusionsDespite the potential benefits of virtual MDTMs, IT issues can waste valuable MDTM time. If hospital organisations plan to continue virtual MDTMs, a functioning infrastructure is required, necessitating appropriate resource and investment.
Physicians’ narratives of communication with patients and their relatives in different phases of the palliative pathway
Authors: Landstad Bodil J , Skorpen Tarberg Anett , Kvangarsnes Marit 
Published: June 2023

ObjectivesTo explore physicians’ experiences of the communication with patients and their relatives in the different phases of the palliative pathway.MethodsPurposeful sampling was employed to recruit a total of 13 oncologists and general practitioners who engaged in palliative care. A qualitative study with a narrative approach was conducted. Interviews with physicians working in primary and specialist healthcare were conducted via Skype Business in the spring of 2020. The interview guide had open-ended questions with each interview lasting between 35 and 60 min.ResultsCommunication between the physicians, their patients and their relatives was contextual and changed depending on the phase in the palliative pathway. In the first phase, physicians told us that patients and their relatives experienced an emotional shock. Transitioning from the curative to palliative phase was difficult, which emphasised the need for trust through communication. In the middle phase, they revealed that communication about the death process became the priority: what was probably going to happen, the family’s role in what was going to happen and perhaps, depending on the illness, any medical decisions that needed to be made. It was important for the physicians to communicate information about the palliative pathway while providing the relatives with knowledge that facilitated any decision making. In the terminal phase, physicians employed a compassionate approach, as bereaved family members needed to process their feelings of guilt and grief.ConclusionsThe study gives new insight into communication with patients and their relatives during different phases of the palliative pathway, from the physician’s perspective. The findings may help physicians improve the quality of communication with patients and their relatives over these vulnerable pathways. The findings also have practical implications in training contexts. The study reveals ethical dilemmas in physicians’ communication with patients and their relatives during a palliative pathway.
ANN and RSM Modeling for the Synthesis of Avocado Seed Starch Combined Orange Peel Extract Antimicrobial Packaging Film
Authors: Waday Yasin Ahmed , Aklilu Ermias Girma 
Published: June 2023

Cooperation of essential oil into film formation results in active packaging materials, which can improve the quality and freshness of the foods and extend the shelf life. In the present study, extraction of starch and essential oil was performed. The active films were developed through the solvent casting method. The influence of avocado seed starch and orange peel essential oil was investigated and optimized using response surface methodology and an artificial neural network on the tensile strength, water vapor permeability, and antimicrobial properties of active films. The results showed that both models performed reasonably well, but trained artificial neural networks have more modeling capability rather than the response surface method. The optimum conditions were found to be orange peel oil of 0.57 g and 30% w/w of avocado seed starch with the values of the corresponding responses of 3.94 MPa,

3.098
×

10

−
10

g/ms Pa, and 17.273 mm for tensile strength, water vapor permeability, and inhibition zone, respectively. Generally, the orange peel extract had an effective and promising alternative for the commercial production of antimicrobial packaging films.
Activation of the Aryl Hydrocarbon Receptor in Muscle Exacerbates Ischemic Pathology in Chronic Kidney Disease
Authors: Balestrieri Nicholas , Palzkill Victoria , Pass Caroline , Tan Jianna , Salyers Zachary R. , Moparthy Chatick , Murillo Ania , Kim Kyoungrae , Thome Trace , Yang Qingping , O’Malley Kerri A. , Berceli Scott A. , Yue Feng , Scali Salvatore T. , Ferreira Leonardo F. , Ryan Terence E. 
Published: June 2023

Background:
Chronic kidney disease (CKD) accelerates the development of atherosclerosis, decreases muscle function, and increases the risk of amputation or death in patients with peripheral artery disease (PAD). However, the mechanisms underlying this pathobiology are ill-defined. Recent work has indicated that tryptophan-derived uremic solutes, which are ligands for AHR (aryl hydrocarbon receptor), are associated with limb amputation in PAD. Herein, we examined the role of AHR activation in the myopathy of PAD and CKD.

Methods:

AHR-related gene expression was evaluated in skeletal muscle obtained from mice and human PAD patients with and without CKD. AHR
mKO
(skeletal muscle–specific AHR knockout) mice with and without CKD were subjected to femoral artery ligation, and a battery of assessments were performed to evaluate vascular, muscle, and mitochondrial health. Single-nuclei RNA sequencing was performed to explore intercellular communication. Expression of the constitutively active AHR was used to isolate the role of AHR in mice without CKD.

Results:

PAD patients and mice with CKD displayed significantly higher mRNA expression of classical AHR-dependent genes (
Cyp1a1
,
Cyp1b1
, and
Aldh3a1
) when compared with either muscle from the PAD condition with normal renal function (
P
<0.05 for all 3 genes) or nonischemic controls. AHR
mKO
significantly improved limb perfusion recovery and arteriogenesis, preserved vasculogenic paracrine signaling from myofibers, increased muscle mass and strength, as well as enhanced mitochondrial function in an experimental model of PAD/CKD. Moreover, viral-mediated skeletal muscle–specific expression of a constitutively active AHR in mice with normal kidney function exacerbated the ischemic myopathy evidenced by smaller muscle masses, reduced contractile function, histopathology, altered vasculogenic signaling, and lower mitochondrial respiratory function.

Conclusions:
These findings establish AHR activation in muscle as a pivotal regulator of the ischemic limb pathology in CKD. Further, the totality of the results provides support for testing of clinical interventions that diminish AHR signaling in these conditions.
The Meaning(lessness) of qubbâ and the Original Text of Numbers 25:8
Authors: Liber Or , Seri-Levi Ariel 
Published: June 2023

Abstract
The hapax legomenon קֻבָּה, which seems to appear out of context in the account of Phinehas killing an Israelite man and a Midianite woman in Num 25:8, has long puzzled commentators, scholars, and translators. This paper presents a new, text-critical explanation, suggesting that the original text read ויבא אחר איש ישראל וידקר את שניהם את איש ישראל אל הקבה ואת האשה אל קבתה, not including קֻבָּה at all: Phinehas pierced the man אֶל הַקֵּבָה, “through the belly,” and the woman אֶל קֳבָתָהּ, “through her belly.” The corruption occurred when the words אל הקבה were moved six words back in the text due to homoioteleuton and a partially successful correction. This unintentionally created the extant sentence ויבא אחר איש ישראל אל הקבה, in which קבה must denote a location, not an organ. Rather than קֵבָה, it was therefore read as קֻבָּה.
China’s New Idea of Socialist Core Value Education: President Xi’s Philosophical Discourse on the Education of Socialist Core Values
Authors: Xue Eryong , Li Jian , Zhang Junjiao 
Published: June 2023

Abstract
The influence of the education of socialist core values includes both domestic and foreign countries, which are embodied in consolidating China’s spiritual strength, safeguarding the national governance system, and enhancing the international discourse power. In education principle, the education of socialist core values has both commonness and individuality, adhering to the guiding direction of Marxism, integrating into the “four modernizations” of life, and conducting sub-subject education close to the masses. In terms of educational content, the education of socialist core values revolves around “three advocations”, namely, advocating great morality, guarding public morality, and strictly practicing private morality. In terms of educational approach, the system and environment of socialist core values education should be optimized, namely, government macro-control, school main body participation, and family and community cooperation in education.
Carotid artery stenting using a 7 French Optimo balloon guide catheter combined with a distal filter
Authors: Harada Kei , Fujimura Haruto , Kajihara Masahito , Arakawa Kei 
Published: June 2023

Objectives Carotid artery stenting (CAS) by proximal occlusion of the common carotid artery (CCA) using a balloon guide catheter (BGC) is a simple proximal protection method to prevent distal embolism, however, it requires at least an 8 French (F) system. A 7 F Optimo BGC is the smallest BGC with an inner lumen diameter of 0.071 inches, and which permits the passage of a 5 F carotid stent. We retrospectively investigated the clinical results and the safety of CAS by using a 7 F Optimo BGC combined with a distal filter. Materials and Methods One-hundred carotid arterial stenosis patients were treated with CAS using combined protection of a 7 F Optimo BGC and a distal filter. The BGC was navigated from the femoral and radial arteries in 85 and 15 patients, respectively. Results The 7 F Optimo BGC was successfully navigated into the CCA in all patients, and the technical success rate of CAS was 100%. Major adverse events of any death, stroke, or myocardial infarction within 30-day after the procedure were observed in one (1%). Post-procedural diffusion-weighted magnetic resonance imaging revealed high signals in 21% of the patients, all of whom were asymptomatic. Conclusions The 7 F Optimo is the smallest BGC to achieve CAS using a proximal protection system. The combined use of a 7 F Optimo BGC and a distal filter is effective for navigating the BGC and distal embolic protection.
Pragmatic guidance for embedding pragmatic clinical trials in health plans: Large simple trials aren’t so simple
Authors: Cocoros Noelle M , Gurwitz Jerry H , Cziraky Mark J , Granger Christopher B , Harkins Thomas , Haynes Kevin , Li Xiaojuan , Parlett Lauren , Seeger John D , Singh Sonal , McMahill-Walraven Cheryl N , Platt Richard 
Published: June 2023

Background: There are unique opportunities related to the design and conduct of pragmatic trials embedded in health insurance plans, which have longitudinal data on member/patient demographics, dates of coverage, and reimbursed medical care, including prescription drug dispensings, vaccine administrations, behavioral healthcare encounters, and some laboratory results. Such trials can be large and efficient, using these data to identify trial-eligible patients and to ascertain outcomes. Methods: We use our experience primarily with the National Institutes of Health Pragmatic Trials Collaboratory Distributed Research Network, which comprises health plans that participate in the US Food & Drug Administration’s Sentinel System, to describe lessons learned from the conduct and planning of embedded pragmatic trials. Results: Information is available for research on more than 75 million people with commercial or Medicare Advantage health plans. We describe three studies that have used or plan to use the Network, as well as a single health plan study, from which we glean our lessons learned. Conclusions: Studies that are conducted in health plans provide much-needed evidence to drive clinically meaningful changes in care. However, there are many unique aspects of these trials that must be considered in the planning, implementation, and analytic phases. The type of trial best suited for studies embedded in health plans will be those that require large sample sizes, simple interventions that could be disseminated through health plans, and where data available to the health plan can be leveraged. These trials hold potential for substantial long-term impact on our ability to generate evidence to improve care and population health.
Performance assessment of a triple-junction solar cell with 1.0 eV GaAsBi absorber
Authors: Paulauskas Tadas , Pačebutas Vaidas , Strazdienė Viktorija , Geižutis Andrejus , Devenson Jan , Kamarauskas Mindaugas , Skapas Martynas , Kondrotas Rokas , Drazdys Mantas , Rudzikas Matas , Šebeka Benjaminas , Vretenár Viliam , Krotkus Arūnas 
Published: June 2023

AbstractGroup III–V semiconductor multi-junction solar cells are widely used in concentrated-sun and space photovoltaic applications due to their unsurpassed power conversion efficiency and radiation hardness. To further increase the efficiency, new device architectures rely on better bandgap combinations over the mature GaInP/InGaAs/Ge technology, with Ge preferably replaced by a 1.0 eV subcell. Herein, we present a thin-film triple-junction solar cell AlGaAs/GaAs/GaAsBi with 1.0 eV dilute bismide. A compositionally step-graded InGaAs buffer layer is used to integrate high crystalline quality GaAsBi absorber. The solar cells, grown by molecular-beam epitaxy, achieve 19.1% efficiency at AM1.5G spectrum, 2.51 V open-circuit voltage, and 9.86 mA/cm2 short-circuit current density. Device analysis identifies several routes to significantly improve the performance of the GaAsBi subcell and of the overall solar cell. This study is the first to report on multi-junctions incorporating GaAsBi and is an addition to the research on the use of bismuth-containing III–V alloys in photonic device applications.
Pallidal GABA B receptors: involvement in cortex beta dynamics and thalamic reticular nucleus activity
Authors: Villalobos Nelson , Magdaleno‐Madrigal Victor Manuel 
Published: June 2023

AbstractThe external globus pallidus (GP) firing rate synchronizes the basal ganglia-thalamus-cortex network controlling GABAergic output to different nuclei. In this context, two findings are significant: the activity and GABAergic transmission of the GP modulated by GABA B receptors and the presence of the GP-thalamic reticular nucleus (RTn) pathway, the functionality of which is unknown. The functional participation of GABA B receptors through this network in cortical dynamics is feasible because the RTn controls transmission between the thalamus and cortex. To analyze this hypothesis, we used single-unit recordings of RTn neurons and electroencephalograms of the motor cortex (MCx) before and after GP injection of the GABA B agonist baclofen and the antagonist saclofen in anesthetized rats. We found that GABA B agonists increase the spiking rate of the RTn and that this response decreases the spectral density of beta frequency bands in the MCx. Additionally, injections of GABA B antagonists decreased the firing activity of the RTn and reversed the effects in the power spectra of beta frequency bands in the MCx. Our results proved that the GP modulates cortical oscillation dynamics through the GP-RTn network via tonic modulation of RTn activity.
H-type hypertension is a risk factor for chronic total coronary artery occlusion: a cross-sectional study from southwest China
Authors: Xiao Kaiyong , Xv Zhe , Xv Yuling , Wang Jianping , Xiao Lian , Kang Zhou , Zhu Jianhui , He Zhongwei , Huang Guan 
Published: June 2023

Abstract
Background
Chronic total coronary occlusion (CTO) is serious and the "last bastion" of percutaneous coronary intervention. Hypertension and hyperhomocysteinemia (HHCY) are synergistic and significantly increase cardiovascular event risk. The relationship between H-type hypertension and CTO remains unclear; thus, this cross-sectional study investigated this potential association.

Methods
Between January 2018 and June 2022, 1446 individuals from southwest China were recruited to participate in this study. CTO was defined as complete coronary artery occlusion persisting for over three months. H-type hypertension was defined as hypertension with plasma homocysteine levels ≥ 15 µmol/L. Multivariate logistic regression models were applied to assess the association between H-type hypertension and CTO. Receiver operating characteristic (ROC) curves were generated to determine the accuracy of H-type hypertension in predicting CTO.

Results
Of the 1446 individuals, 397 had CTO, and 545 had H-type hypertension. After multivariate adjustment, the odds ratio (OR) for CTO in individuals with H-type hypertension was 2.3-fold higher (95% CI 1.01–5.26) than that in healthy controls. The risk of CTO is higher in individuals with H-type hypertension than in those with isolated HHCY and hypertension. The area under the ROC curve for CTO was 0.685 (95% CI, 0.653–0.717) for H-type hypertension.

Conclusions
In southwest China, H-type hypertension is significantly related to the occurrence of CTO.

Trial registration
This retrospective study was registered with the Chinese Clinical Trials Registry (http://www.chictr.org.cn, ChiCTR2100050519.2.2).
Closing the gap in our understanding of infectious diseases
Authors: Kalinda Chester , Temfack Elvis 
Published: June 2023

AbstractSystematic reviews (SR) and meta-analyses (MA) have become important in addressing specific questions of clinical importance and presenting evidence from an in-depth analysis of literature and aiding clinical decision-making. The “Systematic Reviews on infectious diseases” collection will address several important questions by summarizing large bodies of evidence in a reproducible and concise approach to advance our knowledge and understanding of infectious diseases.
Establishment and validation of an AI-aid method in the diagnosis of myocardial perfusion imaging
Authors: Zhang Ruyi , Wang Peng , Bian Yanzhu , Fan Yan , Li Jianming , Liu Xuehui , Shen Jie , Hu Yujing , Liao Xianghe , Wang He , Song Chengyu , Li Wangxiao , Wang Xiaojie , Sun Momo , Zhang Jianping , Wang Miao , Wang Shen , Shen Yiming , Zhang Xuemei , Jia Qiang , Tan Jian , Li Ning , Wang Sen , Xu Lingyun , Wu Weiming , Zhang Wei , Meng Zhaowei 
Published: June 2023

Abstract
Background
This study aimed to develop and validate an AI (artificial intelligence)-aid method in myocardial perfusion imaging (MPI) to differentiate ischemia in coronary artery disease.

Methods
We retrospectively selected 599 patients who had received gated-MPI protocol. Images were acquired using hybrid SPECT-CT systems. A training set was used to train and develop the neural network and a validation set was used to test the predictive ability of the neural network. We used a learning technique named “YOLO” to carry out the training process. We compared the predictive accuracy of AI with that of physician interpreters (beginner, inexperienced, and experienced interpreters).

Results
Training performance showed that the accuracy ranged from 66.20% to 94.64%, the recall rate ranged from 76.96% to 98.76%, and the average precision ranged from 80.17% to 98.15%. In the ROC analysis of the validation set, the sensitivity range was 88.9 ~ 93.8%, the specificity range was 93.0 ~ 97.6%, and the AUC range was 94.1 ~ 96.1%. In the comparison between AI and different interpreters, AI outperformed the other interpreters (most P-value < 0.05).

Conclusion
The AI system of our study showed excellent predictive accuracy in the diagnosis of MPI protocols, and therefore might be potentially helpful to aid radiologists in clinical practice and develop more sophisticated models.
Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage
Authors: Prasetyo Bambang Tri , Kurniawan Ricky Gusanto , Rilianto Beny , Windiani Pratiwi Raissa , Gotama Kelvin Theandro , Salam Sardiana , Sari Ita Muharram , Musridharta Eka , Arham Abrar , Kusdiansah Muhammad , Kiemas Lyna Soertidewi , Bustami Mursyid 
Published: June 2023

AbstractBackgroundLength of stay (LOS) is an important indicator of the optimization of health services and hospital financing efficiency in aneurysmal subarachnoid hemorrhage (aSAH) patients. The purpose of this study was to develop a scoring model to predict the LOS of patients with aSAH.MethodA clinical scoring was developed based on retrospectively collected data from the cerebral aneurysm registry of the National Brain Center Hospital, Jakarta, from January 2019 to June 2022. Multivariate logistic regression was used to determine the odds ratio for risk-adjusted prolonged LOS. LOS predictors were obtained based on the regression coefficients and converted into a point score model.ResultsOf the 209 aSAH patients observed, 117 patients had prolonged LOS (> 14 days of hospital stay). A clinical score was developed with a range of 0–7 points. Four variables were chosen as predictors of prolonged LOS: the presence of high-grade aSAH (1 point), aneurysm treatment (endovascular coiling: 1 point; surgical clipping: 2 points), cardiovascular comorbidities (1 point), and hospital-acquired pneumonia (3 points). The score showed good discrimination with an area under the receiving operating characteristics curve (AUC) of 0.8183 (SE 0.0278) and ap-value for the Hosmer–Lemeshow (HL) goodness-of-fit of 0.9322.ConclusionThis simple clinical score reliably predicted prolonged LOS in aneurysmal subarachnoid hemorrhage cases and may aid clinicians in improving patient outcomes and decreasing healthcare costs.