bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overdose and off-label psychotropic prescribing in patients with borderline personality disorder: A retrospective series
Authors: Ning Anna Y , Theodoros Theo , Harris Keith , Isoardi Katherine Z 
Published: February 2023

Objective Borderline personality disorder (BPD) is common and poses many clinical challenges. Despite limited evidence of effectiveness, psychotropic medications are often prescribed. We aimed to characterise overdose presentations in patients with BPD. Method This is a retrospective observational series of patients with BPD presenting to a tertiary hospital following an overdose from January 2019 to December 2020. Medical records were reviewed to determine baseline characteristics, overdose details, clinical features, treatment, and disposition. Results There were 608 presentations in 370 people (76% female), median age 28 years (range 16–75 years). The majority (331[89%]) of patients were prescribed at least one psychotropic medication, with 129 (35%) being prescribed three or more different psychotropic agents. Of the total prescribed psychotropics, 520/1459 (36%) were for off-label indications. The majority of agents (860/1487[58%]) taken in overdose were prescribed. The commonest drug classes taken in overdose were benzodiazepines (241[16%]) and antipsychotics (229[15%]). Severe toxicity occurred in 99 (16%) cases with either coma (GCS<9) or hypotension (systolic BP <90 mmHg). The commonest agent associated with severe toxicity was quetiapine 39/99 (39%). Conclusions Psychotropic polypharmacy is common in BPD, often with off-label indications. Prescribed medications are commonly taken in overdose. Quetiapine is over-represented both in off-label prescribing and associated harm.
Atypical Fibroxanthoma: Outcomes from a Large Single Institution Series
Authors: McClure Erin , Carr Michael J , Patel Ayushi , Hussnain Naqvi Syed Mahrukh , Kim Youngchul , Harrington Michael , Cruse Wayne , Gonzalez Ricardo J , Sondak Vernon K , Sarnaik Amod A , Messina Jane L , Zager Jonathan S 
Published: February 2023

Background Atypical fibroxanthomas (AFX) are rare malignant cutaneous neoplasms. Unfortunately, limited clinicopathologic and outcomes data on this cancer exists. Objective We report the clinical, pathologic, and treatment characteristics, as well as oncologic outcomes in this single-institution retrospective analysis. Methods This retrospective cohort study compiled clinical, pathologic, treatment, and outcome data for all patients with AFX on definitive excision diagnosed, evaluated, and treated primarily by surgical resection at a single institution between 2000-2020. Descriptive statistics evaluated clinical and pathologic characteristics. Kaplan-Meier method and Cox proportional-hazards models were used to evaluate overall survival and recurrence-free survival. Results 78 patients with AFX were identified. The majority were elderly, immunocompetent, Caucasian men. 85% of tumors were located on the head and neck. 63% of patients were correctly diagnosed only after complete resection of the index lesion. The median surgical margin was 1.0 cm. Overall, only 1.3% (1/78) of patients developed a local recurrence (RFS). No patients died of disease. Conclusion This study suggests that resection margins of 1 cm achieve excellent local control with close to 99% RFS and 100% disease-specific survival.
Impact of distance of the catheter tip from cavo-atrial junction on bubble test (delay) time: A prospective study
Authors: Stefano Elli , Dario D’amata , Silvia Cavalli , Gloria Cambiaghi , Mariavittoria Giorgianni , Francesco Marino , Jessica Pozzoli , Mario Russo , Alberto Lucchini , Giuseppe Foti , Matteo Pozzi , Marco Giani 
Published: February 2023

Introduction: Correct tip positioning is a critical aspect in central vascular access devices insertion. The verification of positioning at the cavo-atrial junction is usually performed by intracavitary electrocardiography. Recently, echocardiographic techniques were proposed, including the direct visualization of the catheter or the visualization of a saline/air bolus (i.e. “bubble test”). As for the latter, a push-to-bubbles delay time below 2 s was proposed to indicate a correct positioning of the catheter tip. The aim of this study was to measure the variations of the push-to-bubbles time at increasing distance from the cavo-atrial junction, to verify if a cut-off of 1–2 s correspond to a well-positioned catheter. Methods: We performed a prospective study including patients with clinical indication of positioning a peripherally inserted central catheter. The catheter tip was positioned at the cavo-atrial junction (P0) via intracavitary electrocardiography, and the push-to-bubbles delay time was measured. The catheter was then retracted 5 cm (P1) and 10 cm (P2), and the test was repeated at this positioning. Push-to-bubbles time measurements were performed off-line by analyzing an audio/video recording which included the echography screen and the voice signal of the operator. Results: Forty-nine patients were included. The average push-to-bubble time when the catheter tip was in the reference position was 0.41 ± 0.21 s. Retraction of the PICC catheter of 5 and 10 cm determined a significant increase of the push-to-bubbles time: mean time difference was +0.34 (95% IC 0.25–0.43, p < 0.001) s between P0 and P1 (5 cm distance), and +0.77 (95% IC 0.62–0.92, p < 0.001) s between P0 and P2 (10 cm distance). When the catheter was at the reference position (i.e. cavo-atrial junction) only 2.1% of bubbles delay times were above 1 s. Conclusion: The push-to-bubbles time is very low when the catheter tip is at the cavo-atrial junction. This delay increases progressively with increasing distance from the target. Push-to-bubbles delay time above 1 s might indicate a catheter not close to the cavo-atrial junction.
A systematic review of proficiency assessment methods in bilingualism research
Authors: Olson Daniel J. 
Published: February 2023

Aims and objectives: Proficiency assessment is a key methodological consideration in the field of bilingualism, and previous reviews have highlighted significant variability in both the use and type of assessment methods. Yet, previous reviews of proficiency assessment methods in bilingualism have failed to consider key study characteristics (e.g., methodology and subfield) that may impact the choice of proficiency assessment method. This paper provides an updated systematic review of proficiency assessment methods in the field of bilingualism, analyzing trends within different methodological approaches and linguistic subfields. Design/methodology/approach: A systematic review was conducted, examining recent research articles in the field of bilingualism, broadly defined. A total of 17 journals (of 100) and 140 empirical research articles (of 478) with bilingual participants fit the relevant inclusionary criteria. Data and analysis: Studies were coded for several characteristics, including methodology (e.g., quantitative vs qualitative), linguistic subfield (e.g., psycholinguistics), and the method of proficiency assessment (e.g., standardized testing, self-reporting). Findings/conclusions: Analyses revealed a number of different methods of proficiency assessment currently used in bilingualism research. However, different trends were found by methodology type and linguistic subfield. Broadly, the results revealed greater use of proficiency assessments in quantitative research than qualitative research. Moreover, while there was significant variability in all of the subfields examined, several within-subfield trends were identified. Originality: This study provides an update to previous findings, establishing current proficiency assessment practices in bilingualism research. In addition, acknowledging the unique needs of different types of research, this study is the first to examine trends within different methodological approaches (i.e., quantitative vs qualitative) and subfields of bilingualism (e.g., psycholinguistics, sociolinguistics). Significance/implications: The notable variability in proficiency assessment methods within different subfields suggests a greater need for subfield-specific norms to facilitate comparative analysis. Several key considerations are given for the selection of proficiency assessment methods in bilingualism research.
‘Everything turned upside down’: A thematic analysis of adolescents’ experiences of everyday life during COVID-19 restrictions
Authors: Stänicke Line Indrevoll , Kurseth Pauline Olin , Bekkhus Mona 
Published: February 2023

Background: At the beginning of the COVID-19 pandemic, people were encouraged to practice social distancing, and schools and leisure venues closed. Aims: We aimed to explore the everyday experiences of Norwegian adolescents during COVID-19 restrictions, when in-person contact with peers was severely limited. Methods: A total of 622 high-school students (16–18 years of age) replied to an online survey containing open-ended questions about the changes they experienced in everyday life during the first three months of the pandemic. Results: Reflexive thematic analysis resulted in four themes: (a) ‘Everyday life turned upside down – everything is on hold’; (b) ‘Alone with my thoughts – new concerns’; (c) ‘A loss of social life – a fear of wasting important time’; and (d) ‘Gratitude – new perspectives in life’. The results are discussed according to mental-health concerns and psychological developmental challenges during adolescence, such as social exploration of roles with peers, autonomy and identity formation during a crisis. Conclusions: The results underline individual variations and positive experiences among adolescents during the COVID-19 pandemic, despite social restrictions. Still, the lack of in-person contact with friends is related to an increased experience of loneliness and mental-health concerns for many adolescents.
Advocating for a dementia-inclusive visual communication
Authors: Ang Pei Soo , Yeo Siang Lee , Koran Leela 
Published: February 2023

Introduction This study examines the underlying visual communication strategies found in existing images of dementia in the public domain. By delineating how experiences of dementia are visualized and their consequent social interpretations, we aim to inform and advocate for a dementia-inclusive visual communication, that is, visual depictions that cultivate and represent a dementia-inclusive society. Methods The visuals were analyzed by employing the Visual Discourses of Disability (ViDD) framework that juxtaposes the “ perspectivizing-personizing” cline with the “ enabling-disabling” continuum . The data studied comprise a total of 432 images sourced from three domains, namely (1) The Star, a Malaysian mainstream English newspaper (2012–2021); (2) Alzheimer’s Disease Foundation Malaysia (ADFM) website (2019–2021); and (3) the Ministry of Health Malaysia (2019–2021) website. Findings from the visual analyses were corroborated by four representatives of ADFM in a group interview. Results There is a predominance of stigmatized images, constructing dementia as a loss and deficit, thus depicting individuals in distanced suffering. Generic representations of people through stock images, a unique focus on the hands, representations of brain degeneration through abstractions and missing puzzle pieces are also prevalent. Despite these, the interview data confirmed that the perspectivizing aspect may be necessary to educate the public on what dementia entails. While personizing images that depict personhood and actual persons living with dementia are ideal, the use of stock images may be necessary if there is a need to maintain confidentiality and observe sensitivities. Similarly, images with positive emotions are encouraged but disabling ones are equally important to reflect reality and inculcate empathy. Conclusion When capturing, selecting and publishing images of dementia, organizations should deliberate on different visual elements which evoke empowerment, advocacy, handicapping and othering implications as outlined in the ViDD framework. Any decision should only be made after considering the purposes of publications and implications such images have on the intended audiences.
Diversity Officer Development Programs: A New Approach to Cultivating High Performing Chief Diversity Officers
Authors: Bohonos Jeremy W. 
Published: February 2023

Problem Increasing numbers of organizations are creating new Chief Diversity Officer positions, and because these roles are relatively new to the corporate landscape, industry lacks established methods for developing employees to excel in these roles. Solution Diversity Officer Development Programs (DODPs) are proposed as a method for organizations to ensure they are developing a robust pipeline of diversity specialists who can move into CDO roles as well as other top leadership positions. Stakeholders Organizations and HRD scholars who are committed to advancing diversity, equity, inclusion, and social justice in the workplace.
Low-Dose Radiation Reduces Doxorubicin-Induced Myocardial Injury Through Mitochondrial Pathways
Authors: Zhao Di , Jiang Xin , Meng Xinxin , Liu Dandan , Du Yanwei , Zhao Lijing , Jiang Hongyu 
Published: February 2023

The use of doxorubicin (DOX) as an anthraquinone antineoplastic agent is limited due to its cardiotoxicity. Our previous study suggested that low-dose radiation (LDR) could mitigate the cardiotoxicity induced by DOX via suppressing oxidative stress and cell apoptosis. However, the molecular targets and protective mechanism of LDR are not understood. In the present study, we sought to investigate the mechanisms underlying LDR’s cardioprotection. Balb/c mice were randomly divided into four groups: Control group (no treatment), DOX group, LDR group (75 mGy), and LDR-72 h-DOX group (LDR pretreatment followed by intraperitoneal injection of DOX). Electron microscopy, PCR, and Western blot analyses indicated that LDR pretreatment mitigated changes in mitochondrial morphology caused by DOX, upregulated activity of mitochondrial complexes, and restored ATP levels in cardiomyocytes that were decreased by DOX. Whole genome microarray and PCR analyses showed that mitochondrial-related genes were altered by LDR pretreatment. Thus, our study showed that LDR can protect cardiomyocytes against DOX through improving mitochondrial function and increasing ATP production. This research could inform DOX chemotherapy strategies and provide new insight into the molecule mechanisms underlying the cardioprotective effects of LDR.
Wireless sensor network security: A recent review based on state-of-the-art works
Authors: Faris Mohammed , Mahmud Mohd Nazri , Salleh Mohd Fadzli Mohd , Alnoor Alhamzah 
Published: February 2023

Wireless sensor networks (WSNs) are a major part of the telecommunications sector. WSN is applied in many aspects, including surveillance battlefields, patient medical monitoring, building automation, traffic control, environmental monitoring, and building intrusion monitoring. The WSN is made up of a vast number of sensor nodes, which are interconnected through a network. However, despite the growing usage of applications that rely on WSNs, they continue to suffer from restrictions, such as security issues and limited characteristics due to low memory and calculation power. Security issues lead to a lack of communication between sensors, wasting more energy. The need for efficient solutions has increased, especially with the rise of the Internet of Things, which relies on the effectiveness of WSNs. This review focuses on security issues by reviewing and addressing diverse types of WSN assaults that happened on each layer of the WSN that were published in security issues in the previous 3 years. As a consequence, this paper gives a taxonomy of security threats for each layer and different algorithmic solutions that numerous researchers who seek to counter this attack have explored. This study also presents a framework for constructing an intrusion detection system in the WSN by emphasising the drawbacks of each approach suggested by researchers to defend against specific forms of assault. In order to diminish the impact of this attack, this summary shows which attacks the majority of researchers have dealt with as well as which ones they have not yet addressed in their academic work.
The definition of a community paramedic: An international consensus
Authors: Shannon Brendan , Baldry Sascha , O’Meara Peter , Foster Nicole , Martin Angela , Cook Matthew , Stewart Karen , Miles Alecka 
Published: February 2023

Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest and adaptation of the community paramedicine model, there is a lack of a clear definition of the role of a community paramedic. This study sought to come to an international consensus on the definition of a community paramedic. A four-phase Delphi methodology was utilised to achieve a global consensus on the definition of a community paramedic. A systematic approach to expert identification was performed and reported in line with the Conducting and REporting of DElphi Studies standard. A total of 94 community paramedicine experts were identified and 76 experts consented to involvement in this Delphi. Response rate ranged from 81.6% (Phase 1) to 63.1% (Phase 2). Participants expressed the importance of community paramedic definition having components attributed to primary health care, health promotion, chronic disease management and advanced clinical assessment. Participants expressed that these are essential components of the community paramedic skill set, which distinguishes the role from other frontline paramedics. A final consensus with 91% agreement on the definition of a community paramedic was achieved. The four-phase Delphi achieved consensus on the definition of a community paramedic as follows: A community paramedic provides person-centred care in a diverse range of settings that address the needs of the community. Their practice may include the provision of primary health care, health promotion, disease management, clinical assessment and needs-based interventions. They should be integrated with interdisciplinary healthcare teams which aim to improve patient outcomes through education, advocacy and health system navigation. The adoption of the global consensus on the definition of a community paramedic will enhance efforts to promote the value of this specialist role, enabling a better understanding of how a community paramedic contributes to the wider healthcare system. [Media: see text]
The Effectiveness of a Patient’s Bedside Ultrasonography in Diagnosing a Pulmonary Embolism, in the Emergency Department
Authors: Taşkın Ömer , Kekeç Zeynep , Belli Fuat , Tuğcan Mustafa Oğuz 
Published: February 2023

Objective: The research aim was to analyze the function of focused cardiac ultrasonography (FoCUS) in diagnosing a pulmonary embolism (PE) and contributing to the practice of emergency medicine and expediting the treatment of PE. Materials and Methods: In this prospective and observational study, Wells scores were calculated on those patients who presented to the emergency department over the last 2 years and were evaluated with a preliminary diagnosis of PE, as well as the biochemical values and imaging techniques. In all cases, FoCUS was used as the diagnostic tool. Results: A PE was detected in 38 (63.3%) of 60 patients. According to Wells score, it was determined that 5 (8.3%) patients had low-risk, 41 (68.3%) had medium-risk, and 14 (23.3%) had high-risk Wells score. There was a statistically significant correlation between the existence of PE and the findings of FoCUS in patients with right ventricular dilatation ( P < .001). According to Wells score, moderate-risk individuals with PE were more likely to exhibit right ventricular dilatation ( P = .003). Conclusion: The FoCUS results either alone or in conjunction with the Wells score, reviewed in the diagnosis of PE, effectively indicated and directed the diagnosis and treatment of patients admitted to this particular emergency department.
Lacticaseibacillus casei T1 attenuates Helicobacter pylori-induced inflammation and gut microbiota disorders in mice
Authors: Yu Zhihao , Cao Mei , Peng Jingshan , Wu Daoyan , Li Shu , Wu Chengmeng , Qing Liting , Zhang Andong , Wang Wenjie , Huang Min , Zhao Jian 
Published: February 2023

AbstractProbiotics are defined as live microbial food elements that are beneficial to human health. Lacticaseibacillus casei T1 was considered to have potential as a bioactive ingredient in functional foods, which was isolated from kurut. Previous research by our group proved that L. casei T1 could prevent inflammatory responses caused by Helicobacter pylori. This study aimed to investigate whether treatment with L. casei T1 resulted in a suppressive effect on H. pylori-induced oxidative stress and inflammatory responses. The results showed that treatment with L. casei T1 could relieve H. pylori-induced overexpression of inflammatory cytokines in GES-1 cells. Experiments in animals suggested that taking long-term L. casei T1 could reduce oxidative stress and inflammatory cytokines and improve H. pylori-induced gastric mucosal damage. Furthermore, taking L. casei T1 could increase the relative abundance of beneficial intestinal bacterium (Lachnospiraceae and Odoribacter) of H. pylori-infected mice and help in maintaining the balance of intestinal microflora.Collectively, L. casei T1 had certain degrees of therapeutic effect against H. pylori. In the future, it combined with antibiotics for H. pylori eradication deserves further study.
Trans-Zeatin induce regulation the biosynthesis of 2-acetyl-1-pyrroline in fragrant rice (Oryza sativa L.) seedlings
Authors: Xing Pipeng , Luo Haowen , He Zhenzhen , He Longxin , Zhao Hua , Tang Xiangru , Duan Meiyang 
Published: February 2023

Abstract
Background
In plants, cytokinin is activated into trans-zeatin to fight abiotic stresses. However, the mechanism of the effect of trans-zeatin on 2-acetyl-1-pyrroline (2-AP) biosynthesis in fragrant rice has yet to be studied. The present study was conducted to explore the effects of exogenous trans-zeatin on enzymes activities, genes expression, and precursors involved in 2-AP biosynthesis and 2-AP contents as well as the seedling quality of a fragrant rice cultivar viz., Meixiangzhan2. Four concentrations of trans-zeatin solutions at 20, 40, and 80 μmol L− 1 (ZT1, ZT2, and ZT3) were sprayed onto rice seedlings.

Results
Compared to the control, trans-zeatin treatments showed significantly higher 2-AP contents of fragrant rice seedlings. Increased plant height and stem width were observed due to trans-zeatin treatments. The trans-zeatin application increased 1-pyrroline, methylglyoxal, proline, and P5C contents, enhanced P5CS and OAT activities, and reduced glutamic acid contents. In addition, expressions of ProDH, P5CS2, and DAO4 were comparatively higher under trans-zeatin treatments than CK in fragrant rice seedlings.

Conclusions
Overall, up-regulation of P5C, 1-pyrroline, and proline and down-regulation of glutamic acid under appropriate trans-zeatin concentrations (20 and 40 μmol L− 1) resulted in enhanced 2-AP biosynthesis in fragrant rice seedlings and 20–40 μmol L− 1 was considered as the suggested concentrations of trans-zeatin application in fragrant rice seedling.